Clinics in dermatology最新文献

{"title":"Ethical obligations to screen for psychiatric disorders and suicidal ideation in patients with alopecia areata.","authors":"Catherine S Taghizadeh, Carolyn Goh, Shari R Lipner","doi":"10.1016/j.clindermatol.2026.09.024","DOIUrl":"10.1016/j.clindermatol.2026.09.024","url":null,"abstract":"<p><p>Alopecia areata is associated with substantial psychosocial morbidity. Population-based studies have identified increased suicide-related risks, although findings are heterogeneous, which raises an ethical question regarding dermatologists' obligation to screen for psychiatric morbidity. Routine screening for depression and psychologic distress may reasonably form part of alopecia areata care. In contrast, formal suicide risk assessment should follow identification of suicidal ideation or other concerning clinical findings rather than be universally administered. This proportionate approach balances beneficence and nonmaleficence with the risks of overmedicalization, false-positive results, and limited referral resources. Screening should occur within a defined response pathway that includes assessment of positive findings, safety measures when indicated, crisis resources, and mental health referral. This approach allows dermatologists to address foreseeable psychologic harm while maintaining appropriate professional boundaries.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030019","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":"Potpourri VI.","authors":"Leonard J Hoenig, Vesna Petronic-Rosic, Franco Rongioletti","doi":"10.1016/j.clindermatol.2026.09.015","DOIUrl":"10.1016/j.clindermatol.2026.09.015","url":null,"abstract":"","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015862","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":"Skinaesthetics Skin aesthetics: The influence of beauty ideals on the medicalization of appearance.","authors":"Agnieszka Polak, Katarzyna Pawlikowska-Łagód, Andrzej Grzybowski","doi":"10.1016/j.clindermatol.2026.09.016","DOIUrl":"10.1016/j.clindermatol.2026.09.016","url":null,"abstract":"<p><p>Throughout history, the skin has been one of the most visible markers of identity, and its appearance has been shaped by cultural norms of beauty, health, and social status. Although skin ideals have changed depending on the era and social context, each period developed its own concept of proper appearance against which people were socially evaluated. In ancient cultures, a smooth and even complexion would be a sign of health and high social standing; in the Middle Ages, it was interpreted with moral and religious terms; and in the Renaissance, the visual ideal of luminous, harmonious skin was established. We have examined how culturally constructed aesthetic norms of appearance gradually became incorporated into clinical ways of observing and classifying the skin. It demonstrates that the development of dermatology in the 18th and 19th centuries, based on the morphologic classification of lesions visible to the naked eye, did not develop in isolation but coexisted with established visual patterns of normal skin. As a result, some features previously assessed in aesthetic terms were then defined as clinical abnormalities requiring classification and treatment. This process was not simply a consequence of influence of art on medicine; rather, it represented the mutual interaction of aesthetic, social, and scientific discourses. Understanding this dynamic allows for an improved grasp of the cultural determinants of contemporary dermatology and the tensions between the treatment of pathology and the medicalization of appearance. Understanding this historic interaction provides important context for contemporary dermatology, where the boundary between the treatment of disease and the modification of appearance is negotiated.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015949","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":"Practical considerations for adopting artificial intelligence clinical decision support tools and large language models in dermatology.","authors":"Ishani Rao Dhamsania, Albert E Zhou, Danielle M Khalilzadeh, Nahid Y Vidal, Laura K Ferris, Jane M Grant-Kels","doi":"10.1016/j.clindermatol.2026.09.012","DOIUrl":"10.1016/j.clindermatol.2026.09.012","url":null,"abstract":"<p><p>Artificial intelligence (AI) in dermatology is a rapidly evolving field, offering promising advances in the diagnosis and management of skin cancers. As global skin cancer incidence rises, tools such as machine learning-based systems and large language models have shown significant potential to support triage of patients with skin cancer. Yet, several key practical and ethical considerations stand in the way of widespread adoption. Limitations in dataset diversity, medicolegal ambiguity, and concerns regarding transparency of AI-generated outputs are challenges that must be addressed. This review explores the current landscape of AI technologies in dermatology, including diagnostic imaging tools, workflow-integrated systems, and generative AI models. We evaluate the advantages and limitations of these tools, workflow optimization, patient trust in AI-driven preliminary diagnoses, and the importance of preserving the physician-patient relationship amid increasing AI integration in dermatology.