Dermatology and Therapy最新文献

Introduction: Surgical treatment is a key strategy for managing advanced hidradenitis suppurativa (HS), but postoperative recurrence remains a challenge. Understanding recurrence patterns and associated risk factors may help improve outcomes. The objectives were to evaluate surgical outcomes in patients with HS undergoing wide excision, to characterise surgical recurrence patterns, and to identify factors associated with each recurrence type.

Methods: This was a retrospective, observational, single-centre study conducted on patients who underwent HS surgical procedures between 2018 and 2024. Demographic, clinical, surgical and follow-up data were analysed. Recurrence was defined as the reappearance of inflammatory lesions within 1 cm of the surgical scar and subclassified as tunnel or abscess/inflammatory nodule (AN) recurrence.

Results: A total of 165 patients underwent 206 surgical procedures. Wide excision with secondary intention healing was the most common approach. The mean time to complete wound healing was 46.4 days. The overall recurrence rate was 18.5%, with tunnel recurrence in 8.3% and AN recurrence in 10.2%. Tunnel recurrence was associated with Hurley stage III, larger and deeper excisions and higher postoperative IHS4 scores, while AN recurrence was associated with BMI > 30 and preoperative ultrasound assessment. In multivariate analysis of overall recurrence, excised area was the only independent predictor (OR per cm², 1.03; p = 0.020), while poorer preoperative inflammatory control and lack of ultrasound assessment showed trends toward increased risk.

Conclusion: Differentiating between recurrence types may better reflect true surgical failure. Tunnel recurrence should be prioritized when evaluating surgical outcomes. Preoperative ultrasound and postoperative inflammatory control are key factors in minimizing recurrence.

Introduction: Fractional microneedle radiofrequency (FMRF) and poly-L-lactic acid (PLLA) each promote dermal remodeling through distinct mechanisms and have demonstrated efficacy as monotherapies for atrophic acne scars (AAS). The objective of this study is to evaluate the efficacy and safety of combining FMRF with transdermal PLLA delivery compared with sterile water in Asian patients with moderate-to-severe AAS.

Methods: In this randomized, split-face, evaluator-blinded clinical trial, 24 participants underwent two monthly FMRF sessions. Immediately after each session, a reconstituted PLLA suspension was applied to one facial half for transdermal delivery through the FMRF-created microchannels, while sterile water was applied to the contralateral side. Outcomes were assessed using three-dimensional imaging (Antera® 3D), standardized photography, and patient self-assessments over a 6-month follow-up. Safety was monitored throughout the study.

Results: PLLA-treated sides demonstrated statistically significant improvements in skin texture and scar volume at 6 months compared with baseline and with control sides (p < 0.05). Patient-reported outcomes paralleled objective findings, with a higher proportion of participants reporting > 75% improvement on the PLLA-treated side. Adverse events were of low incidence, transient, self-limited, and no serious complications occurred.

Conclusions: Combining FMRF with transdermal PLLA delivery is a safe and effective approach for moderate-to-severe AAS in Asian patients. The combination produced progressive, sustained, and clinically meaningful improvements compared with FMRF alone.

Trial registration: Thai Clinical Trials Registry: TCTR20250803007.

Introduction: Itch and pain are two of the most common and burdensome symptoms for moderate to severe Chronic Hand Eczema (CHE). Here, we assess changes in itch/pain in patients with moderate to severe CHE treated with delgocitinib cream 20 mg/g or cream vehicle for 16 weeks.

Methods: In a pooled DELTA 1 (NCT04871711)/DELTA 2 (NCT04872101) analysis (delgocitinib [n = 639]; cream vehicle [n = 321]; twice-daily), the Hand Eczema Symptom Diary captured patient-reported itch/pain severity on a numeric rating scale. Changes in itch/pain from baseline were assessed daily during week 1 and weekly from week 1 to 16.

Results: In delgocitinib-treated patients, a statistically significant least square mean reduction from baseline was observed for itch from day 1 ([delgocitinib cream/cream vehicle] 0.75/0.32; P < 0.001) and pain from day 3 (0.98/0.58; P = 0.001) after the first application. Among patients with ≥ 4-point baseline itch/pain score, a significantly greater percentage of delgocitinib-treated patients achieved ≥ 4-point reduction from week 2 (14.2%/17.3%) versus cream vehicle (6.3%/6.9%; P < 0.001). Reductions were maintained up to week 16 with delgocitinib cream treatment. Delgocitinib cream was well tolerated.

Conclusion: Early onset of itch/pain reduction was observed within week 1 for delgocitinib-treated patients, thereby providing further support of the use and efficacy of delgocitinib cream in adults with moderate to severe CHE.

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.