Dermatology and Therapy最新文献

Introduction: Biologic therapies have significantly improved treatment options for patients with moderate-to-severe psoriasis. Brodalumab's effectiveness, efficacy, and safety have been demonstrated in clinical trials. Real-world data are now available to confirm these outcomes in diverse populations, including those at higher risk of reduced treatment response.

Methods: This observational, prospective, multicentre study included 143 patients between 2020 and 2022. Baseline data included demographics, medical history, Psoriasis Area and Severity Index (PASI), presence of high-impact areas (HIA), Dermatology Life Quality Index (DLQI), comorbidities, and prior treatments. Follow-up visits (weeks 12-16 and 52) documented PASI, DLQI, and drug survival. The analysis focused on four potential modifiers of treatment response: body mass index (BMI), biologic treatment history, number of HIA, and age.

Results: Brodalumab demonstrated effectiveness and safety in patients with moderate-to-severe psoriasis requiring systemic therapy. Time of exposure to brodalumab was 13 months (52 weeks ± 4). At weeks 12/16, 49.6% achieved PASI 100, sustained in 61.9% at week 52. DLQI scores improved at both follow-ups, with increased proportions achieving DLQI ≤ 1. At week 52, PASI 100 and DLQI ≤ 1 were observed in 62.5% and 73.2% of patients with overweight, 48.6% and 61.8% of patients with obesity, respectively. Among older patients, 60.9% achieved PASI 100 and 65.2% reported DLQI ≤ 1. In patients with ≥ 2 HIA, 60.0% achieved PASI 100 and 68.9% experienced DLQI ≤ 1. Response was favourable across treatment history: 65.5% of bionaïve and 51.7% of bioexperienced patients achieved PASI 100; DLQI ≤ 1 was observed in 75.0% and 64.3%, respectively. Drug survival was high overall (94.6%) and across subgroups (88.3-100%). The safety profile was consistent with clinical trial data.

Conclusion: Real-world data supports brodalumab use as a valuable long-term treatment for HIA and specific subpopulations such as older, bionaïve, bioexperienced, and patients with overweight or obesity. This article is a post hoc analysis of the PSO-TARGET clinical trial (Evaluation of the Sensitivity and Specificity of a Novel Quality of Life Tool to Assess the Treatment Satisfaction in Psoriasis Patients).

Trial registration: ClinicalTrial.gov, NCT04765332.

Introduction: Hyperpigmentation disorders and skin tone unevenness are a very frequent concern worldwide, especially in China; 2-mercaptonicotinoyl glycine (2-MNG, Melasyl^®) is an innovative anti-pigmentation ingredient which binds with melanin precursors, being an alternative to tyrosinase inhibitors. Our goal was to evaluate the effects of a 2-MNG-containing serum on improving facial skin tone evenness and hyperpigmentation.

Methods: Two clinical studies were conducted in China. Clinical study 1, a randomised controlled intra-individual study, included 32 healthy individuals (individual typology angle, ITA° value within 20-41° at test back area), using a ultraviolet (UV)-induced pigmentation model. Three areas were selected and treated with either the tested serum, a positive control, or a negative control. Skin pigmentation was assessed over 4 weeks of product use, comparing the results of treated areas with the negative control. Clinical study 2, an open label study, included 42 healthy female individuals presenting at least one dark spot on their face, treated during the 56 days with the tested serum twice a day. Skin colour and melanin index were assessed over time including 7 days after discontinuation. Individual typology angle, ITA°, is a parameter for characterising human skin colour by measuring skin L*a*b* colour-space data with a skin colorimeter or a reflectance spectrophotometer. Melanin index, MI, is a parameter for characterising skin melanin content by measuring the absorption of specific wavelengths at the skin surface.

Results: The 2-MNG-containing serum can significantly improve ITA° value, MI and visual skin colour score. It also significantly improves skin brightness and reduces melanin content in facial skin and dark spots. Additionally, it offers moisturising benefits, helps improve the appearance of wrinkles and shows good tolerance.

Conclusions: The 2-MNG-containing serum reduces melanin content in the skin and leads to significant improvements on dark spots and skin brightening. It also has good tolerance and is suitable for sensitive skin.

