Pub Date : 2026-03-01Epub Date: 2026-03-09DOI: 10.1016/S0022-202X(26)00554-3
Daniela Mendoza Millan MD , Laura Ghanem , Bárbara Baptista Lopes , Martin Cevallos-Cueva , Devanie Martani , Cristina Sicorschi Gutu MD , Virginia Velasco-Tamariz MD , Peter Chien MD PhD
Ruxolitinib cream is currently FDA-approved for treating mild-to-moderate atopic dermatitis (AD) in patients ≥12 years, with a potential expansion to include children aged 2—11 years under active review. This updated systematic review and meta-analysis evaluated the efficacy and safety of ruxolitinib cream compared to vehicle, with a focus on age-based outcomes. We included 5 randomized controlled trials comprising 1912 patients aged 2—70 years. Subgroup analyses were performed for children (<12 years, n=265) versus adolescents/adults (≥12 years). Ruxolitinib significantly improved IGA-TS (RR 4.00, 95% CI 2.97—5.38) and EASI75 (RR 3.16, 95% CI 2.21—4.51) at 8 weeks. Both age groups showed significant benefit in IGA-TS (RR 3.43 in children vs. 5.07 in adolescents/adults) and EASI75 (RR 4.69 vs. 2.30), with no significant differences between groups. The incidence of TEAEs was unsignificantly increased in children (RR 1.14; p=0.55), while adolescents/adults showed a reduction (RR 0.83; p=0.04). However, some pediatric outcomes may reflect limited statistical power due to the smaller sample size compared to broader adult data. These findings support the expanding role of topical ruxolitinib as a non-steroidal, well-tolerated option for pediatric AD. As the FDA evaluates its use in children as young as 2 years, our results highlight the need for further high-powered pediatric trials, long-term safety studies, and real-world data to guide age-appropriate clinical use.
Ruxolitinib乳膏目前已被fda批准用于治疗≥12岁患者的轻中度特应性皮炎（AD），并有可能扩大到2-11岁的儿童，目前正在积极审查中。这一更新的系统综述和荟萃分析评估了ruxolitinib乳膏与对照剂相比的疗效和安全性，重点是基于年龄的结果。我们纳入了5项随机对照试验，包括1912名年龄在2-70岁的患者。对儿童（12岁，n=265）和青少年/成人（≥12岁）进行亚组分析。Ruxolitinib在8周时显著改善IGA-TS （RR 4.00, 95% CI 2.97-5.38）和EASI75 （RR 3.16, 95% CI 2.21-4.51）。两个年龄组在IGA-TS（儿童RR为3.43，青少年/成人RR为5.07）和EASI75 （RR为4.69，青少年/成人RR为2.30）方面均有显著获益，组间无显著差异。儿童teae发生率无显著升高（RR = 1.14; p=0.55），而青少年/成人发生率降低（RR = 0.83; p=0.04）。然而，与广泛的成人数据相比，由于样本量较小，一些儿科结果可能反映出有限的统计效力。这些发现支持外用ruxolitinib作为一种非甾体、耐受性良好的儿科AD治疗选择的作用扩大。由于FDA评估其在2岁以下儿童中的使用，我们的结果强调需要进一步的高强度儿科试验，长期安全性研究和实际数据来指导适合年龄的临床使用。
{"title":"Assessing Topical Ruxolitinib for Atopic Dermatitis Across Age Groups: A Meta-Analysis of Pediatric and Adult Data","authors":"Daniela Mendoza Millan MD , Laura Ghanem , Bárbara Baptista Lopes , Martin Cevallos-Cueva , Devanie Martani , Cristina Sicorschi Gutu MD , Virginia Velasco-Tamariz MD , Peter Chien MD PhD","doi":"10.1016/S0022-202X(26)00554-3","DOIUrl":"10.1016/S0022-202X(26)00554-3","url":null,"abstract":"<div><div>Ruxolitinib cream is currently FDA-approved for treating mild-to-moderate atopic dermatitis (AD) in patients ≥12 years, with a potential expansion to include children aged 2—11 years under active review. This updated systematic review and meta-analysis evaluated the efficacy and safety of ruxolitinib cream compared to vehicle, with a focus on age-based outcomes. We included 5 randomized controlled trials comprising 1912 patients aged 2—70 years. Subgroup analyses were performed for children (<12 years, n=265) versus adolescents/adults (≥12 years). Ruxolitinib significantly improved IGA-TS (RR 4.00, 95% CI 2.97—5.38) and EASI75 (RR 3.16, 95% CI 2.21—4.51) at 8 weeks. Both age groups showed significant benefit in IGA-TS (RR 3.43 in children vs. 5.07 in adolescents/adults) and EASI75 (RR 4.69 vs. 2.30), with no significant differences between groups. The incidence of TEAEs was unsignificantly increased in children (RR 1.14; p=0.55), while adolescents/adults showed a reduction (RR 0.83; p=0.04). However, some pediatric outcomes may reflect limited statistical power due to the smaller sample size compared to broader adult data. These findings support the expanding role of topical ruxolitinib as a non-steroidal, well-tolerated option for pediatric AD. As the FDA evaluates its use in children as young as 2 years, our results highlight the need for further high-powered pediatric trials, long-term safety studies, and real-world data to guide age-appropriate clinical use.</div></div>","PeriodicalId":16311,"journal":{"name":"Journal of Investigative Dermatology","volume":"146 3","pages":"Page S5"},"PeriodicalIF":5.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147428567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-09-04DOI: 10.1016/j.jid.2025.08.034
