Dermatology and Therapy最新文献

{"title":"Gender Influence on Bimekizumab Response in Patients with Psoriasis: Results of a Real-World Multicenter Retrospective Study-IL PSO (Italian Landscape PSOriasis).","authors":"Helena Gioacchini, Agnese Rossi, Maria Esposito, Emanuele Vagnozzi, Maria Concetta Fargnoli, Paolo Gisondi, Francesco Bellinato, Chiara Assorgi, Pina Brianti, Santo Raffaele Mercuri, Martina Burlando, Emanuele Cozzani, Giovanna Brunasso, Stefano Caccavale, Anna Balato, Giacomo Caldarola, Clara De Simone, Elena Campione, Alessandro Giunta, Francesco Tonon, Marina Venturini, Carlo Giovanni Carrera, Angelo Valerio Marzano, Andrea Carugno, Paolo Sena, Antonio Costanzo, Alessandra Narcisi, Francesco Cusano, Paolo Dapavo, Pietro Quaglino, Annunziata Dattola, Antonio Giovanni Richetta, Francesca Gaiani, Piergiorgio Malagoli, Matteo Megna, Luca Potestio, Edoardo Mortato, Francesco Loconsole, Francesca Romano, Andrea Faragalli, Rosaria Gesuita, Tommaso Bianchelli, Federico Diotallevi, Diego Orsini, Anna Campanati","doi":"10.1007/s13555-025-01435-w","DOIUrl":"10.1007/s13555-025-01435-w","url":null,"abstract":"<p><strong>Introduction: </strong>Several studies have demonstrated that psoriasis severity is generally greater in male patients, but it is unclear whether this gender difference may affect short-term therapeutic response. Notably, no studies have specifically investigated bimekizumab, a humanized, full-length IgG1 monoclonal antibody that acts as a dual inhibitor of interleukin (IL)-17A and IL-17F.</p><p><strong>Methods: </strong>This was a cross-sectional, observational, retrospective, multicenter analysis. A cohort of 318 patients with moderate to severe psoriasis, 229 male patients (median [IQR] age 35 [23-67] years) and 89 female patients (median [IQR] age 33 [20-68] years), were retrospectively evaluated for short-term response (16 weeks) to bimekizumab according to standard dosage (320 mg at weeks 0, 4, 8, 12, and 16, and every 8 weeks thereafter). Patients were assessed to evaluate whether gender differences in demographic and clinical characteristics can affect treatment response to standard dose of bimekizumab, during the first 16 weeks of treatment. Therapeutic outcomes were evaluated by analyzing Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) scores recorded in each patient at three consecutive time points: baseline (T0), after 4 weeks (T4), and after 16 weeks of treatment (T16).</p><p><strong>Results: </strong>Male patients showed more severe disease at baseline, compared to female patients (p = 0.01). A significant reduction in disease severity was observed in both male and female patients after 16 weeks of treatment, but male patients showed a faster decrease in PASI score between baseline and week 4 of treatment compared to female patients (p < 0.001). Nevertheless, by week 16, difference in PASI response and DLQI reduction between genders became less pronounced.</p><p><strong>Conclusion: </strong>Although male patients exhibit greater disease severity at baseline compared to female patients, this does not result in a differential response to bimekizumab over the short term. Both male and female patients had equal probability of achieving complete or near-complete disease remission within the first 4 weeks of treatment, and both maintain this response status through week 16. The therapeutic benefit of bimekizumab may be due to the rapid dual inhibition of IL-17A and IL-17F, which may lead to consistent and robust clinical response across genders, regardless of baseline disease severity. Our results suggest a \"gender severity-invariant effect\" of bimekizumab, highlighting the treatment as rapidly effective in both genders, despite initial differences in disease severity.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1797-1811"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972387","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 Practical Approach to Chronic Hand Eczema.","authors":"Sophia A Mense, Sawyeh Maher, Raj Chovatiya","doi":"10.1007/s13555-025-01433-y","DOIUrl":"10.1007/s13555-025-01433-y","url":null,"abstract":"<p><p>Chronic hand eczema (CHE) is a multifactorial condition with significant physical, psychological, and socioeconomic burdens. Its complex pathogenesis often does not align with clinical presentation, leading to overlapping etiologic subtypes, including allergic contact dermatitis (ACD), irritant contact dermatitis (ICD), and atopic hand eczema (AHE). While patch testing remains the gold standard for confirming ACD, its clinical utility can be limited owing to frequent subtype overlap, impracticality of allergen avoidance, and practical considerations relating to the process and availability of patch testing itself. This review provides a practical, clinician-oriented framework for managing CHE, emphasizing the importance of clinical judgment in deciding when patch testing is indicated versus when prompt treatment should take priority. We explore the role of patch testing in CHE within the context of real-world practice, incorporating global perspectives where they inform practical clinical decision-making. With the emergence of targeted therapies addressing CHE immunopathogenesis, balancing traditional diagnostic approaches with early, effective treatment is increasingly necessary. A streamlined, patient-centered strategy balancing diagnostic thoroughness with timely interventions may aid clinicians in optimizing outcomes in this complex disease.