Dermatology and Therapy最新文献

{"title":"Habitual Scratching in Atopic Dermatitis and Its Association with Disease Severity: Findings from Japanese Health Insurance Claims and App-Based Data.","authors":"Takeshi Nakahara, Shinichi Noto, Miyuki Matsukawa, Yasuhito Konishi, Rikiya Toda, Daisaku Michikami, Hiroyuki Murota","doi":"10.1007/s13555-025-01525-9","DOIUrl":"https://doi.org/10.1007/s13555-025-01525-9","url":null,"abstract":"<p><strong>Introduction: </strong>In atopic dermatitis (AD), scratching sustains inflammation and impairs the skin barrier. Beyond scratching driven by itch, affected individuals may engage in habitual scratching, defined as repetitive, unconscious scratching that occurs without itch. The extent and clinical significance of habitual scratching in Japanese patients remain unclear. This study aimed to assess the frequency of habitual scratching and its association with AD severity in the Japanese population.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in Japan using data from anonymized health insurance claims and a nationwide app-based questionnaire administered in October 2022. Included individuals were adults (aged 19-74 years) and children (aged ≤ 18 years) with a self-reported diagnosis of AD and either symptoms or treatment within the previous 6 months. Habitual scratching was assessed using two yes/no questions. Disease severity was measured using the Patient-Oriented Eczema Measure (POEM), and associations were tested using the Cochran-Armitage trend test.</p><p><strong>Results: </strong>A total of 1507 adults and 525 children were included. Among adults, 44.5% reported scratching without feeling itchy, and 30.0% reported only noticing scratching when it was pointed out; among children, these proportions were 57.5% and 53.3%, respectively. The proportion of patients exhibiting both behaviors increased significantly with POEM severity. For scratching without itch, rates ranged from 35.1% to 62.9% in adults and from 44.5% to 82.6% in children (p < 0.001 for both). For unnoticed scratching, rates ranged from 19.0% to 50.3% in adults and from 41.2% to 69.6% in children (p < 0.001 for both).</p><p><strong>Conclusions: </strong>Habitual scratching was commonly reported across all severity levels of AD in Japan and was associated with greater disease severity. These findings highlight the importance of recognizing/noticing and actively managing unconscious scratching behaviors as part of comprehensive AD care.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946355","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":"Prevalence and Association of Autoimmune Comorbidities Among Adults with Vitiligo: A Systematic Literature Review and Meta-analysis of USA-Based Studies.","authors":"Jinan Liu, Sudheer Matangi, Yogitha Malempati, Adnan Nasir, David Rosmarin","doi":"10.1007/s13555-025-01506-y","DOIUrl":"10.1007/s13555-025-01506-y","url":null,"abstract":"<p><strong>Introduction: </strong>Vitiligo is an autoimmune, depigmenting skin disease affecting 0.1-1.6% of adults in the USA. Despite observed correlations between vitiligo and other autoimmune conditions in global patient populations, a focused review of comorbidities in US patients with vitiligo is lacking. This systematic literature review and meta-analysis evaluated the prevalence of autoimmune comorbidities in adult patients with vitiligo in the USA.</p><p><strong>Methods: </strong>A systematic literature search of the PubMed and Embase electronic databases (January 1, 2012-November 30, 2022) selected observational studies reporting data on prevalence of autoimmune diseases in US patients with vitiligo. The Grading of Recommendations, Assessment, Development, and Evaluation approach for prognosis was applied to assess certainty of evidence.</p><p><strong>Results: </strong>Eight studies were eligible for inclusion, encompassing 10,246 patients with vitiligo. Thyroid diseases (14.2%), psoriasis (5.1%), rheumatoid arthritis (3.2%), and alopecia areata (2.7%) were among the most common comorbidities by pooled prevalence rates, with the highest certainty of evidence for associations with thyroid disease and alopecia areata. In addition, there was high or moderate certainty of evidence that greater vitiligo extent is associated with increasing prevalence of thyroid disease, type 1 diabetes, rheumatoid arthritis, and pernicious anemia.