Wooil Choi , Dong Jun Park , Robert A. Dorschner , Katie Pool , Sakeef Sayeed , Jenny Kezios , Jaebin Lee , Sebastian Adlawan , Brian P. Eliceiri
Normal cutaneous wound healing is a multicellular process that involves the release of small extracellular vesicles (sEVs) that coordinate intercellular communication by delivery of sEV payloads to recipient cells. We have recently shown how the proreparative activity of inflammatory cell sEVs, especially macrophage and neutrophil-derived sEVs, in the wound bed is dysregulated in impaired wound healing. In this study, we show that loss of Rab27A, a small GTPase that has a regulatory function in sEV secretion, reduces the release of neutrophil and macrophage-derived sEVs. Proteomic profiling of sEVs identified Rab27A-dependent protein payloads relevant in neutrophil activation, such as CD44, leukotriene A4 hydrolase, complement C5, and neutrophilic granule protein. We defined the activity of sEVs derived from Rab27A-knockout donors by demonstrating a delayed neutrophil recruitment in the initial injury response. The dysfunction of Rab27-knockout sEVs was linked to an increase in the release of CCL4, consistent with the sustained inflammation observed in vivo and reduced neutrophil migration in vitro. Together, these findings show how a specific regulator of sEV biogenesis can direct protein payloads and activities that mediate neutrophil trafficking in wound healing.
正常皮肤伤口愈合是一个多细胞过程，涉及小细胞外囊泡（sEV）的释放，通过向受体细胞递送sEV有效载荷来协调细胞间通讯。我们最近展示了炎症细胞sev的促修复活性，特别是巨噬细胞和中性粒细胞衍生的sev，在伤口愈合受损时是如何失调的。本研究表明，Rab27A（一种对sEV分泌具有调节功能的小GTPase）的缺失会减少中性粒细胞和巨噬细胞衍生的sEV的释放。sev的蛋白质组学分析鉴定了与中性粒细胞活化相关的rab27a依赖性蛋白有效载荷，如CD44、白三烯A4水解酶、补体C5和中性粒细胞颗粒蛋白。我们通过证明在初始损伤反应中中性粒细胞的延迟募集来定义来自Rab27A敲除供体的sev的活性。Rab27 KO sev的功能障碍与CCL4释放增加有关，这与体内观察到的持续炎症和体外中性粒细胞迁移减少相一致。综上所述，这些发现表明了sEV生物发生的特定调节因子如何指导伤口愈合过程中介导中性粒细胞运输的蛋白质有效载荷和活动。
{"title":"Regulated Release of Small Extracellular Vesicles Directs Neutrophil Recruitment in Cutaneous Wound Healing","authors":"Wooil Choi , Dong Jun Park , Robert A. Dorschner , Katie Pool , Sakeef Sayeed , Jenny Kezios , Jaebin Lee , Sebastian Adlawan , Brian P. Eliceiri","doi":"10.1016/j.jid.2025.08.034","DOIUrl":"10.1016/j.jid.2025.08.034","url":null,"abstract":"<div><div>Normal cutaneous wound healing is a multicellular process that involves the release of small extracellular vesicles (sEVs) that coordinate intercellular communication by delivery of sEV payloads to recipient cells. We have recently shown how the proreparative activity of inflammatory cell sEVs, especially macrophage and neutrophil-derived sEVs, in the wound bed is dysregulated in impaired wound healing. In this study, we show that loss of Rab27A, a small GTPase that has a regulatory function in sEV secretion, reduces the release of neutrophil and macrophage-derived sEVs. Proteomic profiling of sEVs identified Rab27A-dependent protein payloads relevant in neutrophil activation, such as CD44, leukotriene A4 hydrolase, complement C5, and neutrophilic granule protein. We defined the activity of sEVs derived from Rab27A-knockout donors by demonstrating a delayed neutrophil recruitment in the initial injury response. The dysfunction of Rab27-knockout sEVs was linked to an increase in the release of CCL4, consistent with the sustained inflammation observed in vivo and reduced neutrophil migration in vitro. Together, these findings show how a specific regulator of sEV biogenesis can direct protein payloads and activities that mediate neutrophil trafficking in wound healing.</div></div>","PeriodicalId":16311,"journal":{"name":"Journal of Investigative Dermatology","volume":"146 3","pages":"Pages 797-811.e1"},"PeriodicalIF":5.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-09-30DOI: 10.1016/j.jid.2025.08.030
Melanie Haverkamp , Astrid S. Plomp , Jeannette Ossewaarde-van Norel , Redmer van Leeuwen , Pim A. de Jong , Frank L.J. Visseren , Wilko Spiering
{"title":"Letter in Response to Verschuere et al","authors":"Melanie Haverkamp , Astrid S. Plomp , Jeannette Ossewaarde-van Norel , Redmer van Leeuwen , Pim A. de Jong , Frank L.J. Visseren , Wilko Spiering","doi":"10.1016/j.jid.2025.08.030","DOIUrl":"10.1016/j.jid.2025.08.030","url":null,"abstract":"","PeriodicalId":16311,"journal":{"name":"Journal of Investigative Dermatology","volume":"146 3","pages":"Pages 850-852"},"PeriodicalIF":5.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-03-09DOI: 10.1016/S0022-202X(26)00619-6
Anastasia Chajecki BS , Colleen Cotton MD
