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Equitable access to biologic therapies in a psoriasis safety-net clinic: A retrospective cohort study. 在银屑病安全网诊所公平获得生物治疗:一项回顾性队列研究。
IF 2.2 4区 医学 Q2 DERMATOLOGY Pub Date : 2025-12-22 DOI: 10.1016/j.clindermatol.2025.12.002
Sammya Mufarrej, Franco Rongioletti, Paolo Romanelli

Access to biologic therapies for psoriasis remains uneven among uninsured or underinsured patients, despite safety-net systems and manufacturer assistance. A retrospective cohort study examined all patients treated for psoriasis at the Psoriasis Biologics Clinic at Jackson Memorial Hospital (Miami, Florida) from January 2020 to May 2025. With no exclusions, the cohort reflected the full clinic population. The study assessed eligibility and initiation of biologics within a model combining hospital financial assistance and manufacturer support. Among 187 patients (mean age 52.7 years; 55.6% women), 67.4% were prescribed biologics. Most identified as Hispanic, with smaller African-American and non-Hispanic White groups. Adalimumab and secukinumab were the most common therapies. Insurance sources included government programs, hospital assistance, and underinsured plans. Barriers to starting biologics were reported in 15.5% of patients, mainly due to insurance denials or lapses. Nearly all patients had no copay, and those using the Jackson Financial Assistance Program received biologics at no cost. Although this safety-net model enabled most patients to access biologics, ongoing racial and insurance-related disparities indicate the need for broader structural and policy solutions to achieve durable equity in care.

对于没有保险或保险不足的患者,即使有安全网系统和制造商的援助,获得牛皮癣生物疗法的机会仍然不均衡。一项回顾性队列研究调查了2020年1月至2025年5月在杰克逊纪念医院(佛罗里达州迈阿密)银屑病生物制剂诊所接受银屑病治疗的所有患者。没有排除,队列反映了全部临床人群。该研究在医院财政援助和制造商支持相结合的模式下评估了生物制剂的资格和启动。187例患者(平均年龄52.7岁,女性55.6%)中,67.4%的患者服用了生物制剂。大多数是西班牙裔,少数是非裔美国人和非西班牙裔白人。阿达木单抗和secukinumab是最常见的治疗方法。保险来源包括政府计划、医院援助和保险不足计划。15.5%的患者开始使用生物制剂存在障碍,主要是由于保险拒绝或疏忽。几乎所有患者都没有共付费用,而那些使用杰克逊卡援助的患者则免费获得了生物制剂。虽然这种安全网模式使大多数患者能够获得生物制剂,但持续存在的种族和保险相关差异表明,需要更广泛的结构和政策解决方案,以实现持久的护理公平。
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引用次数: 0
Self-made journals in dermatology: Navigating the ethical landscape of dermatologist-sponsored independent journals. 皮肤病学自制期刊:皮肤科医生赞助的独立期刊的伦理景观导航。
IF 2.2 4区 医学 Q2 DERMATOLOGY Pub Date : 2025-11-24 DOI: 10.1016/j.clindermatol.2025.11.003
Julia Ross, Camilla M Lee, Timothy Klufas, Albert E Zhou, Jane M Grant-Kels

Dissemination of research findings is a crucial part of academic progress; however, many barriers to publishing in dermatology may prevent equitable researcher involvement and representation. The term "independent journal" (IJ) is not yet widely established in the academic literature. IJs refer to self-initiated and potentially self-sponsored journals. IJs are typically initiated by individual clinicians or small groups rather than well-established organizations or commercial entities and have the goal of disseminating new research ideas or filling a current gap in the literature. Although many IJs in dermatology have gained respect and contribute meaningfully to the field, there are ethical concerns regarding potential founding-sponsorship bias, peer-review protocols, and the resources used to ensure academic quality. To avoid potential ethical concerns regarding IJs' credibility, the goals of the journal and the peer-review processes should be clearly delineated. IJs offer the opportunity to make research more accessible and transform the publishing industry. Herein, we define and delineate IJs from other journals, while exploring ethical issues and directions for clinicians to consider when studying or creating journals.

