Pyoderma gangrenosum (PG) is a neutrophilic dermatosis characterized by the rapid onset of painful ulcers. Previous retrospective population-based studies have identified a relationship between PG and major adverse cardiovascular events (MACE). However, these studies lacked appropriate control groups and were not conducted in the United States (US).
This study examines the association between PG and MACE using the All of Us (AoU) database, a nationwide initiative created to increase research in underrepresented populations.
We performed a nested case-control study among US adults in the AoU programme from 6 May 2018 to 2 March 2025. SNOMED codes were used to identify all conditions. PG cases were then matched 4:1 to controls by age, sex, ethnicity and smoking status. MACE was assessed using logistic regression adjusting for hypertension, diabetes mellitus, hyperlipidemia, systemic lupus erythematosus and rheumatoid arthritis.
We identified 579 PG cases. MACE was significantly associated with PG compared to controls, showing (OR, 2.19; 95% CI, 1.47−3.27; p < 0.001) in our multivariable model.
In this nationally representative US cohort, PG was independently associated with increased odds of MACE. These findings highlight the importance of comprehensive cardiovascular screening in patients with PG and support the need for proactive risk management. Further studies exploring the pathophysiological mechanisms underlying this association may help guide more targeted and effective care strategies.
Epidermolysis bullosa (EB) is a rare genetic skin fragility disease. The Recessive Dystrophic subtype (RDEB) causes severe manifestations and leads to early mortality. Two topical therapies have recently been approved, but they are not curative. We have developed a cell therapy utilizing genetically corrected patient-derived stem cells to treat RDEB wounds. Preclinical animal studies showed effective delivery of these cells incorporating Spincare, a temporary skin substitute mimicking the extracellular matrix. While Spincare is approved in Europe for burns, it has not yet been evaluated in EB clinical trials.
This study is a pilot trial assessing the safety and tolerability of Spincare matrix dressing on RDEB patients with chronic and recurrent wounds.
This is a randomized, split-body, intra-patient controlled trial conducted at a single site. Eligible patients had RDEB, were aged 6 years or older, with at least 6 wounds. Wounds within a matched pair were randomized to standard of care (control) or Spincare matrix (1:1). Caregivers applied the matrix to wounds weekly at home, and uploaded wound photos for healing assessment by blinded investigators. The primary endpoint was 90% wound closure from baseline to Week 16. Secondary endpoints included 50% and 70% wound closure, adverse events (AEs), wound pain and itch.
Six RDEB patients with 42 wounds were enroled; 21 wounds were treated with Spincare matrix and 21 wounds with standard of care. There was no significant difference in wound closure between matrix-treated and control wounds at all time points. Spincare matrix did not increase wound pain or itch compared with control wounds. No AEs were related to Spincare.
This pilot trial demonstrated that the Spincare matrix is a safe and feasible on RDEB wounds. Because the Spincare matrix does not heal wounds, it would be an effective vehicle for cell therapy in future RDEB trials.
The global distribution of pemphigus varies according to genetic, ethnic, socioeconomic, and cultural backgrounds. Despite the increased utilization of global health records and reporting systems, epidemiological data remain limited and poorly categorized.
To provide a detailed analysis of the epidemiological, clinical, and therapeutic features of pemphigus from a multicenter study in Morocco.
A cross-sectional descriptive multicenter study included patients treated for pemphigus at dermatology departments across eleven different university hospitals in Morocco between January 1990 and December 2023.
Our multicenter cohort consisted of 978 patients. The average annual incidence was estimated at 0.7 cases per million inhabitants per year, with a prevalence of 2.56/100,000 population. The female-to-male ratio was 1.4:1, and the median age was 55.9 years. The most common variant was pemphigus vulgaris (519 cases), followed by seborrheic pemphigus (229 cases), pemphigus foliaceous (135 cases), and pemphigus vegetans (65 cases). Treatment strategies included corticosteroids alone (27.9%) or in association with immunosuppressive agents (72.1%). The evolution was marked by remission in 60.9% of patients, relapse in 31.8%, and death in 7.2%.
Our national multicenter study provides data on pemphigus in Morocco; it identified 978 cases over a 33-year period and highlighted the epidemiological, clinical, therapeutic and evolutionary characteristics of our population.
Treatment for vitiligo is limited, with variable efficacy, and can be time-consuming or expensive. Recent developments within biologic therapy have demonstrated promising results with managing chronic autoimmune conditions.
To evaluate the efficacy of tildrakizumab in inducing repigmentation in vitiligo.
This was an investigator-initiated, open label, pilot study involving a single arm of 12 patients with stable non-segmental vitiligo. Patients were treated with once monthly subcutaneous 200 mg/mL tildrakizumab across 24 weeks. The primary outcome was change/percentage improvement in Vitiligo Area Scoring Index and Vitiligo Extent Score from baseline to Week 24.
Twelve patients were enroled and eight completed the study. A nonsignificant mean percentage improvement of 1.15% in total VASI score from baseline to week 24 (95% CI, −13.77 to 16.10%, p = 0.87) and a nonsignificant mean improvement of 13.80% in VES (95% CI, −34.99 to 30.85, p = 0.89) was observed. There were no severe adverse events from the study. The most common minor adverse events recorded were upper respiratory tract infections (coryzal symptoms), erythema and hyperpigmentation.
Subcutaneous tildrakizumab did not demonstrate statistically significant repigmentation, however further research is warranted to explore it as an alternative option for the management of active vitiligo and as a maintenance therapy. Limitations: The study was limited due to the open-label nature of the study, small sample size, broad inclusion criteria and selection of patients with stable, treatment-resistant lesions.
A 42-year-old women presents with a sharply demarcated itching erythema with numerous seropapules and vesicles on her left middle finger extending up to the proximal interphalangeal joint that has been present for 2 days (Figure 1). She previously treated a bleeding cut at this site with a plaster. The patient reported that many years ago, a patch test showed a positive reaction to adhesives.
In contact allergy, the skin reacts upon allergen contact with localised pruritus, oedematous erythema, seropapules and vesicles. The most common allergens are metals as nickel, fragrances, preservatives as parabens, formaldehyde and methylisothiazolinone and, as seen in our patient, components like colophony, rubber accelerators or adhesive acrylates in sticking plasters and tapes. Immediate removal of the substance causing the reaction and washing the area with mild soap and water is recommended to reduce symptoms. Topical corticosteroid therapy alleviates inflammation and itching.
Sarah Preis and Knut Brockow devised the project, the main conceptual idea and the proof outline. Sarah Preis wrote the paper. Knut Brockow critically revised the manuscript and approved the version to be published.
All patients in this manuscript have given written informed consent for participation in the study and the use of their deidentified, anonymised, aggregated data and their case details (including photographs) for publication. Ethical Approval: not applicable.
The authors declare no conflicts of interest.
Delusional infestation (DI) is a psychiatric condition involving a false belief of parasitic infection. A 79-year-old woman with persistent pruritus and scabies delusion refused antipsychotics but improved after relocating to assisted living. This highlights social isolation's role in DI, as dopamine dysregulation and altered sensory processing contribute to delusions. Her symptom resolution suggests non-pharmacological interventions, emphasising the need to address psychosocial factors in DI management. Further research into neurobiological and social influences is warranted.
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