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015888","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":"Hair and Scalp Effects of GLP-1 Receptor Agonists in Practice.","authors":"Alina G Bridges, Tiaranesha Jackson","doi":"10.1016/j.clindermatol.2026.09.017","DOIUrl":"https://doi.org/10.1016/j.clindermatol.2026.09.017","url":null,"abstract":"<p><p>Hair loss is an emerging and clinically significant adverse effect associated with glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy, occurring in approximately 3%-5% of treated patients across pivotal clinical trials, with a pooled risk ratio of approximately 3.3 compared with placebo. The predominant mechanism is telogen effluvium (TE) secondary to rapid weight loss and caloric restriction, though direct effects on the hair follicle via GLP-1 receptor expression in dermal white adipose tissue (dWAT), hormonal shifts, and nutritional insufficiency also contribute. Pharmacovigilance data from the United States Food and Drug Administration Adverse Event Reporting System (FAERS) and large real-world cohort studies further support a clinically meaningful signal. This chapter reviews the epidemiology and agent-specific differences in GLP-1 RA-associated alopecia, the pathophysiologic mechanisms, potential beneficial effects on androgenetic alopecia (AGA) and cicatricial conditions, and a systematic approach to clinical evaluation and management. Management strategies include nutritional optimization with protein targets of 1.2-2.0 g/kg/day based on adjusted body weight, patient counseling on the anticipated time course of hair shedding, and pharmacologic options including low-dose oral minoxidil. The hair loss profile of GLP-1 RAs is compared with that of bariatric surgery, where pooled incidence ranges from 47%-57%. Practical guidance for the clinician is provided throughout.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015898","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":"Animal remedies for warts: Insights from the folklore.","authors":"Uwe Wollina, Leonard J Hoenig, Ayman Abdelmaksoud, Lawrence Charles Parish","doi":"10.1016/j.clindermatol.2026.09.013","DOIUrl":"10.1016/j.clindermatol.2026.09.013","url":null,"abstract":"<p><p>Folk medicine played an important role in human history. Its sources were shaped by experience, superstition, and religion. In this contribution, we analyze traditions of wart therapy, focusing on Europe from a medical-historical perspective. We focus on zootherapy, ie, the use of animals to treat common skin warts. Both domestic and wild animals were used. Mollusks, reptiles, spiders, insects, fish, and mammals are mentioned in the literature. Often, the animals used died an agonizing death in these rites. The cruelty of such procedures may reflect the harsh living conditions of common people in history. In contrast to healing, folk medicine used terms such as \"drive away,\" \"lose,\" or \"disappear.\" Successes were usually individualized. Suggestion and autosuggestion were important. Given the high rate of spontaneous remission (up to 2 of 3 within 2 years), the \"effect\" of the procedures was probably due to this phenomenon, and we would not recommend any of them. Interestingly, some antimicrobial compounds have recently been isolated from snails and ants.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149007706","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":"MD Training in Medical Semiology in the Museum: The Example of the Museum of Fine Arts of Bourg-en-Bresse, France.","authors":"Philippe Charlier, Corinne Déchelette, Magali BriatPhilippe","doi":"10.1016/j.clindermatol.2026.09.005","DOIUrl":"https://doi.org/10.1016/j.clindermatol.2026.09.005","url":null,"abstract":"<p><p>Dermatology is a visually oriented specialty in which diagnosis relies heavily on the recognition and interpretation of morphologic features. Fine arts museums may provide complementary educational environments for developing structured visual semiology. We have explored the potential of artworks as educational tools for dermatologic and medical visual semiology, using selected works from the Museum of Fine Arts of Bourg-en-Bresse, France. The permanent collection was examined for figurative artworks displaying recognizable dermatologic or medical signs. Selected paintings and sculptures were analyzed using a structured