Dermatology and Therapy最新文献

{"title":"Initiating Biologics in Atopic Dermatitis: Global Practices and Recommendations from the AMAZE Project.","authors":"April W Armstrong, Hyun Jung Kim, Andrew E Pink, Joe Gorelick, Mariateresa Rossi, Magdalena Trzeciak, Mette Deleuran, Saeko Nakajima, Vimal H Prajapati","doi":"10.1007/s13555-026-01942-4","DOIUrl":"https://doi.org/10.1007/s13555-026-01942-4","url":null,"abstract":"<p><strong>Introduction: </strong>Biologics have expanded treatment options for moderate-to-severe atopic dermatitis (AD), but practical guidance on how to initiate and manage these therapies in routine care remains limited. The advancing management of atopic dermatitis and eczema (AMAZE ) project examined global clinical practices and developed expert-informed recommendations to support biologic initiation and long-term management.</p><p><strong>Methods: </strong>An online survey of 150 dermatologists from North America, Europe, and Japan assessed real-world approaches to biologic management. Findings were interpreted by an international global steering committee and further refined through expert discussion meetings. Best practice recommendations were developed on the basis of survey findings, expert consensus, and a narrative literature review.</p><p><strong>Results: </strong>Respondents reported considerable variability in biologic initiation practices. Overall, 47% of dermatologists intended biologic therapy for long-term use, while Japanese clinicians more frequently anticipated shorter treatment durations (4-12 months), reflecting national guideline recommendations. Transition practices from conventional systemic therapies varied substantially between dermatologists: 49% reported overlapping, 33% transitioned directly without overlap, and 18% used a washout period. European clinicians were more likely to discontinue conventional systemic therapies prior to biologic initiation, whereas overlapping strategies were more common in North America and Japan. Early follow-up within 4 weeks was reported by 36% of dermatologists and was most common in Japan, largely owing to healthcare system requirements. Expert-informed recommendations emphasized: establishing patient-centered treatment goals focused on long-term disease control; individualized transition strategies when switching from conventional systemic therapies; structured follow-up with formal assessment of treatment response around 12-16 weeks after treatment initiation; and proactive management of flares through continued use of emollients and topical anti-inflammatory therapies.</p><p><strong>Conclusions: </strong>The AMAZE project highlights substantial regional variation in biologic initiation practices for AD. These expert-informed recommendations provide practical guidance to support individualized, patient-centered approaches to initiating and managing biologic therapy in routine clinical practice. Graphical plain language summary available for this article at https://doi.org/10.6084/m9.figshare.32991755 .</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223503","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":"Cumulative Disease Control with Upadacitinib in Moderate-to-Severe Atopic Dermatitis-A 52-Week Multicenter Real-World Study: IL-AD (Italian Landscape Atopic Dermatitis).","authors":"Luca Potestio, Matteo Bianco, Luca Mastorino, Francesca Maria Gaiani, Francesca Barei, Francesca di Vico, Stefano Bighetti, Raul Armando Luyo Saboya, Martina Maurelli, Eugenia Veronica Di Brizzi, Flavia Manzo Margiotta, Mattia Cristallo, Anna Francesca Cavaliere, Manfredi Magliulo, Andrea Carugno, Antonio Podo Brunetti, Ruggero Cascio Ingurgio, Giulia Carpentieri, Francesco Messina, Marco Campoli, Chiara Assorgi, Franco Rongioletti, Nicola Zerbinati, Massimo Gola, Francesco Loconsole, Maria Concetta Fargnoli, Maria Esposito, Anna Graziella Burroni, Eustachio Nettis, Marco Romanelli, Pietro Morrone, Anna Balato, Giampiero Girolomoni, Elena Pezzolo, Mario Bruno Guanti, Mariateresa Rossi, Cataldo Patruno, Maddalena Napolitano, Angelo Valerio Marzano, Silvia Mariel Ferrucci, Piergiorgio Malagoli, Michela Ortoncelli, Simone Ribero, Antonio Costanzo, Alessandra Narcisi, Diego Orsini","doi":"10.1007/s13555-026-01958-w","DOIUrl":"https://doi.org/10.1007/s13555-026-01958-w","url":null,"abstract":"<p><strong>Introduction: </strong>Fixed-timepoint endpoints may not fully capture longitudinal treatment benefit in atopic dermatitis (AD). We evaluated the 52-week real-world effectiveness and safety of upadacitinib, focusing on cumulative disease control.