JAMA dermatology最新文献

英文中文

Diffuse Alopecia of the Scalp and Eyebrows. 头皮和眉毛的弥漫性脱发。

IF 11 1区医学 Q1 DERMATOLOGY

JAMA dermatology

Pub Date : 2026-03-01 DOI: 10.1001/jamadermatol.2025.5973

Tian Xie, Xuegang Xu

引用次数: 0

Purpuric Edematous Papules in a Man With Prostate Cancer. 前列腺癌患者的紫癜性水肿丘疹。

IF 11 1区医学 Q1 DERMATOLOGY

JAMA dermatology

Pub Date : 2026-02-25 DOI: 10.1001/jamadermatol.2025.6238

Ruoxuan Su, Julie Hancock, Joshua L Owen

引用次数: 0

Benefits and Costs of Biologics and Phototherapy in Psoriasis Treatment. 生物制剂和光疗在银屑病治疗中的利弊。

IF 11 1区医学 Q1 DERMATOLOGY

JAMA dermatology

Pub Date : 2026-02-25 DOI: 10.1001/jamadermatol.2025.6193

Edward L Kong, Elizabeth A Buzney

Importance: Phototherapy remains an effective and cost-efficient treatment for psoriasis, yet its use is constrained by coverage policies and the inconvenience of in-office treatment.Objective: To compare the efficacy, quality-of-life gains, and cost-effectiveness of biologics, phototherapy, and step-therapy strategies.Design, setting, and participants: Simulation modeling study in patients with moderate to severe plaque psoriasis (Psoriasis Area and Severity Index [PASI] ≥12) using published estimates of efficacy, costs, and mappings between PASI score and quality-adjusted life-years (QALYs) from 2013 through 2025. Analysis was conducted between July 1 and November 21, 2025.Exposures: One year of treatment with a representative biologic (bimekizumab), narrowband UV-B phototherapy (home or office) or a step-therapy regimen where patients initiated phototherapy for 16 weeks and switched to biologics if PASI90 (an improvement in PASI score of ≥90%) was not achieved, continuing the more effective therapy.Main outcomes and measures: Main outcomes were PASI reductions at 32 weeks, QALYs monetized as $100 000 per QALY, and total treatment costs to payers. Secondary outcomes included out-of-pocket costs and net willingness to pay, defined as monetized QALYs minus costs. Sensitivity analyses considered risankizumab and adalimumab.Results: Among 500 000 simulated adult patients, the mean (SD) baseline PASI value was 20.2 (7.5). Mean (SD) PASI reductions were 91.6% (20.1%) for biologics, 71.1% (30.3%) for phototherapy, and 95.2% (10.8%) for the step-therapy regimen. Mean (SD) reductions were most variable for phototherapy (71.1% [30.3%]) and least variable for step therapy (95.2% [10.8%]). Mean (SD) QALY gains were 0.24 (0.08) for biologics, 0.18 (0.09) for phototherapy, and 0.23 (0.06) for step therapy. Mean (SD) monetized gains were $24 107 ($7916) for biologics, $17 916 ($9421) for phototherapy, and $22 560 ($6324) for step therapy. Mean (SD) annual total costs were $84 034 (0) for biologics, $14 760 (0) for office phototherapy, and $6222 (0) for home phototherapy. Mean (SD) out-of-pocket costs were $2000 (0) for biologics, $5004 ($9241) for office phototherapy, and $1450 (0) for home phototherapy. From the payer perspective, mean (SD) net willingness to pay was highest for home phototherapy ($11 694 [$9421]) and lowest for biologics (-$59 926 [$7916]). For patients, the mean (SD) willingness to pay was positive across all regimens and highest for biologics ($22 107 [$7916]), followed by home phototherapy ($16 466 [$9421]) and office phototherapy ($12 912 [$13 192]). Among biologics, payers preferred adalimumab, whereas patients preferred bimekizumab.Conclusions and relevance: In this study, biologics provided the largest quality-of-life gains, while step-therapy strategies achieved similar b

