Editor's Picks September 2025

Abstract

Carle Paul

Atopic dermatitis (AD) is one of the most common skin diseases. Wollenberg et al. summarize updated living AD guidelines (with participation from clinicians and patient representatives), now encompassing a large armamentarium of injectable/oral agents for patients with moderate to severe disease. Topical therapy with corticosteroids or topical calcineurin inhibitors remain the standard of care for mild to moderate disease, while biologic agents and oral JAK inhibitors show long-term efficacy with moderate to severe AD. The stepped-care plan for children with AD delineates a new life-changing path that will ensure long-term control of AD (see Figure 1).

Wollenberg A, Kinberger M, Arents B, et al. European Guideline (EuroGuiDerm) on atopic eczema: Living update. J Eur Acad Dermatol Venereol 2025; 39: 1537–1566. https://doi.org/10.1111/jdv.20639.

Alternatives to topical corticosteroids are needed in patients with moderate to severe chronic hand eczema. Delgocitinib is a topical JAK inhibitor approved for the treatment of moderate to severe hand eczema. In this open-label phase I pharmacokinetic trial, Thaçi et al. showed that systemic exposure to topical delgocitinib after twice daily application to the hands was minimal, with a relative bioavailability versus oral dosing of <1%, indicating the absence of a systemic immunosuppressive effect (see Figure 2). It is unknown if application on larger surfaces (including areas with thin skin and higher absorption) can cause significant systemic exposure.

Thaçi D, Gooderham M, Lovato P, et al. Systemic exposure and bioavailability of delgocitinib cream in adults with moderate to severe Chronic Hand Eczema. J Eur Acad Dermatol Venereol 2025; 39: 1612–1621. https://doi.org/10.1111/jdv.20777.

In most healthcare systems, patients with skin diseases are usually seen first by a general practitioner (GP) and referred to a dermatologist only when needed. In this study from Finland, Lovén et al. evaluated the cost-effectiveness of integrating dermatologists into primary care with direct examination of patients with skin diseases by a dermatologist, without a prior GP appointment. While this strategy increased the likelihood of detecting skin cancers and appropriately diagnosing skin diseases, dramatically reducing healthcare costs, it should be balanced with its feasibility and the likely high number of dermatologists required (see Figure 3).

Lovén M, Huilaja L, Paananen M, et al. The integration of dermatology experts into primary care to assess and treat patients with skin lesions is cost-effective: A quasi-experimental study. J Eur Acad Dermatol Venereol 2025; 39: 1666–1674. https://doi.org/10.1111/jdv.20451.

The risk of developing psoriasis is a combination of genetic and environmental factors (including increased body mass index and exposure to tobacco and alcohol). In this large and well-conducted population-based study, Chattopadhyay et al. investigated the association between sodium consumption and a diagnosis of psoriasis. They found that every gram increase in 24-h sodium intake was associated with an 18% increased risk of psoriasis. Although several confounders may exist, these data are important and should motivate dermatologists to promote healthy eating in patients with psoriasis or at risk (see Figure 4).

Chattopadhyay A, Ye M, Chiang B, et al. Increased sodium consumption is associated with psoriasis: A population-based cohort study. J Eur Acad Dermatol Venereol 2025; 39: 1622–1630. https://doi.org/10.1111/jdv.20540.