Dermatology and Therapy最新文献

{"title":"Exploring Vitiligo History and Mental Health Burden Among People Within EU5 Countries: Findings from the Global VALIANT Study.","authors":"Khaled Ezzedine, John E Harris, Iltefat H Hamzavi, Kristen Bibeau, Jessy Gao, Haobo Ren, Nanja van Geel","doi":"10.1007/s13555-025-01451-w","DOIUrl":"https://doi.org/10.1007/s13555-025-01451-w","url":null,"abstract":"<p><strong>Introduction: </strong>Vitiligo is a chronic autoimmune disease characterized by destruction of pigment-producing melanocytes in the skin. This study explores the patient and treatment history of vitiligo and associated mental health burden in EU5 countries.</p><p><strong>Methods: </strong>The cross-sectional global Vitiligo and Life Impact Among International Communities (VALIANT) study recruited people with vitiligo via an online panel and surveyed them regarding clinical characteristics, vitiligo treatment, quality of life (QoL), and mental health.</p><p><strong>Results: </strong>A total of 1151 patients were surveyed in EU5 countries (France, n = 250; Germany, n = 250; Italy, n = 200; Spain, n = 200; UK, n = 251). Half of patients (50.3%) reported a family history of vitiligo, with highest rates in France (66.4%) and Germany (58.8%). Many patients experienced flares during periods of stress (65.1%) or itching before/during a flare (61.5%), with highest rates in Germany (78.4%/78.8%, respectively; P < 0.01 vs all). German patients used the greatest mean number of vitiligo treatments (6.5; P < 0.0001 vs all), and French patients reported the highest rates of current non-treatment (20.8%; P < 0.05 vs Germany). Half of patients (53.9%) reported frequently hiding their vitiligo lesions, with highest rates in Germany (60.4%) and France (58.4%; both P < 0.05 vs Italy/Spain). German and French patients also reported highest disease burden (P < 0.05 vs Italy/Spain/UK). Over half (58.3%) of patients reported diagnosed mental health conditions (anxiety [26.5%]; depression [23.4%]). Rates of moderate to severe depressive symptoms were highest in Germany (64.8%; P < 0.05 vs all).</p><p><strong>Conclusion: </strong>Among EU5 countries, patients from Germany and France generally reported higher burden than those from Italy, Spain, or the UK, although the impact of vitiligo on these patients cannot be discounted. Patients reported flares during periods of stress and great impact of vitiligo on their QoL and mental health. There is continued need for improved management strategies for patients with vitiligo, including the reduction of QoL and mental health burden.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559485","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":"Guselkumab Retention, Effectiveness, and Safety in Psoriasis: A 260-Week Real-World Multicenter Retrospective Study Exploring the Role of Concomitant PsA-IL PSO (Italian Landscape Psoriasis).","authors":"Mario Valenti, Luciano Ibba, Sara Di Giulio, Paolo Dapavo, Piergiorgio Malagoli, Angelo V Marzano, Francesco Loconsole, Martina Burlando, Anna Balato, Valentina Dini, Matteo Megna, Giampiero Girolomoni, Emanuele Trovato, Claudia Lasagni, Massimo Travaglini, Claudio Guarneri, Nicola Zerbinati, Simone Ribero, Francesca M Gaiani, Carlo G Carrera, Emanuele C Cozzani, Eugenia V Di Brizzi, Alessandra Michelucci, Luca Potestio, Martina Maurelli, Martina Dragotto, Luca Mastorino, Eleonora Bongiovanni, Francesco Messina, Andrea Sechi, Rossana Moroni, Antonio Costanzo, Alessandra Narcisi","doi":"10.1007/s13555-025-01476-1","DOIUrl":"https://doi.org/10.1007/s13555-025-01476-1","url":null,"abstract":"<p><strong>Introduction: </strong>Guselkumab is a monoclonal antibody targeting the p19 subunit of interleukin (IL)-23, approved for the treatment of moderate-to-severe plaque psoriasis and psoriatic arthritis (PsA). While patients with psoriasis often achieve high clinical response rates (Psoriasis Area and Severity Index [PASI] 90 and PASI 100), the presence of PsA may influence long-term outcomes. We conducted a 260-week, multicenter, retrospective study to compare the effectiveness, safety, and drug survival of guselkumab in patients with and without concomitant PsA.</p><p><strong>Methods: </strong>A total of 1765 patients were enrolled, including 352 with a concomitant diagnosis of PsA and 1413 with isolated skin involvement. All patients were treated with guselkumab following the approved dosing schedule for moderate-to-severe plaque psoriasis for at least 1 year. Treatment effectiveness was evaluated in terms of PASI 90, PASI 100, and absolute PASI ≤ 2 at weeks 16, 28, 52, 104, 156, 204, and 260. Guselkumab drug survival was assessed using the Kaplan-Meier method at the same time points. The safety profile was evaluated by analyzing adverse events recorded in medical charts at each follow-up visit.