JEADV clinical practice最新文献

In this article, Huang et al. describe the clinicopathologic features of 27 young adult patients in Taiwan with a peculiar eruption consisting of monomorphous, discrete, tiny, superficial pustules on the face and/or the neck. The number of lesions ranged from a few to hundreds and lasted 1–4 weeks, recurring in 80% of the patients. Itch was present in 45% of the cases. More than 90% of patients responded well to topical steroids with complete clearance of pustules. Histopathology in three cases showed infundibular pustules filled with neutrophils and a perivascular lymphohistiocytic infiltrate in the dermis. No microorganism was identified with Gram staining, and cultures in two patients yielded Cutibacterium acnes. The authors claim that this form of pustular eruption appears distinct from other facial dermatoses with follicular pustules.

In this article, Oh et al. analyze the gene transcriptomic expression of tumor and immune response genes, and provide a comprehensive profiling of virus in cutaneous squamous cell carcinoma (cSCC) and normal tissue in 53 Asian patients, comparing the results between organ transplant recipients and patients without an organ transplant. Organ transplant recipients are known to have an increased risk of cSCC. In comparison with normal skin, cSCC tissue was characterized by a protumorigenic immune environment, increased immune signaling, and tumor remodeling. Likewise, viruses were particularly enriched in cSCC tissue, as compared with normal skin. cSCCs of organ transplant recipients exhibited greater expression of tumor markers and reduced expression of T-cell cytokines, and enrichment of viruses including multiple virus types beyond HPV and EBV. The characterization of cSCCs holds potential for specific therapeutic approaches in high-risk populations.

In this article, Rosendahl et al. critically review the existing literature regarding the concept of “dysplastic nevus,” a term that has been used for over four decades, under the unsupported assumption that it is a melanoma precursor. Rather, with precise diagnostic criteria, the consideration of “dysplastic nevus” as a melanoma-associated nevus is hardly sustainable. Hence, the authors state that a histologic diagnosis of “dysplastic nevus” has no clinical relevance at all.

While the authors acknowledge that there are zones of diagnostic uncertainty between nevus and melanoma that can be classified as “borderline” or “indeterminate” lesions, a designation of “dysplastic nevus” lacks clinical relevance and may lead to inappropriate management options for patients.

The skin rejuvenation market is rapidly expanding, driven by demand for effective, minimally invasive solutions. Modern esthetic dermatology embraces a comprehensive approach combining evidence-based lifestyle practices, advanced procedures, and dermocosmetics to deliver personalized, natural-looking outcomes. This review focuses on minimally invasive procedures, which are increasingly favored for their rapid results and minimal recovery time. Key modalities include injectables, energy-based devices, chemical and mechanical treatments, often enhanced through combination protocols. Regenerative technologies show promise in esthetic dermatology, including advanced peptides, exosomes, stem cell-derived vesicles, nano collagen, and fat extracts. Dermatologists must consider patient-specific factors such as skin type and gender, while leveraging emerging tools like AI and social media to improve care and education. Despite growing popularity, more robust clinical evidence is needed to support practice. The future lies in holistic, patient-centered strategies that promote long-term skin wellness.

Advances in dermatology are embracing a patient-centered, proactive approach through the ‘4P model’: Personalized, Predictive, Preventive, and Participatory care. This shift aims to improve treatment efficacy and safety as well as patient's quality of life. This review explores the applications of ‘4P medicine’ in dermatology, highlighting key concepts and examples like innovations in onco-dermatology and the skin microbiome. In onco-dermatology, molecular profiling guides targeted treatments, while genetic insights improve risk prediction and prevention. Genetic profiling, such as the identification of BRAF mutations in melanoma, has enabled targeted therapies like BRAF/MEK inhibitors to improve patient outcomes. Predictive technologies, including machine learning, are enabling early detection and risk assessment for both melanoma and non-melanoma skin cancers. Preventive strategies focus on proactive skin care, with public education campaigns and digital tools to increase sun protection behaviors and early detection. Participatory care engages patients in decision making, leading to better adherence and outcomes. This integrated approach optimizes outcomes and reduces the burden of skin cancer. Microbiome research has also transformed dermatology, enabling personalized treatments that target microbial imbalances in conditions such as atopic dermatitis, psoriasis and acne. Predictive dermatology uses microbiome signatures to forecast disease risk and response to treatment, enabling earlier intervention. Preventive strategies aim to maintain a healthy microbiome and prevent disease exacerbations. Participatory dermatology encourages patients to engage in microbiome-focused skin care to optimize outcomes. However, challenges remain in terms of treatment optimization, economic sustainability, ethical considerations and equitable access to care. Addressing these challenges requires innovative solutions, collaborative research, and strategies to ensure the accessibility and cost-effectiveness of dermatologic care.

The burden of dermatologic conditions is increasing worldwide and this rise is closely related to the interplay between epidemiologic trends and etiologic influences. The global population is experiencing an unprecedented increase in the proportion of older people. An aging population may be more susceptible to the effects of pollution and lifestyle-induced skin changes due to age-related declines in skin barrier function. Climate change alters the onset and progression of skin conditions through factors such as sunlight exposure, temperature, humidity, and extreme weather. In general, their effects have been associated with an increased incidence of various skin conditions. Environmental pollution, occupational and lifestyle factors not only exacerbate existing skin conditions but also contribute to the development of new dermatologic diseases. Urbanisation leads to increased exposure to pollutants that can induce oxidative stress and inflammatory responses in the skin, contributing to diseases such as atopic dermatitis and psoriasis. Lifestyle factors such as diet, stress, sleep patterns and skin care affect the skin's physiological processes, microbiome and immune response, influencing the onset and progression of various skin conditions. Advances in medical treatments, while improving disease outcomes and prolonging lifespan, are creating new dermatologic challenges that are exacerbated in vulnerable populations. As complexity and prevalence of skin conditions increase due to the intricate interactions of epidemiologic and etiologic factors, dermatologists and healthcare providers must rise to the challenge with understanding and innovation. This special issue will provide a dive deep into transformative strategies and groundbreaking paradigms that are reshaping the future of dermatological practice.

Integration of digital technologies in dermatology is revolutionising patient care by increasing accessibility, accuracy and personalisation. This review explores the impact of emerging digital technologies in dermatology, including teledermatology, artificial intelligence (AI), mobile applications, wearable devices and 3D imaging and printing. Teledermatology, using real-time videoconferencing and store-and-forward imaging, has expanded since the COVID-19 pandemic, improving access to dermatologic care in underserved areas. AI-powered algorithms are being increasingly used, particularly in skin cancer detection, by helping clinicians make faster and more accurate diagnosis and treatment decisions in diverse clinical settings. AI is also improving clinical workflows, increasing automation and reducing documentation burden. Mobile health applications, including AI-based tools, are transforming patient self-management and monitoring. Wearable devices enable continuous monitoring of skin health and environmental factors, providing real-time insights into conditions like atopic dermatitis and melanoma. In addition, advances in 3D imaging and printing technologies are enabling for more precise grafts and early detection of skin cancer, leading to improved clinical outcomes. Despite these advancements, significant challenges remain, including automation bias, the need for standardised validation protocols and equitable access across diverse populations. Successful integration of these technologies into clinical practice will require addressing these issues and ensuring data security, improved digital literacy and clear guidelines for their use. Future research should focus on assessing the real-world effectiveness of these technologies and ensuring their equitable use in diverse geographies and patient populations.