Background: Hidradenitis suppurativa (HS) is a chronic inflammatory disease characterized by recurrent painful abscesses and sinus tracts, significantly impacting pediatric patients’ quality of life. Although surgical interventions such as deroofing have demonstrated promising outcomes in adults, there remains a lack of data regarding the effectiveness of these procedures in the pediatric population. Objective: This study aims to evaluate the clinical outcomes of pediatric HS patients post-deroofing, including recurrence rates, healing duration, complications, and remission length. We also aim to identify clinical and demographic predictors of surgical success. Methods: This retrospective cohort study identified 26 pediatric HS patients who underwent surgical deroofing at Children’s National Hospital between 08/ 01/2023 and 09/15/2024. Eligibility required ≥1 year postoperative follow-up. Data collection is still ongoing. Outcomes to be assessed include recurrence, healing time, complications, and remission duration. Multivariate analysis will identify preoperative demographic and clinical predictors significantly associated with positive surgical outcomes. Conclusion: By analyzing the outcomes of deroofing in pediatric HS patients, this study aims to improve surgical decision-making, inform patient selection, and optimize the management of HS in pediatric patients. Additional data collection from other sites to improve the generalizability of our observations is planned.
{"title":"Outcomes and Predictors of Success in Pediatric Hidradenitis Suppurativa Deroofing Procedures","authors":"Anastasia Chajecki BS , Colleen Cotton MD","doi":"10.1016/S0022-202X(26)00619-6","DOIUrl":"10.1016/S0022-202X(26)00619-6","url":null,"abstract":"<div><div>Background: Hidradenitis suppurativa (HS) is a chronic inflammatory disease characterized by recurrent painful abscesses and sinus tracts, significantly impacting pediatric patients’ quality of life. Although surgical interventions such as deroofing have demonstrated promising outcomes in adults, there remains a lack of data regarding the effectiveness of these procedures in the pediatric population. Objective: This study aims to evaluate the clinical outcomes of pediatric HS patients post-deroofing, including recurrence rates, healing duration, complications, and remission length. We also aim to identify clinical and demographic predictors of surgical success. Methods: This retrospective cohort study identified 26 pediatric HS patients who underwent surgical deroofing at Children’s National Hospital between 08/ 01/2023 and 09/15/2024. Eligibility required ≥1 year postoperative follow-up. Data collection is still ongoing. Outcomes to be assessed include recurrence, healing time, complications, and remission duration. Multivariate analysis will identify preoperative demographic and clinical predictors significantly associated with positive surgical outcomes. Conclusion: By analyzing the outcomes of deroofing in pediatric HS patients, this study aims to improve surgical decision-making, inform patient selection, and optimize the management of HS in pediatric patients. Additional data collection from other sites to improve the generalizability of our observations is planned.</div></div>","PeriodicalId":16311,"journal":{"name":"Journal of Investigative Dermatology","volume":"146 3","pages":"Page S21"},"PeriodicalIF":5.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147427083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-03-09DOI: 10.1016/S0022-202X(26)00612-3
Maria Gnarra Buethe MD, PhD , Joyce Teng MD , James Treat MD , Alison Small MD , Jeff Martini MD , Christiaan Noyes
The Treatment Satisfaction Questionnaire for Medication (TSQM) is an important tool to capture a patient’s perspective on efficacy, convenience, and tolerability of a treatment and can serve as important evidence to assess clinical meaningfulness and support FDA labeling. For chronic conditions like microcystic lymphatic malformations (mLM), a serious disease with no FDA-approved therapies, treatment satisfaction is key to supporting adherence and sustained clinical benefit. QTORIN™ 3.9% rapamycin anhydrous gel is an innovative and patented targeted topical formulation designed to deliver high concentrations of rapamycin to the dermis with low systemic absorption. In a recently completed Phase 2 study, participants aged ≥6 years with mLM applied the therapy once daily. Efficacy was assessed at Week 12 and satisfaction was measured using the TSQM. High patient satisfaction was reported, with 100% of participants expressing overall satisfaction. The therapy was rated highly for ability to treat the condition, convenience, and ease of use. Most participants were confident the medication was good for them and the benefits outweighed downsides. These results suggest the therapy is perceived as effective, convenient, and well tolerated, attributes important for life-long therapy where adherence is required for chronic disease. Patient-reported satisfaction adds important context to efficacy and safety data, helping ensure treatment benefits are meaningful to those living with mLM.
