Dermatology and Therapy最新文献

{"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}

{"title":"OX40 Ligand/OX40 Axis as the Inflammatory Prequel in Atopic Dermatitis: A Narrative Review.","authors":"Shawn G Kwatra, Emma Guttman-Yassky, John Oppenheimer, Bob Geng, Stephan Weidinger, Tiago Torres, Ahmed Ameen, Nicolas Gaudenzio, Kassim Rahawi, Chia Hui Chung","doi":"10.1007/s13555-026-01896-7","DOIUrl":"10.1007/s13555-026-01896-7","url":null,"abstract":"<p><p>Atopic dermatitis is a complex and relapsing inflammatory skin disease attributed to skin barrier dysfunction and immune dysregulation. Because of the heterogeneous and unpredictable nature of the disease, moderate to severe atopic dermatitis remains challenging to treat, with a continued need for therapeutics capable of modulating multiple inflammatory pathways. Antigen-presenting cells (APCs) drive T cell activation through both primary and secondary signals. As part of the secondary, costimulatory signals, OX40 ligand (OX40L), expressed on activated APCs, binds the OX40 receptor expressed on T cells. The OX40L/OX40 signaling pathway is active during a dynamic phase of atopic dermatitis pathogenesis, representing the immune system's preparatory state that precedes the onset of the overt immune imbalance. During this critical period, defined here as the inflammatory prequel, OX40L/OX40 interactions promote T cell proliferation, survival, and cytokine production and release, therefore priming and amplifying inflammatory pathways central to atopic dermatitis pathogenesis and development of the disease. Sustained OX40L/OX40 signaling further promotes the generation of memory T cells and inhibits regulatory T cell function, contributing to chronic inflammation. Uniquely positioned at the crossroads of inflammatory pathways, OX40L/OX40 represents an alternative therapeutic target for atopic dermatitis and potentially other T cell-driven inflammatory diseases. Clinical trials evaluating antibodies targeting OX40L or OX40 are ongoing, with new evidence still emerging. Clinical studies have demonstrated efficacy in skin clearance and pruritus that persists beyond active treatment, supporting the role of this pathway in atopic dermatitis. Targeting the inflammatory prequel and intervening during the activation of the inflammatory cascade may therefore offer an opportunity to modulate immune dysregulation and achieve more sustained disease control in patients with atopic dermatitis.Graphical abstract available for this article.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"4873-4886"},"PeriodicalIF":4.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105513","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":"Dual-Targeted Therapy in Refractory Pyoderma Gangrenosum: A Focused Systematic Review of Convergent Pathway Targeting.","authors":"Mohammed Shanshal, George Karanasios","doi":"10.1007/s13555-026-01895-8","DOIUrl":"10.1007/s13555-026-01895-8","url":null,"abstract":"<p><strong>Background: </strong>Refractory pyoderma gangrenosum (PG) may persist despite corticosteroids, ciclosporin, biologics or sequential treatment escalation. Dual-targeted therapy (DTT) is increasingly used in medically complex inflammatory bowel disease (IBD), but PG is often recorded only as an extraintestinal manifestation. We examined the direction, extractability and attribution limits of PG outcomes reported during concurrent DTT.</p><p><strong>Methods: </strong>PubMed, Embase via Ovid and Web of Science Core Collection were searched from inception to 26 July 2026. Eligible reports described at least one patient with PG receiving concurrent systemic DTT, defined as biologic-biologic, biologic-Janus kinase (JAK) inhibitor or biologic-phosphodiesterase-4 inhibitor combinations. Screening and extraction were performed independently and in duplicate. The analytic unit was the PG exposure. Outcomes were retained as source-reported and were not pooled because PG assessment, follow-up and co-intervention reporting were non-standardised.</p><p><strong>Results: </strong>Fourteen reports described 17 PG exposures. Of these, 14 had an extractable PG-specific cutaneous outcome, all source-reported using non-standardised assessments as improved or resolved. This 14-of-14 pattern reflects the direction of published outcome-bearing observations, not a denominator-based response estimate. Three additional cohort-level records documented PG exposure without a separable cutaneous end-point. A total of 16 exposures were IBD-associated and 11 involved JAK-containing regimens. Individual regimen mapping, diagnostic ascertainment, follow-up and co-intervention reporting were frequently incomplete. All evidence was uncontrolled, safety reporting was limited and the complete exposure denominator was unknown.