Rethinking the Inflammatory Balance in Psoriasis and Atherosclerosis.

Guénin S, Kazemi A, Cline A, et al. Rethinking the inflammatory balance in psoriasis and atherosclerosis. J Drugs Dermatol. 2023;22(8):832-833. doi:10.36849/JDD.7082.

Hair-Loss Perceptions and Treatment Expectations in Young People of Color.

BACKGROUND: While much research has been dedicated to hair loss in older patients, little has addressed hair loss perception and treatment expectations among young people of color (POC). This study evaluates disease perceptions, willingness to utilize specific therapies, and treatment expectations in younger versus older POC with any form of hair loss. METHODS: An online survey was utilized to analyze 217 responses to 37 questions assessing perceptions of hair loss, hair care practices, and treatment expectations among others. These parameters were measured on a 1–5 Likert scale. Comparison between groups was be done using Chi-Square tests for proportions and Student t-tests. RESULTS: Included were 52 respondents between the ages of 18 and 29 (POC<30), and 36 respondents greater than 30 years of age (POC>30). The reported average hair loss in POC<30 was 67.0%, compared to POC>30 reporting 60.0% (P<0.05). Average embarrassment was 2.6 for POC<30 versus 3.4 for POC>30 (P<0.001). Average pain was 2.0 for POC<30 versus 1.8 for POC>30 (P<0.05). Average hair thinning was 3.0 for POC<30 versus 3.7 for POC>30 (P<0.001). Average willingness to use topical treatments including creams, solutions, ointments, and gels was 3.0 in POC<30 versus 3.8 in POC>30 (P<0.001). The average perceived effectiveness of topical treatments was 2.9 in POC<30 versus 3.6 in POC>30 (P<0.01). CONCLUSION: Early identification and appropriate management of young POC with hair loss may facilitate follicular rescue. This, in turn, may help reduce the negative consequences of advanced hair loss, such as embarrassment, as seen in older POC. J Drugs Dermatol. 2021;20(7):746-750. doi:10.36849/JDD.5960.

Safety and Efficacy of Clobetasol Propionate 0.05% Emollient Foam for the Treatment of Central Centrifugal Cicatricial Alopecia.

Background: There is currently an unmet need for the treatment of women with central centrifugal cicatricial alopecia (CCCA). Objective: To evaluate the safety and efficacy of Clobetasol propionate 0.05% emollient foam for the treatment of women with CCCA. Methods: Adult women of African descent that presented with clinical evidence of early CCCA were enrolled (N=30). Clobetasol propionate 0.05% emollient foam was applied daily in an open-label fashion. Safety and efficacy assessments were performed at weeks 2, 6, 12, and 14. Results: Subjects achieved substantial improvements in pruritus, pain, tenderness, erythema and scaling. Scalp biopsies revealed considerable improvements in severe inflammation and perifollicular edema. Overall, clobetasol propionate 0.05% emollient foam was well-tolerated. Limitations: This was a nonrandomized, open-label study. Enrollment was limited to subjects with clinically mild CCCA. Conclusion: Subjects with CCCA that applied topical clobetasol propionate 0.05% emollient foam to their scalp daily demonstrated continuous clinical improvement throughout the 14-week study. ClinicalTrials.gov Identifier: NCT01111981 J Drugs Dermatol. 2020;19(7): doi:10.36849/JDD.2020.5201.

Optimal wound care management in hidradenitis suppurativa.

INTRODUCTION: Hidradenitis suppurativa (HS) presents the problem of a chronic, relapsing, painful, draining wound. There is a myriad of HS wound care management strategies implemented by clinicians and patients centered around which dressings to use. Many factors affect which HS wound care dressing is the most appropriate to use such as the type of HS wound, cost, ease of application, patient comfort, absorbency and odor management among many others. AIM: In this work, the authors aim to prepare a set of guidelines for optimal HS wound care dressing use based on a tier system, ideal characteristics of HS dressings and the type of HS lesion. The dressing recommendations focus on cost-effectiveness for patients, ease of accessibility and ultimately, improvement in the quality of life of patients suffering from HS. METHODS: PubMed was utilized to search the terms 'wound care + HS'; 'non-surgical wound care + HS'; 'optimal wound care + HS'; 'HS wounds'; and 'optimal wound dressings'. RESULTS: Silver-impregnated foam is considered the most optimal HS wound care dressing because it contains nearly all characteristics of an ideal wound care dressing. CONCLUSION: However, silver-impreganted foam is expensive and difficult to access for patients, so lower-tier HS wound care dressings must be considered prior to utilizing this tier 4 dressing.

Subcutaneous Sparganosis of the Breast.

A 77-year-old African American woman presented to the dermatologist with two pruritic lumps in her right breast. She reported traveling to Mexico on a cruise ship two years prior to the onset of her lesions, but denied a history of previous breast masses or malignancy. Despite former radiographic evaluation by her internist revealing benign growths, and despite dermatologic treatment with intralesional steroid injections, a third new, firm nodule developed in her right breast. One such nodule eventually formed into an ulcer, and a punch biopsy revealed thin-walled vascular channels in loose inflamed stroma, coarse fibrosis, calcareous corpuscles, and an elongated parasite. Further review confirmed the parasite to be Sparganum, which is the larval stage of cestodes in the genus Spirometra. Sparganosis is a rare parasitic infection caused by the plerocercoid larva of the diphyllobothroid tapeworm. Though subcutaneous sparganosis of the breast is exceedingly rare, clinicians should consider this infection in their differential of nodular breast masses.

Psoriasis therapy and aortic inflammation - translating statistical to clinical significance.

Psoriasis patients are known to have comorbid aortic vascular inflammation, which is one of the leading causes of cardiovascular morbidity and mortality in this population. Many studies report statistically significant improvements in aortic vascular inflammation after use of tumor necrosis factor inhibitors or interleukin-12/23 antagonists. However, the clinical significance in reduction of adverse cardiovascular events in psoriatic patients owing to biologic therapy has not been examined. Regardless of clinically significant cardiovascular benefits, dermatologists should continue to treat psoriasis patients optimally to mitigate the unfavorable effect this disease has on quality of life.