Dermatology Medicine Research Articles

Perspectives of Regenerative Medicine in Dermatology and Cosmetology

Regenerative medicine has revolutionized the field of biological sciences, pharmacology and healthcare, bringing a new approach to treatments of various health conditions. Dermatology and aesthetic medicine are interested in these new scientific approaches as well. From this point of view, many areas of skin health and cosmetology may be involved, but several questions should be answered before these procedures become routine in offices and hospitals. Indeed scientific, ethical, and financial issues still have to be addressed in detail. Nevertheless, ongoing research and technological advancements are expected to further improve therapies. The integration of artificial intelligence and machine learning could enhance the precision of regenerative treatments, making them more effective and accessible in forthcoming years.

REVIEW OF NANOEMULGEL FOR TREATMENT OF FUNGAL INFECTIONS

The skin is the largest of the body’s organs and it has a big role to play in maintaining homeostasis and defending against microbial invaders. Fungal infections are responsible for a large proportion of the global burden of skin diseases; affecting millions, especially in developing countries. The application of antifungal drugs as topical agents is one of the best techniques to treat major fungal infections that affect the skin, which involves several advantages such as localized delivery, and lower systemic toxicity among others. These findings also suggest that nano-emulgel could be used as an alternative system for delivering drugs through topical administration. However, issues such as the inability to load bulky drug molecules and safety concerns about surfactants and gelling agents limit their potential use as drug carriers by this pathway. It is necessary to carefully study these issues further so that we can exploit fully what this nano-emulgel may offer in terms of dermatological medications.

Chinese expert consensus on management of antifungal-resistant dermatophytoses (2024 edition).

Antifungal-resistant dermatophytes (ARD) infection is a hotspot issue in clinical microbiology and the dermatology field. Trichophyton indotineae as the dominant species of dermatophyte with terbinafine-resistance or multidrug resistance, is easy to be missed detection clinically, which brings severe challenges to diagnosis and treatment. ARD infection cases have emerged in China, and it predicts a risk of transmission among human. Based on the existing medical evidence and research data, the Mycology Group of Combination of Traditional and Western Medicine Dermatology and Chinese Antifungal⁃Resistant Dermatophytoses Expert Consensus Group organized experts to make consensus on the management of the infection. Here, the consensus formulated diagnosis and treatment recommendations, to raise attention to dermatophytes drug resistance problem, and expect to provide reference information for the clinical diagnosis, treatment, prevention and control.

Treating Chronic Pruritus: Are We at the Threshold of a Breakthrough?

Chronic pruritis, characterized by persistent itchiness lasting more than six weeks, affects up to 15% of the population, significantly impairing quality of life. Despite its prevalence and impact, there is an absence of FDA-approved medications specifically for the treatment of chronic pruritus, highlighting a significant unmet need in dermatology. Advancements in dermatologic medications, however, including the development of biologics and Janus kinase (JAK) inhibitors, signal potential breakthroughs in pruritus management through a radically different mechanism of action that focuses on their effect on the nervous system. Currently, the most commonly utilized treatments for pruritis are sedating antihistamines, which have been largely ineffective for non-histamine-induced itch, underscoring the necessity for novel approaches. This editorial reviews key studies and clinical trials with a particular focus on cases of prurigo nodularis, where itch serves as the primary pathology rather than just a symptom. The effectiveness of dupilumab in phase III trials for treating prurigo nodularis, independent of its effects on dermatitis or atopic background, alongside the success of JAK inhibitors in managing chronic idiopathic pruritus, indicates a shift towards therapies that directly and specifically target itch nerve pathways instead of indirectly via immune system modulation or sedation. These developments suggest that significant progress may be on the horizon for treating chronic itch, providing hope for those suffering from pruritis, the number one cause of misery in dermatology.

Efficacy of spironolactone in treating hidradenitis suppurativa in women of childbearing age: a single-center retrospective analysis.

