Pub Date : 2025-12-01DOI: 10.1001/jamadermatol.2025.4072
Yi-Han Chang, John A McGrath, Chao-Kai Hsu
{"title":"Regression of Extensive Keloids During Imatinib Therapy for Gastrointestinal Stromal Tumor.","authors":"Yi-Han Chang, John A McGrath, Chao-Kai Hsu","doi":"10.1001/jamadermatol.2025.4072","DOIUrl":"10.1001/jamadermatol.2025.4072","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"1293-1294"},"PeriodicalIF":11.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1001/jamadermatol.2025.3512
Debby Cheng, Katherine Sanchez, Ursula Biba, Nora Bensellam, Sherry Ershadi, Samantha Gregoire, Yevgeniy R Semenov, Arash Mostaghimi, John S Barbieri, Nicholas Theodosakis
{"title":"Validating the Use of ICD-10 Codes for Identifying Vitiligo.","authors":"Debby Cheng, Katherine Sanchez, Ursula Biba, Nora Bensellam, Sherry Ershadi, Samantha Gregoire, Yevgeniy R Semenov, Arash Mostaghimi, John S Barbieri, Nicholas Theodosakis","doi":"10.1001/jamadermatol.2025.3512","DOIUrl":"10.1001/jamadermatol.2025.3512","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"1283-1284"},"PeriodicalIF":11.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1001/jamadermatol.2025.4240
Chelsea N Campbell, Matthew S Krantz, Alexis Yu, Elizabeth J Phillips
<p><strong>Importance: </strong>Carriage of HLA-B*58:01 has been shown to be associated with allopurinol-induced Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) and drug reaction with eosinophilia and systemic symptoms (DRESS) in many populations globally; however, there is a critical need to investigate whether this is generalizable to populations of mixed ancestry, such as those in the US.</p><p><strong>Objective: </strong>To assess the association of human leukocyte antigen (HLA) class I and II in a cohort of US patients who received a diagnosis of allopurinol-induced SJS/TEN or DRESS compared with allopurinol-tolerant and population control participants.</p><p><strong>Design, setting, and participants: </strong>This genetic association study included consenting individuals who had specialist-adjudicated allopurinol-induced SJS/TEN or DRESS (collectively allopurinol-induced severe cutaneous adverse reactions [SCARs]) between January 1, 2015, and December 31, 2024. HLA carriage in these individuals was compared with allopurinol-tolerant and population control participants identified through the Vanderbilt University Medical Center biobank, which includes 94 489 individuals with imputed HLA class I and II typing from genotyping array data. Data were analyzed from January 2025 to August 2025.</p><p><strong>Main outcomes and measures: </strong>The main outcome measure was the association of HLA class I and II alleles with allopurinol-induced SCARs. HLA class I and II conditional logistic regression case-control analyses were performed between patients with allopurinol-induced SCARs and both population control and allopurinol-tolerant control participants matched on age, sex, and self-identified race. Odds ratios (ORs) and 95% CIs were reported, with Bonferroni-corrected P < .05.</p><p><strong>Results: </strong>This genetic association study used conditional logistic regression analyses and included 16 patients with allopurinol-induced SCAR (mean [SD] age, 61.1 [12.6] years; 9 female patients [56.25%] and 7 male patients [43.75%]) and 160 allopurinol-tolerant control participants matched 10:1. Two HLA class I alleles were found to be independently associated with increased risk of allopurinol-induced SCAR: HLA-B*58:01 (OR, 28.0 [95% CI, 8.6-100.6]) and HLA-A*34:02 (OR, 20.6 [95% CI, 3.3-131.1]). No HLA class II alleles meeting the Bonferroni-corrected P < .05 level of significance were identified.</p><p><strong>Conclusions and relevance: </strong>These findings suggest that although HLA-B*58:01 was found to be associated with allopurinol-induced SCARs, generalizing findings from previous studies, the allele was absent in more than one-third of the patient cohort and is therefore an incomplete indicator of risk. Importantly, in the US allopurinol-induced SCAR cohort, HLA-A*34:02 was found to be a second independent genetic risk factor for allopurinol-induced SCARs. These findings underscore the need to conduct population-based stud
