Dermatologic Therapy最新文献

{"title":"Oral JAK Inhibitors as Rescue Therapy for Cosmetic Injectable–Associated Granulomatous Reactions: A Narrative Synthesis of Case Reports","authors":"Mohammed Shanshal, George Karanasios","doi":"10.1155/dth/6959518","DOIUrl":"https://doi.org/10.1155/dth/6959518","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cosmetic injectable procedures, including dermal fillers and mesotherapy, can trigger delayed granulomatous reactions that are diagnostically challenging and may be refractory to conventional therapies. Oral Janus kinase (JAK) inhibitors have recently emerged in scattered reports as off-label rescue options.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To synthesize published case-level evidence on oral JAK inhibitor use in cosmetic injectable–associated granulomatous reactions and characterize clinical patterns, treatment regimens, reported outcomes, and limitations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, Embase via Ovid, Web of Science Core Collection, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched from inception to 13 June 2026, supplemented by backward reference screening. Eligible reports described oral JAK inhibitor use for cosmetic injectable–associated granulomatous reactions with extractable patient-level treatment data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ten publications comprising 17 patients were included. All patients were women; 16 reactions involved the face or periorbital region and one involved the buttocks. Reported materials included hyaluronic acid, collagen, poly-L-lactic acid, silicone, patient-procured hyaluronic-acid mesotherapy, and mixed mesotherapy products. Histologic confirmation was available in 7 of 17 patients, while other diagnoses were clinical or supported by imaging, dermoscopy, ultrasound, Doppler ultrasound, or reflectance confocal microscopy. Tofacitinib was the most frequently reported agent, followed by abrocitinib, upadacitinib, ruxolitinib, and baricitinib. Using prespecified response categories, 4 of 17 patients were classified as complete/near-complete response and 13 of 17 as partial response; no treatment failure or progression was reported after JAK inhibitor initiation. No patient received first-line standalone JAK monotherapy; 9 of 17 received rescue JAK therapy without a clearly newly added adjunct, and 8 of 17 received rescue JAK therapy with adjunctive treatment. Safety reporting was incomplete and nonstandardized.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Uncontrolled case reports describe clinical improvement in all 17 patients, but confounding by adjunctive therapy and the absence of standardized outcomes preclude attribution to JAK inhibition or estimation of effect size. The current evidence remains hy","PeriodicalId":11045,"journal":{"name":"Dermatologic Therapy","volume":"2026 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/dth/6959518","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Trichoscopic Differentiation of Fibrosing Alopecia in a Pattern Distribution From Female Pattern Hair Loss: A Biopsy-Confirmed Diagnostic Accuracy Study","authors":"Korn Triyangkulsri,&nbsp;Chaninan Kositkuljorn,&nbsp;Kanchana Leerunyakul,&nbsp;Suthinee Rutnin,&nbsp;Poonkiat Suchonwanit","doi":"10.1155/dth/4572946","DOIUrl":"https://doi.org/10.1155/dth/4572946","url":null,"abstract":"<p>Female pattern hair loss (FPHL) and fibrosing alopecia in a pattern distribution (FAPD) share similar clinical presentations but differ fundamentally in pathophysiology and management. Reliable, noninvasive trichoscopic criteria to distinguish these entities remain inadequately defined. This prospective cross-sectional study enrolled 63 consecutive women with biopsy-confirmed patterned alopecia (21 FAPD and 42 FPHL), matched for hair loss severity using the Sinclair scale, to compare clinical and trichoscopic features and develop a hierarchical diagnostic algorithm. