Differential Diagnosis, Prevention, and Treatment of mpox (Monkeypox): A Review for Dermatologists.

The current 2022 mpox (monkeypox) outbreak has been officially recognized as a public health emergency. The mpox clinical symptoms include high fever, fatigue, chills, headache, swollen lymph nodes, muscle aches, and a disseminated painful rash. However, recent cases of mpox have shown a shift in clinical symptoms, with anogenital skin lesions emerging as the predominant feature. Due to the predominant skin manifestations of mpox, dermatologists could be crucial in detecting new mpox cases and educating frontline healthcare professionals about mpox. The mpox virus is continuously evolving and has several variants. Genome sequencing has revealed that the Clade IIb variant is responsible for the 2022 mpox outbreak. Mpox spread may occur through animal-to-human and human-to-human transmission; however, unlike coronavirus disease 2019 (COVID-19), long-range airborne transmission has not been reported. Healthcare professionals are at higher risk of becoming infected since they are usually in close contact with both the patients and potentially contaminated fomites (e.g., examination table, gowns, gloves). Both public and healthcare professionals should take preventive and avoidance measures to limit the spread. Mpox is usually self-limiting and may require only symptomatic treatment; however, it may cause severe complications in special populations such as immunocompromised individuals. For severe infection, clinicians may consider antiviral drugs (off-label), tecovirimat and brincidofovir, originally approved for smallpox treatment. Two smallpox vaccines, ACAM2000® and JYNNEOSTM, can be used as pre-exposure prophylaxis against mpox. JYNNEOSTM, which carries approval for mpox use, has less adverse effect potential than ACAM2000®, and may also be used as post-exposure prophylaxis, preferably within 4 days of exposure.

Olumiant® (Baricitinib)-A Newly Approved Janus Kinase Inhibitor for the Treatment of Alopecia Areata

Olumiant® (Baricitinib) is a newly approved treatment for alopecia areata. Baricitinib is a selective and reversible inhibitor of Janus kinase that has shown promising results in two randomized, placebo-controlled phase-3 trials. A significantly higher number of patients achieved at least 80% scalp coverage following 36 weeks of treatment, compared to the placebo group. Adverse effects reported include acne and urinary tract infections, in addition to the warnings and precautions as highlighted in the product monograph. The current recommended regimen is 2 mg or 4 mg taken once daily, depending on the extent of hair loss. Other approved indications for baricitinib treatment include management of rheumatoid arthritis and the COVID-19 infections. (SKINmed. 2022;20:452-455).

Clinical profile and in-hospital outcomes of COVID-19 among adolescents at a tertiary care hospital in India.

Introduction: We aimed to describe the clinical profile and risk factors for severe disease in adolescents hospitalised with coronavirus disease 2019 (COVID-19). Methods: A retrospective analysis of an admitted cohort of COVID-19 patients was performed at a tertiary hospital in North India. Adolescents aged 12-18 years who were hospitalised during the first wave (March-December, 2020) and the second wave (March-June, 2021) were included. Data on the demographic details, clinical presentation, laboratory parameters, disease severity at admission, treatments received, and in-hospital outcomes were retrieved. Results: The study included 197 adolescents with a median [inter-quartile range (IQR)] age of 15 (13-17) years, of whom 117 (59.4%) were male. Among these, 170 (86.3%) were admitted during the first wave. Underlying co-morbidities were present in nine (4.6%) patients. A total of 60 (30.9%) patients were asymptomatic. In the severity grading, 148 (84.6%) had mild, 16 (9.1%) had moderate, and 11 (6.3%) had severe disease. Fever (14.9%) and cough (14.9%) were the most commonly encountered symptoms. The median (IQR) duration of hospital stay was 10 (8-13) days, and six (3.1%) patients died in the hospital. Conclusion: Adolescents admitted with COVID-19 had predominantly asymptomatic or mild disease, and the mortality rate was 3.1%.

Hair loss treatment and restoration: Online interest trends and video-based social media content.

