JAMA dermatology最新文献

{"title":"Age, Sex, and Anatomical Location Patterns in Cutaneous Pyogenic Granuloma Cases.","authors":"Umber Dube, Meagan Corliss, Kevin M Bowling, Jonathan W Heusel, Carrie C Coughlin","doi":"10.1001/jamadermatol.2024.5447","DOIUrl":"https://doi.org/10.1001/jamadermatol.2024.5447","url":null,"abstract":"<p><strong>Importance: </strong>Cutaneous pyogenic granulomas (PGs) are commonly encountered, benign, vascular tumors, in which epidemiologic factors have been variably reported, in part, due to sample size limitations and a focus on either adult or pediatric patients.</p><p><strong>Objective: </strong>To assemble a large dataset of pathologically diagnosed PGs across the continuum of age and investigate patterns of PGs by demographic factors, including age, sex, and anatomical location.</p><p><strong>Design, setting, and participants: </strong>This retrospective case series included case reports of patients with pathologically confirmed PGs of cutaneous origin reported between April 1, 2010, to March 31, 2020. The pathology database at a large tertiary academic center in the Midwestern US was queried for case reports that included the term pyogenic granuloma or lobular capillary hemangioma. Individuals were included in the analytic sample if they had a pathologically confirmed diagnosis of a PG. PG cases were excluded if they included PG only as a part of the pathological differential diagnoses; were recurrent; or were of noncutaneous origin. These data were analyzed between March 2022 and March 2023.</p><p><strong>Main outcomes and measures: </strong>The main outcomes were sex biases in frequency overall, by anatomical region, and by left-right laterality using exact binomial tests. Additional outcomes included differences in age-by-sex distribution overall and by anatomical region using Kolmogorov-Smirnov tests.</p><p><strong>Results: </strong>Of 1009 unique pathologically confirmed PG records from 987 individuals, 376 individuals (38.1%) were younger than 18 years, of whom 122 (32.4%) were female. A total of 611 individuals were 18 years and older, of whom 364 (59.6%) were female. Overall, PGs between male and female individuals were equally distributed for all anatomical locations except lower extremities, in which females were more frequently affected. The distribution of PGs by age was significantly different between male and female individuals, with this difference primarily associated with the head/neck and trunk but not with upper extremity or lower extremity anatomical locations. Neither left-right laterality bias among upper extremity PGs nor anterior-posterior bias among truncal PGs was observed.</p><p><strong>Conclusions and relevance: </strong>In this retrospective case series, an age-by-sex interaction was found in the incidence of PGs, with PGs on the head/neck and trunk being more common in males younger than 20 years and in females 20 to 50 years of age. These findings suggest that trauma may not be a major etiologic factor for PGs. Future studies are necessary to confirm this and to understand the causes of the age-by-sex interaction.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on Consensus for Generalized Pustular Psoriasis.","authors":"Shayan Waseh, Sylvia Hsu, Mark G Lebwohl","doi":"10.1001/jamadermatol.2024.6063","DOIUrl":"https://doi.org/10.1001/jamadermatol.2024.6063","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combination of Baricitinib and Phototherapy in Adults With Active Vitiligo: A Randomized Clinical Trial.","authors":"Julien Seneschal, Mathilde Guyon, Ribal Merhi, Juliette Mazereeuw-Hautier, Nicolas Andreu, Sarah Cazenave, Khaled Ezzedine, Thierry Passeron, Katia Boniface","doi":"10.1001/jamadermatol.2024.5737","DOIUrl":"https://doi.org/10.1001/jamadermatol.2024.5737","url":null,"abstract":"<p><strong>Importance: </strong>Vitiligo is a chronic autoimmune disorder leading to skin depigmentation and reduced quality of life (QOL). Patients with extensive and very active disease are the most difficult to treat.</p><p><strong>Objective: </strong>To assess the efficacy and adverse events of baricitinib combined with narrowband UV-B in adults with severe, active, nonsegmental vitiligo.</p><p><strong>Design, setting, and participants: </strong>This academic, multicenter, double-blind, noncomparative randomized clinical trial was conducted at 4 dermatology departments between July 2021 and April 2023 and included adult patients with extensive and active nonsegmental vitiligo. The study was designed to evaluate the effect of baricitinib plus narrowband UV-B based solely on the results from this experimental group. The placebo group was used as a calibration group. Data were analyzed from August to November 2023.</p><p><strong>Interventions: </strong>Participants were randomized 3:1 to baricitinib, 4 mg per day, or placebo for 36 weeks alone for the first 12 weeks and then in combination with narrowband UV-B twice a week from weeks 12 to 36.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was mean percentage change in total Vitiligo Area Scoring Index (VASI) score from baseline to week 36 (baricitinib group). The prespecified aim of the study was to show that the reduction in the baricitinib plus narrowband UV-B was significantly greater than 42.9%, a repigmented surface threshold previously observed in patients treated with narrowband UV-B alone. Adverse events and secondary outcomes of change in disease activity and QOL were assessed. Post hoc analyses were additionally performed.