Dermatology online journal最新文献

{"title":"Outcomes of atypical fibroxanthoma treated with mohs surgery or wide local excision: A retrospective review.","authors":"Kevin Varghese, William Liakos, Atieh Jibbe","doi":"10.25251/t4e0x094","DOIUrl":"10.25251/t4e0x094","url":null,"abstract":"<p><strong>Background: </strong>Atypical fibroxanthoma (AFX) is a rare cutaneous spindle cell neoplasm that typically affects elderly men on sun-exposed sites. Mohs micrographic surgery (MMS) and wide local excision (WLE) are common treatments, but comparative outcomes remain incompletely defined.</p><p><strong>Objective: </strong>This study evaluated recurrence, metastasis, and surgical outcomes of AFX treated with MMS versus WLE, with emphasis on immunosuppression as a prognostic factor.</p><p><strong>Methods: </strong>A retrospective review was performed of 23 patients with histologically confirmed AFX treated at a single academic center from 2010 to 2024. Demographic, clinical, and surgical variables were abstracted. Outcomes included local recurrence, metastasis, and defect size. Fisher exact and Mann-Whitney U tests were used for exploratory analysis.</p><p><strong>Results: </strong>Fourteen patients underwent MMS and 9 underwent WLE. Recurrence rates were similar between groups (14% versus 11%). However, all recurrences and the single metastasis occurred in immunosuppressed patients, who had a higher recurrence rate than immunocompetent patients (67% versus 5%; <i>P</i> = .10). Postoperative defect size was smaller with MMS than with WLE (3.1 cm versus 5.5 cm; <i>P</i> < .001).</p><p><strong>Conclusion: </strong>MMS provided effective tumor clearance with tissue conservation. Immunosuppression was strongly associated with adverse outcomes, underscoring the need for close surveillance in this high-risk subgroup.</p>","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"32 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148600187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of the indications, safety, and efficacy of deucravacitinib: An expert consensus panel.","authors":"Milaan Shah, Lauren DeBusk, M Hunter Bohman, Angela Rosenberg, Joshua Burshtein, Danny Zakria, April Armstrong, Erin Boh, Alice B Gottlieb, Saakshi Khattri, Graham Litchman, Joseph Merola, Andrea Murina, Mark Lebwohl","doi":"10.25251/ymnfwz12","DOIUrl":"10.25251/ymnfwz12","url":null,"abstract":"<p><strong>Background: </strong>Deucravacitinib is a novel, allosteric, selective TYK2 inhibitor FDA-approved for the treatment of moderate-to-severe plaque psoriasis in adults. Currently, deucravacitinib is under investigation in numerous clinical trials to establish its efficacy and safety for other indications. Thus, this expert consensus panel was assembled to provide clinical guidance on the applications of and clinical considerations for deucravacitinib.</p><p><strong>Objective: </strong>The aim of this study was to assess the literature and formulate consensus statements covering the indications, safety, and efficacy of deucravacitinib.</p><p><strong>Methods: </strong>A comprehensive literature search of PubMed, Scopus, and Google Scholar was completed for English-language original research articles regarding deucravacitinib. The expert panel, which included eight dermatologists with advanced knowledge on both dermatologic and rheumatologic conditions, reviewed the pertinent literature and developed consensus statements regarding the additional indications, safety, and efficacy of deucravacitinib. Using a modified Delphi process, each statement had supermajority approval and was designated a strength of recommendation based on the Strength of Recommendation Taxonomy criteria.</p><p><strong>Key findings: </strong>The panel unanimously voted to adopt 14 consensus statements and recommendations: 11 were a strength of \"A\", 1 was a strength of \"B\", and two were a strength of \"C\". The 14 consensus statements created by the expert panel provide expert recommendations regarding the efficacy, safety, and additional potential indications for deucravacitinib. Additionally, the expert panel notes that deucravacitinib is generally safe, as it can be safely combined with conventional synthetic DMARDs, immunosuppressants, and biologics and currently does not have data that support elevated malignancy risk, tuberculosis reactivation, increased risk for herpes zoster, or associated laboratory abnormalities.</p><p><strong>Conclusion: </strong>Deucravacitinib is an established treatment for plaque psoriasis that has shown strong evidence supporting safety and efficacy for psoriatic arthritis, cutaneous lupus, and systemic lupus erythematosus. Overall, deucravacitinib is a versatile and safe medication that may warrant further therapeutic consideration by clinicians. The expert panel concludes that deucravacitinib is an exciting medication that will likely have a larger role in the treatment of various conditions in the future.