JAMA dermatology最新文献

{"title":"Budget Impact Analysis of Gene Therapies for Recessive Dystrophic Epidermolysis Bullosa.","authors":"Adam J N Raymakers, Aaron S Kesselheim, William B Feldman","doi":"10.1001/jamadermatol.2026.3240","DOIUrl":"10.1001/jamadermatol.2026.3240","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919902","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":"Drug Survival of Omalizumab and Factors Associated With Discontinuation in Chronic Urticaria: A Meta-Analysis.","authors":"Alhasan Altayf, Pavel Kolkhir, Mukhtar Alwefati, Pedro Mendes-Bastos, Ranad Jirafa, Torsten Zuberbier, Muhammed Elhadi","doi":"10.1001/jamadermatol.2026.2043","DOIUrl":"10.1001/jamadermatol.2026.2043","url":null,"abstract":"<p><strong>Importance: </strong>Omalizumab is a recommended second-line therapy for chronic urticaria (CU), yet clinical evidence regarding long-term drug survival and determinants of discontinuation remains limited. Understanding drug survival patterns may inform clinical decision-making and patient stratification.</p><p><strong>Objective: </strong>To evaluate the long-term drug survival of omalizumab in patients with CU and identify factors associated with discontinuation.</p><p><strong>Data sources: </strong>PubMed, Embase, and Web of Science were systematically searched from database inception to January 20, 2026.</p><p><strong>Study selection: </strong>Observational clinical studies that reported on time to discontinuation or drug survival outcomes for omalizumab in patients with CU were included. Studies lacking survival data or sufficient information for reconstruction of survival curves were excluded.</p><p><strong>Data extraction and synthesis: </strong>Time-to-event data were reconstructed from published Kaplan-Meier curves using a validated algorithm implemented in the IPDfromKM framework. Pooled hazard ratios (HRs) were synthesized using a random-effects meta-analysis. Analyses followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.</p><p><strong>Main outcomes and measures: </strong>Primary outcomes included overall drug survival and reasons for discontinuation. Secondary outcomes included predictors of discontinuation, expressed as HRs with 95% CIs.</p><p><strong>Results: </strong>Eight studies comprising 4516 patients with CU (3167 female individuals [70.1%]; 3276 with chronic spontaneous urticaria [CSU]) were included. The median drug survival for omalizumab was 3.1 years (95% CI, 2.8-3.4). Over a 7-year follow-up period, patients continued to receive treatment for a mean of 3.75 years (95% CI, 3.62-3.87). Long-term drug survival appeared higher in chronic inducible urticaria (with or without concomitant CSU) than in CSU alone (7-year survival, 43%-49% vs 30%). Early discontinuation was primarily due to well-controlled disease. Discontinuation due to adverse events was uncommon. Autoimmune comorbidity was associated with a higher risk of discontinuation due to lack of efficacy (HR, 2.03; 95% CI, 1.20-3.41), while an atopic background was associated with an increased risk of discontinuation due to well-controlled disease.</p><p><strong>Conclusions and relevance: </strong>The results of this systematic review and meta-analysis suggest that omalizumab demonstrates long-term drug survival in CU, with discontinuation more often due to disease control than adverse events. Autoimmune comorbidities (mainly thyroid-related) were associated with reduced drug survival, primarily due to lack of efficacy, whereas atopic comorbidities were associated with discontinuation after disease control, underscoring the need for improved endotype-driven treatment strategies.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919946","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":"Diffuse Melanosis Cutis and Melanuria in Advanced Melanoma.","authors":"Nike Breitenhuber, Peter Rohrer, Teresa Kränke","doi":"10.1001/jamadermatol.2026.2718","DOIUrl":"https://doi.org/10.1001/jamadermatol.2026.2718","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919943","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":"Inflammatory Bowel Disease and Interleukin-17 Inhibitors in Hidradenitis Suppurativa: A Systematic Review and Meta-Analysis.","authors":"Marley Cutrona, Eliana L Jolkovsky, Sarah Romanelli, Ross O'Hagan, Ahuva Cices","doi":"10.1001/jamadermatol.2026.3373","DOIUrl":"10.1001/jamadermatol.2026.3373","url":null,"abstract":"<p><strong>Importance: </strong>Interleukin (IL)-17 inhibitors have emerged as effective therapies for moderate to severe hidradenitis suppurativa (HS), but concerns remain regarding their potential association with inflammatory bowel disease (IBD). It is known that there is an increased risk of IBD in HS populations, but it remains unclear whether IL-17 inhibition increases the IBD risk or unmasks underlying disease.</p><p><strong>Objective: </strong>To evaluate the incidence of IBD in patients with HS treated with IL-17 inhibitors and to compare IBD event rates between treatment and placebo groups.</p><p><strong>Data sources: </strong>PubMed, Embase, and the Cochrane CENTRAL were searched from inception through November 2025.</p><p><strong>Study selection: </strong>Randomized clinical trials (RCTs), nonrandomized studies, and case reports reporting IBD outcomes in patients with HS treated with IL-17 inhibitors were included. Of 1467 records identified, 24 studies met inclusion criteria (10 RCTs, 11 nonrandomized studies, and 3 case reports).