</p><p><strong>Methods: </strong>This multicenter retrospective analysis of prospectively collected LANDSCAPE registry data included patients with moderate-to-severe AD receiving stable upadacitinib 15 mg or 30 mg once daily. Patients who underwent dose modification from 15 to 30 mg or from 30 to 15 mg during the 52-week observation period were excluded from the present analysis to ensure that longitudinal outcomes and cumulative disease-control estimates could be consistently attributed to a stable upadacitinib dose. Outcomes were assessed at baseline and weeks 16, 32, and 52. Moderate disease control was defined as EASI75 plus peak pruritus numerical rating scale (pp-NRS) ≤ 4, and optimal disease control/minimal disease activity (MDA) as EASI90 plus pp-NRS ≤ 1. Cumulative control was estimated as equivalent days in target using a time-in-target approach.</p><p><strong>Results: </strong>Overall, 433 patients were included; 315 (72.7%) received 15 mg and 118 (27.3%) received 30 mg. At week 52, EASI75 and EASI90 were achieved by 85.7% and 72.7% of patients, respectively; moderate and optimal disease control/MDA were achieved by 80.6% and 62.6%. Patients spent a mean of 253.3 ± 101.9 equivalent days in moderate disease control and 176.1 ± 124.4 days in optimal control/MDA. Sustained moderate and optimal disease control from weeks 16 to 52 were achieved by 63.0% and 38.3%, respectively. Overall, 27.0% experienced at least one adverse event, with no permanent treatment discontinuations due to adverse events.</p><p><strong>Conclusion: </strong>Upadacitinib provided sustained real-world disease control over 52 weeks. Time-in-target measures may complement conventional endpoints by better reflecting persistence of therapeutic benefit.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191980","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 Colorimetric Scale for Skin of Color (CSSC) can Provide a Standardized Classification System for Patients with Diverse Skin Tones.","authors":"Philip R Cohen","doi":"10.1007/s13555-026-01939-z","DOIUrl":"https://doi.org/10.1007/s13555-026-01939-z","url":null,"abstract":"<p><p>The colorimetric scale for skin of color (CSSC) is an inexpensive, easy to use, rapidly performed assessment for the classification of skin color type of individuals with dark skin. The scale only includes colors, is not based on sun-reactive skin types, and requires minimal training of the person doing the evaluation. The colors in the CSSC range from very light beige to very dark brown; each color corresponds to a numerical skin color type: very light beige (skin color type 1), light brown (skin color type 2), medium brown (skin color type 3), dark brown (skin color type 4), and very dark brown (skin color type 5). Importantly, the CSSC provides a non-ethnic and non-racial categorization of people with dark skin which potentially not only diminishes racial disparities in dermatology but also promotes healthcare equity. The expected reliability and reproducibility of the scale remain to be validated by prospective studies. In addition, for individuals with dark skin, it is anticipated that the scale shall not only be an integral component in forensic pathology but also useful for improving diagnosis of dermatologic conditions, determining appropriate cosmetic procedures and devices, assessing the risk of skin cancer development, establishing skin type-directed photoprotection, and enhancing research in dermatology. The design of the CSSC enables the potential creation of an artificial intelligence-based system to establish more objective parameters for the classification of individuals with dark skin. In summary, the CSSC is an ideal tool for classifying individuals with dark skin.