</p><p><strong>Conclusions: </strong>Favourable PG outcomes were reported across several DTT pathway pairings, but these uncontrolled published observations do not establish efficacy, comparative advantage or added benefit from simultaneous pathway blockade. The next step is a dermatology-embedded prospective registry within IBD DTT programmes, with standardised PG diagnosis, lesion documentation, co-intervention recording and exposure-specific safety ascertainment. Until such evidence is available, DTT should remain an exceptional multidisciplinary consideration rather than an established PG treatment strategy.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"4913-4929"},"PeriodicalIF":4.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850145","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":"Emerald Touchless Sensor Quantifies Nighttime Scratching and Sleep Quality in Children With Atopic Dermatitis: PEDISTAD EMERALD Study.","authors":"Cory J Rubin, Lara W Lee, Amal Assa'ad, Irene Lara-Corrales, Dina Katabi, Hariharan Rahul, Siqiao Ruan, Pranav Krishna, Rumen Hristov, Karen J Chandross, Rajan Gupta, Marius Ardeleanu, Annie Zhang","doi":"10.1007/s13555-026-01864-1","DOIUrl":"10.1007/s13555-026-01864-1","url":null,"abstract":"<p><strong>Introduction: </strong>In children with atopic dermatitis (AD), itch-related nighttime scratching is associated with significant sleep disturbances. The aim of this study is to report the feasibility of using the Emerald touchless sensor to quantify nighttime scratching and sleep patterns in pediatric patients.</p><p><strong>Methods: </strong>PEDISTAD EMERALD (NCT05235724), an open-label, 12-week, exploratory study, included 20 pediatric patients with moderate-to-severe AD aged 6-11 years from the PEDISTAD registry (NCT03687359). The Emerald touchless sensor measures sleep onset and efficiency. Correlation analyses were performed between sleep onset and Peak Pruritus Numeric Rating Scale (PP-NRS), scratching events and time per hour and PP-NRS, and weekly averages of nightly scratching events per hour and sleep efficiency.</p><p><strong>Results: </strong>We show strong statistically significant correlations between sleep onset and PP-NRS (Pearson correlation coefficient: r = 0.50; p = 0.049) and between scratching events per hour and sleep efficiency (r = - 0.66; p = 0.003). Additionally, we observed positive correlations between scratching events (r = 0.46; p = 0.076) and scratching time per hour (r = 0.43; p = 0.096) and PP-NRS that did not reach statistical significance.</p><p><strong>Conclusions: </strong>The Emerald touchless sensor can provide objective measures of itch-related scratching and sleep disturbance in children with AD in a home setting, demonstrating its feasibility for use in pediatric clinical trials.</p><p><strong>Trial registration: </strong>NCT05235724.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"5037-5047"},"PeriodicalIF":4.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817434","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":"Window of Opportunity and Predictors of Sustained Remission in Patients with Hidradenitis Suppurativa Treated with Adalimumab: A 540-Patient Cohort Study.","authors":"Eva Vilarrasa, Patricia Garbayo-Salmons, Emili Masferrer, Oriol Corral, Veronica Mora, Julio Bassas-Vila, Mar Luque, Irene Fuertes, Rosa Fornons-Servent, Gemma Martin-Ezquerra, Rafael S Aguayo-Ortiz, Joan Ceravalls, Álvaro Gómez-Tomás, Jordi Mollet, Clara Matas, Ignasi Gich, Jorge Romaní","doi":"10.1007/s13555-026-01900-0","DOIUrl":"10.1007/s13555-026-01900-0","url":null,"abstract":"<p><strong>Introduction: </strong>Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. Predicting responses of \"prolonged disease-free remission\" to biological therapy is essential for identifying a \"window of opportunity\" for disease modification.</p><p><strong>Methods: </strong>A retrospective multicenter cohort study (2015-2023) of 540 patients with HS treated with adalimumab (ADA) was performed. A super-response to ADA (ADA-SR; ADA super-responders) was defined as sustained complete remission (absence of nodules, abscesses, and inflamed or draining tunnels) for ≥ 12 months leading to drug discontinuation. Predictors were analyzed using multivariable Cox regression. Clinically interpretable thresholds were derived post hoc via maximally selected log-rank statistics.