BACKGROUND: Public interest in hair loss topics and treatments can be observed by examining online trends, such as those monitored by Google Trends. Social media has also gained the interest of the dermatology community. Video-based social media sites are being used to provide the public with informational content related to hair loss and treatments, but it may not always be unbiased or reliable. AIMS: This research examined the interest in hair loss and treatment related trends in recent years through Google Trends, as well as examined what videos from YouTube and TikTok that the average person may encounter when performing searches related to hair loss and treatments. RESULTS: Google Trends showed that the COVID-19 pandemic had an initial negative impact on interests of hair loss and treatment related topics, both worldwide and in the United States. External events, such as a celebrity receiving a hair transplant, can influence the interests of the general public with the topic. The social media sites showed that there was a high level of interest in the topics, approximately 25% of videos involved a medical professional, and many involved personal experiences or natural remedies. CONCLUSIONS: Interest in hair loss and treatments continues to grow. Clinicians should do their best to follow the current public interests and be aware of where patients may be obtaining information. Being aware of general interest trends online can benefit clinicians by allowing them to prepare their clinics for potential influxes.

Changing trends in surgical hair restoration: Use of Google Trends and the ISHRS practice census survey.

BACKGROUND: Hair loss affects most people at some point in their lifetime, causing anxiety and decreased self-esteem. There are multiple surgical and nonsurgical treatments available, with the surgical options having greater and longer-lasting effects. Such treatments have evolved over time with advances in technology and research, with numerous patients researching these treatments on Google. Many surgeons who provide these treatments belong to the International Society of Hair Restoration Surgeons (ISHRS). AIMS: To investigate trends in surgical hair restoration treatment from both the surgeon and patient perspectives. METHODS: Patient epidemiological and surgical data from the ISHRS were combined with search trend data from Google to analyze changing trends in surgical hair restoration treatment. RESULTS: Worldwide Internet searches for "hair transplant" have increased from 2004 to the present. Follicular unit excision (FUE) has supplanted follicular unit transplant (FUT) as the most popular hair transplant performed. Since 2004, there has been an increase in both nonsurgical and surgical female patients. Beard and eyebrow transplants have increased in popularity. Google searches follow this trend. Nonsurgical treatments such as platelet-rich plasma (PRP) are being searched more frequently. Hair restoration clinics and Google searches were affected adversely by the COVID-19 pandemic. CONCLUSION: Technological advances in available therapies, improvement in delivery systems, changes in hair fashion, and global events have direct impact on hair restoration treatments offered by physicians and researched by patients. It is in the best interest of all hair restoration providers to keep abreast of changing technologies and treatment trends to stay at the forefront of their profession.

The shifting preferences of patients and physicians in nonsurgical hair loss treatment.

BACKGROUND: There are multiple etiologies for hair thinning and loss, including genetic, hormonal, immune, scaring, and infectious. Hair loss treatment involves both surgical intervention and nonsurgical therapies such as pharmaceuticals, haircare products, vitamins, and low-level laser therapy (LLLT). While pharmaceuticals have been extensively researched, the efficacy of other therapies remains inconclusive. With so many available treatments, consumers often research their options using search engines such as Google and/or seek help from hair restoration physicians. AIMS: To identify and analyze changing trends in international consumer and physician interest in nonsurgical hair loss therapies. METHODS: Worldwide trends in Google searches of hair loss products (2004-2020) were compared with product prescription frequency surveys from members of the International Society of Hair Restoration Surgery (2004-2019, ~29% response rate). RESULTS: Minoxidil and finasteride were the most prescribed hair loss treatments, while "minoxidil" was the most "Googled" term. Generic products were searched more often than their brand counterparts. Nutritionals and haircare prescriptions increased over time. LLLT was also increasingly prescribed, with Internet searches increasing following government regulation announcements. The COVID-19 pandemic initially negatively affected hair loss treatment searches, which have since returned to, and surpassed, pre-pandemic levels. CONCLUSION: Regulations and social media have influence on consumer interest in hair loss products. A weak economy and coronavirus fears may persuade consumers to turn to cheaper hair loss treatment alternatives. Hair restoration specialists need to keep abreast of online trends to communicate effectively with their patients. Patients should be cognizant of the safety and efficacy of hair restoration treatments.