Hidradenitis suppurativa (HS) is a chronic skin disease characterized by recurrent nodules that affect areas with a high density of apocrine sweat glands, such as the axillae and groin. Androgens are implicated in the pathophysiology of HS. Therefore, spironolactone, an antiandrogen therapy, is recommended. However, data on its use in women of childbearing age are limited, especially since its antiandrogenic effects may affect menstruation, fertility, and pubertal development. To evaluate the efficacy and safety of spironolactone in the treatment of hidradenitis suppurativa in women of childbearing age and to identify factors associated with treatment response. A retrospective analysis was conducted on female patients aged 12 to 50 with HS treated with spironolactone at Michigan Medicine dermatology clinics from 2000 to 2021. The patients' demographic data, HS characteristics, and spironolactone responses were examined. Statistical assessments were performed to determine the efficacy indicators. Of the 157 patients reviewed, 31 showed an improvement in treatment. Variables such as axillary involvement, previous treatment failures, and use of intralesional steroids were linked to a lack of improvement in spironolactone. Through adjusted multiple logistic regression analysis, a significant association was observed between improvement status and Hurley stage 3 (odds ratio = 0.15 [95% CI: 0.02-0.79], P = .036), suggesting that patients with Hurley stage 3 were 85% less likely to exhibit improvement in spironolactone therapy. The study's retrospective nature and reliance on single-center data can limit generalizability. The sample size is limited and therefore affects the study's statistical power. Thus, spironolactone may offer therapeutic benefits for HS in women of childbearing age. However, patients with severe disease (Hurley stage 3) had reduced response rates. Further prospective studies are recommended to validate these findings and determine the most suitable patient profile for spironolactone therapy for HS.

From skin checking to suturing: efficacy of a sequential dermatology simulation for medical students.

Clinical simulations have been shown to increase medical students’ understanding of and interest in dermatology. The New York University Grossman School of Medicine Dermatology Interest Group developed and evaluated a new simulation that more fully mimics the process of diagnosing pigmented lesions by emulating a dermatologist’s actual workflow. After participating in the simulation, students demonstrated increased knowledge in both short- and long-term assessments, and 96% felt that the simulation should be a mandatory part of their curriculum.

Precision Dermatology: A Review of Molecular Biomarkers and Personalized Therapies.

The evolution of personalized medicine in dermatology signifies a transformative shift towards individualized treatments, driven by the integration of biomarkers. These molecular indicators serve beyond diagnostics, offering insights into disease staging, prognosis, and therapeutic monitoring. Specific criteria guide biomarker selection, ensuring attributes like specificity, sensitivity, cost feasibility, stability, rapid detection, and reproducibility. This literature review, based on data from PubMed, SCOPUS, and Web of Science, explores biomarkers in Hidradenitis Suppurativa (HS), Psoriasis, Atopic Dermatitis (AD), Alopecia Areata (AA), Vitiligo, and Chronic Spontaneous Urticaria (CSU). In HS, TNF-α, IL-1β, and MMPs serve as biomarkers, influencing targeted therapies like adalimumab and anakinra. Psoriasis involves biomarkers such as TNF-α, IL-23, and HLA genes, shaping treatments like IL23 and IL17 inhibitors. AD biomarkers include ECP, IL-4, IL-13, guiding therapies like dupilumab and tralokinumab. For AA, lipocalin-2, cytokines, and genetic polymorphisms inform JAK inhibitors' use. Vitiligo biomarkers range from cytokines to genetic markers like TYR, TYRP1, guiding treatments like JAK inhibitors. CSU biomarkers encompass IgE, cytokines, and autologous serum tests, influencing therapies like omalizumab and cyclosporine. Comparing conditions, common proinflammatory markers reveal limited specificity. While some biomarkers aid diagnosis and standard treatments, others hold more scientific than clinical value. Precision medicine, driven by biomarkers, has shown success in skin malignancies. Future directions involve AI-powered algorithms, nanotechnology, and multi-omics integration for personalized dermatological care.

