JAMA dermatology最新文献

{"title":"Nicotinamide for Skin Cancer Chemoprevention.","authors":"Kimberly F Breglio, Katlyn M Knox, Jonathan Hwang, Rachel Weiss, Kyle Maas, Siwei Zhang, Lydia Yao, Chris Madden, Yaomin Xu, Rebecca I Hartman, Lee Wheless","doi":"10.1001/jamadermatol.2025.3238","DOIUrl":"10.1001/jamadermatol.2025.3238","url":null,"abstract":"<p><strong>Importance: </strong>Nicotinamide supplementation has been studied as a chemopreventive medication for reducing skin cancer risk, but large-scale data are limited.</p><p><strong>Objective: </strong>To determine the clinical efficacy of nicotinamide supplementation for skin cancer prevention in the general population and among solid organ transplant recipients.</p><p><strong>Design, setting, and participants: </strong>A retrospective cohort study was conducted using electronic health record data (October 1, 1999, to December 31, 2024) from the Veterans Affairs Corporate Data Warehouse (CDW) of 33 822 patients. Analyses were conducted from January 17, 2025, to May 9, 2025. Patients who were exposed to nicotinamide were propensity score matched based on the number and year of skin cancers after which treatment with nicotinamide was initiated, age, sex, self-reported race, exposure to acitretin, exposure to field therapy, history of chronic lymphocytic leukemia, and history of solid organ transplant. The index date was the first prescription of nicotinamide filled within the VA system. Stratified Cox models were used to investigate the association of nicotinamide with skin cancer development.</p><p><strong>Exposures: </strong>Nicotinamide, 500 mg, twice daily for longer than 30 days as documented in the electronic health record.</p><p><strong>Main outcomes and measures: </strong>Time to the next skin cancer after baseline.</p><p><strong>Results: </strong>There were 12 287 patients (mean [SD] age, 77.2 [8.9] years; 241 women [2.0%]; 31 [0.3%] American Indian or Alaska Native, 3 [<0.1%] Asian, 13 [0.1%] Black or African American, 59 [0.5%] Native Hawaiian or other Pacific Islander, and 11 662 [94.9%] White individuals) exposed to oral nicotinamide, 500 mg, twice daily for longer than 30 days who were matched to 21 479 unexposed patients (mean [SD] age, 76.9 [8.7] years; 374 women [2.0%]; 49 [0.2%] American Indian or Alaska Native, 3 [<0.1%] Asian, 16 [0.1%] Black or African American, 88 [0.4%] Native Hawaiian or other Pacific Islander, and 20 517 [95.3%] White individuals). Within the matched dataset, there were 10 994 instances of basal cell carcinoma after nicotinamide exposure and 12 551 cutaneous squamous cell carcinoma (cSCC). A total of 1334 (3.9%) in the matched cohort were solid organ transplant recipients. Overall, there was a significant 14% reduction in skin cancer risk. When nicotinamide was initiated after a first skin cancer, the risk reduction rose to 54%, although this benefit declined with initiation following subsequent skin cancers. This risk reduction was seen for skin cancers overall, basal cell carcinoma, and cSCC, with the greatest risk reduction seen for cSCC. Among solid organ transplant recipients, no overall significant risk reduction was observed, although early nicotinamide use was associated with reduced cSCC incidence.</p><p><strong>Conclusions and relevance: </strong>The results of this cohort study suggest th","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075359","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":"Diagnostic Utility of Initial Cardiac Screening in Patients With Cutaneous Sarcoidosis.","authors":"Eric Xia, Ahana Gaurav, Sanjay Divakaran, Sotonye Imadojemu","doi":"10.1001/jamadermatol.2025.3198","DOIUrl":"10.1001/jamadermatol.2025.3198","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075382","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":"Topical β-Blocker Wet Wrap Therapy for Amivantamab-Induced Scalp and Facial Necrosis.","authors":"Hsuan-Chi Chen, Wen-Hung Chung, How-Wen Ko, Jong-Hwei Su Pang, Yu-Shien Ko, Mei-Jun Chen, Chun-Wei Lu","doi":"10.1001/jamadermatol.2025.3122","DOIUrl":"https://doi.org/10.1001/jamadermatol.2025.3122","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029748","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":"A Risk Prediction Tool for Invasive Melanoma.","authors":"David C Whiteman, Catherine M Olsen, Huanwei Wang, Matthew H Law, Rachel E Neale, Nirmala Pandeya","doi":"10.1001/jamadermatol.2025.3028","DOIUrl":"10.1001/jamadermatol.2025.3028","url":null,"abstract":"<p><strong>Importance: </strong>Increasingly, strategies to systematically detect melanomas invoke targeted approaches, whereby those at highest risk are prioritized for skin screening. Many tools exist to predict future melanoma risk, but most have limited accuracy and are potentially biased.</p><p><strong>Objectives: </strong>To develop an improved melanoma risk prediction tool for invasive melanoma.