iconodiagnosis approach including morphologic description, anatomic localization, artistic medium, historic context, and level of diagnostic evidence. Four artworks displaying probable dermatologic or medical signs were identified. Probable dermal nevi were observed in three works, including two representations of Marc-Antoine Puvis in different media, showing concordant morphology and anatomic location. A probable dermal nevus and a possible Frank's sign were also identified on a marble bust of Charles-Philippe Robin. All observations were classified as level II evidence because no independent historical or medical documentation confirmed the suspected lesions. These artworks may function as \"pictorial patients,\" allowing learners to practice structured observation, morphologic description, diagnostic hypothesis generation, and assessment of uncertainty. Repeated representations of the same individual may also help distinguish reproducible anatomic features from artistic conventions. Fine arts museums, including regional and local institutions, may represent valuable complementary environments for training dermatologic visual semiology. Portraits, figurative paintings, and sculptures may contain numerous unexplored pictorial patients, and collaboration between dermatologists, medical educators, art historians, and museum professionals could help to transform museum collections into accessible resources for innovative visual training in dermatology.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001347","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 clinical and genetic landscape of junctional skin disorder in children: A scoping review.","authors":"Cecilia Del Vecchio, Elena Maria Nardacchione, Luisa Zupin, Sara Roncarà, Chiara Moltrasio, Angelo Valerio Marzano, Sergio Crovella, Paola Maura Tricarico","doi":"10.1016/j.clindermatol.2026.09.014","DOIUrl":"10.1016/j.clindermatol.2026.09.014","url":null,"abstract":"<p><p>Cellular junctions, including desmosomes, hemidesmosomes, and adherens, tight, and gap junctions, are essential for epidermal integrity, barrier function, and cell signaling. Variants in genes encoding proteins involved in cellular junctions lead to a spectrum of skin disorders, commonly referred to as junctional genodermatoses, often presenting with phenotypic overlaps and multisystemic involvement in pediatric patients. This systematic scoping review aims to comprehensively map pediatric genodermatoses, correlating specific genetic variants with clinical manifestations to improve diagnostic and prognostic accuracy. A systematic literature review was conducted in PubMed, Web of Science, Embase, and Scopus. The key terms included genetic skin disease and cellular junctions; case reports, case series, or observational studies of pediatric patients with skin diseases, specified junctional genes, and detailed clinical descriptions were considered. From 9,409 records, 159 studies were included, covering 25 key genes across five junctional complexes. Defects in anchoring complexes primarily manifested as skin fragility and blistering, including lethal neonatal forms of genodermatoses. Tight junction mutations were associated with syndromic ichthyoses, whereas gap junction variants showed high pleiotropy, ranging from palmoplantar keratoderma to keratitis-ichthyosis-deafness syndrome. Adherens junction defects were specifically associated with hypotrichosis. Extracutaneous involvement, including sensorineural hearing loss and arrhythmogenic cardiomyopathy, emerged as critical sentinel features in several junctional syndromes. In conclusion, pediatric junctional genodermatoses feature overlapping skin manifestations, but the specific complex dictates the primary disease mechanism. Early genetic characterization is determinant to guide multidisciplinary surveillance for life-threatening systemic comorbidities.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001364","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":"From Gila Monster Venom to Dermatology: The History of GLP-1 Receptor Agonists.","authors":"Sarah Dyson, Leonard Hoenig, Nick J Levell","doi":"10.1016/j.clindermatol.2026.09.011","DOIUrl":"https://doi.org/10.1016/j.clindermatol.2026.09.011","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have evolved from novel therapies for type 2 diabetes mellitus into widely used treatments for obesity and metabolic disease. Their origins can be traced to the Gila monster (Heloderma suspectum), a venomous lizard native to the deserts of the southwestern United States and northwestern Mexico. The discovery of exendin-4, a peptide isolated from the venom of the Gila monster, led to the subsequent development of longer acting GLP-1RAs. Long before its contribution to modern medicine would be recognized, the Gila monster was revered in Navajo culture