Dermatology最新文献

{"title":"Cumulative Life Course Impairment in Moderate-to-Severe Atopic Dermatitis: A Cross Sectional Study in Singapore.","authors":"Meng Jie Ho, Rehena Sultana, Karen Choo, Haur Yueh Lee","doi":"10.1159/000548368","DOIUrl":"https://doi.org/10.1159/000548368","url":null,"abstract":"<p><strong>Introduction: </strong>Atopic dermatitis (AD) is a chronic inflammatory skin disease with lifelong consequences for patients' well-being. Quality-of-life tools such as DLQI and POEM assess disease burden at a specific time point but do not capture long-term life course impairment. The Cumulative Life Course Impairment (CLCI) model describes the multidimensional, cumulative effects of a chronic condition over an individual's life course, influencing their trajectory and fulfillment. Two instruments to assess CLCI were recently developed. The CLCI-R assesses retrospective, irreversible cumulative damage since disease onset, while the CLCI-P identifies patients at risk of future life course impairment. Both tools measure the psychosocial impact of chronic skin disease over time, extending beyond conventional cross-sectional quality-of-life measures. This study aims to quantify the extent of CLCI in adult patients with moderate-to-severe AD seen at an academic medical center.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at Singapore General Hospital among 82 adults with moderate-to-severe AD. Participants completed CLCI-R and CLCI-P questionnaires, while EASI, DLQI, POEM, Itch and sleep Visual Analogue Scale (VAS) scores were collected in the same visit. Spearman's correlation, Mann-Whitney U tests, and multiple linear regression were used to analyse associations and predictors of CLCI.</p><p><strong>Results: </strong>Mean CLCI-R score was 29.4±1.9, with no significant difference between moderate and severe AD (p=0.907), indicating substantial retrospective impairment in both. CLCI-P scores were significantly higher in severe AD patients (Mean: 28.4±5.5 vs. 15.9±2.0; p=0.007), highlighting greater future impairment's association with severe disease. CLCI-P correlated significantly with DLQI (r=0.611) and disease severity (r=0.489). In multivariable analysis, greater prospective impairment was associated with higher DLQI, CLCI-R and disease duration ≥ 21 years.</p><p><strong>Conclusion: </strong>This study underscores the substantial cumulative burden faced by patients with AD, particularly in those with longer disease duration and more severe disease. Integrating CLCI into dermatology assessments may help identify patients at higher risk of life course impairment and offers an opportunity to mitigate future cumulative burden with treatment.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"1-20"},"PeriodicalIF":2.7,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plant Extracts in Rosacea Management-a narrative review.","authors":"Mathieu Leti, Lucile Garidou, Stéphane V Cuisiat, Aline Stennevin, Gautier Doat, Fabrice Lestienne","doi":"10.1159/000548793","DOIUrl":"https://doi.org/10.1159/000548793","url":null,"abstract":"<p><p>Rosacea is a prevalent, chronic inflammatory skin disorder increasingly affecting middle-aged individuals worldwide. Characterized by facial erythema, flushing, papules, pustules, and telangiectasia, rosacea arises from complex, dysregulated immune responses with chronic inflammation and vascular instability. Given its multifactorial nature, treatment approaches focus on managing symptoms and often require a multidisciplinary strategy that integrates targeted skincare, topical and systemic therapies, and physical modalities to address the condition's diverse clinical manifestations, subtypes, and severity effectively. Validated conventional treatments, like metronidazole and azelaic acid, offer symptom relief to varying extents; however, many patients find these therapies insufficient, leading to a growing interest in alternative therapies. Dermocosmetic products containing natural ingredients, particularly botanicals, are gaining in popularity, driven not only by their reported anti-inflammatory properties and perceived favorable tolerability, but also because they often appear to align with the personal values and beliefs of many individuals, and offer a more holistic approach to care. Emerging clinical evidence suggests that plant-based ingredients may help alleviate rosacea symptoms by modulating inflammation, regulating keratinization, and supporting vascular health, thereby promoting skin restoration, vessel stability, and reduced sensitivity. This review provides an up-to-date summary of advancements in the use of botanical ingredients for the management of rosacea. By exploring both well-studied botanicals and emerging plant extracts, this review highlights the growing role of natural adjunctive treatments in rosacea care.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"1-48"},"PeriodicalIF":2.