Although type 2 inflammatory pathway dysfunction is a hallmark of atopic dermatitis (AD), disease symptoms in many patients are also driven by other immune/inflammatory pathway dysfunctions, all of which lead to varied treatment response profiles of targeted systemic therapies for individual patients. Adding complexity to the process of identifying which systemic therapy to prescribe for an individual patient is that these treatments have varied safety profiles, routes of administration, monitoring requirements, and costs—all of which are reviewed during today’s shared decision-making discussions. This patient assessment study aimed to better understand patients' attitudes toward contemporary AD treatments, their experiences, and their perceptions of a molecular test to predict treatment response. A 32-question assessment tool, deemed eligible for IRB exemption, was made available to any attendees with AD at the 2024 Eczema Expo who wished to complete it. Regarding treatment objectives, results indicated the top three factors most important to respondents (n = 40) were itch control (70
The skin is a temporally dynamic organ governed by intrinsic molecular clocks operating across multiple cell types. Circadian regulation influences epidermal renewal, barrier function, pigmentation, immune activity, DNA damage responses, and wound repair. This narrative review critically summarizes current mechanistic, translational, and clinical evidence linking the cutaneous circadian clock to skin physiology and selected dermatological diseases and evaluates the emerging concept of chronodermatology. A targeted literature search of PubMed/MEDLINE and reference lists of relevant articles was used to identify foundational and recent studies addressing cutaneous clock mechanisms, melanoma, atopic dermatitis, psoriasis, wound healing, photobiology, and chronotherapeutic strategies. Evidence was strongest for intrinsic circadian oscillation in skin cells, time-dependent epidermal and DNA-repair biology, and rhythmic wound-healing processes; however, many proposed therapeutic applications remain supported primarily by preclinical, observational, or early translational data. Chronodermatology therefore represents a promising framework for investigating treatment timing and individualized temporal biology, but prospective human trials are required before routine time-specific prescribing, photoprotection, or clock-targeted therapy can be recommended.
Adalimumab, a monoclonal antibody targeting tumor necrosis factor-alpha, has been approved for the treatment of severe plaque psoriasis in children aged 4 years and older. Data on its use in the clinical management of pediatric psoriasis in China remains limited. This study is the first prospective analysis of the adalimumab biosimilar (GELELI®, the first biosimilar of adalimumab approved in China, and QLETLI® in the UK) safety and effectiveness for severe pediatric plaque psoriasis in China. Weight-based dosage was administered to 80 patients (ages 4–18 years) from multiple centers. Primary endpoints included the proportions of patients achieving PASI75 and PGA 0/1 at week 16. The mean psoriasis area and severity index (PASI) score decreased from 15.31 ± 8.375 at baseline to 6.29 ± 4.208 at week 4. PASI 50/90/100 response rates were 91.1
Although isotretinoin is approved for severe recalcitrant nodular acne, it is broadly used among patients with acne in clinical practice. The objective of this study was to characterize the profile and therapeutic journey of patients with acne treated with isotretinoin. Using the MarketScan® Commercial Claims and Encounters Database, we identified patients diagnosed with acne who received isotretinoin before 30 June 2023. Outcomes included: time to isotretinoin discontinuation, antibiotic initiation after isotretinoin discontinuation, isotretinoin restart, and acne treatment reinitiation. Treatment courses prior to isotretinoin initiation were also assessed. A total of 71,340 patients were included. Overall, 28.4
Following the positive findings of the phase 3 CheckMate 238 trial, adjuvant nivolumab has become a standard therapy in patients with completely resected stage III–IV melanoma. The prospective, ongoing AdjuMel study is evaluating the real-world use, effectiveness, and safety of adjuvant nivolumab in patients with resected melanoma in France. Here we report 2-year results from the third interim analysis of AdjuMel. This observational, prospective study is evaluating data from patients with resected stage III–IV melanoma treated with adjuvant nivolumab in France. Study outcomes include effectiveness, safety, and treatment patterns of anti-programmed cell death-1 (PD-1, nivolumab) under routine clinical practice in the adjuvant setting. The primary endpoint was relapse-free survival (RFS). This third interim analysis (data cut-off: 3 November 2023) included patients with ≥ 1 follow-up visit, using data collected up to the 24-month visit. Overall, 343 patients (median [range] age 65 [27–95] years; 57.7
