Dermatologic Therapy最新文献

{"title":"New Advances in Biologic Treatment for Malignant Atrophic Papulosis: A Systematic Review","authors":"Jia-Wei Liu,&nbsp;Xiao Ma,&nbsp;Dong-Lai Ma","doi":"10.1155/dth/6276060","DOIUrl":"https://doi.org/10.1155/dth/6276060","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Malignant atrophic papulosis (MAP) is the systemic subtype of Degos disease, characterized by high lethality. Currently there is no standardized treatment protocol. Steroids and immunosuppressive therapies result in limited effectiveness. Biologic treatments offer promising therapeutic potential for MAP and significantly improve prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This review aims to systematically evaluate the applications of various biologics in the treatment of MAP and to explore their potential efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We systematically searched three electronic databases (Scopus, Embase, and PubMed) from inception to November 30, 2025. All cases involving biologics for the treatment of MAP were included and analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of six different biologics have been utilized in the treatment of MAP. Among all the biologics, eculizumab demonstrated the highest response rate, reaching 76.5% (<i>n</i> = 13/17). The use of rituximab has yielded inconsistent outcomes in the treatment of MAP. Neither tocilizumab nor natalizumab demonstrated satisfactory therapeutic efficacy, while the use of TNF inhibitors may result in disease exacerbation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Eculizumab is recommended as a potential salvage therapy, and its combination with treprostinil may result in longer disease remission time. TNF inhibitors should be avoided in patients with MAP. More studies are needed to assess the long-term safety and efficacy of biologics in the treatment of MAP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11045,"journal":{"name":"Dermatologic Therapy","volume":"2026 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/dth/6276060","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275019","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":"Correction to “Serum Neurofilament Light Chain Levels Correlate With Skin Inflammation and Scratch Lesions in Patients With Pruritus”","authors":"","doi":"10.1155/dth/9762436","DOIUrl":"https://doi.org/10.1155/dth/9762436","url":null,"abstract":"<p>S. M. Mueller, J. Zhu, O. Brandt, et al., “Serum Neurofilament Light Chain Levels Correlate With Skin Inflammation and Scratch Lesions in Patients With Pruritus,” <i>Dermatologic Therapy</i>, 2024, https://doi.org/10.1155/2024/3542876.</p><p>In the article, there is an error in the legend of Figure 1. The correct Figure legend is shown below:</p><p><i>Figure 1: Examples of patients’ SISL scores and their corresponding sNfL percentiles (based on healthy controls of same age and BMI) (a–c) and the correlation between sNfL percentiles and SISL scores (d). (a–c) Patients diagnosed with (a) atopic dermatitis, (b) suberythrodermic atopic dermatitis, and (c) erythrodermic atopic dermatitis. (d) Positive correlation between sNfL percentiles and the severity of skin inflammation and scratching injuries (as measured by the SISL score; Spearman’s rho = 0.70,</i> <i>p</i> = 0.031<i>, n = 10)</i>.</p><p>We apologize for this error.</p>","PeriodicalId":11045,"journal":{"name":"Dermatologic Therapy","volume":"2026 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/dth/9762436","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146256439","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":"Cross-Sectional Analysis of the Impact of Humidity on Acitretin Prescription Patterns Among Medicare Providers From 2013 to 2019","authors":"Yash Kumar,&nbsp;Bryan T. Carroll,&nbsp;Jake X. Wang","doi":"10.1155/dth/6177518","DOIUrl":"https://doi.org/10.1155/dth/6177518","url":null,"abstract":"<p>Acitretin is used for psoriasis and for prevention of keratinocyte carcinomas. Almost all patients experience mucocutaneous side effects, such as dry mouth and xerosis. As these side effects are amplified in low-humidity environments, we sought to determine if humidity influenced the geographical prescription patterns of acitretin. Cross-sectional analysis was conducted at the state level from 2013 to 2019 using Medicare Part D Claims Data and the UN’s Food and Agriculture Organization’s (FAO) Climate Information Tool AgERA5 dataset. Using all states, relative humidity percentage was a statistically significant positive predictor of acitretin