重要性：光疗仍然是治疗牛皮癣的一种有效且经济的治疗方法，但其使用受到覆盖政策和在办公室治疗的不便的限制。目的：比较生物制剂、光疗和分步治疗策略的疗效、生活质量和成本效益。设计、设置和参与者：在2013年至2025年的中度至重度斑块型银屑病（银屑病面积和严重程度指数[PASI]≥12）患者中进行模拟建模研究，使用已发表的疗效、成本和PASI评分与质量调整生命年（QALYs）之间的映射关系。分析时间为2025年7月1日至11月21日。暴露：一年的代表性生物制剂（比美珠单抗）治疗，窄带UV-B光疗（家庭或办公室）或分步治疗方案，患者开始光疗16周，如果PASI90 （PASI评分改善≥90%）未达到，则切换到生物制剂，继续更有效的治疗。主要结果和措施：主要结果是32周PASI减少，每个QALY货币化为100,000美元 000，以及支付者的总治疗费用。次要结果包括自付费用和净支付意愿，定义为货币化qaly减去成本。敏感性分析考虑了利桑单抗和阿达木单抗。结果：在50万例模拟成人患者中，基线PASI均值（SD）为20.2（7.5）。生物制剂组PASI平均（SD）降低率为91.6%(20.1%)，光疗组为71.1%(30.3%)，分步治疗组为95.2%（10.8%）。平均（SD）降低变化最大的是光疗（71.1%[30.3%]），最小的变化是阶梯疗法（95.2%[10.8%]）。生物制剂的平均（SD）质量增益为0.24(0.08)，光疗的平均（SD）增益为0.18(0.09)，步进治疗的平均（SD）增益为0.23（0.06）。生物制剂的平均货币化收益为24 107美元（7916美元），光疗的平均货币化收益为17 916美元（9421美元），阶梯疗法的平均货币化收益为22 560美元（6324美元）。生物制剂的平均年总费用为84 034美元(0)，办公室光疗为14 760美元(0)，家庭光疗为6222美元(0)。生物制剂的平均自付费用为2000美元(0)，办公室光疗为5004美元（9241美元），家庭光疗为1450美元(0)。从付款人的角度来看，家庭光疗的平均（SD）净支付意愿最高（11美元 694[$9421]），生物制剂的最低（- 59美元 926[$7916]）。对于患者而言，所有方案的平均（SD）支付意愿均为正，生物制剂的支付意愿最高（22美元 107[$7916]），其次是家庭光疗（16美元 466[$9421]）和办公室光疗（12美元 912[$13 192]）。在生物制剂中，付款人更喜欢阿达木单抗，而患者更喜欢比美珠单抗。结论和相关性：在本研究中，生物制剂提供了最大的生活质量收益，而分步治疗策略获得了类似的收益，变异性更小，系统成本更低。对付款人来说，光疗仍然具有成本效益。不同的激励机制——支付者偏爱光疗，而患者偏爱生物制剂——强调了调整覆盖范围的必要性，包括减少家庭光疗的费用分担，以提高可及性和系统的可持续性。

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引用次数: 0

Dermatologic Infections After Migration Through Latin America. 拉丁美洲移民后的皮肤感染。

IF 11 1区医学 Q1 DERMATOLOGY

JAMA dermatology

Pub Date : 2026-02-25 DOI: 10.1001/jamadermatol.2025.6161

Amir M Mohareb, Jessica Hunnewell, Sarah Draugelis, George A Yendewa, Samuel Bishop, Reena Goswami, Florian Schmitzberger, Andrés F Henao-Martínez, Christian Olivo-Freites, Valeska Padovese, Mara Medeiros, Rodolfo Norberro Jiménez-Juárez, Carlos Franco-Paredes

引用次数: 0

Dupilumab Use in Severe Epidermolysis Bullosa Simplex. Dupilumab在严重单纯大疱性表皮松解症中的应用

IF 11 1区医学 Q1 DERMATOLOGY

JAMA dermatology

Pub Date : 2026-02-25 DOI: 10.1001/jamadermatol.2025.5754

Orsola Crespi, Nathalia Bellon, Julie Bonigen, Smail Hadj-Rabia, Fabienne Charbit-Henrion, Maria Leite-de-Moraes, Christine Bodemer