</p><p><strong>Results: </strong>Of the 540 patients, 19 (3.5%) were identified as ADA-SR. Median [interquartile range (IQR)] overall ADA survival was 56.2 (51.15-80.25) months, while the median time to ADA discontinuation in ADA-SR was 18.6 (IQR 23.3-41) months. After discontinuation, six of the 19 ADA-SR patients (31.6%) experienced relapse during follow-up; only one required the reintroduction of biologic therapy. ADA-SR patients demonstrated distinct clinical, demographic, and therapeutic profiles. Independent predictors of sustained remission included lower body mass index (BMI < 29 kg/m²), shorter time from disease onset to biologic initiation (within 3 years), and lower baseline tunnel burden (< 3 tunnels).</p><p><strong>Conclusion: </strong>Lower BMI, early biologic intervention, and a limited baseline burden of tunnels are key predictors for achieving sustained remission off-drug, supporting a limited window of opportunity in HS. Graphical abstract available for this article.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"5175-5193"},"PeriodicalIF":4.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105423","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 New Phototherapy Regimen Coupled with Oral Vitamin D Supplementation, for the Long-Term Control of Atopic Dermatitis: A French Multicenter, Randomized, Crossover, Pragmatic Trial.","authors":"Catherine Droitcourt, Sébastien Barbarot, Valérie Visseiche, Annabel Maruani, Monica Dinulescu, Laure Darrieux, Laurent Misery, Emilie Brenaut, Angèle Soria, Annie Vermersch, Hervé Maillard, Julien Seneschal, Alain Taieb, Cécile Chabbert, Henri Adamski, Alain Dupuy, Emmanuel Oger","doi":"10.1007/s13555-026-01914-8","DOIUrl":"10.1007/s13555-026-01914-8","url":null,"abstract":"<p><strong>Introduction: </strong>The global burden of atopic dermatitis (AD) will continue to rise in the coming two decades, underscoring the need for affordable and globally accessible therapies given restricted access to high-cost medications in many regions. The study aimed to evaluate the efficacy of a novel phototherapy-based regimen as an add-on therapy, together with vitamin D supplementation, on long-term disease control in AD.</p><p><strong>Methods: </strong>The PRADA trial combined two independent randomizations within the same population: an open-label, crossover comparison of narrowband ultraviolet B (NB-UVB) phototherapy versus observation, and a double-blind, parallel-group comparison of vitamin D versus placebo, both superimposed on standard topical anti-inflammatory treatments (TAT). It was conducted between 2015 and 2023 across 16 French hospital centers. The trial included patients aged ≥ 15 years with moderate-to-severe (IGA > 2) AD and with fewer than 100 lifetime phototherapy sessions. The primary outcome was a hierarchical composite endpoint based on: (1) repeated measures of Patient-Oriented SCORing Atopic Dermatitis (PO-SCORAD) severity score over 1 year; and (2) the cumulative use of TAT from October to March.</p><p><strong>Results: </strong>A total of 53 participants were allocated to the vitamin D (26 received NB-UVB during the first period), and 57 to the placebo (27 received NB-UVB during the first period). A total of 93 participants were available for the main analysis for the primary endpoint. Vitamin D was significantly associated with lower PO-SCORAD scores compared with placebo (mean [95% CI] difference -5.6 [-12.1 to -1.78]), however, this effect size remained below the prespecified minimum clinically important difference (nine points). NB-UVB showed no significant effect on PO-SCORAD scores (mean difference: 1.25 [-3.90 to 1.40]). Adverse event incidence was 0.33 per 100 patient-months, mainly nonserious photosensitivity reactions (n = 38).</p><p><strong>Conclusions: </strong>In the PRADA trial (underpowered due to a recruitment short fall), NB-UVB phototherapy showed no clinically meaningful benefit on the long-term control of moderate-to-severe AD. The observed benefit of vitamin D supplementation on PO-SCORAD, although statistically significant, did not reach the threshold for clinical relevance.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT02537509.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"5229-5244"},"PeriodicalIF":4.