JAMA dermatologyPub Date : 2025-03-26DOI: 10.1001/jamadermatol.2025.0207
Laura K Ferris, Adewole S Adamson
{"title":"Promises and Pitfalls of 3D Total-Body Photography for Melanoma Early Detection.","authors":"Laura K Ferris, Adewole S Adamson","doi":"10.1001/jamadermatol.2025.0207","DOIUrl":"https://doi.org/10.1001/jamadermatol.2025.0207","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709727","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}
JAMA dermatologyPub Date : 2025-03-19DOI: 10.1001/jamadermatol.2025.0141
Andrea D Maderal
{"title":"Need for Consideration of Patient-Specific Risk Factors in Step Therapy.","authors":"Andrea D Maderal","doi":"10.1001/jamadermatol.2025.0141","DOIUrl":"https://doi.org/10.1001/jamadermatol.2025.0141","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656750","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}
JAMA dermatologyPub Date : 2025-03-19DOI: 10.1001/jamadermatol.2025.0128
Nina A Ran, Emily E Granger, David G Brodland, Javier Cañueto, David R Carr, Joi B Carter, John A Carucci, Kelsey E Hirotsu, Shlomo A Koyfman, Aaron R Mangold, Fabio Muradás Girardi, Kathryn T Shahwan, Divya Srivastava, Allison T Vidimos, Tyler J Willenbrink, Ashley Wysong, Emily S Ruiz
{"title":"Risk Factor Number and Recurrence, Metastasis, and Disease-Related Death in Cutaneous Squamous Cell Carcinoma.","authors":"Nina A Ran, Emily E Granger, David G Brodland, Javier Cañueto, David R Carr, Joi B Carter, John A Carucci, Kelsey E Hirotsu, Shlomo A Koyfman, Aaron R Mangold, Fabio Muradás Girardi, Kathryn T Shahwan, Divya Srivastava, Allison T Vidimos, Tyler J Willenbrink, Ashley Wysong, Emily S Ruiz","doi":"10.1001/jamadermatol.2025.0128","DOIUrl":"10.1001/jamadermatol.2025.0128","url":null,"abstract":"<p><strong>Importance: </strong>Cutaneous squamous cell carcinoma (CSCC) risk stratification is central to management, and physicians rely on tumor staging systems to estimate risk. The Brigham and Women's Hospital (BWH) T staging system predicts risk based on 4 tumor risk factors (RFs). However, stage is not precisely associated with the number of RFs, as BWH stage T2b includes CSCCs with 2 and 3 RFs.</p><p><strong>Objective: </strong>To determine how RF number is associated with the risk of recurrence, metastasis, and disease-related death.</p><p><strong>Design, setting, and participants: </strong>This retrospective multination cohort study of CSCCs diagnosed between October 1, 1991, and July 19, 2023, was conducted at 12 centers in the US (10), Spain (1), and Brazil (1). Invasive CSCCs with confirmed negative margins longer than 14 days were included. Tumors were excluded if they were metastatic at presentation or received adjuvant therapy. Data were analyzed from October 2023 to August 2024.</p><p><strong>Interventions or exposures: </strong>CSCCs were stratified by the number of the following RFs (0, 1, 2, 3, or 4): a diameter of 2 cm or larger, poorly differentiated histology, tumor extension beyond subcutaneous fat, and large caliber nerve invasion.</p><p><strong>Main outcomes and measures: </strong>Five-year cumulative incidences of local recurrence, nodal metastasis, distant metastasis, and disease-specific death.</p><p><strong>Results: </strong>A total of 16 844 CSCCs were included (5978 female individuals [35.5%]; median [IQR] age, 73.9 [65.7-81.8] years), with 0 (12 657 [75.1%]), 1 (2892 [17.2%]), 2 (1015 [6.0%]), 3 ( 225 [1.3%]) or 4 (55 [0.3%]) RFs. Median (IQ) follow up time was 33.6 (14.5-60.3) months. For local recurrence, the risk increased as the number of RF increased from 0 (1.7%; 95% CI, 1.5%-2.0%) to 1 (5.0%; 95% CI, 4.1%-5.9%) to 2 (8.8%; 95% CI, 7.0%-11.0%) to 3 (16.0%; 95% CI, 11.0%-22.0%) to 4 (33.0%; 95% CI, 19.0%-47.0%; P < .001 for between-group differences). This increase was also observed for nodal metastasis (0.6% [95% CI, 0.4%-0.7%] vs 3.6% [95% CI, 2.9%-4.4%] vs 11.0% [95% CI, 9.2%-13.0%] vs 20.0% [95% CI, 15.0%-26.0%] vs 28.0% [95% CI, 15.0%-42.0%], respectively; P < .001), distant metastasis (0.2% [95% CI, 0.1%-0.3%] vs 1.1% [95% CI, 0.7%-1.6%] vs 2.3% [95% CI, 1.4%-3.4%] vs 7.9% [95% CI, 4.6%-12.0%] vs 8.4% [95% CI, 2.6%-19.0%], respectively; P < .001), and disease-specific death (0.3% [95% CI, 0.2%-0.4%] vs 1.9% [95% CI, 1.4%-2.7%] vs 5.4% [95% CI, 4.0%-7.0%] vs 11.0% [95% CI, 6.7%-16.0%] vs 25% [95% CI, 12%-39%], respectively; P < .001). CSCCs with 3 RFs had higher cumulative incidences of local recurrence (1.6-fold), nodal metastasis (1.9-fold), distant metastasis (4.3-fold), and disease-specific death (1.9-fold) compared with those with 2 RFs.</p><p><strong>Conclusions and relevance: </strong>The results of this cohort study suggest that the number of RFs is an indicator of risk, and among BWH T2b tumors,","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656927","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}
JAMA dermatologyPub Date : 2025-03-19DOI: 10.1001/jamadermatol.2025.0144
Aaron M Drucker, Rinku Sutradhar, Vicki Ling, Jodi M Gatley, Lihi Eder, Christine Fahim, Michael Fralick, Tara Gomes, Ping Li, Sue MacDougall, Morris Manolson, Paula A Rochon, Mina Tadrous
