Journal of Drugs in Dermatology最新文献

Pseudo-psoriatic nail dystrophy, a form of allergic contact dermatitis (ACD) secondary to nail product use, often mimics nail changes associated with psoriasis, leading to diagnostic delays. This review focuses on identifying dystrophic nail changes, particularly those resembling pseudo-psoriatic alterations, caused by cosmetic nail products and offers diagnostic and management strategies. Among the allergens listed as culprits, triethylene glycol dimethacrylate, hydroxyethyl acrylate, and hydroxyethyl methacrylate were the most common. This poses a challenge in differentiating between ACD and psoriatic onychodystrophy. Thus, enhanced diagnostic approaches emphasizing thorough history taking and appropriate patch testing recommendations are required. This study highlights the clinical overlap while emphasizing the absence of pathognomonic features like oil drops and salmon patches in PPND. Specialized patch testing for acrylates, often missing in standard panels, is crucial for accurate diagnosis. Findings show cessation of offending products significantly improves nail appearance within 3.5 months, reducing the need for systemic psoriasis treatments.  .

Background: Advanced topical nonsteroidal therapies are expanding options for atopic dermatitis (AD) by providing targeted anti-inflammatory control without many limitations of long-term topical corticosteroids. As these agents become more available, practical guidance is needed on their use as first-line therapy, proactive maintenance, combination regimens, safety, and long-term management.

Objective: To develop expert consensus statements defining the clinical role of advanced topical nonsteroidal therapies in AD.

Methods: A seven-dermatologist expert panel used a structured Delphi process informed by a literature review. Statements were drafted, iteratively refined, and voted on across multiple rounds. Evidence quality and strength of recommendations were assessed using the Strength of Recommendation Taxonomy (SORT). Consensus was predefined as ≥75% agreement.

Results: The panel reached unanimous consensus on seven statements regarding advanced topical nonsteroidal therapies, including topical ruxolitinib, tapinarof, roflumilast, crisaborole, tacrolimus, pimecrolimus, and delgocitinib. These therapies were considered effective in reducing AD signs and symptoms, including pruritus, and appropriate as first-line agents for many patients. Their use was associated with longer disease control, fewer relapses, and reduced cumulative topical corticosteroid exposure. The panel agreed that these therapies improve patient-reported outcomes, including quality of life and sleep, and can be safely incorporated into combination regimens with other topical or systemic treatments. They demonstrated favorable safety and tolerability profiles without the need for baseline or ongoing laboratory monitoring. Compared with topical corticosteroids, nonsteroidal therapies were preferred for long-term management to avoid steroid-associated adverse effects, with simplified dosing and suitability for sensitive and high-impact sites supporting adherence.

Conclusion: Advanced topical nonsteroidal therapies represent an important evolution in AD management and are appropriate first-line options across disease severities, supporting sustained disease control and improved quality of life.

Background: Eyebrow madarosis, or eyebrow alopecia, has significant cosmetic and psychosocial implications. Nonscarring causes are diverse, including autoimmune, infectious, endocrine, genetic, nutritional, traumatic, and iatrogenic etiologies. Despite its frequency in dermatologic practice, guidance for evaluation and management remains limited.

Methods: A comprehensive PubMed search (1960–2025) was performed using terms related to "eyebrow alopecia," "eyebrow madarosis," and specific disease processes. English-language studies were included if they evaluated eyebrow involvement and provided data on etiology, diagnosis, or treatment. Review articles without new patient data and studies limited to scalp alopecia were excluded.

Results: Nonscarring eyebrow alopecia can be caused by autoimmune disorders such as alopecia areata, infections including syphilis and tinea faciei, endocrinologic conditions like hypothyroidism, and inflammatory dermatoses such as atopic or seborrheic dermatitis. Additional causes include nutritional deficiencies, trauma, and drug-induced alopecia. Reported treatments include corticosteroids, calcineurin inhibitors, JAK inhibitors, immunomodulators, antifungals, zinc supplementation, and behavioral therapy. Novel agents such as dupilumab and roflumilast have shown promise for inflammatory-related eyebrow loss.

Conclusion: Nonscarring eyebrow madarosis encompasses a wide range of reversible causes. Early recognition and targeted therapy can lead to eyebrow regrowth and improve psychosocial outcomes. Further studies are needed to establish evidence-based treatment algorithms and validated tools to assess eyebrow regrowth.

Background: Alzheimer's disease (AD) and dementia create major global health and economic burdens. Herpes simplex virus (HSV) infects over 3 billion people, and chronic infection is increasingly linked to neurodegeneration.