研究成果的传播是学术进步的重要组成部分;然而,许多障碍发表在皮肤病学可能会阻止公平的研究人员参与和代表性。独立期刊(Independent Journal, IJ)一词在学术文献中尚未广泛确立。ij指的是自主创办和潜在的自费期刊。ij通常由临床医生个人或小团体发起,而不是成熟的组织或商业实体,其目标是传播新的研究思想或填补当前文献中的空白。虽然许多皮肤病学的ij已经获得了尊重,并为该领域做出了有意义的贡献,但在潜在的创始赞助偏见、同行评审协议和用于确保学术质量的资源方面存在伦理问题。为了避免潜在的关于ij可信度的伦理问题,期刊和同行评议过程的目标应该清楚地描述。ij有机会使研究更容易获得,并代表着改变出版业的机会。在此,我们定义和描述来自其他期刊的ij,同时探索临床医生在研究或创建期刊时需要考虑的伦理问题和方向。
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引用次数: 0
Anatolian contribution to surgery and medicine in the 15th century - Şerefeddin Sabuncuoğlu. 15世纪安纳托利亚对外科和医学的贡献- Şerefeddin Sabuncuoğlu。
IF 2.2 4区 医学 Q2 DERMATOLOGY Pub Date : 2025-11-11 DOI: 10.1016/j.clindermatol.2025.11.002
Uwe Wollina, Ayşe Serap Karadağ

Şerefeddin Sabuncuoğlu (1385 to 1468 or 1470), a physician and surgeon from Amasya in Anatolia, is the author of three major books on pharmacy, medicine, and surgery, as well as the author of the first illustrated surgical textbook in the Turkish-Islamic literature, Cerrahiyyet'ul-Haniyye (Imperial Surgery), written in Turkish. It is the first book to contain colored illustrations of surgical procedures and instruments. Sabuncuoğlu was an unpretentious, curious, and intelligent physician and surgeon, a calligrapher, and a miniature artist. Although the teachers of medicine and the surgeons in Central Anatolia used his book, it was ignored by the Ottoman scientific elite in Istanbul during his lifetime.

Şerefeddin Sabuncuoğlu(1385年至1468年或1470年),来自安纳托利亚阿马西亚的内科医生和外科医生,著有三本关于药剂学、医学和外科的主要著作,也是土耳其-伊斯兰文学Cerrahiyyet'ul-Haniyye(帝国外科)中第一本带插图的外科教科书的作者,该书用土耳其语写成。这是第一本包含外科手术过程和仪器的彩色插图的书。Sabuncuoğlu是一位谦逊、好奇、聪明的内科医生、外科医生、书法家和微型艺术家。尽管安纳托利亚中部的医学教师和外科医生使用过他的书,但在他有生之年,伊斯坦布尔的奥斯曼科学精英却对他的书视而不见。
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引用次数: 0
Tadeusz Stępniewski: Polish dermatologist and “Righteous Among the Nations” Tadeusz stepeniewski:波兰皮肤科医生和“正义的国家”。
IF 2.2 4区 医学 Q2 DERMATOLOGY Pub Date : 2025-11-01 Epub Date: 2025-10-03 DOI: 10.1016/j.clindermatol.2025.09.023
Sophie Walter BMed, MD, BSc(Med) (Hons)
This presentation presents the life and career of Tadeusz Stępniewski (1905-1987), a Polish dermatologist awarded the title “Righteous Among the Nations” for his bravery saving Jews during the Holocaust, collates information about other dermatologists who have also received the title and reflects on the place of virtue in the profession. Various sources were used to provide information about Stępniewski, including copies of materials held by the Archives Department of Yad Vashem, Israel’s Holocaust memorial authority. At the outbreak of World War II, Stępniewski had a private dermatology practice in central Warsaw and was affiliated with the Skin and Venereal Diseases Clinic at the University of Warsaw. During the German occupation, he assisted Jews by helping them escape from the Warsaw ghetto, hiding them in various locations, providing dermatologic care and other medical treatments, contributing to an underground medical publication, and giving financial aid. Stępniewski is one of seven dermatologists who have received the Righteous Among the Nations title. Their heroic deeds bring to the forefront the role of virtue in all aspects of the lives of dermatologists and other medical professionals.