引用次数: 0

Measuring Progress of 2030 Skin-Related Neglected Tropical Diseases Sustainable Development Goals. 衡量2030年与皮肤有关的被忽视热带病可持续发展目标的进展。

IF 11 1区医学 Q1 DERMATOLOGY

JAMA dermatology

Pub Date : 2026-02-25 DOI: 10.1001/jamadermatol.2025.6135

Xueshan Cao, Minmin Wang, Mengge Zhou, Xingguang Zhang, Yuanqi Mi, Peixin Yu, Jiaxu Gu, Cong Huang, Yang Guo

Importance: Skin-related neglected tropical diseases (NTDs) pose a public health threat, yet despite the establishment of related Sustainable Development Goals (SDGs), systematic analyses of skin-related NTDs SDGs progress are limited.

Objective: To measure the progress and project attainment to 2030 of the skin-related NTDs SDGs and to explore potential associated factors.

Design, setting, and participants: The disability-adjusted life-years (DALYs) data of 6 skin NTDs, including cutaneous and mucocutaneous leishmaniasis, fungal skin diseases, leprosy, lymphatic filariasis, onchocerciasis, and scabies, were extracted from the Global Burden of Disease Foresight Visualization study. The general population and 2 vulnerable subpopulations, school-aged children and women of childbearing age, were analyzed. Data were collected from December 2024 to August 2025, and data were analyzed from March to August 2025.

Main outcomes and measures: Based on the World Health Organization strategic framework, the progress toward the 2030 skin-related NTDs SDGs targeting a 75% reduction in DALYs from 2020 levels was evaluated. The Skin NTDs SDG Index was developed to quantify the progress to meet the target at the national level and evaluate the role of socioeconomic and health care factors and the COVID-19 pandemic.

Results: Globally, between 2020 and 2030, DALYs were estimated to increase for cutaneous and mucocutaneous leishmaniasis, fungal skin diseases, scabies, and onchocerciasis and decrease for lymphatic filariasis and leprosy. Only a limited number of countries were on track to meet the target, with 11 countries projected to achieve the skin-related NTDs SDGs for 1 type of skin-related NTD. The novel Skin NTDs SDG Index revealed substantial national variation in progress, with the highest in Central Europe, Eastern Europe, and Central Asia and lowest in Sub-Saharan Africa. Government health spending per total health spending was a crucial factor for better progress. The COVID-19 pandemic showed complex roles for different skin NTDs in the short term and the long term. Analyses of 2 vulnerable subpopulations revealed divergent trends, with DALYs declining in school-aged children but rising in women of childbearing age, accompanied by unique index distribution patterns.

Conclusions and relevance: In this study, the progress toward attaining the skin-related NTDs SDGs targets has been largely insufficient. Regional inequalities, influenced by health spending levels, the COVID-19 pandemic, and vulnerable group disparities, pose major challenges. Targeted action and sustained health investment are urgently needed.

