Editor’s Picks May 2025

Abstract

Carle Paul

Hidradenitis suppurativa (HS) represents one of the most burdensome skin diseases and has long been unrecognized and neglected. Zouboulis et al. updated comprehensive management guidelines that will elevate the standard of care in HS. The holistic combination of medical and surgical treatment should help patients experience relief from the enormous impact of the disease. The approval of biological agents over the past few years is transforming patient care and will help modify the disease course (as in the Figure 1 algorithm). We are living a time of new hope in HS.

Zouboulis, CC, Bechara, FG, Benhadou, F et al. European S2k guidelines for hidradenitis suppurativa/acne inversa part 2: treatment. J Eur Acad Dermatol Venereol 2025; 39: 899–941. https://doi.org/10.1111/jdv.20472.

As we face a shortage of dermatologists in many countries, the exact role of dermatologists in hospitals is frequently challenged based on the public perception of dermatology as a superficial, frivolous specialty. In this analysis from a Swiss University hospital, Cazzaniga et al. show increased marginalization of dermatologists in managing dermatological emergencies (Figure 2), with only 2% of total hospitalized patients admitted to a dermatology ward. These important data reveal the opinion others may have on the specialty and call for action to maintain our expertise in treating patients with dermatological emergencies.

Cazzaniga, S, Heidemeyer, K, Zahn, CA et al. Dermatological emergencies and determinants of hospitalization in Switzerland: a retrospective study. J Eur Acad Dermatol Venereol 2025; 39: 1001–1010. https://doi.org/10.1111/jdv.20176.

Multidisciplinary care of patients always surpasses individual approaches. Scleromyxedema, a life-threatening condition, is a rare form of sclerodermic disorder associated with monoclonal gammopathy. High-dose IV immunoglobulins are the recommended treatment for scleromyxedema; however, some patients require long-term maintenance, or relapse while still on therapy.

In this clinical report from dermatologists and haematologists, Theves et al. show that the combination of IV Immunoglobulins and plasma-cell directed treatment with various agents is able to induce long-term remission of scleromyxedema (Figure 3). Indeed, seeing a disease from various angles can lead to medical improvement and tangible patient benefits.

Theves, F, Lahuna, C, Mahévas, T et al. Plasma cell-directed therapies induce profound clinical and durable responses in patients with severe or relapsed/refractory scleromyxedema. J Eur Acad Dermatol Venereol 2025; 39: 1011–1016. https://doi.org/10.1111/jdv.20257.

Darier disease has long been a difficult-to-treat genodermatosis. Ettinger et al. have summarized the current understanding of Darier disease pathophysiology focusing on chronic skin inflammation (Figure 4) and the potential role of targeting Th17 cells. The progress in personalized evaluation of patients' skin inflammatory markers will certainly help to develop a tailored treatment approach for Darier disease. Bianco et al. reported clinical improvement after treatment with a JAK inhibitor. High quality clinical trials are needed to confirm the promising reports on the efficacy of IL17 antagonists and JAK inhibitors.

Ettinger, M, Kimeswenger, S, Deli, I et al. Darier disease: current insights and challenges in pathogenesis and management. J Eur Acad Dermatol Venereol 2025; 39: 942–951. https://doi.org/10.1111/jdv.20448.

Bianco M, Di Giulio S, Ibba L, et al. Clearance of Darier disease lesions in a patient with concomitant atopic dermatitis treated with abrocitinib. J Eur Acad Dermatol Venereol 2025; 39: e417–e419. doi: https://doi.org/10.1111/jdv.20399.