Dermatology and Therapy最新文献

{"title":"Tralokinumab Versus Dupilumab for the Treatment of Atopic Dermatitis with Moderate-to-Severe Hand Involvement: A Matching-Adjusted Indirect Comparison.","authors":"April Armstrong, Leon Kircik, Andrei Metelitsa, Richard B Warren, Adrian Rodriguez, Sebastian Volc, Naiem Issa, Raj Chovatiya, Rie von Eyben, Teodora Festini, Pierre Johansen, Benjamin Ehst","doi":"10.1007/s13555-026-01922-8","DOIUrl":"https://doi.org/10.1007/s13555-026-01922-8","url":null,"abstract":"<p><strong>Introduction: </strong>Both tralokinumab and dupilumab have shown efficacy in atopic dermatitis (AD) with moderate-to-severe hand involvement in double-blind phase 3 trials. As there are no head-to-head studies of tralokinumab and dupilumab, an anchored matching-adjusted indirect comparison (MAIC) was conducted.</p><p><strong>Methods: </strong>In the ADHAND trial, adults with AD with moderate-to-severe hand involvement were randomised to tralokinumab 300 mg or placebo every 2 weeks for 16 weeks. In the LIBERTY-AD-HAFT trial, adults and adolescents (≥ 12 years) with moderate-to-severe AD with hand and/or foot involvement were randomised to dupilumab 300 mg or placebo every 2 weeks for 16 weeks. An anchored MAIC was conducted using individual patient data from ADHAND weighted to match aggregate data for age, sex, race, and baseline Hand Eczema Severity Index (HECSI) score from LIBERTY-AD-HAFT, with placebo as the common anchor. Endpoints compared at week 16 were proportions of patients with Investigator's Global Assessment scores of 0/1, HECSI-75 and HECSI-90, and percent reductions in HECSI and the Routine Activity Impairment domain of the Work Productivity and Activity Index. Reductions in itch and pain and proportions of patients with ≥ 4-point itch improvement were also compared.</p><p><strong>Results: </strong>LIBERTY-AD-HAFT included 133 patients (dupilumab, n = 67, placebo, n = 66) while ADHAND included 235 patients (tralokinumab, n = 156; placebo, n = 79). The effective sample size after matching was 99 (tralokinumab, n = 76, placebo, n = 23). Anchor-adjusted relative treatment differences significantly favoured tralokinumab compared with dupilumab for the proportions of patients achieving HECSI-90 (17.5% [95% CI 0.8, 34.2]; p = 0.040) and decrease in percent routine activity impairment (16.0% [95% CI 4.8, 27.1]; p = 0.005). Relative differences for other endpoints favoured tralokinumab over dupilumab but were not significantly different between treatments.</p><p><strong>Conclusion: </strong>In this anchored MAIC, tralokinumab was associated with a higher placebo-adjusted response than dupilumab, with a higher proportion achieving HECSI-90, and a significantly greater improvement in ability to perform regular daily activities versus dupilumab. Other endpoints were numerically in favour of tralokinumab. Graphical abstract and video abstract available for this article.</p><p><strong>Clinical trial registration: </strong>NCT05958407, NCT04417894. Video Abstract (MP4 112997 KB).</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":"149105260","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 of Apremilast in Patients with Psoriasis with Limited Skin Involvement, Including High-Impact Site Involvement: A Pooled Analysis of Six Trials.","authors":"Bruce Strober, Mark Lebwohl, Peter van de Kerkhof, Linda Stein Gold, Joseph F Merola, Yukari Okubo, Paolo Gisondi, Zhenwei Zhou, Siddharth Chaudhari, Cynthia Deignan, Ulrich Mrowietz","doi":"10.1007/s13555-026-01921-9","DOIUrl":"https://doi.org/10.1007/s13555-026-01921-9","url":null,"abstract":"<p><strong>Introduction: </strong>Plaque psoriasis is associated with decreased quality of life (QOL) even in patients with limited skin involvement, particularly those with high-impact site (HIS) involvement. The efficacy of apremilast in patients with plaque psoriasis has been demonstrated in phase 3 and 4 clinical trials. Here, we evaluated the efficacy of apremilast across six clinical trials for patients with psoriasis with low affected body surface area (BSA), including patients with HIS involvement.