Clinics in dermatology最新文献_第9页

Acrokeratosis paraneoplastica (Bazex syndrome) 副瘤性角化Acrokeratosis （Bazex综合征）。

IF 3.5 4区医学

Clinics in dermatology Pub Date : 2026-09-01 Epub Date: 2026-07-29 DOI: 10.1016/j.clindermatol.2026.07.015

Humza Zaidi BS, Campbell L. Stewart MD

{"title":"Acrokeratosis paraneoplastica (Bazex syndrome)","authors":"Humza Zaidi BS, Campbell L. Stewart MD","doi":"10.1016/j.clindermatol.2026.07.015","DOIUrl":"10.1016/j.clindermatol.2026.07.015","url":null,"abstract":"<div><div>Acrokeratosis paraneoplastica of Bazex (APB) is a paraneoplastic dermatosis heralding an underlying malignancy, most commonly squamous cell carcinoma of the upper aerodigestive tract. The syndrome is characterized by psoriasiform, violaceous, scaly plaques localized to acral areas and the ears and nose. Involvement of the nails, helical rim, and nasal tip are also common. Histologically, APB demonstrates spongiosis, interface dermatitis, and lichenoid inflammation, with direct immunofluorescence revealing variable deposits of immunoglobulins and complement along the basement membrane. Although the pathophysiology of APB is unclear, proposed mechanisms include tumor-derived factors, immune-mediated processes, and metabolic deficiencies. Recognizing this syndrome’s distinctive cutaneous findings is essential for early cancer detection, as these manifestations often precede the diagnosis of malignancy by months. Management focuses on treating the underlying malignancy, with cutaneous lesions typically resolving upon successful cancer therapy. Symptomatic relief may be achieved with topical or systemic treatments, although these do not address the primary cause.</div></div>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":"44 5","pages":"Pages 770-774"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618815","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}

引用次数: 0

Neutrophilic dermatoses 中性皮肤疾病。

IF 3.5 4区医学

Clinics in dermatology Pub Date : 2026-09-01 Epub Date: 2026-07-27 DOI: 10.1016/j.clindermatol.2026.07.026

Emiley Vrooman BSN, Jane M. Grant-Kels MD

引用次数: 0

Medicine’s commodity dependencies and the Strait of Hormuz 诊所皮肤科伦理角文章类型：医药的商品依赖和霍尔木兹海峡。

IF 3.5 4区医学

Clinics in dermatology Pub Date : 2026-09-01 Epub Date: 2026-07-28 DOI: 10.1016/j.clindermatol.2026.07.011

Aaron D. Smith MD, Vidya Mani PhD, MBA, Reid B. Adams MD, Jane M. Grant-Kels MD, Micaela A. Shulman BA, Taison D. Bell MD, MBA

{"title":"Medicine’s commodity dependencies and the Strait of Hormuz","authors":"Aaron D. Smith MD, Vidya Mani PhD, MBA, Reid B. Adams MD, Jane M. Grant-Kels MD, Micaela A. Shulman BA, Taison D. Bell MD, MBA","doi":"10.1016/j.clindermatol.2026.07.011","DOIUrl":"10.1016/j.clindermatol.2026.07.011","url":null,"abstract":"<div><div>The 2026 closure of the Strait of Hormuz has disrupted approximately one-fifth of global petroleum transit, sending oil prices sharply upward and exposing medicine’s structural dependence on petrochemicals, helium, and globalized manufacturing. This contribution examines how medicine’s reliance on globalized commodities exposes patients to medication and device shortages during sustained supply disruption. Prior crises, including the 1973 oil embargo and the 2021 Suez blockage, revealed vulnerabilities that current just-in-time supply chains have deepened. We urge practice leaders, hospital administrators, and clinicians to establish supply continuity frameworks now, before scarcity forces improvised rationing and reactive procurement.</div></div><div>The 2026 closure of the Strait of Hormuz has disrupted approximately one-fifth of global petroleum transit, sending oil prices sharply upward and exposing medicine’s structural dependence on petrochemicals, helium, and globalized manufacturing. This contribution examines how medicine’s reliance on globalized commodities exposes patients to medication and device shortages during sustained supply disruption. Prior crises, including the 1973 oil embargo and the 2021 Suez blockage, revealed vulnerabilities that current just-in-time supply chains have deepened. We urge practice leaders, hospital administrators, and clinicians to establish supply continuity frameworks now, before scarcity forces improvised rationing and reactive procurement.</div>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":"44 5","pages":"Pages 865-868"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599843","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}

