Dermatology and Therapy最新文献

{"title":"Comparison of Dermatology Life Quality Index Scores in Adults and Adolescents with Alopecia Areata.","authors":"Kent A Hanson, Sergio Vañó-Galván, Andrew Messenger, Helen Tran, Lynne Napatalung, Keith L Davis, Lizzi Esterberg, Ernest H Law","doi":"10.1007/s13555-025-01417-y","DOIUrl":"10.1007/s13555-025-01417-y","url":null,"abstract":"<p><strong>Introduction: </strong>This study assessed Dermatology Life Quality Index (DLQI) scores of patients with alopecia areata (AA) and compared scores between adults and adolescents.</p><p><strong>Methods: </strong>This was a retrospective chart review in France, Germany, Spain, and the UK. Patients with ≥ 50% scalp hair loss (SHL) due to AA and a DLQI score recorded at their index date (first date of ≥ 50% SHL) were included. The DLQI (scale 0-30; higher scores indicate greater impact) assesses the impact of AA on health-related quality of life (QOL). Multivariable linear regression was used to examine the effect of age on DLQI score, adjusting for covariates. Modified Poisson regression analysis was used to estimate relative risks (RRs) between age groups and DLQI categories (none to moderate effect, very large effect, and extremely large effect), adjusting for covariates, including baseline Severity of Alopecia Tool (SALT) score.</p><p><strong>Results: </strong>Overall, 335 patients were included (249 adults, 86 adolescents). At index, adults had a higher mean (SD) SALT score than adolescents (63.7 [15.5] vs 60.4 [12.8]), whereas mean (SD) DLQI scores were higher in adolescents than adults (22.1 [5.3] vs 18.2 [7.5]). Most patients (84%) had DLQI scores indicating a very large or extremely large impact on their lives; this was more pronounced in adolescents than adults (98% vs 80%). In the multilinear model, adolescents had significantly higher DLQI scores than adults (β = 3.51; P < 0.001), indicating a 3.51-point increase in DLQI score associated with being an adolescent. The RR (95% CI) of a DLQI score indicating a very large effect (1.28 [1.07-1.53]) or extremely large effect (1.40 [1.21-1.61]) relative to no or moderate effect was significantly higher for adolescents vs adults.</p><p><strong>Conclusion: </strong>This study demonstrates that, at the time of experiencing ≥ 50% SHL due to AA, both adults and adolescents reported significant impacts on their QOL, with a higher impact on adolescents.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1543-1553"},"PeriodicalIF":3.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062657","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":"Topical Crisaborole for the Treatment of Recalcitrant Palmoplantar Pustulosis: A Case Series.","authors":"Yen-Yi Sung, Tsen-Fang Tsai","doi":"10.1007/s13555-025-01419-w","DOIUrl":"10.1007/s13555-025-01419-w","url":null,"abstract":"<p><p>Palmoplantar pustulosis (PPP) is a chronic, relapsing disease with sterile pustules involving the palms and soles. The pathogenesis of PPP remains unclear and there is currently no standard treatment. We present three cases of recalcitrant PPP treated with topical 2% crisaborole cream in our clinic from October 2024 to February 2025. All of the patients had received skin biopsy to prove their diagnosis and had been treated with various treatments with limited response. After 4 weeks of topical crisaborole, their palmoplantar pustulosis area and severity index decreased from 7.2 to 2.8, 9 to 1.8, and 28.4 to 0, respectively. Given that PPP involves the skin locally, an effective topical treatment may provide a convenient, inexpensive alternative for such patients. The positive response of topical crisaborole observed in our cases also echoes the efficacy of apremilast, a systemic phosphodiesterase 4 (PDE4) inhibitor which successfully treated PPP in other reports, highlighting the potential role of PDE4 in the pathophysiology of PPP. Further studies are needed for a more comprehensive evaluation.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1579-1585"},"PeriodicalIF":3.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956191","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":"Management of Challenging Psoriasis Clinical Scenarios.","authors":"Linda Stein Gold, Andrew Alexis, Brad P Glick, Mona Shahriari, Eingun James Song, Bruce Strober, Najat M Watch, Melodie Young","doi":"10.1007/s13555-025-01393-3","DOIUrl":"10.1007/s13555-025-01393-3","url":null,"abstract":"<p><p>Psoriasis, a chronic inflammatory skin condition, can have a significant impact on patients' quality of life. Adoption of novel and emerging treatments has significantly improved psoriasis care in clinical practice, but challenges remain. The 'Bridging the Gaps in Challenging Psoriasis' meeting was held in October 2024 to discuss relevant evidence, knowledge gaps, and best practices pertaining