Latest news with #corticosteroids
Medscape
11 hours ago
- Health
- Medscape
Hair Experts Report Varying Steroid Techniques for Alopecia
A national survey found broad consensus among hair experts on the use of intralesional corticosteroid (ILC) injections for alopecia but highlighted inconsistencies in dosing and injection parameters. METHODOLOGY: Researchers surveyed 28 dermatologists with hair expertise using a 77-question REDCap survey. Participants averaged 17.7 years of experience, with completion of residency between 1985 and 2022. The response rate was 75% (21 experts completed the survey). The survey assessed ILC injection techniques across alopecia types, including facial alopecia. TAKEAWAY: For nonscarring alopecia, 5 mg/mL was the most common ILC dose (85.7%), followed by 2.5 mg/mL (38.1%); 95.2% of experts injected between 1 and 1.5 mL per session, 95.2% used a 30-gauge needle, and 95.2% injected in a grid pattern. Most experts (71.4%) employed identical ILC techniques for both scarring and nonscarring alopecia, with 61.9% and 60%, respectively, preferring 6-week treatment intervals. The most common ILC dose for scarring alopecia was 5 mg/mL (60%), followed by 7.5 mg/mL (40%) and 10 mg/mL or more (40%). For facial alopecia, 80% of experts used a lower concentration of 2.5 mg/mL, and 90% typically performed 3-4 sessions. For nonscarring alopecia, experts suggested injecting parallel to the direction of hair growth to reduce pain and avoid follicle damage, and for scarring alopecia, they recommended starting with peripheral injections and moving toward the center of the lesion. For facial alopecia, experts recommended shallow injections and avoiding visible vessels to prevent atrophy and bruising. IN PRACTICE: 'Our findings reveal general agreement amongst experts on the use of ILCs for alopecia; however, variation remains in concentration, injection spacing, and treatment duration, especially for facial and scarring alopecia,' the study authors wrote. Although a Delphi study 'could help standardize' ILC treatment approaches, they added, their results 'provide practical guidance for dermatologists on intralesional corticosteroid techniques for the treatment of various alopecia types.' SOURCE: This study was led by Noelle Desir, Department of Dermatology, University of Pennsylvania, Philadelphia, and was published online on June 3 in JAAD International . LIMITATIONS: Limitations included the hair expert identification process and potential response bias in the survey. DISCLOSURES: This study did not receive any funding. One study author reported serving as a consultant, advisory board member, speaker, and investigator for various pharmaceutical and cosmetic companies, including AbbVie, Arcutis Biotherapeutics, Pfizer, and L'Oréal, and also reported receiving royalties from McGraw Hill. Another author reported serving as an advisory board member for Beiersdorf. The remaining authors reported no conflicts of interest.
Medscape
09-06-2025
- Health
- Medscape
Antenatal Corticosteroids Safe for Child Development
A systematic review of 14 studies found that most neurodevelopmental outcomes showed no association with antenatal corticosteroids. While modest decreases were noted in nonverbal intelligence and visual memory scores, studies with a strong design showed no link to adverse development. METHODOLOGY: Researchers conducted a systematic review and meta-analysis of 14 studies, comprising eight randomized controlled trial follow-up studies (n = 2233) and six quasi-experimental studies (n = 277,679). Analysis utilized random-effects meta-analyses to synthesize outcomes based on blinded adjudication of appropriateness for pooling by clinical experts in child neurodevelopment. Investigators evaluated the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation methodology. A total of 23 neurodevelopmental outcomes were examined. TAKEAWAY: Most neurodevelopmental outcomes (19/23) showed no association with antenatal corticosteroid administration. Children exposed to antenatal corticosteroids showed modestly decreased nonverbal intelligence scores (standardized mean difference [SMD], -0.16; 95% CI, -0.32 to -0.01) and visual memory scores (SMD, -0.29; 95% CI, -0.51 to -0.07). Randomized trial follow-ups indicated a nonsignificant trend toward protective effects for general development, while quasi-experimental studies suggested increased risk. Studies with low or moderate risk for bias revealed no association between antenatal corticosteroid administration and adverse child neurodevelopment. IN PRACTICE: 'Among studies with low or moderate risk of bias, we found no association between antenatal corticosteroid administration and adverse child neurodevelopment. There is no consistent evidence that antenatal corticosteroids are associated with an increased risk of impaired childhood neurodevelopment among studies with a strong design to control for confounding,' wrote the authors of the study. SOURCE: The study was led by Jessica Liauw, MD, Department of Obstetrics and Gynaecology at University of British Columbia in Vancouver, Canada. It was published online in Obstetrics & Gynecology . LIMITATIONS: Most randomized controlled trial follow-up studies had significant losses to follow-up, with the two largest studies experiencing 66% and 40% attrition rates, leading to potential selection bias. Researchers noted that few studies specifically investigated the effects of antenatal corticosteroids administered in the late preterm period, limiting understanding of the timing-specific impacts. Additionally, the authors acknowledged that sibling-comparison studies did not adequately control for differences in pregnancy complications that determine why corticosteroids were administered in one pregnancy but not another. DISCLOSURES: The study was supported by a project grant from the Canadian Institutes of Health Research. Liauw received a Michael Smith BC Health Professional Investigator Award, and Jennifer Hutcheon, PhD, was supported by a Canada Research Chair in perinatal population health. The funders had no role in the research design or manuscript submission decisions. The authors reported no potential conflicts of interest.
