Dermatology and Therapy最新文献

{"title":"Age-Associated Differences in Facial Skin Structure in Chinese Women: a Cross-Sectional Study.","authors":"Chengfeng Zhang, Keming Wang, Lin Gao, Jiewei Wu, Vladimir Melnikov, Yucong Wang, Hequn Wang, Weimin Song, Hang Wang, Zongke Guo, Xiaoqin Wang, Frederic Flament, Bin Yang, Qin Li, Fei Liu, Leihong Xiang","doi":"10.1007/s13555-026-01931-7","DOIUrl":"https://doi.org/10.1007/s13555-026-01931-7","url":null,"abstract":"<p><strong>Introduction: </strong>Facial skin aging is a process leading to structural degradation and visible phenotypical changes. Prior studies examined age-related skin parameters and suggested accelerated changes occurring in the early 30s, yet precise timing remains insufficiently defined, and few assessed their interrelationships across facial zones in Chinese populations.</p><p><strong>Methods: </strong>In this cross-sectional study, 547 Chinese women aged 18-65 years from three cities underwent facial skin assessments using two-photon microscopy (TPM) and high-frequency ultrasound, collecting structural parameters, biophysical measures and clinical phenotypes. Age-related trends were analyzed, and principal component analysis (PCA) was applied to structural parameters in the cheek and eye corner zones to explore associations with surface-level characteristics via multiple linear regression.</p><p><strong>Results: </strong>Key age-associated structural differences included decreased second harmonic generation to autofluorescence aging index of dermis and dermal density, increased elastin-to-collagen ratio, and dermo-epidermal junction flattening becoming prominent in the 36-45-year age group and beyond. Biophysical measurements, such as skin elasticity, hydration and lightness declined with age, while phenotypical aging signs (wrinkle and pigmentation severity) increased. PCA-derived principal component 1 (PC₁) represented dermal integrity and echogenicity, while principal component 2 (PC₂) reflected the elastin-to-collagen profile, explaining 46-48% of the variance of skin aging in our study population. Principal component (PC) logistic regression showed positive association of PC₁ with favorable skin characteristics such as skin elasticity, hydration and lightness, and lower severity of phenotypical aging signs, including wrinkles and hyperpigmentation (p < 0.05). The inverse was true for PC₂ (p < 0.05).</p><p><strong>Conclusions: </strong>This study provides a comprehensive evaluation of age-associated differences in facial skin parameters in Chinese women, revealing structural underpinnings of visible aging signs. The findings highlight zone-specific aging patterns and support the utility of TPM and ultrasound in integrated imaging techniques for dermatological aging assessments and personalized aesthetic interventions.</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":"149126765","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":"Malar Edema after Hyaluronic Acid Dermal Fillers: Expert Recommendations on Etiology, Prevention, and Management.","authors":"Wioletta Baranska-Rybak, José V Lajo-Plaza, Lee Walker, Navid Alizadeh","doi":"10.1007/s13555-026-01920-w","DOIUrl":"https://doi.org/10.1007/s13555-026-01920-w","url":null,"abstract":"<p><p>Malar edema is a relatively common complication following injection of hyaluronic acid (HA) filler into the infraorbital area. The Complication Assessment and Risk Evaluation (CARE) board, established to develop guidelines on prevention and management of adverse reactions after HA filler use, identified malar edema as a priority complication. This review presents the CARE board recommendations on etiology of malar edema, prevention, and management. Malar edema is a result of HA injection interacting adversely with a delicate lymphatic system situated between the orbicularis retaining ligament and zygomaticocutaneous ligament, which has limited drainage and is, therefore, prone to excess fluid accumulation. Risk factors for malar edema include patient-related characteristics, such as older age, previous periorbital surgery, allergies, infection, and certain systemic diseases. Risk factors relating to injection technique include high volume of filler or incorrect placement (e.g. superficial to the malar septum). Fillers should be nonpermanent, with low hydrophilicity and elastic modulus (G'), and should be approved for use in the infraorbital area. Prior to injection, a thorough medical history should be conducted to evaluate patient suitability for treatment. The CARE board has developed a questionnaire to aid patient selection. This should be accompanied by physical examination to assess for existing edema and other abnormalities such as skin laxity. Patients should be fully educated in posttreatment care to avoid development of edema in the weeks following injection. When malar edema develops, management should be tailored to the individual patient and situation. The CARE board provides an algorithm to support the management of malar edema, including clinical assessment, noninvasive treatments, and medication.