</p><p><strong>Design, setting, and participants: </strong>This population-based prospective cohort study (the QSkin Study) in Queensland, Australia, involved 10 years of follow-up from the baseline survey in 2011 and included individuals aged between 40 to 69 years who were melanoma-free at baseline and completed a comprehensive risk factor survey at recruitment. The data analysis was conducted from October 2024 to April 2025.</p><p><strong>Exposures: </strong>Thirty-one candidate variables collected at baseline were identified a priori as potential predictors of future risk of invasive melanoma.</p><p><strong>Main outcomes and measures: </strong>Histologically confirmed invasive melanomas newly diagnosed from baseline through to December 31, 2021, captured by data linkage to the Queensland Cancer Register. Follow-up was censored on diagnosis of melanoma in situ or death. Cox proportional hazards models with forward and backward selection approaches were used to identify the best-fitting model.</p><p><strong>Results: </strong>Of 41 919 eligible participants, 55% were female, and the mean (SD) age at baseline was 55.4 (8.2) years. A total of 706 new invasive melanomas were identified during 401 356 person-years of follow-up. The best-fitting model retained 14 predictors (age, sex, ancestry, nevus density, freckling density, hair color, tanning ability, adult sunburns, family history, other cancer prior to baseline, previous skin cancer excisions, previous actinic keratoses, smoking status, and height) and 2 statistical terms (age squared, age-by-sex interaction), yielding an apparent discriminatory accuracy of 0.74 (95% CI, 0.73-0.76). The Youden index was optimized at a screening threshold selecting the top 40% of predicted risk, which captured 74% of cases (number needed to screen = 32).</p><p><strong>Conclusions and relevance: </strong>This cohort study has identified an improved tool that offers enhanced accuracy for predicting the future risk of invasive melanoma compared with existing tools.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029688","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":"A Solitary Firm Nodule on the Left Cheek.","authors":"Rafael Fayos-Gregori, Miguel Mansilla-Polo, Rafael Botella-Estrada","doi":"10.1001/jamadermatol.2025.2516","DOIUrl":"https://doi.org/10.1001/jamadermatol.2025.2516","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029648","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":"Mycosis Fungoides Palmaris et Plantaris.","authors":"Juliette M Kersten, Rosanne Ottevanger, Rein Willemze","doi":"10.1001/jamadermatol.2025.3013","DOIUrl":"https://doi.org/10.1001/jamadermatol.2025.3013","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029658","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":"Autoantibody Positivity Rates in Classic and Clinically Amyopathic Dermatomyositis.","authors":"Xiwei Yang, Shae Chambers, Aretha On, Hammad Ali, Touraj Khosravi-Hafshejani, Lais Lopes Almeida Gomes, Rui Feng, Victoria P Werth","doi":"10.1001/jamadermatol.2025.3143","DOIUrl":"10.1001/jamadermatol.2025.3143","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029669","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":"Polyomavirus Antibodies for Merkel Cell Carcinoma Recurrence Detection.","authors":"Lindsay Gunnell, Daniel S Hippe, Song Youn Park, Alex Fu, Tomoko Akaike, Kristina Lachance, Kelsey Cahill, Coley Doolittle-Amieva, Paul Nghiem","doi":"10.1001/jamadermatol.2025.3155","DOIUrl":"10.1001/jamadermatol.2025.3155","url":null,"abstract":"<p><strong>Importance: </strong>Merkel cell carcinoma (MCC) is typically caused by the Merkel cell polyomavirus (MCPyV) and recurs in 40% of patients. Half of patients with MCC produce antibodies to MCPyV oncoproteins, the titers of which rise with disease recurrence and fall after successful treatment.</p><p><strong>Objective: </strong>To assess the utility of MCPyV oncoprotein antibodies for early detection of first recurrence of MCC in a real-world clinical setting.</p><p><strong>Design, setting, and participants: </strong>This prospective cohort study used a data and specimen repository from 2008 to 2020 in Seattle, Washington. Patients with MCC with locoregional disease underwent serum antibody testing at diagnosis. Statistical analysis was conducted between 2020 and 2025.</p><p><strong>Main outcomes and measures: </strong>The first posttreatment titer was necessary to establish a trend and was not used to assess risk (deferred). Subsequent titers were defined as (1) falling or negative, (2) rising, or (3) stable compared with the preceding titer.