JAMA dermatology最新文献

{"title":"Rapidly Enlarging Erythematous Plaque of the Forearm in an Older Man.","authors":"Emilie Holder, Mona Mitcov, Antoine Braud","doi":"10.1001/jamadermatol.2026.1685","DOIUrl":"10.1001/jamadermatol.2026.1685","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"952-953"},"PeriodicalIF":10.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404881","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":"Dyschromatosis and Blistering in a Young Male.","authors":"Kittu Malhi, Debajyoti Chatterjee, Keshavamurthy Vinay","doi":"10.1001/jamadermatol.2026.2027","DOIUrl":"10.1001/jamadermatol.2026.2027","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"954-955"},"PeriodicalIF":10.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549151","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":"Enfortumab Vedotin-Induced Cutaneous Toxic Effects and Survival in Urothelial Carcinoma.","authors":"Eudora Lee, Ralina Karagenova, Charles Lu, Parisa Farokh, Marjan Azin, Federico Repetto, Soma Jobbagy, Rosalynn M Nazarian, Kerry Reynolds, Shadmehr Demehri, Philip J Saylor, Lirit Fuksman, Yevgeniy R Semenov","doi":"10.1001/jamadermatol.2026.2543","DOIUrl":"10.1001/jamadermatol.2026.2543","url":null,"abstract":"<p><strong>Importance: </strong>Enfortumab vedotin (EV) is an antibody-drug conjugate approved for the treatment of locally advanced or metastatic urothelial cancer. Cutaneous adverse events (cAEs) are common during EV therapy, with prior studies suggesting an association between EV-related cAEs and improved survival; however, there are insufficient data to delineate the survival benefit of EV-induced cAEs from those associated with concurrent immune checkpoint inhibitors (ICIs).</p><p><strong>Objective: </strong>To evaluate the association of EV-induced cAEs with survival and to characterize the timing and morphologic mechanisms of EV-induced cAEs.</p><p><strong>Design, setting, and participants: </strong>This was a multi-institutional retrospective study of patients with locally advanced or metastatic urothelial cancer treated with EV between 2020 and 2025. Patient characteristics were extracted manually, and likelihood scoring was used to attribute cAEs to either EV or other causes. Data were analyzed from September 2025 to January 2026.</p><p><strong>Exposure: </strong>EV treatment.</p><p><strong>Main outcomes and measures: </strong>Progression-free (PFS) and overall (OS) survival were estimated using the Kaplan-Meier method. Multivariable time-varying and landmark Cox regression models were used to evaluate associations between EV-induced cAE and survival. Sensitivity analyses were performed at landmarks from 15 to 105 days.</p><p><strong>Results: </strong>Of 449 patients (mean [SD] age, 71.9 [9.2] years; 122 females [27.2%] and 327 males [72.8%]), 206 (45.9%) developed a cAE; 39 (18.9%) were high-grade and 127 (61.7%) were attributed to EV. The most common cAEs were pruritus (85 patients [41.3%]), unspecified and desquamating dermatitis (76 [37.3%]), and morbilliform dermatitis (58 [27.7%]). Across all treatment groups, survival was longer in patients with EV-induced cAEs. Developing an EV-induced cAE was protective across all landmark times assessed, with a hazard ratio of 0.60 (95% CI, 0.43-0.82; P < .001) for PFS and 0.46 (95% CI, 0.31-0.67; P < .001) for OS at 30 days (primary landmark). Early-onset EV-induced cAEs were protective at all landmark times and high-grade EV-induced cAEs were not associated with worse survival outcomes.</p><p><strong>Conclusions and relevance: </strong>In this cohort study, EV-induced cAEs were independently associated with improved PFS and OS in patients with locally advanced or metastatic urothelial cancer, even after accounting for immortal time bias and ICI exposure. Distinguishing EV-induced cAEs from other causes in timeline and morphologic mechanisms may help guide oncologic and dermatologic treatment and management.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"922-930"},"PeriodicalIF":10.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620154","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":"High-Dose Oral Vitamin D for Toxic Effects of the Skin Associated With Chemotherapy and Radiation.","authors":"Mihir K Patil, Goranit Sakunchotpanit, Sushila A Toulmin, Natalie Braun, Sofia Milosavljevic, Farrah L Ezzeddine, Thomas Z Rohan, W Austin Wyant, Lauren M Guggina, Vinod E Nambudiri, Christopher Iriarte","doi":"10.1001/jamadermatol.2026.2267","DOIUrl":"10.1001/jamadermatol.2026.2267","url":null,"abstract":"<p><strong>Importance: </strong>Severe cutaneous toxic effects from chemotherapy and radiation often require treatment interruptions. High-dose oral vitamin D (hdVD) has shown potential as a rapid immunomodulator in experimental models and small human studies, but robust clinical data in oncology populations remain limited.</p><p><strong>Objective: </strong>To evaluate the clinical response, safety profile, and time to improvement for hdVD in patients with toxic erythema of chemotherapy (TEC) and acute radiation dermatitis (ARD).