{"title":"Assessing Clinical Meaningfulness to Patients Through the TSQM: Results from a Phase 2 Trial with QTORIN TM Rapamycin","authors":"Maria Gnarra Buethe MD, PhD , Joyce Teng MD , James Treat MD , Alison Small MD , Jeff Martini MD , Christiaan Noyes","doi":"10.1016/S0022-202X(26)00612-3","DOIUrl":"10.1016/S0022-202X(26)00612-3","url":null,"abstract":"<div><div>The Treatment Satisfaction Questionnaire for Medication (TSQM) is an important tool to capture a patient’s perspective on efficacy, convenience, and tolerability of a treatment and can serve as important evidence to assess clinical meaningfulness and support FDA labeling. For chronic conditions like microcystic lymphatic malformations (mLM), a serious disease with no FDA-approved therapies, treatment satisfaction is key to supporting adherence and sustained clinical benefit. QTORIN™ 3.9% rapamycin anhydrous gel is an innovative and patented targeted topical formulation designed to deliver high concentrations of rapamycin to the dermis with low systemic absorption. In a recently completed Phase 2 study, participants aged ≥6 years with mLM applied the therapy once daily. Efficacy was assessed at Week 12 and satisfaction was measured using the TSQM. High patient satisfaction was reported, with 100% of participants expressing overall satisfaction. The therapy was rated highly for ability to treat the condition, convenience, and ease of use. Most participants were confident the medication was good for them and the benefits outweighed downsides. These results suggest the therapy is perceived as effective, convenient, and well tolerated, attributes important for life-long therapy where adherence is required for chronic disease. Patient-reported satisfaction adds important context to efficacy and safety data, helping ensure treatment benefits are meaningful to those living with mLM.</div></div>","PeriodicalId":16311,"journal":{"name":"Journal of Investigative Dermatology","volume":"146 3","pages":"Page S19"},"PeriodicalIF":5.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147427093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-03-09DOI: 10.1016/S0022-202X(26)00592-0
Ana Carolina Ventura de Santana de Jesus , Ana Carolina Putini Vieira , Ana Clara Felix de Farias Santos , Karine Matos de Albuquerque , Maria LR Defante , Pablo Augusto Araujo Silva , Lorena Oliveira Fonseca MD , Luisa Medeiros Visentini , Alice Villa Bella Meirelles , Evardo Barros de Deus Nunes Junior MD
Dermatitis artefacta (DA) is a factitious dermatosis characterized by self-inflicted skin lesions, often linked to psychological distress. Though well-known in adults, pediatric cases remain underrecognized, leading to frequent misdiagnosis and mismanagement. This systematic review characterizes dermatological findings and psychiatric comorbidities in pediatric DA. Following PRISMA guidelines, we conducted a systematic review by searching PubMed, Embase, and Web of Science through June 2025 for observational studies and case series with more than five pediatric patients with DA. 9 studies were included, comprising 640 patients aged 1.8 to 18 years. The most commonly reported cutaneous manifestations included excoriations (10.2%), erythematous-shedding plaques (9.9%), and bruises (9.6%). Lesions often presented in multiple forms and anatomical sites, predominantly affecting head and neck, and limbs. Patients diagnosed with DA demonstrated a significant risk and prevalence of anxiety, obsessive-compulsive disorder, and depression. Psychosocial stressors, such as family dysfunction, and bullying were frequently identified as contributing factors. Most of the studies exhibited a low risk of bias. This pediatric-focused review highlights the link between skin and psychiatric issues in DA, stressing the need for early psychiatric care, multidisciplinary evaluation, and increased clinical awareness to improve outcomes for affected children.