</p><p><strong>Results: </strong>Throughout the study period, response rates remained comparable between the two cohorts of patients, with a significant difference at 2 years of follow-up in terms of PASI 90 (80.51% versus 74.02%). Drug survival overall remained stable and similar, with 79.5% (95% confidence interval (CI) 76.9-81.9) of patients without PsA and 78.5% (95% CI 72.9-83.1) of patients with PsA still receiving guselkumab treatment after 5 years.</p><p><strong>Conclusions: </strong>Our results confirm the long-term effectiveness, persistence, and favorable safety profile of guselkumab in patients with moderate-to-severe psoriasis, regardless of the presence of concomitant PsA.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144552592","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":"Efficacy and Safety of Cold Atmospheric Plasma-Assisted Therapy for Herpes Zoster: A Randomized, Parallel, Positive-Controlled, Non-inferiority Multicenter Clinical Trial.","authors":"Jingwen Wang, Ke Xue, Jing Gao, Chengda Yuan, Zebin Meng, Linge Li, Lili He, Chenchen Zhang, Xingyu Yang, Jing Wang, Yongmei Lv, Xin Du, Liyun Wang, Chuyu Fu, Na Wang, Yuyan Cheng, Feng Wang, Qing Li, Tingfang Zhang, Yong Cui, Chunjun Yang","doi":"10.1007/s13555-025-01467-2","DOIUrl":"https://doi.org/10.1007/s13555-025-01467-2","url":null,"abstract":"<p><strong>Introduction: </strong>There is growing evidence that cold atmospheric plasma (CAP) can boost skin wound healing and inhibit various viruses. Here, we evaluated the effectiveness and safety of CAP as an adjunct treatment for herpes zoster (HZ). We hypothesized that CAP was similar to or better than the helium-neon (He-Ne) laser in promoting HZ wound and pain recovery.</p><p><strong>Methods: </strong>We recruited 187 patients with acute HZ who received either CAP once per day for at least 2 min per treatment area or He-Ne laser therapy once per day for 20 min per session, in addition to a standard treatment regime. The primary endpoint was the efficacy rate, defined as the percentage of patients in each group whose treated area exhibited drying of blisters in ≥ 50% of the area after the final treatment. Secondary evaluation indicators included treatment duration (in days), onset time of scabbing, scab rate, visual analog scale pain scores, and quality of life scores.</p><p><strong>Results: </strong>Efficacy rates after the last treatment were not significantly different between the CAP and He-Ne laser groups (at 3 ± 1 and 10 ± 2 days after the last treatment, respectively, p > 0.05). Treatment duration, scab formation onset time, and complete scab formation time were shorter in the CAP group than in the He-Ne laser group. No severe adverse events or reactions occurred in the CAP group.</p><p><strong>Conclusion: </strong>CAP is an effective and safe therapeutic option for HZ.</p><p><strong>Trial registration: </strong>This study has been registered at www.chictr.org.cn (ChiCTR2300069993). A graphical abstract is available for this article.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539487","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":"Real-World Skin Clearance and Quality of Life with risankizumab in Patients with Psoriasis with Moderate Skin Involvement and Those Eligible for Systemic Therapy Per International Psoriasis Council Classification.","authors":"Bruce Strober, Manish Patel, Mark I Kaldas, Greg St John, Huzefa Photowala, Adam P Sima, Thomas Eckmann, Alicia Beeghly, April Armstrong","doi":"10.1007/s13555-025-01474-3","DOIUrl":"https://doi.org/10.1007/s13555-025-01474-3","url":null,"abstract":"<p><strong>Introduction: </strong>The International Psoriasis Council (IPC) reclassified patients eligible for systemic therapy to include those with body surface area (BSA) > 10%, psoriasis lesions in high-impact areas, or failure of topical therapy. Risankizumab is an interleukin-23 inhibitor approved for the treatment of moderate-to-severe plaque psoriasis. This retrospective study evaluated the real-world effectiveness of risankizumab in patients with BSA 3-10% and patients meeting IPC systemic therapy criteria, addressing existing gaps in knowledge regarding its effectiveness in these patient groups.