Objectives: To evaluate whether antiviral therapy for oral, mucocutaneous, or anogenital HSV lowers the subsequent risk of AD and dementia.

Methods: A retrospective cohort study with propensity-score matching was performed in the TriNetX Research Network. On 24 May 2024, 615,324 individuals with HSV were identified; those with prior AD, intracranial injury, or cerebral infarction were excluded. Matching balanced age, sex, race, body-mass index, smoking, diabetes, and hypertension between antiviral-treated and untreated groups. Therapies included acyclovir, valacyclovir, penciclovir, ganciclovir, valganciclovir, and famciclovir. Incidences of AD and dementia were identified by ICD-10 codes, and relative risks (RR) with 95% confidence intervals (CI) were calculated.

Results: After matching, 231,277 patients per cohort (mean age 36.8 y; 67.7% female) were analyzed. Antiviral treatment for oral/mucocutaneous HSV significantly reduced the risk of AD (RR 0.87; 95% CI 0.73-0.92) and dementia (RR 0.83; 95% CI 0.77-0.90). No significant association was observed for anogenital HSV.

Conclusions: Antiviral therapy for oral or mucocutaneous HSV was associated with a 13% to 17% reduction in risk for AD and dementia. These findings suggest that early antiviral management of HSV infections may represent a feasible preventive strategy against neurodegenerative disease, meriting prospective confirmation.  .

Background: Plaque psoriasis is a chronic immune-mediated disease driven by proinflammatory cytokines. Brodalumab—a recombinant, human monoclonal antibody that functions as an interleukin-17 receptor A blocker—was approved in 2017 in the United States for treatment of moderate-to-severe plaque psoriasis in adults who are candidates for systemic or phototherapy and have failed to respond to/have lost response to other systemic therapies. While efficacy and safety of brodalumab for moderate-to-severe plaque psoriasis were demonstrated across phase 2 and 3 clinical trials, long-term data from these trials and several real-world studies have since been published.

Methods: In this review, we summarize efficacy/safety findings from long-term clinical trials and real-world studies. Updated US pharmacovigilance data collected over 8 years of clinical brodalumab usage are also provided.

Results: Across clinical trials and real-world studies, brodalumab consistently delivered rapid skin clearance, high rates of complete response, and sustained disease control, even among patients who have not achieved adequate benefit with other biologics. An integrated analysis of 5 clinical trials showed brodalumab was well tolerated and not associated with increased risk of malignancy, major adverse cardiac events, suicidal ideation/behavior, or fatal adverse events over 52 weeks. This, combined with 8 years of pharmacovigilance experience, affirms a stable safety profile, with no new safety signals and no demonstrated causal links to increased psychiatric events.

Conclusion: These findings reinforce that brodalumab is an important, well-tolerated therapeutic option for achieving high levels of disease control in patients with moderate-to-severe psoriasis, including those with prior biologic exposure or difficult-to-treat disease manifestations.  .

Background: Skin thinning, known as dermatoporosis, is an expected consequence of aging that involves structural weaknesses, barrier deficiencies, and cellular senescence, posing challenges for maintaining long-term skin health.

Objective: To introduce Skin Activation as a dermatologic strategy for promoting skin longevity. It is supported by clinical and preclinical evidence, combining methods to remodel the extracellular matrix (ECM) and dermo-epidermal junction (DEJ), restore the barrier, and enhance hydration, along with reducing senescent cells. This improves the skin's functional resilience.

Methods: Data were generated from a multicenter dermatoporosis trial, a randomized controlled trial, and specific cohorts of sensitive skin patients, in addition to preclinical studies. Study endpoints included trans-epidermal water loss (TEWL), hydration levels, LC-Optical Coherence Tomography (LC-OCT), assessments of the DEJ, ultrasound measurements, senescent markers, and histology. The data also included measures of senescence, cytokine profiles, and biomarkers of cellular renewal.

Results: Among 400 participants, notable changes included a 20-40% reduction in TEWL, an 80% increase in hydration based on corneometer readings, a 5% rise in skin thickness, and improved DEJ integrity in 83% of subjects compared to 17% of controls. In preclinical ex vivo models, decreases in fibroblast senescence levels were observed, along with activation of the JAG/NOTCH pathway.

Conclusion: A recently developed skin activator program shifts dermatologic skin health strategies from a broad anti-aging focus to a more targeted skin activation approach focused on structure, function, and cellular energy and renewal. This reinforces the ongoing commitment to dermatological innovation and establishes a more structured approach to skin longevity.  .