</p><p><strong>Results: </strong>Among the 503 patients in the cohort (median [IQR] age at diagnosis, 70 [62-77] years; 40% female), 1402 tests were performed; 247 (49%) were seropositive. A total of 877 were falling or negative, 62 were rising, 317 were stable, and 146 were deferred. Median (IQR) follow-up was 4.2 (1.8-7.4) years. On average, antibody titers fell by half every 3 months among patients not experiencing a recurrence. After a falling or negative titer, the likelihood that a given patient would remain recurrence-free for 3 months was 99.3% (95% CI, 98.6%-99.8%). In contrast, after a single rising titer, the risk of recurrence over the next 3 months was 36% (95% CI, 22%-52%), increasing to 58% (95% CI, 40%-78%) by 12 months and 68% (95% CI, 48%-86%) by 24 months. A rising titer preceded clinical or radiographic evidence of recurrence in 57% of cases (20/35). The median (IQR) interval between a rising titer and clinical disease detection was 3.7 (1.1-7.5) months, with 90% of recurrences (18/20) occurring within 14 months of the rising titer. Recurrences and antibody titers were analyzed in 196 patients with multiple blood draws.</p><p><strong>Conclusions and relevance: </strong>In this prospective cohort study, given a negative predictive value of 99.3%, a falling or negative titer may obviate the need for imaging, reducing radiation and contrast dye exposure. Conversely, a rising antibody titer should trigger closer follow-up, as it may lead to earlier detection of clinical recurrence and initiation of therapy.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029795","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":"Is Wide Local Excision After Primary Excision of Melanoma In Situ Unnecessary?","authors":"Katy J L Bell, H Peter Soyer, Peter M Ferguson","doi":"10.1001/jamadermatol.2025.3077","DOIUrl":"10.1001/jamadermatol.2025.3077","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954811","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":"Local Recurrence and Survival in Patients With Melanoma In Situ.","authors":"Clio Dessinioti, Aggeliki Befon, Mihaella Plaka, Aikaterini Niforou, Katerina Kypreou, Alan C Geller, Alexander J Stratigos","doi":"10.1001/jamadermatol.2025.3078","DOIUrl":"10.1001/jamadermatol.2025.3078","url":null,"abstract":"<p><strong>Importance: </strong>The overdiagnosis of melanoma in situ (MIS) is well documented. There is limited evidence on the rate of local recurrence of the non-lentigo maligna (non-LM)/non-acral lentiginous melanoma (non-ALM) subtypes.</p><p><strong>Objective: </strong>To investigate local recurrence and prognosis in non-LM/non-ALM MIS, the histopathological clearance of the excisional biopsy margins, and the association with the size of wide excision margins.</p><p><strong>Design, setting, and participants: </strong>This retrospective cohort study included patients with non-LM/non-ALM MIS diagnosed from 1991 to 2023 who were followed up for at least 1 year at the Skin Cancer and Melanoma Unit of Andreas Sygros University Hospital in Athens, Greece. Patients with a history of invasive melanoma or a histopathological diagnosis of LM or ALM in situ were excluded. Median (IQR) follow-up was 5.2 (2.9-7.9) years. Deidentified data on patient demographics and clinical characteristics, including the histopathological clearance of margins of the initial excisional biopsy and the size of margins of the wide excision, were obtained from medical records.</p><p><strong>Main outcomes and measures: </strong>The primary outcomes were local recurrence, metastasis, and melanoma-specific survival.</p><p><strong>Results: </strong>A total of 401 patients (214 [53.4%] women) with 403 non-LM/non-ALM MIS and a median (IQR) age of 52 (40-62) years were included in the analysis. MIS was frequently located on the trunk (201 lesions [49.9%]), followed by the lower extremity (99 [24.6%]), the upper extremity (71 [17.6%]), and the head and neck (32 [7.9%]). All lesions were initially treated with excisional biopsy, followed by wide excision for 372 (92.3%). There was only 1 local recurrence in a patient with involved margins at the excisional biopsy who did not undergo wide excision and developed an invasive melanoma 14 months later. Thirty lesions in 30 patients had clear excisional biopsy margins with no wide excision and had no recurrence at a median (IQR) follow-up of 8.1 (4.1-12.9) years. In 23 patients with 23 lesions that had wide excision with narrower than the standard 0.5-cm margins (mean [SD] margin size, 0.36 [0.07] cm), no recurrences were found at a median (IQR) follow-up of 4.3 (2.7-6.2) years. During follow-up, 6 patients (1.5%) developed a lesion suspicious for recurrence near the excision scar, which was excised and showed nevus or solar lentigo on histopathology. No patients had metastasis or melanoma-specific death.</p><p><strong>Conclusions and relevance: </strong>This cohort study found that diagnostic excisional biopsies with clear margins may be sufficient for treating MIS; however, larger studies are necessary.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954800","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}