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1953-1971"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093159","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 Evidence for Baricitinib in the Treatment of Atopic Dermatitis and Alopecia Areata: Systematic Literature Review 2020-2023.","authors":"Julien Seneschal, Lgnasi Figueras Nart, Silvia Sabatino, Manny Papadimitropoulos, Srishti Dabral, Anastasia Lampropoulou","doi":"10.1007/s13555-025-01425-y","DOIUrl":"10.1007/s13555-025-01425-y","url":null,"abstract":"<p><strong>Introduction: </strong>Baricitinib is an oral selective Janus kinase 1/2 inhibitor approved for the treatment of the immune-mediated inflammatory skin diseases atopic dermatitis (AD) and alopecia areata (AA). We report the findings of a systematic literature review of real-world outcomes with baricitinib in patients with AD or AA.</p><p><strong>Methods: </strong>Databases, conference proceedings, and other sources were searched for publications covering July to November 2023 that provided real-world evidence in baricitinib-treated patients; extracted study variables included study population characteristics, interventions, and outcomes.</p><p><strong>Results: </strong>In total, 76 publications meeting inclusion criteria were identified, most of which were single-centre studies; 1134 unique patients with AD and 598 unique patients with AA were included. Studies in AD mostly focused on effectiveness outcomes, followed by treatment patterns, patient-reported outcomes, and safety. Most AA publications focused on effectiveness outcomes, followed by safety then treatment patterns.</p><p><strong>Conclusion: </strong>Overall, baricitinib consistently improved the signs and symptoms of AD in patients receiving baricitinib in real-world settings, was effective for the treatment of AA in both adult and paediatric patients and was associated with improvements in patient-reported outcomes. The most common reasons for baricitinib discontinuation in AD were ineffectiveness and adverse events, although discontinuation rates due to adverse events were low. Patients initiating baricitinib for AD had often been treated previously with a biologic and were frequently receiving immunosuppressive and topical treatments before treatment initiation. Treatment discontinuation and prior treatment data were limited for studies in AA, but several studies reported concomitant minoxidil use in patients with AA treated with baricitinib. No new safety signals for baricitinib were observed in patients with AD or AA, and no serious adverse events were reported. In conclusion, real-world data on baricitinib in the treatment of AD and AA support the effectiveness and tolerability reported in clinical trials.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1719-1754"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076798","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":"Efficacy and Safety of JAK Inhibitors in the Management of Vitiligo: A Systematic Review and Meta-analysis.","authors":"Alzahra A Mohammed, Anna S Lengyel, Fanni A Meznerics, István Szondy, Anna Walter, Bence Szabó, Dorottya Pál, Adrienn Bojtor, András Bánvölgyi, Norbert Kiss, Péter Hegyi, Lajos V Kemény, Zsuzsanna Kurgyis","doi":"10.1007/s13555-025-01397-z","DOIUrl":"10.1007/s13555-025-01397-z","url":null,"abstract":"<p><strong>Introduction: </strong>Vitiligo, a chronic skin disease affecting 1-2% of the global population, is associated with significant impairment in quality of life. Current pharmacological treatment options have limited efficacy and considerable side effects. Recent studies have shown promising results when using Janus kinase inhibitors (JAKis). Despite these favourable findings, there remains a critical need for comprehensive data on the efficacy and safety of JAKi in the treatment of vitiligo.</p><p><strong>Methods: </strong>Three databases were searched for studies on patients with vitiligo treated with oral or topical JAKi, with or without conventional therapy. Placebo or vehicle cream were comparators in randomised controlled trials (RCTs). Outcomes included a 75% improvement in Facial-Vitiligo Area Scoring Index (F-VASI), mean Vitiligo Area Scoring Index (VASI) improvement, repigmentation percentage and adverse events. We performed three analyses: one using RCT data, one from case reports and a novel cohort of JAKi-treated patients from case reports. The protocol is registered with PROSPERO (CRD42023445503).