JAMA dermatology最新文献

{"title":"Emollients to Prevent Pediatric Eczema: A Randomized Clinical Trial.","authors":"Eric L Simpson, LeAnn C Michaels, Katrina Ramsey, Lyle J Fagnan, Donald E Nease, Mary Henningfield, Rowena J Dolor, Jodi Lapidus, Xaviera Martinez-Ziegenfuss, Annette Vu, Laura Ferrara, Katharine E Zuckerman, Cynthia D Morris, Hywel C Williams","doi":"10.1001/jamadermatol.2025.2357","DOIUrl":"10.1001/jamadermatol.2025.2357","url":null,"abstract":"<p><strong>Importance: </strong>Atopic dermatitis (AD) imposes a global health burden for children and is a risk factor for developing food allergy and asthma. Few studies have evaluated emollient intervention for primary AD prevention in infants not selected for risk.</p><p><strong>Objective: </strong>To determine whether emollient intervention in infants not selected for risk reduces AD incidence by age 24 months.</p><p><strong>Design, setting, and participants: </strong>A randomized, decentralized pragmatic clinical trial was conducted that involving 1247 infant-parent dyads recruited from 25 community-based pediatric and family medicine clinics that are members of 4 statewide practice-based research networks. Participants were recruited from July 2018 to February 2021, with follow-up completed through February 2023.</p><p><strong>Intervention: </strong>Dyads were randomized to 1 of 2 groups: a daily full-body emollient application daily moisturizer group starting by age 9 weeks or a control group that refrained from emollient use.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was physician-diagnosed AD recorded in the patient's medical record by age 24 months. Participants completed quarterly electronic surveys to report adverse events and alert the team if an AD diagnosis had been made. Trained research coordinators abstracted participants' medical records.</p><p><strong>Results: </strong>Of 1247 infants, 553 (44.3%) were female, and the mean (SD) age at randomization was 23.9 (16.3) days. At 24 months, the cumulative incidence of AD was 36.1% (SE, 2.1) in the daily moisturizer group and 43.0% (SE 2.1) in the control group, with a relative risk (RR) of 0.84 (95% CI, 0.73-0.97; P = .02), and the magnitude of effect was larger in the population not at high risk of AD (RR, 0.75; 95% CI, 0.60-0.90; P = .01). The protective effect was significantly modified by the presence of a dog in the home (RR, 0.68; 95% CI, 0.50-0.90; P = .01). There were no between-group differences in cutaneous adverse events.</p><p><strong>Conclusions and relevance: </strong>This randomized clinical trial found that daily emollient application beginning before age 9 weeks in a representative US population not selected for risk reduced the cumulative incidence of AD at age 24 months. Implementing this approach to pediatric skin care may be a feasible way to reduce the burden of AD in US communities.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT03409367.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12287936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lichen Sclerosus Prevalence and Squamous Cell Carcinoma Development in Female Medicare Beneficiaries.","authors":"Surya A Veerabagu, Yao Li, Michaela Grinsfelder, Alicia J Little, Divya Srivastava, Mackenzie R Wehner","doi":"10.1001/jamadermatol.2025.2257","DOIUrl":"10.1001/jamadermatol.2025.2257","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12287932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postzygotic Gain-of-Function Variant in TRPM4 and Inflammatory Linear Verrucous Epidermal Nevus.","authors":"Zhouliang Liu, Zhijun Zhao, Kunlun Lv, Huijun Wang, Fan Yang, Zhimiao Lin","doi":"10.1001/jamadermatol.2025.2205","DOIUrl":"https://doi.org/10.1001/jamadermatol.2025.2205","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690349","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":"Emollients to Prevent Atopic Dermatitis-Is New Evidence a Game Changer?","authors":"Cathryn Sibbald, Robert J Boyle, Aaron M Drucker","doi":"10.1001/jamadermatol.2025.2354","DOIUrl":"10.1001/jamadermatol.2025.2354","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690345","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":"Lichen Sclerosus-A Call for an Evidence-Based Approach.","authors":"Kelly H Tyler","doi":"10.1001/jamadermatol.2025.2256","DOIUrl":"https://doi.org/10.1001/jamadermatol.2025.2256","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690348","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":"Quantifying the Role of Specialty Medications in Medicare Part D Expenditures in Dermatology.","authors":"Edward L Kong, Arash Mostaghimi","doi":"10.1001/jamadermatol.2025.2142","DOIUrl":"10.1001/jamadermatol.2025.2142","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;The rising cost of prescription drugs is a major concern in health care. Specialty medications, particularly biologics, have transformed dermatologic care but are expensive and may be factors in disproportionate growth in spending.