Advances in clinical application of H1 antihistamines in the treatment of skin diseases.

Histamine receptors are classified into 4 types: H1, H2, H3, and H4, each mediating distinct physiological effects and possessing its corresponding antagonistshat that can be used for the prevention and treatment of various diseases. Among them, H1 antihistamines are the fundamental medications in dermatology and are widely used in many diseases such as urticaria and atopic dermatitis. In recent years, with the emergence of novel antihistamines and the discovery of new potential indications for traditional H1 antihistamines, the clinical application of antihistamines is facing new challenges. Further investigation of the novel mechanism for H1 antihistamines, the use of multiple doses of common drugs and potential indications will furnish vital insights for practical clinical application.

Advancements in Dermatological Therapies

Dermatology has witnessed remarkable advancements in therapeutic approaches, revolutionizing the field and transforming the landscape of skin health. From innovative treatment modalities to novel drug discoveries, the realm of dermatological therapies has expanded exponentially, offering new hope and improved outcomes for patients. These advancements have not only revolutionized the way we address various skin conditions but have also opened doors to personalized and targeted treatments. Exploring and embracing these advancements is crucial for dermatologists to provide the highest level of care and enhance the quality of life for their patients. The advent of biologics and targeted therapies has been a game-changer in dermatology. Conditions such as psoriasis, atopic dermatitis, and various autoimmune disorders now have targeted treatment options that specifically address the underlying mechanisms of the disease. Biologics, including monoclonal antibodies and immune modulators, have shown exceptional efficacy in managing these conditions, providing long-lasting relief and reducing disease burden for patients. Additionally, advancements in molecular research and genetic profiling have paved the way for personalized medicine in dermatology, allowing for tailored treatment plans based on an individual's unique genetic makeup and characteristics.
 Furthermore, technological innovations have brought forth significant advancements in dermatological therapies. Laser and light-based treatments have revolutionized the management of various skin conditions, including acne scars, vascular lesions, and unwanted pigmentation. These non-invasive procedures offer precise targeting and minimal downtime, delivering remarkable results with reduced risks. Moreover, the integration of artificial intelligence and digital health technologies has enhanced diagnostic accuracy and improved treatment outcomes. From teledermatology to image analysis algorithms, these technologies streamline patient care, facilitate remote consultations, and enable efficient data-driven decision-making.
 Collaborative efforts between dermatologists and pharmaceutical companies have also led to the development of novel therapeutic agents. New drug discoveries, formulations, and delivery systems have expanded treatment options for conditions such as skin cancer, fungal infections, and chronic inflammatory disorders. Researchers continue to explore innovative pathways, including immunotherapies and microbiome-targeted therapies, opening doors to further advancements in the field. Advancements in dermatological therapies have ushered in a new era of precision and effectiveness in the management of various skin conditions. From targeted biologics to technological innovations, these breakthroughs have transformed the way dermatologists approach patient care. Embracing these advancements and staying abreast of the latest developments is essential for dermatologists to provide the best possible care and improve patient outcomes. As the field continues to evolve, ongoing research, collaboration, and technological integration will shape the future of dermatological therapies, empowering both clinicians and patients in their pursuit of optimal skin health

JAAD Game Changer: Sexual dysfunction in men taking systemic dermatologic medication: A systematic review

JAAD Game Changer: Sexual dysfunction in men taking systemic dermatologic medication: A systematic review

43316 Attitudes and Utilization of Complementary and Alternative Medicine in Dermatology: A Single Center Cross-Sectional Study

43316 Attitudes and Utilization of Complementary and Alternative Medicine in Dermatology: A Single Center Cross-Sectional Study

The Pharmacist's role in dermatology: Patient medication adherence.