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) were calculated with 95% confidence intervals. Loss of follicular ostia was identified in all FAPD cases, but only 2.4% of FPHL cases (AUC 0.99), and white fibrotic patches occurred exclusively in FAPD (47.6%), while yellow dots were found only in FPHL (83.3%). Vellus hairs &gt; 10% were significantly less frequent in FAPD than FPHL (47.6% vs. 95.2%), reflecting a relative vellus hair depletion, termed the “vellus paradox,” likely caused by preferential destruction of miniaturized follicles by the lichenoid inflammatory process. FAPD patients also had shorter disease duration and more frequent scalp symptoms, including burning sensation and tenderness. A hierarchical two-step trichoscopic algorithm using specificity-based rule-in (loss of follicular ostia or white fibrotic patches) and sensitivity-based rule-out heuristics (hair diameter diversity or vellus proportion) achieved 100% sensitivity, 97.6% specificity, and 98.4% overall accuracy (AUC 0.99) for identifying FAPD. Distinct trichoscopic features, particularly loss of follicular ostia, white fibrotic patches, and relative vellus hair depletion, reliably differentiate FAPD from FPHL. The proposed algorithm enables rapid, noninvasive bedside diagnosis in this derivation cohort; external validation is required before routine implementation.</p>","PeriodicalId":11045,"journal":{"name":"Dermatologic Therapy","volume":"2026 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/dth/4572946","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Treatment Patterns and Characteristics of Patients Aged 15 Years and Older Treated With Baricitinib for Alopecia Areata in Japan","authors":"Kazutoshi Harada,&nbsp;Taisuke Kojima,&nbsp;Yasuhiro Miki,&nbsp;Yoshitaka Isaka,&nbsp;Yumiko Nishikawa,&nbsp;Hitoe Torisu-Itakura,&nbsp;Manabu Ohyama","doi":"10.1155/dth/3512539","DOIUrl":"https://doi.org/10.1155/dth/3512539","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to describe real-world treatment patterns and clinical characteristics of Japanese patients with alopecia areata (AA), particularly focusing on those treated with baricitinib.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective observational study involved patients (aged ≥ 15 years) with a confirmed diagnosis of AA between January 1, 2018, and September 30, 2023. Patient demographics, hospital characteristics, comorbidities, and treatment patterns as described in a Japanese claims database were analyzed for overall and severe AA subtypes. Baricitinib users were assessed for treatment patterns, dose modifications, persistence, and the use of combination therapies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 81,555 patients with AA included, 421 (0.52%) received baricitinib. The mean age was 40.7 years, with a higher proportion of females (58.91%). Most AA cases were diagnosed in clinics. Severe AA patients showed similar age and gender distributions. Comorbidities such as allergic rhinitis (34.01%) and atopic dermatitis (18.69%) were more prevalent among overall AA population. Topical corticosteroids (85.78%) and oral antihistamines (78.42%) were the most commonly used treatment. Intravenous corticosteroid pulse therapy (29.98%) and baricitinib (7.55%) were more frequently adopted for patients with severe AA than in the overall AA population (2.20% and 0.52%, respectively). Baricitinib users (<i>n</i> = 403) were more often diagnosed in hospitals, especially university hospitals, than in clinics. Treatment was initiated predominantly at a 4-mg dose (84.86%). Among 403 baricitinib users, treatment persistence at 3 and 9 months was 85.70% and 70.90%, respectively; combination therapy with topical corticosteroids (43.92%) and oral antihistamines (36.97%) was the most common treatment, while 34.49% received monotherapy with baricitinib. Atopic dermatitis (64.27%) and allergic rhinitis (32.75%) were frequent comorbidities among baricitinib users.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Topical corticosteroids remain the common treatment for AA in Japan. High treatment persistence was observed with baricitinib and was occasionally used in combination with other therapies. These findings highlight evolving treatment trends and the distinct clinical profile of patients with AA treated with baricitinib in Japan.