{"title":"Systemic Therapies for Psoriatic Disease and Serious Infections in Older Adults.","authors":"Aaron M Drucker, Rinku Sutradhar, Vicki Ling, Jodi M Gatley, Lihi Eder, Christine Fahim, Michael Fralick, Tara Gomes, Ping Li, Sue MacDougall, Morris Manolson, Paula A Rochon, Mina Tadrous","doi":"10.1001/jamadermatol.2025.0144","DOIUrl":"10.1001/jamadermatol.2025.0144","url":null,"abstract":"<p><strong>Importance: </strong>Systemic treatments for psoriatic disease affect the immune system and may increase infection risk. Older adults are at high risk for infection, and the relative safety of systemic treatments for them is unknown.</p><p><strong>Objective: </strong>To evaluate the association of systemic treatments for psoriatic disease with rates of serious infection among older adults.</p><p><strong>Design, setting, and participants: </strong>This cohort study used linked population-based health administrative data from 2002 to 2021 in Ontario, Canada. Participants included Ontario residents 66 years and older with psoriatic disease who were dispensed their first systemic medication between April 1, 2002, and December 31, 2020. Data were analyzed between November 2021 and August 2024.</p><p><strong>Exposure: </strong>Time-varying use of systemic medications categorized as (1) methotrexate; (2) other older systemic medications; (3) anti-tumor necrosis factor (anti-TNF) biologics; (4) other biologics (targeting interleukin [IL]-12, IL-23, and IL-17); and (5) tofacitinib.</p><p><strong>Main outcomes and measures: </strong>The main outcome was time to serious infection, defined as hospitalization for any infectious cause occurring up to March 2021. Multivariable Andersen-Gill recurrent event regression was used to estimate the association between each medication category and serious infection rates. The relative rates (RRs) of serious infection with 95% CIs for time actively using each medication category vs time not using that medication category were calculated.</p><p><strong>Results: </strong>Of 11 641 new users of systemic therapy, 6114 (53%) were female, and the median (IQR) age was 71 (68-76) years. There were 1967 serious infections during a median (IQR) of 4.8 (2.3-8.4) years of follow-up. There were 2.7 serious infections per 100 person-years using methotrexate, 2.5 per 100 person-years using other older systemic drugs, 2.2 per 100 person-years using anti-TNF biologics, 1.4 per 100 person-years using other biologics, and 8.9 per 100 person-years using tofacitinib. In the multivariable-adjusted model, methotrexate (RR, 0.95 [95% CI, 0.85-1.07]), other older systemic medications (RR, 0.92 [95% CI, 0.79-1.07]), and anti-TNF biologics (RR, 0.87 [95% CI, 0.69-1.10]) were not associated with serious infection compared to person-time not using those respective medications. Other biologics (RR, 0.65 [95% CI, 0.48-0.88]) were associated with lower rates of serious infection, whereas tofacitinib (RR, 2.89 [95% CI, 1.14-7.34]) was associated with higher rates of serious infection.</p><p><strong>Conclusions and relevance: </strong>In this cohort study, biologics targeting IL-12, IL-23, or IL-17 were associated with a lower rate of serious infection among older adults with psoriatic disease. These biologics may have important safety benefits for older adults with higher infection risk.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656953","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}
JAMA dermatologyPub Date : 2025-03-19DOI: 10.1001/jamadermatol.2025.0201
Kanade Shinkai
{"title":"JAMA Dermatology-The Year in Review, 2024.","authors":"Kanade Shinkai","doi":"10.1001/jamadermatol.2025.0201","DOIUrl":"https://doi.org/10.1001/jamadermatol.2025.0201","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656823","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}
JAMA dermatologyPub Date : 2025-03-12DOI: 10.1001/jamadermatol.2025.0063
Ruba Srour, Zaaroura Hiba, Salih Mishlab
{"title":"A Firm Pigmented Plaque on the Forearm of a Child.","authors":"Ruba Srour, Zaaroura Hiba, Salih Mishlab","doi":"10.1001/jamadermatol.2025.0063","DOIUrl":"https://doi.org/10.1001/jamadermatol.2025.0063","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604857","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}
JAMA dermatologyPub Date : 2025-03-12DOI: 10.1001/jamadermatol.2025.0025
Kylie A Fletcher, Rachel S Goodman, Aleigha Lawless, Rachel Woodford, Faisal Fa'ak, Asha Tipirneni, J Randall Patrinely, Hui Ling Yeoh, Suthee Rapisuwon, Andrew Haydon, Iman Osman, Janice M Mehnert, Georgina V Long, Ryan J Sullivan, Matteo S Carlino, Alexander M Menzies, Anna K Dewan, Douglas B Johnson
{"title":"Characterizing Chronic Cutaneous Immune-Related Adverse Events Following Immune Checkpoint Inhibitors.","authors":"Kylie A Fletcher, Rachel S Goodman, Aleigha Lawless, Rachel Woodford, Faisal Fa'ak, Asha Tipirneni, J Randall Patrinely, Hui Ling Yeoh, Suthee Rapisuwon, Andrew Haydon, Iman Osman, Janice M Mehnert, Georgina V Long, Ryan J Sullivan, Matteo S Carlino, Alexander M Menzies, Anna K Dewan, Douglas B Johnson","doi":"10.1001/jamadermatol.2025.0025","DOIUrl":"10.1001/jamadermatol.2025.0025","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11904794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604858","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}