</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":"149126774","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":"Describing Patient Characteristics, Treatment Patterns, and Disease Burden Among Patients with Alopecia Areata in Mexico: A Secondary Analysis of the Adelphi Real World Alopecia Areata Disease Specific Programme.","authors":"Luis E Sanchez-Duenas, Ashley S Cha-Silva, Peter Anderson, Martha Alicia Aceves-Villalvazo, Veronica J Guajardo-Barron, Carlos A Barrera-Ochoa, Raul A Becerra-Cerecedo, Jorge Alberto Barragan Garfias, William Jones, Samantha K Kurosky, Nelly A Espinoza-Gonzalez","doi":"10.1007/s13555-026-01943-3","DOIUrl":"https://doi.org/10.1007/s13555-026-01943-3","url":null,"abstract":"<p><strong>Introduction: </strong>Alopecia areata (AA) is a common autoimmune disease characterized by nonscarring hair loss, yet real-world data on AA in Mexico are sparse. This study aimed to characterize disease burden and identify unmet treatment needs among patients with AA in Mexico.</p><p><strong>Methods: </strong>Clinical data were analyzed from Adelphi Real World's AA II Mexico Disease Specific Programme™ (October 2024-April 2025), a linked physician and patient cross-sectional survey with retrospective elements. Dermatologists provided clinical and treatment information for eight consecutive patients with AA within prespecified severity quotas (three mild, three moderate, and two severe/very severe). Patients completed the Hospital Anxiety and Depression Scale, the Alopecia Areata Patient Priority Outcomes instrument, and the Skindex-16 AA questionnaire. Analyses were stratified by physician-assessed AA severity (mild, moderate, severe/very severe).</p><p><strong>Results: </strong>Of the 319 patients included, 123 had mild, 112 moderate, and 84 severe/very severe AA. Disease duration, percent scalp hair loss, nonscalp hair loss (eyebrow, eyelash, and body), and hair regrowth at consultation differed significantly across severity groups. Traditional medications, such as intralesional, topical, and oral corticosteroids, were the most frequently prescribed treatments across all severity groups. Physician-reported satisfaction with current treatment decreased with increasing AA severity and was significantly different across severity groups (P < 0.0001). Overall, 23.0% of patients with moderate AA and 29.0% with severe/very severe AA reported satisfaction with their current treatment and believed the best control had been achieved compared with 60.6% of patients with mild AA (P < 0.0001). Patients with severe/very severe AA experienced greater quality-of-life impairment and higher rates of anxiety and depression.</p><p><strong>Conclusion: </strong>This study helps address the gap in real-world evidence on AA in Mexico. The reliance on traditional therapies, combined with low treatment satisfaction among physicians and patients with moderate to very severe AA, suggests a need for improved access to advanced therapies within the Mexican healthcare system.</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":"149126811","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":"Urticaria Voices: Perspectives of Dermatologists and Allergists Regarding Chronic Urticaria Care and Its Treatment in China.","authors":"Zuotao Zhao, Yi Li, Tara Raftery, Nadine Chapman-Rothe, Cristina Constantinescu, Shuang Hao, Ruixin Tan, Pallavi Saraswat, Bin Yang","doi":"10.1007/s13555-026-01938-0","DOIUrl":"https://doi.org/10.1007/s13555-026-01938-0","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic urticaria (CU) causes recurrent itchy wheals (hives), angioedema, or both for > 6 weeks, classified as chronic spontaneous urticaria (CSU) or chronic inducible urticaria (CIndU) based on identifiable trigger presence. China ranks second globally in disability-adjusted life years for urticaria, calling for tailored interventions. This study investigated perceptions of Chinese dermatologists and allergists regarding the disease burden and management in patients with CU.