引用次数: 0

Cutaneous granulomatous disorders and associations with malignancy 皮肤肉芽肿性疾病及其与恶性肿瘤的关系。

IF 3.5 4区医学

Clinics in dermatology Pub Date : 2026-09-01 Epub Date: 2026-07-28 DOI: 10.1016/j.clindermatol.2026.07.020

Bingjie Pecha PhD, Devyn Zaminski BA, Juliana Berk-Krauss MD, Mariam Alam MD, Avrom S. Caplan MD

{"title":"Cutaneous granulomatous disorders and associations with malignancy","authors":"Bingjie Pecha PhD, Devyn Zaminski BA, Juliana Berk-Krauss MD, Mariam Alam MD, Avrom S. Caplan MD","doi":"10.1016/j.clindermatol.2026.07.020","DOIUrl":"10.1016/j.clindermatol.2026.07.020","url":null,"abstract":"<div><div>Granulomatous inflammation of the skin can arise in patients with inflammatory disorders, malignancy, or infections and in reactions to medications or foreign bodies. Granulomatous disorders describe a group of diseases marked by the presence of granulomatous inflammation in the dermis and can be categorized into infectious and noninfectious causes. Inflammatory, noninfectious granulomatous disorders, including granuloma annulare (GA), necrobiosis lipoidica, rheumatic nodules, cutaneous sarcoidosis, reactive granulomatous dermatitis (RGD), and necrobiotic xanthogranuloma (NXG), can occur in the setting of underlying systemic disease, and some cutaneous granulomatous disorders, including GA, RGD, and NXG, may rarely be associated with malignancy. Due to the varied clinical and histologic presentations of granulomatous infiltrates and given rare presentations and ongoing debates regarding strength of disease associations, potential for confusion may arise among clinicians when approaching the diagnosis, differentiation, and systemic evaluation of granulomatous disorders. Given the potential of certain granulomatous disorders to herald a new diagnosis of a malignancy, it is imperative that dermatologists approach granulomatous inflammation systemically to ensure best patient outcomes. We review clinical presentations and histologic findings of GA, RGD, and NXG and discuss the associations of these granulomatous disorders with malignancy. Further, we provide a framework for clinicians to pursue additional diagnostic evaluation for underlying malignancy in these conditions.</div></div>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":"44 5","pages":"Pages 730-741"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599858","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}

引用次数: 0

Ethical considerations in standardized letters of evaluation for dermatology residency selection. 皮肤科住院医师选择的标准化评估信中的伦理考虑。

IF 3.5 4区医学

Clinics in dermatology Pub Date : 2026-08-30 DOI: 10.1016/j.clindermatol.2026.08.015

Haya Alkiswani, Umayr R Shaikh, Christopher G Richter, Leela K Raj, H William Higgins, Jane M Grant-Kels