prescriptions per prescriber (<i>β</i> = 0.034, <i>p</i> = 0.038). The top 5 most humid states had higher acitretin prescriptions per prescriber (6.72 vs. 5.50, <i>p</i> = 0.015) compared to the bottom 5 least humid states. Moreover, the groups did not statistically significantly differ on acitretin cost ($812.36 vs. $807.29, <i>p</i> = 0.88), apremilast prescriptions per prescriber (9.46 vs. 8.23, <i>p</i> = 0.23), or apremilast cost ($2789.86 vs. $2884.37, <i>p</i> = 0.21). Relative humidity correlates with Medicare providers’ acitretin-prescribing habits with prescriptions decreasing in low-humidity environments. Recognizing the potential impact of climate on prescribing retinoids may help guide treatment for dermatologic conditions.</p>","PeriodicalId":11045,"journal":{"name":"Dermatologic Therapy","volume":"2026 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/dth/6177518","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275040","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":"Mini-Winograd Procedure and Preoperative Nail Groove Drainage for Pyogenic Paronychia With Granulation Tissue","authors":"Meng-yi Zhang,&nbsp;Yue Yin","doi":"10.1155/dth/7025119","DOIUrl":"https://doi.org/10.1155/dth/7025119","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pyogenic paronychia with granulation tissue usually requires surgical intervention and preoperative inflammation control. We developed a modified surgical procedure (the mini-Winograd procedure) and an innovative method for preoperative inflammation control for such cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Materials</h3>\u0000 \u0000 <p>Between June 2022 and June 2023, 100 consecutive patients who underwent the mini-Winograd procedure were retrospectively analyzed, including 43 patients with preoperative nail groove drainage and 57 patients with traditional preoperative treatment. Perioperative conditions were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Preoperative inflammation (42.1% vs. 7.0%, <i>p</i> &lt; 0.001), postoperative edema (36.8% vs. 14.0%, <i>p</i> = 0.020), and postoperative pain (VAS: 3.2 ± 1.6 vs. 2.3 ± 1.2, <i>p</i> = 0.001) were significantly less in patients with preoperative nail groove drainage. Patients with drainage gained earlier recovery in walking ability (3.1 ± 1.0 vs. 2.7 ± 1.1, <i>p</i> = 0.035). The logistic regression results indicated that the preoperative inflammation status was an independent risk factor for SSI (OR = 11.67; <i>p</i> &lt; 0.001) and postoperative severe pain (OR = 22.73; <i>p</i> = 0.003).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The mini-Winograd procedure with preoperative nail groove drainage is an effective treatment for pyogenic paronychia with granulation tissue, which improves preoperative inflammation management, reduces postoperative pain, and enhances recovery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11045,"journal":{"name":"Dermatologic Therapy","volume":"2026 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/dth/7025119","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147268894","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":"Polynucleotides for Facial Erythema and Skin Barrier Repair in Adult Atopic Dermatitis: A Pilot Study","authors":"Kui Young Park","doi":"10.1155/dth/8371821","DOIUrl":"https://doi.org/10.1155/dth/8371821","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Facial erythema in adult patients with atopic dermatitis (AD) presents a persistent therapeutic challenge, often resistant to conventional treatment. Polynucleotides (PN) have anti-inflammatory and tissue-repair properties and are being explored for inflammatory dermatoses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the clinical and biophysical efficacy and safety of intradermal PN injections for facial erythema and barrier dysfunction in adults with AD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective pilot study included 19 adults with mild-to-moderate AD and visible facial erythema. Participants received three sessions of intradermal PN injections at 3-week intervals. Clinical assessments were performed at baseline and weeks 3, 6, and 10. Objective parameters included erythema index (EI), melanin index (MI), transepidermal water loss (TEWL), corneometer-measured hydration, and skin elasticity (R2, R5, R7). The Investigator Global Assessment (IGA), patient satisfaction, and standardized facial imaging were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant improvements were observed in TEWL (<i>χ</i>² = 31.16, <i>p</i> &lt; 0.000001), hydration (<i>χ</i>² = 14.56, <i>p</i> = 0.002), and EI (<i>χ</i>² = 26.05, <i>p</i> &lt; 0.001). Skin elasticity showed favorable trends without statistical significance. IGA scores improved significantly (<i>χ</i>² = 26.02, <i>p</i> &lt; 0.00001), while patient satisfaction increased (<i>χ</i>² = 3.44, <i>p</i> = 0.179). No serious adverse events were reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Intradermal PN injection is a safe and potentially effective option for facial erythema in AD patients, leading to improved clinical and biophysical outcomes. Larger controlled trials are warranted.