</p><p><strong>Conclusions: </strong>There is clear evidence of correlations between vitiligo and select autoimmune comorbidities in US adults despite the limitations of this study, including the small number of available high-quality studies. The findings presented here demonstrate the importance of future longitudinal studies to identify causal links between vitiligo and comorbidities, and to evaluate potential benefits of screening and early management for thyroid disease, rheumatoid arthritis, and other autoimmune comorbidities.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871913","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":"Cocaine-Induced Dermatomucositis: Clarifying Diagnostic Controversies and Introducing IgG4 Positivity as a New Histopathological Feature.","authors":"Francisco Reyes Albaladejo, Miguel Mansilla-Polo, Rafael Botella-Estrada","doi":"10.1007/s13555-025-01512-0","DOIUrl":"10.1007/s13555-025-01512-0","url":null,"abstract":"<p><p>Cocaine-induced dermatomucositis is a recently described clinical entity with significant controversy regarding its diagnostic criteria and pathophysiology. While previous reports have identified a distinct pattern of chronic inflammatory mucocutaneous lesions in people who use cocaine, the absence of standardized diagnostic markers has led to inconsistencies in classification. This case series aims to clarify and unify the defining characteristics of cocaine-induced dermatomucositis by analyzing its clinical presentations, histopathologic findings, and immunologic features. Notably, we introduce immunoglobulin G4 (IgG4) positivity as a newly observed characteristic, challenging previous assumptions that excluded IgG4-related immune responses from its pathogenesis. By consolidating clinical and histologic patterns, this study contributes to the ongoing effort to establish cocaine-induced dermatomucositis as a distinct and recognizable disorder, paving the way for improved diagnosis and management.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882321","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":"Cancer Risk in Vitiligo: No Evidence of Increased Prevalence-A Systematic Review and Meta-analysis.","authors":"Alzahra A Mohammed, Anna S Lengyel, Fanni A Meznerics, István Szondy, Anna Walter, Benedek Nagy, Zsófia Csábi, András Bánvölgyi, Norbert Kiss, Péter Hegyi, Zsuzsanna Kurgyis, Lajos V Kemény","doi":"10.1007/s13555-025-01520-0","DOIUrl":"https://doi.org/10.1007/s13555-025-01520-0","url":null,"abstract":"<p><strong>Introduction: </strong>Vitiligo, a chronic depigmenting disorder affecting 1-2% of the global population, is caused by immune-mediated melanocyte destruction. While its pathogenesis is multifactorial, the relationship between vitiligo and malignancy risk remains controversial. Some studies suggest an increased cancer risk, while others propose a potential protective effect, particularly against skin cancers. This study provides a comprehensive evaluation of malignancy risks in patients with vitiligo.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed PRISMA 2020 guidelines and was registered with PROSPERO (CRD42023483130). A comprehensive search was conducted across Medline, EMBASE, and Cochrane databases. Studies reporting hazard ratios for malignancy incidence in patients with vitiligo were included. Data extraction and risk of bias assessment were performed using the Cochrane ROBINS-E tool.</p><p><strong>Results: </strong>Of 7753 records identified, 6378 remained after duplicates were removed, and 12 studies were included in the final review. Quantitative analysis was performed on six studies. The combined sample comprised 3,267,951 participants, including 289,322 patients with vitiligo. Three meta-analyses were conducted for melanoma, non-melanoma skin cancer, and lymphoma. The pooled hazard ratio (HR) for lymphoma was 1.00 (95% CI 0.40-2.53), for melanoma 0.80 (95% CI 0.27-2.34), and for non-melanoma skin cancer 0.38 (95% CI 0.00-732.76), suggesting no consistent associations.</p><p><strong>Conclusion: </strong>This meta-analysis did not identify significant differences in cancer risk across the examined subgroups. While a protective effect of vitiligo against some malignancies cannot be excluded, substantial heterogeneity among studies warrants cautious interpretation. Further high-quality research is needed to clarify these associations.