{"title":"Ethical considerations in standardized letters of evaluation for dermatology residency selection.","authors":"Haya Alkiswani, Umayr R Shaikh, Christopher G Richter, Leela K Raj, H William Higgins, Jane M Grant-Kels","doi":"10.1016/j.clindermatol.2026.08.015","DOIUrl":"10.1016/j.clindermatol.2026.08.015","url":null,"abstract":"<p><p>The introduction of dermatology's specialty-specific standardized letter of evaluation for the 2026-2027 residency cycle aims to improve fairness and comparability and reduce bias in applicant assessment. Although standardization may reduce differences in writing style and interpretation, it does not eliminate subjectivity and may shift how and where bias affects the process. Rating inflation, ceiling effects, and interrater variability have been reported in dermatology and other specialties, yet evidence that standardized ratings predict residency performance remains limited. In addition, standardizing evaluation does not standardize opportunity: ratings of research, professionalism, and communication may reflect differences in mentorship, resources, clinical exposure, and evaluator relationships. Programs should therefore avoid interpreting small numerical differences as precise measures of ability and instead treat standardized letters of evaluation as part of a holistic review. Ethical implementation will require ongoing assessment of rating inflation, interrater variability, demographic disparities, and predictive validity. Ultimately, the standardized letter of evaluation's value will depend on whether it improves comparability and transparency without creating false precision or masking unequal opportunities.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148860485","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}

引用次数: 0

Ethical considerations in suspected isotretinoin nonadherence and/or diversion. 可疑异维甲酸不依从和/或转移的伦理考虑。

IF 3.5 4区医学

Clinics in dermatology Pub Date : 2026-08-30 DOI: 10.1016/j.clindermatol.2026.08.014

Lauren Fleshner, Timothy Klufas, Jane M Grant-Kels

引用次数: 0

Alopecia areata universalis in Leonardo da Vinci's Mona Lisa: A systematic retrospective iconodiagnosis. 列奥纳多·达·芬奇《蒙娜丽莎》中的斑秃：系统性回顾性图像诊断。

IF 3.5 4区医学

Clinics in dermatology Pub Date : 2026-08-24 DOI: 10.1016/j.clindermatol.2026.08.011

Luigi Laino

{"title":"Alopecia areata universalis in Leonardo da Vinci's Mona Lisa: A systematic retrospective iconodiagnosis.","authors":"Luigi Laino","doi":"10.1016/j.clindermatol.2026.08.011","DOIUrl":"10.1016/j.clindermatol.2026.08.011","url":null,"abstract":"<p><p>The face of Leonardo da Vinci's Mona Lisa (ca 1503-1519) has attracted several medical presentations, most recently the hypothesis of frontal fibrosing alopecia masquerading as Renaissance fashion. I present a systematic retrospective iconodiagnosis grounded in an explicit methodological framework, in the technical literature on the painting, including 13-band multispectral imaging, and in the documented biography of the sitter, Lisa Gherardini (ca 1479-1542). Four reproducible findings are legible on the panel: complete bilateral absence of the eyebrows; complete bilateral absence of the eyelashes; a frontal hairline without a transition zone; and intact, non-scarred periocular and frontal skin. Tested against these findings, Renaissance cosmetic depilation, frontal fibrosing alopecia, secondary syphilis, lepromatous leprosy, telogen effluvium, and trichotillomania each fail on at least one cardinal sign, whereas alopecia areata universalis accounts for all four without exception. The single supraciliary hair detected by multispectral analysis, previously read as the relic of a vanished painted eyebrow, is reinterpreted as a faithfully depicted solitary surviving terminal hair-a recognized expression of incomplete, asynchronous follicular involvement in alopecia areata, illustrated here by a clinical photograph of an 8-year-old patient with an identical finding. The sitter's documented age (24 years in 1503), and biographic stressors are congruent with the early-onset epidemiology of extensive alopecia areata. Limitations of retrospective diagnosis are addressed, and explicit criteria for disproof are also stated. The most contemplated face in Western art is reframed as a dignified Renaissance document of alopecia areata universalis.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812153","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}

引用次数: 0

Ethical issues surrounding maternity and paternity leave. 关于产假/陪产假的道德问题。

IF 3.5 4区医学

Clinics in dermatology Pub Date : 2026-08-14 DOI: 10.1016/j.clindermatol.2026.08.009

