Describe the key data for the management of onychomycosis with a focus on topical treatment options

Identify patients for the management of onychomycosis

Discuss strategies to optimize care for patients with onychomycosis 

Targeting Onychomycosis with Topicals: Treat to Terminate: On Demand CME Activity 

Hair and Nails

In a study published online Aug. 31 in
 
 JAMA Dermatology
 
 , the authors expand the genotypic spectrum of uncombable hair syndrome (UHS) and identify pathogenic variants in
 
 PADI3
 
 ,
 
 TCHH
 
 , and
 
 TGM3.
 




 F. Buket Basmanav, Ph.D., from the University of Bonn in Germany, and colleagues examined the genetic spectrum of UHS in a cohort study including 107 unrelated index patients with a suspected diagnosis of UHS and their family members who were recruited worldwide from January 2013 to December 2021.




 The researchers found that in 80 of 107 index patients (74.8 percent) who carried biallelic pathogenic variants in
 
 PADI3
 
 ,
 
 TGM3
 
 , or
 
 TCHH
 
 (i.e., genes that encode functionally related hair shaft proteins), the genetic characteristics were established. The molecular genetic findings from 11 of these patients have already been published. The UHS phenotype was associated with pathogenic variants in
 
 PADI3
 
 in 76 patients (71.0 percent). Of the 152 variant
 
 PADI3
 
 alleles, 73 and 57 (48.0 and 37.5 percent) were accounted for by the two most commonly observed variants. Two individuals harbored variants in
 
 TGM3
 
 , and pathogenic variants in
 
 TCHH
 
 were seen in two others. A founder effect was suggested in haplotype analyses for the four most commonly observed pathogenic variants in the
 
 PADI3
 
 gene.




 "This cohort study extends and gives an overview of the genetic variant spectrum of UHS based on molecular genetic analyses of the largest worldwide collective of affected individuals, to our knowledge," the authors write. "Formerly, a diagnosis of UHS could only be made by physical examination of the patient and confirmed by microscopical examination of the hair shaft. The discovery of pathogenic variants in
 
 PADI3
 
 ,
 
 TCHH
 
 , and
 
 TGM3
 
 may open a new avenue for clinicians and affected individuals by introducing molecular diagnostics for UHS."




 One author disclosed financial ties to the pharmaceutical industry.




 <a class="rm-stats-tracked" href="https://jamanetwork.com/journals/jamadermatology" target="_blank">
 Abstract/Full Text (subscription or payment may be required)
 </a>

Genetic Spectrum of Uncombable Hair Syndrome Described

Congenital and congenital-type nail matrix nevi (NMN) have clinical and dermatoscopic features similar to those observed in adult subungual melanoma, according to a study published in the September issue of the
 
 Journal of the American Association of Dermatology
 
 .




 Félix Pham, M.D., from Centre Hospitalier Lyon Sud in France, and colleagues describe the initial clinical and dermatoscopic features of NMN appearing at birth or after birth but before age 5 years (congenital and congenital-type, respectively) using data collected from 102 hospitals or private medical offices across 30 countries from 2009 to 2019.




 The researchers identified 69 congenital and 161 congenital-type NMNs. An irregular pattern of longitudinal microlines (64 percent) was displayed by congenital and congenital-type NMN, reminiscent of subungual melanoma in adults. The distal fibrillar pattern was present in 27.8 percent of patients, which was encountered more frequently in congenital than in congenital-type NMN. Compared with congenital-type NMN, congenital NMN more frequently displayed a periungual pigmentation and Hutchinson's sign.




 "Further studies of the cohort will focus on the evolutive characteristics of these lesions and hopefully will help us to better define management guidelines," the authors write.




 <a class="rm-stats-tracked" href="https://www.jaad.org/article/S0190-9622(22)00158-X/fulltext" target="_blank">
 Abstract/Full Text (subscription or payment may be required)
 </a>

Congenital and congenital-type nail matrix nevi predominantly display irregular pattern of longitudinal microlines

Features of Congenital Nail Matrix Nevi Similar to Adult Subungual Melanoma

About half of postmenopausal women experience female pattern hair loss (FPHL), according to a study published online Feb. 14 in
 
 Menopause
 
 .