重要性：在全球许多人群中，HLA-B*58:01的携带已被证明与别嘌呤醇诱导的史蒂文斯-约翰逊综合征和中毒性表皮坏死松解（SJS/TEN）以及嗜酸性粒细胞增多和全身症状（DRESS）的药物反应有关；然而，迫切需要调查这是否适用于混合血统的人群，比如美国人。目的：与别嘌呤醇耐受组和人群对照组比较，评估诊断为别嘌呤醇诱导的SJS/TEN或DRESS的美国患者中人类白细胞抗原（HLA） I类和II类的相关性。设计、环境和参与者：该遗传关联研究包括在2015年1月1日至2024年12月31日期间接受专家判定的别嘌呤醇诱导的SJS/TEN或DRESS（总别嘌呤醇诱导的严重皮肤不良反应[scar]）的同意个体。将这些人的HLA携带情况与范德比尔特大学医学中心生物银行鉴定的别嘌呤醇耐受者和人群对照者进行比较，其中包括94 489名从基因分型阵列数据中输入HLA I类和II类分型的个体。数据分析时间为2025年1月至2025年8月。主要结局和指标：主要结局指标是HLA I类和II类等位基因与别嘌呤醇诱导的疤痕的相关性。在别嘌呤醇诱导的疤痕患者与年龄、性别和种族匹配的人群对照组和别嘌呤醇耐受对照组之间进行HLA I类和II类条件logistic回归病例对照分析。结果：该遗传关联研究采用条件logistic回归分析，纳入了16例别嘌呤醇诱导的SCAR患者（平均[SD]年龄61.1[12.6]岁，9例女性患者[56.25%]，7例男性患者[43.75%]）和160例别嘌呤醇耐受对照患者（比例为10:1）。发现两个HLA I类等位基因与别嘌呤醇诱导的SCAR风险增加独立相关：HLA- b *58:01 （OR, 28.0 [95% CI, 8.6-100.6]）和HLA- a *34:02 （OR, 20.6 [95% CI, 3.3-131.1]）。结论和相关性：这些发现表明，尽管发现HLA- b *58:01与别嘌呤醇诱导的疤痕相关，但从以往的研究结果来看，该等位基因在超过三分之一的患者队列中缺失，因此是一个不完整的风险指标。重要的是，在美国别嘌呤醇诱导的SCAR队列中，HLA-A*34:02被发现是别嘌呤醇诱导的SCAR的第二个独立遗传危险因素。这些发现强调了开展基于人群的研究的必要性，这些研究既重现已知的HLA关联，又揭示新的HLA关联，从而通过筛查、风险分层和诊断来减少危害。
{"title":"HLA-B*58:01 and Risk of Allopurinol-Induced Severe Cutaneous Adverse Reactions in the US.","authors":"Chelsea N Campbell, Matthew S Krantz, Alexis Yu, Elizabeth J Phillips","doi":"10.1001/jamadermatol.2025.4240","DOIUrl":"10.1001/jamadermatol.2025.4240","url":null,"abstract":"<p><strong>Importance: </strong>Carriage of HLA-B*58:01 has been shown to be associated with allopurinol-induced Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) and drug reaction with eosinophilia and systemic symptoms (DRESS) in many populations globally; however, there is a critical need to investigate whether this is generalizable to populations of mixed ancestry, such as those in the US.</p><p><strong>Objective: </strong>To assess the association of human leukocyte antigen (HLA) class I and II in a cohort of US patients who received a diagnosis of allopurinol-induced SJS/TEN or DRESS compared with allopurinol-tolerant and population control participants.</p><p><strong>Design, setting, and participants: </strong>This genetic association study included consenting individuals who had specialist-adjudicated allopurinol-induced SJS/TEN or DRESS (collectively allopurinol-induced severe cutaneous adverse reactions [SCARs]) between January 1, 2015, and December 31, 2024. HLA carriage in these individuals was compared with allopurinol-tolerant and population control participants identified through the Vanderbilt University Medical Center biobank, which includes 94 489 individuals with imputed HLA class I and II typing from genotyping array data. Data were analyzed from January 2025 to August 2025.</p><p><strong>Main outcomes and measures: </strong>The main outcome measure was the association of HLA class I and II alleles with allopurinol-induced SCARs. HLA class I and II conditional logistic regression case-control analyses were performed between patients with allopurinol-induced SCARs and both population control and allopurinol-tolerant control participants matched on age, sex, and self-identified race. Odds ratios (ORs) and 95% CIs were reported, with Bonferroni-corrected P < .05.