JAMA dermatology最新文献

{"title":"Acne Conglobata and Bimekizumab.","authors":"Matiar Madanchi, Florence Jeker, Hazem A Juratli, Riccardo Curatolo","doi":"10.1001/jamadermatol.2025.0416","DOIUrl":"https://doi.org/10.1001/jamadermatol.2025.0416","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025669","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":"IL-5 Inhibitor Treatment in Drug Reaction With Eosinophilia and Systemic Symptoms.","authors":"Baraa Hijaz, Vinod E Nambudiri, Sotonye Imadojemu","doi":"10.1001/jamadermatol.2025.0441","DOIUrl":"https://doi.org/10.1001/jamadermatol.2025.0441","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984085","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":"Use and Cost of First-Line Biologic Medications to Treat Plaque Psoriasis in the US.","authors":"Benjamin N Rome, Jihye Han, Helen Mooney, Aaron S Kesselheim","doi":"10.1001/jamadermatol.2025.0669","DOIUrl":"https://doi.org/10.1001/jamadermatol.2025.0669","url":null,"abstract":"<p><strong>Importance: </strong>Plaque psoriasis is increasingly managed using anti-inflammatory biologic medications, including tumor necrosis factor (TNF)-α and interleukin (IL) 12/23, IL-17, and IL-23 inhibitors. How these differently priced biologics are used has implications for the overall cost of care in the US.</p><p><strong>Objective: </strong>To measure trends in the use and cost of first-line biologic treatments for plaque psoriasis from 2007 to 2021.</p><p><strong>Design, setting, and participants: </strong>This was a cross-sectional study using a national commercial claims dataset (2007-2021) of biologic medication-naive patients with plaque psoriasis who initiated a biologic medication from 1 of 4 mechanistic classes, including 4 TNF-α inhibitors, 1 IL-12/IL-23 inhibitors, 3 IL-17 inhibitors, and 3 IL-23 inhibitors. Data analyses were performed from August 2023 to October 2024.</p><p><strong>Exposures: </strong>Patient demographic characteristics (sex, age, geographic location, insurance type) and clinical characteristics (comorbidities, previous nonbiologic treatments for plaque psoriasis).</p><p><strong>Outcomes: </strong>Trends in the proportion of patients initiating each biologic medication and the average estimated annual treatment costs over time, using commercial estimates of net prices accounting for average manufacturer rebates. Logistic regression was used to evaluate demographic and clinical characteristics associated with initiating TNF-α vs IL inhibitors. Estimated savings were calculated for patients who had initiated the lowest-cost treatment within each class.</p><p><strong>Results: </strong>Among 76 781 patients with plaque psoriasis who initiated biologic medications, 50.4% were female and 49.6% male, 71.8% were age 30 to 59 years, and 30% had concurrent inflammatory arthritis. From 2007 to 2021, the proportion of patients initiating IL rather than TNF-α inhibitors increased; in 2021, 42% initiated IL-23 inhibitors and 21% initiated IL-17 inhibitors. The average annual treatment cost increased from $21 236 in 2007 to $47 125 in 2021. In 2021, costs ranged from $12 413 (infliximab) to $70 043 (risankizumab). If patients initiated the lowest-cost medication in each class, the average annual treatment cost would have been 44% lower in 2021 ($26 363). Patients who were male, older, residing in the Northeast, and did not have comorbid arthritis or inflammatory bowel disease had higher odds of initiating IL inhibitors than TNF-α inhibitors.</p><p><strong>Conclusions and relevance: </strong>This cross-sectional study found that from 2007 to 2021, treatment costs increased for biologic medications used to treat plaque psoriasis. Substantial savings are available if more patients and physicians use the lowest-cost options and/or if drug prices were better aligned with the comparative effectiveness and safety of each medication.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996740","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":"Congenital Erythropoietic Porphyria.","authors":"Alba Álvarez-Abella, Andrea Núñez-Conde, Marco A Alba","doi":"10.1001/jamadermatol.2025.0306","DOIUrl":"https://doi.org/10.1001/jamadermatol.2025.0306","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021031","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":"Digital Photography Guide for Dermatologists With Special Considerations for Diverse Populations.","authors":"Madison Grinnell, Arielle Carolina Mora Hurtado, Rick Guidotti, Nada Elbuluk","doi":"10.1001/jamadermatol.2025.0699","DOIUrl":"https://doi.org/10.1001/jamadermatol.2025.0699","url":null,"abstract":"<p><strong>Importance: </strong>Dermatology has a complex history with photography, particularly photographs of those with skin of color. Evaluation of best practices for capturing clinically accurate digital images, particularly emphasizing techniques to improve photography portraying individuals of color, dermatologic conditions in skin of color, and pigmentary disorders is needed.</p><p><strong>Observations: </strong>Historically, many different kinds of photographic technologies have calibrated color correction using participants with light skin, thus creating inaccurate photographs of those with skin of color. In photographing darker skin, royal blue backgrounds are often preferred, as this background color offers increased contrast without creating aberrant hues. Soft diffuse lighting, such as that emitted from an attachable ring light, should be used when possible. Furthermore, other aspects of photography in the clinical setting should be standardized to include a fixed distance from the patient and a dedicated space for photography. In accurately capturing erythema, inflammation, and pigmentary alterations in skin of color, specific lighting techniques such as cross-polarization may be used. In addition to these photographic techniques, there are several humanistic aspects that should be considered when photographing a patient's dermatologic condition.