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871954","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":"Clinical Characteristics of Super Responders to Anti-IL-4Rα Biologic Therapy in Atopic Dermatitis.","authors":"Litian Zhang, Linglu Fang, Kun Zhong, Ying Zhou","doi":"10.1007/s13555-025-01514-y","DOIUrl":"https://doi.org/10.1007/s13555-025-01514-y","url":null,"abstract":"<p><strong>Introduction: </strong>Biologics have revolutionized the treatment of moderate-to-severe atopic dermatitis (AD), with dupilumab, an anti-interleukin-4Rα monoclonal antibody, showing notable clinical efficacy. However, some patients achieve rapid and profound improvement-termed super responders (SRs), while others respond poorly. This study aimed to identify SRs to dupilumab in patients with AD and analyze their clinical characteristics to inform personalized treatment strategies.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients with moderate-to-severe AD treated with dupilumab, sourced from the National Clinical Research Center for Skin and Immune Diseases in China. Clinical and follow-up data were reviewed. Categorical variables were compared using Chi-square or Fisher's exact tests, while continuous variables were compared via t-tests or Mann-Whitney U tests. Furthermore, a logistic regression model was employed to evaluate the predictive ability of clinical and demographic variables collected at baseline on the probability of becoming SRs.</p><p><strong>Results: </strong>Among 1,034 patients with AD, 125 (12.09%) were identified as SRs, achieving significant clinical improvement within 16 weeks. Further univariate analysis indicated that factors closely associated with SRs included: older age, higher body mass index, later disease onset, higher baseline scores of pruritus intensity (Peak pruritus Numerical Rating Scale, PP-NRS)/disease severity (Eczema Area and Severity Index, EASI)/quality of life (Dermatology Life Quality Index, DLQI), prior systemic therapy use, no prior biologics, elevated eosinophil count, high-dose dupilumab, shorter dosing intervals of dupilumab, and absence of concomitant therapies. Logistic regression identified moderate baseline pruritus (PP-NRS) and higher baseline DLQI scores (moderate-to-severe impact) as strong predictors of SRs (moderate pruritus Adj odds ratio (OR): 8.38, 95% confidence interval (CI) 2.56-27.42; moderate DLQI Adj OR: 11.01, 95% CI 3.34-36.29; severe DLQI Adj OR: 14.52, 95% CI 4.70-44.91; all p < 0.001).</p><p><strong>Conclusions: </strong>Baseline pruritus and quality of life impairment are key predictors of super response to dupilumab in AD. Early identification may guide more tailored, effective treatment strategies.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859043","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 5-Fluorouracil 4% Cream in the Treatment of Hyperkeratotic Actinic Keratosis: A Single-Center Retrospective Real-World Study.","authors":"Federica Li Pomi, Andrea d'Aloja, Marta Vitale, Michelangelo Rottura, Natasha Irrera, Mario Vaccaro, Francesco Borgia","doi":"10.1007/s13555-025-01518-8","DOIUrl":"https://doi.org/10.1007/s13555-025-01518-8","url":null,"abstract":"<p><strong>Introduction: </strong>Actinic keratosis (AK) is recognized as the main precursor of cutaneous squamous cell carcinoma (cSCC). Given the unpredictable potential for progression, current guidelines recommend treating all AKs, irrespective of their clinical grade. However, many approved treatments are not indicated for hyperkeratotic AKs. Among topical therapies, 5-fluorouracil (5-FU) 4% cream (Tolak®/Tolerak®; Pierre Fabre) is a chemotherapeutic agent that has shown excellent results in treating non-hyperkeratotic AKs on the face, ear, and scalp, both in clinical trials and real-life experiences. However, its effectiveness in managing hyperkeratotic AKs remains unexplored.</p><p><strong>Methods: </strong>A retrospective, single-center study was conducted at the Dermatology Unit of the University of Messina, Italy, between September 2024 and March 2025. The study included 66 hyperkeratotic AK lesions in 19 consecutive patients, treated with 5-FU cream for 28 consecutive days.</p><p><strong>Results: </strong>At the 3-month follow-up, total clearance (complete lesion resolution) was observed in 54.5% of hyperkeratotic lesions, while partial clearance (> 75% lesion reduction) was recorded in 24.2%. The treatment demonstrated a good safety profile, with good patient tolerability. Among local skin reactions (LSRs), erythema was the most frequently observed, occurring in 89.5% of patients, followed by stinging, which was reported in 73.6% of cases. No patient discontinued the treatment as a result of the onset of adverse events.