Spironolactone for alopecia: Blood pressure changes
Authors of a research letter published in JAAD explored the influence of spironolactone on blood pressure (BP) when used for alopecia treatment. The average dose of spironolactone was 108.6 mg with an average duration from initial visit to first follow-up of 112.8 days, with the maximum BP effects commonly presenting around seven weeks after initiation. For systolic blood pressure, the mean BP prior to treatment was 118.2 mmHg and 117.1 mmHg when measured at first follow-up. For diastolic BP, pre-spironolactone mean was 78.8 mmHg and 75.8 mmHg post-spironolactone. No significant difference was noted in either systolic or diastolic BP before and after spironolactone at 50 mg, 100 mg, 150 mg, or 200 mg.
DermWorld Insights and Inquiries: The appropriate dermatologic response when considering the capillary malformation-arteriovenous malformation syndrome — Fast flow to referral
I have had the privilege of contributing to Dr. Ronni Wolf’s outstanding AAD symposium devoted to emergency dermatology by presenting the lecture, “Dermatological Urgent Care: When Banalities Surprise You,” discussing several cutaneous disorders that could easily be dismissed as “nothing to worry about” but should demand attention because of potential profound systemic complications. An excellent example of this concept is the Capillary Malformation-Arteriovenous Malformation (CM-AVM), which is the focus of this commentary. Keep reading!
FDA approves lebrikizumab for moderate-to-severe atopic dermatitis
The FDA has approved lebrikizumab-lbkz (EBGLYSS™), a targeted IL-13 inhibitor for the treatment of adults and children 12 years of age and older who weigh at least 88 pounds with moderate-to-severe atopic dermatitis that is not well controlled with topical prescription therapies. Lebrikizumab 250 mg/2 mL injection can be used with or without topical corticosteroids and is dosed as a single monthly maintenance injection following the initial phase of treatment.
[As biologic therapies expand indications to children and adolescents, what do dermatologists need to know about balancing the risks and benefits? Read more.]
In an average of two studies, 38% of people who took lebrikizumab achieved clear or almost-clear skin at 16 weeks (versus 12% with placebo) and 10% saw these results as early as four weeks. Of the people who experienced clear or almost-clear skin at week 16, 77% maintained those results at one year with once-monthly dosing, and 48% of responders who were switched from lebrikizumab to placebo at week 16 maintained these results at one year. Similarly, in both studies, many people experienced itch relief as well (43% of people felt itch relief at 16 weeks compared to 12% who took placebo).
Learn more about understanding and treating chronic itch inDermWorld.
Management of scabies in children weighing less than 15 kg, pregnant or breastfeeding women
An article published in the British Journal of Dermatology highlighted recommendations for treating scabies in children weighing less than 15 kg and pregnant or breastfeeding women. For better tolerance, permethrin is preferred for children younger than one year old or cases involving facial/damaged skin. Permethrin, benzyl benzoate, and ivermectin are recommended in the second and third trimesters of pregnancy, with ivermectin being recommended as a second-line treatment in the first trimester. For breastfeeding women, all three treatments are suggested as first-line options.
Experts discuss treatment options and tips for successfully diagnosing and treating lice and scabies. Read more.
Assessing supervision, complication-reporting in medical spas
Authors of a study published in Dermatologic Surgery aimed to determine who performs cosmetic procedures, provides medical supervision, and who is being informed of complications. Of 63 medical spas reviewed, most of the injectable treatments (73%) were performed by nonphysicians. An onsite physician who supervised or personally performed the cosmetic procedures was present in only 38.1% of the spas surveyed. Only 46% of surveyed medical spas notify a medical director/supervising physician in the event of a complication and only 39.7% of surveyed spas had a number to call after regular business hours.
Non-physician providers seek authority to perform cosmetic medical procedures, threatening patient safety and the value of specialty medical training. Read more.
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