</p><p><strong>Methods: </strong>Biologic-naïve adults with moderate-to-severe plaque psoriasis who initiated risankizumab between April 2019 and August 2023 and were treated for 12 (± 3) months were identified from the CorEvitas Psoriasis Registry and stratified by baseline BSA. At 12 months, skin clearance was assessed by achievement of Psoriasis Area Severity Index (PASI) 90, PASI 100, and National Psoriasis Foundation (NPF) treat-to-target goals. Patient-reported outcomes (PROs) included achievement of Dermatology Life Quality Index (DLQI) 0/1, improvements in psoriasis symptoms, and work and activity impairment.</p><p><strong>Results: </strong>Of 272 patients analyzed, 123 had BSA 3-10% (78 had any high-impact area involvement and 105 had prior topical therapy experience) and 149 patients had BSA > 10%. Among those with BSA 3-10%, 77.9% achieved PASI 90 and 67.2% achieved PASI 100. NPF acceptable and target responses were met by 95.3% and 87.9%, respectively. Regarding PROs, 68.1% of patients with moderate skin involvement (BSA 3-10%) attained a DLQI score of 0/1. Significant improvements from baseline in psoriasis symptoms and reductions in work and life impairments were also reported (P < .001). Comparable positive outcomes were observed across all IPC systemic therapy eligible patient subgroups.</p><p><strong>Conclusion: </strong>In patients with BSA 3-10% and those systemic-eligible per IPC classification, continuous treatment with risankizumab for 12 months resulted in high levels of skin clearance and improvements in PROs.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539488","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":"Mental Health and Psychosocial Burden Among Patients with Skin of Color Living with Vitiligo: Findings from the Global VALIANT Study.","authors":"Pearl Grimes, Iltefat H Hamzavi, Kristen Bibeau, John E Harris, Nanja van Geel, Davinder Parsad, Jackie Gardner, Yan Valle, Gaone Tlhong Matewa, Jessy Gao, Haobo Ren, Khaled Ezzedine","doi":"10.1007/s13555-025-01412-3","DOIUrl":"10.1007/s13555-025-01412-3","url":null,"abstract":"<p><strong>Introduction: </strong>Factors associated with vitiligo burden in patients with darker skin (Fitzpatrick skin types IV-VI) are not fully understood. This analysis of patients in the global VALIANT study examined the quality of life (QoL) and psychosocial health among patients with vitiligo by skin type.</p><p><strong>Methods: </strong>Participants from 17 countries were surveyed regarding their clinical characteristics, everyday experiences with vitiligo, impact of vitiligo on daily activities, emotional well-being, and mental health.</p><p><strong>Results: </strong>Of 3541 surveyed patients, 40.8% (n = 1445) had darker skin versus 59.2% (n = 2096) with fairer skin (types I-III). Patients with darker skin had greater median disease extent than those with fairer skin (6.6% vs 2.5%; P < 0.0001). Mean Vitiligo Impact Patient scale scores were higher among patients with darker skin (31.2 vs 24.5; P < 0.0001); daily activities and emotional well-being were significantly more impacted among patients with darker skin. Among individual skin types, patients with types V and VI expressed considerably higher rates of burden versus all other skin types in all assessments. Interestingly, among patients with fairer skin, those with skin type I reported higher rates of burden than those with skin types II and III.</p><p><strong>Conclusion: </strong>Patients with darker skin, particularly skin types V and VI, were more impacted in their daily lives, emotional well-being, and mental health than those with fairer skin, suggesting that a disproportionate need for strategies to improve QoL and mental health burden exists among patients with vitiligo who have skin of color.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1931-1939"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biologics for the Treatment of Moderate-to-Severe Plaque Psoriasis: A Systematic Review and Network Meta-analysis.","authors":"Mark G Lebwohl, André Carvalho, Akihiko Asahina, Jianzhong Zhang, Mir Sohail Fazeli, Ellen Kasireddy, Paul Serafini, Thomas Ferro, Ranga Gogineni, Diamant Thaçi","doi":"10.1007/s13555-025-01423-0","DOIUrl":"10.1007/s13555-025-01423-0","url":null,"abstract":"<p><strong>Introduction: </strong>Moderate-to-severe plaque psoriasis is a chronic disease impacting quality of life (QoL). This network meta-analysis (NMA) compared efficacy and safety of all biologics approved for the treatment of moderate-to-severe plaque psoriasis to better inform providers on mid-term outcomes, with a focus on the interleukin-23 p19 inhibitor tildrakizumab.