JAMA dermatology最新文献

{"title":"3D Total-Body Photography in Patients at High Risk for Melanoma: A Randomized Clinical Trial.","authors":"H Peter Soyer, Dilki Jayasinghe, Astrid J Rodriguez-Acevedo, Louisa G Collins, Liam J Caffery, David C Whiteman, Brigid Betz-Stablein, Sonya R Osborne, Anna Finnane, Caitlin Horsham, Clare Primiero, Leonard C Gray, Monika Janda","doi":"10.1001/jamadermatol.2025.0211","DOIUrl":"10.1001/jamadermatol.2025.0211","url":null,"abstract":"<p><strong>Importance: </strong>Three-dimensional (3D) total-body photography (TBP) can support clinicians in monitoring and identifying changes to skin lesions in patients at high risk of melanoma.</p><p><strong>Objective: </strong>To assess clinical outcomes between patients at high risk of melanoma receiving usual clinical care compared with those receiving usual care plus 3D TBP and sequential digital dermoscopy imaging (SDDI) every 6 months via teledermatology.</p><p><strong>Design, setting, and participants: </strong>This randomized clinical trial was conducted at a research hospital in Brisbane, Australia, from April 2018 to October 2021, with adult patients (≥18 years) at high risk of developing a primary or subsequent melanoma. Data analysis was conducted from March 2022 to June 2024.</p><p><strong>Intervention: </strong>Usual care plus 3D-TBP in person and SDDI via teledermatology at baseline, 6, 12, 18, and 24 months. The control group continued usual care and completed online surveys every 6 months.</p><p><strong>Main outcome measures: </strong>Number and rates of excisions and/or biopsies of lesions suggestive of melanoma, and results of histopathologic testing.</p><p><strong>Results: </strong>The analysis included 314 participants (mean [SD] age, 51.6 [12.8] years; 194 females [62%]) who completed all of the study procedures (158 in the intervention and 156 in the control). In all, 1527 excisions (905 intervention and 622 in the control) were performed among 226 participants (122 intervention and 104 controls), with 67 (4%) histopathologically confirmed as melanoma and 402 (26%) as keratinocyte cancer (KC). The mean (SD) number of lesions of any type excised per person was significantly higher in the intervention (5.73 [6.77]; 95% CI, 4.66-6.79) compared to the control group (3.99 [5.72]; 95% CI, 3.08-4.89; P = .02). Fewer melanomas were detected among the intervention group compared with the control (24 [35%] vs 43 [64%], respectively), and therefore, a lower incidence rate: 2.03 (95% CI, 1.30-3.02) vs 3.62 (95% CI, 2.62-4.88), respectively. After 1 year of follow-up, the intervention had a lower, but not statistically significant, rate of melanoma per person: 0.08 (95% CI, 0.03-0.13) compared with 0.16 (95% CI, 0.08-0.25) in the control; an average of 0.86 (95% CI, 0.55-1.16) vs 0.42 (95% CI, 0.24-0.59) KCs per person; and 2.01 (95% CI, 1.50-2.51) vs 1.39 (95% CI, 0.98-1.82) excisions or biopsies per person, respectively.</p><p><strong>Conclusions and relevance: </strong>The results of this randomized clinical trial indicate that the addition of 3D-TPB and SDDI to usual care in a teledermatology setting without AI (artificial intelligence) increased the number and rate of skin excisions and biopsies performed. Further studies are required to compare teledermatology to usual care rather than adding it, and to study whether the use of AI can improve the teledermatology outcomes. Larger studies in multiple settings with a greater num","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"472-481"},"PeriodicalIF":11.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709810","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":"Late-Onset Diffuse Xanthomas in an Adult Man.","authors":"Reid Weisberg, Sameera Husain, Jason E Liebowitz","doi":"10.1001/jamadermatol.2025.0189","DOIUrl":"10.1001/jamadermatol.2025.0189","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"547-548"},"PeriodicalIF":11.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709725","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 Box.","authors":"","doi":"10.1001/jamadermatol.2025.0619","DOIUrl":"10.1001/jamadermatol.2025.0619","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"562"},"PeriodicalIF":11.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709820","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":"Tripe Palms.","authors":"Pedro Simões Farinha, Margarida Brito Caldeira, João Oliveira Torres","doi":"10.1001/jamadermatol.2025.0195","DOIUrl":"10.1001/jamadermatol.2025.0195","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"546"},"PeriodicalIF":11.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763884","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":"Reexamining Medication Impact in Hidradenitis Suppurativa and Pregnancy.","authors":"Yan-Han Li, Shu-Han Chuang, Hui-Ju Yang","doi":"10.1001/jamadermatol.2025.0507","DOIUrl":"10.1001/jamadermatol.2025.0507","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"561"},"PeriodicalIF":11.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811389","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":"At-Home LED Devices for the Treatment of Acne Vulgaris: A Systematic Review and Meta-Analysis.","authors":"Sherry Ershadi, John S Barbieri","doi":"10.1001/jamadermatol.2025.0019","DOIUrl":"10.1001/jamadermatol.2025.0019","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"552-555"},"PeriodicalIF":11.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556790","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":"JAMA Dermatology-The Year in Review, 2024.","authors":"Kanade Shinkai","doi":"10.1001/jamadermatol.2025.0201","DOIUrl":"10.1001/jamadermatol.2025.0201","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"467-469"},"PeriodicalIF":11.5,"publicationDate":"2025-05-01","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}