Medication non-adherence is currently estimated to have caused at least 100 000 preventable deaths and over $100 billion in preventable medical costs. Adherence is particularly poor in dermatological conditions, with more than 50% of patients discontinuing topical treatments within the first year. Pharmacists are among the most accessible health-care professionals with the potential to greatly impact medication non-adherence through patient education, medication therapy management, and improved access to care. This review aimed to determine how pharmacists have improved medication adherence in dermatology and discuss strategies for further involvement. An extensive medical literature search using the PubMed database was conducted to evaluate clinical studies, published in the last 20 years, that have evaluated the pharmacist's role and impact on adherence of to dermatological products. PubMed search terms include: "pharmacists' role in dermatologic medication adherence", "pharmacist-led interventions in dermatology", "pharmacist medication adherence dermatology" and "pharmacist intervention dermatology". A total of 18 relevant studies were identified. Pharmacists improved dermatological medication adherence by increasing access to medications, providing medication counseling programs, and performing treatment monitoring services. However, corticophobia may contribute to pharmacists' hesitancy in making corticosteroid over-the-counter recommendations. Pharmacists are accessible health-care providers with the potential to improve dermatological medication adherence. Future advanced training in dermatology medications may refine pharmacists' knowledge of dermatological products.

H09 Is cannabis use in dermatology topical? Reviving the historical highs

Abstract Cannabis refers to product derived from a plant species known as Cannabis sativa. The plant contains cannabinoids, two of the most prominent being tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the primary psychoactive component in cannabis, while CBD, discovered by chemist Roger Adams in 1942, is nonpsychoactive. Cannabis with high THC levels is referred to as marijuana. With global policy changes and government approvals, CBD has recently garnered significant interest due to increased awareness of its therapeutic potential. This surge in demand has fuelled the multi-billion-dollar global CBD market with projections of sustained growth in the future. The use of cannabis for medicinal purposes has a rich history, dating back to ancient civilizations. From traditional Chinese medicine using cannabis preparations for rashes to ancient Egyptians using it for wounds to Arab traditional medicine using it to treat lichen planus, the therapeutic benefits of cannabis have been widely recognized throughout history. Sir William O’Shaughnessy, an Irish physician, discovered the therapeutic properties of cannabis in India in the 19th century and led to its widespread use in Europe and North America. However, in the early 20th century, cannabis was banned in many countries as part of a movement to control the use of addictive substances. The discovery of the endocannabinoid system in the late 20th century marked a turning point in the understanding of how cannabinoids interact with our bodies. This intricate network, made up of endocannabinoids, cannabinoid receptors and enzymes, regulates pain perception, metabolism, circadian rhythm, immune system, and more. Preclinical evidence supports the therapeutic potential of topical CBD for dermatological inflammatory diseases such as acne and eczema, as well as skin cancer (Lowe H, Toyang N, Steele B et al. The endocannabinoid system: a potential target for the treatment of various diseases. Int J Mol Sci 2021; 22:9472). The accumulation of evidence supporting its therapeutic potential has led to a change in societal and cultural perspectives toward cannabis, resulting in the UK government’s approval of limited medicinal use in 2018, as well as the opening of the nation’s first legal cannabis farm in 2021. In 2018, Epidyolex® (cannabidiol) became the first US Food and Drug Administration-approved medical-grade CBD for treating rare forms of epilepsy. Cannabis’ potential therapeutic properties offer a promising outlook for cannabis-based medicine in dermatology. While CBD’s lipophilic nature and its instability in solution pose challenges for its transdermal delivery, ongoing research and study may offer solutions. It is imperative that dermatologists stay informed about CBD advancements as its growing availability and potential indications are likely to drive its popularity.

Integrating Precision Medicine into Medical Dermatology Clinical Practice: An Expert Consensus Panel.