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179943","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 Economic Burden of Chronic Urticaria in Portugal: A Patient-Reported Cost-of-Illness Study.","authors":"Pedro S Coelho, Jorge M Mendes, João Maia Silva","doi":"10.1007/s13555-026-01955-z","DOIUrl":"https://doi.org/10.1007/s13555-026-01955-z","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic urticaria (CU) substantially impairs an individual's quality of life, yet its costs are seldom quantified and no full cost-of-illness analysis has been published for Portugal. We have estimated the annual societal cost associated with CU in Portuguese adults and examined whether quality-of-life impairment is associated with productivity loss.</p><p><strong>Methods: </strong>This was a cross-sectional, patient-reported study of 147 adults with a physician-established CU diagnosis, recruited through the national patient association in 2021-2022. A bottom-up, prevalence-based design was applied from a societal perspective. Estimates were post-stratified by disease severity to the AWARE study distribution, and both weighted and unweighted estimates are reported. Per-patient costs were the primary outcome, and national aggregates were secondary outcomes. Regression models adjusted for the severity strata used in the weighting related productivity loss to the Dermatology Life Quality Index (DLQI). Costs are expressed in 2022 euros.</p><p><strong>Results: </strong>The weighted mean annual societal cost was estimated at €4687 per patient (unweighted €7014). Presenteeism accounted for 62.4% (€2927) of the total; employed patients lost 64.2 working days/year [95% confidence interval (CI) 40.6-87.8] to reduced productivity at work, against 1.5 days of absence. Direct costs were €1132 per patient (unweighted €2500), of which patients paid 64% out of pocket. Among employed patients, each DLQI point was associated with €270 (95% CI 131-408) of annual productivity loss after adjustment for severity, and the estimate was unchanged when the work-related DLQI item was excluded. National estimates ranged from €202 million to €927 million per year across prevalence scenarios.</p><p><strong>Conclusions: </strong>In this self-selected sample, the societal cost of CU was dominated by presenteeism, and the most direct costs were borne by patients. Poorer quality of life was associated with greater productivity loss independently of disease severity. Patient-level estimates are more robust than national extrapolations.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180076","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":"Obesity and Early Biologic Failure in Psoriasis: An Italian Multicentre Retrospective Cohort Study.","authors":"Jacopo Tartaglia, Massimo Donini, Carlo Garbo, Alessandro Gatti, Paolo Gisondi, Niccolò Romagnolo, Lorenzo Schiesari, Stefano Piaserico","doi":"10.1007/s13555-026-01956-y","DOIUrl":"https://doi.org/10.1007/s13555-026-01956-y","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity may reduce biologic effectiveness in psoriasis, but its effect on specific reasons for treatment discontinuation is less well defined. We evaluated the association between obesity and biologic drug survival, with particular attention to primary failure and therapeutic class.</p><p><strong>Methods: </strong>This retrospective multicentre cohort study included patients with plaque psoriasis treated with biologics at five Italian dermatology centres. Analyses were conducted at the treatment-line level using Kaplan-Meier methods and Cox proportional hazards models. Obesity was defined as body mass index (BMI) ≥ 30 kg/m². BMI was also examined continuously and using a natural cubic spline. Logistic regression and Cox models with standard errors clustered by patient were used as sensitivity analyses.</p><p><strong>Results: </strong>Overall, 573 patients contributed 770 treatment lines; 193 of 562 patients with available BMI data (34.3%) were obese. Primary failure occurred in 17.0% of treatment lines from patients with obesity and 5.8% of treatment lines from patients without obesity (log-rank p < 0.001). In the adjusted Cox model, obesity was associated with a higher risk of primary failure (hazard ratio [HR] 2.75, 95% confidence interval [CI] 1.59-4.77). Each 5 kg/m² increase in BMI was associated with a 37% higher risk (HR 1.37, 95% CI 1.14-1.65), with evidence of non-linearity (likelihood ratio p = 0.0018). Compared with tumour necrosis factor-α inhibitors, interleukin (IL)-17 inhibitors (HR 0.49, 95% CI 0.24-0.97) and IL-23 pathway inhibitors (HR 0.47, 95% CI 0.24-0.93) showed lower primary failure risks. Obesity was not associated with secondary failure or safety-related discontinuation.