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11045,"journal":{"name":"Dermatologic Therapy","volume":"2026 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/dth/3512539","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Study on the Efficacy and Safety Assessment of Ultralow-Dose Rituximab in the Treatment of Pemphigus","authors":"Shurui Wu,&nbsp;Han Zhang,&nbsp;Yuhan Ji,&nbsp;Lin Shen,&nbsp;Fangfang Wei,&nbsp;Liang Ma,&nbsp;Biwen Lin,&nbsp;Cuihao Song,&nbsp;Chengxin Li","doi":"10.1155/dth/8747613","DOIUrl":"https://doi.org/10.1155/dth/8747613","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To evaluate the efficacy and safety of ultralow-dose (200 mg) versus low-dose (500 mg) rituximab, each combined with glucocorticoids, in the treatment of pemphigus during the 6-month follow-up period.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This nonrandomized controlled study enrolled 26 pemphigus patients. The ultralow-dose group (&lt;i&gt;n&lt;/i&gt; = 18) and the low-dose group (&lt;i&gt;n&lt;/i&gt; = 8) received rituximab at their respective doses on Day 1, Day 14, and (based on clinical condition) 6 months later, combined with glucocorticoids. The primary endpoints included the Pemphigus Disease Area Index (PDAI) and the proportion of patients achieving complete remission on minimal therapy (CRmin) at 6 months. Secondary endpoints included anti-Dsg1/Dsg3 antibody levels, B-cell counts) at 6 months. Secondary endpoints included anti-Dsg1/Dsg3 antibody levels, B-cell counts, and glucocorticoid tapering.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The PDAI score decreased significantly over time in both groups (&lt;i&gt;p&lt;/i&gt; &lt; 0.001), with no statistically significant difference in overall efficacy between the two groups. At 6 months of treatment, the proportions of patients achieving CRmin were 50% in the ultralow-dose group and 75% in the low-dose group (RD = −0.25 [95% CI: −0.57 to 0.07]; RR = 0.67 [95% CI: 0.35 to 1.28]; &lt;i&gt;p&lt;/i&gt; = 0.395) (Supporting Table 1). Even in patients with traditional contraindications such as active hepatitis B (HBsAg-positive, detectable HBV-DNA but stable liver function) or elderly frailty (advanced age, multiple comorbidities, poor general condition, and inability to tolerate intensive immunosuppression), the ultralow-dose regimen demonstrated a manageable safety profile, with no severe adverse events such as viral reactivation. B-cell reconstitution was observed at 6 months in both groups.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Within the limited sample size of this study, the ultralow-dose (200 mg) rituximab regimen showed no statistically significant difference from the 500-mg regimen in terms of 6-month short-term efficacy and steroid-sparing effect for the treatment of pemphigus. This regimen demonstrated a manageable safety profile in patients with active hepatitis B, elderly frailty, and other comorbidities, with no severe adverse events such as viral reactivation. These findings provide preliminary evidence for future large-scale randomized controlled trials. The observed B-cell reconstitution suggests that longer follow-up is needed to assess the risk of relapse and the necessity of mai","PeriodicalId":11045,"journal":{"name":"Dermatologic Therapy","volume":"2026 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/dth/8747613","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148943200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Effect of 2 Years of Persistent Guselkumab Therapy on Disease Severity and Patient-Reported Outcomes in the CorEvitas Psoriasis Registry","authors":"Bruce E. Strober,&nbsp;April W. Armstrong,&nbsp;Timothy Fitzgerald,&nbsp;Katelyn Rowland,&nbsp;Olivia Choi,&nbsp;Daphne Chan,&nbsp;Jud C. Janak,&nbsp;Maya Marchese,&nbsp;Rachel E. Teneralli,&nbsp;Hyung-Joo Kang,&nbsp;Alvin H. Li,&nbsp;Steven R. Feldman","doi":"10.1155/dth/7233752","DOIUrl":"https://doi.org/10.1155/dth/7233752","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Guselkumab, an IL-23 inhibitor, improved disease activity through five years in clinical trials of patients with moderate to severe plaque psoriasis. However, real-world long-term effectiveness of persistent use of guselkumab is not well characterized.