Dermatology and Therapy最新文献

{"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, Kwinten Bosman, Andrew Korotzer","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}

{"title":"The Association Between Atopic Dermatitis and Select Disease Events in Adults in the United States: A Retrospective Cohort Study in the Optum Electronic Health Records Database.","authors":"Adina R Lemeshow, Alexander Egeberg, Thomas Edwards, Stephen E Schachterle, William Romero, Daniela E Myers, Shefali Vyas, Jonathan I Silverberg","doi":"10.1007/s13555-025-01375-5","DOIUrl":"10.1007/s13555-025-01375-5","url":null,"abstract":"<p><strong>Introduction: </strong>Previous studies have reported positive associations between atopic dermatitis (AD) and select disease events; however, definitive conclusions are lacking. The aim of this study was to characterize demographic and clinical characteristics of patients with and without AD and estimate crude incidence rates (IRs) and adjusted hazard rate ratios (HRRs) of select disease events in these cohorts.</p><p><strong>Methods: </strong>This retrospective observational analysis used Optum® Market Clarity Electronic Health Records, a US administrative healthcare database. Adults with and without AD between 2016 and 2021 with ≥ 12 months of database activity prior to index date (based on diagnosis or first treatment) were included. Each patient with AD was matched on age and index date with five patients without AD. The AD cohort was stratified by treatment prescribed within 30 days of AD diagnosis: no AD treatment; topical corticosteroids (TCS)/topical calcineurin inhibitors (TCI) only (\"TCS/TCI only\"); phototherapy with/without TCS/TCI (\"phototherapy\"); and systemic therapy, including oral corticosteroids with/without phototherapy and with/without TCS/TCI (\"systemics\"). Crude IRs and adjusted HRRs of infections, malignancies, cardiovascular events, mental health outcomes, asthma, fracture, and death across patient subgroups were estimated.</p><p><strong>Results: </strong>The total cohort comprised 161,646 adults. Among the 25,915 patients with AD, 8384 (32.35%), 13,459 (51.94%), 366 (1.41%), and 3706 (14.30%) were included in the \"no AD treatment,\" \"TCS/TCI only,\" \"phototherapy,\" and \"systemics\" subgroups, respectively. Crude IRs/1000 patient-years were higher among patients with AD versus those without AD for serious infections (38.35 vs. 19.21), major adverse cardiovascular events (16.51 vs. 11.82), venous thromboembolism (11.12 vs. 6.89), malignancies (excluding nonmelanoma skin cancer; 17.51 vs. 15.25), and depression (63.50 vs. 44.18); similar trends were observed after controlling for potential confounding variables. When stratified by treatment, IRs and HRRs of these events were generally higher in patients in the \"systemics\" subgroup versus other treatment subgroups.</p><p><strong>Conclusions: </strong>Overall, certain disease event rates were higher in the population with AD versus the population without AD, with a trend towards higher rates among patients prescribed systemic therapies compared with those prescribed TCS/TCI only. This study further informs the relationship between AD and the risk of select disease events.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1371-1390"},"PeriodicalIF":3.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987868","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":"Prospective Comparative Study of an Oral Synbiotic and a Myoinositol-Based Herbal Supplement in Modifying Hormone Levels and the Gut Microbiome in Non-cystic Acne.","authors":"Mildred Min, Nasima Afzal, Jessica Maloh, Ajay S Dulai, Nabeel Ahmad, David Pinzauti, Raja K Sivamani","doi":"10.1007/s13555-025-01411-4","DOIUrl":"10.1007/s13555-025-01411-4","url":null,"abstract":"<p><strong>Introduction: </strong>Acne pathogenesis is multifactorial, involving systemic factors including gut dysbiosis, hormones, and chronic inflammation. Probiotics, myoinositol, and plant-derived molecules may modulate acne by targeting these factors. The objective is to compare a synbiotic containing herbs against a myoinositol-based herbal supplement on how they influence acne, the gut microbiome, short chain fatty acids (SCFAs), and hormonal profiles.