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To assess the role of specialty medications in Medicare Part D drug spending among physician dermatologists and dermatology-focused advanced practice clinicians (nurse practitioners and physician assistants) from 2013 to 2022.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This economic analysis used Medicare Part D prescriber data on drug prescriptions from 2013 to 2022 to report on prescription drug claims from physician dermatologists and dermatology-focused advanced practice clinicians, identified using validated administrative claims-based definitions. Data were analyzed from December 17, 2024, to May 31, 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposure: &lt;/strong&gt;Prescription volumes, average prices, and the introduction of new drugs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;The primary outcome was growth in inflation-adjusted total dermatology drug spending, decomposed by specialty status, prescriptions, prices, and US Food and Drug Administration approval year assessed from Centers for Medicare and Medicaid Services Part D prescriber data from 2013 to 2022.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In 94 900 359 drug claims from 24 731 dermatology care professionals, inflation-adjusted Medicare Part D spending increased by 16.1% annually, from $768 million in 2013 to $2.95 billion in 2022. Specialty medications contributed 98.4% of this growth, increasing from 30.8% of all dermatology drug spending in 2013 to 80.9% in 2022, despite being only 2.9% of prescriptions. Average inflation-adjusted prices per 30-day prescription for specialty medications increased by 5.1% per year, from $3738 in 2013 to $5872 in 2022. In contrast, prices for nonspecialty medications decreased by 5.3% annually relative to inflation, from $68 in 2013 to $42 in 2022. Most of the growth in specialty medication spending was due to increased prescribing (80.5%) rather than higher prices (19.5%). New therapies approved after 2013 (Otezla, Cosentyx, Taltz, Dupixent, Tremfya, Skyrizi, and Odomzo) accounted for 69.5% of all spending growth. Prescription rates increased more slowly for older specialty drugs (Humira, Enbrel, Stelara, and Erivedge), but their prices increased more (9.2% annually) than prices for newer agents.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;Results of this economic evaluation suggest that specialty medications have become a substantial factor in dermatology drug spending. While the price of the average dermatologic medication has increased rapidly, this primarily reflects increased prescribing of newly introduced specialty drugs. While these therapies expand treatment options, their rising share of costs highlights the need for policies that balance innovati","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ixekizumab and Malignant Neoplasms: A Pooled Analysis of Data From 25 Randomized Clinical Trials.","authors":"Joseph F Merola, Kim A Papp, Atul Deodhar, Andrew Blauvelt, Andris Kronbergs, Meghan Feely McDonald, Nadezdha Eberhart, Danting Zhu, Elsa Inman, Elsie Grace, Thorsten Holzkaemper, Proton Rahman, Helena Marzo-Ortega, Alice B Gottlieb, Sergio Schwartzman, Mark Lebwohl","doi":"10.1001/jamadermatol.2025.2056","DOIUrl":"10.1001/jamadermatol.2025.2056","url":null,"abstract":"<p><strong>Importance: </strong>Assessing malignant neoplasm risk among patients with long-term biologic exposure is of interest. This study provides insight into the risk of malignant neoplasm among patients with psoriasis (PsO), psoriatic arthritis (PsA), or axial spondyloarthritis (axSpA) who received ixekizumab (IXE) over time.</p><p><strong>Objective: </strong>To determine the incidence of malignant neoplasms among patients with PsO, PsA, or axSpA who received long-term (up to 6 years) IXE treatment, and to compare the recorded incidences (excluding nonmelanoma skin cancer) with those observed in the US general population.</p><p><strong>Design, setting, and participants: </strong>This multicenter, global pooled analysis examined patient data from 25 randomized clinical trials (RCTs) in patients with PsO, PsA, or axSpA receiving at least 1 dose of IXE over 5 years (PsO) or 3 years (PsA and axSpA). Eligibility criteria varied across the 25 RCTs, but most of the patients were naive to biologic treatments. The primary analysis was performed in March 2021 (PsA) and March 2022 (PsO and axSpA).</p><p><strong>Intervention: </strong>Long-term treatment with IXE.</p><p><strong>Main outcomes and measures: </strong>Incidence rates of malignant neoplasms and standardized incidence ratios (SIRs).