The Journal of dermatological treatment最新文献

Background: Ivarmacitinib (SHR0302) is a novel and highly selective Janus kinase 1 inhibitor for treating moderate to severe atopic dermatitis (AD).

Objective: This study aimed to evaluate the impacts of patient characteristics on the efficacy and safety of Ivarmacitinib.

Methods: This post-hoc analysis used data from a randomized, double-blind, placebo-controlled, multicenter phase 3 trial of Ivarmacitinib in patients with moderate to severe AD in which patients were randomized (1:1:1) to receive Ivarmacitinib 4 mg or 8 mg or placebo for 16 weeks. Subgroup analyses were conducted based on baseline characteristics.

Results: At week 16, both Ivarmacitinib 4 or 8 mg showed better efficacy over placebo in achieving Eczema Area and Severity Index (EASI) 75, EASI 90, and Worst Itch Numeric Rating Scale (WI-NRS) score ≥4-point responses in most subgroups based on age, sex, body mass index, AD duration, Investigator's Global Assessment score, EASI score, WI-NRS score, body surface area involvement, history of comorbid allergies, or previous systemic therapies. The overall incidence of adverse events and most of the adverse events of special interest were similar between Ivarmacitinib and placebo across all subgroups.

Conclusion: Ivarmacitinib demonstrated efficacy and good tolerability in treating moderate to severe AD with diverse patient characteristics.

Background: Healthcare resource utilization (HCRU) costs in those on conventional systemics for mild-moderate psoriasis are poorly described.

Objectives: This study aimed to describe HRCU, disease severity and health-related quality of life in patients with mild-moderate psoriasis requiring systemic therapy.

Methods: UK single-center retrospective longitudinal cohort study including adults with mild-moderate psoriasis (PASI < 10, no historical PASI ≥ 10, no prior biologics) on conventional systemic therapy with 3-year data capture from first PASI recording (2014-2019, pre-COVID). Patients discontinued due to reaching PASI ≥ 10, starting biologics or being lost to follow-up.

Results: The median annual HCRU cost was £1923 (mean £3361), largely driven by visit costs. A total of 50.8% patients achieved a PASI ≤ 2 and 30.6% achieved PASI ≤ 2 and DLQI ≤ 5 during follow-up. The difference between the maximum and minimum PASI for a patient and follow-up time were statistically significant predictors of total costs (p < 0.05).

Conclusion: Despite high healthcare costs, nearly half of the patients did not achieve clear/nearly clear skin. These data, in the context of reducing costs for biosimilars, may provide a basis to challenge care pathways and access criteria for 'high-cost' treatments.

Female pattern hair loss (FPHL) significantly affects women's well-being and quality of life (QoL), and low-dose oral minoxidil (LDOM) has increasingly gained attention as a convenient and effective treatment option. Although hypertrichosis is reported more often with LDOM than with topical formulations, patient perceptions and tolerance of this side effect remain poorly understood. We conducted a telephone survey at a single institution among women with FPHL currently taking or previously treated with LDOM for at least one month to evaluate treatment effectiveness, QoL, and side effect burden using the Women's Androgenetic Alopecia Quality of Life Questionnaire (WAA-QOL). Among 102 participants, the median duration of LDOM use was 12 months. Hair loss severity improved from a median score of 7 to 4 on a 10-point scale. Unwanted hair growth occurred in 71.6% of patients, most commonly on the face, arms, and legs; however, 93.2% did not consider it a reason to discontinue treatment, and most cases were mild or moderate. WAA-QOL scores improved significantly from baseline (67 to 39, p<0.001), with no predictors of unwanted hair growth identified. Overall, patients experienced clinical and QoL improvements, supporting a favorable patient-centered profile for LDOM.

Objectives: The potential utility of a novel microwave device for the treatment of a variety of superficial dermatologic indications is reviewed.

