Archives of Dermatological Research最新文献

Systemic sclerosis (SSc) and morphea are fibrosing skin conditions with limited treatment options and often unpredictable responses. Interleukin-17 (IL-17), a pro-inflammatory cytokine, has emerged as a potential target given its complex role in fibrosis. Early studies of brodalumab have suggested potential improvement in SSc skin scores, though results remain preliminary and unpublished. Secukinumab has shown benefit in several case reports involving morphea and stiff skin syndrome. However, concerns remain about long-term safety, including cardiovascular risks and rare cases of drug-induced scleroderma-like illness. In this narrative review, we summarize the current clinical and translational literature on IL-17 blockade in fibrosing skin disease, including two phase II trials and five case reports published between 2019 and 2024. Across these studies, IL-17 inhibitors were associated with improvements in skin thickening, disease activity, and quality-of-life scores in select patients. We also explore the immunologic rationale for IL-17 inhibition and its interplay with TGF-β and fibroblast activation. While current data remain limited, IL-17 blockade shows early promise as a targeted therapy for fibrosing skin disease. Further investigation is needed to clarify patient selection criteria, validate long-term efficacy, and ensure safety. As our understanding of immune-mediated fibrosis deepens, IL-17 inhibitors may offer a novel therapeutic approach for patients with refractory or progressive skin fibrosis.

Metal contact allergies have consistently ranked among the most prevalent contact allergies globally. However, trends in the allergies vary by region. This study aimed to assess the prevalence and trends of contact allergies to metals in the baseline series over the past decade. It also sought to identify factors associated with the metal allergies comparing to those without metal allergies. We analyzed patch test data for the metallic allergens—nickel, cobalt, and chromium, —collected from January 2013 to December 2022. The rate of all metal contact allergies decreased. Nickel emerged as the most prevalent allergen (21.7%), followed by chromium (9.6%), and cobalt (7.9%). Notable associated factors for metal contact allergies include female sex, occupational exposure, and a history of suspected metal contact allergy. Concomitant positive reactions were most frequently observed with the combinations of nickel and cobalt. A decline in metal contact allergy prevalence in Thailand, correspond to rising popularity in various novel metal substitutes; plastic, resin or natural materials. Dermatologists should also keep track of contact allergy to those metal substitutes.

Acne vulgaris affects approximately 9.4% of the global population and disproportionately burdens individuals with skin of color (SOC) through persistent postinflammatory hyperpigmentation (PIH) and acne scarring. Conventional therapies primarily target inflammatory lesions but have limited efficacy for pigmentary sequelae. Energy-based devices (EBDs) have emerged as valuable adjuncts, yet most available evidence is derived from studies in lighter skin phototypes. This narrative review evaluates the efficacy, safety, and clinical considerations of EBDs for acne and its sequelae in SOC, with a focus on Fitzpatrick skin types IV–VI. We reviewed clinical trials, case series, and systematic reviews investigating ablative and non-ablative lasers, picosecond lasers, radiofrequency (RF), intense pulsed light (IPL), and combination therapies, assessing outcomes such as acne clearance, acne scar remodeling, PIH improvement, and adverse events. Fractional non-ablative lasers and long-wavelength Nd: YAG devices consistently demonstrated improvements in acne scars and pigmentation, with mostly self-limited PIH, although studies were small (n < 50) and short-term. Picosecond lasers showed promise for both acne scarring and pigmentary disorders with low complication rates, while RF microneedling improved acne scar texture with minimal pigmentary risk due to its chromophore-independent mechanism. IPL and LED therapies yielded modest lesion reductions but variable patient satisfaction. Across modalities, PIH was the most frequent adverse event, typically transient but more common with higher fluence or higher density settings. The current evidence base is limited by small sample sizes, underrepresentation of SOC populations, particularly Black and Afro-Caribbean patients, and a lack of standardized outcome measures. EBDs represent valuable adjuncts for acne and acne scarring in SOC when conservative parameters and tailored protocols are used, with RF microneedling and longer-wavelength lasers appearing most favorable. Larger, SOC-inclusive randomized trials are urgently needed to establish evidence-based guidelines and ensure equitable, safe, and effective acne care.

Psoriasis is a long lasting autoimmune disorder of the skin that is marked by excessive cell proliferation of keratinocytes and chronic inflammation that is usually hard to treat by the traditional treatment. Although biologics and new pharmacological agents have been developed, their use is still hampered by factors like low levels of penetration through the skin, systemic effects, and the inability to deliver them on an individual basis. The use of innovative treatment and diagnostic methods is thus important. Three-dimensional (3D) printing is one of them and has since become popular to personalize treatments as well as fabricate complex scaffolds. More recent developments in 3D printing have created game-changing opportunities in the development of 3D-printed individualized topical preparations, bioengineered skin scaffolds, and patient-specific diagnostic models. The use of 3D printing technology is changing the way psoriasis is studied and developed into therapeutic approaches because it allows the creation of drug-loaded scaffolds and in vitro skin models that tightly mimic psoriatic microenvironment. Extremely sophisticated methods, like extrusion-based, inkjet and stereolithographic bioprinting, allow creating physiologically relevant skin constructs, improving the analysis of novel formulations and therapeutic reactions. The scaffold-based and scaffold-free models are also the models to fill the translational gap between the preclinical testing and clinical application of a psoriasis-on-a-chip. Together, these developments underscore the central role of 3D printing in enhancing patient-centered and clinically translatable 3D printing applications in the management of psoriasis. This review unites the concepts of pharmaceuticals, dermatology, and tissue engineering to demonstrate the way in which 3D printing is transforming the therapeutic and diagnostic approach to psoriasis. The review covers recent advances that have been made in 3D printing skin scaffolds, approaches to creating synthetic human skin, and commercial 3D in-vitro models are used to determine the safety and effectiveness of dermatological therapy.