</p><p><strong>Results: </strong>Among the 35 articles identified, 19 were included in the statistical analyses. A meta-analysis of three randomised controlled trials (RCTs) on topical Janus kinase inhibitors (JAKis) suggested that patients treated with JAKi were more likely to achieve Facial Vitiligo Area Scoring Index 75 (F-VASI75) than those using vehicle cream (risk ratio (RR) 3.47, 95% confidence interval (CI) 0.98-12.22), with no significant difference in adverse events between groups (RR 1.27; 95% CI 0.88-1.82). A meta-analysis of four single-arm trials showed a 43.8% mean Vitiligo Area Scoring Index (VASI) improvement (95% CI 0.71-0.93). A cohort (n = 28) from case reports and series revealed significant repigmentation increases of 48.7% and 63.7% (p = 0.0018; p < 0.001) in patients treated with JAKi alone or with narrowband ultraviolet B (UVB). However, data were insufficient to determine if combination treatments were superior to JAKi alone.</p><p><strong>Conclusion: </strong>Our systematic review evaluated the efficacy and safety of JAKi for vitiligo using data from RCTs, single-arm trials and case reports. While topical ruxolitinib showed promising but non-significant results in RCTs, single-arm trials and case studies highlighted significant repigmentation, particularly with oral JAKis combined with other therapies. Oral JAKis showed effectiveness but require caution due to potential adverse effects such as immune suppression and cardiovascular risks. Furthermore, it is important to acknowledge that a considerable proportion of patients do not respond to these therapies. Additional RCTs are needed to address long-term safety, optimise application strategies and establish standardised endpoints for combination therapies.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1657-1679"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962191","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":"Clinical Utility Findings of a Transcriptomic Psoriasis Biologic Test Demonstrate Altered Physician Prescribing Behavior and Improved Patient Outcomes.","authors":"Bruce E Strober, Michael Bukhalo, April W Armstrong, David Pariser, Leon Kircik, Brian Johnson, Paul Montgomery, Tobin J Dickerson","doi":"10.1007/s13555-025-01441-y","DOIUrl":"10.1007/s13555-025-01441-y","url":null,"abstract":"<p><strong>Introduction: </strong>This randomized, prospective study (MATCH) was designed to assess the clinical utility of a machine learning-based tool (Mind.Px) that predicts patient response to the biologic drug classes used in the management of psoriasis.</p><p><strong>Methods: </strong>Patients with psoriasis who were biologic naïve or approaching a medication change owing to nonresponse were enrolled into the study (N = 210). At baseline, a dermal biomarker patch was applied to lesional skin, and Mind.Px test results were provided to physicians for patients in the informed arm of the study prior to biologic selection. The choice of biologic was recorded, and, in the case of physician nonconcordance with Mind.Px test results, a questionnaire was completed to determine the reason for nonconcordance. Patients were evaluated at weeks 4 and 12 after baseline using Psoriasis Area and Severity Index (PASI). Statistical analysis between groups was performed using Fisher's exact test.</p><p><strong>Results: </strong>Physician prescribing behavior was measured with and without the inclusion of Mind.Px test results in the decision-making process (N = 205). Additional comparisons were made to a previously collected data set identical to the Mind.Px-uninformed arm (N = 429). Statistical analysis of concordance between the Mind.Px-informed and Mind.Px-uninformed groups (92.3% versus 62.9%, respectively) showed that when given access to Mind.Px results, physician behavior was significantly altered (p = 8.08 × 10^-7). Furthermore, analysis of patients whose physicians followed Mind.Px results showed that not only did more patients reach the clinical endpoint (PASI75) at 12 weeks (p = 5.4 × 10^-4), but also more patients reached this endpoint by week 4 than those in the treatment-as-usual arm (p = 0.01).</p><p><strong>Conclusions: </strong>These results provide evidence of the clinical utility of Mind.Px by showing that physicians utilize test results in psoriasis biologic decision-making, leading to improved patient outcomes. These improved patient outcomes can also potentially translate into cost savings for healthcare systems. Mind.Px can minimize the trial-and-error approach to psoriasis treatment, and provide physicians, patients, and payers with an effective tool for re-envisioning the management of patients with psoriasis.</p><p><strong>Clinicaltrials: </strong></p><p><strong>Gov listing: </strong>NCT05036889.