</p><p><strong>Methods: </strong>Data were pooled across five randomized, double-blind, placebo-controlled trials (patients were randomized to apremilast or placebo until week 16, followed by open-label apremilast) and one single-arm, open-label trial of apremilast for the treatment of plaque psoriasis. Patients in this post hoc pooled analysis had limited skin involvement (BSA, 3-10%), many with HIS involvement in the scalp, genital area, and/or nails. Week 16 and 32 assessments included BSA, Psoriasis Area and Severity Index (PASI), static Physician's Global Assessment, Dermatology Life Quality Index, and HIS-specific measurements. Nonresponder imputation was used for missing data for binary endpoints; a mixed-effects model for repeated measures was used to analyze continuous endpoints.</p><p><strong>Results: </strong>Of 1152 patients in this analysis (mean BSA, 6.3%; PASI, 6.8), those who received apremilast (n = 671) versus placebo (n = 481) had significantly greater improvements in skin clearance and QOL at week 16 (all endpoints assessed, p < 0.0001), with improvements generally maintained at week 32. Apremilast also yielded clinically greater improvements in patients with scalp, genital, and/or nail psoriasis at week 16 versus placebo (all endpoints assessed in affected patients, p < 0.01), with responses generally maintained at week 32.</p><p><strong>Conclusion: </strong>Apremilast improved skin clearance and QOL at week 16, and responses were generally maintained at week 32, in a pooled population of patients with psoriasis with limited skin involvement, including HIS involvement. Graphical abstract available for this article. Trial Registration ClinicalTrials.gov identifiers-NCT03721172, NCT03777436, NCT03123471, NCT03774875, NCT02425826, and NCT03930186.</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":"149105426","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":"Baricitinib Efficacy Through 4 Years in Responders and Safety up to 5 Years in Adults with Severe Alopecia Areata: Final Results from BRAVE-AA1 and BRAVE-AA2.","authors":"Ruth Ann Vleugels, Bianca Maria Piraccini, Natasha Mesinkovska, Arash Mostaghimi, Yutaka Shimomura, Angelina Sontag, Fionn McSwiney, Najwa Somani, Hitendra Pandey, Karen Denning, Brett King","doi":"10.1007/s13555-026-01886-9","DOIUrl":"https://doi.org/10.1007/s13555-026-01886-9","url":null,"abstract":"<p><strong>Introduction: </strong>Long-term efficacy and safety data are imperative for therapies used to treat severe alopecia areata (AA) because the disease is chronic, loss of response can be devastating to patients, and the safety profile needs to support long-term therapy. Baricitinib, a selective JAK inhibitor, has been approved for severe AA in adults and is being studied in pediatric patients. This study evaluates the final long-term efficacy and safety of baricitinib in adults with severe AA.</p><p><strong>Methods: </strong>Efficacy was assessed for patients randomized to baricitinib 4 mg or 2 mg who achieved response (Severity of Alopecia Tool [SALT] score ≤ 20) at Week 52 (4 mg, N = 133; 2 mg, N = 72) and stayed on the same dose through Week 200. Proportions of patients maintaining a SALT score ≤ 20 and achieving a Clinician-Reported Outcome Measure for Eyebrow/Eyelash (EB/EL) Hair Loss™ score of 0 or 1 with ≥ 2-point improvement from baseline were reported using the modified last-observation-carried-forward method. Safety is reported as incidence rates (IR) per 100 patient-years at risk for the All BARI AA group (N = 1303) and Extended BARI AA group (N = 948) through 248 weeks of exposure RESULTS: For baricitinib 4 mg and 2 mg, respectively, among Week 52 responders, 115/133 (86.5%) and 61/72 (84.7%) maintained a SALT score ≤ 20 at Week 200. Regrowth of EB/EL hair continued beyond Week 52 and was maintained through Week 200. In up to 5 years of exposure with baricitinib, the IR for serious infections, nonmelanoma skin cancer malignancies, deep vein thrombosis/pulmonary embolism, and major adverse cardiovascular events remained low relative to background rates. No deaths occurred, and adverse event rates remained stable over time.</p><p><strong>Conclusions: </strong>Within this population, ~ 85% of responders maintained SALT scores ≤ 20 through approximately 4 years with continued benefit for EB/EL. Baricitinib's safety profile remained consistent over 5 years of treatment, in line with prior BRAVE program findings.</p><p><strong>Trial registration number: </strong>BRAVE-AA1, ClinicalTrials.gov number, NCT03570749, start date, September 24, 2018; BRAVE-AA2, ClinicalTrials.gov number, NCT03899259, start date, July 8, 2019.