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There is no definite effective treatment modality for multiple warts. Intralesional Candida antigen can yield high response rates, but it can also be associated with various constitutional manifestations, including fever, bone and muscle aches, vomiting, and abdominal pain. While the bivalent HPV vaccine can give variable clinical improvements, it may have higher recurrence rates in responding cases. To assess the clinical outcomes regarding recurrence, response, and side effects after combining intralesional Candida antigen with the bivalent HPV vaccine over their use as monotherapy. A randomized clinical trial involving 150 patients with multiple warts divided into three groups (A, B, and C) received intralesional Candida antigen, bivalent HPV vaccine, or both at 2-week intervals for five sessions. Complete remission was obtained in 68% of the patients in the Candida antigen group, 28% in the bivalent HPV vaccine group, and 74% in the combined group. Local tissue reaction and flu-like symptoms were significantly higher in the Candida antigen group than in the other two groups. The recurrence rate in the responding group was 0% in the combined group. The combined immunotherapeutic treatment may have more advantages regarding response, side effects, or recurrence rates than mono-therapeutic agents.

Clinicaltrials.gov listing: NCT05291845.

Hidradenitis suppurativa can significantly affect quality of life, yet remains underdiagnosed and undertreated. Research indicates a higher prevalence among Black females, who are frequently underrepresented in clinical trials. To enhance the generalizability of findings, it is imperative that clinical trials include diversity in investigating HS therapies. This study aims to assess the diversity and inclusion of underrepresented groups in Hidradenitis suppurativa (HS) clinical trials in the United States. In this systematic review and meta-analysis, we identified clinical trials regarding HS and its associated therapies, published or completed between 2018 and 2023, from the major medical literature databases MEDLINE (PubMed), Embase (Elsevier) and ClinicalTrials.gov. Using double-blinded procedures, an initial 245 search returns were screened using eligibility criteria and the final sample’s data was extracted using a standardized form. Information on each study’s included participants based on race, ethnicity, sex, and age, along with general trial characteristics was recorded. We then used the Clinical trial Diversity Rating (CDR) framework to evaluate the diversity of the trials. Of 10 eligible studies, half were phase 2 trials, and 6/10 (60%) of the trials were performed at a single site. Our analysis found (6/10, 60%) had an overall CDR rating of Poor for race/ethnicity, with an underrepresentation of Black and Asian and an overrepresentation of white participants. Males and females were adequately represented across the studies. Regarding age, we found that 8/10 (80%) of clinical trials were rated Poor in their inclusion of older adults. In summary, this study noted the underrepresentation of Blacks and Asians relative to white participants in HS clinical trials in the US. We hope these findings encourage policy changes in the recruitment and enrollment of historically minoritized participants to understand better HS treatment, safety, efficacy, and validity of study outcomes.

Autoimmune bullous diseases (AIBDs) are life-threatening diseases caused by immunologically mediated cell adhesion compromise in the skin and mucous membranes. Proposed diagnosis of AIBDs on a clinicopathological basis usually requires confirmation by other sophisticated and expensive laboratory facilities. This emphasizes the urgency of a simple, approachable and cost-effective method to clarify the diagnosis of AIBDs. This work aimed to outline the distinguishing trichoscopic characters of some immunobullous disorders [pemphigus vulgaris (PV), pemphigus foliaceus (PF) and bullous pemphigoid (BP)] in a group of Upper Egyptian patients and to examine any potential connections between these features and certain disease aspects. Sixty patients with AIBDs affecting the scalp were included. Twenty-nine patients were diagnosed as PV, seventeen patients were PF and fourteen were diagnosed as BP. Diagnosis was based on clinico-pathological correlations. The scalp’s Pemphigus disease area index (PDAI-Scalp) was determined for every patient. Trichoscopic examination of scalp lesions and documentation of features were done. Yellow haemorrhagic crusts were the most frequent trichoscopic observation in the three patients’ groups. Extravasation was also common in all groups. In PV, dotted vessels, linear serpentine vessels, polymorphic vessels, and dotted vessels with whitish halo were significantly more frequent as compared to the other groups. Regarding PF, polygonal scaling, perifollicular scaling and hair casts were the most characteristic trichoscopic features. However, in BP, the characteristic trichoscopic feature was well-defined creamy yellow round/oval areas. Trichoscopy can serve as a rapid preliminary non-invasive diagnostic procedure to signify AIBDs.