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by painful nodules, abscesses, draining tunnels and substantial impairment in quality of life. Bimekizumab, a monoclonal antibody that selectively inhibits interleukin-17A and interleukin-17F, was recently approved in Italy for the treatment of moderate-to-severe HS. However, real-world evidence remains limited. This was a retrospective multicenter study of patients with HS treated with bimekizumab across Italian dermatology referral centers. Effectiveness was assessed at weeks 4, 16 and 24 using the following measurement tools and scales: Hidradenitis Suppurativa Clinical Response (HiSCR), HiSCR75, HiSCR90, HiSCR100 (at least 75
Refractory pyoderma gangrenosum (PG) may persist despite corticosteroids, ciclosporin, biologics or sequential treatment escalation. Dual-targeted therapy (DTT) is increasingly used in medically complex inflammatory bowel disease (IBD), but PG is often recorded only as an extraintestinal manifestation. We examined the direction, extractability and attribution limits of PG outcomes reported during concurrent DTT. PubMed, Embase via Ovid and Web of Science Core Collection were searched from inception to 26 July 2026. Eligible reports described at least one patient with PG receiving concurrent systemic DTT, defined as biologic–biologic, biologic–Janus kinase (JAK) inhibitor or biologic–phosphodiesterase-4 inhibitor combinations. Screening and extraction were performed independently and in duplicate. The analytic unit was the PG exposure. Outcomes were retained as source-reported and were not pooled because PG assessment, follow-up and co-intervention reporting were non-standardised. Fourteen reports described 17 PG exposures. Of these, 14 had an extractable PG-specific cutaneous outcome, all source-reported using non-standardised assessments as improved or resolved. This 14-of-14 pattern reflects the direction of published outcome-bearing observations, not a denominator-based response estimate. Three additional cohort-level records documented PG exposure without a separable cutaneous end-point. A total of 16 exposures were IBD-associated and 11 involved JAK-containing regimens. Individual regimen mapping, diagnostic ascertainment, follow-up and co-intervention reporting were frequently incomplete. All evidence was uncontrolled, safety reporting was limited and the complete exposure denominator was unknown. Favourable PG outcomes were reported across several DTT pathway pairings, but these uncontrolled published observations do not establish efficacy, comparative advantage or added benefit from simultaneous pathway blockade. The next step is a dermatology-embedded prospective registry within IBD DTT programmes, with standardised PG diagnosis, lesion documentation, co-intervention recording and exposure-specific safety ascertainment. Until such evidence is available, DTT should remain an exceptional multidisciplinary consideration rather than an established PG treatment strategy.
Icotrokinra, a first-in-class targeted oral peptide, precisely blocks the interleukin (IL)-23 receptor and inhibits IL-23 pathway signaling. In phase 3 studies (ICONIC-LEAD, ICONIC-TOTAL, ICONIC-ADVANCE 1 and 2), icotrokinra provided superior skin clearance versus placebo and deucravacitinib in adults and adolescents with moderate-to-severe psoriasis and psoriasis affecting high-impact sites. This analysis evaluates icotrokinra safety through 1 year using pooled data from these four studies. Icotrokinra-randomized participants received 200-mg pills once daily, and placebo-randomized participants crossed over to icotrokinra at week 16; participants randomized to deucravacitinib 6 mg (ICONIC-ADVANCE 1 and 2 only) switched to icotrokinra at week 24. Pooled safety data are summarized for the placebo-controlled period (week 0–16, all studies), active-controlled period (week 0–24, ICONIC-ADVANCE 1 and 2), and through week 52 (all studies). During the placebo-controlled period across all studies, 568 participants received placebo and 1296 received icotrokinra. From week 0 to 24 in the ICONIC-ADVANCE studies, 632 participants received icotrokinra and 634 received deucravacitinib. Through week 52, 2400 icotrokinra-treated participants contributed 1840 participant-years [PY] of follow-up. Through week 16, in the icotrokinra and placebo groups, respectively, exposure-adjusted incidence rates/100 PY of adverse events (AEs; 232 and 269), serious AEs (5.2 and 6.6), infections (91 and 104), and AEs leading to discontinuation (6.6 and 10.0) were comparable between groups. Through week 24, in the ICONIC-ADVANCE studies, rates/100 PY with icotrokinra versus deucravacitinib were as follows: AEs, 204 vs 265; serious AEs, 6.4 vs 7.2; infections, 81 vs 119; AEs leading to discontinuation, 5.7 vs 6.8. Through week 52, event rates/100 PY in icotrokinra-treated participants were as follows: AEs, 167; serious AEs, 4.6; infections, 76; AEs leading to discontinuation, 3.0. In this analysis of 2400 icotrokinra-treated participants with psoriasis followed through 1 year, icotrokinra demonstrated favorable safety; event rates through week 16 were similar to placebo and remained consistent through week 52. NCT06095115, NCT06095102, NCT06143878, NCT06220604. Infographic available for this article.