人工皮炎（DA）是一种人为皮肤病，其特征是自己造成的皮肤损伤，通常与心理困扰有关。虽然在成人中众所周知，但儿科病例仍未得到充分认识，导致经常误诊和管理不善。本系统综述了儿科DA的皮肤病学表现和精神病学合并症。遵循PRISMA指南，我们通过检索PubMed、Embase和Web of Science进行了一项系统综述，检索了截至2025年6月的观察性研究和5例以上儿童DA患者的病例系列。纳入9项研究，包括640名年龄在1.8至18岁之间的患者。最常见的皮肤表现包括擦伤（10.2%）、红斑脱落斑块（9.9%）和瘀伤（9.6%）。病变通常表现为多种形式和解剖部位，主要影响头颈部和四肢。诊断为DA的患者表现出焦虑、强迫症和抑郁症的显著风险和患病率。社会心理压力因素，如家庭功能障碍和欺凌经常被认为是促成因素。大多数研究显示偏倚风险较低。这篇以儿科为重点的综述强调了DA中皮肤与精神问题之间的联系，强调了早期精神病学护理、多学科评估和提高临床意识以改善患儿预后的必要性。
{"title":"Pediatric Dermatitis Artefacta: A Systematic Review of Dermatological Features and Psychiatric Comorbidities","authors":"Ana Carolina Ventura de Santana de Jesus , Ana Carolina Putini Vieira , Ana Clara Felix de Farias Santos , Karine Matos de Albuquerque , Maria LR Defante , Pablo Augusto Araujo Silva , Lorena Oliveira Fonseca MD , Luisa Medeiros Visentini , Alice Villa Bella Meirelles , Evardo Barros de Deus Nunes Junior MD","doi":"10.1016/S0022-202X(26)00592-0","DOIUrl":"10.1016/S0022-202X(26)00592-0","url":null,"abstract":"<div><div>Dermatitis artefacta (DA) is a factitious dermatosis characterized by self-inflicted skin lesions, often linked to psychological distress. Though well-known in adults, pediatric cases remain underrecognized, leading to frequent misdiagnosis and mismanagement. This systematic review characterizes dermatological findings and psychiatric comorbidities in pediatric DA. Following PRISMA guidelines, we conducted a systematic review by searching PubMed, Embase, and Web of Science through June 2025 for observational studies and case series with more than five pediatric patients with DA. 9 studies were included, comprising 640 patients aged 1.8 to 18 years. The most commonly reported cutaneous manifestations included excoriations (10.2%), erythematous-shedding plaques (9.9%), and bruises (9.6%). Lesions often presented in multiple forms and anatomical sites, predominantly affecting head and neck, and limbs. Patients diagnosed with DA demonstrated a significant risk and prevalence of anxiety, obsessive-compulsive disorder, and depression. Psychosocial stressors, such as family dysfunction, and bullying were frequently identified as contributing factors. Most of the studies exhibited a low risk of bias. This pediatric-focused review highlights the link between skin and psychiatric issues in DA, stressing the need for early psychiatric care, multidisciplinary evaluation, and increased clinical awareness to improve outcomes for affected children.</div></div>","PeriodicalId":16311,"journal":{"name":"Journal of Investigative Dermatology","volume":"146 3","pages":"Page S14"},"PeriodicalIF":5.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147427326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-03-09DOI: 10.1016/S0022-202X(26)00596-8
Andrea Moir BSc , Grace Tam BSc , Wingfield Rehmus MD, MPH
As the number of dermatology staff at BC Children’s Hospital has decreased in recent years, efforts were made to reduce pediatric emergency department (PED) consultations while maintaining access to care. A trial of 7 per week designated “direct-to-dermatology” appointment slots was undertaken, allowing PED physicians to book pediatric dermatology (PD) appointments for their patients without a formal consultation. This quality improvement project aims to explore the use of this initiative. Appointment booking sheets and relevant visit data from May-Nov 2024 were reviewed. 77.4% of the slots were filled and 93.8% of the appointments were attended. The mean interval between PED and PD presentation was 1.98 days. The mean presentation number prior to PD consultation was 1.34 and 90.8% have yet to re-present. Of the 62% male and 38% female patients, all were from Metro Vancouver and 89.2% had a family doctor. The top ED diagnoses were Rash NYD, eczema, impetigo, and cellulitis. The top dermatology diagnoses were eczema, impetigo, and fungal/yeast-related disorders. 50% of PED diagnoses were not congruent with the corresponding PD diagnosis. Overall, the initiative high uptake and attendance rates. It allows for prompt PD assessment with follow-up as needed, which could prevent unnecessary treatment, diagnosis delays, and decrease the use of PED resources.