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the 2-year effectiveness of persistent guselkumab therapy among US and Canadian real-world patients with moderate to severe plaque psoriasis in the CorEvitas Psoriasis Registry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adult patients enrolled in the CorEvitas Psoriasis Registry between July 2017 and September 2021 with moderate to severe plaque psoriasis (body surface area [BSA] ≥ 3% and Investigator’s Global Assessment [IGA] ≥ 3) at index visit); moderate to severe disease activity; 2 years of persistent guselkumab therapy after index date; and a clinical visit 18–24 months postinitiation of guselkumab. Results were summarized by descriptive statistics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 183 patients were included, with a mean duration of guselkumab use of 20.5 months (SD = 1.9). Most patients were White (<i>n</i> = 147; 80%) and were male (<i>n</i> = 108; 59%), with a mean age of 50 years and a mean disease duration of 16 years; 58% (<i>n</i> = 106) were biologic-experienced. For the overall cohort, most patients achieved clinically meaningful skin clearance: IGA 0/1 (<i>n</i> = 126; 69% [95% confidence interval (CI): 62%, 76%]), PASI 90 (<i>n</i> = 105; 58% [50%, 65%]), and National Psoriasis Foundation target response (BSA ≤ 1%) (<i>n</i> = 122; 67% [60%, 74%]). Patients reported meaningful improvement in VAS scores for fatigue (mean change: −14.4 [SD = 29.7]), itch (−41.3 [SD = 34.3]), skin pain (−28.1 [SD = 34.3]), and patient global assessment (−35.9 [SD = 34.9]). Over two-thirds achieved DLQI 0/1 (<i>n</i> = 124/180, 69%). Improvements in clinically meaningful outcomes were reported for both biologic-experienced and biologic-naïve groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The majority of patients with moderate to severe plaque psoriasis who were persistent on guselkumab therapy for 2 years achieved clinically meaningful and durable improvements in skin clearance, disease activity, and PROs regardless of prior biologic experience.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11045,"journal":{"name":"Dermatologic Therapy","volume":"2026 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/dth/7233752","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148943238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Risk Factors of Coronary Microvascular Dysfunction in Psoriasis Patients: A Systematic Review and Meta-Analysis","authors":"Sheng Lin,&nbsp;Yunze Li,&nbsp;Hongkun Xu,&nbsp;Qi Jin,&nbsp;GuangZhong Zhang","doi":"10.1155/dth/3505867","DOIUrl":"https://doi.org/10.1155/dth/3505867","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Coronary microvascular dysfunction (CMD) is an increasingly recognized precursor to major adverse cardiovascular events (MACEs). While patients with psoriasis (PsO) and psoriatic arthritis (PsA) exhibit elevated cardiovascular risk, the specific epidemiological burden and risk factors of CMD in this population remain poorly synthesized. This systematic review and meta-analysis aimed to determine the pooled prevalence of CMD and evaluate its associated risk factors to guide clinical screening.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Systematic literature retrieval was performed across PubMed, Web of Science, Embase, and the Cochrane Library, covering the period from each database’s establishment to January 2025. Two investigators carried out independent study screening and extracted data related to CMD prevalence and risk factors. Included studies were observational research (cohort, case–control, and cross-sectional) focusing exclusively on PsO/PsA patients, with reported CMD outcomes, full-text availability in English, and clear diagnostic criteria for CMD. Excluded were reviews, case reports, populations without PsO/PsA, overlapping cohorts, and studies lacking explicit CMD definitions. Methodological quality was evaluated using the Joanna Briggs Institute Critical Appraisal Checklist for prevalence studies. Pooled prevalence and risk estimates were calculated using random-effects models. This study was prospectively registered in PROSPERO (CRD42025637507).