to challenging presentations of psoriasis. This report captures important insights and practice impacting guidance gathered from the panel discussion on five topics. The meeting commenced with an in-depth discussion on managing psoriasis in high-impact areas (e.g., scalp, intertriginous regions, nails, and the palms and soles) followed by a discussion on the importance of identifying and addressing common comorbidities associated with psoriasis. The panel explored key considerations and unique challenges when treating psoriasis in patients with darker skin tones ('skin of color') and highlighted the need for tailored therapeutic approaches. A comprehensive dialogue ensued on strategies for managing primary and secondary treatment failures. The session concluded with a concise discussion on the future of psoriasis treatments and pharmacologic therapies currently being developed to manage psoriasis. While discussing various challenging psoriasis scenarios, the dermatology experts emphasized the need to approach psoriasis as a systemic disease and advocated for comprehensive management that addresses both the skin and the broader health of the patient.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1555-1567"},"PeriodicalIF":3.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958898","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":"Complete/Near-Complete Itch Response Observed in Patients with Moderate-to-Severe Atopic Dermatitis Initiating Dupilumab: 3-Year, Real-World, Interim Data from the PROSE Registry.","authors":"Neal Bhatia, Charles W Lynde, Luz Fonacier, Liyang Shao, Andrew Korotzer, Kwinten Bosman","doi":"10.1007/s13555-025-01395-1","DOIUrl":"10.1007/s13555-025-01395-1","url":null,"abstract":"<p><strong>Introduction: </strong>Atopic dermatitis (AD) is a chronic, relapsing disease that can start at any age and has a significant negative impact on quality of life, including a significant itch burden. Here we report the proportion of patients in a real-world study achieving a complete/almost complete resolution of itch, as measured by the Peak Pruritus Numeric Rating Scale (PP-NRS) and improvement in overall disease severity score (ODS), in patients aged ≥ 12 years with moderate-to-severe AD up to 3 years after commencing dupilumab treatment.</p><p><strong>Methods: </strong>PROSE is an ongoing, prospective, observational, multicenter registry in the USA and Canada, collecting real-world data from patients aged ≥ 12 years with moderate-to-severe AD who initiated dupilumab in accordance with country-specific prescribing information. Assessments include patient-reported PP-NRS (range 0-10) and clinician-measured ODS score (range 0-4).</p><p><strong>Results: </strong>A total of 857 patients were enrolled, of whom 42% were male and 6.4% were adolescents aged ≥ 12 to < 18 years. The mean [standard deviation (SD)] age was 40.1 (17.9) years, and the duration of AD was 17.4 (16.2) years. The subsequent mean (SD) duration of dupilumab treatment was 23.1 (13.7) months. The proportion of patients achieving complete/almost complete itch resolution (PP-NRS score of 0 or 1) improved consistently over time, from 2.7% (17/622) of patients at baseline to 56.3% (58/103) at 3 years. Additionally, by year 3, 65.1% (54/83) of patients had an ODS score of no/minimal disease (score of 0 or 1), versus 2.2% (19/852) at baseline.</p><p><strong>Conclusions: </strong>In this real-world setting of the PROSE registry, adult and adolescent patients with moderate-to-severe AD followed up for up to 3 years after the initiation of dupilumab treatment experienced sustained and substantial improvement in pruritus and ODS, using the stringent endpoints of PP-NRS 0 or 1 and ODS 0 or 1.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT03428646.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1523-1531"},"PeriodicalIF":3.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987029","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":"Prescribing and Dispensing of Oral Isotretinoin and Noncompliance with Recommendations in France before and during the COVID-19 Pandemic.","authors":"Anaïs Havet, Aurélie Moskal, Cécile Payet, Jérôme Massardier, Bénédicte Lebrun-Vignes, Anne-Pierre Jonville-Béra, Marc Chanelière, Marie Viprey","doi":"10.1007/s13555-025-01409-y","DOIUrl":"10.1007/s13555-025-01409-y","url":null,"abstract":"<p><strong>Introduction: </strong>The coronavirus disease 2019 (COVID-19) pandemic disrupted care organization in France, likely changing the use of oral isotretinoin and worsening noncompliance with recommendations. We described the number of dispensations of isotretinoin, use of teleconsultation, and noncompliance with recommendations, before and during the COVID period.