Journal of Drugs in Dermatology最新文献

Background: The pivotal Phase 3 VOYAGE 1 and VOYAGE 2 studies established the robust efficacy and safety of guselkumab for up to 5 years in patients with moderate-to-severe psoriasis. Here, the long-term efficacy of guselkumab by baseline disease severity and treatment history was analyzed using pooled data from the VOYAGE studies.

Methods: Patients were randomized to guselkumab 100 mg every 8 weeks, placebo with week 16 crossover to guselkumab, or adalimumab with week 52 crossover to guselkumab (VOYAGE 1) or week 28-76 randomized withdrawal/re-treatment (VOYAGE 2); all patients then received open-label guselkumab through week 252. These post hoc analyses evaluated the Investigator’s Global Assessment of cleared/minimal (IGA 0/1) and Psoriasis Area and Severity Index (PASI) 90 responses from week 100-252 by baseline PASI (<20/≥20), IGA (=3/=4), body surface area (BSA; <20%/≥20%), and prior psoriasis treatments. Analyses used observed data after applying treatment failure rules.

Results: At all assessment timepoints from weeks 100-252, response rates were similar by baseline PASI <20 vs ≥20 (IGA 0/1: 82.0%-85.4% vs 81.1%-81.4%; PASI 90: 78.6%-81.1% vs 81.4%-83.8%), IGA=3 vs =4 (IGA 0/1: 82.7%-85.4% vs 77.6%-79.0%; PASI 90: 79.1%-82.7% vs 79.7%-82.9%), BSA <20% vs ≥20% (IGA 0/1: 82.5%-86.2% vs 81.1%-82.6%; PASI 90: 80.4%-82.7% vs 79.1%-82.0%), prior phototherapy no vs yes (IGA 0/1: 81.7%-84.3% vs 81.5%-83.8%; PASI 90: 82.2%-84.0% vs 77.5%-81.1%), prior nonbiologic use no vs yes (IGA 0/1: 81.1%-84.5% vs 81.9%-84.1%; PASI 90: 80.9%-83.0% vs 79.0%-82.0%), and prior biologic use no vs yes (IGA 0/1: 83.2%-85.3% vs 75.3%-79.5%; PASI 90: 82.2%-83.8% vs 71.2%-76.3%).

Conclusions: Durable guselkumab efficacy was sustained through 5 years of treatment among patient subpopulations irrespective of baseline disease severity or prior treatment history. J Drugs Dermatol. 2025;24(2):196-202. doi:10.36849/JDD.8344.

Dermatology has entered the long-awaited paradigm shift from steroidal to non-steroidal therapeutics for the topical treatment of atopic dermatitis. Topical Janus kinase (JAK) inhibitors have garnered a strong recommendation for the treatment of adult atopic dermatitis (AD) by the American Academy of Dermatology in the most recent updated guidelines as of 2023. Ruxolitinib 1.5% cream is the only FDA-approved topical JAK inhibitor available in the US and is approved for the short-term and intermittent chronic treatment of mild-to-moderate AD in adolescents and adults aged >= 12 years with up to 20% affected body surface area (BSA). Since approval in 2021, ruxolitinib cream has been shown to be consistently effective across disease severities, age groups, and anatomic sites of special interest (ie, head and neck region, hands). Real-world usage as monotherapy and in combination with other topicals have confirmed its efficacy in practice and further led to reduced usage of topical corticosteroids. Ruxolitinib cream also has the potential to reduce economic costs due to AD-related decline in work productivity. Here, we review the most up-to-date clinical trial and real-world efficacy data that position ruxolitinib 1.5% cream as a first-line AD therapeutic. J Drugs Dermatol. 2025;24:2(Suppl 2):s5-15.

Scalp health is essential for healthy hair growth and may be affected by intrinsic or extrinsic factors. Reactive oxygens species are key contributors to aging and can have a detrimental impact on scalp health. Oxidative stress on the scalp is thought to be a factor in developing dandruff. We present consensus statements on scalp barrier health and its effects on hair through a systematic literature search and expert panel discussion. Three dermatologists with extensive experience in hair were selected to form a panel that formulated consensus statements that would best capture the current understanding of scalp health. The consensus statements developed and presented in this manuscript highlight the current literature and broader discussion surrounding scalp health and its impact on hair and dandruff. It also highlights the often-overlooked effects of scalp conditions on hair health and growth. Through our research, we found that there has been minimal emphasis on scalp health in the setting of dandruff, with most studies focusing on other inflammatory diseases such as psoriasis and atopic dermatitis. Here, we review the clinical importance of focusing on the impact of the scalp barrier condition on hair health. J Drugs Dermatol. 2025;24:2(Suppl 1):s3-7.

Acne vulgaris affects approximately 80% of young adults and adolescents in the world. Acne presents as comedones, pustules, papules, and nodules on the face, chest, shoulders, or back. It can lead to a significant decrease in quality of life with a high risk of associated depression and anxiety. Hyperstimulation of sebaceous glands by androgens play a pivotal role in acne pathogenesis. Clascoterone 1% cream is a first-in-class topical androgen receptor inhibitor approved for treatment of acne in patients 12 years and older. In the following real-world cases, expert dermatologists demonstrate use of clascoterone cream as monotherapy or in combination with other agents to treat acne in a variety of patients. Experts found that twice-daily use led to best overall results with patients. Real-world cases serve as invaluable guides for patients and dermatologists to help form personalized, targeted acne regimens. J Drugs Dermatol. 2025;24:1(Suppl 2):s3-10.

