Most effective monotherapy for androgenetic alopecia
According to a study published in the Journal of Cosmetic Dermatology, oral dutasteride 0.5 mg outperformed other monotherapy options for treating androgenetic alopecia (AGA) in men, delivering superior improvements in hair density than both minoxidil and finasteride. The analysis evaluated monotherapy with minoxidil, finasteride, or dutasteride at 24 and 48 weeks for both total and terminal hair density.
The researchers found that oral dutasteride 0.5 mg/day was significantly more effective than oral finasteride 1 mg/day and oral minoxidil 5 mg/day. Oral dutasteride 0.5 mg per day ranked highest for improving total hair density at 24 weeks and was significantly more effective than dutasteride administered via mesotherapy. For an FDA-approved option, oral finasteride 1 mg/day remains the most effective monotherapy for AGA.
Finasteride: Risk of depression and suicide? Read more.
DermWorld Insights and Inquiries: Twenty-first century pellagra
With obesity (defined as a body mass index > 30) affecting more than 40% of the adult population of the United States, it is difficult to fathom that nutritional deficiencies still exist. The cutaneous manifestations of nutritional deficiency often enter our differential diagnosis, especially in hospitalized patients. Dermatologists know that the presentation is usually due to multiple nutritional deficiencies. This commentary will focus exclusively on pellagra due to niacin (vitamin B3) deficiency. Pellagra is characterized by the “three D’s” — dermatitis, diarrhea, and dementia, which may culminate in the fourth “D” — death due to inadequate energy to support critical functions. Keep reading!
Is there an association between JAKis and malignancy risk in alopecia areata?
A study published in the Archives of Dermatological Research evaluated the association between JAK inhibitors (JAKis) and malignancy risk in alopecia areata (AA). Patients with severe AA were categorized by treatment history, including JAKis, traditional immunosuppressants, and no systemic treatment.
[Dermatologists discuss the influx of new JAK inhibitors in dermatology. Read more.]
Among 920 patients treated with traditional immunosuppressants and 920 treated with JAKis, SCC and BCC risk was not significantly different. However, internal and hematologic malignancy risks were significantly higher with traditional immunosuppressants. No significant difference in malignancy risk was observed between JAKi-treated and untreated patients. According to the authors, their findings align with previous research in autoimmune diseases, which have not linked JAKis to increased malignancy risk.
A meta-analysis published in the Journal of Cosmetic Dermatology assessed the efficacy and safety of a combination of platelet-rich plasma (PRP) and fractional laser for patients with vitiligo. Seven studies involving 366 patients were reviewed. The combination of PRP and fractional laser therapy significantly improved the mean grade of repigmentation and patients’ satisfaction score. The treatment also reduced the no response rate, compared with control groups, including monotherapy, topical drug or sun exposure only, and fractional lasers plus narrowband ultraviolet B. The incidence of adverse events for combination therapy was comparable to that of the control groups.
A study published in the Journal of Cosmetic Dermatology examined the practice patterns of fellowship-trained laser dermatologists and compared them to medical spas and plastic surgeons offering laser services. Physician involvement in laser procedures was significantly higher among dermatologists (60%) compared to plastic surgeons (33%) and medical spas (9%).
[Get insights from dermatologists on dealing with complications from cosmetic procedures. Read more.]
Only 41% of medical spas provided direct on-site physician supervision. Most dermatologists and plastic surgeons customized laser treatments, compared to 63% of medical spas. Dermatologists dedicated more clinical time to laser procedures, with 19% spending over 50% of their practice on lasers. According to the authors, while medical spas offer lower costs and shorter wait times, the lack of physician oversight and limited training among non-physician providers may represent substandard care.
2024 MIPS performance feedback, final scores, and targeted review now available
CMS has released 2024 MIPS performance feedback and final scores. Your 2024 final score will determine your 2026 MIPS payment adjustment, which CMS expects to release in about one month.
You can also request a targeted review if you believe there is an error in your final score. The review period is open now and will remain open for approximately 60 days (closes 30 days after MIPS payment adjustments are released).
For more information please use the guidance below.
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