Tadeusz Stepniewski(1905-1987)是一位波兰皮肤科医生,因其在大屠杀期间拯救犹太人的英勇行为而被授予“国际正义”称号,他的生活和职业生涯整理了其他获得该称号的皮肤科医生的信息,并反思了美德在该职业中的地位。提供关于斯特普涅夫斯基的信息使用了各种来源,包括以色列大屠杀纪念机构亚德瓦谢姆档案馆持有的材料副本。第二次世界大战爆发时,斯特普涅夫斯基在华沙市中心开了一家私人皮肤科诊所,隶属于华沙大学的皮肤和性病诊所。在德国占领期间,他帮助犹太人逃离华沙隔都,把他们藏在不同的地方,提供皮肤护理和其他医疗服务,为地下医学出版物撰稿,并提供经济援助。斯蒂芬尼夫斯基是七位获得“国际正义”称号的皮肤科医生之一。他们的英雄事迹使美德在皮肤科医生和其他医疗专业人员生活的各个方面发挥了重要作用。
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引用次数: 0
Primary cutaneous mucinoses in connective tissue diseases as a diagnostic and prognostic challenge 结缔组织疾病的原发性皮肤粘液病作为诊断和预后的挑战。
IF 2.2 4区 医学 Q2 DERMATOLOGY Pub Date : 2025-11-01 Epub Date: 2025-10-03 DOI: 10.1016/j.clindermatol.2025.09.028
Giorgio Stabile MD , Nazario Pesce MD , Giorgia Di Marco MD , Antonio Podo Brunetti MD , Gianmarco Diego Bigotto MD , Stefania Guida MD , Franco Rongioletti MD
Mucin deposition in the skin, a hallmark feature in dermatopathology, is frequently associated with connective tissue diseases such as lupus erythematosus, dermatomyositis, and, to a lesser extent, scleroderma. Although mucin deposition commonly accompanies specific skin lesions in lupus erythematosus, dermatomyositis, and sometimes scleroderma, its occurrence as a distinct clinical manifestation with defining histopathologic features is rare. Such presentations that are classified as primary cutaneous mucinoses not only aid in diagnosis but may also have prognostic implications. This study systematically reviews the literature to evaluate case demographics, clinical characteristics, histologic findings, immunologic markers, and treatment responses of primary cutaneous mucinoses linked to connective tissue diseases. Our findings highlight that mucin deposition exhibits variable presentations and serves as a valuable diagnostic clue, particularly when integrated with other clinical and histopathologic criteria.
Mucin, a high-molecular-weight glycoprotein complex primarily composed of hyaluronic acid, is a standard component of dermal connective tissues. It is produced in small amounts by fibroblasts and mast cells and is known for its high water-holding capacity. Excessive mucin deposition, however, which can occur in certain pathologic states, leads to dermal swelling known as myxedema. Cutaneous mucinosis is often associated with connective tissue diseases, in which mucin deposition can serve as histologic evidence for conditions such as lupus erythematosus (LE) or dermatomyositis (DM), particularly in the appropriate clinical context. Less frequently, mucin is also observed in scleroderma cases.1,2 Although mucin deposition can accompany specific skin lesions in LE and DM, cases in which it is a prominent and defining histopathologic feature are rare. Such cases classified into the chapter of primary cutaneous mucinoses have diagnostic value and may also serve as prognostic indicators. This review assesses the diagnostic and prognostic significance of primary cutaneous mucinoses associated with connective tissue diseases.
皮肤中的粘蛋白沉积是皮肤病理学的一个标志性特征,通常与结缔组织疾病如红斑狼疮(LE)、皮肌炎(DM)以及在较小程度上与硬皮病有关。尽管粘蛋白沉积通常伴随着LE、DM和硬皮病的特定皮肤病变,但其作为明确的组织病理学特征的独特临床表现是罕见的。这些被归类为原发性皮肤粘液病的表现不仅有助于诊断,而且可能具有预后意义。本研究系统地回顾文献,以评估与结缔组织疾病相关的原发性皮肤粘液病的病例人口统计学、临床特征、组织学表现、免疫标志物和治疗反应。我们的研究结果强调粘蛋白沉积表现出不同的表现,并作为一种有价值的诊断线索,特别是当与其他临床和组织病理学标准相结合时。
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引用次数: 0
Rethinking research metrics in dermatology and beyond 重新思考皮肤病学及其他领域的研究指标。
IF 2.2 4区 医学 Q2 DERMATOLOGY Pub Date : 2025-11-01 Epub Date: 2025-08-26 DOI: 10.1016/j.clindermatol.2025.08.002
Waseem Hassan PhD , Fred Paas PhD
Assessing academic performance in dermatology is an interesting and evolving challenge. Early-career researchers often look for clear indicators to identify leading authors; however, reliance on single measures such as citation counts or the h-index provides only a limited view of scholarly influence. Using diverse bibliometric indicators from Scopus, we observed that author rankings shifted considerably depending on the metric applied, reflecting the lack of agreement on how best to capture academic impact. Similarly, we noted that ethical publications (letters, notes, and related formats) in dermatology may contribute to scholarly discussions and institutional practices but often receive modest citation profiles, highlighting the gap between measurable indicators and genuine value. Inflated authorship practices and citation manipulation further complicate fair evaluation. Fractional authorship models and multidimensional frameworks that consider publication type, journal quality, collaboration, funding strength, and broader societal contributions may offer more balanced perspectives. We suggest that institutions, journals, and training programs promote the ethical use of metrics and integrate qualitative assessments alongside quantitative ones. Such an approach can foster fairness, transparency, and meaningful recognition within dermatology and academic medicine more broadly.