</p><p><strong>Design, setting, and participants: </strong>This retrospective multicenter case series included 33 patients treated across 3 academic medical centers between December 2021 and January 2024. Eligible participants were those receiving hdVD (100 000 international units) for TEC or ARD with at least 10 days of follow-up.</p><p><strong>Exposures: </strong>One or 2 oral doses of 100 000 international units of cholecalciferol or ergocalciferol.</p><p><strong>Main outcomes and measures: </strong>The primary outcomes were time to patient-reported symptomatic relief and clinician-assessed objective improvement in erythema (using a 5-point Likert scale). Secondary outcomes included changes in serum calcium and the ability to continue anticancer therapy.</p><p><strong>Results: </strong>Among 33 patients (mean [SD] age, 60.9 [14.6] years; 19 [58%] female), 28 (85%) had TEC and 5 (15%) had ARD. Subjective symptom relief was reported by 26 of 30 patients (87%) within 10 days of treatment. The median (range) time to improvement was 5 (1-28) days overall and 3 (1-16) days for the inpatient subgroup. The mean (SD) Likert erythema score decreased from 4.36 (0.60) at baseline to 2.21 (1.36) by day 10. Patients with neutrophilic eccrine hidradenitis and Stevens-Johnson syndrome/toxic epidermal necrolysis-like subtypes showed the most rapid responses. No meaningful changes in serum calcium levels were observed, and 24 of the 33 patients (73%) continued anticancer therapy without interruption. No treatment-related adverse events were reported during the study.</p><p><strong>Conclusions and relevance: </strong>In this case series, hdVD was associated with rapid symptomatic and objective improvement in chemotherapy- and radiation-induced toxic effects of the skin without treatment-related adverse events. These findings support further study of hdVD as a supportive care approach in oncodermatology.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"888-893"},"PeriodicalIF":10.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148446992","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":"Consensus Guidelines for Staging and Surveillance Imaging in Cutaneous Squamous Cell Carcinoma.","authors":"Bina Kassamali, Jonathan D Schoenfeld, Rosh Sethi, Richard L Bakst, Christopher A Barker, Alok A Bhatt, Carol R Bradford, Paul M Bunch, David R Carr, John A Carucci, Sunandana Chandra, Michelle Chen, Karen L Connolly, Addison M Demer, Bently Doonan, Kevin Emerick, Ben J Friedman, Linna L Gali, Thomas J Galloway, Jessica L Geiger, Jeffrey P Guenette, Hillary R Kelly, Nikhil I Khushalani, Laurie Kohen, Shlomo Koyfman, Shweta Sharat Kumar, Kim O Learned, Justin J Leitenberger, Elizabeth J Lilley, John Nicholas Lukens, Theresa Medina, Devarati Mitra, David Ozog, Itai Pashtan, Vishal Anil Patel, Nancy Pham, Molly C Powers, Divya Srivastava, Paul L Swiecicki, Charlotte S Taylor, Matthew E Witek, Ashley Wysong, David Zander, Ann W Silk, Anokhi Jambusaria-Pahlajani, Emily S Ruiz","doi":"10.1001/jamadermatol.2026.2163","DOIUrl":"10.1001/jamadermatol.2026.2163","url":null,"abstract":"<p><strong>Importance: </strong>There is no consensus on staging and surveillance imaging for cutaneous squamous cell carcinoma (CSCC). Although imaging has been shown to affect management, broad recommendations from the National Comprehensive Cancer Network have led to variability in clinical practice.</p><p><strong>Objective: </strong>To develop multidisciplinary consensus recommendations on the use of staging and surveillance imaging of localized CSCC.</p><p><strong>Evidence review: </strong>A multidisciplinary expert panel across academic and clinical practice settings convened a Delphi consensus, with 3 iterative survey rounds from January to June 2025. Data were analyzed from February 2025 to January 2026. Eligibility defined by at least 1 to 2 CSCC publications during the previous 5 years, involvement in a relevant clinical trial, experience treating at least 3 patients monthly with CSCC, and/or 5 years or longer of clinical practice. Fifty-four experts were invited and 45 (83%) completed all 3 rounds and were included in the final analysis. Structured Delphi surveys evaluated clinical scenarios, imaging modalities, and surveillance strategies for CSCC. Consensus and near-consensus recommendations were generated, defined as 80% or greater and 70% to 79% agreement, respectively.</p><p><strong>Findings: </strong>The 45 participants (21 female individuals [47%] and 24 male individuals [53%]; 14 Asian individuals [31%], 1 multiracial individual [2%], and 30 White individuals [67%]) consisted of dermatology (15 [33%]), medical oncology (7 [16%]), radiation oncology (9 [20%]), radiology (9 [20%]), surgery (3 [7%]), and otolaryngology specialists (2 [4%]). The Delphi panel recommended staging and surveillance for CSCCs with at least a 15% risk of metastasis. Consensus or near consensus was reached to recommend staging and surveillance imaging for tumors with a concern for metastasis, bone invasion, invasion beyond subcutaneous fat, large-caliber nerve invasion, or a diameter of 4 cm or larger or the combination of tumors with poorly differentiated histology and any of the following: diameter of 2 cm or larger, lymphovascular invasion and subcutaneous fat invasion, or lymphovascular invasion and small-caliber perineural invasion. Computed tomography imaging was the preferred modality for nodal staging (38 [84%]) and surveillance (35 [78%]). For surveillance duration, consensus was reached to provide imaging for at least 2 years, and near consensus was reached for at least 3 years.