</p><p><strong>Methods: </strong>MEDLINE®, Embase, and CENTRAL were searched for randomized clinical trials (RCT) from inception through January 2024. RCTs comparing biologics against placebo or each other reporting Psoriasis Area and Severity Index (PASI), Physician Global Assessment (PGA) 0/1, or Dermatology Life Quality Index (DLQI) 0/1 responses and safety outcomes (adverse events [AEs] or serious AEs [SAEs]) were sought. Bayesian NMAs were performed at week 28 as the primary time point of interest. Analyses were also performed at weeks 12 and 16. Findings were expressed as risk ratios (RR; efficacy outcomes), risk differences (RD; safety outcomes), and numbers needed to treat (NNT) with 95% credible intervals.</p><p><strong>Results: </strong>Of 7418 publications screened, 187 describing 124 RCTs of 12 biologics were included in the systematic literature review, and 103 RCTs were included for NMA. All treatments demonstrated improved efficacy and QoL vs. placebo at week 28. Tildrakizumab efficacy at week 28 was comparable to risankizumab and guselkumab, respectively, for PASI 75 (RR 8.74 vs. 8.92 and 8.91), PASI 90 (RR 14.09 vs. 14.81 and 14.77), and PGA 0/1 (RR 9.34 vs. 10.29 and 10.23). No biologics exhibited an increased risk of SAEs vs. placebo; tildrakizumab exhibited no increased risk vs. placebo for AEs.</p><p><strong>Conclusions: </strong>The investigated biologics demonstrated improved efficacy and QoL relative to placebo at week 28, with no increased risk of SAEs vs. placebo through week 16. At week 28, efficacy of tildrakizumab, risankizumab, and guselkumab was comparable. Limitations include lack of placebo comparators after week 12 or 16, which could affect results.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1633-1656"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Influence on Bimekizumab Response in Patients with Psoriasis: Results of a Real-World Multicenter Retrospective Study-IL PSO (Italian Landscape PSOriasis).","authors":"Helena Gioacchini, Agnese Rossi, Maria Esposito, Emanuele Vagnozzi, Maria Concetta Fargnoli, Paolo Gisondi, Francesco Bellinato, Chiara Assorgi, Pina Brianti, Santo Raffaele Mercuri, Martina Burlando, Emanuele Cozzani, Giovanna Brunasso, Stefano Caccavale, Anna Balato, Giacomo Caldarola, Clara De Simone, Elena Campione, Alessandro Giunta, Francesco Tonon, Marina Venturini, Carlo Giovanni Carrera, Angelo Valerio Marzano, Andrea Carugno, Paolo Sena, Antonio Costanzo, Alessandra Narcisi, Francesco Cusano, Paolo Dapavo, Pietro Quaglino, Annunziata Dattola, Antonio Giovanni Richetta, Francesca Gaiani, Piergiorgio Malagoli, Matteo Megna, Luca Potestio, Edoardo Mortato, Francesco Loconsole, Francesca Romano, Andrea Faragalli, Rosaria Gesuita, Tommaso Bianchelli, Federico Diotallevi, Diego Orsini, Anna Campanati","doi":"10.1007/s13555-025-01435-w","DOIUrl":"10.1007/s13555-025-01435-w","url":null,"abstract":"<p><strong>Introduction: </strong>Several studies have demonstrated that psoriasis severity is generally greater in male patients, but it is unclear whether this gender difference may affect short-term therapeutic response. Notably, no studies have specifically investigated bimekizumab, a humanized, full-length IgG1 monoclonal antibody that acts as a dual inhibitor of interleukin (IL)-17A and IL-17F.</p><p><strong>Methods: </strong>This was a cross-sectional, observational, retrospective, multicenter analysis. A cohort of 318 patients with moderate to severe psoriasis, 229 male patients (median [IQR] age 35 [23-67] years) and 89 female patients (median [IQR] age 33 [20-68] years), were retrospectively evaluated for short-term response (16 weeks) to bimekizumab according to standard dosage (320 mg at weeks 0, 4, 8, 12, and 16, and every 8 weeks thereafter). Patients were assessed to evaluate whether gender differences in demographic and clinical characteristics can affect treatment response to standard dose of bimekizumab, during the first 16 weeks of treatment. Therapeutic outcomes were evaluated by analyzing Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) scores recorded in each patient at three consecutive time points: baseline (T0), after 4 weeks (T4), and after 16 weeks of treatment (T16).