</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":"149105421","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 Evidence of Upadacitinib in Atopic Dermatitis after Inadequate Response or Intolerance to Dupilumab: The CAN UpTIMISE Study.","authors":"Vimal H Prajapati, Vipul Jain, Melinda J Gooderham, Michael Cecchini, Jason K Lee, Charles W Lynde, Parbeer Grewal, Andrew Ferrier, David Préfontaine, Carly Sterling, H Chih-Ho Hong","doi":"10.1007/s13555-026-01907-7","DOIUrl":"10.1007/s13555-026-01907-7","url":null,"abstract":"<p><strong>Introduction: </strong>Upadacitinib and dupilumab are both approved treatments for moderate-to-severe atopic dermatitis (AD). Some dupilumab-treated patients may experience an inadequate response and/or safety/tolerability issues. Real-world data on the effectiveness of upadacitinib in this population remain limited. The objective was to evaluate the effectiveness and safety of upadacitinib in adults diagnosed with moderate-to-severe AD who were inadequate responders to dupilumab or discontinued dupilumab for safety/tolerability reasons.</p><p><strong>Methods: </strong>CAN UpTIMISE was a Canadian prospective, observational study in adults treated with dupilumab for moderate-to-severe AD with a decision to switch to upadacitinib (15/30 mg), per local label. Effectiveness was assessed over 4 months using the validated Investigator Global Assessment for AD (vIGA-AD), facial IGA, Eczema Area and Severity Index (EASI), Worst Pruritus Numerical Rating Scale (WP-NRS), Dermatology Life Quality Index (DLQI), and Patient Oriented Eczema Measurement (POEM). Results are presented using descriptive statistics.</p><p><strong>Results: </strong>Among 108 patients (94.4% with vIGA-AD ≥ 2), 83.3% discontinued dupilumab due to inadequate effectiveness and 16.7% discontinued due to safety/tolerability reasons. At month 4, 65.9% (95% CI 55.1-75.2) achieved vIGA-AD 0/1 by observed case analysis (primary outcome), with improvements evident as early as month 1. At month 4 after upadacitinib initiation, 90.2%, 82.9%, and 52.4% of patients achieved EASI ≤ 7, ≤ 3, and ≤ 1, respectively; 70.5% with baseline WP-NRS > 4 had ≥ 4-point reduction and 46.7% reported WP-NRS 0/1. DLQI and POEM scores improved similarly, with 36.0% and 34.3%, respectively, achieving scores indicating no impact or clear/almost clear disease. Minimal disease activity (EASI ≤3 and WP-NRS 0/1) was reached by 43.8% of patients. Upadacitinib was generally well tolerated and no new safety signals were identified.</p><p><strong>Conclusions: </strong>Upadacitinib provided rapid, clinically meaningful, and generally sustained improvements in disease activity, itch, and quality of life, supporting its role as an effective and well-tolerated treatment for patients with inadequate response or intolerance to dupilumab in real-world practice. Graphical abstract available for this article.</p><p><strong>Trial registration: </strong>NCT05394792.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"5195-5214"},"PeriodicalIF":4.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954895","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":"Correction: Effectiveness and Tolerability of Low-Dose Micronized Isotretinoin in Patients with Severe Recalcitrant Nodular Facial Acne in India: A Real-World Retrospective Study Using Electronic Medical Records.","authors":"Byalakere S Chandrashekar, Maya Vedamurthy, Seetharamanjaneyulu Kolalapudi, Vijaya Bhaskar Mallela, Shahnaz Arsiwala, Anil Ganjoo, Abir Saraswat, Farida Modi, Sowmya C Sujatha, Satish Udare, Surajit Gorai, Mukesh Gabhane, Bhavesh Lalan, Gaurang Jani, Aditi Jain, Shruti Dharmadhikari, Chintan Khandhedia, Prashant Devkare, Amey Mane, Asif Shaikh, Suyog Mehta","doi":"10.1007/s13555-026-01904-w","DOIUrl":"10.1007/s13555-026-01904-w","url":null,"abstract":"","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"4945-4946"},"PeriodicalIF":4.