</p><p><strong>Methods: </strong>A cross-sectional online survey (40 min) was conducted among 265 specialists (81% dermatologists, 19% allergists) across China. Eligible physicians had autonomous prescribing authority for all CU treatments including biologics, and active CSU/CIndU caseloads. Participants recalled patient characteristics, burden across life domains, and treatment patterns.</p><p><strong>Results: </strong>Physicians reported that patients consulted a mean of four specialists before diagnosis. At initial assessment, 25% presented with severe/very severe symptoms. Currently, 19% of patients with CSU and 18% with CIndU have inadequately controlled disease (urticaria control test [UCT] < 12). Among these patients, physicians reported substantial burden: 7/10 for mental/emotional and financial domains and 6/10 for social relationships (10 = extreme negative impact). Overall, 61% were assessed as moderately impaired in achieving full life potential. Sleep disturbances affected 44% of all patients with CU. While 93% of physicians prioritize complete symptom control, they believe this is achievable in 59% of patients. Physicians attempt a mean of three antihistamine switches before biologic escalation.</p><p><strong>Conclusions: </strong>Despite recalling ~20% inadequate disease control rates, physicians recognize substantial burden with most patients impaired in achieving life potential. The gap between treatment goals and perceived achievability, combined with diagnostic delays and conservative escalation patterns, highlights opportunities for comprehensive CU management in China.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105457","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":"Canadian Expert Consensus Recommendations on the Use of Photodynamic Therapy in Actinic Keratosis.","authors":"Vimal H Prajapati, Vincent Richer, Megan Sander, Alim R Devani, Sonya Abdulla, Maxwell Sauder, Simon Nigen, Ivan V Litvinov, Charles W Lynde, Jaggi Rao","doi":"10.1007/s13555-026-01949-x","DOIUrl":"https://doi.org/10.1007/s13555-026-01949-x","url":null,"abstract":"<p><strong>Introduction: </strong>Actinic keratosis (AK), a common ultraviolet light-induced keratinocyte neoplasm arising within chronically photodamaged skin, is associated with field cancerization and potential progression to cutaneous squamous cell carcinoma (cSCC). Photodynamic therapy (PDT) is an established field-directed treatment option for AK, but Canadian-specific practical guidance on its use remains limited. This study aimed to develop Canadian expert consensus recommendations on the overall role, positioning, technique, safety, follow-up, and use of PDT as well as PDT use in special sites and populations.</p><p><strong>Methods: </strong>A targeted literature review was conducted using PubMed/MEDLINE for English-language publications from 2005 onward, with the final search run on October 10, 2025. Evidence was used to inform candidate statements across predefined PDT-related domains. Ten Canadian dermatologists with extensive experience with management of AK and use of PDT participated in a structured modified Delphi process, rating statements anonymously over two rounds using a 5-point Likert scale. Consensus was defined a priori as at least 75% agreement or strong agreement.</p><p><strong>Results: </strong>All 10 panelists participated in both Delphi rounds. A total of 25 consensus statements were finalized across six domains: disease framing and need for AK treatment; lesion- versus field-directed treatment strategies for AK management; role and positioning of PDT in AK management; PDT technique and modalities for AK management; PDT for AK management in special sites and populations; and PDT safety, follow-up, and combination strategies. All finalized statements achieved consensus. The panel positioned PDT as an effective field-directed strategy, particularly for non-hypertrophic facial and scalp AKs, with treatment selection guided by disease extent and the need for field cancerization with PDT; efficacy, tolerability, cosmetic outcome, and access to PDT; and patient preference for PDT.</p><p><strong>Conclusion: </strong>This Canadian expert consensus supports PDT as a practical field-directed strategy for appropriately selected patients with AK, while emphasizing individualized care, shared decision-making, realistic expectations for chronic disease management, and ongoing follow-up. Further research is needed to clarify re-treatment intervals, outcomes for special sites and populations, and optimal combination strategies.