</p><p><strong>Results: </strong>Male patients showed more severe disease at baseline, compared to female patients (p = 0.01). A significant reduction in disease severity was observed in both male and female patients after 16 weeks of treatment, but male patients showed a faster decrease in PASI score between baseline and week 4 of treatment compared to female patients (p < 0.001). Nevertheless, by week 16, difference in PASI response and DLQI reduction between genders became less pronounced.</p><p><strong>Conclusion: </strong>Although male patients exhibit greater disease severity at baseline compared to female patients, this does not result in a differential response to bimekizumab over the short term. Both male and female patients had equal probability of achieving complete or near-complete disease remission within the first 4 weeks of treatment, and both maintain this response status through week 16. The therapeutic benefit of bimekizumab may be due to the rapid dual inhibition of IL-17A and IL-17F, which may lead to consistent and robust clinical response across genders, regardless of baseline disease severity. Our results suggest a \"gender severity-invariant effect\" of bimekizumab, highlighting the treatment as rapidly effective in both genders, despite initial differences in disease severity.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1797-1811"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Practical Approach to Chronic Hand Eczema.","authors":"Sophia A Mense, Sawyeh Maher, Raj Chovatiya","doi":"10.1007/s13555-025-01433-y","DOIUrl":"10.1007/s13555-025-01433-y","url":null,"abstract":"<p><p>Chronic hand eczema (CHE) is a multifactorial condition with significant physical, psychological, and socioeconomic burdens. Its complex pathogenesis often does not align with clinical presentation, leading to overlapping etiologic subtypes, including allergic contact dermatitis (ACD), irritant contact dermatitis (ICD), and atopic hand eczema (AHE). While patch testing remains the gold standard for confirming ACD, its clinical utility can be limited owing to frequent subtype overlap, impracticality of allergen avoidance, and practical considerations relating to the process and availability of patch testing itself. This review provides a practical, clinician-oriented framework for managing CHE, emphasizing the importance of clinical judgment in deciding when patch testing is indicated versus when prompt treatment should take priority. We explore the role of patch testing in CHE within the context of real-world practice, incorporating global perspectives where they inform practical clinical decision-making. With the emergence of targeted therapies addressing CHE immunopathogenesis, balancing traditional diagnostic approaches with early, effective treatment is increasingly necessary. A streamlined, patient-centered strategy balancing diagnostic thoroughness with timely interventions may aid clinicians in optimizing outcomes in this complex disease.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1953-1971"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 Evidence for Baricitinib in the Treatment of Atopic Dermatitis and Alopecia Areata: Systematic Literature Review 2020-2023.","authors":"Julien Seneschal, Lgnasi Figueras Nart, Silvia Sabatino, Manny Papadimitropoulos, Srishti Dabral, Anastasia Lampropoulou","doi":"10.1007/s13555-025-01425-y","DOIUrl":"10.1007/s13555-025-01425-y","url":null,"abstract":"<p><strong>Introduction: </strong>Baricitinib is an oral selective Janus kinase 1/2 inhibitor approved for the treatment of the immune-mediated inflammatory skin diseases atopic dermatitis (AD) and alopecia areata (AA). We report the findings of a systematic literature review of real-world outcomes with baricitinib in patients with AD or AA.</p><p><strong>Methods: </strong>Databases, conference proceedings, and other sources were searched for publications covering July to November 2023 that provided real-world evidence in baricitinib-treated patients; extracted study variables included study population characteristics, interventions, and outcomes.</p><p><strong>Results: </strong>In total, 76 publications meeting inclusion criteria were identified, most of which were single-centre studies; 1134 unique patients with AD and 598 unique patients with AA were included. Studies in AD mostly focused on effectiveness outcomes, followed by treatment patterns, patient-reported outcomes, and safety. Most AA publications focused on effectiveness outcomes, followed by safety then treatment patterns.