JAMA dermatology最新文献

{"title":"Annular and Erosive Plaques on the Back of a Male Patient.","authors":"Aline Garcia, Nicolas Poulalhon, Emmanuel Ribereau-Gayon","doi":"10.1001/jamadermatol.2026.2529","DOIUrl":"https://doi.org/10.1001/jamadermatol.2026.2529","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148828826","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 With γδ Immunophenotype.","authors":"Eleanor Ostroff, Katherine De Jong, Paola Aguilar Neuville, Stephanie Ocejo, Xiaolong A Zhou, Joan Guitart","doi":"10.1001/jamadermatol.2026.3001","DOIUrl":"https://doi.org/10.1001/jamadermatol.2026.3001","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148828845","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":"Contextualizing the Global Dermatology Workforce.","authors":"Mya L Roberson, Adewole S Adamson","doi":"10.1001/jamadermatol.2026.3102","DOIUrl":"https://doi.org/10.1001/jamadermatol.2026.3102","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148828846","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":"Prevalence of Vulvar Lichen Sclerosus Among Females.","authors":"Pooja R Shah, Atekana Nyamaa, Bria Midgette, Andrew Strunk, Amit Garg","doi":"10.1001/jamadermatol.2026.2970","DOIUrl":"https://doi.org/10.1001/jamadermatol.2026.2970","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148828808","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 Disparities in Access to Dermatological Care.","authors":"Esther E Freeman, J Michael Yardman-Frank, Jennifer Kilmer, Ann Pacheco, Karry Su, Devon E McMahon, Christine Li, Sarah Anwar, Kathryn Barger, Yiqi Qian, Alexis Strahan, Simon Westby, Ramesh Bhat, Mahira El Sayed, Wendemagegn Enbiale, Cristina Galvan-Casas, Xinghua Gao, Srie P Gondokaryono, Abdul-Ghani Kibbi, Adriene Lee, Fatimata Ly, Jorge Ocampo-Candiani, Marie-Aleth Richard, Ricardo Romiti, Henry W Lim, Junko Takeshita, Delphine Kerob, Bertrand Chuberre, Guénolée de Lambert, L Claire Fuller, Christopher E M Griffiths, Ncoza C Dlova","doi":"10.1001/jamadermatol.2026.3112","DOIUrl":"https://doi.org/10.1001/jamadermatol.2026.3112","url":null,"abstract":"<p><strong>Importance: </strong>There are 4.7 to 4.9 billion cases of skin disease a year, contributing to disability, stigma, and reduced quality of life. Data on dermatologic care access and workforce distribution remain limited.</p><p><strong>Objective: </strong>To assess key metrics of access to dermatologic care globally.</p><p><strong>Design, setting, and participants: </strong>This cross-sectional study surveyed dermatological care across 194 World Health Organization (WHO) member states and 3 additional geographic areas. A 47-question Delphi-derived instrument was distributed to dermatology leaders in each country from August 2024 to October 2025.</p><p><strong>Exposure: </strong>World Bank Income (WBI) levels (low-income countries [LICs], lower-middle-income countries, upper-middle-income countries, and high-income countries [HICs]) and WHO regions.</p><p><strong>Main outcomes and measures: </strong>Primary outcomes were the estimated density of dermatologists per 100 000 globally and number of dermatologists worldwide. Secondary outcomes included training program density, workforce distribution, perceived access to care, and role of nondermatologist practitioners. Outcomes were compared across WBI levels and WHO regions. Response certainty and data source were assessed.</p><p><strong>Results: </strong>Responses were obtained from 158 countries (>80% response rate), representing 97% of the global population (21 of 27 respondents from LICs [78%]; 45 of 52 respondents from lower-middle-income countries [87%]; 40 of 53 respondents from upper-middle-income countries [75%]; 52 of 65 respondents from HICs [80%]). Mean (SD) dermatologist density was 2.66 (2.92) per 100 000 population, ranging from 0.37 (0.80) in LICs to 5.05 (3.00) per 100 000 population in HICs. There were an estimated 175 633 (95% prediction interval, 173 598-177 668) dermatologists globally. Based on countries reporting adequate access to dermatologic care, the estimated threshold for sufficient workforce density was 5.63 dermatologists per 100 000; only 17% of countries (27 countries) met this threshold. Of all responding countries, 21% (31 countries) lacked dermatology training programs, with training availability varying by WBI level. Dermatologists were primarily based in urban centers (mean [SD], 79% [23%]), with increasing maldistribution in lower-income settings. Overall, 42% of countries (57 countries) reported inadequate or extremely poor access to dermatological care. There was significant variation in access to subspecialty care (pediatric, surgical, and dermatopathology) across WBI levels, with worse access in LICs. Primary care physicians were cited as frequently as dermatologists as the main providers of care for skin disease. Other nondermatologist health care workers, including nurses, pharmacists, and traditional healers, also bore substantial responsibility. Overall, 85% of countries (115 of 136 countries) indicated they were certain or very certain of thei","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148828788","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":"Error in the Figure.","authors":"","doi":"10.1001/jamadermatol.2026.3505","DOIUrl":"10.1001/jamadermatol.2026.3505","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148828773","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":"AI-Assisted Line-Field Confocal Optical Coherence Tomography to Detect Subclinical Basal Cell Carcinoma.","authors":"Moritz Ronicke, Laura Dürr, Michael W Höner, Léonie Staats, Michael Erdmann, Carola Berking","doi":"10.1001/jamadermatol.2026.2992","DOIUrl":"https://doi.org/10.1001/jamadermatol.2026.2992","url":null,"abstract":"<p><strong>Importance: </strong>Basal cell carcinoma (BCC) is the most common type of skin cancer worldwide. Particularly on the face, its locally destructive growth leads to functional and aesthetic impairment. Early diagnosis enables less invasive treatment. Line-field confocal optical coherence tomography (LC-OCT) is an effective noninvasive imaging method for the diagnosis of BCC.