</p><p><strong>Results: </strong>This genetic association study used conditional logistic regression analyses and included 16 patients with allopurinol-induced SCAR (mean [SD] age, 61.1 [12.6] years; 9 female patients [56.25%] and 7 male patients [43.75%]) and 160 allopurinol-tolerant control participants matched 10:1. Two HLA class I alleles were found to be independently associated with increased risk of allopurinol-induced SCAR: HLA-B*58:01 (OR, 28.0 [95% CI, 8.6-100.6]) and HLA-A*34:02 (OR, 20.6 [95% CI, 3.3-131.1]). No HLA class II alleles meeting the Bonferroni-corrected P < .05 level of significance were identified.</p><p><strong>Conclusions and relevance: </strong>These findings suggest that although HLA-B*58:01 was found to be associated with allopurinol-induced SCARs, generalizing findings from previous studies, the allele was absent in more than one-third of the patient cohort and is therefore an incomplete indicator of risk. Importantly, in the US allopurinol-induced SCAR cohort, HLA-A*34:02 was found to be a second independent genetic risk factor for allopurinol-induced SCARs. These findings underscore the need to conduct population-based stud","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"1258-1263"},"PeriodicalIF":11.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12573116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145389732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1001/jamadermatol.2025.3858
Houriah Y Nukaly, Renad F Althobaiti, Waseem K AlHawsawi, Sumayyah I Alrefaie, Sarah B Aljoudi
{"title":"Lamellar Ichthyosis Improvement With Acitretin and Dupilumab.","authors":"Houriah Y Nukaly, Renad F Althobaiti, Waseem K AlHawsawi, Sumayyah I Alrefaie, Sarah B Aljoudi","doi":"10.1001/jamadermatol.2025.3858","DOIUrl":"10.1001/jamadermatol.2025.3858","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"1291-1293"},"PeriodicalIF":11.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1001/jamadermatol.2025.3824
Austin N Johnson, Pirunthan Pathmarajah, Edward Eid, Shehla Admani, Johann W Bauer, Susan J Bayliss, Emily S Gorell, Irene Lara-Corrales, Amy S Paller, Antonia Reimer-Taschenbrecker, Albert S Chiou, Joyce M C Teng
{"title":"Development and Validation of a Scale to Assess Epidermolysis Bullosa Simplex Severity.","authors":"Austin N Johnson, Pirunthan Pathmarajah, Edward Eid, Shehla Admani, Johann W Bauer, Susan J Bayliss, Emily S Gorell, Irene Lara-Corrales, Amy S Paller, Antonia Reimer-Taschenbrecker, Albert S Chiou, Joyce M C Teng","doi":"10.1001/jamadermatol.2025.3824","DOIUrl":"10.1001/jamadermatol.2025.3824","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"1287-1289"},"PeriodicalIF":11.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12529319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1001/jamadermatol.2025.2612
Marina de la Puente Alonso, Verónica Parra Blanco, Minia Campos Domínguez
{"title":"Unusual Congenital Scalp Lesion in a Child.","authors":"Marina de la Puente Alonso, Verónica Parra Blanco, Minia Campos Domínguez","doi":"10.1001/jamadermatol.2025.2612","DOIUrl":"10.1001/jamadermatol.2025.2612","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"1277-1278"},"PeriodicalIF":11.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1001/jamadermatol.2025.4051
Maria C Bell, Thilini W Gangodawila, Claudia S Morr, Gloria R Xue, Arslan Iqbal, Emily A Merkel, Abraham H Abdulhak, James E Slaven, Syril Keena T Que
<p><strong>Importance: </strong>Hydrocolloid dressings (HCDs) are designed to promote wound healing; however, there are no randomized clinical trials comparing changes in scar appearance using HCD vs daily petroleum ointment after excisional surgery.</p><p><strong>Objective: </strong>To determine whether a 1-time application of HCD for 1 week after excisional surgery affects scar appearance and surgical complications compared to daily petroleum ointment.