</p><p><strong>Conclusion: </strong>Overall, baricitinib consistently improved the signs and symptoms of AD in patients receiving baricitinib in real-world settings, was effective for the treatment of AA in both adult and paediatric patients and was associated with improvements in patient-reported outcomes. The most common reasons for baricitinib discontinuation in AD were ineffectiveness and adverse events, although discontinuation rates due to adverse events were low. Patients initiating baricitinib for AD had often been treated previously with a biologic and were frequently receiving immunosuppressive and topical treatments before treatment initiation. Treatment discontinuation and prior treatment data were limited for studies in AA, but several studies reported concomitant minoxidil use in patients with AA treated with baricitinib. No new safety signals for baricitinib were observed in patients with AD or AA, and no serious adverse events were reported. In conclusion, real-world data on baricitinib in the treatment of AD and AA support the effectiveness and tolerability reported in clinical trials.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1719-1754"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of JAK Inhibitors in the Management of Vitiligo: A Systematic Review and Meta-analysis.","authors":"Alzahra A Mohammed, Anna S Lengyel, Fanni A Meznerics, István Szondy, Anna Walter, Bence Szabó, Dorottya Pál, Adrienn Bojtor, András Bánvölgyi, Norbert Kiss, Péter Hegyi, Lajos V Kemény, Zsuzsanna Kurgyis","doi":"10.1007/s13555-025-01397-z","DOIUrl":"10.1007/s13555-025-01397-z","url":null,"abstract":"<p><strong>Introduction: </strong>Vitiligo, a chronic skin disease affecting 1-2% of the global population, is associated with significant impairment in quality of life. Current pharmacological treatment options have limited efficacy and considerable side effects. Recent studies have shown promising results when using Janus kinase inhibitors (JAKis). Despite these favourable findings, there remains a critical need for comprehensive data on the efficacy and safety of JAKi in the treatment of vitiligo.</p><p><strong>Methods: </strong>Three databases were searched for studies on patients with vitiligo treated with oral or topical JAKi, with or without conventional therapy. Placebo or vehicle cream were comparators in randomised controlled trials (RCTs). Outcomes included a 75% improvement in Facial-Vitiligo Area Scoring Index (F-VASI), mean Vitiligo Area Scoring Index (VASI) improvement, repigmentation percentage and adverse events. We performed three analyses: one using RCT data, one from case reports and a novel cohort of JAKi-treated patients from case reports. The protocol is registered with PROSPERO (CRD42023445503).</p><p><strong>Results: </strong>Among the 35 articles identified, 19 were included in the statistical analyses. A meta-analysis of three randomised controlled trials (RCTs) on topical Janus kinase inhibitors (JAKis) suggested that patients treated with JAKi were more likely to achieve Facial Vitiligo Area Scoring Index 75 (F-VASI75) than those using vehicle cream (risk ratio (RR) 3.47, 95% confidence interval (CI) 0.98-12.22), with no significant difference in adverse events between groups (RR 1.27; 95% CI 0.88-1.82). A meta-analysis of four single-arm trials showed a 43.8% mean Vitiligo Area Scoring Index (VASI) improvement (95% CI 0.71-0.93). A cohort (n = 28) from case reports and series revealed significant repigmentation increases of 48.7% and 63.7% (p = 0.0018; p < 0.001) in patients treated with JAKi alone or with narrowband ultraviolet B (UVB). However, data were insufficient to determine if combination treatments were superior to JAKi alone.</p><p><strong>Conclusion: </strong>Our systematic review evaluated the efficacy and safety of JAKi for vitiligo using data from RCTs, single-arm trials and case reports. While topical ruxolitinib showed promising but non-significant results in RCTs, single-arm trials and case studies highlighted significant repigmentation, particularly with oral JAKis combined with other therapies. Oral JAKis showed effectiveness but require caution due to potential adverse effects such as immune suppression and cardiovascular risks. Furthermore, it is important to acknowledge that a considerable proportion of patients do not respond to these therapies. Additional RCTs are needed to address long-term safety, optimise application strategies and establish standardised endpoints for combination therapies.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1657-1679"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}