</p>\u0000 \u0000 <p><b>Trial Registration:</b> Korean Clinical Trial Registry (KCT): KCT0011301</p>\u0000 </section>\u0000 </div>","PeriodicalId":11045,"journal":{"name":"Dermatologic Therapy","volume":"2026 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/dth/8371821","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147268916","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":"Efficacy of Human Foreskin Fibroblast–Conditioned Medium in the Treatment of Androgenic Alopecia: A Pilot Trial","authors":"Elham Behrangi,&nbsp;Nastaran Kabiri Samani,&nbsp;Ehsan Taghiabadi,&nbsp;Afsaneh Sadeghzadeh-Bazargan,&nbsp;Nazila Heidari,&nbsp;Amirhossein Heidari,&nbsp;Masoumeh Roohaninasab,&nbsp;Mohammad Ali Nilforoushzadeh","doi":"10.1155/dth/5161053","DOIUrl":"https://doi.org/10.1155/dth/5161053","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Androgenetic alopecia (AGA) is a common and distressing medical condition that negatively affects the patient’s quality of life. The conditioned medium (CM) contains secreted proteins and has been investigated for several therapeutic applications. This study sought to assess the efficacy of human foreskin fibroblast (HFF)–CM in AGA treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A pilot trial was conducted on eligible AGA patients. Initially, HFFs were isolated, expanded under sterile GMP-compliant conditions, and characterized by mesenchymal surface marker expression prior to HFF–CM preparation. The resulting HFF–CM was collected after serum-reduced culture, cleared of cellular debris, sterilized by filtration, and analyzed by ELISA to quantify key growth factors. Subjects received four injections of HFF–CM at 4-week intervals. The cases were followed up for 6 months, and structural changes were evaluated by sonography, VisioFace software, and trichoscopy. Moreover, subjective satisfaction was assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During HFF–CM preparation, HFF exhibited MSC-like morphology and mesenchymal marker expression, and the resulting CM contained a diverse growth factor profile, with IGF-1 and KGF/FGF-7 present at the highest levels. Fourteen eligible cases were included in this study (mean age: 34.8 ± 8.1 years, female: 78.6%). The pre- and post-treatment results indicated significant changes in Ludwig’s score (<i>p</i> = 0.38). Sonography showed notable changes from baseline in complete and dermal density (<i>p</i> &lt; 0.001), as well as significant improvements in trichosan at both × 60 and × 150 magnification (<i>p</i> &lt; 0.001). Physician and patient satisfaction assessments revealed excellent and good results in most cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>AGA treatment with HFF–CM led to improvement in both objective and subjective parameters. However, large-scale clinical studies with long-term follow-ups are recommended.</p>\u0000 \u0000 <p><b>Trial Registration:</b> Iranian Registry of Clinical Trials: IRCT20221026056309N1</p>\u0000 </section>\u0000 </div>","PeriodicalId":11045,"journal":{"name":"Dermatologic Therapy","volume":"2026 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/dth/5161053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146256264","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":"Exploring the Impact of Nutrition on Atopic Dermatitis: A Review","authors":"Jiayao Pan,&nbsp;Lunfei Liu","doi":"10.1155/dth/5683408","DOIUrl":"https://doi.org/10.1155/dth/5683408","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Atopic dermatitis (AD) is a chronic, recurrent inflammatory skin disease with a complex etiology involving genetic, environmental, and immunologic factors. In recent years, the influence of diet on AD has attracted widespread attention. However, the relationship between dietary components and AD remains complex and requires further investigation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Up until October 2024, a thorough literature search was conducted using the