</p><p><strong>Design, setting, and participants: </strong>This was an investigator-blinded, individually randomized clinical trial conducted from October 2022 to October 2023 at a large public university in Indiana of adult (≥18 years) patients undergoing standard excision or Mohs micrographic surgery with linear bilayered repair. Exclusion criteria included flap or graft use, topical chemotherapy agents used on surgical site, allergy to adhesives, scar in hair-bearing site, previous use of HCD, and communication barriers. Data analysis was conducted from November 2023 to March 2025.</p><p><strong>Interventions: </strong>HCD application over the excisional surgery site for 1 week or daily reapplication of petroleum ointment.</p><p><strong>Main outcomes and measures: </strong>Patient-reported scar appearance using a modified Visual Analog Scale (VAS). Secondary outcomes included VAS scores from 3 Mohs surgeons who were blinded, rates of surgical complications, and patient ratings for comfort and convenience.</p><p><strong>Results: </strong>Of the 444 screened, 146 patients (mean [SD] age, 61.9 [12.9] years; 85 female [58%] and 61 male [41.8%] individuals) were randomized, 72 to HCD and 74 to petroleum ointment; demographic characteristics were similar between groups. Surgeon and patient ratings for overall appearance were clinically comparable. At 7 days, the difference in mean VAS rating between HCD and petroleum groups was -0.40 (95% CI, -0.70 to -0.10); at 30 days, it was -0.08 (95% CI, -0.38 to 0.23); and at 90 days, -0.09 (95% CI, -0.41 to 0.23). The HCD group had higher, but not statistically significant, rates of adverse events, including postoperative bleeding (20.6% for HCD vs 8.8% for petroleum), wound dehiscence (6.2% vs 0), and surgical site pain (21.2% vs 12.3). No patients required postoperative antibiotics. A greater proportion in the HCD group rated the HCD as convenient or extremely convenient (86.9% vs 46.8%; difference, 40.1% [95% CI, 24.9% to 55.3%]) and comfortable or extremely comfortable (73.8% vs 48.3%; difference, 25.4% [95% CI, 8.7% to 42.2]).</p><p><strong>Conclusions and relevance: </strong>This randomized clinical trial found that HCD is a suitable postoperative option after dermatologic surgery, yielding similar scar appearance and complication rates as daily petroleum ointment. Therefore, the clinical decision to use HCD vs daily petroleum ointment should balance cost and patient preferences with their risk of postoperative complications.</p><p><strong>Trial registra
{"title":"Hydrocolloid Dressing vs Petroleum Ointment for Scar Appearance After Dermatologic Surgery: A Randomized Clinical Trial.","authors":"Maria C Bell, Thilini W Gangodawila, Claudia S Morr, Gloria R Xue, Arslan Iqbal, Emily A Merkel, Abraham H Abdulhak, James E Slaven, Syril Keena T Que","doi":"10.1001/jamadermatol.2025.4051","DOIUrl":"10.1001/jamadermatol.2025.4051","url":null,"abstract":"<p><strong>Importance: </strong>Hydrocolloid dressings (HCDs) are designed to promote wound healing; however, there are no randomized clinical trials comparing changes in scar appearance using HCD vs daily petroleum ointment after excisional surgery.</p><p><strong>Objective: </strong>To determine whether a 1-time application of HCD for 1 week after excisional surgery affects scar appearance and surgical complications compared to daily petroleum ointment.</p><p><strong>Design, setting, and participants: </strong>This was an investigator-blinded, individually randomized clinical trial conducted from October 2022 to October 2023 at a large public university in Indiana of adult (≥18 years) patients undergoing standard excision or Mohs micrographic surgery with linear bilayered repair. Exclusion criteria included flap or graft use, topical chemotherapy agents used on surgical site, allergy to adhesives, scar in hair-bearing site, previous use of HCD, and communication barriers. Data analysis was conducted from November 2023 to March 2025.