Dermatology

Two‑trial rule applied inconsistently; discrepant phase‑3 pairs not uniformly change approvals

Among 9,925 phase‑3 trials (2010–2024), researchers identified 498 duplicated studies (5%), forming 246 pairs or triplets. Results were available for 206 pairs, and 35 pairs (17%) had discrepant statistical conclusions. The FDA still granted authorization for 14 drugs despite discrepancies; an additional RCT was required in 8 cases. Authors note outcome changes and unblinding influenced some second trials, and regulatory responses to discrepancies lacked consistency. 1

Oral Centella asiatica 200 mg/day modestly reduces wrinkles and improves TEWL at 12 weeks

In 112 middle‑aged Korean women randomized to 200 mg/day Centella asiatica or placebo for 12 weeks, wrinkle measures fell significantly versus baseline. Average wrinkle depth decreased 11.1%, largest wrinkle depth decreased 14.4%, and total wrinkle volume and surface roughness improved. Epidermal hydration increased and TEWL decreased, indicating barrier improvement; elasticity and brightness changes were statistically small. No serious adverse events occurred, but authors caution that long‑term durability and generalisability are unknown. 2

AI shows promise for skin cancer detection but heterogeneity limits immediate clinical adoption

This umbrella review of 28 systematic reviews reported wide performance ranges for AI: basal cell carcinoma sensitivity 83.7–94.4%, squamous cell carcinoma 57.0–90.1%, melanoma sensitivity 48–100%. Specificity and AUC values varied greatly across studies, with AUCs spanning 0.61–0.99, reflecting substantial heterogeneity. Narrative comparisons often found deep‑learning models non‑inferior or superior to clinicians, but prospective, real‑world validation was limited. Authors recommend standardised validation, multimodal models, and real‑world testing before routine clinical deployment. 3