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1787-1796"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995556","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":"Assessing Long-Term Pain Reduction with Secukinumab in Moderate to Severe Hidradenitis Suppurativa: A Post Hoc Analysis of the SUNSHINE and SUNRISE Phase 3 Trials.","authors":"John R Ingram, Jacek C Szepietowski, Lukasz Matusiak, Georgios Kokolakis, Magdalena B Wozniak, Christine-Elke Ortmann, Angela Llobet Martinez, Shoba Ravichandran, Nicolas Thomas, Ivette Alarcon, Christelle C Pieterse, Maryam Shayesteh Alam, Dimitrios Ioannides, Alexa B Kimball","doi":"10.1007/s13555-025-01426-x","DOIUrl":"10.1007/s13555-025-01426-x","url":null,"abstract":"<p><strong>Introduction: </strong>Hidradenitis suppurativa (HS) is a chronic, painful skin disease associated with a high disease burden. Disease-related pain is frequently reported as the most troublesome symptom of HS. The SUNSHINE and SUNRISE phase 3 trials previously reported that secukinumab improved control of pain in patients with moderate to severe HS. The objective of this analysis was to evaluate the impact of secukinumab on multiple aspects of pain in patients with HS from SUNSHINE and SUNRISE.</p><p><strong>Methods: </strong>Patients were randomised to receive secukinumab 300 mg every 2 (SECQ2W) or 4 weeks (SECQ4W), or placebo until week 16. At week 16, the placebo group switched to receive SECQ2W (placebo-SECQ2W) or SECQ4W (placebo-SECQ4W), whereas the secukinumab groups continued their treatment, until week 52. Pain was assessed using the Patient's Global Assessment of skin pain‒at worst on a continuous numeric rating scale (NRS) through week 52. Quartiles were used to categorise pain severity groups based on baseline NRS scores (NRS ≤ 3.3; NRS > 3.3 to ≤ 5.4; NRS > 5.4 to ≤ 7.2; NRS > 7.2). Additional assessments included quality of life (QoL) and pain medication use.</p><p><strong>Results: </strong>At week 16, a greater mean (standard deviation) absolute change from baseline in skin pain was observed for patients treated with secukinumab [SECQ2W (- 1.35 (2.16)); SECQ4W (- 1.05 (2.02))] versus placebo [- 0.47 (2.07)]. In the SECQ2W and SECQ4W groups, in patients with NRS > 7.2 at baseline, 20.0% and 12.7% had NRS ≤ 3.3 at week 16, respectively. This improvement in pain was maintained through week 52. Moreover, patients in the NRS ≤ 3.3 category generally experienced better QoL. The proportion of patients reporting pain medication use was generally reduced at weeks 16 and 52 versus baseline in the secukinumab groups.</p><p><strong>Conclusion: </strong>This analysis highlights the sustained benefits of secukinumab in reducing pain in patients with moderate to severe HS. These pain reductions were associated with QoL improvements.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT03713619 (SUNSHINE) and NCT03713632 (SUNRISE).</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1833-1849"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076783","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":"Inflammatory Bowel Disease Prevalence in Patients with Hidradenitis Suppurativa Using Prospective Symptom-Based Questionnaires and Fecal Calprotectin Testing.","authors":"Niamh Kearney, Emily K Pender, Rosalind Hughes, Collette McCourt, Graham Turner, Graham Morrison, Glen Doherty, Juliette Sheridan, Donal O'Kane, Brian Kirby","doi":"10.1007/s13555-025-01438-7","DOIUrl":"10.1007/s13555-025-01438-7","url":null,"abstract":"<p><strong>Introduction: </strong>Hidradenitis suppurativa (HS) is associated with inflammatory bowel disease (IBD). Using healthcare databases, an estimated 2.1% of patients with HS have IBD. Prospective screening of patients with HS with IBD sign/symptom-based questions and fecal calprotectin (FC) has not been studied. Our aim was to evaluate the prevalence of IBD in HS and the utility of a sign/symptom-based questionnaire and FC testing.</p><p><strong>Methods: </strong>All patients with HS attending two clinics were invited to participate. Information was collected on demographics, HS severity, and IBD risk factors. Fecal samples were returned by patients for calprotectin testing (≤ 50 μg/g = negative, 50-150 μg/g = borderline, ≥ 150 μg/g = positive).</p><p><strong>Results: </strong>We recruited 150 patients including 124 women (82.7%) with a median age of 36 years and Hurley stage 2/3 disease (88.6%); 11 patients had established IBD (7.3%). Up to 44.7% of patients reported gastrointestinal symptoms. In 98 patients who returned a fecal sample for calprotectin measurement, 10 had previously diagnosed IBD (10.3%), 81 had a negative FC (82.7%), 13 had a borderline FC (13.3%) and 4 had a positive FC (4.1%). Among 4 patients with a positive result, 2 had known IBD (50%); 2 without established IBD were referred to gastroenterology and 1 had a negative endoscopy reporting an acute diarrheal illness at the time of their FC. The second patient was diagnosed with endoscopic and histologic Crohn's disease.</p><p><strong>Conclusions: </strong>We report an IBD prevalence of 8%, higher than previous studies. Routine IBD sign/symptom-based assessment is currently recommended. In our study, this would result in a referral rate of 44.7%. Among 88 FC tests in patients without established IBD, 1 patient was diagnosed with incident occult Crohn's disease. At a number needed to screen (NNS) of 88, routine evaluation of all patients with HS with FC may be justified especially prior to the use of interleukin (IL)-17 antagonists.