重要性：与皮肤相关的被忽视热带病（NTDs）构成公共卫生威胁，然而，尽管建立了相关的可持续发展目标（SDGs），但对与皮肤相关的被忽视热带病（SDGs）进展的系统分析有限。目的：衡量皮肤相关非传染性疾病可持续发展目标的进展和项目实现情况，并探讨潜在的相关因素。设计、环境和参与者：从全球疾病预测可视化研究中提取了6种皮肤NTDs的残疾调整生命年（DALYs）数据，包括皮肤和粘膜皮肤利什曼病、真菌皮肤病、麻风病、淋巴丝虫病、盘尾丝虫病和疥疮。对一般人群和学龄儿童和育龄妇女2个易感亚人群进行分析。数据采集时间为2024年12月至2025年8月，数据分析时间为2025年3月至8月。主要成果和措施：根据世界卫生组织战略框架，评估了2030年与皮肤有关的被热带病可持续发展目标的进展情况，该目标的目标是在2020年的基础上减少75%的伤残补偿年。制定皮肤被忽视热带病可持续发展目标指数是为了量化在国家层面实现目标的进展情况，并评估社会经济和卫生保健因素以及COVID-19大流行的作用。结果：在全球范围内，2020年至2030年期间，估计皮肤和粘膜利什曼病、真菌皮肤病、疥疮和盘尾丝虫病的DALYs将增加，淋巴丝虫病和麻风病的DALYs将减少。只有少数国家有望实现这一目标，预计有11个国家将实现针对一种与皮肤有关的被忽视热带病的可持续发展目标。新的皮肤被忽视热带病可持续发展目标指数显示，各国在进展方面存在很大差异，中欧、东欧和中亚最高，撒哈拉以南非洲最低。政府卫生支出占卫生支出总额的比例是取得更好进展的关键因素。COVID-19大流行在短期和长期内对不同的皮肤被忽视疾病表现出复杂的作用。对2个弱势亚群的分析显示出不同的趋势，学龄儿童的DALYs下降，而育龄妇女的DALYs上升，并伴有独特的指数分布模式。结论和相关性：在本研究中，实现与皮肤相关的被忽视热带病可持续发展目标的进展在很大程度上是不足的。受卫生支出水平、COVID-19大流行和弱势群体差异影响的区域不平等构成了重大挑战。迫切需要有针对性的行动和持续的卫生投资。

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引用次数: 0

Dupilumab in Patients With Chronic Spontaneous Urticaria: Phase 3 LIBERTY-CSU CUPID Randomized Clinical Trials. Dupilumab治疗慢性自发性荨麻疹：3期LIBERTY-CSU CUPID随机临床试验

IF 11 1区医学 Q1 DERMATOLOGY

JAMA dermatology

Pub Date : 2026-02-18 DOI: 10.1001/jamadermatol.2025.6023

Thomas B Casale, Sarbjit S Saini, Moshe Ben-Shoshan, Ana M Giménez-Arnau, Jonathan A Bernstein, Koremasa Hayama, Nikhil Amin, Lacey B Robinson, Deborah Bauer, Paula Dakin, Elizabeth Laws, Allen Radin, Melanie Makhija

Importance: Chronic spontaneous urticaria (CSU) is an inflammatory disease characterized by recurrent pruritic hives and/or angioedema. Many patients with CSU remain symptomatic despite standard-of-care, histamine 1-receptor antagonist (H1-AH) treatment. Dupilumab blocks IL-4/IL-13 signaling and is approved in multiple disease states associated with type 2 inflammation. In the phase 3 LIBERTY-CSU CUPID-A trial, dupilumab significantly reduced itch and hives severity in anti-immunoglobulin E (IgE)-naive patients with CSU uncontrolled with H1-AH. However, a replicate trial (CUPID-C) was required per US Food and Drug Administration registration requirements.Objective: To further evaluate the efficacy and safety of dupilumab vs placebo in anti-IgE-naive patients with CSU uncontrolled by H1-AH.Design, setting, and participants: The LIBERTY-CSU CUPID-C (2022-2024) was a randomized, placebo-controlled, double-blind, 24-week phase 3 trial using the same trial design as CUPID-A (2019-2021). CUPID-A and CUPID-C were performed in 10 countries in Asia, Europe, and North and South America with anti-IgE-naive patients aged 6 to 80 years with CSU uncontrolled with H1-AH. Data were analyzed from August to September 2024.Interventions: Dupilumab or placebo.Main outcomes and measures: In CUPID-C and pooled CUPID-A and -C analyses, change from baseline at week 24 in Itch Severity Score over 7 days (ISS7) or Urticaria Activity Score over 7 days (UAS7), with the other as a key secondary end point, per regional regulatory requirements.Results: The CUPID-C analysis included 151 participants (mean [SD] age, 44.7 [16.9] years; 106 females [70.2%]), of whom 77 (51%) were taking H1-AH at a dosage higher than recommended, and 90 (59.6%) had a baseline UAS7 of 28 or greater. Significant improvements in ISS7 and UAS7 were observed with dupilumab vs placebo at week 24. Least squares mean (SE) changes were -8.64 (1.41) vs -6.10 (1.40), respectively (difference: -2.54 points [95% CI, -4.65 to -0.43]; P = .02) for ISS7 and -15.86 (2.66) vs -11.21 (2.65), respectively (difference: -4.65 points [95% CI, -8.65 to -0.65]; P = .02) for UAS7. CUPID-A and -C combined data (289 participants) demonstrated greater improvements in UAS7 and ISS7. Safety outcomes were generally consistent with the known dupilumab safety profile; 77 patients (53.5%) taking dupilumab vs 81 patients (55.9%) taking placebo reported treatment-emergent adverse events in the pooled analysis.Conclusions and relevance: The CUPID-C randomized clinical trial confirmed CUPID-A findings, and pooled data demonstrated dupilumab significantly reduced urticaria activity by reducing itch and hives severity in anti-IgE-naive patients with CSU who remained symptomatic despite the use of H1-AH.Trial registration: ClinicalTrials.gov Identifier: N