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954909","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: Three-Year Efficacy and Safety of Lebrikizumab in Patients with Moderate-to-Severe Atopic Dermatitis: A Long-Term Extension (ADjoin).","authors":"Emma Guttman-Yassky, Alan D Irvine, Melinda Gooderham, Stephan Weidinger, Lynda Spelman, Jonathan I Silverberg, Heidi Crane, Hany ElMaraghy, Louise DeLuca-Carter, Maria Lucia Buziqui Piruzeli, Georgia Martimianaki, Evangeline Pierce, Helena Agell, Diamant Thaçi","doi":"10.1007/s13555-026-01876-x","DOIUrl":"10.1007/s13555-026-01876-x","url":null,"abstract":"","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"5263-5264"},"PeriodicalIF":4.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850078","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":"Factors Associated with Previous Aesthetic Procedures among Men: A Cross-Sectional Online Survey.","authors":"Andreza Cunha Moreira, Ana Claudia Carbone, Antony de Paula Barbosa, Murilo Fanchiotti Cerri, Anna Raphaella Autran Colaco, Gilberto Melo, Giancarlo De la Torre Canales","doi":"10.1007/s13555-026-01889-6","DOIUrl":"10.1007/s13555-026-01889-6","url":null,"abstract":"<p><strong>Introduction: </strong>The number of men undergoing aesthetic procedures has increased substantially worldwide, highlighting the need to understand the characteristics of those who undergo them. However, evidence focusing on male populations remains limited. This study aimed to describe the sociodemographic characteristics and FACE-Q scale patient-reported outcomes of men with and without previous aesthetic procedures, and to explore which characteristics were associated with having undergone them.</p><p><strong>Methods: </strong>This cross-sectional online survey included 231 men aged 18-65 years. Participants were allocated into two groups according to previous experience with aesthetic procedures: yes to aesthetic procedures (YAP; n = 93) and no to aesthetic procedures (NAP; n = 138). Sociodemographic variables and six independently functioning FACE-Q scales were collected: aging appraisal, appearance-related psychosocial distress, satisfaction with facial appearance, psychological function, social function, and satisfaction with lower face and jawline. Univariate between-group comparisons and exploratory multivariate analyses were performed.</p><p><strong>Results: </strong>Participants in the YAP group were more frequently from Brazil, aged ≥ 31 years, and in the higher-income group (p < 0.05). They reported lower Aging Appraisal scores, (trimmed mean difference -15.8; 95% CI -21.6 to -9.9), greater appearance-related psychosocial distress (+13.1; 95% CI 6.4-19.7), and lower satisfaction with facial appearance (- 8.6), psychological function (-8.6), and satisfaction with the lower face and jawline (-11.4). Multivariate analysis showed substantial overlap between groups (R²Y = 0.292; Q² = 0.256). In the exploratory logistic regression, Brazilian participants (OR 0.29; 95% CI 0.14-0.57), age ≥ 31 years (OR 2.35; 95% CI 1.08-5.13), and higher income (OR 2.90; 95% CI 1.27-6.61) were associated with previous aesthetic procedures, whereas no FACE-Q scale was independently associated with the outcome.</p><p><strong>Conclusions: </strong>Men undergoing previous aesthetic procedures did not demonstrate a clearly psychosocial profile compared with the general male population. However, age, country, and income, but not any FACE-Q, were independently associated with undergoing these procedures.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"4975-4991"},"PeriodicalIF":4.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789432","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":"Patterns of Clinical Response in Rollover Adolescent Patients with Alopecia Areata Treated with Ritlecitinib in the Ongoing Long-Term, Open-Label, Phase 3 ALLEGRO-LT Study.","authors":"Ulrike Blume-Peytavi, Brittany Craiglow, Ilka Arun Netravali, Isabella Doche, Kazutoshi Harada, Dalia Wajsbrot, Gianluca Bonfanti, Rahmat Ishowo-Adejumo, Robert Wolk, Helen Tran","doi":"10.1007/s13555-026-01911-x","DOIUrl":"10.1007/s13555-026-01911-x","url":null,"abstract":"<p><strong>Introduction: </strong>Ritlecitinib, a JAK3/TEC family kinase inhibitor, demonstrated efficacy in adolescents with alopecia areata (AA) in the ALLEGRO phase 2b/3 study. The present study evaluated long-term Severity of Alopecia Tool (SALT) score response patterns in adolescents from ALLEGRO-2b/3 who rolled over into the open-label, phase 3 ALLEGRO-LT study.