</p><p><strong>Methods: </strong>This nationwide cohort included all subjects with isotretinoin dispensation between 2019 and 2022, using data from the French Health Data System (SNDS). The pre-COVID period corresponded to 2019, and the COVID period to 2020, 2021, and 2022. The first lockdown took place between March and May 2020. We calculated the relative change in the number of total and first dispensations and the difference in the percentage of teleconsultation and noncompliance with recommendations, including treatment initiation by dermatology specialists, prescription renewal, and pregnancy testing (PT), for each month, using 2019 as the reference. PT compliance was assessed in women aged 11-50 years.</p><p><strong>Results: </strong>A total of 2,020,624 dispensations were identified between 2019 and 2022, including 18.1% of first dispensations. Compared with the pre-COVID period, the number of total dispensations decreased (April 2020: -12.6%; May 2020: -9.7%), as did the number of first dispensations (March 2020: -18.3%; April 2020: -37.6%). Nevertheless, the number of total and first dispensations increased over the other months. The teleconsultation rate was close to 0 in the pre-COVID period and increased by 21.8% in April 2020. Noncompliance with treatment initiations by dermatologists increased throughout the COVID period compared with the pre-COVID period (mean: 2.2%; range: -0.5% to 5.5%). Noncompliance with prescription renewal and PT increased during the first lockdown (April 2020: 8.9% and 9.5%, respectively), and tended to stabilize thereafter.</p><p><strong>Conclusions: </strong>The effect of the COVID-19 pandemic on isotretinoin use was mainly observed during the first lockdown. This study also highlights persistent noncompliance and the need to assess the new French communication actions.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1533-1541"},"PeriodicalIF":3.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964140","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":"Dupilumab, a Novel Treatment for Peripheral Neuropathy: A Case Series.","authors":"Sunny B Patel, David R Roy, Bart W B Sweers, Michael K Coffin","doi":"10.1007/s13555-025-01415-0","DOIUrl":"10.1007/s13555-025-01415-0","url":null,"abstract":"<p><p>Peripheral neuropathy is a chronic neurological disorder that can present with a multitude of symptoms. It is observed in association with various disease states and organ systems. In the process of treatment for atopic dermatitis, we have observed that patients reported improvements in their previously diagnosed neuropathies, essentially, relief from neuropathic symptoms such as burning, itching, or tingling. On the basis of these observations, we conducted a single-arm trial to survey the qualitative changes in patients with peripheral neuropathy. Ten patients with atopic dermatitis with previously diagnosed peripheral neuropathies were treated with dupilumab (DP) and observed for symptom changes over 6 months. A paired t-test was used to determine whether DP might potentially be used as an off-label treatment for patients with peripheral neuropathy and dermatological conditions. Our patients showed significant symptom relief, thus suggesting that further investigation of the use of DP for patients with neuropathies is warranted.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1569-1577"},"PeriodicalIF":3.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982644","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":"Polarized Dermoscopy and Ultraviolet-Induced Fluorescence Dermoscopy of Basal Cell Carcinomas in the H- and Non-H-Zones of the Head and Neck.","authors":"Irena M Wojtowicz, Adam A Reich, Magdalena Żychowska","doi":"10.1007/s13555-025-01432-z","DOIUrl":"10.1007/s13555-025-01432-z","url":null,"abstract":"<p><strong>Introduction: </strong>Basal cell carcinoma (BCC) is the most common skin cancer, primarily affecting the head and neck region. This study aimed to evaluate the characteristics of BCCs in different facial areas using polarized dermoscopy (PD) and ultraviolet-induced fluorescence dermoscopy (UVFD).</p><p><strong>Methods: </strong>BCCs were examined using a Dermlite DL5 dermatoscope in polarized and UVFD modes. The tumors were categorized based on their location within the high-risk H-zone (ear and periauricular region, temple, eyes and periorbital area, nose and paranasal region, oral region, chin) and non-H-zone (forehead, cheek, rest of the face, scalp, neck). PD features were characterized according to standard dermoscopic criteria for skin cancer assessment. UVFD characteristics included dark silhouettes, interrupted follicle patterns, ulcerations/erosions, white-blue scales, arborizing vessels, absence of pink-orange or blue-green fluorescence, blue-fluorescent fibers, pink-orange fluorescence, black globules, white depigmentation, white clods, and well-defined margins.