</p><p><strong>Conclusion: </strong>Obesity was associated mainly with early biologic failure in psoriasis. The association was most evident with tumour necrosis factor-α inhibitors.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179955","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":"Eczema-Psoriasis Overlap: An eDelphi Consensus on Clinical Presentation and Therapeutic Management Among Italian Experts.","authors":"Eleonora De Luca, Anna Campanati, Marco Galluzzo, Niccolò Gori, Matteo Megna, Maddalena Napolitano, Giulia Rech, Giacomo Caldarola","doi":"10.1007/s13555-026-01950-4","DOIUrl":"https://doi.org/10.1007/s13555-026-01950-4","url":null,"abstract":"<p><strong>Introduction: </strong>Atopic dermatitis and psoriasis (PsO) are common chronic inflammatory skin diseases traditionally considered distinct, driven by Th2 and Th1/Th17 pathways, respectively. However, evidence reveals that some patients may present with both eczematous and psoriatic lesions, either simultaneously or sequentially. This study's objective was to establish an Italian consensus on the clinical definition and management of eczema-psoriasis overlap.</p><p><strong>Methods: </strong>A steering committee of eight dermatologists identified three key areas: problem definition, clinical presentation and therapeutic management. Forty-three statements were drafted and distributed to 131 dermatologists for evaluation via an eDelphi process, using a 1-9 numeric rating scale. Consensus was defined as a mean score ≥ 7.</p><p><strong>Results: </strong>Of the 131 invited participants, 104 responded (79.4%). Consensus was reached for 42/43 statements. The only statement that failed to achieve consensus concerned the influence of respiratory atopic comorbidities on biologic choice in PsO; as a result of its dichotomous nature, it was not revised or re-voted on.</p><p><strong>Conclusions: </strong>Eczema and PsO exist on a continuum of immune dysregulation, which may manifest sequentially or concomitantly, with phenotypic switches that can be spontaneous or drug induced. Assessment of risk factors for drug-induced forms should guide therapeutic choices. Mild cases can often be managed with topical therapies, while moderate-to-severe forms may require broader T cell-targeting treatments.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180011","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":"Diagnostic Value of Skin Biopsy in Fatal Histoplasmosis-Associated Hemophagocytic Lymphohistiocytosis: A Case Report.","authors":"Jaclyn Roland-McGowan, Riyad N H Seervai, Claudia Lee, Stephanie Mengden Koon, Jesse J Keller","doi":"10.1007/s13555-026-01959-9","DOIUrl":"https://doi.org/10.1007/s13555-026-01959-9","url":null,"abstract":"<p><strong>Introduction: </strong>Hemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening hyperinflammatory syndrome most commonly triggered in adults by infection, malignancy, or autoimmune disease. Disseminated histoplasmosis is an uncommon but recognized infectious trigger, particularly in immunosuppressed patients. Its cutaneous manifestations may be subtle and nonspecific but can provide accessible tissue for diagnostic evaluation.</p><p><strong>Case report: </strong>A 41-year-old man with psoriasis treated with adalimumab presented with 5 months of progressive constitutional and abdominal symptoms followed by fever, shock, pancytopenia, hepatosplenomegaly, coagulopathy, hypertriglyceridemia, and extreme hyperferritinemia (>  89,000 ng/mL). Bone marrow biopsy demonstrated hemophagocytosis but was negative for fungal organisms on Grocott methenamine silver staining. Punch biopsy of scattered pink-to-violaceous acneiform papules on the forehead and scalp demonstrated numerous tissue-invasive microorganisms, and subsequent molecular testing identified Histoplasma capsulatum. He received dexamethasone, ruxolitinib, and liposomal amphotericin B; etoposide was withheld because of ongoing hemorrhage. Despite treatment, he succumbed to hemorrhagic shock and multiorgan failure and died. Autopsy demonstrated widespread histoplasmosis.