{"title":"Dedicated Direct-to-Dermatology Appointment Slots for Pediatric Emergency Department Use","authors":"Andrea Moir BSc , Grace Tam BSc , Wingfield Rehmus MD, MPH","doi":"10.1016/S0022-202X(26)00596-8","DOIUrl":"10.1016/S0022-202X(26)00596-8","url":null,"abstract":"<div><div>As the number of dermatology staff at BC Children’s Hospital has decreased in recent years, efforts were made to reduce pediatric emergency department (PED) consultations while maintaining access to care. A trial of 7 per week designated “direct-to-dermatology” appointment slots was undertaken, allowing PED physicians to book pediatric dermatology (PD) appointments for their patients without a formal consultation. This quality improvement project aims to explore the use of this initiative. Appointment booking sheets and relevant visit data from May-Nov 2024 were reviewed. 77.4% of the slots were filled and 93.8% of the appointments were attended. The mean interval between PED and PD presentation was 1.98 days. The mean presentation number prior to PD consultation was 1.34 and 90.8% have yet to re-present. Of the 62% male and 38% female patients, all were from Metro Vancouver and 89.2% had a family doctor. The top ED diagnoses were Rash NYD, eczema, impetigo, and cellulitis. The top dermatology diagnoses were eczema, impetigo, and fungal/yeast-related disorders. 50% of PED diagnoses were not congruent with the corresponding PD diagnosis. Overall, the initiative high uptake and attendance rates. It allows for prompt PD assessment with follow-up as needed, which could prevent unnecessary treatment, diagnosis delays, and decrease the use of PED resources.</div></div>","PeriodicalId":16311,"journal":{"name":"Journal of Investigative Dermatology","volume":"146 3","pages":"Page S15"},"PeriodicalIF":5.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147427327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-03-09DOI: 10.1016/S0022-202X(26)00610-X
Nina Magnolo , Lara Wine Lee , Adam Reich , Irene Lara-Corrales , Akimichi Morita , Michael Bukhalo , Asunción Vicente , Toni Anschutz , Rosie D Lyles , Kristina Unnebrink , Cynthia Huber , Doug G Ashley , Tshepiso Madihlaba , Manish Patel , Arathi R Setty , Toni Anschutz , Amy S Paller
Pediatric psoriasis (PsO) treatment options are limited. Risankizumab (RZB) is an interleukin 23 inhibitor approved for moderate-to-severe PsO in adults. OptIMMize-1 (NCT04435600) was a phase 3, multicenter, 4-part study of RZB in pediatric patients with moderate-to-severe PsO. In part 2 period A (P2PA), adolescents (12 to <18 years) were randomized 2:1 to RZB or ustekinumab (UST) for 16 weeks (W). In Part 4 (P4), children (6 to <12 years) received open-label RZB for 52W. Co-primary endpoints (≥75% improvement in Psoriasis Area and Severity Index [PASI75], static Physician’s Global Assessment of clear/ almost clear [sPGA0/1], sPGA0/1 with ≥2-grade improvement [sPGA0/1+≥2GI]), secondary endpoints (PASI90/100), and safety were assessed (descriptive statistics). In P2PA (RZB, n=54; UST, n=28), W16 primary endpoint response rates (95%CI) were similar with RZB vs UST (PASI75: 85.2% [72.9,93.4] vs 85.7% [67.3,96.0]; sPGA0/1: 79.6% [66.5,89.4] vs 75.0% [55.1,89.3]; sPGA0/1+≥2GI: 68.5% [54.4,80.5] vs 67.9% [47.6,84.1]). RZB vs UST rates were PASI90: 64.8% (50.6,77.3) vs 60.7% (40.6,78.5) and PASI100: 40.7% (27.6,55.0) vs 17.9% (6.1,36.9). In P4 (n=30), W16 rates (95%CI) were PASI75: 86.7% (69.3,96.2); sPGA0/ 1: 90.0% (73.5,97.9); sPGA0/1+≥2GI: 83.3% (65.3,94.4); PASI90: 76.7% (57.7,90.1); and PASI100: 43.3% (25.5,62.6). W52 responses were maintained or improved. The RZB safety profile was generally consistent with adult studies in PsO. These findings support RZB to treat pediatric PsO.
