Isotretinoin is a highly effective treatment for severe acne vulgaris in both adult and pediatric patients. Although uncommon, isotretinoin-associated musculoskeletal adverse effects, including arthritis, remain a clinically important consideration in dermatologic practice, specifically in pediatric populations. This scoping review explores the existing literature on the incidence and clinical presentations of isotretinoin-associated arthritis in pediatric patients for early recognition, appropriate management, and risk-benefit assessment in pediatric acne treatment. A PRISMA-ScR-guided scoping review was conducted using PubMed, CINAHL, MEDLINE, and Web of Science to identify English-language primary studies published between 2000 and 2025 evaluating arthritis following isotretinoin initiation in patients under the age of 18 years. These findings suggest that isotretinoin-associated arthritis, while a rare presentation, may represent a clinically significant adverse effect in pediatric patients, particularly those with severe inflammatory acne or underlying autoinflammatory conditions. Increased clinician awareness and further prospective research are needed to identify at-risk populations and optimize management strategies.
Seborrheic dermatitis (SD) and psoriasis are common chronic inflammatory conditions with overlapping immunopathogenesis. While emerging evidence suggests potential co-occurrence of SD and psoriasis (termed “sebopsoriasis”), their association and its implications on healthcare resource utilization (HCRU) and treatment strategy remain understudied. We conducted a cross-sectional analysis of approximately 12.4 billion weighted ambulatory care visits using the 2003–2015 National Ambulatory Medical Care Survey. Regression models assessed the association between SD and psoriasis and differences in HCRU, and chi-square assessed differences in medication prescribing patterns. Between 2003 and 2015, approximately 0.10
The management of keloids remains clinically challenging. While intralesional corticosteroid injection is the first-line treatment, it is limited by pain, secondary scarring, and variable efficacy. Dermoscopy holds significant potential to guide and optimize clinical management. This study aims to explore whether pretreatment dermatoscopic features of keloids can predict response to corticosteroid injection. Fifty-nine proliferative keloids treated with intralesional corticosteroid injection alone were included. Demographic data, clinical characteristics, Vancouver Scar Scale (VSS) scores, and dermoscopic images were collected. The primary outcome was the treatment response at the 1-year follow-up. The relationship between baseline dermoscopic features and the outcome was analyzed. Among 59 lesions, 20 (33.9
This study investigated whether the development of cutaneous viral warts is associated with ABO and Rh blood groups. A total of 113 patients who presented to the dermatology outpatient clinic between January 2020 and November 2025 and were clinically diagnosed with verrucae, along with 250 age- and sex-matched healthy individuals, were retrospectively evaluated. ABO blood group, Rh status, and demographic characteristics were compared using the chi-square test and the independent samples t-test; independent variables affecting the presence of warts were analyzed using multiple logistic regression. The most common blood group in the patient group was O (44.2
Acne vulgaris (AV) is a chronic inflammatory disorder of the pilosebaceous unit in which pro-inflammatory cytokines contribute to lesion development and severity. Oral isotretinoin is an effective treatment for moderate-to-severe AV, but its systemic and transcriptional immunomodulatory effects remain incompletely characterized. This study aimed to investigate serum cytokine levels and expression profiles of selected pro-inflammatory markers in patients with AV before and after oral isotretinoin treatment. Fifty patients with moderate-to-severe AV receiving oral isotretinoin therapy and fifty healthy controls were enrolled. Serum levels of IL-1α, IL-1β, TNF-α, IL-8 and IFN-γ were quantified by multiplex ELISA, and peripheral blood leukocyte mRNA expression of the same targets was assessed by RT-qPCR. Paired pre/post comparisons, comparisons with healthy controls, and correlation analyses were performed. Serum levels of pro-inflammatory cytokines decreased after isotretinoin therapy, accompanied by reduced transcript levels of these mediators. Gene expression and serum concentrations were positively correlated for all evaluated cytokines. Change in acne severity (∆IGA) was significantly associated with reduction in serum IL-1β levels, whereas the association with IL-8 did not remain significant after correction for multiple testing. Oral isotretinoin therapy was associated with coordinated suppression of key pro-inflammatory pathways at both transcript and protein levels. The association between clinical improvement and decreased IL-1β supports a potential role for the IL-1β axis in treatment-associated inflammatory change. These findings suggest that IL-1β may represent a potential biomarker of treatment-associated inflammatory modulation, although further validation is required.
Basosquamous carcinoma (BSC) is a non-melanoma skin cancer that shares features of both basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) and exhibits higher rates of recurrence and metastasis than conventional BCC. Clinically, it cannot be reliably distinguished from BCC; however, dermoscopy and reflectance confocal microscopy may assist in diagnosis, revealing both basaloid and squamous characteristics. Histopathology, complemented by immunohistochemical techniques, remains the gold standard. To date, no consensus exists regarding optimal management, and prospective studies are needed to better characterize the biology, treatment, and prognosis of this tumor. Wide local excision and Mohs micrographic surgery are the most widely used therapeutic approaches. Sentinel lymph node biopsy, chemotherapy and radiotherapy are supported only by limited evidence; however, radiotherapy may play a palliative role when surgery is not feasible. Novel therapies under investigation include Sonic Hedgehog pathway inhibitors and anti–PD-1 immune checkpoint inhibitors; case reports have demonstrated encouraging results, supporting their potential as alternatives for unresectable, locally advanced, or metastatic BSC. Overall, current evidence positions BSC as molecularly closer to BCC, while its clinical behavior warrants management as high-risk BCC with cSCC-like vigilance.