</p><p><strong>Interventions: </strong>HCD application over the excisional surgery site for 1 week or daily reapplication of petroleum ointment.</p><p><strong>Main outcomes and measures: </strong>Patient-reported scar appearance using a modified Visual Analog Scale (VAS). Secondary outcomes included VAS scores from 3 Mohs surgeons who were blinded, rates of surgical complications, and patient ratings for comfort and convenience.</p><p><strong>Results: </strong>Of the 444 screened, 146 patients (mean [SD] age, 61.9 [12.9] years; 85 female [58%] and 61 male [41.8%] individuals) were randomized, 72 to HCD and 74 to petroleum ointment; demographic characteristics were similar between groups. Surgeon and patient ratings for overall appearance were clinically comparable. At 7 days, the difference in mean VAS rating between HCD and petroleum groups was -0.40 (95% CI, -0.70 to -0.10); at 30 days, it was -0.08 (95% CI, -0.38 to 0.23); and at 90 days, -0.09 (95% CI, -0.41 to 0.23). The HCD group had higher, but not statistically significant, rates of adverse events, including postoperative bleeding (20.6% for HCD vs 8.8% for petroleum), wound dehiscence (6.2% vs 0), and surgical site pain (21.2% vs 12.3). No patients required postoperative antibiotics. A greater proportion in the HCD group rated the HCD as convenient or extremely convenient (86.9% vs 46.8%; difference, 40.1% [95% CI, 24.9% to 55.3%]) and comfortable or extremely comfortable (73.8% vs 48.3%; difference, 25.4% [95% CI, 8.7% to 42.2]).</p><p><strong>Conclusions and relevance: </strong>This randomized clinical trial found that HCD is a suitable postoperative option after dermatologic surgery, yielding similar scar appearance and complication rates as daily petroleum ointment. Therefore, the clinical decision to use HCD vs daily petroleum ointment should balance cost and patient preferences with their risk of postoperative complications.</p><p><strong>Trial registra","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"1246-1251"},"PeriodicalIF":11.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12547672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1001/jamadermatol.2025.3663
Xiajing Chu, Javeria Mubasher, Lina Chen, Alexandro W L Chu, Paul Oykhman, Romina Brignardello-Petersen, Gordon H Guyatt, Anja Fog Heen, David A Khan, David M Lang, Diane R Baker, Eric T Oliver, Javed Sheikh, Lisa A Beck, Moshe Ben-Shoshan, Sameer K Mathur, Susan Waserman, Emily F Cole, Jeffrey Chan, Kathryn E Wheeler, Kathryn P Trayes, Lauren Runyon, Paul Tran, Rachel N Asiniwasis, Donna D Gardner, Sanaz Eftekhari, Tonya Winders, Jamie Tattrie, Jonathan A Bernstein, Sarbjit S Saini, Derek K Chu
Importance: Patient and caregiver values and preferences should inform clinical management. An update to the American Academy of Allergy, Asthma & Immunology/American College of Allergy, Asthma and Immunology's Joint Task Force on Practice Parameters guidelines on chronic urticaria (CU) plans to incorporate them; however, a systematic review of evidence on the values and preferences of patients with CU and their caregivers has not been previously available.
Objective: To synthesize patient and caregiver values and preferences regarding CU treatment options.
Evidence review: A systematic search was conducted of MEDLINE, Embase, PsycINFO, and CINAHL databases, from inception to May 15, 2025, for studies addressing patient and/or caregiver values and preferences for CU management. Paired reviewers independently screened studies, extracted data, and assessed risk of bias. Thematic and inductive content analysis was used to qualitatively synthesize findings and certainty of evidence was rated per the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative Research approach.