Introduction: A matching-adjusted indirect comparison evaluated the short-term efficacy of lebrikizumab plus topical corticosteroids (TCS) versus dupilumab plus TCS in adults with moderate-to-severe atopic dermatitis (AD).

Methods: Individual patient data from the ADhere trial (lebrikizumab 250 mg every 2 weeks [Q2W] plus TCS) and aggregate data from the CHRONOS trial (dupilumab 300 mg Q2W plus TCS) were matched using the method of moments approach to adjust baseline differences. Matching was done at the study level (primary analysis) and at the study arm level (sensitivity analysis). Efficacy endpoints up to week 16 included the proportion of patients achieving an Investigator's Global Assessment of 0 or 1 (IGA 0/1); a ≥ 50%, ≥ 75%, and ≥ 90% improvement from baseline in the Eczema Area and Severity Index (EASI 50/75/90); a ≥ 4-point improvement from baseline in the Pruritus Numerical Rating Scale score (PNRS ≥ 4); and a ≥ 4-point improvement from baseline in the Dermatology Life Quality Index score (DLQI ≥ 4). Placebo-adjusted efficacy outcomes were compared using odds ratios (ORs), risk ratios (RRs), and risk differences (RDs) with 95% confidence intervals (CIs).

Results: At week 16, lebrikizumab plus TCS had comparable odds to dupilumab plus TCS of achieving EASI 75 (OR 1.14, 95% CI 0.42-3.09), IGA 0/1 (OR 1.39, 95% CI 0.42-4.59), PNRS ≥ 4 (OR 0.48, 95% CI 0.17-1.37), and DLQI ≥ 4 (OR 0.89, 95% CI 0.29-2.69). At earlier timepoints, lebrikizumab plus TCS had comparable odds to dupilumab plus TCS of achieving PNRS ≥ 4 at week 2 (OR 2.04, 95% CI 0.24-17.05) and week 4 (OR 3.59, 95% CI 0.90-14.36). RR and RD estimates were consistent with OR estimates of efficacy. Sensitivity analyses confirmed the findings of the primary analysis.

Conclusion: Lebrikizumab plus TCS was comparable to dupilumab plus TCS across all efficacy endpoints at week 16.

Introduction: Sonidegib and vismodegib are Hedgehog pathway inhibitors (HHIs) approved for the treatment of locally advanced basal cell carcinoma (laBCC), as well as metastatic basal cell carcinoma (mBCC) for vismodegib. Few studies have compared real-world treatment patterns associated with HHI treatment. The objective of this study was to investigate the real-world treatment patterns and conditions of patients receiving HHIs for BCC.

Methods: In this longitudinal study, claims from the Komodo Health Claims Database (between 2016 and 2023) were used to identify patients. Baseline characteristics and comorbidities of patients were assessed. Time to treatment discontinuation (TTD), odds of discontinuation, and clinical conditions experienced during treatment were analyzed.

Results: Patients who received sonidegib remained on treatment longer than those on vismodegib (log-rank test; P = 0.041) and were 23% less likely (P = 0.036) and 32% less likely (P = 0.013) to discontinue treatment at 6 and 9 months, respectively. Sonidegib-treated patients were less likely to experience gastrointestinal-related conditions (33% less likely; P = 0.045), taste- and smell-related conditions (71% less likely; P = 0.048), and muscle spasms (52% less likely; P = 0.009) during treatment compared with patients who received vismodegib.

Conclusion: In the real-world setting, sonidegib-treated patients remained on treatment longer than vismodegib-treated patients and were less likely to experience pharmacologically relevant clinical conditions.

Introduction: Psoriasis is a chronic inflammatory skin disease with a global prevalence of 1-5%, however its clinical and demographic profile in Kenya remains underexplored. This article describes the establishment of the Kenyan Psoriasis Registry at Moi Teaching and Referral Hospital in Eldoret, Kenya.

Methods: 214 subjects were enrolled between October 2024 and August 2025 at Moi Teaching and Referral Hospital. Both healthy controls and patients with psoriasis completed enrollment surveys and physical exams, and donated saliva samples.