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The global burden of adolescent acne: trends from 1990 to 2021 and future projections to 2050.","authors":"Gang Li, Xuezhuang Yue, Yan Lu, Chengzhong Zhang","doi":"10.1159/000548450","DOIUrl":"https://doi.org/10.1159/000548450","url":null,"abstract":"<p><p>Introduction Adolescent acne poses unique therapeutic challenges and imposes a substantial burden. However, study of its global impact has been limited and neglected. Objective To analyze the global disease burden and epidemiologic trend of adolescent acne. Methods Data was extracted from the global burden of disease Study the 2021 database. All the analysis procedures graphic representation were undertaken by R statistical software and GraphPad Prism 9. Results The global burden of adolescent acne increased significantly from 1990 to 2021, with consistently higher rates observed in females compared to males. Meanwhile, both the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR) and age-standardized YLD rate (ASDR) continued to rise significantly, with an average annual percentage change (AAPC) of 0.7%, 0.6%, 0.6%. Population analysis revealed a unimodal age distribution, characterized by high burden among adolescent with the age of 11-14. National and Regional, the distribution of the disease burden was highly uneven. The global burden can be mostly attributed to epidemiological changes (58.7%), aging (40.0%). Significant regional disparities grouped by socio-demographic index (SDI) were observed. Projections indicate that by 2050, the incidence, ASIR, prevalence, ASPR, DALYs and ASDR of of adolescent acne will rise to 122 million, 4,265 per 100,000, 201 million, 7,015 per 100,000, 4.326 million and 151.2 per 100,000. Conclusion The study demonstrates a significant and growing global burden of adolescent acne from 1990 to 2021, underscoring the urgent need for targeted prevention and management strategies worldwide.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"1-20"},"PeriodicalIF":2.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Participant heterogeneity of psoriasis interventional trials.","authors":"Shuntong Kang, Dingyao Zhang, Bo Zhang, Cheng Zhao, Shihang Zhou, Yue Xin, Pinglang Ruan, Yaqing Huang, Jingru Tian, Qianjin Lu","doi":"10.1159/000548168","DOIUrl":"https://doi.org/10.1159/000548168","url":null,"abstract":"<p><strong>Introduction: </strong>Participant heterogeneity as a part of clinical heterogeneity has been proved to alter the intervention efficacy, however, factors associated with participant heterogeneity in psoriasis randomized clinical trials (RCTs) are not clear. This study set out to explore participant heterogeneity of randomized clinical trials (RCTs) in psoriasis represented by participant adherence.</p><p><strong>Methods: </strong>A systematic search of the scientific literature was performed for interventional psoriasis RCTs within published English-language articles from peer-reviewed journals and registered trials in clinical trials registries on July 20, 2021, using 3 databases and 4 registries. Meta-analyses were carried out to calculate the risk ratio (RR) of participant adherence in the intervention and control groups.</p><p><strong>Results: </strong>A total of 1,714 trials met our inclusion criteria. Factors associated with overall high withdrawal rate were unique between countries with different national incomes. The participant adherence ratio between intervention and control groups was also distinctly influenced by the national income of the trial-conducted country. In low and middle-income countries, the withdrawal ratio was relatively constant, while for trials conducted in high-income countries, the results were altered by compliance reporting, number of participants, disease severity, and country. Moreover, trials conducted in low and middle-income countries tended to have better basal participant adherence.</p><p><strong>Conclusions: </strong>Our study has revealed the unexpected participant heterogeneity brought by national income in psoriasis RCTs worldwide. Results from high-income countries should be interpreted carefully and rigorously designed single-country trials are always needed for developing local clinical management.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"1-13"},"PeriodicalIF":2.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Cutaneous Lupus Erythematosus: An Evidence-based Review.","authors":"Wei Xiong, Heya Lin, Lili Fu, Jie Yi, Jiantang Yang","doi":"10.1159/000548335","DOIUrl":"https://doi.org/10.1159/000548335","url":null,"abstract":"<p><p>Cutaneous lupus erythematosus (CLE) is a chronic and recurrent autoimmune disorder that predominantly affects the skin. It may cause alterations in appearance and psychological distress, thereby exerting an impact on the quality of life. Consequently, the pursuit of safer, more effective, and more convenient therapeutic approaches is of paramount importance. To assess the efficacy and safety of treatments for cutaneous lupus erythematosus, a systematic electronic search was conducted in the following databases to identify clinical studies on the prevention and treatment of CLE: PubMed, MEDLINE (OVID), Web of Science, and CENTRAL. After the search, relevant literature was included based on pre-established criteria, and the results were analyzed. Existing research evidence suggests that topical treatments are generally regarded as a first-line option for CLE owing to their convenience and safety, particularly for milder lesions or those limited to the skin. In contrast, systemic therapies are more appropriate for patients with severe conditions or those at risk of developing systemic lupus erythematosus. Currently, the precise mechanisms of action of CLE treatments have not been fully elucidated. The therapeutic potential of some novel therapies and their complex roles in disease progression remain unclear, necessitating further basic and clinical research for clarification.