</p><p><strong>Conclusions and relevance: </strong>The techniques discussed in this digital photography guide can help capture high-quality images representative of dermatologic disease processes across all skin colors, facilitate the monitoring of dermatologic disease, and create a positive experience for patients. Beyond the utility of high-quality photographs in dermatology clinics, high-quality photography can enhance skin of color representation in educational materials, expand access to dermatologic services by improving on the provision of teledermatology care, and may serve as a valuable tool for grading disease severity in clinical trials. Progress in these areas can help improve dermatologic care and health equity for diverse populations.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970083","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":"What Is Scleroderma?","authors":"Brook Abegaze, Anna Haemel","doi":"10.1001/jamadermatol.2024.5291","DOIUrl":"https://doi.org/10.1001/jamadermatol.2024.5291","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010425","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":"Dermatologic Care and Skin Health of Migrant Populations in the US: A Scoping Review.","authors":"Herbert B Castillo Valladares, Penelope Kim-Lim, Aileen Y Chang","doi":"10.1001/jamadermatol.2025.0404","DOIUrl":"https://doi.org/10.1001/jamadermatol.2025.0404","url":null,"abstract":"<p><strong>Importance: </strong>Despite literature on migrant skin health globally, there remains a critical gap in understanding the dermatologic care and skin health of migrants in the US, where immigrants represent 13.9% of the population.</p><p><strong>Objective: </strong>To understand the spectrum of dermatologic conditions reported among US migrant populations, identify considerations for dermatologic care delivery, and synthesize the current literature on skin health.</p><p><strong>Evidence review: </strong>PubMed, Embase, and ClasePeriodica were searched for articles published from January 2000 to December 2022 using search terms related to dermatologic conditions and migrants. Original research articles, review articles, case reports, and case series that reported on dermatologic conditions affecting migrant populations within the US and US territories were included.</p><p><strong>Findings: </strong>Of 87 articles included, cross-sectional studies accounted for 37 (42.5%), followed by case reports and case series (36 [41.4%]), qualitative studies (3 [3.4%]), and a mixed-methods study (1 [1.1%]). Articles discussed a range of dermatologic conditions: infections (45 [51.7%]), inflammatory conditions (33 [37.9%]), traumatic wounds (16 [18.4%]), neoplasms (10 [11.5%]), pigmentary disorders (10 [11.5%]), signs of torture/violence (4 [4.6%]), cosmetic (3 [3.4%]), hair/nail disorders (1 [1.1%]), and genodermatoses (1 [1.1%]). Of 65 articles (74.6%) reporting migrants' country of origin, Mexico was most frequently reported (28 [43.0%]), followed by Guatemala (14 [21.5%]), Vietnam (8 [12.3%]), and 38 other countries. Four themes were developed: (1) exposures before and during migration were risk factors for dermatologic conditions that presented at destination; (2) occupational and environmental exposures were risk factors for dermatologic conditions that developed at destination; (3) structural factors limited migrants' access to quality health care; and (4) educational interventions targeting different learner groups were opportunities to improve skin health of migrants.</p><p><strong>Conclusions and relevance: </strong>This scoping review found that exposures before, during, and after migration and health care access are associated with the skin health of US migrant populations. Research opportunities include focusing on a broad spectrum of dermatologic diseases, countries of birth, occupations, and vulnerable populations, such as women and children, as well as implementing and evaluating policy that addresses structural barriers migrants face in accessing quality health care.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811382","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":"Global Applicability of a Risk Prediction Tool for Sentinel Node Positivity in Patients With Primary Cutaneous Melanoma.","authors":"Serigne N Lo, Caroline Gjorup, Annette Hougaard Chakera, Lisbet Rosenkrantz Hölmich, Marc Moncrieff, Alastair MacKenzie Ross, Oliver Cassell, Jiawen Ma, Marie Brinch-Møller Weitemeyer, Roger Olofsson Bagge, Siri Klausen, Vinicius F Calsavara, João P Duprat Neto, Eduardo Bertolli, Sydney Ch'ng, Robyn P M Saw, Kerwin F Shannon, Andrew J Spillane, Omgo E Nieweg, Jonathan R Stretch, Graham J Mann, Jenny L C Geh, Lauren E Haydu, Richard C W Martin, Cimarron Sharon, Giorgos C Karakousis, Mohammed Kashani-Sabet, George Adigbli, Mary-Ann El Sharouni, Jeffrey E Gershenwald, Richard A Scolyer, John F Thompson, Alexander H R Varey","doi":"10.1001/jamadermatol.2025.0318","DOIUrl":"10.1001/jamadermatol.2025.0318","url":null,"abstract":"<p><strong>Importance: </strong>The Melanoma Institute Australia (MIA) sentinel node (SN) metastasis risk calculator provides estimates of positivity for individual patients based on 6 standard clinicopathological parameters and the full 6-parameter model has been externally validated previously using US data. However, given its geographically widespread use, further validation is required to ensure its applicability to other populations.