Materials and methods: The Swift^® microwave system applies low-dose microwave energy (8 GHz) noninvasively using a precision applicator to directly target lesional tissue, while modulating power setting and application time to maintain patient comfort during heat application. The device has been approved for general dermatology use, with some models labeled more-specifically for HPV-associated lesions and actinic keratosis. New case treatment data and published case reports were reviewed for viral skin infection, fungal nail infection, nodular cystic acne, neoplastic skin lesions, hidradenitis suppurativa (HS), and intractable plantar keratosis (IPK).

Results: Case reports demonstrate preliminary efficacy of microwave hyperthermia in viral skin infection, fungal nail infection, nodular cystic acne, and neoplastic skin lesions, with few reported adverse events. Microwaves additionally provided good pain control for the reviewed cases of HS and IPK.

Conclusions: The data support a possible role for the microwave device in the studied indications. Microwave treatment may be more tolerable for patients than cryotherapy or laser comparators. More systematic investigation of microwave hyperthermia is warranted to better define optimum dosing regimens and efficacy, as well as a wider safety profile.

Objectives: IL-17 inhibitors (IL-17i) and IL-23 inhibitors (IL-23i) are advanced treatments for moderate-to-severe plaque psoriasis. This study aimed to assess the persistence of IL-17i and IL-23i in patients with plaque psoriasis in Taiwan, where a unique healthcare reimbursement policy makes biologic persistence highly reflective of real-world effectiveness.

Methods: We conducted a retrospective cohort study in bio-naïve patients with plaque psoriasis in Taiwan using the Chang Gung Research Database. Persistence was defined as the duration from initiation to discontinuatin of a biologic agent. Patients who were diagnosed with plaque psoriasis and initiated an IL-17i or an IL-23i between January 2015 and December 2022 were included. Persistence rates were estimated by Kaplan-Meier methods, using discontinuation as the event of interest.

Results: A total of 544 and 334 patients were included in the IL-17i and IL-23i cohorts, respectively. Numerically higher persistence was observed for IL-23i compared with IL-17i (p < 0.001). The 48-week and 96-week persistence rates were 71.3% (67.5-75.4%) and 55.2% (50.7-60.1%) for IL-17i, and 82.2% (78.1-86.6%) and 75.1% (70.1-80.5%) for IL-23i.

Conclusions: These findings may inform clinical decision-making by healthcare providers, patients, and policymakers. Further research integrating richer clinical information with extended follow-up will allow deeper investigation of biologic treatment patterns in real‑world settings.

Objective: Facial erythema and telangiectasia in rosacea are commonly treated with vascular lasers. Combination with ivermectin 1% cream, may enhance outcomes when combined with laser therapy. This study assesses whether topical ivermectin improves the efficacy of Potassium Titanyl Phosphate (KTP) 532 nm laser for facial erythema in rosacea.

Methods: This is a randomized, evaluator-blinded, split-face study. 24 patients with rosacea received four KTP laser sessions; one facial side was additionally treated daily with ivermectin 1% cream. The primary outcome was the change in Normalized Erythema Index (NEI). Secondary measures included Skin Redness Index (SRI), Clinical Erythema Assessment, Physician Global Assessment, telangiectasia score, inflammatory lesion counts, patient satisfaction, and safety.

Results: At week 16, the combination side showed a significantly greater NEI reduction than laser alone (ΔNEI%: 16.6 vs 5.3; p = 0.04). No significant differences were observed in SRI, and all other scores. However, papule reduction across visits was significantly greater with ivermectin (p = 0.02). Both treatments were well tolerated, with no serious adverse events.

Conclusion: KTP laser effectively reduces erythema and inflammatory lesions; adjunctive ivermectin may further enhance papulopustular lesions. The combination is well tolerated, suggesting a potential adjunctive role for topical ivermectin in laser-based rosacea therapy.

Clinical trial register: clinicalTrials.gov (NCT06033352).

