Clinics in dermatology最新文献

{"title":"Emotional Support Animals in Dermatology: An Ethical and Practical Framework.","authors":"Catherine S Taghizadeh, Shari R Lipner","doi":"10.1016/j.clindermatol.2026.09.038","DOIUrl":"https://doi.org/10.1016/j.clindermatol.2026.09.038","url":null,"abstract":"<p><p>Emotional support animals (ESAs) may provide companionship and psychological support to individuals with mental health conditions, and dermatologists may encounter patients requesting ESA documentation or seeking to bring an animal into the clinical setting. These situations raise distinct ethical, legal, and practical considerations. Unlike service animals trained to perform disability-related tasks, ESAs do not have the same federal public-access protections. This paper provides a framework to help dermatologists distinguish service animals from ESAs, evaluate requests for ESA documentation, determine when additional evaluation is needed, and manage animal-access questions in clinical settings. A proportionate approach can support patients with disability-related needs while maintaining appropriate professional boundaries and consistent clinical practice.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLP-1 receptor agonists in psoriasis management.","authors":"Marley Cutrona, Jordan Talia, Ahuva Cices","doi":"10.1016/j.clindermatol.2026.09.037","DOIUrl":"https://doi.org/10.1016/j.clindermatol.2026.09.037","url":null,"abstract":"<p><p>Psoriasis is a systemic chronic inflammatory skin disease associated with musculoskeletal, cardiovascular, metabolic, psychiatric, and gastrointestinal comorbidities. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 RAs have emerged as potential therapeutic adjuncts in psoriasis because, beyond their metabolic effects, these agents exhibit anti-inflammatory properties and may reduce expression of cytokines and inflammatory biomarkers. This review summarizes the current evidence from randomized trials and nonrandomized studies evaluating GLP-1 RAs and dual GIP/GLP-1 RAs in patients with psoriasis and discusses their potential role in disease management. Observational studies of liraglutide, semaglutide, exenatide, dulaglutide, and tirzepatide generally demonstrated improvements in psoriasis severity, body weight, metabolic parameters, inflammatory biomarkers, and quality of life, although most were limited by small sample sizes and uncontrolled designs. Randomized trials similarly suggest dermatologic benefit, particularly among patients with obesity and/or type 2 diabetes mellitus. Most notably, the phase 3b TOGETHER trial demonstrated greater skin clearance and weight reduction with ixekizumab plus tirzepatide compared with ixekizumab alone in patients with moderate-to-severe psoriasis and overweight or obesity. Complementary findings from the TOGETHER-PsA trial showed improvement in psoriatic arthritis disease activity as early as week 4, before clinically meaningful weight loss, supporting potential weight-independent anti-inflammatory effects of these agents. Future studies should include patients without obesity or diabetes to clarify the relative contributions of weight loss and direct anti-inflammatory effects to clinical response and determine whether the dermatologic benefits of GLP-1-based therapies extend to patients without underlying metabolic dysfunction.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare malignant tumors of the eyelid: A comprehensive clinicopathologic, molecular, and management review of adnexal and neuroendocrine neoplasms.","authors":"Valentina Caputo, Fabio Biondi, Stefania Guida, Paolo Romanelli, Franco Rongioletti","doi":"10.1016/j.clindermatol.2026.09.035","DOIUrl":"10.1016/j.clindermatol.2026.09.035","url":null,"abstract":"<p><p>Although basal cell carcinoma, squamous cell carcinoma, and melanoma represent the most frequent malignant tumors of the eyelids, a diverse group of rarer adnexal and neuroendocrine neoplasms also demonstrates a strong predilection for this anatomic site. These tumors, including sebaceous carcinoma, Merkel cell carcinoma, primary cutaneous mucinous carcinoma, endocrine mucin-producing eccrine gland carcinoma, primary apocrine adenocarcinoma, and primary signet ring (histiocytoid) carcinoma, are characterized by unique epidemiologic patterns, biologic behavior, and histopathologic features. The specialized microanatomy of the eyelid-with a dense concentration of meibomian (sebaceous), apocrine (Moll), and eccrine glands-combined with thin tissue planes, rich lymphovascular networks, and chronic ultraviolet exposure, contributes to their development, patterns of local invasion, and potential for metastasis. Accurate diagnosis often requires careful clinicopathologic correlation, incorporating immunohistochemical and molecular studies to distinguish primary lesions from eyelid metastases and identify syndromic associations. This review provides a comprehensive synthesis of the epidemiology, pathogenesis, clinical presentation, detailed histopathology, genetic alterations, differential diagnosis, management, and prognosis of these rare malignant eyelid tumors, with emphasis on early recognition and multidisciplinary care.