</p><p><strong>Methods: </strong>This was an 8-week, randomized study involving 36 male and female patients aged 12 to 45 years with non-cystic acne. Subjects received either a synbiotic or a myoinositol-based herbal supplement (MBHS). Acne lesions were counted, stool samples were collected for gut microbiome and SCFA analyses, and hormone collections were performed at baseline, 4, and 8 weeks.</p><p><strong>Results: </strong>Several gut bacteria increased by at least threefold at both week 4 and 8 in the synbiotic (Erysipelatoclostridium merdavium, Blautia argi, Faecalibacterium prausnitzii, Prevotella copri, Streptococcus sp001556435, Blautia sp900541955) and MBHS group (Megamonas funiformis, Ligilactobacillus ruminis, Prevotella ssp015074785, Prevotella copri, Gca-900199835 sp900176495). Acne lesion counts decreased significantly in both groups at week 4 (p < 0.0001) and week 8 (synbiotic, p < 0.0001; MBHS, p < 0.0001). There were significant and trending increases in stool and plasma SCFAs in both cohorts at week 4 and 8. After 8 weeks of MBHS, 17-OHP and androstenedione significantly decreased from 27.3 to 11.3 pg/ml (p = 0.001) and 94.9 to 68.0 pg/ml (p = 0.04), respectively.</p><p><strong>Conclusion: </strong>Both the synbiotic and MBHS improved gut health, augmented SCFAs, and reduced lesion counts in those with non-cystic acne. The MBHS may act by reducing hormone levels of 17-OHP and androstenedione.</p><p><strong>Clinical trial registration: </strong>www.</p><p><strong>Clinicaltrials: </strong>gov (NCT05919810).</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1331-1350"},"PeriodicalIF":3.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986332","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":"Lichen Planus: A Cross-Sectional Evaluation of US Dermatologists' Comorbidity Screening and Management Patterns.","authors":"Savanna I Vidal, Nikita Menta, Adam Friedman","doi":"10.1007/s13555-025-01422-1","DOIUrl":"10.1007/s13555-025-01422-1","url":null,"abstract":"<p><strong>Introduction: </strong>Lichen planus (LP) is a chronic inflammatory dermatosis affecting up to 0.91% of the US's population. LP is associated with various comorbid conditions, among them autoimmune conditions. LP has various treatment strategies, although none are US Food and Drug Administration (FDA)-approved; this is further complicated by the lack of any clinical or expert guidelines. This study aimed to explore dermatology practitioners' comorbidity screening patterns and treatment practices for management of LP.</p><p><strong>Methods: </strong>An institutional review board (IRB)-approved, anonymous survey was distributed to members of the ODAC Conference listserv, targeting dermatology practitioners. The survey collected data on demographics, comorbidity screening, and treatment strategies.</p><p><strong>Results: </strong>A total of 406 respondents (17.4% response rate) participated. Hepatitis C virus was the most screened for condition (91.0%), despite its overall low prevalence in patients with LP. Screening rates for highly prevalent comorbidities such as hypertension (10.1%), dyslipidemia (9.7%), depression (18.7%), and anxiety (17.3%) were low. Importantly, almost one-third (32.5%) of respondents reported performing no screening for any comorbid conditions. Topical corticosteroids were the most prescribed therapy (97.8%), followed by topical calcineurin inhibitors (67.7%) and intralesional corticosteroids (64.8%), consistent with high-level evidence for their use in LP treatment. Phototherapy and systemic treatments, including oral immunosuppressants and retinoids, were less frequently utilized despite strong evidence supporting their use.</p><p><strong>Conclusion: </strong>These data highlight gaps in the comorbidity screening practices among dermatology practitioners managing LP, with significant underscreening for prevalent conditions. While respondents commonly relied on some evidence-based topical treatments, there is notable underutilization of systemic treatments for moderate to severe disease. These results emphasize the need for clinical guidelines for LP management, aiming to enhance patient care and outcomes.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1455-1465"},"PeriodicalIF":3.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968772","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}