</p><p><strong>Conclusions and relevance: </strong>This study provides an expert consensus-based framework to standardize imaging in localized CSCC that may inform future guidelines.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"939-947"},"PeriodicalIF":10.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404927","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":"Melasma.","authors":"Karishma Daftary, Roopal V Kundu","doi":"10.1001/jamadermatol.2026.0413","DOIUrl":"10.1001/jamadermatol.2026.0413","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"968"},"PeriodicalIF":10.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404901","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":"Lobomycosis.","authors":"Luis Escalante, Astrid Maldonado, Faisal Ali","doi":"10.1001/jamadermatol.2026.2252","DOIUrl":"10.1001/jamadermatol.2026.2252","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"948-949"},"PeriodicalIF":10.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620094","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":"Errors in Table 2.","authors":"","doi":"10.1001/jamadermatol.2026.3745","DOIUrl":"10.1001/jamadermatol.2026.3745","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":"162 9","pages":"967"},"PeriodicalIF":10.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982817","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":"ctDNA or Merkel Virus Antibodies for Surveillance of Merkel Cell Carcinoma Recurrence.","authors":"Manisha Thakuria, Tomoko Akaike, Ann W Silk, Daniel S Hippe, Peter Y Ch'en, Rian Alam, Joshua E Chan, Song Y Park, Karam Khaddour, Kate B Biese, Austin J Jabbour, Alex Fu, Macy W Gilmour, Ariel Finberg, Meliea W Chiu, Hannah Kim, Nicole M Urman, Evan Thomas Hall, Shailender Bhatia, Paul Nghiem, Lisa C Zaba","doi":"10.1001/jamadermatol.2026.2153","DOIUrl":"10.1001/jamadermatol.2026.2153","url":null,"abstract":"<p><strong>Importance: </strong>Merkel cell carcinoma (MCC) is associated with a high recurrence rate of 40%. It is important to know which of 2 blood-based tumor biomarkers available for use in clinical practice is more accurate in detecting MCC recurrence.</p><p><strong>Objective: </strong>To compare the performance of circulating tumor DNA (ctDNA) and the MCC polyomavirus (MCPyV) oncoprotein antibody test for detecting MCC recurrence.</p><p><strong>Design, setting, and participants: </strong>In this multicenter cohort study across 3 US academic centers (Stanford, Dana-Farber Brigham, and University of Washington), patients with stage I-IV MCC underwent serial paired ctDNA and antibody testing for disease surveillance between April 2020 and March 2024. ctDNA was considered positive if mean tumor molecules per milliliter of plasma values were greater than 0.00, while a rising antibody test result was defined as a 30% or greater increase in titer. Inclusion criteria were clinically disease-free at baseline, detectable MCPyV antibodies at diagnosis, and both ctDNA and antibody tests performed within 45 days of each other in at least 1 time point per patient. Predictive performance for recurrence was assessed and compared between tests.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was clinical recurrence. Predictive performance measures for each test included positive (PPV), negative predictive value (NPV), and hazard ratios (HRs).</p><p><strong>Results: </strong>In this study among 169 patients with 703 paired tests (median testing interval, 96 days; 109 males [64%]; 60 females [36%]), there were 36 clinical recurrences from 32 patients over a median follow-up of 483 days (IQR, 274-714 days). Compared with antibody testing, ctDNA had a significantly higher PPV at 365 days (73% [95% CI, 58%-85%] vs 52% [95% CI, 32%-71%]; P = .02), higher NPV at 90 days (99% [95% CI, 98.8%-100%] vs 97% [95% CI, 95%-98%]; P = .001), and a greater HR (HR, 47.9 [95% CI, 16.5-139.0] vs 7.3 [95% CI, 3.8-13.9]; HR ratio, 6.6 [95% CI, 2.5-41.0]; P < .001). Use of both ctDNA and antibody tests together identified only 1 additional recurrence compared with the use of ctDNA testing alone.</p><p><strong>Conclusions and relevance: </strong>This study found that ctDNA was more accurate than MCPyV antibody testing in detecting recurrence of MCC. ctDNA appears to be a more reliable guide than the MCPyV antibody for surveillance practices and ongoing risk stratification in most patients with MCC.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"880-887"},"PeriodicalIF":10.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404960","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":"Vascular Alterations in Plasmacytoma in AESOP Syndrome.","authors":"Yukihiro Ozawa, Masato Nakaguro, Mariko Ogawa-Momohara, Katsuya Furukawa, Takuya Takeichi, Masashi Akiyama","doi":"10.1001/jamadermatol.2026.1994","DOIUrl":"10.1001/jamadermatol.2026.1994","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"965-967"},"PeriodicalIF":10.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620113","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}