Currently, available technologies and procedures enable aesthetic dermatologists to provide their patients with beneficial treatment outcomes for a wide variety of skin conditions. These treatments range from laser resurfacing and radiofrequency procedures to chemical peels and microneedling. The concept of integrated skincare is based on the application of adjunct therapies before, during, or after cosmetic medical procedures to promote healing, minimize discomfort, shorten down-time, and enhance overall aesthetic outcomes. Numerous peer-reviewed studies have demonstrated the benefit of combining a variety of adjunct treatments with cosmetic procedures. The concurrent application of integrated skincare can improve these skin-related issues and provide patients with greater global outcomes. The primary objective of the following consensus roundtable was to discuss best practices for aesthetic providers with or without dermatological training when treating patients with aging skin complaints and review considerations for evaluating patients interested in cosmetic procedures with concomitant skin issues, such as skin dyschromias, lines, and wrinkles. A roundtable discussion was held by several notable experts in their field during a special addition to the Thriving in Diversity webinar series on Saturday, July 8, 2023. The discussion included four leading dermatologists, one oculoplastic surgeon, and one facial plastic surgeon who provided their clinical experience and consensus recommendations for applying integrated skincare in the aesthetic medical practice. J Drugs Dermatol. 2025;24(1):47-53. doi:10.36849/JDD.7999.

Obesity is a metabolic disease that is marked by excessive fat accumulation and is objectively defined as a body mass index (BMI) ≥30 kg/m2. Obesity is associated with several other comorbidities, including psoriasis, which is a chronic autoimmune skin disease. Adipocytes produce pro-inflammatory signaling molecules, namely adipokines and classic cytokines, that drive increased inflammation axnd may contribute to the pro-inflammatory pathways driving psoriasis disease pathogenesis. Optimizing dermatologic management of obese patients with psoriasis may be challenging due to the effect of comorbid obesity on the pharmacokinetics of systemic therapies. Biologic therapy is a mainstay of psoriasis treatment in these patients. The IL-17 and IL-23 inhibitor classes, including those targeting the IL-17 receptor (brodalumab), IL-17 cytokine antagonists (secukinumab, ixekizumab, bimekizumab), and IL-23 cytokine antagonists (guselkumab, risankizumab, tildrakizumab). In general, the most efficacious biologics that work well for generalized plaque psoriasis also tend to work well for most obese psoriasis patients. For example, brodalumab, an IL-17 receptor inhibitor, demonstrated comparable efficacy across BMI categories in both clinical trial and real-world practice data. In addition to psoriasis-specific therapy, interventions targeted at weight loss may help treat obesity and decrease psoriasis disease severity. These interventions include glucagon-like peptide-1 receptor agonist therapy, caloric restriction, and different forms of bariatric surgery. Clinical trials and real-world data evaluating the efficacy of different biologic treatments and weight-loss interventions in the treatment of obese psoriasis patients should be used to support clinical decision-making for treatment options. J Drugs Dermatol. 2025;24:1(Suppl 1):s4-14.

Background: Delayed reactions to hyaluronic acid (HA) fillers have been reported following various immunologic and infectious triggers.

Aim: Herein, we describe cases of delayed immunologic reactions (DIRs) following HA-soft tissue augmentation fillers precipitated by triggers not previously described in the literature.  Patients: Case 1 describes a 57-year-old female with DIR to HA-filler following a motor vehicle accident in the marionette lines and nasolabial folds. Case 2 is a 54-year-old female who had a filler-related DIR following an episode of contact dermatitis shortly after laser resurfacing. Finally, in Case 3, we diagnosed a 54-year-old female with DIR to HA-filler on the hands following prolonged gardening without gloves.  Conclusion: DIRs are an important filler-related complication. Practitioners need to be aware of the variable clinical presentations and a wide array of triggers. Given that these may not always be preventable, it is important for patients to understand the risk of DIRs, albeit low. J Drugs Dermatol. 2025;24(1):101-103.    doi:10.36849/JDD.8468.

Background: Lentigo maligna (LM), a type of melanoma in situ (MIS), usually develops on sun-damaged skin in the elderly. If left untreated, it may advance to the point of dermal invasion, developing into lentigo maligna melanoma (LMM). While surgeons have achieved robust clinical outcomes for LM treated with Mohs micrographic surgery (MMS), performing this treatment for LMM remains controversial and is not standard amongst all Mohs surgeons.

Objective: We examined survival outcomes in LM/LMM cases treated with MMS and wide local excision (WLE).

Methods: Data from the National Cancer Institute Surveillance, Epidemiology, and End Results (NCI SEER) program, collected from 2000-2019, was retrospectively analyzed. Patients with microscopically confirmed diagnosis of LM/LMM who received surgical treatment with MMS or WLE were included. The effect of different surgery types on melanoma survival was evaluated.

Results: A total of 22,852 LM/LMM cases performed during the years 2000-2019 were considered for analysis. There were no significant differences in disease-specific survival comparing WLE to MMS.

Conclusion: Our research hints at the utility of MMS for LM/LMM. We encourage practitioners to consider MMS for the management LM/LMM when appropriate. J Drugs Dermatol. 2024;23(12):1094-1099.  doi:10.36849/JDD.7898.