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.

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.

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.

Aim: Given the chronic nature of acne, two 6-month studies were conducted to evaluate the long-term efficacy and tolerability of clindamycin phosphate 1.2%/adapalene 0.15%/benzoyl peroxide (BPO) 3.1% gel (CAB)-the only approved triple-combination acne topical-and its effects on scarring/dyspigmentation in participants with moderate to severe acne.

Materials and methods: Data were pooled from 2 identical, open-label, single-center studies conducted in participants (N = 50) aged ≥12 years with Investigator's Global Assessment (IGA) score of 3/4. Endpoints included change from baseline in IGA score, inflammatory/noninflammatory lesions, skin appearance (dryness, postinflammatory hyperpigmentation [PIH], postinflammatory erythema [PIE]), and scarring. Adverse events and tolerability (itching, burning, redness, swelling) were assessed.

Results: At week 24, 67% of participants achieved treatment success, and significant reductions from baseline in inflammatory (88%) and noninflammatory (68%) lesions were observed (p < 0.001, both). Significant reductions in scarring (33%), investigator- and participant-assessed PIH (71%; 78%, respectively), and PIE (77%; 77%, respectively) were demonstrated (p < 0.001, all). Most participants (>70%) reported no tolerability issues throughout the studies. Seven adverse events occurred; 4 were related to CAB, and 3 led to study discontinuation (BPO allergy [n = 2], irritant contact dermatitis to BPO [n = 1]).

Conclusions: These findings suggest that CAB is an appropriate and effective topical option for the long-term treatment of acne vulgaris.

Objectives: Vitiligo is an autoimmune skin disorder characterized by melanocyte destruction and frequently associated with autoantibodies such as antinuclear antibodies (ANA). However, the clinical relevance of ANA positivity in relation to phototherapy response remains unclear. This study aimed to evaluate whether ANA positivity influences the efficacy and safety of 308-nm excimer light therapy in patients with vitiligo.

Methods: In this cohort study, 86 patients with vitiligo received 308-nm excimer light therapy combined with topical agents, with oral mini-pulse prednisone added for active disease when necessary. Patients were stratified by ANA status, and therapeutic response was evaluated using the Vitiligo Area Scoring Index and standardized photographs over 6 months.

Results: Of the 23 ANA-positive patients (26.7%), 19 (82.6%) had a titer of 1:100 and 4 (17.4%) had a titer of 1:320, with women comprising 73.9% of this group. ANA-positive lesions on the face and neck more frequently achieved moderate repigmentation (50-74%) but were less likely to reach excellent repigmentation (≥75%) compared with ANA-negative lesions. No significant differences were observed in cumulative treatment doses, adverse events, or the occurrence of new autoimmune conditions.

Conclusions: In conclusion, this single-center cohort study suggests that ANA positivity does not significantly affect the efficacy or safety of 308-nm excimer light therapy in vitiligo, indicating that the impact of low-titer ANA may be limited.

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.

Background: The management of psoriasis presents challenges, prompting many patients to seek alternative treatments. Cannabidiol (CBD) has demonstrated potential antioxidant and anti-inflammatory properties which may offer therapeutic benefits for skin conditions.

Objective: To evaluate the efficacy and safety of cannabidiol oil compared to placebo in chronic plaque psoriasis patients.

Methods: The randomized, double-blind, placebo-controlled trial enrolled 28 participants, who were administered either oral CBD oil 60 mg/day or placebo. The primary outcome was the Psoriasis Area and Severity Index (PASI) score. Secondary outcomes encompassed disease severity, quality of life, and sleep parameters. Safety was monitored through adverse events and laboratory assessments.

Results: The CBD group did not demonstrate a significant improvement in PASI scores. However, there was a notable reduction in itch scores by Week 8, and sleep onset latency decreased by Week 6, although this effect was not sustained. Adverse events were mild to moderate in nature and similar across both groups.

Limitations: The study duration may not fully capture the long-term effects, and the race and disease severity may limit the generalizability of the findings. A larger sample size is suggested for future studies.

Conclusion: Cannabidiol oil was well-tolerated; however, it did not result in a significant reduction in psoriasis severity. Temporary improvements in itch relief and sleep onset indicate that further research with higher doses and extended durations is warranted.

Objectives: To assess the efficacy and safety of topical compound flumethasone pivalate-salicylic acid cream for verrucous epidermal nevus (VEN), a benign keratinocytic hamartoma with limited current treatment options.

Methods: A 25-year-old male with 20-year VEN (right buttock/lower limb plaques) was treated with the compound cream (0.2 mg flumethasone pivalate + 30 mg salicylic acid/gram) twice daily for over 2 months, followed by 14-week follow-up.

Results: Lesions showed progressive thinning, significantly reduced hyperpigmentation, and no adverse events. The Dermatology Life Quality Index score improved from 13 to 3, with no recurrence at follow-up.

Conclusions: Topical compound flumethasone pivalate-salicylic acid cream is effective and safe for VEN, potentially via inhibiting abnormal keratinocyte proliferation, serving as a practical topical option.