Journal of Drugs in Dermatology最新文献

Brodalumab is a recombinant, fully human monoclonal antibody antagonist of the human interleukin-17 (IL-17) receptor A. It is indicated for the treatment of moderate-to-severe plaque psoriasis in adult patients who are candidates for systemic therapy or phototherapy and have failed to respond or have lost response to other systemic therapies. Brodalumab blocks signaling mediated by IL-17 cytokines, disrupting the inflammatory feedback loop between immune cells and keratinocytes that drives psoriasis, which may explain its efficacy in clinical trials. To explore its postapproval effectiveness, this review synthesizes real-world evidence of brodalumab across 14 international studies. Studies showed rapid onset of action and sustained effectiveness through extended follow-up periods. Notably, brodalumab achieved high response rates in patients whose psoriasis had failed to respond to prior IL-17A inhibitors. Comparative analyses position brodalumab favorably against other biologics, demonstrating its superior response rates and faster onset of action. Furthermore, brodalumab was efficacious in difficult-to-treat psoriasis manifestations, including nail psoriasis, generalized pustular psoriasis, and psoriatic erythroderma. Limitations of this report include variations in study designs, follow-up durations, and baseline characteristics across reviewed studies. The evidence collectively establishes brodalumab as a valuable therapeutic option, particularly for patients with treatment-resistant psoriasis and challenging subtypes.  .

Background: Racial disparities in clinical trial enrollment can limit the generalizability of therapeutic data, which is particularly damaging for conditions that disproportionately impact minority patients, such as mycosis fungoides and Sézary syndrome.

Objective: To characterize the racial demographics of mycosis fungoides/Sezary syndrome (MF/SS) clinical trials and explore potential barriers to enrollment for Black patients in the United States (US).

Methods: We searched the terms "mycosis fungoides," "Sezary syndrome," "CTCL," and "Cutaneous T-Cell Lymphoma" on ClinicalTrials.gov. Interventional trials that were completed with results posted and had at least one site within the US were included. We assessed racial demographics, trial enrollment proportions relative to 2023 US Census data, geographic access, exclusion criteria, and race-based reporting practices.

Results: A total of 1483 participants across 27 trials were characterized, 154 (10.4%) of whom identified as Black. Compared to population data from the 2023 US Census, Black patients were significantly underrepresented (P<0.001) in MF/SS trials overall, overrepresented in Phase 1 trials (P=0.013), and underrepresented in Phase 3 trials (P<0.001). Most trial sites (69%) were in areas with moderate (12.6-49.9%) to high (≥50%) Black populations. There were no significant differences in exclusion criteria between low- and high-Black-enrolling trials. Of 36 trial-related publications identified, only 14 (39%) reported participant race.

Conclusions: The findings of this study reveal significant racial disparities in MF/SS clinical trial enrollment. Identifying these disparities and investigating barriers to enrollment ensures that MF/SS patients of all racial backgrounds are appropriately represented at each phase of the experimental process.  .

Introduction: Dominant dystrophic epidermolysis bullosa (DDEB) is a hereditary genetic disorder with a mutation of the type VII collagen gene (COL7A1), leading to a destabilized dermal-epidermal junction. Current treatments for DDEB are supportive, and new gene therapies are being developed to target DDEB. However, gene therapy can be expensive.

Case report: A 59-year-old woman presented with eroded blisters on her right lower extremity. Genetic testing identified a pathogenic COL7A1 mutation, confirming the diagnosis of DDEB. She was treated with 6 weeks of gentian violet and trichloroacetic acid peel, resulting in significant improvement of her lesions.

Discussion: DDEB is characterized by dysregulated inflammation of chronic wounds and aberrant fibroblast activity. Gentian violet and trichloroacetic acid may address inflammation while reducing fibroblast activity and preventing infection. The treatment worked well for the patient, and there was minimal pain with the application of these topical therapies.  .

Background: Deucravacitinib, a first-in-class, oral, selective TYK2 inhibitor, has redefined systemic therapy options for moderate-to-severe plaque psoriasis. This review synthesizes published data from the POETYK phase 3 and long-term extension (LTE) studies, together with current research and real-world clinical evidence, to provide clinicians a comprehensive perspective on the agent’s long-term efficacy, safety, and clinical utility.

Objective: To synthesize long-term efficacy and safety data for deucravacitinib and provide practical insights for real-world use.

Discussion: We reviewed published, long-term data for 1,519 patients on deucravacitinib over 5,000 person-years of exposure. Sustained clinical response was observed in the efficacy cohort (n=513), with PASI 75/90/100 responses maintained at 67%, 46%, and 22% at week 256 (mNRI). Nearly half of patients achieved minimal disease impact on daily life (DLQI 0/1). Patient-reported outcomes confirmed durable improvement in symptoms, itch, and quality of life. Deucravacitinib demonstrated a consistent safety profile with no new signals in the available long-term data. Rates of adverse and serious adverse events declined over time; acne, when present, was mild and transient. The agent’s selective TYK2 regulatory-domain inhibition distinguishes it mechanistically from broader JAK inhibitors, underpinning its favorable safety and tolerability.