 Sukanya Chaikittisilpa, M.D., from Chulalongkorn University and King Chulalongkorn Memorial Hospital in Bangkok, Thailand, and colleagues assessed the prevalence of FPHL in healthy postmenopausal women. The analysis included 178 postmenopausal women (aged 50 to 65 years).




 The researchers found that the prevalence of FPHL was 52.2 percent. FPHL severity, as measured by Ludwig classification, was 73.2 percent for grade I, 22.6 percent for grade II, and 4.3 percent for grade III. Age, time since menopause, and body mass index (BMI) were all significantly associated with FPHL, but when adjusting for age and family history of FPHL, only BMI ≥25 kg/m
 
 2
 
 was significantly associated with FPHL (adjusted odds ratio, 2.65).




 "Female pattern hair loss was prevalent and associated with lower self-esteem in healthy postmenopausal women in this small cross-sectional study," Stephanie Faubion, M.D., medical director of the North American Menopause Society, said in a statement. "A better understanding of the mechanisms responsible for this common type of hair loss in women may lead to more effective preventive strategies and treatment options."




 <a class="rm-stats-tracked" href="https://journals.lww.com/menopausejournal/Abstract/9000/Prevalence_of_female_pattern_hair_loss_in.96812.aspx" target="_blank">
 Abstract/Full Text (subscription or payment may be required)
 </a>








 <a href="https://consumer.healthday.com/u/physiciansbriefingstaff">
 <img alt="HealthDay" src="https://assets.rbl.ms/23636171/origin.png" style="max-width: 150px;"/>
 </a>

Female Pattern Hair Loss Common During Menopause Transition

In Episode 5 of&nbsp;Cutaneous Miscellaneous, our host Nicholas Brownstone, MD, talks with Dawn L. Sammons, DO, Program Director at Ohio Health Dermatology Residency.&nbsp; The episode begins with board review prep on hair loss. The following disorders are discussed: androgenetic alopecia, alopecia areata, CCCA, and lichen planopilaris. &nbsp;

Sponsored by: <a target="_blank" rel="noopener noreferrer" href="https://castletestinfo.com/"><img style="height:auto;margin-left:10px;max-width:250px;" src="https://fchealth-assets.s3.amazonaws.com/castle-fc-podcast-page.png" alt=""></a> In Episode 5 of&nbsp;Cutaneous Miscellaneous, our host Nicholas Brownstone, MD, talks with Dawn L. Sammons, DO, Program Director at Ohio Health Dermatology Residency.&nbsp; The episode begins with board review prep on hair loss. The following disorders are discussed: androgenetic alopecia, alopecia areata, CCCA, and lichen planopilaris. &nbsp; The remainder of the episode discusses how to learn and teach as a dermatology resident effectively. For junior dermatology residents, Dr. Sammons gives tips on absorbing the vast amount of information required when starting a dermatology residency. She specifically discusses successful learning methods and how to best integrate academic knowledge with clinical skills. For senior residents, Dr. Brownstone asks Dr. Sammons how they can best teach and mentor junior dermatology residents and medical students and how to give effective feedback. The episode ends with a few pointers on teaching patients about their diagnoses.&nbsp; The learning and teaching tips offered in this episode are useful for all 3 years of dermatology residency and beyond!

Cutaneous Miscellaneous Podcasts

Learning and Teaching as a Dermatology Resident

In this episode of Derms &amp; Conditions, James Q. Del Rosso, DO gleans up-to-date practical information on hair loss from Natasha Mesinkovska, MD, PhD, based on her extensive clinical and research experience in&nbsp;this area of dermatology.