Precision medicine utilizes an individual’s genomics to improve diagnosis, prognosis, and therapy. The joint American Academy of Dermatology and National Psoriasis Foundation 2019 guidelines recognized the need to identify biomarkers that can predict the optimal biologic agent for an individual patient. This paper examines the current state of precision medicine in dermatology and how its use can improve outcomes in psoriasis. A search of PubMed/MEDLINE using the terms precision medicine, personalized medicine, biomarkers, genomics, and dermatology was performed to identify relevant publications. An expert consensus panel was then convened to assign levels of evidence to each article using strength of recommendation taxonomy and create consensus statements requiring a two-thirds supermajority for agreement utilizing a modified Delphi approach. Thirteen articles met inclusion and exclusion criteria and were assigned levels of evidence. The panel created 10 consensus statements on how precision medicine can improve patient outcomes, all of which received a unanimous (6/6) vote. Choosing a biologic medication for psoriasis often relies on patient preference, provider preference, and a trial-and-error approach. Utilizing precision medicine tests such as Mind.Px can help providers identify biomarkers unique to a patient’s pathophysiology and choose the optimal medication through a targeted and evidence-based approach. Zakria D, Brownstone N, Armstrong AW, et al. Integrating precision medicine into medical dermatology clinical practice: an expert consensus panel. J Drugs Dermatol. 2023;22(6):588-593. doi:10.36849/JDD.7432.

Patient-Centric Design of Topical Dermatological Medicines.

Topical treatments are essential approaches to skin diseases but are associated with poor adherence. Topical vehicles have the primary purpose of ensuring drug effectiveness (by modulating drug stability and delivery, as well as skin properties) but have a marked impact on treatment outcomes as they influence patient satisfaction and, consequently, adherence to topical treatments. There is also a wide variety of vehicles available for topical formulations, which can complicate the decisions of clinicians regarding the most appropriate treatments for specific skin disorders. One of the possible strategies to improve topical-treatment adherence is the implementation of patient-centric drug-product design. In this process, the patient's needs (e.g., those related to motor impairment), the needs associated with the disease (according to the skin lesions' characteristics), and the patient's preferences are taken into consideration and translated into a target product profile (TPP). Herein, an overview of topical vehicles and their properties is presented, along with a discussion of the patient-centric design of topical dermatological medicines and the proposal of TPPs for some of the most common skin diseases.

Association of Nonmelanoma Skin Cancers, Melanoma, and Merkel Cell Carcinoma with Dermatologic Medications: A Case-Control Pharmacovigilance Study of the FDA Adverse Events Reporting System

Background: Medications used in the treatment of dermatologic conditions have been associated with squamous cell carcinoma (SCC), basal cell carcinoma (BCC), melanoma, and Merkel cell carcinoma (MCC). Objective: The objective of the study was to examine the relationship between systemic dermatologic medications and skin cancer in the FDA Adverse Event Reporting System (FAERS). Methods: Case-control analyses were performed in FAERS from 1968 to 2021 to examine the reporting odds ratios (RORs) for SCC, BCC, melanoma, and MCC. Results: The oral immunosuppressants were all associated with increased ROR of SCC, BCC, melanoma, and MCC. Azathioprine had the highest ROR for SCC (34.13, 95% CI 29.07–40.08), BCC (21.15, 95% CI 20.63–25.98), and MCC (44.76, 95% CI 31.52–63.55), while quinacrine and guselkumab had the highest ROR for melanoma (13.14, 95% CI 1.84–93.89 vs. 12.73, 95% CI 10.60–15.30, respectively). The TNF-α inhibitors were associated with an increased ROR for all skin cancers investigated. Conclusions: The oral immunosuppressants and many biologic medications were associated with an increased ROR of skin cancers including TNF-α inhibitors (etanercept, adalimumab, infliximab), IL-23 or IL-12/23 inhibitors (ustekinumab, risankizumab), and the CD-20 inhibitor rituximab but not dupilumab or IL-17 inhibitors.