Results: The initial cohort of 214 subjects (108 patients with psoriasis, 106 healthy controls) provides valuable insights into the demographics, clinical profiles, quality of life, and mental health characteristics of patients with psoriasis in Kenya. The mean age of psoriasis onset was 30.4 years, and mean age of diagnosis by a medical provider was 38.9 years old. 13.9% of patients with psoriasis reported a positive family history of psoriasis, and 9.3% of patients with psoriasis reported a diagnosis of psoriatic arthritis. The mean psoriasis area and severity index was 9.9 and mean Investigator Global assessment score was 3.0. Examination of treatment patterns revealed that moisturizers, prescription topical medications, and methotrexate were commonly tried while only 9.3% of individuals had ever received a biologic therapy. Patients with psoriasis reported significantly worse sleep disturbance, quality of life, and mental health compared to healthy controls.

Conclusion: This data highlights the unique characteristics of patients with psoriasis in Kenya. The Kenyan Psoriasis Registry continues to enroll patients and conduct yearly follow-ups, aiming to deepen the understanding of psoriasis in this population. These findings underscore the need for targeted research and advocacy to improve psoriasis care in Kenya.

Atopic dermatitis (AD) is a chronic inflammatory skin condition characterized by intense itching, redness, and eczema. It significantly impacts the quality of life of affected individuals, often requiring long-term management strategies. Abrocitinib, an oral Janus kinase 1 (JAK1) inhibitor, is approved for the treatment of moderate-to-severe AD. Phase 2 and phase 3 abrocitinib randomized clinical trials in the JAK1 Atopic Dermatitis Efficacy and Safety (JADE) clinical development program have demonstrated the efficacy and safety of abrocitinib in both adults and adolescents with moderate-to-severe AD. This review article explores the benefit-risk profile of a flexible abrocitinib dosing approach, tailoring dose based on individualized treatment of patients and highlighting the available supportive data from the JADE randomized clinical trials for healthcare professionals as part of joint provider-patient decision making. Dosing flexibility and maintenance with the lowest effective dose is necessary to treat patients according to their individual disease course while minimizing safety risks. Safety data indicate that incidence of treatment-emergent adverse events is reflective of the current dosage, with no carry-over risk from a previous higher dosage. Overall, abrocitinib represents a valuable AD therapy that can be administered according to individual patient needs.Graphical abstract available for this article.

Cutaneous T cell lymphomas (CTCL) are non-Hodgkin T cell malignancies defined by malignant T cell transformation and accumulation in the skin. Limited understanding of CTCL pathogenesis, including the role of the tumor microenvironment, hinders effective treatment. Emerging evidence implicates the skin microbiota as a key modulator of disease, with microbial dysbiosis contributing to progression and representing a novel therapeutic target. This review synthesizes findings from 37 rigorously selected studies, outlining current knowledge of the CTCL-associated microbiome, mycobiome, and virome. It evaluates therapeutic strategies aimed at microbial colonization, emphasizing the potential of modulating host-microbe interactions. Additionally, we provide comprehensive clinical insight into the indications for microbial-modulating strategies of the microbiota in CTCL.

Introduction: Management of atrophic acne scars remains challenging, and conventional treatments often yield suboptimal or inconsistent outcomes. Stromal vascular fraction (SVF), a cell-rich fraction derived from adipose tissue, has recently gained attention as a promising regenerative therapy. Several previous studies have reported benefits of SVF when combined with other treatment modalities; however, its stand-alone efficacy for atrophic acne scars has not been clearly investigated. In addition, molecular evidence supporting the regenerative effects of SVF in acne scar treatment remains limited.

Methods: This randomized, evaluator-blinded, split-face clinical trial was conducted in 14 patients with bilateral facial atrophic acne scars. One side was treated with intradermal SVF injection, while the contralateral side received normal saline (NS). Clinical outcomes were assessed using scar counts, Évaluation Clinique des Cicatrices d'Acne (ECCA) scores, Scar Global Assessment (SGA) scores, and standardized photography at baseline, 5 weeks, and 10 weeks. Skin biopsies were analyzed via immunohistochemistry for markers of epidermal regeneration (cytokeratin 14, cytokeratin 15, p63, integrin β1) and dermal remodeling (collagen I, elastin, vimentin).