</p><p><strong>Conclusions: </strong>In patients with HLH, subtle skin lesions may provide accessible tissue for demonstrating invasive infection and obtaining organism-specific confirmation, even when fungal staining of another tissue is negative. Careful skin examination and targeted biopsy of new, atypical, or evolving lesions should be considered in immunocompromised adults with unexplained systemic inflammation, particularly those receiving tumor necrosis factor-alpha inhibitors.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179942","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":"An Investigational Mechanism-Informed Therapy for Netherton Syndrome: Introduction to QRX003 and A Pediatric Compassionate-Use Case Report.","authors":"Alan D Irvine, Alain Hovnanian, Michael Myers, Denise Carter","doi":"10.1007/s13555-026-01948-y","DOIUrl":"https://doi.org/10.1007/s13555-026-01948-y","url":null,"abstract":"<p><p>QRX003 is an investigational topical lotion under clinical evaluation for Netherton syndrome (NS) and other genodermatoses. Netherton syndrome is a severe genetic ichthyosis caused by a deficiency of LEKTI, a serine protease inhibitor crucial for kallikrein regulation. Hyperactive kallikreins drive premature corneodesmosome cleavage and accelerated desquamation, causing impaired skin barrier integrity, chronic inflammation, and intense chronic pruritus. The active ingredient in QRX003 is DiPalmitoyl HydroxyProline (DPHP), a competitive broad-spectrum serine protease inhibitor that is being evaluated for its potential to reduce excess serine protease activity associated with LEKTI deficiency. QRX003 is being investigated as a mechanism-informed topical approach to address the underlying pathophysiology of NS, intended to modulate disease-relevant protease activity and associated abnormalities in desquamation and epidermal barrier function. Regulatory designations, including Food and Drug Administration (FDA) Rare Pediatric Disease, Orphan Drug, Fast Track Designation, European Medicines Agency (EMA) Orphan Drug, and MHLW Orphan Drug designations, reflect recognition of the unmet need associated with NS and support further clinical development. QRX003 was administered on a compassionate-use basis to a pediatric patient with NS. After 6 weeks of once-daily whole-body application, the patient demonstrated improvements in hallmark symptoms of NS (e.g., reductions in pruritus, skin erythema and fissuring, alongside enhanced visual skin appearance), which were sustained during 21 months of treatment. Symptom worsening during treatment interruption and improvement after reinitiation were reported, consistent with a possible treatment-associated effect. During the treatment period, the patient discontinued previously required medications, including antihistamines, glucocorticoids, and antivirals. No further antibiotic treatment was reported after whole-body application of QRX003 was initiated, and the caregiver reported that the patient began sleeping through the night. No adverse events considered treatment-related were reported by the family or treating physician. Transient peeling after initial application and a brief cooling sensation after application were reported but were not considered clinically significant. In conclusion, QRX003 is being evaluated as an investigational, mechanism-informed topical therapy for NS, with early clinical observation suggesting that QRX003 treatment may be associated with improvement in clinical signs and symptoms as well as family-reported quality-of-life improvement. Ongoing clinical trials will explore the long-term safety and efficacy profile of QRX003.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179979","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":"Does Baseline Severity of Atopic Dermatitis Impact the Long-Term Efficacy of Abrocitinib? Post-hoc Analysis of Two Randomized Trials.","authors":"Andrew E Pink, Zakiya P Rice, Melinda J Gooderham, Fang Wang, Andreas Wollenberg, Pinaki Biswas, Gary Chan, Justine Alderfer, Melissa Watkins","doi":"10.1007/s13555-026-01937-1","DOIUrl":"https://doi.org/10.1007/s13555-026-01937-1","url":null,"abstract":"<p><strong>Introduction: </strong>Baseline severity of atopic dermatitis (AD) may influence treatment response. The objective of this analysis was to assess short- and long-term abrocitinib efficacy and safety by baseline AD severity.