{"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":"490-497"},"PeriodicalIF":11.5,"publicationDate":"2025-05-01","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}

{"title":"Error in Abstract.","authors":"","doi":"10.1001/jamadermatol.2025.0620","DOIUrl":"10.1001/jamadermatol.2025.0620","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"562"},"PeriodicalIF":11.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709817","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":"Mohs Surgery vs Wide Local Excision in Primary High-Stage Cutaneous Squamous Cell Carcinoma.","authors":"David M Wang, Michelangelo Vestita, Fadi G Murad, Frederick C Morgan, Rachael Rowley, Eleni M Rettig, William Lotter, Abigail B Waldman, Emily S Ruiz, Chrysalyne D Schmults","doi":"10.1001/jamadermatol.2024.6214","DOIUrl":"10.1001/jamadermatol.2024.6214","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;High-stage cutaneous squamous cell carcinoma (cSCC) has an increased risk of recurrence, metastasis, and mortality. Studies investigating the outcomes of high-stage cSCC among patients treated with Mohs surgery compared with those treated with wide local excision (WLE) are limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To assess the outcomes of primary high-stage cSCC among patients treated with Mohs surgery compared with those treated with WLE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This retrospective cohort study using propensity score weighting was conducted in a tertiary academic medical center in Boston, Massachusetts. Patients were included if they had primary high-stage cSCC and had been treated with either Mohs surgery or WLE between January 1, 2000, and December 31, 2019. Data analysis was performed between November 3 and 6, 2023.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposures: &lt;/strong&gt;Primary surgical treatment with Mohs surgery or WLE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;Outcomes included local recurrence, nodal metastasis, distant metastasis, any recurrence (ie, a composite outcome of recurrence or metastasis), and disease-specific death. Propensity scores were estimated via logistic regression using baseline patient and tumor characteristics. Competing risk regression analysis was used to compute crude and inverse probability of treatment weighting (IPTW), cause-specific hazard ratios (HRs), and Fine-Gray subdistribution HRs and to derive cumulative incidence functions stratified by Mohs and WLE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;This study included 216 patients with high-stage cSCC who had a mean (SD) age of 73.5 (13.3) years; 151 (69.9%) were men and 65 (30.1%) were women. The median follow-up time was 33.1 months (IQR, 11.3-77.6 months). After IPTW, the baseline characteristics were well balanced between the WLE and Mohs surgery treatment groups, with absolute standardized differences of less than 0.10 across all characteristics. In the IPTW competing risks model, the 3-year cumulative incidence of all adverse outcomes were greater among patients in the WLE group compared with those in the Mohs surgery group, including local recurrence (19.8% vs 9.6%; weighted cause-specific HR, 2.33 [95% CI, 1.39-3.92]; P = .001), nodal metastasis (17.9% vs 11.0%; weighted cause-specific HR, 1.80 [95% CI, 1.07-3.02]; P = .03), distant metastasis (8.4% vs 4.4%; weighted cause-specific HR, 2.10 [95% CI, 0.97-4.57]; P = .06), any recurrence (32.0% vs 15.8%; weighted cause-specific HR, 2.38 [95% CI, 1.57-3.61]; P &lt; .001), and disease-specific death (17.5% vs 7.1%; weighted cause-specific HR, 2.74 [95% CI, 1.54-4.88]; P = .001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;The findings of this cohort study suggest that Mohs surgery was associated with improved outcomes in the treatment of primary high-stage cSCC compared with WLE. These findings further suggest that Mohs surgery or alternative methods of peri","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"508-514"},"PeriodicalIF":11.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449065","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}