Carlie J Reeves, Joshua R Jennings, Jane M Grant-Kels

引用次数: 0

Ethical responsibilities of physician inventors: Access and justice. 医师发明者的伦理责任：获取和公正。

IF 3.5 4区医学

Clinics in dermatology Pub Date : 2026-08-14 DOI: 10.1016/j.clindermatol.2026.08.008

Janice Kim, Ali Aljassabi, Tarek Zieneldien, Sophia Ma, Jane M Grant-Kels

{"title":"Ethical responsibilities of physician inventors: Access and justice.","authors":"Janice Kim, Ali Aljassabi, Tarek Zieneldien, Sophia Ma, Jane M Grant-Kels","doi":"10.1016/j.clindermatol.2026.08.008","DOIUrl":"10.1016/j.clindermatol.2026.08.008","url":null,"abstract":"<p><p>Dermatologist inventors have ethical responsibilities extending beyond demonstrating that an innovation is helpful, accurate, and safe. Diagnostic technologies can be a positive influence on access to care, health care equity, and patient trust, particularly when these technologies are intended for rural and resource-limited communities. Ethical development of novel dermatologic diagnostic technologies requires consideration of beneficence, justice, transparency, accessibility, and responsible commercialization. Physician inventors should evaluate whether a technology addresses a meaningful clinical need, performs adequately across diverse patient populations, and can be integrated into real-world clinical settings. Accessibility should also be considered during the design process rather than after development. Eliminating unnecessary cold-chain requirements may improve the feasibility of distributing diagnostic technologies to rural and low-resource settings in which refrigeration and temperature-controlled transportation might be limited. These design strategies should be supported by appropriate analytical and clinical validation to ensure that accessibility does not compromise diagnostic performance. Such validations could lead to perpetuating inequities in underserved communities, where low-cost technologies are most likely to have the greatest impact.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758088","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}

引用次数: 0

Glucagon-like peptide-1 receptor agonists and related incretin therapies in dermatology: Patient selection and shared decision-making. 皮肤病学中胰高血糖素样肽-1受体激动剂和相关肠促胰岛素治疗：患者选择和共同决策。

IF 3.5 4区医学

Clinics in dermatology Pub Date : 2026-08-09 DOI: 10.1016/j.clindermatol.2026.08.005

Somto Ndubisi, Peter Lio

{"title":"Glucagon-like peptide-1 receptor agonists and related incretin therapies in dermatology: Patient selection and shared decision-making.","authors":"Somto Ndubisi, Peter Lio","doi":"10.1016/j.clindermatol.2026.08.005","DOIUrl":"10.1016/j.clindermatol.2026.08.005","url":null,"abstract":"<p><p>Glucagon-like peptide-1 receptor agonists and related incretin therapies have moved rapidly from second-line diabetes agents to widely prescribed cardiometabolic medications, and dermatologists increasingly encounter patients who are already taking them. Obesity is common among dermatology patients and is particularly prevalent in psoriasis and hidradenitis suppurativa, yet most eligible patients are not receiving glucagon-like peptide-1 receptor agonist therapy, and nearly all prescriptions originate outside dermatology. This positions dermatologists at the intersection of two distinct clinical questions: how to manage the cutaneous consequences of therapy in patients already receiving these agents, and when to raise the possibility of treatment in patients who may benefit. This narrative review examines patient selection, including the metabolic and inflammatory phenotypes most likely to see dermatologic benefit, and the practical demands of therapy that influence whether treatment succeeds. It reviews the dermatology-relevant adverse effects that patients most often notice, including facial volume loss, hair shedding, and gastrointestinal intolerance, along with a monitoring approach suited to the dermatology visit. Throughout, it argues that shared decision-making offers a useful framework for an area where the evidence is still evolving and where treatment can reshape how patients look and feel.</p>","PeriodicalId":10358,"journal":{"name":"Clinics in dermatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700934","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}

引用次数: 0