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Seven studies involving 905 patients were included. The pooled prevalence of CMD was 34.68% (95% confidence interval [CI]: 20.34%–50.54%, &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 88.6%). Comparative risk analysis indicated a potential trend toward a higher risk of CMD in PsO patients compared to non-PsO controls, though this did not reach statistical significance (relative risk [RR] = 3.30, 95% CI: 0.96–11.32; &lt;i&gt;p&lt;/i&gt; = 0.058; heterogeneity &lt;i&gt;p&lt;/i&gt; = 0.019). Hypertension (odds ratio [OR] = 2.38, 95% CI: 1.46–3.89), PsA subtype (OR = 1.90, 95% CI: 1.20–3.00), Psoriasis Area and Severity Index (PASI) scores, and prolonged disease duration were important risk factors for CMD. Gender differences were not considered statistically significant (&lt;i&gt;p&lt;/i&gt; = 0.9427). Limitations include a small number of included studies (&lt;i&gt;n&lt;/i&gt; = 7), high heterogeneity (&lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; &gt; 85%), overlapping cohorts in three Italian studies, and limited data for subgroup analyses.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Over one-third of PsO","PeriodicalId":11045,"journal":{"name":"Dermatologic Therapy","volume":"2026 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/dth/3505867","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148943204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Oral JAK Inhibitors on SALT Score Improvement and Adverse Events in Alopecia Areata: A Meta-Analysis","authors":"Lan Jiang,&nbsp;Tianyu Cao,&nbsp;Ling Liu","doi":"10.1155/dth/7870264","DOIUrl":"https://doi.org/10.1155/dth/7870264","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This meta-analysis aimed to systematically evaluate the efficacy and safety of oral Janus kinase (JAK) inhibitors in the treatment of alopecia areata (AA), thereby providing evidence-based reference for clinical medication.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Computerized searches were conducted in PubMed (MEDLINE), Embase, Web of Science, and the Cochrane Library to collect randomized controlled trials (RCTs) on oral JAK inhibitors for AA published from database inception to April 2026. Two reviewers independently screened the literature, extracted data, and evaluated the quality. Meta-analysis was performed using RevMan software Version 5.4.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Nine articles (10 studies) were included, involving 924 control and 2493 experimental cases. The results of the meta-analysis showed that oral JAK inhibitors were significantly superior to placebo in improving the severity of AA. The differences were statistically significant for SALT50 [OR = 6.10, 95% CI (3.94, 9.44)], SALT75 [OR = 5.81, 95% CI (2.73, 12.36)], SALT90 [OR = 7.91, 95% CI (2.44, 25.63)], SALT ≤ 20 [OR = 10.50, 95% CI (5.21, 21.16)], and SALT ≤ 10 [OR = 13.06, 95% CI (4.28, 39.83)] (all &lt;i&gt;p&lt;/i&gt; &lt; 0.0001). Significant heterogeneity was observed for SALT90, SALT ≤ 20, and SALT ≤ 10. Subgroup analysis indicated that baricitinib had a stable efficacy; deuruxolitinib showed a dose-dependent effect, with the high dose (12 mg) demonstrating the strongest effect in achieving near-complete hair regrowth (SALT ≤ 10) (OR = 118.38); and ritlecitinib was associated with a relatively lower risk of adverse events (AEs) in the safety analysis. Regarding safety, the JAK inhibitor group had a higher incidence of any AEs compared with the control group [OR = 1.32, 95% CI (1.13, 1.56), &lt;i&gt;p&lt;/i&gt; = 0.0006], but no statistically significant difference in the incidence of serious AEs (SAEs) was observed between the two groups [OR = 0.99, 95% CI (0.62, 1.58), &lt;i&gt;p&lt;/i&gt; = 0.95]. Subgroup analysis suggested differences in the risk of AEs among different drugs: the deuruxolitinib group had a higher risk than the baricitinib group, and the baricitinib group had a higher risk than the ritlecitinib group.