Acne is a chronic inflammatory skin disorder with multiple pathogenic pathways. The aim of this initiative was to develop United Arab Emirates (UAE)-specific consensus statements supporting the clinical integration of dermocosmetics into acne management. An expert panel comprising 13 eminent dermatologists practicing in the UAE completed a pre-meeting survey on local acne management practices, followed by a meeting to appraise the proposed consensus statements. Consensus required a ≥ 70
There is limited clinical research evaluating the role of topical corticosteroids in preventing hand-foot syndrome (HFS) caused by capecitabine. Although the precise cause of HFS remains unclear, inflammatory mechanisms are thought to contribute to its development. This study investigated whether prophylactic use of a medium-class topical corticosteroid was associated with a lower incidence of capecitabine-related HFS in patients with colorectal cancer. We retrospectively assessed 78 patients prescribed medium-class topical steroids as a preventive against HFS associated with capecitabine and 32 topical steroid-free patients undergoing capecitabine-based chemotherapy. We evaluated the incidence of each grade of HFS during chemotherapy. Between January 2022 and March 2025, 110 patients were enrolled in the study. Grade ≥ 2 HFS occurred in 23.1
Tinea capitis is a fungal infection of the scalp in which trichoscopy plays an important role by allowing early identification of characteristic hair shaft alterations before mycological confirmation. We describe two adult women who are immunosuppressed with endothrix tinea capitis caused by Trichophyton violaceum. Both patients presented with diffuse scalp alopecia and scaling. Trichoscopic examination revealed unusually elongated corkscrew hairs, and fungal cultures confirmed the diagnosis. Elongated corkscrew hairs represent a previously unreported trichoscopic pattern in chronic endothrix tinea capitis. Awareness of this finding may facilitate earlier diagnostic suspicion and prompt targeted mycological investigation in patients who are immunosuppressed.
Discoid lupus erythematosus (DLE) is the most common chronic form of cutaneous lupus erythematosus and can lead to scarring, dyspigmentation, and permanent alopecia. The disease often causes visible disfigurement and has a substantial psychosocial impact. Although many patients respond to standard treatment, a subset continues to experience persistent or relapsing disease that remains difficult to control. A focused literature search was performed using PubMed, Google Scholar, Web of Science, and Scopus to identify English-language studies published from January 1990 through October 2025. Search terms included “discoid lupus erythematosus,” “cutaneous lupus erythematosus,” “chronic cutaneous lupus,” “pathogenesis,” “therapy,” “antimalarial,” “immunosuppressant,” “biologic therapy,” “JAK inhibitor,” “small molecule therapy,” and “targeted therapy.” Recent clinical trials, consensus guidelines, and review articles were prioritized. Reference lists of key publications were manually screened to capture additional relevant studies. Current first-line topical pharmacotherapeutic treatment options of DLE include photoprotection, topical corticosteroids, and calcineurin inhibitors for localized disease, and antimalarial therapy as a first-line systemic treatment. For refractory disease, systemic immunosuppressants remain common second-line options. Emerging therapies targeting interferon and cytokine signaling pathways, including anifrolumab, belimumab, and tyrosine kinase (TYK2) inhibitors such as deucravacitinib and the plasmacytoid dendritic cell modulators litifilimab and daxdilimab have shown early promise in improving cutaneous disease activity in patients with refractory DLE. Procedural modalities such as laser therapy are being studied as adjuncts for scarring and dyspigmentation. Ongoing advances in understanding the immune mechanisms underlying DLE are shaping a transition from broad immunosuppression toward more targeted treatment strategies. Integrating newer biologic and small-molecule therapies with conventional management may offer improved control and better long-term outcomes for patients with chronic disease.