</p><p><strong>Conclusions: </strong>Our findings, albeit initial, support the efficacy and safety of 5-FU 4% cream for the treatment of hyperkeratotic AKs.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Lived Experience of Patients Diagnosed with Vitiligo and a Preliminary Conceptual Disease Model: Insights from Patients, Patient Advocates, and Clinicians.","authors":"Khaled Ezzedine, Ahmed M Soliman, Mary Kathleen Ladd, Stavonnie Patterson, Rohini Sen, Sarah Ofori, Karin S Coyne, Robin Pokrzywinski","doi":"10.1007/s13555-025-01510-2","DOIUrl":"https://doi.org/10.1007/s13555-025-01510-2","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with vitiligo experience high disease and psychosocial burden, and dissatisfaction with current treatment options, highlighting a need to understand the disease from a patient perspective. This study gathered insights from key opinion leaders (KOLs) and patient advocates on a conceptual disease model of vitiligo and gained patient perspectives through qualitative interviews on the disease burden and concepts important to patients with nonsegmental vitiligo (NSV), and what degree and anatomical location of repigmentation may constitute a meaningful change with treatment.</p><p><strong>Methods: </strong>This cross-sectional, observational study involved virtual, semi-structured, qualitative interviews with expert KOLs treating patients with vitiligo, patient advocates, and patients diagnosed with NSV.</p><p><strong>Results: </strong>Patient advocates (n = 5) and KOLs (n = 6) felt that the conceptual disease model comprehensively captured the signs, symptoms, and impact of vitiligo, and had minor changes including reordering symptoms. Of 22 patients interviewed, most experienced depigmentation on their arms, trunk, hands, feet; and 86.4% had vitiligo on their face. The most frequently reported sign or symptom was increased sensitivity to the sun (82%). Patients reported that vitiligo broadly impacts many facets of life, most commonly emotional well-being (82%). Patients reported that perceived treatment success is driven by the extent of vitiligo repigmentation, especially on the face and hands, and would consider 20-25% repigmentation a meaningful improvement.</p><p><strong>Conclusion: </strong>This study provides insight into the lived experience of patients with NSV, and alignment from patient advocates and KOLs on the conceptual disease model of vitiligo. The findings increase our understanding and inform vitiligo clinical studies.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854895","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":"Skin-Directed Therapies in Mycosis Fungoides: An Update.","authors":"Maciej Tota, Magdalena Łyko, Piotr Misiąg, Julia Łacwik, Julia Laska, Karol Biliński, Julita Kulbacka, Alina Jankowska-Konsur","doi":"10.1007/s13555-025-01511-1","DOIUrl":"10.1007/s13555-025-01511-1","url":null,"abstract":"<p><p>Mycosis fungoides (MF) is the most common subtype of cutaneous T cell lymphoma (CTCL), characterized by monoclonal proliferation of malignant T cells primarily involving the skin. The management of MF, especially in the early stages, involves skin-directed therapies (SDTs) to achieve disease control, alleviate symptoms, and enhance the quality of life (QoL). This review provides an updated overview of SDTs in MF treatment, including topical agents such as corticosteroids, retinoids, mechlorethamine, carmustine, imiquimod, as well as photodynamic therapy (PDT); phototherapy modalities including narrowband UVB (nb-UVB) and psoralen-UVA (PUVA); local radiotherapy; total skin electron beam radiotherapy (TSEBT) and total skin helical tomotherapy (TSHT). We review the indications, mechanisms of action, efficacy data, and adverse effect profiles associated with both established and emerging SDTs. Additionally, we present ongoing clinical trials evaluating emerging SDTs in the treatment of MF.