internet databases of Web of Science, Cochrane, PubMed, and Scopus. The following keywords were used in the search strategy: “Atopic Dermatitis,” “Nutrition,” “Nutrients,” “Dietary Factors,” “Fatty Acids,” “Vitamin,” “Mineral,” “Zinc,” “Iron,” “Nickel,” “Probiotics,” “Prebiotics,” “Synbiotics,” “Breastfeeding,” “Maternal Diet,” “Phytochemicals,” “Polyphenol,” “Mediterranean Diet,” “Vegan Diet,” “Plant-Based Diet,” “Gluten,” “Food Allergies,” “Elimination Diets,” “Dietary Exclusion,” and “Food Elimination.” This review systematically evaluates the literature on the impact of various dietary and nutritional factors on AD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevention or management of AD may benefit from a number of nutritional factors, including fatty acids, vitamins, minerals, probiotics, prebiotics, synbiotics, phytochemicals, and gluten, as well as dietary patterns, including breastfeeding, the Mediterranean diet, vegan diets, and elimination diets. By enhancing skin barrier function, lowering inflammatory responses, and modifying immunological responses, these nutrients and dietary strategies may help prevent and manage AD. However, the evidence currently available to support generalized dietary interventions as standard treatment for AD is still insufficient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There are still a lot of inconsistencies in the research on the relationship between nutrients and AD. This review aims to inform future research and clinical practice in the management of AD and explore the potential of nutritional interventions in managing AD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11045,"journal":{"name":"Dermatologic Therapy","volume":"2026 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/dth/5683408","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147280083","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":"Addressing Unmet Needs in Prurigo Nodularis: Expert Canadian Dermatology Perspectives","authors":"Vimal H. Prajapati,&nbsp;H. Chih-Ho Hong,&nbsp;Melinda Gooderham,&nbsp;Kim A. Papp","doi":"10.1155/dth/5545394","DOIUrl":"https://doi.org/10.1155/dth/5545394","url":null,"abstract":"<p>Prurigo nodularis (PN) is a distinct chronic, inflammatory, neuroimmune-mediated skin condition characterized by pruritic, often symmetrically distributed nodules, papules, and/or plaques. Recognition of PN as a distinct entity is complicated by the absence of a precise disease definition, uncertain epidemiologic estimates, and limited assessments of disease burden. The aim of this review is to provide a critical overview of global epidemiologic data of PN and current disease definitions. The available diagnostic criteria and assessment tools to determine disease severity for PN are examined. The psychosocial and healthcare burden of PN is also reviewed. Finally, other prevailing shortcomings in this therapeutic area are discussed, including the need for a standardized treatment algorithm for PN using currently available therapies, a greater understanding of disease pathophysiology, and the development of new targeted therapies for PN.</p>","PeriodicalId":11045,"journal":{"name":"Dermatologic Therapy","volume":"2026 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/dth/5545394","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146256256","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":"Application of Vitamin C in Melasma: A Meta-Analysis and Systematic Review","authors":"Lincen He","doi":"10.1155/dth/9921217","DOIUrl":"https://doi.org/10.1155/dth/9921217","url":null,"abstract":"<p>Melasma is a chronic acquired facial hyperpigmentation disorder that remains a persistent clinical challenge due to its high recurrence rate and lack of a definitive cure. It imposes a substantial psychological burden on affected individuals, often leading to significant impairment of health-related quality of life. Vitamin C (ascorbic acid) has emerged as a promising depigmenting agent for melasma, and this systematic review and meta-analysis aimed to evaluate the efficacy and safety of vitamin C–containing depigmenting formulations for melasma treatment. Systematic literature searches were conducted in PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, Web of Science, Google Scholar, and Scopus up to October 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Statistical analyses were performed using Review Manager 5.4 software, and the Cochrane risk-of-bias tool for randomized controlled trials (RCTs) was used to assess study quality. A total of 11 eligible studies involving 