</p><p><strong>Results: </strong>A total of 151 BCCs were analyzed, with 61.6% located in the H-zone, where the nose and paranasal region were the most affected area (37.6%). Nodular (65.6%) and nonpigmented (86%) subtypes predominated in the H-zone. PD most commonly revealed arborizing vessels (52.7%), short fine telangiectasias (46.2%), red-white homogeneous areas (40.9%), and ulcerations/micro-ulcerations (40.9%). Under UVFD, BCCs in the H-zone frequently exhibited dark silhouettes (77.4%), interrupted follicle patterns (51.6%), absence of blue-green (51.6%) or pink-orange fluorescence (44%), and well-defined lesion borders (43%). Compared to non-H-zone tumors, BCCs in the H-zone were significantly more likely to display ulcerations/micro-ulcerations under PD (p = 0.021), and erosions/ulcerations (p = 0.019), blue-fluorescent fibers (p = 0.009), and absence of blue-green fluorescence (p = 0.019) under UVFD.</p><p><strong>Conclusion: </strong>BCCs in the head and neck exhibit distinct characteristics under UVFD, with certain findings more commonly observed in H-zone tumors. The addition of UVFD to PD serves as a valuable, noninvasive diagnostic tool that enhances early detection of BCCs in this anatomically and cosmetically significant region.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1507-1522"},"PeriodicalIF":3.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987168","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":"Best Responders and Super-Responders to Calcipotriol and Betamethasone Dipropionate PAD-Cream: A Post Hoc Pooled Analysis of Two Phase 3 Trials.","authors":"Andreas Pinter, Jordi Galván, Frank Freischläger","doi":"10.1007/s13555-025-01418-x","DOIUrl":"10.1007/s13555-025-01418-x","url":null,"abstract":"<p><strong>Introduction: </strong>Individual endpoints from phase 3 trials demonstrated high efficacy and convenience for the calcipotriol/betamethasone dipropionate (CAL/BDP) cream based on polyaphron dispersion (PAD) technology compared to CAL/BDP gel. The objectives are to assess the proportion of best responders to CAL/BDP PAD-cream at weeks 4 and 8 and to identify the super-responders through the patients' key baseline characteristics associated with best response.</p><p><strong>Methods: </strong>This was a post hoc pooled analysis of adult patients with mild-to-moderate psoriasis from two phase 3 trials: MC2-01-C2 (NCT03308799) and MC2-01-C7 (NCT03802344). Patients were randomly assigned (3:1:3) to CAL/BDP PAD-cream, PAD-cream vehicle, or CAL/BDP gel once daily. Best responders at weeks 4 and 8 were defined as patients achieving a restrictive endpoint comprising the combination of Physician's Global Assessment (PGA) controlled disease, modified Psoriasis Area and Severity Index (mPASI) success, and Dermatology Life Quality Index (DLQI) satisfaction. Best response rates were compared between treatments by logistic regression using multiple imputation. A classification and regression tree (CART) based on observed cases identified super-responders through the key baseline characteristics associated with best response among CAL/BDP PAD-cream users. All analyses were based on the modified intention-to-treat (mITT) population.</p><p><strong>Results: </strong>The mITT included 551 patients on CAL/BDP PAD-cream, 542 on CAL/BDP gel, and 178 on vehicle. The CAL/BDP PAD-cream group showed a statistically significant higher best response rate compared to CAL/BDP gel at week 4 (10.7% vs 6.1%; p = 0.0048) and week 8 (27.4% vs 16.1%; p < 0.0001), and also compared to vehicle. Among CAL/BDP PAD-cream users, 63.6% of patients with a baseline DLQI < 7 and mPASI < 4.0 achieved best response at week 8 and were considered super-responders.</p><p><strong>Conclusion: </strong>CAL/BDP PAD-cream demonstrated higher best response rates compared to CAL/BDP gel and vehicle in adults with mild-to-moderate psoriasis. Baseline DLQI and mPASI scores may predict which patients are most likely to achieve best response to CAL/BDP PAD-cream.</p><p><strong>Trials registration: </strong>ClinicalTrials.gov identifiers, NCT03308799 (MC2-01-C2) and NCT03802344 (MC2-01-C7).</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1441-1453"},"PeriodicalIF":3.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995115","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":"Exploring Factors That Influence the Measurement of Patient-Reported Impacts of Alopecia Areata.","authors":"Arash Mostaghimi, Adam Gibson, Georges Dwyer, Yemi Oluboyede, Iyar Mazar, Kristina Gorbatenko-Roth, Ernest Law","doi":"10.1007/s13555-025-01400-7","DOIUrl":"10.1007/s13555-025-01400-7","url":null,"abstract":"<p><strong>Introduction: </strong>The ALLEGRO- 2b/3 (Clinicaltrials.gov Identifier: NCT03732807) study demonstrated efficacy and safety of ritlecitinib in patients with alopecia areata (AA). Despite clinically meaningful improvement in hair regrowth, differences in patient-reported emotional symptoms or activity limitations (subscales of the Alopecia Areata Patient Priority Outcomes [AAPPO]) between treatment groups were not significant. This study aimed to identify potential factors that may impact the measurement of patient-reported outcomes in AA.