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896736","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":"Modern Therapies for Discoid Lupus Erythematosus: A Narrative Review.","authors":"Anshu Jonnalagadda, Rhys L Richmond, Gaurav N Pathak, Amar D Desai, Ummuguslum Yildiz-Altay, Jeffrey R Gehlhausen, Matthew D Vesely","doi":"10.1007/s13555-026-01888-7","DOIUrl":"10.1007/s13555-026-01888-7","url":null,"abstract":"<p><strong>Background: </strong>Discoid lupus erythematosus (DLE) is the most common chronic form of cutaneous lupus erythematosus and can lead to scarring, dyspigmentation, and permanent alopecia. The disease often causes visible disfigurement and has a substantial psychosocial impact. Although many patients respond to standard treatment, a subset continues to experience persistent or relapsing disease that remains difficult to control.</p><p><strong>Methods: </strong>A focused literature search was performed using PubMed, Google Scholar, Web of Science, and Scopus to identify English-language studies published from January 1990 through October 2025. Search terms included \"discoid lupus erythematosus,\" \"cutaneous lupus erythematosus,\" \"chronic cutaneous lupus,\" \"pathogenesis,\" \"therapy,\" \"antimalarial,\" \"immunosuppressant,\" \"biologic therapy,\" \"JAK inhibitor,\" \"small molecule therapy,\" and \"targeted therapy.\" Recent clinical trials, consensus guidelines, and review articles were prioritized. Reference lists of key publications were manually screened to capture additional relevant studies.</p><p><strong>Results: </strong>Current first-line topical pharmacotherapeutic treatment options of DLE include photoprotection, topical corticosteroids, and calcineurin inhibitors for localized disease, and antimalarial therapy as a first-line systemic treatment. For refractory disease, systemic immunosuppressants remain common second-line options. Emerging therapies targeting interferon and cytokine signaling pathways, including anifrolumab, belimumab, and tyrosine kinase (TYK2) inhibitors such as deucravacitinib and the plasmacytoid dendritic cell modulators litifilimab and daxdilimab have shown early promise in improving cutaneous disease activity in patients with refractory DLE. Procedural modalities such as laser therapy are being studied as adjuncts for scarring and dyspigmentation.</p><p><strong>Conclusions: </strong>Ongoing advances in understanding the immune mechanisms underlying DLE are shaping a transition from broad immunosuppression toward more targeted treatment strategies. Integrating newer biologic and small-molecule therapies with conventional management may offer improved control and better long-term outcomes for patients with chronic disease.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"4857-4872"},"PeriodicalIF":4.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789409","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 Effectiveness and Safety of 12 Months of Tralokinumab in Patients with Atopic Dermatitis.","authors":"April W Armstrong, Ahmed Ameen, Silvia Ferrucci, José-Juan Pereyra-Rodríguez, Michael J Cork, Cory Rubin, Abel Jarell, Alessandra Narcisi, Pierre-Andre Becherel, Jennifer Beecker, Teodora Festini, Ida Vittrup, Frank Vinther, Diamant Thaçi","doi":"10.1007/s13555-026-01869-w","DOIUrl":"10.1007/s13555-026-01869-w","url":null,"abstract":"<p><strong>Introduction: </strong>Atopic dermatitis (AD) is a chronic, inflammatory skin condition in which interleukin (IL)-13 is a key driver. Tralokinumab, an IL-13-targeting monoclonal antibody, has demonstrated efficacy and a favorable safety profile in patients with moderate-to-severe AD in phase 3 trials. However, data on long-term effectiveness and safety in routine clinical practice remain limited. This study aimed to assess changes in clinical signs and symptoms of AD and evaluate safety in patients treated with tralokinumab in a real-world setting.</p><p><strong>Methods: </strong>TRACE is an international, non-interventional, prospective study of adults with AD prescribed tralokinumab and followed for up to 12 months of treatment. The primary outcome was investigator-assessed AD severity (Investigator's Global Assessment [IGA], Eczema Activity and Severity Index [EASI], and/or SCORing AD [SCORAD]). Patient-reported outcomes (PROs) were collected if part of routine practice. Safety was also assessed.</p><p><strong>Results: </strong>A total of 824 patients (mean age 44.1 years; 24.9% with prior biologic therapy) were included. At baseline, 414 (50.3%) patients had moderate AD (IGA 3), 281 (34.1%) had severe AD (IGA 4), mean EASI was 20.1, and mean SCORAD was 47.1. Early improvements in AD clinical signs and symptoms were sustained over 12 months of treatment with tralokinumab, with the percentage of composite responders (IGA 0/1, EASI-75, or SCORAD < 10) increasing from 5.3% at baseline to 79.1% at month 12. Rapid and sustained improvements in PROs were also reported throughout the study. AEs were reported by 232 (28.1%) patients, with the majority being non-serious and mild or moderate in severity. Conjunctivitis was reported in 4.4% of patients.