Conclusions: Long-term evidence affirms deucravacitinib’s durable disease control, stable safety, and patient-friendly convenience. With once-daily oral dosing, minimal laboratory monitoring, and efficacy across difficult-to-treat sites, deucravacitinib represents a practical and reliable long-term therapy with oral simplicity for patients with moderate-to-severe plaque psoriasis. J Drugs Dermatol. 2026;25:2(Suppl 1):s3-s10.

Acne vulgaris is an inflammatory skin condition affecting adolescents and adults of both sexes. Clascoterone cream 1% is indicated for the topical treatment of acne vulgaris in patients ≥12 years of age based on the results of two Phase 3 trials (NCT02608450 and NCT02608476). This post hoc analysis evaluated the efficacy and safety of clascoterone cream 1% in patient subgroups defined by age (adolescent vs adult) and sex (male vs female). Patients ≥12 years of age with mild-to-moderate acne applied clascoterone cream 1% or vehicle twice daily for 12 weeks. Efficacy was assessed from Investigator’s Global Assessment (IGA) treatment success and inflammatory, noninflammatory, and total lesion counts, and safety from frequency and severity of adverse events. Treatment with clascoterone cream 1% vs vehicle resulted in significantly greater IGA treatment success rates for all subgroups: at week 12, 47/287 (16.4%) vs 12/306 (3.9%) adolescent, 77/330 (23.3%) vs 29/309 (9.4%) adult, 32/226 (14.2%) vs 13/252 (5.2%) male, and 92/391 (23.5%) vs 28/363 (7.7%) female patients achieved IGA treatment success. Patients treated with clascoterone cream 1% vs vehicle in all subgroups also experienced significantly greater lesion count reductions. From baseline to week 12, clascoterone cream 1% treatment resulted in significantly larger reductions in lesion counts in adult vs adolescent patients; there were no statistically significant differences between male and female patients. Adverse events were similar across subgroups. These results further support the efficacy and tolerability of clascoterone cream 1% across the spectrum of patients ≥12 years of age with acne vulgaris.  .

Background: Granuloma annulare (GA) is a benign inflammatory dermatosis characterized by dermal granuloma formation. While its etiology is unclear, GA has been linked to systemic comorbidities. Localized GA typically responds to corticosteroids, but generalized GA often follows a more refractory course. Pentoxifylline has emerged as a potential steroid-sparing agent, though data are limited.

Methods: A retrospective chart review was conducted on 102 patients diagnosed with GA at a single academic dermatology clinic in rural Appalachia. Demographic data, disease subtype, treatment history, and comorbidities were recorded. Comorbidity prevalence was compared with state and national averages. Statistical analysis assessed associations between disease extent, treatment response, and comorbidity burden.

Results: The cohort was 79% female with a mean age of 46 years; 19% of cases were pediatric. Generalized GA accounted for 46% of cases and showed elevated rates of type 2 diabetes (36%), hypothyroidism (26%), and autoimmune disease (15%). Patients with ≥3 comorbidities were more likely to have prolonged disease (>2 years). Generalized GA required more treatment attempts (P<0.001) and had higher failure rates than localized disease. Pentoxifylline achieved a 64% response rate in generalized GA, outperforming hydroxychloroquine and topical corticosteroids.

Conclusions: Generalized GA is more treatment-resistant and associated with a greater comorbidity burden. Pentoxifylline demonstrated favorable efficacy and may serve as a first-line systemic agent in refractory cases. Further multi-center studies are needed to validate these findings and guide evidence-based management of GA.  .

Lichen planus pigmentosus (LPP) is a rare pigmentary disorder primarily affecting patients with skin of color. Currently, comprehensive evaluations for procedural interventions for LPP are limited in the literature. In this review, we assess current procedural options for LPP treatment, focusing on their efficacy, safety, and practical considerations. A comprehensive literature search using PubMed and Embase identified English studies published through December 2024 that examined cosmetic procedures for the treatment of LPP. Keywords included “lichen planus pigmentosus,” “laser,” “chemical peel,” “glycolic acid,” “salicylic acid,” “TCA,” “jessner,” “VI,” “cosmetic procedure,” “procedure”, and related terms. Articles without original data, sufficient results, or human participants were excluded. Data on study design, participant characteristics, procedural details, and clinical outcomes were extracted and reported in this descriptive review. A total of 16 studies were reviewed, which highlighted procedural approaches to managing LPP, including chemical peels (eg, phenol and glycolic acid), laser therapy (eg, Q-switched Nd:YAG, CO2 fractional, Picosecond Nd:YAG, erbium-doped fiber), and platelet-rich plasma therapy. Evidence was limited by small sample sizes, lack of randomized controlled trials, and reliance on case reports and series. Most studies included fewer than 20 participants, limiting the generalizability of findings. In conclusion, procedural interventions can serve as an alternative treatment option for LPP, especially for those unresponsive to standard treatments. Further research with larger cohorts and comparative trials are needed to further elucidate current findings. J Drugs Dermatol. 2026;25(2): doi:10.36849/JDD.9209.