小儿牛皮癣（PsO）的治疗选择是有限的。Risankizumab （RZB）是一种被批准用于成人中度至重度PsO的白细胞介素23抑制剂。optimize -1 （NCT04435600）是一项针对中重度PsO患儿RZB的3期、多中心、4部分研究。在第二部分A期（P2PA）中，青少年（12至18岁）被2:1随机分配到RZB或ustekinumab （UST）组，持续16周(W)。在第4部分（P4）中，儿童（6至12岁）接受52W的开放标签RZB。共同主要终点（银屑病面积和严重程度指数改善≥75% [PASI75]，静态医师总体评估明确/几乎明确[sPGA0/1]， sPGA0/1改善≥2级[sPGA0/1+≥2GI]），次要终点（PASI90/100）和安全性进行评估（描述性统计）。在P2PA （RZB, n=54； UST, n=28）中，W16主要终点缓解率（95%CI）与RZB vs UST相似（PASI75: 85.2% [72.9,93.4] vs 85.7% [67.3,96.0]; sPGA0/1: 79.6% [66.5,89.4] vs 75.0% [55.1,89.3]; sPGA0/1+≥2GI: 68.5% [54.4,80.5] vs 67.9%[47.6,84.1]）。RZB与UST的比值为PASI90: 64.8% (50.6,77.3) vs 60.7% (40.6,78.5), PASI100: 40.7% (27.6,55.0) vs 17.9%（6.1,36.9）。在P4 （n=30）中，W16率（95%CI）为PASI75: 86.7% (69.3,96.2)；sPGA0/ 1: 90.0% (73.5,97.9)；sPGA0/1+≥2GI: 83.3% (65.3,94.4)；Pasi90: 76.7% (57.7,90.1)；PASI100: 43.3%（25.5,62.6）。W52反应维持或改善。RZB的安全性与PsO的成人研究基本一致。这些发现支持RZB治疗小儿PsO。
{"title":"Efficacy and Safety of Risankizumab in Pediatric Patients With Psoriasis: Results From the OptIMMize-1 Phase 3 Study","authors":"Nina Magnolo , Lara Wine Lee , Adam Reich , Irene Lara-Corrales , Akimichi Morita , Michael Bukhalo , Asunción Vicente , Toni Anschutz , Rosie D Lyles , Kristina Unnebrink , Cynthia Huber , Doug G Ashley , Tshepiso Madihlaba , Manish Patel , Arathi R Setty , Toni Anschutz , Amy S Paller","doi":"10.1016/S0022-202X(26)00610-X","DOIUrl":"10.1016/S0022-202X(26)00610-X","url":null,"abstract":"<div><div>Pediatric psoriasis (PsO) treatment options are limited. Risankizumab (RZB) is an interleukin 23 inhibitor approved for moderate-to-severe PsO in adults. OptIMMize-1 (NCT04435600) was a phase 3, multicenter, 4-part study of RZB in pediatric patients with moderate-to-severe PsO. In part 2 period A (P2PA), adolescents (12 to <18 years) were randomized 2:1 to RZB or ustekinumab (UST) for 16 weeks (W). In Part 4 (P4), children (6 to <12 years) received open-label RZB for 52W. Co-primary endpoints (≥75% improvement in Psoriasis Area and Severity Index [PASI75], static Physician’s Global Assessment of clear/ almost clear [sPGA0/1], sPGA0/1 with ≥2-grade improvement [sPGA0/1+≥2GI]), secondary endpoints (PASI90/100), and safety were assessed (descriptive statistics). In P2PA (RZB, n=54; UST, n=28), W16 primary endpoint response rates (95%CI) were similar with RZB vs UST (PASI75: 85.2% [72.9,93.4] vs 85.7% [67.3,96.0]; sPGA0/1: 79.6% [66.5,89.4] vs 75.0% [55.1,89.3]; sPGA0/1+≥2GI: 68.5% [54.4,80.5] vs 67.9% [47.6,84.1]). RZB vs UST rates were PASI90: 64.8% (50.6,77.3) vs 60.7% (40.6,78.5) and PASI100: 40.7% (27.6,55.0) vs 17.9% (6.1,36.9). In P4 (n=30), W16 rates (95%CI) were PASI75: 86.7% (69.3,96.2); sPGA0/ 1: 90.0% (73.5,97.9); sPGA0/1+≥2GI: 83.3% (65.3,94.4); PASI90: 76.7% (57.7,90.1); and PASI100: 43.3% (25.5,62.6). W52 responses were maintained or improved. The RZB safety profile was generally consistent with adult studies in PsO. These findings support RZB to treat pediatric PsO.</div></div>","PeriodicalId":16311,"journal":{"name":"Journal of Investigative Dermatology","volume":"146 3","pages":"Page S19"},"PeriodicalIF":5.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147427339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-03-09DOI: 10.1016/S0022-202X(26)00544-0
Akshaya Sekar DO , Harinivaas Shanmugavel Geetha