</p><p><strong>Conclusions: </strong>TRACE is the largest real-world study of tralokinumab to date. Treatment with tralokinumab over 12 months substantially improved signs and symptoms of AD as well as PROs across all outcome measures, providing evidence supporting the rapid and long-term effectiveness of tralokinumab. No new safety signals were identified.</p><p><strong>Trial registration: </strong>EU PAS register-EUPAS44659.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"4993-5011"},"PeriodicalIF":4.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789342","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":"Expert Consensus on the Role of Dermocosmetics in Acne Management in the United Arab Emirates.","authors":"Ahmed Ameen, Ayman Alnaeem, Ahmed Aldhaheri, Ashraf Reda, Fatima Albreiki, Huda Rajab Ali, Hussein Abdel Dayem, Jawaher Alnaqbi, Mariam Al Suwaidi, Meera Al Adawi, Raghda Al Maashari, Sahar Al Nowais, Jerry Tan, Muna Al Murrawi","doi":"10.1007/s13555-026-01903-x","DOIUrl":"10.1007/s13555-026-01903-x","url":null,"abstract":"<p><strong>Introduction: </strong>Acne is a chronic inflammatory skin disorder with multiple pathogenic pathways. The aim of this initiative was to develop United Arab Emirates (UAE)-specific consensus statements supporting the clinical integration of dermocosmetics into acne management.</p><p><strong>Methods: </strong>An expert panel comprising 13 eminent dermatologists practicing in the UAE completed a pre-meeting survey on local acne management practices, followed by a meeting to appraise the proposed consensus statements. Consensus required a ≥ 70% level of agreement through anonymous online voting.</p><p><strong>Results: </strong>According to the pre-meeting survey, most patients with acne were aged 13-35 years. Acne-induced hyperpigmentation and scarring were the most common complications. Despite their potential benefits, dermocosmetics were underutilized in routine clinical practice. Some dermocosmetics contain dermatologically active ingredients with clinical evidence supporting benefits in acne-prone skin, particularly for barrier support, tolerability, oil control, photoprotection, maintenance, and adherence. In total, the expert panel developed seven consensus statements that endorsed the value of dermocosmetics as: (1) initial therapy in mild acne, (2) adjuvant therapy to enhance tolerability and adherence in moderate-to-severe acne, and (3) maintenance therapy to sustain remission and prevent relapse. They highlighted its benefits in acne-induced hyperpigmentation, especially in darker phototypes and oilier skin phenotypes, which are common in the UAE. Additionally, the expert panel advocated for individualized treatment strategies according to the need, skin type, and acne severity of each patient.</p><p><strong>Conclusion: </strong>To our knowledge, this represents the first UAE-specific consensus guiding the integration and standardization of dermocosmetics into acne management. The statements are aligned to international standards and can be adapted to other regions sharing similar characteristics as UAE.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"5099-5116"},"PeriodicalIF":4.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850163","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":"The Circadian Skin: Chronobiology as a New Frontier in Dermatological Therapy.","authors":"Diala Haykal","doi":"10.1007/s13555-026-01908-6","DOIUrl":"10.1007/s13555-026-01908-6","url":null,"abstract":"<p><p>The skin is a temporally dynamic organ governed by intrinsic molecular clocks operating across multiple cell types. Circadian regulation influences epidermal renewal, barrier function, pigmentation, immune activity, DNA damage responses, and wound repair. This narrative review critically summarizes current mechanistic, translational, and clinical evidence linking the cutaneous circadian clock to skin physiology and selected dermatological diseases and evaluates the emerging concept of chronodermatology. A