and folklore. We have examined the historic development of GLP-1 RAs, from the natural history and cultural significance of the Gila monster to the discovery of exendin-4 and the subsequent development of modern therapeutics. We describe the scientific advances that led to the translation of a venom-derived peptide into a major therapeutic class, including the development of exenatide, liraglutide and semaglutide. The history of GLP-1 receptor agonists demonstrates how observations in nature can lead to major therapeutic advances. What began with a view of a venomous desert lizard has evolved into one of the most important therapeutic classes in modern metabolic medicine, with expanding therapeutic applications in dermatology. The Gila monster (Heloderma suspectum) is a venomous lizard native to the deserts of the southwestern United States and northwestern Mexico. Long revered in indigenous cultural traditions, the Gila monster made an unexpected contribution to modern medicine. The discovery of exendin-4, a peptide within its venom, ultimately led to the development of glucagon-like peptide-1 receptor agonists (GLP-1RAs), representing one of the most significant therapeutic advances in modern metabolic medicine. GLP-1RAs are synthetic polypeptides that mimic the actions of the endogenous incretin hormone glucagon-like peptide-1. Initially developed for the treatment of type 2 diabetes mellitus, they have transformed obesity management and are now among the most widely prescribed therapies worldwide. As recognition of obesity has emerged as a major global public health challenge, GLP-1RAs have provided an effective pharmacologic approach to weight management. According to the World Health Organization, more than 1 billion people worldwide have been living with obesity as of 2022 [1]. The success of GLP-1RAs can be traced to the discovery of exendin-4, a peptide isolated from Gila monster venom that shares key biologic properties with human GLP-1 while demonstrating greater resistance to enzymatic degradation. Emerging evidence suggests that GLP-1RAs may influence inflammatory skin disease through a combination of weight reduction, improvements in metabolic health, and modulation of inflammatory and immune pathways [2]. This has generated increasing interest in the potential applications of GLP-1RAs within dermatology. In this review, we have ","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982050","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":"Immune checkpoint inhibition in locally advanced, recurrent, and metastatic cutaneous squamous cell carcinoma.","authors":"A Maria Vromans, Bridget Harrop, Nicole Flores, Jane M Grant-Kels, Maria Constantinou, Matthew J Hadfield","doi":"10.1016/j.clindermatol.2026.09.009","DOIUrl":"10.1016/j.clindermatol.2026.09.009","url":null,"abstract":"<p><p>Cutaneous squamous cell carcinoma (cSCC) is a potentially aggressive nonmelanoma skin cancer with rising incidence attributed to ultraviolet radiation exposure, chronic inflammation, aging, immunosuppression, and improved detection technology. Immune checkpoint inhibitors have transformed treatment for advanced cSCC. Cemiplimab and pembrolizumab are programmed cell death 1 inhibitors and cosibelimab is a programmed death ligand 1 inhibitor; all are United States Food and Drug Administration-approved for advanced cSCC. We describe the latest updates in immune checkpoint inhibitors for the treatment of aggressive, unresectable, or metastatic cSCC, inclusive of ongoing clinical trials exploring neoadjuvant and adjuvant applications. For unresectable, locally advanced and metastatic disease, several trials investigating immune checkpoint inhibitors found ∼50% overall response rate. C-POST (NCT03969004) established adjuvant cemiplimab after surgery and radiation for patients at high risk of recurrence. In contrast, KEYNOTE-630, which evaluated adjuvant pembrolizumab, was stopped for futility after an independent data monitoring committee review determined it was not meeting its prespecified recurrence-free survival threshold. Neoadjuvant cemiplimab has generated high pathologic response rates and the randomized phase 2 MATISSE trial supports continued investigation of neoadjuvant nivolumab with or without ipilimumab. Despite the biologic rationale for biomarker-guided treatment, tumor mutational burden and programmed death ligand 1 expression have not shown sufficiently consistent, predictable values for clinical selection. Active investigations into the efficacy of immune checkpoint inhibitors in advanced resectable and unresectable cSCC are rapidly shifting management, with evidence revealing promises of greater disease-free survival through neoadjuvant and adjuvant approaches.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955179","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}