</p><p><strong>Methods: </strong>This post hoc analysis included adolescents aged 12-17 years with AA and ≥ 50% scalp hair loss who received ritlecitinib 50 mg daily, with or without a 4-week 200-mg loading dose. Individual SALT score trajectories from baseline to month 24 were used to categorize adolescents as early (SALT score ≤ 20 at week 24 and months 12 and 24), middle (SALT ≤ 20 at months 12 and 24), or late responders (SALT ≤ 20 at month 24) or partial responders (maintained 30% improvement), relapsers (achieved but did not maintain 30% improvement), or true non-responders (did not achieve 30% improvement). Baseline disease characteristics were assessed by SALT score ≤ 20 response status.</p><p><strong>Results: </strong>Among 57 adolescents, 42.1% had SALT score ≤ 20 response through month 24 (17.5% early, 17.5% middle, and 7.0% late responders). The remaining 57.9% did not achieve SALT score ≤ 20 response, with 15.8% partial responders, 21.1% relapsers, and 21.1% true non-responders. SALT score ≤ 20 responders had shorter AA episode duration, less frequent alopecia totalis/universalis, and were more frequently female versus non-responders.</p><p><strong>Conclusion: </strong>A large proportion of adolescents treated with ritlecitinib had an early, middle, or late SALT score ≤ 20 response pattern during 24 months of treatment. Responders (SALT score ≤ 20) had less extensive scalp hair loss and shorter AA episode duration at baseline, and a higher proportion of responders were female compared with non-responders (SALT score > 20). Infographic available for this article.</p><p><strong>Clinicaltrials: </strong></p><p><strong>Gov registration: </strong>NCT03732807 and NCT04006457.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"5215-5227"},"PeriodicalIF":4.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105259","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":"Rezpegaldesleukin and Regulatory T Cell Restoration in Immune-Mediated Skin Diseases.","authors":"João Domingues, Raj Chovatiya, Brett King, Tiago Torres","doi":"10.1007/s13555-026-01936-2","DOIUrl":"https://doi.org/10.1007/s13555-026-01936-2","url":null,"abstract":"<p><p>Inflammatory skin diseases such as atopic dermatitis (AD), psoriasis, and alopecia areata (AA) are characterized by immune dysregulation involving impaired regulatory T cell (T_reg) function and persistent activation of effector inflammatory pathways. Current targeted therapies largely suppress downstream inflammatory signaling rather than correcting upstream regulatory abnormalities. Rezpegaldesleukin (REZPEG; NKTR-358) is a first-in-class, T_reg-selective interleukin-2 (IL-2) receptor agonist engineered to preferentially expand cluster of differentiation 4 positive (CD4⁺) FOXP3⁺ T_regs while minimizing activation of conventional effector T cells and natural killer (NK) cells. This review summarizes the biological rationale, mechanism of action, and emerging clinical evidence supporting REZPEG across dermatologic indications, particularly AD and AA. In phase 1 and phase 1b studies, REZPEG induced selective and durable T_reg expansion, attenuation of inflammatory biomarkers, and clinical improvements in AD and psoriasis, including prolonged off-treatment responses. In the phase 2b REZOLVE-AD trial, all active dosing regimens significantly improved Eczema Area and Severity Index outcomes versus placebo, with responses maintained or further deepened through week 52 with monthly or quarterly maintenance dosing. In severe AA, the phase 2b REZOLVE-AA trial did not meet its primary endpoint: mean Severity of Alopecia Tool (SALT) reductions at week 36 were 28.2% and 30.3% with REZPEG 24 and 18 µg/kg, respectively, versus 11.2% with placebo (p = 0.186 and p = 0.121). A supportive sensitivity analysis excluding four participants with major eligibility violations reached statistical significance, while hypothesis-generating extension data suggested further hair regrowth through week 52. Across completed studies, REZPEG has demonstrated a favorable tolerability profile, predominantly characterized by mild injection-site reactions, without major safety signals. Collectively, these findings support selective T_reg expansion as a mechanistically novel therapeutic strategy in immune-mediated skin disease, while further controlled studies are needed to define REZPEG's long-term efficacy and therapeutic positioning.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105285","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}