targeted literature search of PubMed/MEDLINE and reference lists of relevant articles was used to identify foundational and recent studies addressing cutaneous clock mechanisms, melanoma, atopic dermatitis, psoriasis, wound healing, photobiology, and chronotherapeutic strategies. Evidence was strongest for intrinsic circadian oscillation in skin cells, time-dependent epidermal and DNA-repair biology, and rhythmic wound-healing processes; however, many proposed therapeutic applications remain supported primarily by preclinical, observational, or early translational data. Chronodermatology therefore represents a promising framework for investigating treatment timing and individualized temporal biology, but prospective human trials are required before routine time-specific prescribing, photoprotection, or clock-targeted therapy can be recommended.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"4887-4896"},"PeriodicalIF":4.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905382","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":"Effectiveness and Tolerability of Low-Dose Micronized Isotretinoin in Patients with Severe Recalcitrant Nodular Facial Acne in India: a Real-World Retrospective Study Using Electronic Medical Records.","authors":"Byalakere S Chandrashekar, Maya Vedamurthy, Seetharamanjaneyulu Kolalapudi, Vijaya Bhaskar Mallela, Shahnaz Arsiwala, Anil Ganjoo, Abir Saraswat, Farida Modi, Sowmya C Sujatha, Satish Udare, Surajit Gorai, Mukesh Gabhane, Bhavesh Lalan, Gaurang Jani, Aditi Jain, Shruti Dharmadhikari, Chintan Khandhedia, Prashant Devkare, Amey Mane, Asif Shaikh, Suyog Mehta","doi":"10.1007/s13555-026-01841-8","DOIUrl":"10.1007/s13555-026-01841-8","url":null,"abstract":"<p><strong>Introduction: </strong>Severe recalcitrant nodular facial acne is a chronic inflammation with considerable psychosocial impact. Conventional oral isotretinoin is effective, but optimal absorption necessitates dietary compliance. Micronized formulations improve bioavailability and allow flexible dosing. This study evaluated the effectiveness and tolerability of low-dose micronized isotretinoin.</p><p><strong>Methods: </strong>This real-world, retrospective, multicenter, observational study analyzed aggregated and anonymized electronic medical records (EMRs) collected over approximately 12 months from patients aged ≥ 12 years with severe recalcitrant nodular facial acne who were treated with low-dose micronized isotretinoin for ≥ 8 weeks. The primary endpoint was improvement in acne severity [in terms of Investigator's Global Assessment (IGA) score] from baseline to 8 ± 2 weeks. Secondary endpoints included improvement at the end of treatment, investigator-graded response, and incidence of adverse events (AEs; serious AEs [SAEs]). Exploratory endpoints assessed patient-graded response and change in nodular/total lesion count.</p><p><strong>Results: </strong>Among 305 patients (86.89% adults; 13.11% adolescents), 59.67% had an IGA score of 3 and 40.33% had an IGA score of 4 at baseline. Post-treatment, the overall IGA score reduced significantly from 3.40 ± 0.49 at baseline to 2.11 ± 0.79 at 8 ± 2 weeks (37.94% reduction; p < 0.001), 1.30 ± 0.82 at 12 ± 2 weeks (61.76% reduction; p < 0.001), and 0.53 ± 0.73 at 16 ± 2 weeks (84.41% reduction; p < 0.001). By 16 ± 2 weeks, 91.81% patients were graded 'clear'/'almost clear' (IGA score ≤ 1), 67.87% had 'excellent' investigator-graded response, and 65.25% had 'very good' self-graded response. After 16 ± 2 weeks, significant reductions were observed in nodular lesion counts (from 7.06 ± 9.22 to 0.38 ± 1.29; 94.62% reduction; p < 0.001) and total lesions (from 32.25 ± 36.95 to 2.46 ± 4.63; 92.37% reduction; p < 0.001). Six (1.97%) patients experienced AEs; no SAE was observed.</p><p><strong>Conclusion: </strong>In this real-world EMR-based study, low-dose micronized isotretinoin was found to be clinically effective and well tolerated in patients with severe recalcitrant nodular facial acne, achieving rapid and sustained improvements in lesion counts and acne severity.</p><p><strong>Trial registration: </strong>Clinical Trials Registry-India, identifier CTRI/2024/07/070813.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"4931-4944"},"PeriodicalIF":4.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683759","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}