评估皮肤科的学术表现是一个有趣的和不断发展的挑战。早期职业研究人员经常寻找明确的指标来确定主要作者;然而,对引用数或h指数等单一指标的依赖只能提供有限的学术影响观点。通过使用来自Scopus的各种文献计量指标,我们观察到作者排名根据所采用的度量标准发生了很大的变化,这反映了在如何最好地捕捉学术影响方面缺乏共识。同样,我们注意到,皮肤病学的伦理出版物(信件、笔记和相关格式)可能有助于学术讨论和机构实践,但往往得到适度的引用,突出了可测量指标与真正价值之间的差距。夸大作者身份和引文操纵进一步使公平评价复杂化。部分作者模型和多维框架——考虑出版类型、期刊质量、合作、资金实力和更广泛的社会贡献——可能提供更平衡的观点。我们建议机构、期刊和培训项目促进指标的道德使用,并将定性评估与定量评估结合起来。这种方法可以促进皮肤病学和学术医学更广泛的公平、透明和有意义的认可。
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引用次数: 0
Lymphocytic and granulomatous cutaneous small-vessel vasculitis after polyadenosine diphosphate–ribose polymerase inhibitor therapy PARP抑制剂治疗后淋巴细胞性和肉芽肿性皮肤小血管炎。
IF 2.2 4区 医学 Q2 DERMATOLOGY Pub Date : 2025-11-01 Epub Date: 2025-10-03 DOI: 10.1016/j.clindermatol.2025.09.021
Carla Stephan MD , Cynthia Magro MD
Olaparib is a polyadenosine diphosphate–ribose polymerase (PARP) inhibitor that is used in the treatment of advanced ovarian cancer. PARP inhibitors result in the accumulation of single-strand DNA breaks that are toxic to tumor cells. PARP inhibition with a concomitant Breast cancer susceptibility gene (BRCA) mutation results in what is known as synthetic lethality to the tumor cells. Cutaneous adverse effects have been reported with PARP inhibition, namely pruritus, photosensitivity reactions, edema, vasculitis, and panniculitis. We present a case of a 36-year-old woman who developed dermatitis on the bilateral lower extremities one month after starting olaparib for advanced ovarian carcinoma. A punch biopsy taken from the eruption was consistent with a lymphocytic and granulomatous small-vessel vasculitis with a component of lobular panniculitis. The exact pathogenic mechanism of vasculitis and panniculitis in the setting of a PARP inhibitor is unclear. Given the multiple functions of PARP at the cellular level, it is not surprising that the inhibition of this superfamily may result in adverse effects. In particular, the inhibition of PARP has been shown to alter the inflammatory milieu from a Th2 predominance to a Th1 predominance. This shift in polarization may play a role in the development of vasculitis and panniculitis in such patients.