In this episode of Derms &amp; Conditions, James Q. Del Rosso, DO gleans up-to-date practical information on hair loss from Natasha Mesinkovska, MD, PhD, based on her extensive clinical and research experience in this area of dermatology. Several entities and challenges are discussed with tips on both diagnosis and management.&nbsp; The latter half focuses on alopecia areata, including its relationships to both atopy and autoimmune disease. The episode concludes with how Dr. Mesinkovska integrates oral JAK inhibitors into her management plan. This discussion is loaded with pearls! FINANCIAL DISCLOSURES: James Q. Del Rosso, DO CONSULTANT/ADVISOR Abbvie, Aclaris, Almirall, Amgen, Arcutis, Bausch Health (Ortho Dermatology), BioFrontera, BioPharmX, Bristol-Myers-Squibb, Cassiopea, Dermata, Dermavant, Encore, EPI Health, Evommune, Ferndale, Galderma, Incyte, JEM Health, Leo Pharma, La Roche Posay, Lilly (Dermira), MC2, Novan, Pfizer, Regeneron, Sanofi-Genzyme, SolGel, Sonoma (IntraDerm), Sun Pharma, Trevi, UCB, Verrica, Vyne (Foamix; Menlo) SPEAKER BUREAU Aclaris, Almirall, Amgen, Arcutis, Bausch Health (Ortho Dermatology), EPI Health, Ferndale, Galderma, Genentech, JEM Health, Leo Pharma, La Roche Posay, Lilly (Dermira), Pfizer, Regeneron, Sanofi-Genzyme, Sun Pharma, UCB, Verrica, Vyne (Foamix; Menlo) RESEARCH INVESTIGATOR Aclaris, Almirall, Amgen, Anaptys Bio, Arcutis, Athenex, Bausch Health (Ortho Dermatology), BioPharmX, Biorasi, Botanix, Brickell, Cara Therapeutics, Cassiopea, Dermavant, EPI Health, Ferndale, Galderma, Incyte, Leo Pharma, Lilly (Dermira), Novan, Pfizer, Ralexar, Regeneron, SolGel, Sun Pharma, UCB, Verrica, Vyne (Foamix; Menlo).

Derms and Conditions Podcast

Tying Up The Loose Ends With Managing Hair Loss: Practical Advice That Will Help Right Now

In this episode, James Del Rosso, DO and Dawn Sammons, DO discuss&nbsp;frequently&nbsp;encountered clinical challenges in everyday practice with patients including chronic hair loss in women, application of topical lovastatin and cholesterol for&nbsp;Porokeratosis, and more.

In this episode, James Del Rosso, DO and Dawn Sammons, DO discuss&nbsp;frequently&nbsp;encountered clinical challenges in everyday practice with patients including chronic hair loss in women, application of topical lovastatin and cholesterol for&nbsp;Porokeratosis, and more. 
Financial Disclosures:
James Del Rosso, DO:
CONSULTANT/ADVISOR Abbvie, Aclaris, Almirall, Amgen, Arcutis, Bausch Health (Ortho Dermatology), BioFrontera, BioPharmX, Bristol-Myers-Squibb, Cassiopea, Dermata, Dermavant, Encore, EPI Health, Evommune, Ferndale, Galderma, Incyte, JEM Health, Leo Pharma, La Roche Posay, Lilly (Dermira), MC2, Novan, Pfizer, Regeneron, Sanofi-Genzyme, SolGel, Sonoma (IntraDerm), Sun Pharma, Trevi, UCB, Verrica, Vyne (Foamix; Menlo)
SPEAKER BUREAU Aclaris, Almirall, Amgen, Arcutis, Bausch Health (Ortho Dermatology), EPI Health, Ferndale, Galderma, Genentech, JEM Health, Leo Pharma, La Roche Posay, Lilly (Dermira), Pfizer, Regeneron, Sanofi-Genzyme, Sun Pharma, UCB, Verrica, Vyne (Foamix; Menlo)
RESEARCH INVESTIGATOR Aclaris, Almirall, Amgen, Anaptys Bio, Arcutis, Athenex, Bausch Health (Ortho Dermatology), BioPharmX, Biorasi, Botanix, Brickell, Cara Therapeutics, Cassiopea, Dermavant, EPI Health, Ferndale, Galderma, Incyte, Leo Pharma, Lilly (Dermira), Novan, Pfizer, Ralexar, Regeneron, SolGel, Sun Pharma, UCB, Verrica, Vyne (Foamix; Menlo). Dawn Sammons, DO:
CONSULTANT/ADVISOR Abbvie, Novartis Pfizer,&nbsp;Lilly, UCB.
SPEAKER BUREAU Abbvie, Novartis Pfizer,&nbsp;Lilly, OrthDermatologics, Sun, Amgen, Janssen.

Hair and Nails Condition Center

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Hair and Nails Episodes to Explore

Learning and Teaching as a Dermatology Resident

Tying Up The Loose Ends With Managing Hair Loss: Practical Advice That Will Help Right Now

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Targeting Onychomycosis with Topicals: Treat to Terminate: On Demand CME Activity