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854894","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":"Evaluating Current and Emergent JAK Inhibitors for Alopecia Areata: A Narrative Review.","authors":"Katherine Sanchez, Hanna Englander, Lana Salloum, Samantha Gregoire, Ursula Biba, Sherry Ershadi, Arash Mostaghimi","doi":"10.1007/s13555-025-01517-9","DOIUrl":"https://doi.org/10.1007/s13555-025-01517-9","url":null,"abstract":"<p><p>Alopecia areata (AA) is an autoimmune condition characterized by non-scarring hair loss on the scalp, face, and body, affecting approximately 2% of the global population. Current treatments, including topical corticosteroids, topical immunotherapies, and systemic immunosuppressants, often demonstrate inconsistent efficacy and raise concerns about long-term safety, emphasizing the need for safer and more effective therapies. Janus kinase (JAK) inhibitors have emerged as a promising treatment option, offering a targeted approach by addressing the immune-mediated mechanisms driving hair follicle destruction in AA. Recent clinical advances have led to FDA approval of three JAK inhibitors-baricitinib, ritlecitinib, and deuruxolitinib-based on pivotal trials showing significant hair regrowth. Baricitinib has demonstrated durable efficacy, with 35-40% of patients achieving a Severity of Alopecia Tool (SALT) score ≤ 20 at 36 weeks. Ritlecitinib similarly reported 23% of patients achieving a SALT score ≤ 20 at week 24. Deuruxolitinib has also shown efficacy with 31% of patients achieving a SALT score ≤ 20 at 24 weeks. Off-label use of JAK inhibitors like tofacitinib and ruxolitinib have also demonstrated efficacy in limited studies. This review aims to consolidate and summarize the latest clinical evidence and trial data on JAK inhibitors for AA, providing an up-to-date resource for clinicians and researchers to guide evidence-based management and optimize therapeutic outcomes.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Bimekizumab in Japanese Patients with Generalised Pustular Psoriasis and Erythrodermic Psoriasis: 3-Year Results from BE BRIGHT, a Multicentre, Open-Label, Phase 3 Study.","authors":"Yukari Okubo, Yayoi Tada, Hidetoshi Takahashi, Masatoshi Abe, Keiichi Yamanaka, Nicola Tilt, Nancy Cross, Delphine Deherder, Mizuho Matano, Hidemi Nakagawa","doi":"10.1007/s13555-025-01509-9","DOIUrl":"https://doi.org/10.1007/s13555-025-01509-9","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to report bimekizumab (BKZ) efficacy and safety in Japanese patients with generalised pustular psoriasis (GPP) and erythrodermic psoriasis (EP).</p><p><strong>Methods: </strong>Patients aged ≥ 18 years with plaque psoriasis, GPP, or EP received BKZ for 144 weeks; only results for GPP and EP reported here. All patients received BKZ 320 mg every 4 weeks (Q4W) at week 0, with dose adjustments for Q4W or Q8W at weeks 16 and 48, depending on Investigator's Global Assessment (IGA) 0/1 response. Efficacy outcomes assessed to week 144: IGA 0/1, Dermatology Life Quality Index (DLQI) 0/1, Clinical Global Impressions-Improvement (CGI-I), ≥ 75/90/100% improvement from baseline Psoriasis Area and Severity Index (PASI 75/90/100), ≥ 75/90/100% improvement from baseline modified Nail Psoriasis Severity Index (mNAPSI 75/90/100), and patient-reported outcomes; GPP-specific outcomes: Japanese Dermatological Association (JDA) severity index and Global Improvement Score (GIS). Treatment emergent adverse events (TEAEs) evaluated through weeks 0-144 and safety follow-up.</p><p><strong>Results: </strong>At week 144, most patients with GPP (8/10) and EP (10/11) completed the study. At week 16, all patients reported efficacy outcomes improving with BKZ, generally persisting through week 144. At week 144 (missing visit: 1 GPP), 6/7 patients with GPP and 8/10 with EP achieved IGA 0/1; 5/7 and 9/10 patients achieved DLQI 0/1; 7/7 and 9/10 patients achieved CGI-I response (\"improved\"/\"remission\"); and 6/7 and 9/10 patients achieved PASI 90, respectively; 2/5 patients with GPP and 4/9 with EP achieved week 144 mNAPSI 100. Among patients with GPP, JDA severity index generally decreased and improvements in GIS were sustained to week 144. Serious TEAEs were observed in 2/10 patients with GPP and 5/11 with EP; BKZ was well tolerated with low incidence of TEAEs leading to study discontinuation (2 GPP, 1 EP).</p><p><strong>Conclusions: </strong>Long-term BKZ treatment over 3 years improved signs and symptoms of GPP and EP; these were sustained through week 144. No new safety signals were identified.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier, NCT03598790.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816042","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}