奥拉帕尼是一种聚腺苷二磷酸核糖聚合酶(PARP)抑制剂,用于治疗晚期卵巢癌。PARP抑制剂导致单链DNA断裂的积累,这对肿瘤细胞是有毒的。PARP抑制与伴随的BRCA突变导致对肿瘤细胞的合成致死。PARP抑制已报道皮肤不良反应,即瘙痒、光敏反应、水肿、血管炎和泛膜炎。我们提出了一个36岁的女性谁在开始奥拉帕尼治疗晚期卵巢癌一个月后出现双侧下肢皮疹的情况。从皮疹上取的穿刺活检符合淋巴细胞性和肉芽肿性小血管炎,伴有小叶性血管炎的成分。PARP抑制剂作用下血管炎和泛膜炎的确切致病机制尚不清楚。考虑到PARP在细胞水平上的多种功能,抑制这个超家族可能会导致不良反应也就不足为奇了。特别是,PARP的抑制已被证明可以改变炎症环境,从Th2为主转变为Th1为主。这种极化的转变可能在这些患者的血管炎和泛膜炎的发展中起作用。
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引用次数: 0
Early history of gender reassignment surgery in Prussia and Saxony 普鲁士和萨克森性别重置手术的早期历史。
IF 2.2 4区 医学 Q2 DERMATOLOGY Pub Date : 2025-11-01 Epub Date: 2025-08-05 DOI: 10.1016/j.clindermatol.2025.07.008
Uwe Wollina MD , Leonard J. Hoenig MD , Lawrence Charles Parish MD, MD (Hon), FRCP (Edin)
This contribution provides a note on the early days of gender reassignment surgery, which was pioneered by Felix Abraham, Erwin Gohrbrandt, Ludwig Levy-Lenz, and Kurt Warnekros need dates during the 1920s. Their experimental surgeries would gain significant attention through the mass media. Such reassignment surgery has been illustrated by the life and death of Danish painter Einar Wegener (1882-1931), who underwent several gender reassignment surgeries. The narratives of his life are discussed with the views of medical progress made from the early 20th century until now.
这篇文章提供了一份关于性别重置手术早期的笔记,这项手术是由费利克斯·亚伯拉罕、欧文·高布兰特、路德维希·莱维-伦茨和库尔特·沃内克罗斯在20世纪20年代首创的。他们的实验性手术通过大众媒体获得了极大的关注。丹麦画家艾纳·韦格纳(Einar Wegener, 1882-1931)接受了多次性别重新分配手术,他的生与死就说明了这种重新分配手术。从20世纪初到现在,他的生活叙述与医学进步的观点进行了讨论。
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引用次数: 0
A collection of saints for sufferers of skin diseases 《皮肤病患者圣徒集》。
IF 2.2 4区 医学 Q2 DERMATOLOGY Pub Date : 2025-11-01 Epub Date: 2025-10-01 DOI: 10.1016/j.clindermatol.2025.09.022
Uwe Wollina MD , Leonard J. Hoenig MD , Lawrence Charles Parish MD, MD (Hon), FRCP (Edin)
Religion has long served as a means to avoid disease and death or to come to terms with the inevitable. Patron saints to protect against disease and to offer a miraculous cure have been adopted in the Christian world since medieval times. The invocation of saints in need and danger is one of the most intrinsic, traditional characteristics of popular piety. More than 14 saints are known as patrons of those who suffer from skin and venereal diseases. We provide an overview of several major saints with a connection to dermatology. Although women were not uncommon among the healers of the period, women saints are very rare, reflecting the traditional medieval patriarchal order.
长期以来,宗教一直是避免疾病和死亡或接受不可避免的事情的一种手段。自中世纪以来,基督教世界一直采用守护神来预防疾病并提供奇迹般的治疗。在需要和危险中对圣人的祈求是大众虔诚最内在、最传统的特征之一。超过14位圣人被认为是皮肤和全身疾病患者的保护人。我们提供了几个主要的圣人与皮肤科的连接的概述。虽然女性在这一时期的治疗师中并不罕见,但女性圣徒却非常罕见,这反映了传统的中世纪父权秩序。
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引用次数: 0
Comment on “Beyond beauty: Neurocosmetics, the skin-brain axis, and the future of emotionally intelligent skincare” 评论“超越美丽:神经化妆品、皮肤-大脑轴和情商护肤的未来”。
IF 2.2 4区 医学 Q2 DERMATOLOGY Pub Date : 2025-11-01 Epub Date: 2025-10-08 DOI: 10.1016/j.clindermatol.2025.10.001
S. Dhanya Dedeepya MD, Vaishali Goel PhD, Nivedita Nikhil Desai MD
{"title":"Comment on “Beyond beauty: Neurocosmetics, the skin-brain axis, and the future of emotionally intelligent skincare”","authors":"S. Dhanya Dedeepya MD,&nbsp;Vaishali Goel PhD,&nbsp;Nivedita Nikhil Desai MD","doi":"10.1016/j.clindermatol.2025.10.001","DOIUrl":"10.1016/j.clindermatol.2025.10.001","url":null,"abstract":"","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":"43 6","pages":"Pages 871-872"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Clinics in dermatology
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