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mystery of Dürer's fever.","authors":"Alexis Demas, Antonio Perciaccante","doi":"10.1016/j.clindermatol.2026.09.028","DOIUrl":"10.1016/j.clindermatol.2026.09.028","url":null,"abstract":"<p><p>Albrecht Dürer's illness has often been interpreted through a splenic and malarial framework, largely due to the famous self-portrait in which he points to a painful area on his left side and refers to a \"yellow spot,\" iet, this interpretation may be too organ-centered. The image may not simply localize pain; it may depict a true cutaneous lesion. Once the malaria hypothesis is weakened, the combination of a recurrent fever, the constitutional decline, and a painful, marked lesion becomes newly legible within the modern spectrum of late-onset autoinflammatory disease, especially the VEXAS syndrome and related neutrophilic dermatoses. These disorders frequently affect older men, commonly present with fever and skin lesions, and may include tender, infiltrated plaques or Sweet syndrome-like eruptions on the trunk. This contribution argues that Dürer's \"yellow spot\" is better interpreted as a painful inflammatory skin lesion-possibly a localized neutrophilic plaque, a pseudopustular lesion, or a confluent Sweet-like eruption-rather than as a projection of splenic pain.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Portraits of Pioneering Scientists in Dermatology: Preserving the Visual History of the Specialty.","authors":"Aydan Yazıcı, Gulfem Unsal, Ayse Serap Karadag, Lawrence Charles Parish","doi":"10.1016/j.clindermatol.2026.09.033","DOIUrl":"https://doi.org/10.1016/j.clindermatol.2026.09.033","url":null,"abstract":"<p><p>Dermatology has long been one of the most visual of the medical specialties, built on observation, illustration, and pattern recognition. While the scientific achievements of its pioneers are well documented, the portraits, engravings, silhouettes, sculptures, medals, and early photographs that preserved their likenesses have received comparatively little attention. These images form a historical archive in their own right, reflecting not only the physicians themselves but the artistic conventions, technical means, and professional culture of their era. This review traces the history of dermatology through a selected series of such portraits, chosen to illustrate major transitions in the field: morphologic classification, clinicopathologic correlation, dermatopathology, medical mycology, immunology, dermatologic surgery, phototherapy, pigment biology, and targeted molecular therapy. Each portrait is discussed within its historical and, where informative, its artistic context, from Renaissance engravings and eighteenth-century silhouettes to nineteenth-century academic paintings and modern photography. The individuals included were selected for their documented, enduring contributions to the specialty and for the availability of authentic visual material; the selection is illustrative rather than exhaustive, and its predominantly European and North American emphasis is acknowledged as a limitation rather than a claim of completeness. Beyond cataloging individual achievement, we argue that these images preserve a collective visual memory of the specialty and illustrate how portraiture has contributed to dermatology's professional identity.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neglected Terebrating Cutaneous Malignancies in the Modern Era: A Retrospective Clinicopathologic Case Series and Determinants of Extreme Diagnostic Delay.","authors":"Franco Rongioletti, Giorgio Filosa","doi":"10.1016/j.clindermatol.2026.09.036","DOIUrl":"https://doi.org/10.1016/j.clindermatol.2026.09.036","url":null,"abstract":"<p><p>Advances in dermoscopy, skin cancer awareness, and modern oncologic therapies have made giant neglected cutaneous malignancies increasingly uncommon in industrialized countries. Nevertheless, exceptionally advanced tumors still occur and provide important insight into the psychological, social, and healthcare-related factors underlying extreme diagnostic delay. We aimed to describe a retrospective personal series of neglected terebrating cutaneous malignancies, identify the determinants of prolonged diagnostic delay, and highlight their clinical implications. We retrospectively reviewed patients with unusually large or deeply destructive malignant cutaneous tumors evaluated between 2005 and 2025. Clinical photographs, histopathologic findings, demographic and socioeconomic characteristics, and psychological factors were analyzed and interpreted in the context of the current literature. Twenty-two patients fulfilled the inclusion criteria (11 men and 11 women; mean age, 74 years; range, 69-99 years). The mean interval between lesion onset and specialist consultation was 5.3 years (range, 3-18 years). Histopathologic diagnoses included 14 giant basal cell carcinomas, four squamous cell carcinomas (including two verrucous carcinomas), two lentigo maligna melanomas, and two Merkel cell carcinomas. Diagnostic delay resulted from multiple interacting determinants. Although slow tumor growth contributed to the progressive enlargement of some lesions, psychological factors-including denial, fear of diagnosis or treatment, self-neglect, and psychiatric or cognitive disorders-emerged as the main drivers of prolonged neglect. Social isolation, socioeconomic vulnerability, limited healthcare access, and, less frequently, physician-related delays further contributed to disease progression. Neglected terebrating cutaneous malignancies remain rare but clinically important manifestations of advanced skin cancer in which prolonged diagnostic delay, rather than biological aggressiveness alone, determines disease severity. Psychological and behavioral factors play a pivotal role and should be actively recognized by dermatologists. Early identification of psychological distress, social vulnerability, and barriers to healthcare, together with a compassionate multidisciplinary approach, may help prevent these devastating yet largely avoidable presentations.