</p><p><strong>Methods: </strong>A post-hoc analysis of patients (aged ≥ 12 years) with moderate-to-severe AD receiving abrocitinib 100 mg or 200 mg or placebo in two studies-JADE COMPARE (ClinicalTrials.gov ID: NCT03720470) and JADE EXTEND (NCT03422822)-was performed. Baseline severity was assessed by several measures, including the Investigator's Global Assessment (IGA) and the Eczema Area and Severity Index (EASI). Efficacy and safety endpoints were stratified by baseline severity.</p><p><strong>Results: </strong>Higher proportions of patients with moderate or severe baseline AD achieved IGA score 0/1 (clear/almost clear) with abrocitinib at week 16 (moderate: 40.8% [100 mg], 50.0% [200 mg]; severe: 19.1% [100 mg], 43.2% [200 mg]) versus placebo (moderate: 18.0%; severe: 2.8%). At week 112, IGA 0/1 was achieved by high proportions of patients receiving abrocitinib with moderate (60.2% [100 mg], 64.3% [200 mg]) or severe (38.6% [100 mg], 54.5% [200 mg]) disease. Response rates were similar with other measures, including co-achievement of EASI-90 (90% improvement from baseline score) and Peak Pruritus Numerical Rating Scale 0/1 (no itch/mild itch). There were no new safety signals.</p><p><strong>Conclusion: </strong>Abrocitinib demonstrated early and sustained improvement in skin clearance and itch through week 112 in adult and adolescent patients, and sustained responses were observed in patients in the moderate and severe baseline AD subgroups.</p><p><strong>Clinical trials registration: </strong>This study was a pooled analysis of data from the phase 3 JADE COMPARE (NCT03720470) and JADE EXTEND (NCT03422822) trials.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126741","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":"Topical Delgocitinib for Capecitabine-Induced Hand-Foot Syndrome: A Therapeutic Option?","authors":"Luca Rapparini, Ginevra Martelli, Stephano Cedirian, Francesca Pampaloni, Francesca Bruni, Michela Starace","doi":"10.1007/s13555-026-01947-z","DOIUrl":"https://doi.org/10.1007/s13555-026-01947-z","url":null,"abstract":"<p><strong>Introduction: </strong>Hand-foot syndrome (HFS) is a frequent and potentially dose-limiting adverse event of capecitabine. Current therapeutic strategies are not always effective. Since inflammatory pathways, including JAK-STAT3 signaling, may contribute to capecitabine-induced HFS, topical JAK inhibition could represent a potential therapeutic approach.</p><p><strong>Methods: </strong>We report two women with metastatic breast cancer receiving capecitabine monotherapy who developed Common Terminology Criteria for Adverse Events (CTCAE) grade 3 HFS involving both palms and soles. Both patients had previously received clobetasol propionate 0.05% combined with urea 30%, with only transient benefit. Delgocitinib 20 mg/g cream was subsequently applied twice daily to palms and soles for 6 weeks. Treatment response was assessed clinically and using the HFS-14 quality-of-life scale.</p><p><strong>Results: </strong>Capecitabine dose and schedule remained unchanged in both patients throughout the 6-week delgocitinib treatment period. In patient 1, HFS improved from CTCAE grade 3 to grade 1, with marked symptomatic improvement and a decrease in HFS-14 score from 73.5 to 17.6. Capecitabine was continued unchanged, and the clinical improvement remained stable during an additional 3 months of follow-up. In patient 2, erythema decreased, but desquamation and burning persisted; HFS remained CTCAE grade 3 and the HFS-14 score decreased from 76.5 to 67.6. Capecitabine was therefore interrupted after the week 6 assessment. No local or systemic adverse events related to delgocitinib were observed.</p><p><strong>Conclusion: </strong>Topical delgocitinib may represent a potential therapeutic strategy for capecitabine-induced HFS, particularly in patients who do not adequately respond to topical corticosteroid therapy. However, the discordant responses observed in these two cases highlight that its therapeutic role remains uncertain and requires further prospective investigation.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126750","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}