</p>","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"32 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148600078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral desensitization therapy for poison ivy urushiol contact allergy: A systematic review.","authors":"Natasha E Barton, John Meisenheimer, Dakota Hitchcock, Parker Juels, Olivia Ueltschi, Emily Woolhsier, Elizabeth Lamberty, Robert P Dellavalle, Cory A Dunnick","doi":"10.25251/pcyj0173","DOIUrl":"10.25251/pcyj0173","url":null,"abstract":"<p><strong>Background: </strong>Oral desensitization is a promising approach to reduce the frequency and severity of allergic contact dermatitis reactions to poison ivy. Rhus dermatitis, characterized by itching, redness, and blistering, can appear up to 3 weeks postexposure in first-time sufferers and within 1 to 2 days in previously sensitized individuals. Bentoquatam cream can serve as a barrier to protect the skin from urushiol resin but must be applied prior to plant contact. Current treatments focus on symptom relief and managing inflammation with topical therapies such as calamine lotion and corticosteroids.</p><p><strong>Methods: </strong>We conducted a systematic review identifying studies that assessed oral desensitization for poison ivy. Eligible studies included human participants receiving small oral doses of urushiol, delivered in liquid or tablet formulations, to induce immune tolerance.</p><p><strong>Results: </strong>Six studies involving 410 participants met inclusion criteria. Most studies reported promising results with minimal adverse effects. Reported side effects included rash, pruritus ani, and flushing.</p><p><strong>Conclusion: </strong>Oral desensitization may reduce the severity and incidence of poison ivy reactions, particularly in individuals at high risk of exposure. However, the limited number of studies and sample sizes highlight the need for further research to establish efficacy and safety.</p>","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"32 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148600147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extrapolating the speed of psoriasis clearance: Head-to-head agents in clinical trials.","authors":"Creighton Pfau, Katie K Lovell, Hanna Ozbeki, Steven R Feldman","doi":"10.25251/t1b8ft53","DOIUrl":"10.25251/t1b8ft53","url":null,"abstract":"<p><strong>Background: </strong>Biologic therapies targeting interleukin-17 (IL-17) and interleukin-23 (IL-23) pathways have transformed psoriasis management, with IL-17 inhibitors widely regarded as achieving faster clearance. However, the clinical significance of differences in clearance times remains unclear.</p><p><strong>Objective: </strong>To compare time to achieve a 75% reduction in the Psoriasis Area and Severity Index (PASI75) between IL-17 and IL-23 inhibitors using data from head-to-head clinical trials.</p><p><strong>Methods: </strong>A PubMed search identified trials reporting PASI75 response times for IL-17 and IL-23 inhibitors. Graphs from 12 studies were analyzed using Engauge Digitizer Software to estimate the time until half of participants reached PASI75.</p><p><strong>Results: </strong>IL-17 inhibitors achieved PASI75 faster than IL-23 inhibitors, with average response times of 4.5 weeks versus 7 weeks, respectively. The fastest IL-17 agent (bimekizumab) reached PASI75 in 2.5 weeks, while the fastest IL-23 agent (risankizumab) required 5.5 weeks. Differences between classes were smaller than anticipated, particularly for newer IL-23 inhibitors targeting the p19 subunit.</p><p><strong>Conclusion: </strong>IL-17 inhibitors generally achieve faster psoriasis clearance than IL-23 inhibitors, but the clinical relevance of this difference is limited. Safety and long-term efficacy profiles should guide treatment selection, highlighting the importance of personalized patient care.</p>","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"32 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148600174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insurance disparities in hidradenitis suppurativa: A comprehensive review of demographics, outcomes, and access to care.","authors":"Alim Osman, Alexandra R Nigro, Michael C Povelaitis, Marc Z Handler","doi":"10.25251/zr1rgs33","DOIUrl":"10.25251/zr1rgs33","url":null,"abstract":"<p><strong>Background: </strong>Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that disproportionately affects women, African Americans, and individuals of biracial descent. It is associated with substantial physical and psychiatric morbidity, reducing quality of life.</p><p><strong>Objective: </strong>This review analyzed disparities in treatment outcomes, disease progression, and healthcare access among HS patients based on insurance type.</p><p><strong>Methods: </strong>Using PRISMA guidelines, a comprehensive literature search identified 7 studies meeting inclusion criteria. Owing to data heterogeneity, studies were qualitatively analyzed.