301 melasma patients were included. Compared with control interventions, vitamin C showed a trend toward reduced melasma severity (standardized mean difference [SMD] = −0.49, 95% confidence interval [CI]: −1.08 to 0.10, <i>p</i> = 0.095). Subgroup analysis by administration route revealed topical vitamin C as the most effective (SMD = −1.13, 95% CI: −1.68 to −0.58), followed by iontophoresis (SMD = −0.51, 95% CI: −1.26 to 0.25), injection (SMD = −0.50, 95% CI: −1.16 to 0.16, <i>I</i>² = 70.5%), and microneedling (SMD = −0.47, 95% CI: −1.39 to 0.46; <i>I</i>² = 82.0%), with no significant differences across routes (<i>p</i> = 0.367). For dosage, the low-dose group had an SMD of −0.57 (95% CI: −1.10 to −0.05, <i>I</i>² = 63.0%), while the high-dose group had an SMD of −0.51 (95% CI: −1.28 to 0.27, <i>I</i>² = 83.5%). There was no statistically significant difference between the two groups (<i>p</i> = 0.894), indicating no dose-dependent enhancement of therapeutic effects within the included dosage range. Regarding treatment regimens, vitamin C combination therapy was numerically superior to monotherapy but not statistically significant (<i>p</i> = 0.197). Notably, vitamin C as an adjuvant significantly improved the efficacy of chemical peeling (combined therapy vs. peeling alone: SMD = −0.97, 95% CI: −1.33 to −0.62, <i>p</i> &lt; 0.001, <i>I</i>² = 0.0%). Vitamin C demonstrated a favorable safety profile with low rates of adverse events. Limitations of this meta-analysis include small sample sizes of included RCTs and substantial heterogeneity in some subgroups.</p>","PeriodicalId":11045,"journal":{"name":"Dermatologic Therapy","volume":"2026 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/dth/9921217","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146196911","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":"Comparative Effectiveness of Monotherapy Versus Combination Therapy in Vitiligo: A Mixed-Effects Model Analysis of Longitudinal VASI Scores","authors":"Amr Molla,&nbsp;Salman Althobaiti","doi":"10.1155/dth/7443487","DOIUrl":"https://doi.org/10.1155/dth/7443487","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Direct evidence comparing single-agent and combination regimens for vitiligo is limited and often overlooks longitudinal outcomes. This study evaluated how combination therapy versus monotherapy influenced repigmentation, measured by the Vitiligo Area Scoring Index (VASI), in a real-world clinical setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare the effectiveness of monotherapy versus combination therapy in vitiligo treatment using longitudinal VASI scores, adjusting for demographic and clinical confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed records from two tertiary centers in Saudi Arabia (Jan 2018–Dec 2023). A total of 500 patients (52% female; aged 1–75 years) contributed approximately 5,000 visit-level VASI scores over 12 months. Treatment was classified as monotherapy (<i>n</i> = 179) or combination therapy (<i>n</i> = 321). Linear mixed-effects models with random intercepts and patient-specific slopes were applied. Fixed effects included therapy modality, visit order, age, sex, nationality, and vitiligo phenotype. Model selection was based on Akaike/Bayesian information criteria and likelihood ratio tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The best-fit model included a therapy-by-visit interaction. Combination therapy was associated with a 2.1-point lower baseline VASI than monotherapy (<i>p</i> &lt; 0.001), with greater reductions over time (−0.31 per visit; <i>p</i> &lt; 0.001). Genital, focal, and acrofacial types responded best; universal vitiligo worsened. Age predicted poorer response; sex and nationality were nonsignificant. ICC = 0.95; marginal and conditional <i>R</i>² were 0.42 and 0.97, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Combination regimens offer faster and more sustained VASI improvements than monotherapy, particularly in extensive or aggressive vitiligo. These findings support personalized treatment strategies incorporating NB-UVB or JAK inhibitors and highlight the importance of phenotype-based care. Further head-to-head trials and meta-analyses are needed to refine regimen selection and address interpatient variability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11045,"journal":{"name":"Dermatologic Therapy","volume":"2026 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/dth/7443487","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146199476","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}