重要性：慢性自发性荨麻疹（CSU）是一种炎症性疾病，其特征是反复出现瘙痒性荨麻疹和/或血管性水肿。许多CSU患者尽管接受了标准治疗组胺1受体拮抗剂（H1-AH）治疗，但仍有症状。Dupilumab阻断IL-4/IL-13信号传导，被批准用于与2型炎症相关的多种疾病状态。在3期libert -CSU CUPID-A试验中，dupilumab显著降低了抗免疫球蛋白E （IgE）初始CSU患者的瘙痒和荨麻疹严重程度。然而，根据美国食品和药物管理局的注册要求，需要进行重复试验（CUPID-C）。目的：进一步评价dupilumab与安慰剂在H1-AH未控制的抗ige -naive CSU患者中的疗效和安全性。设计、环境和参与者：LIBERTY-CSU丘比特-c（2022-2024）是一项随机、安慰剂对照、双盲、为期24周的3期试验，采用与丘比特- a（2019-2021）相同的试验设计。我们在亚洲、欧洲、北美和南美的10个国家对6 ~ 80岁的未受H1-AH控制的CSU患者进行了抗ige - a和CUPID-C试验。数据分析时间为2024年8月至9月。干预措施：Dupilumab或安慰剂。主要结局和测量：在CUPID-C和合并的CUPID-A和-C分析中，根据区域监管要求，瘙痒严重评分超过7天（ISS7）或荨麻疹活动评分超过7天（UAS7）与基线相比在第24周发生变化，另一个作为关键的次要终点。结果：copid - c分析纳入151名参与者（平均[SD]年龄44.7[16.9]岁，106名女性[70.2%]），其中77名（51%）患者服用的H1-AH剂量高于推荐剂量，90名（59.6%）患者的基线UAS7为28或更高。与安慰剂相比，dupilumab在第24周观察到ISS7和UAS7的显著改善。最小二乘平均（SE）变化分别为-8.64（1.41）和-6.10(1.40)(差异：-2.54点[95% CI， -4.65至-0.43]；2)，分别为-15.86（2.66）和-11.21(2.65)(差异：-4.65点[95% CI， -8.65至-0.65]；02)用于UAS7。CUPID-A和-C联合数据（289名参与者）显示UAS7和ISS7有更大的改善。安全性结果与已知的dupilumab安全性概况基本一致；在合并分析中，77名服用dupilumab的患者（53.5%）和81名服用安慰剂的患者（55.9%）报告了治疗后出现的不良事件。结论和相关性：CUPID-C随机临床试验证实了CUPID-A的发现，汇总数据表明，dupilumab通过降低抗ige初始CSU患者的瘙痒和荨麻疹严重程度，显着降低了荨麻疹活性，尽管使用H1-AH仍有症状。试验注册：ClinicalTrials.gov标识符：NCT04180488。

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引用次数: 0

Sunscreen Costs in Association With Sun Protective Behaviors. 防晒霜的价格与防晒行为有关。

IF 11 1区医学 Q1 DERMATOLOGY

JAMA dermatology

Pub Date : 2026-02-18 DOI: 10.1001/jamadermatol.2025.6150

Maya Mundada, Jeffrey Schneider, Maria L Wei

Importance: Sunscreen use has known benefits, including decreasing the risk of developing skin cancer and photoaging. Previous studies have reported that the amount of sunscreen used decreased with increased unit price and that individuals underapply sunscreen.