</p><p><strong>Results: </strong>The mean age across the 3 indications was 45.9 years; most patients in the PsO and axSpA cohorts were male (4696/6892 [68.1%] and 650/932 [69.7%], respectively), whereas the proportion of male to female patients in the PsA cohort was largely balanced (679/1401 [48.5%] vs 722/1401 [51.5%], respectively). The study included 6892 patients with PsO, 1401 patients with PsA, and 932 patients with axSpA, representing a cumulative exposure to IXE of 22 371.1 patient-years (PY) (18 025.7 PY for PsO, 2247.7 PY for PsA, and 2097.7 PY for axSpA). Malignant neoplasms were reported among 141 patients with PsO (2.0%; incidence rate [IR], 0.8 per 100 PY [95% CI, 0.7-0.9]), 15 patients with PsA (1.1%; IR, 0.7 per 100 PY [95% CI, 0.4-1.1]), and 9 patients with axSpA (1.0%; IR, 0.4 per 100 PY [95% CI, 0.2-0.8]). IRs of malignant neoplasms at 1-year intervals remained low (≤1.2 per 100 PY) and constant over time. SIRs with 95% CIs were below or near 1 (PsO, 0.89 [95% CI, 0.71-1.08]; PsA, 0.49 [95% CI, 0.13-0.85]; axSpA, 1.07 [95% CI, 0.37-1.77]).</p><p><strong>Conclusions and relevance: </strong>This pooled analysis of 25 RCTs demonstrated that the safety profile of IXE supports long-term use in patients with PsO, PsA, or axSpA. This is evidenced by incidences of malignant neoplasms consistent with previous reports, and with SIRs of malignant neoplasms across indications similar to the US general population.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hidradenitis Suppurativa Unroofing Procedure Costs in the Context of Medical Inflation.","authors":"Zachary Ruffolo, Ashwath J Sampath, Allison Locy, Peter A Khoury, Austin Cohrs, Matthew Helm, Galen Foulke","doi":"10.1001/jamadermatol.2025.0819","DOIUrl":"10.1001/jamadermatol.2025.0819","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"763-765"},"PeriodicalIF":11.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nemolizumab for Cholestatic Pruritus in a Patient With Liver Transplant and Primary Sclerosing Cholangitis.","authors":"Gabriela Soto-Canetti, Jordan Talia","doi":"10.1001/jamadermatol.2025.1471","DOIUrl":"10.1001/jamadermatol.2025.1471","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"775-776"},"PeriodicalIF":11.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215877","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":"Dermatologic Care and Skin Health of Migrant Populations in the US: A Scoping Review.","authors":"Herbert B Castillo Valladares, Penelope Kim-Lim, Aileen Y Chang","doi":"10.1001/jamadermatol.2025.0404","DOIUrl":"10.1001/jamadermatol.2025.0404","url":null,"abstract":"<p><strong>Importance: </strong>Despite literature on migrant skin health globally, there remains a critical gap in understanding the dermatologic care and skin health of migrants in the US, where immigrants represent 13.9% of the population.</p><p><strong>Objective: </strong>To understand the spectrum of dermatologic conditions reported among US migrant populations, identify considerations for dermatologic care delivery, and synthesize the current literature on skin health.</p><p><strong>Evidence review: </strong>PubMed, Embase, and ClasePeriodica were searched for articles published from January 2000 to December 2022 using search terms related to dermatologic conditions and migrants. Original research articles, review articles, case reports, and case series that reported on dermatologic conditions affecting migrant populations within the US and US territories were included.</p><p><strong>Findings: </strong>Of 87 articles included, cross-sectional studies accounted for 37 (42.5%), followed by case reports and case series (36 [41.4%]), qualitative studies (3 [3.4%]), and a mixed-methods study (1 [1.1%]). Articles discussed a range of dermatologic conditions: infections (45 [51.7%]), inflammatory conditions (33 [37.9%]), traumatic wounds (16 [18.4%]), neoplasms (10 [11.5%]), pigmentary disorders (10 [11.5%]), signs of torture/violence (4 [4.6%]), cosmetic (3 [3.4%]), hair/nail disorders (1 [1.1%]), and genodermatoses (1 [1.1%]). Of 65 articles (74.6%) reporting migrants' country of origin, Mexico was most frequently reported (28 [43.0%]), followed by Guatemala (14 [21.5%]), Vietnam (8 [12.3%]), and 38 other countries. Four themes were developed: (1) exposures before and during migration were risk factors for dermatologic conditions that presented at destination; (2) occupational and environmental exposures were risk factors for dermatologic conditions that developed at destination; (3) structural factors limited migrants' access to quality health care; and (4) educational interventions targeting different learner groups were opportunities to improve skin health of migrants.</p><p><strong>Conclusions and relevance: </strong>This scoping review found that exposures before, during, and after migration and health care access are associated with the skin health of US migrant populations. Research opportunities include focusing on a broad spectrum of dermatologic diseases, countries of birth, occupations, and vulnerable populations, such as women and children, as well as implementing and evaluating policy that addresses structural barriers migrants face in accessing quality health care.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"739-746"},"PeriodicalIF":11.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12338999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}