Findings: The search resulted in 18 studies addressing the values and preferences among 28 497 participants. Moderate certainty evidence showed that patients were likely to place a high value on rapid improvement (eg, 2 days to 2 weeks) of disease signs and symptoms, long-term effectiveness, and treatments that were easy to prepare, use, and self-manage-oral or topical treatments were favored over injections, with the least favored being infusions. Low certainty evidence suggested that patients accepted minor feasibility burdens for rapid and sustained symptom relief but prioritized safety and tolerability as the risk or severity of adverse effects (eg, kidney injury, vomiting) increased.
Conclusions and relevance: This systematic review suggests that patients with CU place high value on immediate and sustained hive, itch, and swelling relief, particularly long-term symptom-free periods, but may shift to prioritizing avoiding harms and burdens as the risk and severity of adverse effects increases. These findings may serve as a resource to improve the trustworthiness of recommendations and inform future CU management and research.
{"title":"Patient Values and Preferences in Chronic Urticaria Treatment: A Systematic Review.","authors":"Xiajing Chu, Javeria Mubasher, Lina Chen, Alexandro W L Chu, Paul Oykhman, Romina Brignardello-Petersen, Gordon H Guyatt, Anja Fog Heen, David A Khan, David M Lang, Diane R Baker, Eric T Oliver, Javed Sheikh, Lisa A Beck, Moshe Ben-Shoshan, Sameer K Mathur, Susan Waserman, Emily F Cole, Jeffrey Chan, Kathryn E Wheeler, Kathryn P Trayes, Lauren Runyon, Paul Tran, Rachel N Asiniwasis, Donna D Gardner, Sanaz Eftekhari, Tonya Winders, Jamie Tattrie, Jonathan A Bernstein, Sarbjit S Saini, Derek K Chu","doi":"10.1001/jamadermatol.2025.3663","DOIUrl":"10.1001/jamadermatol.2025.3663","url":null,"abstract":"<p><strong>Importance: </strong>Patient and caregiver values and preferences should inform clinical management. An update to the American Academy of Allergy, Asthma & Immunology/American College of Allergy, Asthma and Immunology's Joint Task Force on Practice Parameters guidelines on chronic urticaria (CU) plans to incorporate them; however, a systematic review of evidence on the values and preferences of patients with CU and their caregivers has not been previously available.</p><p><strong>Objective: </strong>To synthesize patient and caregiver values and preferences regarding CU treatment options.</p><p><strong>Evidence review: </strong>A systematic search was conducted of MEDLINE, Embase, PsycINFO, and CINAHL databases, from inception to May 15, 2025, for studies addressing patient and/or caregiver values and preferences for CU management. Paired reviewers independently screened studies, extracted data, and assessed risk of bias. Thematic and inductive content analysis was used to qualitatively synthesize findings and certainty of evidence was rated per the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative Research approach.</p><p><strong>Findings: </strong>The search resulted in 18 studies addressing the values and preferences among 28 497 participants. Moderate certainty evidence showed that patients were likely to place a high value on rapid improvement (eg, 2 days to 2 weeks) of disease signs and symptoms, long-term effectiveness, and treatments that were easy to prepare, use, and self-manage-oral or topical treatments were favored over injections, with the least favored being infusions. Low certainty evidence suggested that patients accepted minor feasibility burdens for rapid and sustained symptom relief but prioritized safety and tolerability as the risk or severity of adverse effects (eg, kidney injury, vomiting) increased.</p><p><strong>Conclusions and relevance: </strong>This systematic review suggests that patients with CU place high value on immediate and sustained hive, itch, and swelling relief, particularly long-term symptom-free periods, but may shift to prioritizing avoiding harms and burdens as the risk and severity of adverse effects increases. These findings may serve as a resource to improve the trustworthiness of recommendations and inform future CU management and research.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"1264-1272"},"PeriodicalIF":11.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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