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Oral JAK inhibitors significantly improve SALT scores in patients with AA. The risk of AEs is increased, but most events are mild to moderate, with no significant increase in the risk of serious AEs. However, the efficacy of JAK inhibitors is heterogeneous, which may be related to the specific","PeriodicalId":11045,"journal":{"name":"Dermatologic Therapy","volume":"2026 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/dth/7870264","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148942905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distal Free-Edge and Periungual Dermoscopic Features Distinguishing Pigmented Nail Unit Melanoma From Benign Melanonychia: A Retrospective Study in an Asian Population","authors":"Hsin-Yi Huang,&nbsp;Sheng-Yiao Lin,&nbsp;Cheng-Che Lan,&nbsp;Chiao-Li Ke,&nbsp;Shih-Tsung Cheng","doi":"10.1155/dth/4229317","DOIUrl":"https://doi.org/10.1155/dth/4229317","url":null,"abstract":"<p>Pigmented nail unit melanoma (NUM) often presents as longitudinal melanonychia and may mimic benign melanonychia, especially in Asian populations. We conducted a retrospective study at a tertiary medical center in Taiwan between 2011 and 2025 to identify dermoscopic features differentiating NUM from benign melanonychia. Twelve histopathologically confirmed NUM cases and 12 benign melanonychia cases were included. Benign lesions were matched by digit location and sex. Dermoscopic images were independently evaluated by experienced dermatologists. Clinical and dermoscopic features, including bandwidth, color, structural patterns, line homogeneity, periungual pigmentation, and distal nail plate pigmentation, were analyzed. Patients with NUM were significantly older than those with benign melanonychia (66.1 vs. 47.1 years, <i>p</i> = 0.010). Melanoma showed broader bandwidth, with ≥ 2/3 nail plate involvement strongly associated with malignancy (91.7% vs. 25.0%, <i>p</i> &lt; 0.001). Black pigmentation (91.7% vs. 50.0%, <i>p</i> = 0.009), gray pigmentation (41.7% vs. 0%, <i>p</i> = 0.037), and structural asymmetry (91.7% vs. 41.6%, <i>p</i> = 0.027) were significantly associated with melanoma. In contrast, homogeneity of thickness (8.3% vs. 66.7%, <i>p</i> = 0.009) and homogeneity of spaces (8.3% vs. 58.3%, <i>p</i> = 0.027) were more frequent in benign lesions. Eponychial Hutchinson or micro-Hutchinson sign occurred in 83.3% of melanoma cases compared to 8.3% of benign lesions (<i>p</i> &lt; 0.001). Hyponychial pigmentation was present in all melanoma cases and absent in benign lesions (100% vs. 0%, <i>p</i> &lt; 0.001). Full-thickness distal nail plate pigmentation was also significantly associated with melanoma (75.0% vs. 16.7%, <i>p</i> = 0.004). These findings suggest that evaluation of periungual structures, particularly hyponychial pigmentation, may aid differentiation of pigmented NUM from benign melanonychia.</p>","PeriodicalId":11045,"journal":{"name":"Dermatologic Therapy","volume":"2026 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/dth/4229317","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148942813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photoacoustic/Ultrasound Dual-Modality Imaging Nomogram for Diagnosing Nonmelanoma Skin Cancer: A Preliminary Diagnostic Accuracy Study","authors":"Ziyang Guo,&nbsp;Nan Li,&nbsp;Bingqing Yu,&nbsp;Xiangyu Wang,&nbsp;Yuhong Shao,&nbsp;Xiuming Sun,&nbsp;Jiajia Zhu,&nbsp;Menglong Ran,&nbsp;Luzeng Chen","doi":"10.1155/dth/6522379","DOIUrl":"https://doi.org/10.1155/dth/6522379","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Nonmelanoma skin cancer is among the most common malignancies worldwide, with rising incidence. Early and accurate diagnosis is critical for improving prognosis. This study aims to develop, with internal validation, a multiparametric nomogram based on photoacoustic and ultrasound dual-modality imaging for the differential diagnosis of NMSC from benign skin tumors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A total of 108 patients with skin tumors (76 nonmelanoma skin cancer, 32 benign tumors) were enrolled. Preoperative dual-modality imaging evaluated tissue oxygen saturation, tumor boundary, stiffness, and blood flow. Stepwise logistic regression identified predictors and constructed a diagnostic nomogram. Performance was assessed using area under the curve (AUC), calibration plots, decision curve analysis, and clinical impact curve.