Perspectives of essential oils usage in dermatological medicines

Perspectives of essential oils usage in dermatological medicines

DERMOCOSMETICS

The objective of this research was to raise a discussion about Dermocosmetics and the technological trends applied in cosmetics and dermocosmetics, and which is the importance of the pharmaceutical professional in this health/beauty segment. Dermocosmetics are products that bring in their composition pharmacological active compounds with therapeutic activity, which are similar to dermatological medicines for topical use. That is, they are products that go beyond the epidermis, with actives that reach the deepest layers of the skin and that bring better results, acting from the inside out. While dermocosmetics general physiological changes, causing changes in the skin, traditional cosmetics work with instant action. They improve the momentary appearance, but do not act on the real causes of these problems. The methodology used in this research was the descriptive qualitative literature review, with bibliographic bases obtained through theses, monographs, scientific technical articles, books, periodicals and virtual library. The period of publications collected for the research was from 2010 to 2021, in Portuguese and English.

Drug interactions between common dermatological medications and the oral anti-COVID-19 agents nirmatrelvir-ritonavir and molnupiravir

The oral antiviral agents nirmatrelvir-ritonavir (NMV/r) and molnupiravir are used to treat mild-to-moderate COVID-19 infection in outpatients. However, the use of NMV/r is complicated by significant drug-drug interactions (DDIs) with frequently prescribed medications. Healthcare professionals should be aware of the possible risk of DDIs, given the emergence of COVID-19 variants and the widespread use of oral COVID-19 treatments. We reviewed available data on DDIs between NMV/r, molnupiravir and common dermatological medications; summarised the potential side effects; and suggest strategies for safe COVID-19 treatment. A systematic review using PubMed was conducted on data published from inception to 18 July 2022 to find clinical outcomes of DDIs between NMV/r, molnupiravir and dermatological medications. We also searched the Lexicomp, Micromedex, Liverpool COVID-19 Drug Interactions database and the National Institutes of Health COVID-19 Treatment Guidelines for interactions between NMV/r and molnupiravir, and commonly used dermatological medications. NMV/r containing the cytochrome P-450 (CYP) 3A4 inhibitor ritonavir has DDIs with other medications similarly dependent on CYP3A4 metabolism. Dermatological medications that have DDIs with NMV/r include rifampicin, clofazimine, clarithromycin, erythromycin, clindamycin, itraconazole, ketoconazole, fluconazole, bilastine, rupatadine, dutasteride, ciclosporin, cyclophosphamide, tofacitinib, upadacitinib, colchicine and systemic glucocorticoids. With no potential DDI identified yet in in vitro studies, molnupiravir may be an alternative COVID-19 therapy in patients taking medications that have complicated interactions with NMV/r, which cannot be stopped or dose adjusted. NMV/r has significant DDIs with many common dermatological medications, which may require temporary discontinuation, dosage adjustment or substitution with other anti-COVID-19 agents such as molnupiravir.

A Pragmatic Study on Nurse-Led Home Phototherapy

BACKGROUND Narrowband ultraviolet phototherapy is a safe and effective treatment option for chronic skin conditions. The requirements of clinic-based phototherapy can be burdensome, with home-based phototherapy as a reasonable alternative. OBJECTIVE This study aimed to analyze the effects of a nurse-led home phototherapy program and describe the clinical resources required. METHODS A pragmatic multicenter prospective observational cohort study was conducted from 2019 to 2021. Eighteen participants were enrolled in the program and followed for 9 months. Outcome measures included clearance rates, erythema incidence, Dermatology Life Quality Index, the burden of treatment scores, dermatologic medication usage, and clinic contacts. RESULTS Fourteen of the 18 patients (77.8%) reported high skin clearance. Mild erythema was common, moderate erythema was rare, and two episodes of severe erythema were recorded overall. Dermatology Life Quality Index and burden of treatment impact were minimal. Adjunct topical medications decreased by half. Nurses successfully reached participants up to the 3-month time point, with completed contacts decreasing over time. Unplanned contacts included phone calls and emails. CONCLUSION Dermatology nurses possess the skills needed to lead safe and effective home phototherapy programs. Although this pragmatic study was small, results are optimistic for the future of nurse-led home phototherapy.