Dermatology

Summary: The SAFA (Spironolactone for Adult Female Acne) trial was a multicenter, phase 3, double-blind, randomized controlled trial in England and Wales and evaluated the efficacy of spironolactone for treating adult women with acne vulgaris. A total of 410 women, aged ≥18 years and suffering from facial acne for a minimum of six months, were randomly assigned to receive either 50 mg/day of spironolactone or a placebo, increasing to 100 mg/day until week 24.

The primary outcome was measured by the Acne-Specific Quality of Life (Acne-QoL) symptom subscale score at week 12 and 24. The trial demonstrated that spironolactone improved Acne-QoL scores more effectively than the placebo, particularly at week 24. Additionally, more participants in the spironolactone group reported acne improvement, and treatment success was significantly higher in this group at week 12. Mild side effects, notably headaches, were more common in the spironolactone group.

The findings from the SAFA trial highlight spironolactone’s effectiveness, safety, and tolerability in treating adult women with acne vulgaris, suggesting it is a viable alternative to long-term antibiotic treatments. Future research is proposed on higher initial dosages of spironolactone, and its effects on different subgroups like patients with different ages, body mass index, and ethnicity.

Article: Effectiveness of spironolactone for women with acne vulgaris (SAFA) in England and Wales: pragmatic, multicentre, phase 3, double blind, randomised controlled trial – The BMJ

Editorial: What do we know about prescribing spironolactone for acne? – The BMJ

News Release: Non-antibiotic treatment for women with persistent acne shown to be effective – University of Southhampton

Cohort Study | 5-mm margins may be adequate for T1a melanoma excision near critical structures

16 May, 2023 | 14:40h | UTC

Association of Excision Margin Size With Local Recurrence and Survival in Patients With T1a Melanoma at Critical Structures – JAMA Dermatology (link to abstract – $ for full-text)

Commentary: Melanoma Excisions with 5 Millimeter Margins Linked to Less Risk of Local Recurrence – HCP Live

Commentary on Twitter

Study on thin melanomas (T1a) near critical anatomic sites such as the head and face showed that 5-mm surgical margins may be safe for patients and decrease reconstructive surgery and potential adverse, including scarring and mental issues. https://t.co/Mw7Ub4xMVX

— JAMA Dermatology (@JAMADerm) April 12, 2023

News Release: A Simple Antibacterial Treatment Solves a Severe Skin Problem Caused by Radiation Therapy – Montefiore Einstein Cancer Center

Commentary on Twitter

Rand trial of 75 pts w/breast cancer + 2 with head/neck cancer showed no pts treated w/bacterial decolonization (BD) developed >gr 1 acute rad'n dermatitis (ARD), vs 24% of pts treated with standard of care, suggesting BD may be preventive vs ARD. https://t.co/6FAFH9kMt1 #RadOnc

— JAMA Oncology (@JAMAOnc) May 4, 2023

Supportive care management recommendations for mucocutaneous manifestations of monkeypox infection

3 May, 2023 | 15:26h | UTC

Supportive Care Management Recommendations for Mucocutaneous Manifestations of Monkeypox Infection – Mayo Clinic Proceedings

Review | Calciphylaxis and kidney disease

3 May, 2023 | 15:20h | UTC

Calciphylaxis and Kidney Disease: A Review – American Journal of Kidney Diseases

RCT | Efficacy and safety of tralokinumab in adolescents with moderate to severe atopic dermatitis

3 May, 2023 | 15:04h | UTC

Efficacy and Safety of Tralokinumab in Adolescents With Moderate to Severe Atopic Dermatitis: The Phase 3 ECZTRA 6 Randomized Clinical Trial – JAMA Dermatology

Commentary: Tralokinumab Efficacious, Well-Tolerated for Adolescents with Atopic Dermatitis – HCP Live

Commentary on Twitter

The ECZTRA 6 trial showed that targeted IL-13 inhibition with tralokinumab was efficacious and well tolerated in adolescents with moderate-to-severe AD, suggesting that it is a valuable treatment option in this age group. https://t.co/h36BW4XThE

— JAMA Dermatology (@JAMADerm) April 19, 2023

Syphilis in dermatology | Recognition and management

2 May, 2023 | 13:40h | UTC

Syphilis in Dermatology: Recognition and Management – American Journal of Clinical Dermatology

Commentary on Twitter

Syphilis in Dermatology: Recognition and Management
This guide by Amor Khachemoune et al. discusses the current epidemiology of syphilis and focuses on practice aspects of diagnosis and management, including public health reporting.#Syphilis https://t.co/uLsVaw4jXP pic.twitter.com/sbXhFCk5De

— Kathy Fraser (@AmJClinDerma) January 23, 2023

USPSTF Statement | There is insufficient evidence to guide skin cancer screening recommendations