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Independent predictors included tumor oxygen saturation, boundary, stiffness, and age. Malignant lesions exhibited significantly lower oxygen saturation than benign tumors (<i>p</i> &lt; 0.001). The nomogram achieved favorable diagnostic performance with an optimism-corrected AUC of 0.980 (95% CI: 0.955–1.000), sensitivity of 92.11% (95% CI: 83.8%–96.3%), specificity of 100.00% (95% CI: 84.5%–100.0%), and a Brier score of 0.039. Calibration was strong, and decision curve analysis confirmed superior net clinical benefit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Photoacoustic and ultrasound dual-modality imaging, combined with a multiparametric nomogram, effectively distinguishes nonmelanoma skin cancer from benign tumors. This noninvasive tool enables precise risk stratification and has potential to support future efforts to reduce unnecessary biopsies, pending prospective validation. However, as this is a preliminary study from a single center without external validation, the findings should be considered exploratory. Prospective multicenter studies are needed to confirm clinical applicability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11045,"journal":{"name":"Dermatologic Therapy","volume":"2026 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/dth/6522379","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148942812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Clinical Outcomes With a 1% SeleniumSulfide/1% Salicylic Acid Shampoo Formulation for Seborrheic Dermatitis and Dandruff: A Multicenter Observational Study","authors":"Maiada Magdi Mohamed Abouzid Elsawah,&nbsp;Fadi AlSabbagh,&nbsp;Abrar Bukhari,&nbsp;Husain Ali Abdulla Mahdi Hasan Juma,&nbsp;Almuntsrbellah Almudimeegh,&nbsp;Baderya Abdulla Rashed Binlaqyous Alshehhi,&nbsp;Najah Sinno,&nbsp;Heba A. Mohamed,&nbsp;Eman Abdulaziz Almukhadeb,&nbsp;Samir Abdellatif Taha Hantirah,&nbsp;Shadan Naji,&nbsp;Salman Bin Dayel","doi":"10.1155/dth/4755440","DOIUrl":"https://doi.org/10.1155/dth/4755440","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Seborrheic dermatitis (SD) and dandruff are chronic, relapsing scalp-related disorders leading to erythema, scaling, greasiness, flakiness, and itching and can significantly affect quality of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this study was to evaluate clinical outcomes associated with use of a shampoo formulation containing 1% selenium sulfide and 1% salicylic acid in SD and dandruff, as well as its tolerability, satisfaction, and cosmetic acceptability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective, observational study was conducted in 86 clinics across Bahrain, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, and the United Arab Emirates from July 2022 to June 2023. It included patients with dandruff or scalp SD across the disease severity spectrum using 1% selenium sulfide/salicylic acid–based shampoo. Demographic information, hair characteristics, and previous SD and/or dandruff treatments were recorded. Clinical examinations of scalp and hair fibers were conducted at the initial visit and at Weeks 4 and 8. Clinical response, tolerability, satisfaction, and cosmetic acceptability were evaluated using a self-reported patient questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 767 of 822 enrolled patients were included in the analysis. The average age was 32.3 years, and 57.9% of the patients were female. Prescription compliance was confirmed in 93.3% of patients. Significant reductions in scalp desquamation, erythema, irritation, affected area, and itching were observed by Weeks 4 and 8 (<i>p</i> &lt; 0.0001 for all). Over 90% of patients showed scalp improvement, and 78.4% reported improved hair fiber quality and integrity. Patients and dermatologists both reported increased satisfaction with the shampoo from Weeks 4 to 8. Overall, 98.3% of the patients tolerated the shampoo well.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Significant improvements in the clinical signs and symptoms of SD and dandruff were observed over the 8-week observation period in patients using the investigational shampoo. The shampoo was well tolerated and associated with high levels of patient and dermatologist satisfaction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11045,"journal":{"name":"Dermatologic Therapy","volume":"2026 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/dth/4755440","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148942789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}