The association between psychiatric disorders and dermatological conditions is well recognized; however, it remains underexplored in individuals with severe mental illness. This study aims to determine the prevalence and types of dermatological manifestations, help-seeking behavior, and their relationship with clinical characteristics among psychiatric inpatients. This cross-sectional study included 128 patients hospitalized in general psychiatry wards at a tertiary psychiatric center. Comprehensive dermatological examination and psychiatric assessment were conducted. Psychiatric and dermatological diagnoses were made according to DSM-5-TR and ICD-10 criteria, respectively. Among 128 participants, 66 (51.6
Recent evidence in psoriasis suggests that alterations in cutaneous nerve fibers may play a crucial role in its pathogenesis, yet specific changes in intraepidermal nerve fiber (IENF) require further understanding. The purpose was to quantify IENF density (IENFD) in psoriatic lesions and non-lesional skin to investigate its relationship with disease severity and pruritus. Histopathologically confirmed psoriasis patients were retrospectively analyzed. IENFD was measured using immunofluorescence staining of paraffin-embedded skin samples. The results presented a significant reduction in IENFD in psoriatic lesions compared to non-lesional skin (p < 0.01). However, no significant correlation was observed between IENFD and disease or itch severity. These findings align with a few studies reporting reduced IENFD in psoriatic skin and suggest potential neural involvement in psoriasis. The study also highlights the utility of paraffin-embedded tissue for IENF analysis often processed by cryosectioning, expanding its applicability for future research.
Educational materials in dermatology underrepresent skin of colour (SOC), despite well-recognized differences in disease presentation and surgical outcomes. We evaluated SOC representation in widely adopted dermatologic surgery textbooks, focusing on images across Fitzpatrick skin types (FST). Two independent reviewers analyzed 3,334 figures from seven textbooks, classifying FST and recording diagnoses, procedures, and pigmentation findings. Only 8.7
The comparative efficacy and safety of small molecule drugs versus adalimumab and its biosimilars in plaque psoriasis remain insufficiently characterized. This systematic review and network meta-analysis, conducted in accordance with PRISMA guidelines, synthesized evidence from PubMed, Web of Science, and Embase, including 32 studies with a total of 14,622 patients across 30 treatment regimens. A Bayesian random-effects network meta-analysis was conducted using the GeMTC package in R to evaluate primary outcomes (PASI-75 and PGA 0/1) and secondary outcomes (PASI-90, PASI-100, and DLQI 0/1). Safety was assessed by adverse event incidence and treatment discontinuation rates. Results showed that HLX03 had the highest probability of achieving PASI-75 (86.6
Rosacea is a chronic inflammatory facial dermatosis that disproportionately affects women and may fluctuate during periods of hormonal transition. Fluctuations in estrogen levels across the female lifespan have been hypothesized to contribute to the development of inflammatory, pigmentary, and androgen-mediated dermatologic conditions. However, population-level data evaluating the association between estrogen exposure and incident rosacea across hormonally defined life stages remain limited. This study aimed to evaluate whether exogenous estrogen exposure is associated with differences in incident rosacea risk across premenopausal, perimenopausal, and postmenopausal women. A retrospective cohort study was conducted using the TriNetX Research Network. Female patients were stratified into premenopausal (18–43 years), perimenopausal (45–55 years), and postmenopausal (≥ 56 years) cohorts. Within each age stratum, estrogen-exposed patients, defined by documented estrogen-containing hormonal contraceptive use or hormone replacement therapy use, were propensity score-matched 1:1 to estrogen-unexposed controls. The primary outcome was incident rosacea (ICD-10 L71.x) within three years following the index event. Secondary outcomes included other/unspecified rosacea [L71.8, L71.9], perioral dermatitis [L71.0], and rhinophyma [L71.1]. Perioral dermatitis was included because of its recognized clinical and diagnostic overlap with rosacea. Time-to-event analyses were performed using Kaplan–Meier methods and Cox proportional hazards models. After matching, cohorts included 742,051 premenopausal, 54,248 perimenopausal, and 378,572 postmenopausal women per exposure group. Across all age groups, estrogen exposure was associated with a significantly lower recorded incidence of rosacea. Hazard ratios (HR) were 0.75 (95
To investigate the correlation between clinical sub-types of melasma and fecal gut microbiota, providing a theoretical basis for personalized treatment and novel microbial-based therapies for melasma. A total of 120 melasma patients were enrolled. Reflectance confocal microscopy (RCM) was used to classify lesions into epidermal- type (ET) and mixed-type (MT) based on melanin distribution. According to inclusion and exclusion criteria, 11 epidermal-type and 9 mixed-type patients were finally included. Fecal samples were collected, and 16 S rRNA sequencing was performed to analyze the composition and differences in gut microbiota between the two groups. Gut microbiota analysis revealed 535 operational taxonomic units (OTUs) clustered at 97