</p><p><strong>Results: </strong>Findings consistently demonstrated that Medicaid patients experienced worse outcomes than those with private insurance or Medicare. Medicaid patients had higher rates of comorbid conditions, including cellulitis and psychiatric disorders, greater reliance on emergency departments, and higher utilization of prescription pain medications, particularly opioids. They were also less likely to access specialized dermatologic care or advanced treatments such as biologics, despite a higher HS prevalence. These disparities were attributed to socioeconomic factors, barriers to specialist care, and limited insurance coverage for evidence-based treatments.</p><p><strong>Conclusion: </strong>Addressing insurance-related disparities could reduce disease severity, enhance medication adherence, and decrease reliance on emergency care and opioids. Future research should evaluate the impact of alternative treatments, such as laser hair removal, and examine insurance-related disparities in detail to improve outcomes for underserved populations.</p>","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"32 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148600161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The doctor-patient communication gap: Reddit as a window into our patients' concerns.","authors":"Courtney A Chau, Nicholas Brownstone, John Koo","doi":"10.25251/zrdgge70","DOIUrl":"10.25251/zrdgge70","url":null,"abstract":"<p><strong>Background: </strong>Physician-patient communication may be limited by time, especially in dermatology, where providers often see a high-volume of patients. Awareness of common patient frustrations may prepare dermatologists to optimize healthcare visits.</p><p><strong>Objective: </strong>This study employs Reddit to characterize sentiment toward dermatologists to identify opportunities to improve patient-physician communication.</p><p><strong>Methods: </strong>We obtained sentiment scores (SSs) for the top 1000 posts in the \"r/Psoriasis,\" \"r/Eczema,\" and \"r/TS_Withdrawal\" subreddits using the Valence Aware Dictionary and sEntiment Reasoner. Paragraphs containing dermatologist-related terms (DPs) and had negative SSs were extracted and reviewed by the authors to identify themes.</p><p><strong>Results: </strong>In all subreddits, DPs had negative mean SSs (mean SS, r/Eczema: -0.097; r/Psoriasis: -0.024; r/TS_Withdrawal: -0.062). Paragraphs without DPs had positive mean SSs (mean SS, r/Eczema: 0.032; r/Psoriasis: 0.012; r/TS_Withdrawal: 0.090). Differences between these paragraph types were significant (r/Eczema: <i>P</i> = .0037; r/Psoriasis: <i>P</i> = .0016; r/TS_Withdrawal: <i>P</i> < .001). Two themes emerged among negative DPs: 1) Patients feel they are not respected by dermatologists, and 2) Negativity toward being repeatedly prescribed topical steroids without adequate explanation of risk.</p><p><strong>Conclusion: </strong>Reddit may serve as a useful window into patient perceptions of dermatologic care that can inform dermatologists of common concerns, facilitating positive communication and improving the doctor-patient relationship in dermatology.</p>","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"32 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148600153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crusted scabies in an immunocompetent patient.","authors":"JuanCamilo Saldarriaga-Giraldo, Maria Del Pilar Marquez-Moron, Ana María Mejía Giraldo","doi":"10.25251/a2wwdb85","DOIUrl":"https://doi.org/10.25251/a2wwdb85","url":null,"abstract":"","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"32 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148600081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral mucosal involvement in mycosis fungoides.","authors":"Meryem El Bakkali, Salim Gallouj, Khedija Bennani, Ouiame El Jouari","doi":"10.25251/qwe4vq89","DOIUrl":"https://doi.org/10.25251/qwe4vq89","url":null,"abstract":"","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"32 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148600182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing cutaneous malignancy risk in hidradenitis suppurativa: A case-control analysis from the all of us research program.","authors":"Malak Husseinali, Tiffany Mayo","doi":"10.25251/8eqvkz83","DOIUrl":"https://doi.org/10.25251/8eqvkz83","url":null,"abstract":"","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"32 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148600011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multimodal reconstruction of the left auricle.","authors":"Helen Chen, Ethan Matthew, Brooke Walterscheid, Alba Posligua","doi":"10.25251/dynsjt55","DOIUrl":"https://doi.org/10.25251/dynsjt55","url":null,"abstract":"","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"32 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148600059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}