24 Apr, 2023 | 14:07h | UTC

Screening for Skin Cancer: US Preventive Services Task Force Recommendation Statement – JAMA

Evidence Report: Skin Cancer Screening: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force – JAMA

Editorials:

The USPSTF I Statement on Skin Cancer Screening—Not a Disappointment but an Opportunity – JAMA Dermatology

Skin Cancer Screening: The Importance of Identifying High-risk Subgroups and the Need for US-Based Population Research – JAMA

Insufficient Evidence for Screening Reinforces Need for Primary Prevention of Skin Cancer – JAMA Internal Medicine

Patient Page: Screening and Prevention of Skin Cancer – JAMA

Author Interview: USPSTF Recommendation: Screening for Skin Cancer – JAMA

Commentary on Twitter

2023 Recommendation Statement from the USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of visual skin examination by a clinician to screen for #skincancer in adolescents and adults (I statement). https://t.co/WB6VN2r1Nv

— JAMA (@JAMA_current) April 18, 2023

RCT | Efficacy and safety of ritlecitinib in adults and adolescents with alopecia areata

21 Apr, 2023 | 13:00h | UTC

Efficacy and safety of ritlecitinib in adults and adolescents with alopecia areata: a randomised, double-blind, multicentre, phase 2b–3 trial – The Lancet (link to abstract – $ for full-text)

News Release: Progress in search for alopecia areata treatment for adolescents – Yale News

Commentary on Twitter

Ritlecitinib might be a treatment option for alopecia areata in patients aged 12 years and older, suggests a new study: https://t.co/jKUxEbo4AZ

Below, a graphical abstract 👇 pic.twitter.com/JIJtTGHeE4

— The Lancet (@TheLancet) April 17, 2023

Podcast | Fungi fun! an in-depth look at tinea infections in children

18 Apr, 2023 | 13:14h | UTC

Fungi Fun! An In-Depth Look at Tinea Infections – The Cribsiders

Phase 2 RCT | Dersimelagon in erythropoietic protoporphyrias

17 Apr, 2023 | 13:05h | UTC

Dersimelagon in Erythropoietic Protoporphyrias – News England Journal of Medicine (link to abstract – $ for full-text)

Commentary on Twitter

In a phase 2 trial, once-daily oral treatment with dersimelagon safely improved tolerance to sun exposure in patients with erythropoietic protoporphyria and X-linked protoporphyria. https://t.co/peZye8R5T7 pic.twitter.com/DO2HmKkM1f

— NEJM (@NEJM) April 12, 2023

RCTs | Eczema Care Online behavioral interventions may support self-care for children and young people

12 Apr, 2023 | 13:02h | UTC

Eczema Care Online behavioural interventions to support self-care for children and young people: two independent, pragmatic, randomised controlled trials – The BMJ

Editorial: How to make Eczema Care Online freely available – The BMJ

News Release: New website helps improve eczema in children and young people – University of Southampton

Guideline | Onychomycosis

Consensus Paper | Safe skin, safe patients: the value of patient hygiene

SR | Efficacy of negative pressure wound therapy in treating pressure ulcers remains uncertain

RCT | Microdosed incisional clindamycin reduces infection rate in skin cancer surgery

Acute generalized exanthematous pustulosis: clinical features, differential diagnosis, and management

MASCC Guidelines for the prevention and management of acute radiation dermatitis | Part 1 – Systematic review

Review | Skin assessments and interventions for maintaining skin integrity in nursing practice

Guidelines on the diagnosis and treatment of foot infection in persons with diabetes

RCT | Spironolactone enhances acne outcomes and offers a viable alternative to oral antibiotics

Cohort Study | 5-mm margins may be adequate for T1a melanoma excision near critical structures

The impact of hyperhidrosis on quality of life: a review of the literature

Cutaneous Lupus Erythematosus | An update on pathogenesis and future therapeutic directions

RCT | Bacterial decolonization for prevention of radiation dermatitis

Cohort Study | Skin biopsy yields 88% sensitivity in detecting meningococcal Purpura Fulminans

Review | A practical guide to hidradenitis suppurativa

Differential diagnosis, prevention, and treatment of mpox (Monkeypox): a review for dermatologists

Supportive care management recommendations for mucocutaneous manifestations of monkeypox infection

Review | Calciphylaxis and kidney disease

RCT | Efficacy and safety of tralokinumab in adolescents with moderate to severe atopic dermatitis

Syphilis in dermatology | Recognition and management

USPSTF Statement | There is insufficient evidence to guide skin cancer screening recommendations

RCT | Efficacy and safety of ritlecitinib in adults and adolescents with alopecia areata

Podcast | Fungi fun! an in-depth look at tinea infections in children

Phase 2 RCT | Dersimelagon in erythropoietic protoporphyrias

RCTs | Eczema Care Online behavioral interventions may support self-care for children and young people

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