Atopic dermatitis (AD) is a chronic, inflammatory skin condition in which interleukin (IL)-13 is a key driver. Tralokinumab, an IL-13-targeting monoclonal antibody, has demonstrated efficacy and a favorable safety profile in patients with moderate-to-severe AD in phase 3 trials. However, data on long-term effectiveness and safety in routine clinical practice remain limited. This study aimed to assess changes in clinical signs and symptoms of AD and evaluate safety in patients treated with tralokinumab in a real-world setting. TRACE is an international, non-interventional, prospective study of adults with AD prescribed tralokinumab and followed for up to 12 months of treatment. The primary outcome was investigator-assessed AD severity (Investigator’s Global Assessment [IGA], Eczema Activity and Severity Index [EASI], and/or SCORing AD [SCORAD]). Patient-reported outcomes (PROs) were collected if part of routine practice. Safety was also assessed. A total of 824 patients (mean age 44.1 years; 24.9
Real-world evidence investigating treatment patterns and associated economic outcomes in patients with psoriasis (PsO) are lacking. This study evaluated treatment patterns, healthcare resource utilisation (HCRU), and costs in biologic-naïve patients with moderate-to-severe PsO initiating biologics in France. Biologic-naïve adults with moderate-to-severe PsO initiating an anti-tumour necrosis factor (TNFα) or anti-interleukin (IL) biologic were identified from the Système National des Données de Santé. Switching and dose escalation rates, calculated using Kaplan–Meier analyses, were assessed over 42 months of follow-up. HCRU and costs were assessed during the 12 months following initiation. Comparisons between switchers/non-switchers and dose escalators/non-dose escalators were conducted using Wilcoxon rank sum, chi-square, and Fisher exact tests. Overall, 20,995 biologic-naïve adult patients initiating a biologic were included in the analysis. At 42 months, switch rates and dose escalation rates were lowest for patients initiating anti-IL-23 agents and highest for anti-TNFα agents. Specifically, the lowest rate of switching (15.0
Alopecia areata (AA), an autoimmune disease, causes hair loss on the scalp, face, and body, with a prevalence of approximately 2
Alopecia areata (AA), an autoimmune disease, causes hair loss on the scalp, face, and body, with approximately 2
Actinic keratosis (AK) is a chronic ultraviolet-induced condition with potential progression to squamous cell carcinoma. This study assessed the efficacy and tolerability of oral retinol, alone or combined with broad-spectrum medical photoprotection containing piroxicam, in patients with mild-to-moderate AK. In this multicenter, prospective, randomized, open-label study, 117 patients with up to six AK lesions were assigned to oral retinol 50,000 international units (IU)/day (group A), oral retinol plus medical photoprotection (group B), or standard photoprotection recommendations (group C). Treatment lasted 6 months, followed by 3 months of follow-up. Assessments were performed at baseline and at months 3, 6, and 9. The primary endpoint was change in Actinic Keratosis Area and Severity Index (AKASI). Secondary outcomes included global clinical efficacy, lesion clearance, tolerability, and exploratory line-field confocal optical coherence tomography findings. All 117 patients were included in the intention-to-treat analysis, and 99 in the per-protocol analysis. AKASI scores decreased significantly in group A at month 6 by − 19.3
With the surge in use of glucagon-like peptide 1-receptor agonists (GLP-1RAs) for weight management, “Ozempic Face,” one of the dermatologic effects describing facial hollowing, sinking cheeks, and skin laxity, has drawn public attention. While substantial media discourse has surrounded certain dermatologic effects, patient-reported data is needed to more accurately characterize them. This study identifies patient-reported changes in skin, hair, and nails associated with weight management treatment with GLP-1RAs, including the frequency of dermatologic effects relative to weight loss. Our study was conducted through an IRB-approved, voluntary, anonymous survey developed via collaboration between obesity medicine physicians and dermatologists. The survey was then distributed to patients of a virtual cardio–kidney–metabolic treatment program. Responses (n = 1226) were sorted by the percent body weight lost and categorized by medication regimen (glucagon-like peptide 1-receptor agonists; GLP-1RA, nonGLP-1RA, or combination therapy). Patients reported dermatologic and overall physical changes. Dermatologic effects were reported more frequently with greater weight loss. Of respondents reporting greater than 20
Scalp psoriasis is often associated with poor adherence to topical therapy. A novel formulation of calcipotriol and betamethasone dipropionate based on polyaphron dispersion (CAL/BDP PAD-cream) showed improved outcomes and satisfaction in the PRO-SCALP study, particularly in patients with high adherence. We evaluated how adherence to CAL/BDP PAD-cream influences patients- and clinicians-reported outcomes and treatment preferences in mild-to-moderate scalp psoriasis under real-life conditions in Europe. PRO-SCALP patients reported their adherence level using a visual analogue scale (VAS). Outcomes were compared between low- and high-adherence subgroups. Among 252 patients, 59.9
