JAMA dermatology最新文献

{"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}

{"title":"Lichen Sclerosus of the Neovagina and Neovulva.","authors":"Sorcha O'Sullivan, Natalia Castrejón de Anta, Stephen Mounsey, Jaime Eduardo Calonje, Fiona Lewis","doi":"10.1001/jamadermatol.2024.6682","DOIUrl":"10.1001/jamadermatol.2024.6682","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"559-560"},"PeriodicalIF":11.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709726","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":"Recurring Papules and Nodules on the Vulva.","authors":"Kaila G Moore, Jayson R Miedema, Sarah B Corley","doi":"10.1001/jamadermatol.2025.0685","DOIUrl":"10.1001/jamadermatol.2025.0685","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"549-550"},"PeriodicalIF":11.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984087","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":"Efficacy, Safety, and Tolerability of Oral DFD-29, a Low-Dose Formulation of Minocycline, in Rosacea: Two Phase 3 Randomized Clinical Trials.","authors":"Neal Bhatia, James Del Rosso, Linda Stein Gold, Edward Lain, Zoe Diana Draelos, Srinivas Sidgiddi","doi":"10.1001/jamadermatol.2024.6542","DOIUrl":"10.1001/jamadermatol.2024.6542","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;A low-dose modified formulation of minocycline hydrochloride, DFD-29, is under evaluation for treating papulopustular rosacea (PPR).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To determine the efficacy and safety of DFD-29, 40 mg, compared with doxycycline, 40 mg, and placebo for treating PPR.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This study included data from 2 double-blind, placebo-controlled, phase 3 randomized clinical trials (MVOR-1 and MVOR-2) conducted between March 2022 and May 2023 at 61 centers in the US and Germany. Healthy adults 18 years and older with moderate to severe PPR were included.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interventions: &lt;/strong&gt;Participants were randomized 3:3:2 to oral DFD-29 (minocycline hydrochloride capsules), 40 mg; doxycycline, 40 mg; or placebo once daily for 16 weeks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;The coprimary efficacy outcomes were (1) proportion of participants with Investigator's Global Assessment (IGA) treatment success with DFD-29 vs placebo and (2) total inflammatory lesion count reductions with DFD-29 vs placebo. Secondary outcomes included comparisons between DFD-29 and doxycycline in coprimary outcomes and between DFD-29 and placebo in erythema reduction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 653 participants enrolled, 323 were randomized in MVOR-1 (247 [76.5%] women; mean [SD] age, 47.2 [13.7] years) and 330 were randomized in MVOR-2 (249 [75.5%] women; mean [SD] age, 51.6 [14.0] years). DFD-29 demonstrated superior efficacy in IGA success rates compared with placebo (MVOR-1: treatment difference [TD], 32.9%; 95% CI, 19.6-46.2; P &lt; .001; MVOR-2: TD, 34.1%; 95% CI, 21.3-46.8; P &lt; .001) and compared with doxycycline (MVOR-1: TD, 18.0%; 95% CI, 5.0-31.1; P = .01; MVOR-2: TD, 28.3%; 95% CI, 17.4-39.3; P &lt; .001). DFD-29 also showed superior efficacy in least-squares mean reductions in total inflammatory lesions vs placebo (MVOR-1: TD, -9.2; 95% CI, -11.5 to -6.9; P &lt; .001; MVOR-2: TD, -6.8; 95% CI, -8.9 to -4.8; P &lt; .001) and doxycycline (MVOR-1: TD, -4.7; 95% CI, -6.7 to -2.8; P &lt; .001; MVOR-2: TD, -3.5; 95% CI, -5.4 to -1.6; P &lt; .001). Adverse events with DFD-29, doxycycline, and placebo were reported in 32 of 121 (26.4%), 25 of 116 (21.6%), and 27 of 76 (35.5%), respectively, in MVOR-1 and 51 of 122 (41.8%), 40 of 121 (33.1%), and 30 of 82 (36.6%), respectively, in MVOR-2. The most common adverse events with DFD-29, doxycycline, and placebo were nasopharyngitis, reported in 4 of 121 (3.3%), 2 of 116 (1.7%), and 3 of 76 (3.9%), respectively, in MVOR-1 and 13 of 122 (10.7%), 10 of 121 (8.3%), and 13 of 82 (15.9%), respectively, in MVOR-2, and COVID-19, reported in 4 of 121 (3.3%), 3 of 116 (2.6%), and 4 of 76 (5.3%) in MVOR-1 and 7 of 122 (5.7%), 8 of 121 (6.6%), and 5 of 82 (6.1%) in MVOR-2.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;In this study, DFD-29 was superior in efficacy to both doxycycline and placebo and demonstrated a favorable risk-benef","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"499-507"},"PeriodicalIF":11.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556888","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":"Risk Prediction Models for Sentinel Node Positivity in Melanoma: A Systematic Review and Meta-Analysis.","authors":"Bryan Ma, Maharshi Gandhi, Sonia Czyz, Jocelyn Jia, Brian Rankin, Selena Osman, Eva Lindell Jonsson, Lynne Robertson, Laurie Parsons, Claire Temple-Oberle","doi":"10.1001/jamadermatol.2025.0113","DOIUrl":"10.1001/jamadermatol.2025.0113","url":null,"abstract":"<p><strong>Importance: </strong>There is a need to identify the best performing risk prediction model for sentinel lymph node biopsy (SLNB) positivity in melanoma.</p><p><strong>Objective: </strong>To comprehensively review the characteristics and discriminative performance of existing risk prediction models for SLNB positivity in melanoma.</p><p><strong>Data sources: </strong>Embase and MEDLINE were searched from inception to May 1, 2024, for English language articles.</p><p><strong>Study selection: </strong>All studies that either developed or validated a risk prediction model (defined as any calculator that combined more than 1 variable to provide a patient estimate for probability of melanoma SLNB positivity) with a corresponding measure of model discrimination were considered for inclusion by 2 reviewers, with disagreements adjudicated by a third reviewer.</p><p><strong>Data extraction and synthesis: </strong>Data were extracted in duplicate according to Data Extraction for Systematic Reviews of Prediction Modeling Studies, Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. Effects were pooled using random-effects meta-analysis.</p><p><strong>Main outcome and measures: </strong>The primary outcome was the mean pooled C statistic. Heterogeneity was assessed using the I2 statistic.</p><p><strong>Results: </strong>In total, 23 articles describing the development of 21 different risk prediction models for SLNB positivity, 20 external validations of 8 different risk prediction models, and 9 models that included sufficient information to obtain individualized patient risk estimates in routine preprocedural clinical practice were identified. Among all risk prediction models, the pooled weighted C statistic was 0.78 (95% CI, 0.74-0.81) with significant heterogeneity (I2 = 97.4%) that was not explained in meta-regression. The Memorial Sloan Kettering Cancer Center and Melanoma Institute of Australia models were most frequently externally validated with both having strong and comparable discriminative performance (pooled weighted C statistic, 0.73; 95% CI, 0.69-0.78 vs pooled weighted C statistic, 0.70; 95% CI, 0.66-0.74). Discrimination was not significantly different between models that included gene expression profiles (pooled C statistic, 0.83; 95% CI, 0.76-0.90) and those that only used clinicopathologic features (pooled C statistic, 0.77; 95% CI, 0.73-0.81) (P = .11).</p><p><strong>Conclusions and relevance: </strong>This systematic review and meta-analysis found several risk prediction models that have been externally validated with strong discriminative performance. Further research is needed to evaluate the associations of their implementation with preprocedural care.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"523-532"},"PeriodicalIF":11.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11904803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604879","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}