Acne vulgaris is an inflammatory skin condition affecting adolescents and young adults, with serious psychosocial and economic impacts with an estimated $3 billion in annual U.S. healthcare costs. The age-adjusted disability-adjusted life year (DALY) rate for acne has increased by 18.1% over the past 30 years. Medicaid, a public health program, plays an important role in covering prescription acne treatments, including tetracyclines and oral retinoids. Our descriptive study analyzed Medicaid Part D spending trends from 2019 to 2023 for minocycline, doxycycline, and isotretinoin, using data from the Centers for Medicare & Medicaid Services database. Variables included total spending, number of claims, average spending per claim, per-unit costs, and total dosage units annually. Isotretinoin spending increased over 1700%, from $77,847 to $1,429,493, with claims rising from 322 to 4,912 and a 3.3% annual per-unit cost increase. Minocycline spending peaked at $16.1 million in 2020 but declined to $12.2 million by 2023, with a slight -1.4% annual per-unit cost drop. Doxycycline spending, the highest overall, decreased from $134 million to $117 million, while dosage units rose from 121 to 152 million and per-unit cost declined by -8.4%. These trends suggest growing reliance on isotretinoin, while doxycycline remains widely used and more cost-efficient, supporting the need for cost-effective, evidence-based treatment strategies to ensure equitable, high-value care within Medicaid.
{"title":"Medicaid Spending Trends on Acne Vulgaris Treatments (2019—2023)","authors":"Akshaya Sekar DO , Harinivaas Shanmugavel Geetha","doi":"10.1016/S0022-202X(26)00544-0","DOIUrl":"10.1016/S0022-202X(26)00544-0","url":null,"abstract":"<div><div>Acne vulgaris is an inflammatory skin condition affecting adolescents and young adults, with serious psychosocial and economic impacts with an estimated $3 billion in annual U.S. healthcare costs. The age-adjusted disability-adjusted life year (DALY) rate for acne has increased by 18.1% over the past 30 years. Medicaid, a public health program, plays an important role in covering prescription acne treatments, including tetracyclines and oral retinoids. Our descriptive study analyzed Medicaid Part D spending trends from 2019 to 2023 for minocycline, doxycycline, and isotretinoin, using data from the Centers for Medicare & Medicaid Services database. Variables included total spending, number of claims, average spending per claim, per-unit costs, and total dosage units annually. Isotretinoin spending increased over 1700%, from $77,847 to $1,429,493, with claims rising from 322 to 4,912 and a 3.3% annual per-unit cost increase. Minocycline spending peaked at $16.1 million in 2020 but declined to $12.2 million by 2023, with a slight -1.4% annual per-unit cost drop. Doxycycline spending, the highest overall, decreased from $134 million to $117 million, while dosage units rose from 121 to 152 million and per-unit cost declined by -8.4%. These trends suggest growing reliance on isotretinoin, while doxycycline remains widely used and more cost-efficient, supporting the need for cost-effective, evidence-based treatment strategies to ensure equitable, high-value care within Medicaid.</div></div>","PeriodicalId":16311,"journal":{"name":"Journal of Investigative Dermatology","volume":"146 3","pages":"Page S2"},"PeriodicalIF":5.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147428503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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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