Objective: To assess how the cost of recommended sunscreen use varies depending on unit price and the other sun protective behaviors.

Design and setting: In this economic evaluation study conducted from July 14 to August 31, 2025, sunscreen application costs were calculated based on recommended application amounts, use of other sun protection strategies, and 2025 sunscreen prices.

Main outcomes and measures: The primary outcome was the annual cost of applying sunscreen based on recommended application amounts, use of other sun protection strategies, and 2025 sunscreen prices from an online retailer.

Results: For sunscreens with similar ingredients and sun protection factor ratings, the unit price of sunscreen varied by up to 17.5-fold across 3 sunscreens. Cost per application varied from $0.04 to $3.79 depending on wearing different combinations of typical clothing, whereas 1 year of sunscreen use was estimated to cost between $39.28 and $1429.42, a 36-fold difference, depending on unit price and other sun protective strategies used. A single week of sunscreen use at the beach, assuming 2 applications a day, costs approximately $6.57 to $135.82, depending on whether wearing shorts or a bikini and sunscreen unit price.

Conclusions and relevance: These findings suggest that the cost of applying sunscreen at the recommended amounts varies significantly depending on unit price and the concurrent use of other sun protective strategies. Decreasing the potential cost by encouraging the use of other sun protective strategies and lower-priced sunscreens could facilitate compliance and reduction in the risk of developing skin cancers.

重要性：使用防晒霜有众所周知的好处，包括降低患皮肤癌和光老化的风险。此前的研究报告称，防晒霜的使用量随着单价的增加而减少，而且人们会涂抹防晒霜不足。目的：评估推荐使用防晒霜的成本如何随单价和其他防晒行为而变化。设计与设置：本经济评价研究于2025年7月14日至8月31日进行，根据防晒霜的推荐涂抹量、其他防晒策略的使用情况和2025年防晒霜的价格计算防晒霜的涂抹成本。主要结果和测量方法：主要结果是基于推荐的涂抹量、其他防晒策略的使用以及在线零售商提供的2025年防晒霜价格计算的年度涂抹防晒霜的成本。结果：对于成分和防晒系数等级相似的防晒霜，3种防晒霜的单价相差高达17.5倍。根据典型服装的不同搭配，每次涂抹防晒霜的成本从0.04美元到3.79美元不等，而防晒霜使用一年的成本估计在39.28美元到1429.42美元之间，根据单价和使用的其他防晒策略，相差36倍。在海滩上使用一周的防晒霜，假设一天两次，大约需要6.57美元到135.82美元，这取决于你是穿短裤还是比基尼，以及防晒霜的单价。结论和相关性：这些发现表明，按推荐量涂抹防晒霜的成本因单价和同时使用其他防晒策略而有很大差异。通过鼓励使用其他防晒策略和价格较低的防晒霜来降低潜在成本，可以促进遵守并降低患皮肤癌的风险。

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引用次数: 0

Subcorneal Pustular Dermatosis. 下角膜脓疱性皮肤病。

IF 11 1区医学 Q1 DERMATOLOGY

JAMA dermatology

Pub Date : 2026-02-18 DOI: 10.1001/jamadermatol.2025.4963

Yi-Shan Teng, Yin-Chun Chen

引用次数: 0

Supporting Dermatologic Health Services Research for Structurally Marginalized Patients. 支持结构边缘化患者的皮肤健康服务研究。

IF 11 1区医学 Q1 DERMATOLOGY

JAMA dermatology

Pub Date : 2026-02-18 DOI: 10.1001/jamadermatol.2025.6093

Mya L Roberson, Howa Yeung

引用次数: 0

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