</p><p><strong>Data extraction and synthesis: </strong>Extracted variables included study design, IL-17 inhibitor, study duration, dosing regimen, sample size, patient age, sex, baseline personal or family history of IBD, new-onset IBD, relapse of preexisting IBD, IBD subtype and clinical features, and time to IBD onset.</p><p><strong>Main outcomes and measures: </strong>Incidence of IBD event, defined as new-onset or worsening Crohn disease or ulcerative colitis during IL-17 inhibitor treatment in a patient with HS. For RCTs, pooled risk differences were calculated using a common effects Mantel-Haenszel model. For nonrandomized studies, a single group meta-analysis of proportions was performed to estimate pooled IBD incidence. Case reports were synthesized qualitatively.</p><p><strong>Results: </strong>Across 10 RCTs, new-onset IBD occurred in 6 of 2572 patients treated with IL-17 inhibitors (0.23%) and in 0 of 1066 patients treated with placebo through week 16. There was no significant difference between groups (risk difference, 0.002; 95% CI, -0.003 to 0.007). In nonrandomized studies, 7 new-onset IBD events occurred among 469 patients (crude incidence, 1.49%), with a pooled incidence of 3.90% (95% CI, 2.30%-6.50%). Across randomized trials, long-term extension studies, and nonrandomized studies, 17 new-onset cases and 4 IBD flares were reported.</p><p><strong>Conclusions: </strong>In this systematic review and meta-analysis, IBD events were rare. No significant increase in IBD risk was observed with IL-17 inhibitors, although low event rates and inconsistent reporting limited interpretation.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919284","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":"Comparison of Pleomorphic Dermal Sarcoma to Advanced Cutaneous Squamous Cell Carcinoma and Soft-Tissue Sarcoma.","authors":"Haley Neff, Caroline Mortelliti, Bina Kassamali, William Lotter, Grace Hanrahan, Brenda Solomon, Emily Karn, Nicole R LeBoeuf, Alexander Gusev, John E Ready, Vinod E Nambudiri, Nina A Ran, Ann W Silk, Emily S Ruiz","doi":"10.1001/jamadermatol.2026.3297","DOIUrl":"10.1001/jamadermatol.2026.3297","url":null,"abstract":"<p><strong>Importance: </strong>Pleomorphic dermal sarcomas (PDSs) are classified as sarcomas; however, they share features with cutaneous carcinomas, such as presentation on sun-exposed areas and high tumor mutational burden (TMB). Data regarding management of PDS are limited, and it is unclear whether sarcoma or cutaneous cancer treatment paradigms should apply. At present, there are no published data comparing the mutational genetics of PDSs to other cutaneous tumors and to other soft-tissue sarcomas (STSs).</p><p><strong>Objective: </strong>To compare TMB, UV signature, and single-nucleotide and pathway-level mutational profiles of PDS to cutaneous squamous cell carcinoma (CSCC) and STS.</p><p><strong>Design, setting, and participants: </strong>This single-center retrospective cohort study was performed at the Dana-Farber Cancer Institute and Brigham and Women's Hospital from January 1, 2015, to October 20, 2025. Patients diagnosed with PDS, metastatic CSCC, and STS were identified by electronic medical records and included if a 447-tumor gene sequencing assay was performed on tumor tissue.</p><p><strong>Main outcomes and measures: </strong>The primary end point was to compare the single-nucleotide variant profiles of PDS, metastatic CSCC, and STS using unsupervised machine learning analysis. The secondary end points were to compare mean TMB, pathway-level mutations, and UV signature status.</p><p><strong>Results: </strong>A total of 9 PDSs, 15 metastatic CSCCs, and 25 STSs were included. At the pathway level, TP53, cell cycle, NOTCH, and receptor tyrosine kinase-Ras pathways were highly mutated in PDS and CSCC, whereas STS lacked major pathway mutations. The mean TMB was 44.6 (95% CI, 37.5-51.8) for PDS, 54.1 (95% CI, 40.4-67.8) for CSCC, and 4.2 (95% CI, 3.2-5.2) for STS. Statistically significant differences in mean TMB were observed between CSCC and STS and between PDS and STS but not between CSCC and PDS. All PDSs and CSCCs displayed UV signature mutations, while none of other STSs did. Principal component analysis of mutational variants and TMB on sequencing assay showed completely overlapping PDS and CSCC clusters and separate, narrow STS clustering.</p><p><strong>Conclusions and relevance: </strong>In this cohort study, PCA analysis of single-nucleotide variants and comparison of TMB, UV signature, and pathway-level alterations between groups suggested similar genetic profiling between metastatic CSCC and PDS, which were distinct from STS.