Background: Pemphigus is a recurrent and potentially life-threatening autoimmune bullous disease. This study aimed to develop a nomogram to predict relapse risk in pemphigus patients after complete remission (CR).

Methods: We retrospectively analyzed 110 pemphigus patients who achieved CR between 2021 and 2023 and were followed for at least 12 months. Independent predictors of relapse were identified using univariate and multivariate Cox regression analyses and incorporated into a nomogram. Model performance was evaluated using calibration curves, receiver operating characteristic (ROC) analysis, and decision curve analysis (DCA).

Results: During follow-up, 41.8% of patients experienced relapse. Multivariate analysis identified anemia, hypercholesterolemia, previous relapse history, elevated desmoglein (Dsg) antibody levels, and discontinuation of therapy after CR as independent risk factors. The nomogram demonstrated good discrimination with a concordance index of 0.726 (95% CI, 0.659-0.793). The AUCs for predicting relapse at 6, 12, and 18 months after achieving CR were 0.771, 0.853, and 0.811, respectively. DCA supported the clinical utility of the model, and survival analysis effectively stratified patients into high- and low-risk groups.

Conclusion: This nomogram may serve as a practical tool for identifying pemphigus patients at high risk of relapse after CR.

Background: Nemolizumab, an anti-IL-31 receptor A antibody, is licensed for atopic dermatitis and prurigo nodularis; its role in other chronic pruritus (CP) syndromes is uncertain.

Objective: To synthesize efficacy, safety and strength of evidence for nemolizumab in CP beyond these indications. Methods: We conducted a PROSPERO-registered systematic review (CRD420251207054) of databases and trial registries to November 2025 for nemolizumab studies in CP outside AD/PN. Eligible reports were extracted and patients grouped as systemic, neurologic/neurogenic, dermatologic (non-AD) or primary CP/CP of unknown origin.

Results: Seventeen reports (one randomized trial, two cohorts, 14 case series/reports) describing 114 patients were included. In chronic kidney disease-associated pruritus, a phase II hemodialysis trial showed modest, statistically uncertain benefit versus placebo, contrasting with rapid, near-complete relief in dialysis and cholestatic case reports. Uncontrolled data in neuropathic itch/pain syndromes, non-AD inflammatory and papular dermatoses (notably amyloidosis and perforating disorders) and long-standing primary CP/CPUO described complete itch clearance. Across indications, nemolizumab was well tolerated, but certainty was low for CKD-aP and very low for other groups.

Conclusions: Nemolizumab shows plausible antipruritic activity across CP phenotypes, yet the evidence base remains fragile; these signals justify cautious experimental use and prioritize etiology-specific IL-31 receptor blockade trials beyond AD/PN.

Objectives: Facial and genital plaques are common manifestations of psoriasis, are challenging to treat, and significantly impact patients' quality of life (QoL).

Methods: GULLIVER is a prospective, non-interventional study conducted in 2020-2023 in Italy, aimed at examining the effectiveness, safety and QoL impact of guselkumab through 52 weeks of treatment in patients with facial and/or genital psoriasis. The primary endpoint was the percentage of patients achieving a static Physician Global Assessment (sPGA) score of ≤1 and a minimum 2-grade improvement in sPGA score at Week 52.

Results: Of 351 enrolled patients, 88.6% remained on guselkumab treatment at Week 52. The proportions of patients achieving the sPGA targets in the facial and genital groups, respectively, were 83.3% and 76.5% at week 12, increasing to 93.8% and 97.9% at Week 52. Mean Dermatology Life Quality Index score improved from 12.0 ± 7.5 at baseline to 1.1 ± 2.0 at Week 52 for patients with facial psoriasis (p-value <0.001) and from 12.0 ± 6.9 to 1.6 ± 3.5 for those with genital psoriasis (p-value <0.001). Guselkumab was well-tolerated and no new safety signals were identified.

Conclusions: This Italian real-world study demonstrated the high effectiveness and a good safety profile of guselkumab in treating facial and genital psoriasis.