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary beverages and cutaneous health: Mechanisms, clinical evidence, and practical implications for dermatologists.","authors":"Gulfem Unsal, Ayse Serap Karadag, Leonard J Hoenig","doi":"10.1016/j.clindermatol.2026.09.032","DOIUrl":"10.1016/j.clindermatol.2026.09.032","url":null,"abstract":"<p><p>Beverage consumption is a common, modifiable lifestyle factor with potential relevance to cutaneous health. The aim of this study was to synthesize clinical and mechanistic evidence on commonly consumed beverages and dermatologic outcomes. A narrative review was conducted using targeted PubMed/MEDLINE searches and supplementary screening of dermatology and nutrition sources, prioritizing randomized trials, prospective cohorts, systematic reviews, meta-analyses, and Mendelian randomization studies. Alcohol has the most consistently reported adverse cutaneous associations, including rosacea triggering, psoriasis, urticaria, and skin cancer risk, although causal evidence is not uniform. Sugar-sweetened beverages and milk are associated with acne in observational studies, but current acne guidelines do not make formal dietary recommendations. Coffee shows mixed observational and Mendelian randomization findings for skin aging and melanoma. For green tea, randomized acne studies show benefit mainly with topical extract, whereas oral effects are limited; the effect of matcha remains supported mainly by mechanistic extrapolation. Spearmint tea lowers free testosterone in women with polycystic ovary syndrome, although objective clinical benefit remains unproven. Evidence for chamomile, rooibos, hibiscus, energy drinks, kombucha, and plant-based milk alternatives is limited or indirect. Citrus cocktails and St. John's wort may cause clinically relevant photosensitization. Beverage-skin associations vary substantially in evidence strength and causality. Beverage assessment can support individualized counseling as a low-risk adjunct to standard dermatologic therapy although avoiding overstatement of findings derived from observational studies, extracts, or nutraceuticals rather than beverages as consumed.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLP-1 Receptor Agonists and the Dermatologist: Promise, Pitfalls, and Responsibility (Part I).","authors":"Vesna Petronic-Rosic, Leonard J Hoenig","doi":"10.1016/j.clindermatol.2026.09.034","DOIUrl":"https://doi.org/10.1016/j.clindermatol.2026.09.034","url":null,"abstract":"","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cystic Neutrophilic and Granulomatous Dermatitis as the Cutaneous Counterpart of Cystic Neutrophilic and Granulomatous Mastitis: A Case Series.","authors":"Taylor Kalomeris, Cynthia Magro","doi":"10.1016/j.clindermatol.2026.09.031","DOIUrl":"https://doi.org/10.1016/j.clindermatol.2026.09.031","url":null,"abstract":"<p><p>Cystic neutrophilic granulomatous mastitis (CNGM) has a distinctive morphology characterized by small cystic spaces with a concentric rim of primarily neutrophils and epithelioid histiocytes. These cystic spaces have a granular basophilic quality; a Gram stain discloses gram-positive bacilli compatible with a Corynebacterium species with the most common isolate being Corynebacterium kroppenstedtii. We identified 16 cases of Corynebacterium related cystic neutrophilic granulomatous dermatitis (CNGD) within our dermatopathology database. The histology in all cases was reproducible being in the context of small microcystic foci surrounded by neutrophils and mononuclear cells. Gram-positive coccobacillary forms were found within the center of the microcysts in a number of the cases. Facial cases are likely reflective of the high concentration of Demodex on the face and could be a further manifestation of a rosacea like diathesis as the natural bacterial endosymbiont for Demodex is Corynebacterium kroppenstedtii. The development of this distinctive cutaneous infection in parts of the body without a high concentration of Demodex could be a sign of impaired immunity. Other potential infectious causes of ringed granulomatous inflammation in the skin would primarily be limited to lipophilic organisms such as Cutibacterium acnes, Malassezia furfur, Bacillus licheniformis, Coxiella burnetti and certain lipid rich fungal organisms, best exemplified by cryptococcosis.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucagon-like peptide-1 receptor agonists in hidradenitis suppurativa: A narrative review of emerging evidence.","authors":"Alex Silberzweig, Amit Garg","doi":"10.1016/j.clindermatol.2026.09.029","DOIUrl":"10.1016/j.clindermatol.2026.09.029","url":null,"abstract":"<p><p>Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by painful nodules, abscesses, and draining tunnels involving intertriginous areas. It frequently occurs alongside disorders of metabolic dysfunction including obesity, insulin resistance, and metabolic syndrome. HS places a substantial quality-of-life burden on its patients. Glucagon-like peptide-1 (GLP-1) receptor agonists (RAs), widely used for the management of type 2 diabetes and obesity, have emerged as promising candidates in managing HS. This narrative review synthesizes current evidence on the metabolic basis of HS and evaluates the role of GLP-1 RAs as adjunctive therapy. Collectively, these studies report improvements in disease activity measures as well as quality-of-life indices and health care utilization. Database analyses demonstrate associations with fewer cardiovascular events and improved extracutaneous outcomes. To date, no randomized controlled trials have evaluated GLP-1 RAs in HS. Current evidence is limited to observational studies, uncontrolled trials, and case reports. Concomitant treatments, lack of control groups, and selection bias limit causal inference. Although findings suggest there is proof of concept for GLP-1 RA therapy in HS, rigorous randomized controlled trials with standardized efficacy measures and adequate sample sizes are essential to establish clinical efficacy and define the role of GLP-1 RAs in the management of HS.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}