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880629","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":"Acantholytic Blistering of the Oroesophageal Mucosa Due to Homozygous DSG3 Pathogenic Missense Variant.","authors":"Emily Avitan-Hersh, Xuming Mao, Farzan Solimani, Gexin Zhao, Ilanit Boyango, Reuven Bergman, Aimee S Payne","doi":"10.1001/jamadermatol.2026.3186","DOIUrl":"10.1001/jamadermatol.2026.3186","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880568","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":"Trends in Dermatologist Density Between Urban and Rural Counties.","authors":"Katie Lu, Sara B Peracca, Amanda R Twigg, Dennis H Oh","doi":"10.1001/jamadermatol.2026.3233","DOIUrl":"10.1001/jamadermatol.2026.3233","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880632","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":"Delphi Consensus Statement on Treatment of Severe Alopecia Areata in US Adults.","authors":"Samantha Gregoire, Eliza Dewey, Ursula Biba, Katherine Sanchez, Hanna Englander, Lana Salloum, Sherry Ershadi, Debby Cheng, Basil Alex McIntosh, Nikki Zangenah, Maria Vazquez-Machado, Aneri Parekh, Lisa Kam, Nora Bensellam, Crystal Aguh, Wilma Bergfeld, Valerie D Callender, Leslie Castelo-Soccio, Brittany Craiglow, Dirk Elston, Ronda Farah, Jennifer Fu, Carolyn Goh, Emma Guttman-Yassky, Kathie P Huang, Ali Jabbari, Chesahna Kindred, Justin Ko, Mark Lebwohl, Kristen I Lo Sicco, Amy McMichael, Natasha A Mesinkovska, Paradi Mirmirani, Melissa Piliang, Maryanne Senna, Jerry Shapiro, Jennifer Soung, Susan Taylor, Antonella Tosti, Benjamin Ungar, Lisa Anderson, Elise A Olsen, Maria Hordinsky, Brett King, Arash Mostaghimi","doi":"10.1001/jamadermatol.2026.2336","DOIUrl":"https://doi.org/10.1001/jamadermatol.2026.2336","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Alopecia areata (AA) is an autoimmune hair loss disorder that affects more than 7 million people in the US. Before US Food and Drug Administration-approved trials of Janus kinase inhibitors, numerous treatments had been explored, with variable efficacy and quality of evidence. The absence of standardized treatment guidelines may lead to poor treatment outcomes and payer coverage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To establish a consensus on treatment for adults with severe AA in the US.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Evidence review: &lt;/strong&gt;Systematic literature reviews for all known therapies used for treating AA were performed in PubMed from inception to December 2024. Inclusion criteria required studies to be randomized clinical trials or have an observational design, evaluate adult (≥18 years old) participants with moderate to severe AA (defined by Severity of Alopecia Tool scores &gt;20%), and be published in English. Studies were excluded if they included patients with non-AA hair loss or if they exclusively evaluated pediatric participants or those with mild AA (Severity of Alopecia Tool scores ≤20%). Three rounds of anonymous, iterative online surveys were administered from May through November 2025. Consensus was predefined at an agreement threshold of 70% or greater. A definition of AA severity was proposed for determining patient eligibility. Experts with recent AA-related research and extensive clinical experience treating adults with severe disease indicated their agreement or disagreement with the use of 29 treatments for adults with severe AA. Treatments that reached consensus for inclusion were further explored with respect to therapeutic positioning, treatment regimens, and long-term management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;Thirty-one US-based AA experts completed 3 rounds of iterative surveys. Consensus was achieved on treatment of adults with severe alopecia areata, as defined by the Alopecia Areata Scale. Oral Janus kinase inhibitors represented the primary, long-term therapy for all patients, with dupilumab as an alternative option for patients with comorbid atopy. Supplemental treatments included oral and topical minoxidil; intralesional, oral, and high-potency topical corticosteroids; and topical Janus kinase inhibitors and prostaglandins, with body site-specific indications. Patient support resources should be offered alongside medical treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion and relevance: &lt;/strong&gt;This study defines expert-established consensus on treatment of adults with severe AA in the US. Additional high-quality investigations are needed to establish the efficacy of existing therapies in subpopulations and enable head-to-head comparisons of new and existing interventions. These recommendations are not indicated for children, pregnant patients, patients with mild to moderate disease, or those with underlying comorbidities; additional research is needed to inform treatment guidelines for these specific pat","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880643","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":"Focal Contact Digital Wrinkling Following Subungual Glomus Tumor Excision.","authors":"Debra K Lee, Alexandria Tso, Angel R Baroz, Emanual Maverakis, Victor Huang","doi":"10.1001/jamadermatol.2026.2240","DOIUrl":"https://doi.org/10.1001/jamadermatol.2026.2240","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880658","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":"Patient Engagement With Dermatology Notes in the Electronic Patient Portal.","authors":"Mihir K Patil, David Stein, Alice J Watson, Elizabeth A Buzney, Vinod E Nambudiri, Connie R Shi","doi":"10.1001/jamadermatol.2026.2072","DOIUrl":"10.1001/jamadermatol.2026.2072","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"957-960"},"PeriodicalIF":10.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404973","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}