</p><p><strong>Methods: </strong>This mixed methods study conducted remote interviews with individuals with self-reported AA. Interviews were designed to understand how experiences with AA impacted study participant health-related quality of life and gain insights into how historical personal circumstances and individual characteristics might impact AAPPO responses. Qualitative data were analyzed using thematic and content analytical processes; quantitative data were analyzed descriptively.</p><p><strong>Results: </strong>Qualitative analysis of interview transcripts of 30 adults with AA (seeking or had received AA treatment) yielded three overarching themes: mechanisms of adaptation (subthemes: behavioral and mental strategies), impact changes over disease journey (subthemes: hair loss and regrowth as an event and changes in impact over time after loss and/or regrowth), and underlying characteristics that moderate adaptation. Participants reported requiring 50-100% regrowth for 6-12 months before they would provide different AAPPO emotional and activity limitation responses.</p><p><strong>Conclusions: </strong>High levels of hair regrowth over a sustained period of time would be required to change AAPPO responses. Factors identified that may affect measurement of patient-reported psychosocial outcomes in AA included length of time since hair regrowth. Understanding factors that impact adaptation can help inform clinical practice and research.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1391-1403"},"PeriodicalIF":3.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983847","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":"Canadian Consensus Guidelines for the Management of Vitiligo.","authors":"Vimal H Prajapati, Harvey Lui, Yvette Miller-Monthrope, Julien Ringuet, Irina Turchin, H Chih-Ho Hong, Charles Lynde, Kim A Papp, Jensen Yeung, Melinda J Gooderham","doi":"10.1007/s13555-025-01402-5","DOIUrl":"10.1007/s13555-025-01402-5","url":null,"abstract":"<p><strong>Introduction: </strong>Vitiligo remains a highly burdensome disease associated with significant autoimmune and psychosocial comorbidities. Although the therapeutic landscape has long been dominated by off-label therapy, new treatments are emerging. Limited guidance on how to safely and effectively utilize available therapies poses challenges for healthcare providers. Herein, we provide generally accepted principles, consensus recommendations, and a treatment algorithm for the management of vitiligo, as developed by a panel of ten Canadian dermatologists with expertise in managing vitiligo.</p><p><strong>Methods: </strong>The three-phase process consisted of identifying themes and research questions; conducting a systematic literature review; and discussing/voting on generally accepted principles, consensus statements, and a treatment algorithm using an iterative consensus process.</p><p><strong>Results: </strong>Experts agreed to 27 generally accepted principles, ten consensus statements, and a treatment algorithm. Education about vitiligo pathogenesis and repigmentation biology can help patients, caregivers, and healthcare providers set realistic expectations for treatment. Treatment should focus on repigmentation or stabilizing progression, rather than on depigmentation. Topical therapies include topical corticosteroids, topical calcineurin inhibitors, and the topical Janus kinase inhibitor ruxolitinib cream. Phototherapy, such as narrow-band ultraviolet B and excimer laser/lamp, can be used as monotherapy or in combination with other treatments. Off-label systemic therapies may be appropriate for patients with unstable or rapidly progressing disease. Surgical therapy may be suitable for patients with localized or stable recalcitrant disease. Maintenance therapy may help mitigate the risk of disease relapse.</p><p><strong>Conclusion: </strong>Improved clarity around the benefits, risks, and limitations of available therapies has supported the development of robust guidelines and a treatment algorithm for vitiligo. Disease stabilization and repigmentation are goals that can largely be achieved, particularly when patients share a mutual understanding of vitiligo and its treatment options. A Graphical Abstract is available for this article.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1351-1369"},"PeriodicalIF":3.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988928","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}