</p><p><strong>Objective: </strong>To further externally validate the MIA SN metastasis risk calculator and increase its precision by refinement of the 95% CIs.</p><p><strong>Design, setting, and participants: </strong>A retrospective multicenter cohort study was carried out using data from 4 continents, including the national Danish Melanoma Database and cancer centers in the UK (n = 3), US (n = 2), New Zealand (n = 1), Sweden (n = 1), and Brazil (n = 1). All patients aged 18 years or older who had an SN biopsy performed for an invasive primary cutaneous melanoma and data available on the following parameters: SN status, patient age at diagnosis, Breslow thickness, and melanoma subtype were included (n = 15 731). Available data were also collected on ulceration status, lymphovascular invasion, and the tumor mitotic rate. Data were collected between July 2021 and December 2023, and the analysis was conducted between January 2024 and June 2024.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was the area under the curve (AUC) of the receiver operating characteristics for the full (6-parameter) risk prediction model. Secondary outcomes were the AUCs for each country and for the limited models (3-5 parameters), the model calibration, and the recalculated 95% CIs for the models. Decision curve analysis was performed to assess the tool's clinical utility.</p><p><strong>Results: </strong>The whole pooled cohort consisted of 15 731 patients; 4989 had all 6 parameters available. The AUC was 73.0% (95% CI, 70.6%-75.3%) in the subset with all 6 parameters available, and 70.8%, 71.5%, and 70.1% when 1, 2, or 3 optional parameters were missing, respectively. Calibration was excellent, with an intercept and calibration slope of 0.01 (95% CI, -0.02 to 0.03) and 1.03 (95% CI, 0.90-1.16), respectively. The updated 95% CI ranges were substantially tighter, with a median reduction of more than 75%.</p><p><strong>Conclusions and relevance: </strong>This study found that the MIA SN-positivity calculator performed best with all 6 parameters and has been significantly improved (version 2), with the same risk point estimates but much tighter 95% CIs. These results demonstrated that the calculator was robust, precise, and applicable to geographically widespread melanoma populations.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811385","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":"Immune Checkpoint Inhibitor-Induced Lipodystrophy.","authors":"Julia Riganti, Ana C Torre, Pietro Sollena, Dimitra Koumaki, Azael Freites-Martinez, Julie Delyon, Antoine Communie, Michela Starace, Luca Rapparini, Aimilios Lallas, Dimitrios Mavroudis, Devaux Suzanne, Luis D Mazzuoccolo, Mattheos Bobos, Vincent Sibaud, Zoe Apalla","doi":"10.1001/jamadermatol.2025.0359","DOIUrl":"10.1001/jamadermatol.2025.0359","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811387","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":"Standard Dermatoscope Images vs an Autonomous Total Body Photography and Dermoscopic Imaging Device.","authors":"Pau Rosés-Gibert, Cristina Heras, Narcis Ricart, Enric Campmol, Núria Ferrera, Susana Puig, J Malvehy","doi":"10.1001/jamadermatol.2025.0565","DOIUrl":"https://doi.org/10.1001/jamadermatol.2025.0565","url":null,"abstract":"<p><strong>Importance: </strong>Recent advancements in autonomous medical devices for skin imaging offer the potential to improve the efficiency and quality of total body photography (TBP) and dermatoscopic documentation, which are essential in treating patients with skin cancer, especially those with high-risk melanoma with atypical mole syndrome.</p><p><strong>Objective: </strong>To compare the image quality and time efficiency of an autonomous TBP and dermoscopic device for TBP and dermoscopic imaging with traditional manual digital dermoscopic techniques.</p><p><strong>Design, setting, and participants: </strong>A prospective cohort study was conducted from March 1, 2023, to October 30, 2023, comparing image quality and time efficiency between an autonomous TBP and dermoscopic device and manual dermoscopic documentation across 316 patients with atypical mole syndrome at 2 dermatology clinics in Spain. All analyses took place in June 2024.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was the acceptability of the images, assessed by 2 independent dermatologists. Secondary outcomes included diagnostic agreement between the 2 methods and time efficiency for image acquisition.</p><p><strong>Results: </strong>Overall, mean (SD) age of patients was 47.13 (3.31) years. The number of male patients was 105 (33%), while the number of female patients was 211 (66%). The autonomous TBP and dermoscopic device produced dermoscopic images with a mean (SD) quality score of 9.84 (0.72), compared with 9.44 (0.85) for manual digital dermoscopy, with no significant differences by body site or lesion type. Diagnostic classification agreement between the 2 methods was 91.60%, with most discrepancies related to small benign lesions. The mean (SD) imaging time for the autonomous device was 570 (169) seconds, compared with 606 (286) seconds for the manual method.</p><p><strong>Conclusions and relevance: </strong>This cohort study found that the autonomous TBP and dermoscopic device produced images of comparable quality to standard dermoscopic techniques while operating with greater time efficiency. These findings suggest that the device may contribute to clinical workflow optimization in dermatology by supporting TBP and dermoscopic imaging.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811391","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}