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105429","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":"Systemic Retinoids in Cutaneous T-Cell Lymphoma: A Scoping Review of Clinical Use and Evidence Gaps.","authors":"Toan Bui, Keon Niknejad, Nicholas Urbanski, Derya Goksu Fidan, Zachary Wolner, Sima Rozati","doi":"10.1007/s13555-026-01926-4","DOIUrl":"https://doi.org/10.1007/s13555-026-01926-4","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic retinoids are ubiquitously used in cutaneous T-cell lymphoma (CTCL), often in combination with skin-directed or systemic therapies, yet their role within contemporary multimodal treatment strategies has not been comprehensively synthesized.</p><p><strong>Methods: </strong>We conducted a PRISMA-ScR-guided scoping review of systemic retinoids in CTCL using PubMed, Embase, Scopus, Web of Science, and the Cochrane Library through December 1, 2025. Study-level and treatment arm-level analyses characterized treatment patterns, outcomes, and reporting practices. Reported response rates were descriptively summarized after excluding case reports and case series.</p><p><strong>Results: </strong>A total of 141 studies comprising 153 treatment arms and 3805 participants with CTCL were included. Bexarotene was the most frequently studied retinoid (113/153, 73.9%), and combination therapy predominated (100/153, 65.4%). Retinoids were used across the treatment continuum, most frequently in salvage settings (85/153, 55.6%). Among treatment arms with reported stage, advanced-stage disease more frequently incorporated bexarotene-containing combination regimens than early-stage disease (80.7% vs 50.0%; p = 0.017). Among 59 overall response rate (ORR) observations from observational studies and clinical trials, median reported ORR was 60.0% for combination therapy and 51.5% for monotherapy; by individual retinoid, median reported ORRs were 56.6% for bexarotene, 59.5% for acitretin, and 57.0% for isotretinoin. Durability and safety reporting remained inconsistent, with progression-free survival and grade ≥ 3 adverse events reported in only 13.1% and 32.0% of treatment arms, respectively.</p><p><strong>Conclusions: </strong>Systemic retinoids remain versatile and clinically relevant components of contemporary CTCL management. Rather than functioning primarily as standalone therapies, they are commonly incorporated into multimodal treatment strategies across disease stages and therapeutic settings, with reported clinical activity across individual agents and both monotherapy and combination approaches. Heterogeneity across studies precludes comparative efficacy conclusions and underscores the need for standardized response assessment, durability endpoints, and comprehensive safety and demographic reporting.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105313","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":"Lifestyle-Driven Phenotypes in Sensitive Skin: A Cross-Sectional, Multicenter Study Across Urbanization Tiers.","authors":"Jade Conway, Irina Berlin, Céline Blanché, Mathieu Grivet-Seyve, Haw Diann Wai, Nicolas Joly Tonetti, Adam Friedman, Krzysztof Piotrowski, Nadège Lachmann, Aaron S Farberg","doi":"10.1007/s13555-026-01946-0","DOIUrl":"https://doi.org/10.1007/s13555-026-01946-0","url":null,"abstract":"<p><strong>Introduction: </strong>Sensitive skin is shaped by intrinsic physiology and environmental exposures, yet how concurrent lifestyle factors modulate its expression remains poorly characterized. This study examined how differing environmental and lifestyle conditions influence sensitive skin phenotypes through clinical evaluation, biophysical measurements, and biomarker profiling.</p><p><strong>Methods: </strong>A cross-sectional, multicenter study enrolled 151 women (aged 35-50 years) into three groups based on environmental and lifestyle factors: non-sensitive highly urbanized lifestyle (NS-1), sensitive skin highly urbanized lifestyle (SSS-1), and sensitive skin moderately urbanized lifestyle (SSS-2). Lifestyle classification was defined using three concomitantly considered indicators: pollution exposure, sleep quality, and psychological stress. Tier 1 PM_2.5 (21.3-28.9 μg/m³) exceeded tier 2 levels (17.2-23.8 μg/m³), both surpassing World Health Organization (WHO) guidelines. 100% of SSS-1 individuals slept < 7 h/night with stress scores ≥ 18; 100% of SSS-2 individuals slept > 7 h/night with stress scores ≤ 14. Assessments included clinical grading, VISIA-CR imaging, bioinstrumentation, and biomarker analysis.