Results: At 10 weeks after initial treatment, the SVF-treated side showed a significantly greater reduction in total scar count compared to the NS-treated side (56.4% vs. 13.2%, p < 0.001). Scar subtype analysis revealed that all scar types (ice pick, boxcar, and rolling) responded more favorably to SVF treatment, with large effect sizes (Cohen's d > 0.99). ECCA and SGA scores were also significantly decreased on the SVF-treated side. Immunohistochemical analysis revealed marked upregulation of epidermal progenitor markers and increased deposition of collagen I, elastin, and vimentin in the SVF-treated tissue.

Conclusion: We clinically demonstrated that SVF injection improves atrophic acne scars and simultaneously revealed its regenerative mechanisms involving epidermal and dermal remodeling. This supports the use of SVF as an evidence-based treatment modality for atrophic acne scars.

Trial registration: ClinicalTrials.gov Identifier, NCT07094958.

Chronic spontaneous urticaria (CSU) is a debilitating inflammatory skin disorder characterized by recurrent wheals and/or angioedema lasting beyond 6 weeks without identifiable triggers. Recent advances have shifted the understanding of CSU from a historically idiopathic condition to one increasingly recognized as an immune-mediated disease with distinct endotypes, including type I (autoallergic) and type IIb (autoimmune). This narrative review synthesizes contemporary insights into CSU pathophysiology, endotype classification, and systemic manifestations, while highlighting the substantial impact on quality of life, sleep, and psychological health. Advances in biomarker research, including total serum immunoglobulin E (IgE) levels, basophil activation tests (BAT), and eosinophil counts, support progress toward personalized treatment approaches. Therapeutically, management of CSU has evolved from empirical symptom control with H1 antihistamines toward mechanism-based precision medicine. Omalizumab remains the established second-line therapy, and dupilumab received US Food and Drug Administration (FDA) approval in 2025 for antihistamine-refractory disease. In parallel, several targeted therapies are under investigation, including Bruton's tyrosine kinase (BTK) inhibitors, anti-KIT antibodies, and Janus kinase (JAK) inhibitors. These therapeutic mechanisms may offer sustained benefit, though long-term outcomes require validation through controlled trials. Integration of psychological interventions, such as cognitive behavioral therapy combined with pharmacotherapy, underscores the need for holistic patient care. Despite these advances, challenges remain in biomarker validation, sequencing of new therapies, and bridging clinical trial evidence with real-world practice. Future directions include refining endotype-driven personalized care, conducting long-term real-world studies, and developing cost-effective, globally accessible treatment strategies to optimize patient outcomes.

Introduction: Atopic dermatitis (AD) is a chronic inflammatory skin condition requiring long-term management to maintain remission and prevent relapse. Appropriate use of topical anti-inflammatory medications is an important factor in improving symptoms in patients with AD. This study aimed to investigate the treatment methods for maintaining remission and application of anti-inflammatory topical therapy.

Methods: This observational study was conducted in October 2022, using medical claims data from DeSC Healthcare Inc., linked with survey data collected from users of kencom®, a health promotion application. Eligible patients were adults aged ≥ 19 years with a confirmed AD diagnosis and prescription history. The survey evaluated (1) the actual treatment situation during the remission maintenance phase; and (2) instructions, actual status and adherence for application of anti-inflammatory topical therapy.

Results: A total of 626 patients who answered the kencom® survey and met eligibility criteria were included. Of these, 42.3% were instructed to stop medication once eczema improved, while 34.2% were instructed to continue during remission. Regarding instructions for the amount applied, the most common response was "No specific instructions" (44.2%), followed by "Fingertip-unit (FTU)" (27.2%). In actual practice, "FTU" was the most common amount (42.2%). Regarding application area, the most frequent instruction and actual practice were "Apply only to areas with eczema with remaining inflammation" at 52.6% and 62.5%, respectively, followed by "Apply not only to the eczema or remaining inflamed areas but also the surrounding areas" at 24.0% and 37.2%. Regarding the application method, "Apply thinly" was the most common instruction and actual practice at 32.7% and 48.4%, respectively. Treatment adherence rates were generally high, at over 60%.

Conclusion: Guidance from healthcare professionals has a crucial role in the proper use of topical therapies for AD. It is essential to ensure that topical medications are used properly to help patients achieve their treatment goals.