</p><p><strong>Results: </strong>Of 49 included patients, 35 (71%) were female, and the median (IQR) age was 49.9 (38.4-59.8) years. A total of 37 patients were randomized to the baricitinib group and 12 to the placebo group. The mean change in total VASI at week 36 was -44.8% (95% CI, -58.4% to -31.3%) for the baricitinib group and -9.2% (95% CI, -27.7% to 24.7%) for the placebo group. This was not significantly greater than the sufficient repigmented surface threshold of 42.9%. Post hoc analyses showed a significant difference at week 36 for total VASI score in the baricitinib plus narrowband UV-B group compared with placebo plus narrowband UV-B (-44.8% vs -9.2%, respectively; P = .02). There was a greater improvement in disease activity and QOL in the baricitinib group vs placebo group and no significant difference in the number of adverse events.</p><p><strong>Conclusions and relevance: </strong>This proof-of-concept randomized clinical trial confirmed the efficacy of baricitinib combined with narrowband UV-B in the treatment of patients with extensive and active vitiligo.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT04822584.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Error in the Results Section.","authors":"","doi":"10.1001/jamadermatol.2024.6382","DOIUrl":"https://doi.org/10.1001/jamadermatol.2024.6382","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on Consensus for Generalized Pustular Psoriasis-Reply.","authors":"Siew Eng Choon, Peter van de Kerkhof, Hervé Bachelez","doi":"10.1001/jamadermatol.2024.6061","DOIUrl":"https://doi.org/10.1001/jamadermatol.2024.6061","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disseminated Pseudovesicles in an Immunocompromised Patient.","authors":"William J Nahm, Michelle C Juarez, Daniel R Mazori","doi":"10.1001/jamadermatol.2024.5875","DOIUrl":"https://doi.org/10.1001/jamadermatol.2024.5875","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Acne Core Outcomes Research Network Patient Global Assessment for Acne.","authors":"Delaney Griffiths, Ali Shields, James Choe, Jerry Tan, Alison Margaret Layton, Diane Thiboutot, John S Barbieri","doi":"10.1001/jamadermatol.2024.5679","DOIUrl":"https://doi.org/10.1001/jamadermatol.2024.5679","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acne Relapse and Isotretinoin Retrial in Patients With Acne.","authors":"Jenny Lai, John S Barbieri","doi":"10.1001/jamadermatol.2024.5416","DOIUrl":"https://doi.org/10.1001/jamadermatol.2024.5416","url":null,"abstract":"<p><strong>Importance: </strong>Isotretinoin is the only medical acne treatment capable of inducing acne remission; however, some patients experience acne relapse and require retrials of isotretinoin. There is a need to understand who is most at risk and how daily dose and cumulative dosage can influence outcomes.</p><p><strong>Objective: </strong>To assess rates of acne relapse and isotretinoin retrial and to identify associated factors among patients with acne who received an isotretinoin treatment course.</p><p><strong>Design, setting, and participants: </strong>This cohort study used data from the MarketScan commercial claims database from January 1, 2017, to December 31, 2020, to identify patients with acne who were 12 years or older and had received isotretinoin for 4 months or longer, with at least 1 year of continuous enrollment after completion of isotretinoin. Data analyses were performed from June 30, 2024, to August 1, 2024.</p><p><strong>Main outcomes and measures: </strong>Multivariable Cox proportional hazards regression was used to quantify associations of patient demographic and treatment characteristics with acne relapse and isotretinoin retrial.</p><p><strong>Results: </strong>A total of 19 907 patients (mean [SD] age, 20.6 [7.8] years; 10 504 females [52.8%]) were included, among whom 4482 (22.5%) had acne relapse and 1639 (8.2%) had isotretinoin retrial. Female sex (hazard ratio [HR], 1.43; 95% CI, 1.35-1.52) was significantly associated with increased rates of acne relapse, and isotretinoin cumulative dosage (mg/kg) was associated with a decreased rate of acne relapse (HR, 0.996; 95% CI, 0.995-0.997). Furthermore, daily dose was not associated with decreased risk of acne relapse or isotretinoin retrial among those with conventional and high cumulative dosages. Female sex (HR, 0.68; 95% CI, 0.62-0.76) and isotretinoin cumulative dosage (HR, 0.99; 95% CI, 0.98-0.99) were associated with decreased rates of isotretinoin retrial. Stratification by cumulative dosage indicated that higher cumulative dosage was associated with decreased rates of retrial among patients with low (<120 mg/kg) and conventional (120-220 mg/kg), but not high (>220 mg/kg) cumulative dosage. Maximum daily dose (mg/kg/d) was not negatively associated with acne relapse or isotretinoin retrial in patients with cumulative dosage of 120 mg/kg or more.</p><p><strong>Conclusions and relevance: </strong>The findings of this cohort study suggest that higher cumulative dosage may potentially reduce risk of acne relapse and isotretinoin retrial. Furthermore, daily dose was not associated with decreased risk of the outcomes for conventional and high cumulative dosage; therefore, daily dosing could be individualized to patient goals and preferences.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of a Buschke-Löwenstein Tumor With Radiotherapy and Cemiplimab.","authors":"Andrew M Farach, Elleana Paradise, Ryan B Kieser","doi":"10.1001/jamadermatol.2024.5826","DOIUrl":"https://doi.org/10.1001/jamadermatol.2024.5826","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Skin Microbiome in Central Centrifugal Cicatricial Alopecia.","authors":"Alexandra Firek, Peng Hou, Jungmin Han, Cassandra J Holmes, Grace Suh, Cheri Frey, Heidi H Kong, Leslie Castelo-Soccio","doi":"10.1001/jamadermatol.2024.5421","DOIUrl":"https://doi.org/10.1001/jamadermatol.2024.5421","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}