</p><p><strong>Results: </strong>In the intrinsic-biology comparison (SSS-1 vs. NS-1), sensitive skin was associated with significantly elevated prostaglandin E₂ (PGE₂) (23.5% higher) and protein carbonylation (17.9% higher), along with 7.9% greater skin tone heterogeneity and 38.0% higher dark spot density. In the lifestyle comparison (SSS-1 vs. SSS-2), highly urbanized living was associated with 185.0% higher PGE₂, 22.5% increased sebum, and 7.5% greater pore visibility, while moderately urbanized high-ultraviolet (UV) conditions were linked to 27.8% higher pigmentation and 27.3% elevated oxidative stress.</p><p><strong>Conclusion: </strong>In this cross-sectional cohort, sensitive skin was associated with elevated protein carbonylation and greater pigmentary reactivity relative to non-sensitive skin under matched highly urbanized conditions. PGE₂, by contrast, tracked with highly urbanized living rather than with skin sensitivity: highest in the urban groups and lowest in the moderately urbanized cohort. Highly urbanized living was associated with greater inflammatory activity and sebum production, whereas the moderately urbanized, high-UV setting was associated with greater oxidative stress and hyperpigmentation. Because the design is cross-sectional and the two cities differ in multiple environmental factors, these findings are associative and hypothesis-generating and support further study of personalized, context-specific management.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105467","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":"Comparative Pharmacologic Characterization of Povorcitinib (INCB054707) as a Highly Selective Oral JAK1 Inhibitor.","authors":"Brittney Wass, Aidan M Fenix, Nina Zolotarjova, Alex Margulis, Guofeng Zhang, Dominic Sales, Maryanne Covington, Leandro L Santos, Chryssa Kanellopoulou, Ricardo Macarrón","doi":"10.1007/s13555-026-01910-y","DOIUrl":"https://doi.org/10.1007/s13555-026-01910-y","url":null,"abstract":"<p><strong>Introduction: </strong>The Janus kinase/signal transducer and activator of transcription (JAK-STAT) pathways mediate signaling by multiple cytokines and growth factors critical for inflammation and immune regulation. Povorcitinib (INCB054707) is an oral JAK1 inhibitor designed to achieve high selectivity over JAK2 and minimize off-target hematologic effects. This study comprehensively assessed the in vitro selectivity and potency of povorcitinib relative to the JAK inhibitors upadacitinib, abrocitinib, baricitinib, and tofacitinib.</p><p><strong>Methods: </strong>Povorcitinib and comparator compounds were characterized using enzymatic assays, full kinome profiling across 370 kinases, cytokine reporter assays, human whole-blood STAT phosphorylation assays, and cell viability studies.</p><p><strong>Results: </strong>Povorcitinib demonstrated potent, selective JAK1 inhibition with minimal activity against JAK2, JAK3, and TYK2, showing ≥ 50-fold selectivity over JAK2 in most assays, exceeding that of other JAK inhibitors. Kinome screening confirmed minimal off-target activity. In cell-based assays, povorcitinib selectively inhibited interleukin (IL)-6- and IL-2-mediated JAK1 signaling with minimal inhibition of thrombopoietin (TPO)-mediated JAK2 signaling, achieving up to 52-fold functional JAK1 selectivity in cytokine reporter assays and greater than tenfold selectivity in human whole blood. In contrast, other selective JAK1 inhibitors, such as upadacitinib, displayed near-equipotent JAK1/JAK2 inhibition in whole-blood assays. Povorcitinib displayed no cytotoxicity at concentrations > 5000 nM in HEK293, HEPG2, HUVEC, and HLF cells, which are JAK-independent. Across orthogonal assays, povorcitinib consistently exhibited the highest JAK1 selectivity among the JAK inhibitors evaluated.</p><p><strong>Conclusions: </strong>These data, together with its favorable pharmacokinetic and emerging clinical safety profile, highlight the potential for povorcitinib as a highly selective, next-generation JAK1 inhibitor.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105490","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":"Monitoring the Response to JAK Inhibitor Treatment in Alopecia Areata Using Reflectance Confocal Microscopy and Videotrichoscopy: A 60-Week Observational Study.","authors":"Kinga Kołcz, Jagienka Włodyka, Adam Reich","doi":"10.1007/s13555-026-01928-2","DOIUrl":"https://doi.org/10.1007/s13555-026-01928-2","url":null,"abstract":"<p><strong>Introduction: </strong>Alopecia areata (AA) is an autoimmune disease affecting approximately 2.1% of the population. JAK inhibitors represent a therapeutic breakthrough for severe AA, yet objective tools for monitoring treatment response remain limited. The objective of this study was to correlate trichoscopic and reflectance confocal microscopy (RCM) features with clinical changes in patients with severe AA treated with JAK inhibitors (upadacitinib and baricitinib) over 60 weeks.