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1901-1913"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141686","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 Impact of Step Therapy on Individuals with Psoriatic Disease in the USA: Patient and Provider Perspectives.","authors":"Georgia Marquez-Grap, Dayna L Pham, Andrea Leung, Melissa C Leeolou, Allison Kranyak, Wilson Liao","doi":"10.1007/s13555-025-01430-1","DOIUrl":"10.1007/s13555-025-01430-1","url":null,"abstract":"<p><p>The management of psoriatic disease has been revolutionized by biologic medications in recent years. Despite their efficacy and safety, patients are often required by insurance plans in the USA or national formulary guidelines in other countries to try and fail other treatments first, which is a strategy called step therapy. Originally designed to contain costs of specialty drugs, step therapy has a number of negative impacts on patients and providers, both personally and clinically. This article is coauthored by a patient with psoriasis and psoriatic arthritis who navigated step therapy. She describes her early experiences with psoriasis and achieving disease control with biologic medication, only to later be diagnosed with psoriatic arthritis and need to revise this treatment plan. She then explains how insurance denials and step therapy impact her life physically, emotionally, socially, and medically. This case is then discussed from the perspective of a dermatologist specializing in inflammatory skin disease. We highlight the psychosocial burden of psoriatic disease, as well as the burden of step therapy and its impacts on patients, providers, and the entire medical system.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1599-1606"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980742","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":"Local Corticosteroids for Alopecia Areata: A Narrative Review.","authors":"Samantha Gregoire, Basil McIntosh, Katherine Sanchez, Ursula Biba, Arash Mostaghimi","doi":"10.1007/s13555-025-01421-2","DOIUrl":"10.1007/s13555-025-01421-2","url":null,"abstract":"<p><p>Alopecia areata (AA) is an autoimmune condition of non-scarring hair loss that affects 2% of the population worldwide. Topical and intralesional (IL) corticosteroids are the two most commonly used treatments for AA. These locally acting glucocorticoid derivatives are thought to treat AA by reducing the CD8+ T-cell-mediated immune attack on hair follicles. Topical corticosteroids are safe and well tolerated with moderate efficacy in mild AA, but recurrence is common after treatment cessation. They are recommended for children and adults with mild AA who cannot tolerate IL injections. IL steroids are more effective than topical steroids given their ability to penetrate the dermis, where the hair follicle resides. Success rates are higher than topical steroids in mild-to-moderate AA. IL steroids are safe and well tolerated; however, treatment is limited by pain during the procedure. Further research is needed on ideal treatment regimens, long-term safety, preferred candidates, and the role of combination therapy to further elucidate the role of local corticosteroids for AA in clinical practice.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1607-1631"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968287","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 and Burden of Hidradenitis Suppurativa: An Italian Hybrid Real-World Study.","authors":"Anna Balato, Marina Venturini, Massimiliano Scalvenzi, Caterina Foti, Giovanni Maifredi, Simona Serao Creazzola, Stefania Antonacci, Arianna Tonelli, Diletta Valsecchi, Donatella Vassellatti, Riccardo Cipelli, Alessandra Ori, Lucia Casoli","doi":"10.1007/s13555-025-01407-0","DOIUrl":"10.1007/s13555-025-01407-0","url":null,"abstract":"<p><strong>Introduction: </strong>Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease that severely impacts quality of life and carries a substantial economic burden.</p><p><strong>Methods: </strong>This multicenter observational study generated real-world evidence on HS in Italy, focusing on clinical profiles, management, and costs. Data were collected from 50 adults at four specialized centers, combining primary data with retrospective administrative data.</p><p><strong>Results: </strong>Patients with moderate-to-severe disease had longer diagnostic delays (median 1.8 versus 0.7 years), lower symptom control (40.7% versus 95.2%), and worse quality of life (Dermatology Life Quality Index: 11.8 versus 8.0) than those with mild disease. Furthermore, HS was associated with higher costs in moderate-to-severe cases, including greater direct (€2214 versus €873) and indirect expenses (€2435 versus €262).</p><p><strong>Conclusions: </strong>The findings highlight the social and economic burden of HS and emphasize the need for increased healthcare awareness for earlier diagnosis and better management.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1771-1785"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984084","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}