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"1-31"},"PeriodicalIF":2.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dupilumab-associated ocular surface disease in patients with atopic dermatitis is frequent: a nationwide real world evidence study.","authors":"Ane Marie Hovmand Nøhr, Pernille May Hansen, Michael Møller-Hansen, Henrik Hedegaard Pliess Larsen, Amalie Thorsti Møller Rønnstad, Simon Francis Thomsen, Claus Otto Carl Zachariae, Kristina Ibler, Charlotte G Mortz, Carsten Bindslev-Jensen, Mette Sondergaard Deleuran, Christian Vestergaard, Peter Bjerring, Jacob P Thyssen, Steffen Heegaard","doi":"10.1159/000548467","DOIUrl":"https://doi.org/10.1159/000548467","url":null,"abstract":"<p><p>New biologic treatments are increasingly used for the treatment of moderate to severe atopic dermatitis (AD). This study examined clinical characteristics of patients with Dupilumab-associated ocular surface disease (DAOSD). 382 patients were included in a retrospective nationwide cohort study of all Danish adults treated with Dupilumab for AD for more than 16 weeks. The frequency of DAOSD was 37.7% with a median follow-up of 1.6 years. Before initiating treatment, 61.3% of the DOASD-patients already had pre-existing ocular sur-face disease (OSD), why the DAOSD-group was then sub divided in two groups: one with pre-existing OSD and one without pre-existing OSD. Patients who developed DAOSD had a longer median duration of AD (41.5 and 44 for patients with pre-existing OSD and patients without pre-existing OSD) vs. 33 years (non-DAOSD), p=0.005), a higher median reduction in EASI score (93.3% and 90.2% vs. 83.8%, p=0.006) and more frequently rhinitis (49.4% and 52.7% vs. 37.1%, p=0.031). In 75% of cases, DAOSD presented before week nine, conjunctivitis was the most common sign of DAOSD (73.2%) and to treat DAOSD, ophthalmolo-gists prescribed lubricating eye drops to patients with pre-existing OSD and patients without pre-existing OSD drops in 88.5% and 87.3 of the cases, and mild (e.g., hydrocortisone) and strong (e.g., dexamethasone) cortico-steroid eye drops equally frequent (24.1 and 25.3% vs. 16.4% and 29.1%). In 5% of the cohort, Dupilumab treatment was discontinued due to DAOSD (n=19), even though these patients received lubricating eyedrops (84%), mild steroids (41.1) and strong steroids (31.6%). DAOSD should be recognized by dermatologists and should lead to consideration of early referral to ophthalmologists.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"1-19"},"PeriodicalIF":2.7,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empowering the Hidradenitis Suppurativa Patient in a Digital Health Landscape.","authors":"Nicole D K Koerts, Barbara Horváth","doi":"10.1159/000548281","DOIUrl":"https://doi.org/10.1159/000548281","url":null,"abstract":"","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"1-5"},"PeriodicalIF":2.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145052112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dimethyl fumarate treatment for psoriasis in real-world clinical practice: An analysis from the Swiss registry.","authors":"Lara Valeska Maul, Melike Ak, Sara E Cerminara, Dario Simic, Elisabeth Victoria Gössinger, Elisabeth Roider, Anna Darzina, Alexander Zink, Iker Oyanguren Monferrer, Felix Oestereich, Eva Mateu, Alexander A Navarini, Thomas Kündig, Julia-Tatjana Maul","doi":"10.1159/000548354","DOIUrl":"https://doi.org/10.1159/000548354","url":null,"abstract":"<p><strong>Introduction: </strong>Limited data are available on the effectiveness and safety of dimethyl fumarate (DMF) for the treatment of moderate-to-severe psoriasis in real-world clinical practice. The objectives were to assess the effectiveness and safety of DMF in patients with moderate-to-severe plaque psoriasis in Switzerland.</p><p><strong>Methods: </strong>Data from 28 adults enrolled in the Swiss Dermatology Network for Targeted Therapies registry who started DMF treatment as first-line or subsequence therapy at registry entry and had ≥3 months of follow-up were analysed. No missing imputation was performed.