</p><p><strong>Methods: </strong>Twenty patients with severe AA were enrolled. Patients were treated with upadacitinib 15 mg/day or baricitinib 4 mg/day. Clinical (Severity of Alopecia Tool score), trichoscopic, and RCM evaluations were performed at baseline and every 12 weeks thereafter.</p><p><strong>Results: </strong>Mean Severity of Alopecia Tool (SALT) decreased from 85% at baseline to 17% at week 60. Upadacitinib treated patients showed faster early response (32.6%% SALT reduction at week 12 vs. 5.2% increase with baricitinib), though both groups achieved comparable outcomes by week 60 (SALT 17%). Trichoscopy showed progressive reduction of activity markers: (yellow dots, black dots, broken hairs, and exclamation mark hairs) with characteristic regrowth sequence: short vellus hairs, upright regrowing hairs, terminal hairs. RCM identified three parameter categories: (1) inflammatory activity markers (epidermal infiltration, bright rimming, luminal bright material, cadaverised hairs), with persistent diffuse follicular inflammation and perifollicular muffle; (2) transient collagen remodelling features without fibrosis; and (3) recovery markers, including follicular normalisation (strongest RCM predictor of response) and vellus-to-terminal transition.</p><p><strong>Conclusions: </strong>JAK inhibitors demonstrated sustained efficacy in severe AA. Multimodal assessment combining SALT, trichoscopy, and RCM enables precise biological response monitoring. RCM uniquely detects subclinical perifollicular inflammation persisting despite clinical improvement, potentially predicting relapse risk after treatment discontinuation.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105460","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":"D-CARE (Delgocitinib-Chronic hAnd Eczema Response Evaluation): A Retrospective, Multicenter, Real-World Study of Patients with Chronic Hand Eczema (CHE) Treated with Delgocitinib 2% Cream-Temporal Analysis of Symptom and Clinical Sign Response.","authors":"Maddalena Napolitano, Martina Turco, Luca Potestio, Paolo Romita, Eustachio Nettis, Maria Carla Pisani, Maria Mariano, Mattia Cristallo, Martina Fico, Flavia Pigliacelli, Francesca di Vico, Maria Concetta Fargnoli, Cataldo Patruno","doi":"10.1007/s13555-026-01929-1","DOIUrl":"https://doi.org/10.1007/s13555-026-01929-1","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic hand eczema (CHE) is a frequent and often refractory inflammatory skin disease with a substantial impact on quality of life. Delgocitinib 2% cream has demonstrated efficacy in phase 3 trials, but real-world evidence remains limited. This study evaluated its effectiveness and the temporal dynamics of clinical and symptomatic response in patients with CHE.</p><p><strong>Methods: </strong>This multicenter, retrospective observational study included 58 adults with CHE treated with delgocitinib 2% cream and followed for 16 weeks. Clinical severity and patient-reported outcomes were assessed at baseline, week 4, and week 16. Changes in the Hand Eczema Severity Index (HECSI), global assessment scores, pruritus, pain, and quality of life were analyzed, together with the evolution of individual HECSI components across anatomical regions.</p><p><strong>Results: </strong>All clinical and patient-reported outcomes improved significantly during follow-up (all p < 0.001). Mean HECSI decreased from 71.5 ± 29.2 at baseline to 19.5 ± 15.1 at week 4 and 6.8 ± 8.9 at week 16. Pruritus and pain both showed marked reductions during follow-up. At week 4, mean vesicle and edema scores were 0.0-0.1 across anatomical regions, while desquamation remained 1.0 ± 1.1 at the fingertips and fingers; at week 16, fissure scores were 0.2 and 0.3 and desquamation scores were 0.4 and 0.3 at the fingertips and fingers, respectively. Quality of life also improved substantially. Two patients (3.4%) experienced adverse events leading to treatment discontinuation.</p><p><strong>Conclusions: </strong>Delgocitinib 2% cream showed rapid and clinically meaningful real-world effectiveness in CHE. Inflammatory signs improved earlier than chronic structural features such as fissures and desquamation. These differential response kinetics may help clinicians interpret early partial responses and counsel patients regarding expected treatment timelines.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105437","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}