</p><p><strong>Results: </strong>The median Psoriasis Area and Severity Index (PASI) decreased from 9.3 to 2.0 (p=0.0136) and 2.3 (p=0.0156) after 6 and 12 months of DMF treatment, respectively. At month 6, 61.5%/61.5%/15.4% of patients achieved a PASI <5/<3/<1 and at month 12, 75.0%/50.0%/37.5%. The proportions of patients achieving a PASI 75/90/100 response were 62.5%/25.0%/12.5% at month 12. At 12 months, median body surface area affected decreased from 10.3% to 1.5% (p<0.01). The most common adverse events were abdominal pain (50.0%) and flushing (35.7%), which occurred in the first 3 months.</p><p><strong>Conclusion: </strong>In a real-world setting, DMF significantly improves the severity and extent of disease in patients with moderate-to-severe psoriasis for up to one year with a safety profile consistent with previously published data on fumarates.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"1-24"},"PeriodicalIF":2.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of Photodynamic Therapy and 5-Fluorouracil Cream versus Surgical Excision in Treatment of Bowen's Disease: a trial based economic evaluation.","authors":"Shima Ahmady, Charlotte A M van Riel, Nicole W J Kelleners-Smeets, Klara Mosterd, Brigitte A B Essers","doi":"10.1159/000548431","DOIUrl":"https://doi.org/10.1159/000548431","url":null,"abstract":"<p><p>Introduction Given the increasing incidence of Bowen's disease, treatment leads to a substantial economic burden for healthcare services. There are several treatment options for Bowen's disease, of which surgical excision, 5-fluorouracil and methylaminolevulinate photodynamic therapy (MAL-PDT) are the most commonly used. Recently, results from a randomized controlled non-inferiority trial showed that 5-fluorouracil was non-inferior to excision and was associated with a better cosmetic outcome. MAL-PDT was not shown to be non-inferior to excision. Although 5-fluorouracil and MAL-PDT were expected to be cheaper than excision, it remains to be determined whether the potential cost savings compensate for the loss of effectiveness. Objectives To determine which treatment is cost-effective from a health care perspective when comparing surgical excision, MAL-PDT, and 5% 5-fluorouracil cream for Bowen's disease. Methods Data were collected alongside a randomized controlled trial with 250 patients in the Netherlands. Valuation of treatment costs was based on documented resource use and Dutch cost prices. A cost-effectiveness was performed from a health care perspective. The primary outcome was the decremental cost-effectiveness ratio (DCER), expressed as the cost-savings per additional recurrence or residual Bowen's disease. Bootstrap analysis and sensitivity analysis were performed to address uncertainty. This trial is registered with ClinicalTrials.gov number, NCT03909646. Results At 12 months after treatment, the costs for 5-fluorouracil cream were significantly lower (- €311(CI: -240 - -378)) and the costs for MAL-PDT were higher (€3 (CI: -74- 65)) compared to excision. 5-fluorouracil cream offers cost savings compared to excision, but is less effective although within the non-inferiority margin of 22%. Our results showed that 5-fluorouracil has the highest probability of being cost-effective at willingness to accept threshold values of €2500 and lower compared to MAL-PDT and surgical excision. Discussion 5-fluorouracil cream is a cost-effective treatment at a threshold value of €2500 and lower when compared to surgical excision and MAL-PDT. Therefore, from a cost-effectiveness point of view, 5-fluorouracil is considered the first-choice treatment option for Bowen's disease.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"1-16"},"PeriodicalIF":2.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategic Targets in Acne, Update 2025: The Microcomedone Is Not Just a Plug, It Is an Egg.","authors":"Bénédicte Oulès, Jean Hilaire Saurat","doi":"10.1159/000547515","DOIUrl":"https://doi.org/10.1159/000547515","url":null,"abstract":"<p><strong>Background: </strong>Maintaining homeostasis in the upper pilosebaceous unit in acne-prone skin has emerged as the primary goal for effective and long-term acne management.</p><p><strong>Summary: </strong>In this review, we describe advances in acne research that have helped redefine the strategic targets for new topical acne treatments, providing the basis for new therapeutic strategies that may allow this goal to be achieved.</p><p><strong>Key messages: </strong>First, we describe the results of studies analyzing apparently uninvolved skin from individuals with acne, using sequential skin surface biopsies. These studies led to the identification of subclinical lesions, referred to as microcomedones, as the root of all subsequent acne lesions, and thus clinically non-lesional acne skin as the strategic target for new acne therapies. We then describe the concept of the comedo switch, in which exposure of progenitor cells in the pilosebaceous unit to comedogenic factors in acne-prone skin leads to the formation of microcomedones. Previously considered as an \"inert plug\", the microcomedone rather appears to be \"an egg\" that can grow into acne lesions.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"1-7"},"PeriodicalIF":2.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}