</p><p><strong>Objectives: </strong>To investigate whether LC-OCT paired with artificial intelligence (AI)-assisted image recognition can identify subclinical BCCs through systematic screening of inconspicuous facial skin in patients at high risk of developing BCC.</p><p><strong>Design, setting, and participants: </strong>This prospective cross-sectional feasibility study was conducted from April 2025 to October 2025 at the Department of Dermatology, Uniklinikum Erlangen, in Erlangen, Germany. Consecutive patients receiving inpatient care who had at least 2 established BCC risk factors were enrolled in the study.</p><p><strong>Exposure: </strong>After the exclusion of lesions macroscopically suggestive of BCC, inconspicuous facial skin was systematically examined using AI-assisted LC-OCT.</p><p><strong>Main outcome and measure: </strong>The prespecified main outcome was positive predictive value (PPV) of AI-assisted LC-OCT for histologically confirmed subclinical BCC.</p><p><strong>Results: </strong>Among 150 patients (mean [SD] age, 72.9 [10.3] years; 57 [38.0%] female; 93 [62.0%] male), 17 subclinical BCCs were identified in 14 patients (9.3%). Of 18 lesions diagnosed as BCC with AI-assisted LC-OCT, 15 were histologically confirmed, corresponding to a PPV of 83.3% (95% CI, 58.1%-96.4%). One lesion had a false-positive result (actinic keratosis); 2 patients declined biopsy. In a sensitivity analysis including the 2 nonbiopsied lesions that were confirmed with expert analysis, PPV was 94.4% (95% CI, 72.7%-99.9%). The distribution of BCC subtypes included 13 cases of superficial BCCs (76.5%), followed by 3 cases of nodular BCCs (17.6%), and 1 case of infiltrative BCC (5.9%). Subtype classification was accurate in 13 of 15 histologically confirmed cases (86.7% [95% CI, 59.5%-98.3%]).</p><p><strong>Conclusions and relevance: </strong>In this cross-sectional feasibility study, the findings suggest that systematic screening with AI-assisted LC-OCT may be a feasible approach for BCC detection at a preclinical stage in populations at high risk for BCC. Further prospective studies are needed to assess the sensitivity and cost-effectiveness of this method, and whether early detection translates to tangible clinical benefit before implementation in routine care can be recommended.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793282","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":"Rethinking Antifungal Therapy in Seborrheic Dermatitis.","authors":"John S Barbieri, Ronald Berna, Avrom S Caplan","doi":"10.1001/jamadermatol.2026.2869","DOIUrl":"https://doi.org/10.1001/jamadermatol.2026.2869","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793247","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":"Cherry Angiomas in Individuals With Neurofibromatosis Type 1.","authors":"Laura Fertitta, Eric Pasmant, Christina Bergqvist, Houda Ayache, Sabine Moryousef, Salah Ferkal, Philippe Le Corvoisier, Ariane Lunati-Rozie, Benoit Funalot, Tu-Anh Duong, Caroline Barau, Sophie Kaltenbach, Patrick Villarese, Fanny Morice-Picard, Christine Labrèze, Sorilla Prey, Julien Masliah Planchon, Laurence Pacot, Dominique Vidaud, Eduard Serra, Eric Legius, Michael Frost, Herb Sarnoff, Léa Pechtimaldjian, Thomas Bettuzzi, Khaled Ezzedine, Cyrielle Robe, Piotr Topilko, François Moisan, Nicolas Ortonne, Pierre Wolkenstein","doi":"10.1001/jamadermatol.2026.2933","DOIUrl":"https://doi.org/10.1001/jamadermatol.2026.2933","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Neurofibromatosis type 1 (NF1) is a multisystem, tumor predisposition syndrome in which vascular manifestations, including cutaneous lesions, remain poorly characterized. Cherry angiomas (CAs) have been sporadically reported in NF1, but their prevalence and biological basis are unknown.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To assess the association between NF1 and CAs and define the histopathologic, cellular, and genetic mechanisms underlying NF1-associated CAs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This prospective, comparative, cross-sectional epidemiological study was conducted from October 2020 to March 2021 at a French national referral center for neurofibromatoses within the dermatology department at Henri-Mondor University Hospital, Créteil, France. It was followed by integrated histopathologic, genomic, and cell-specific molecular analyses. The epidemiological analysis included individuals 15 years or older with confirmed NF1 and controls without NF1. Pathophysiological analyses were conducted on CAs from individuals with NF1 and healthy volunteers following written consent. Data were analyzed in 2022.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;Outcomes included the prevalence of CAs; age-adjusted and sex-adjusted odds ratios; histopathologic features; detection of somatic NF1 second-hit variants; identification of co-occurring oncogenic variants; localization of NF1 loss within vascular cell populations; and evidence of rat sarcoma-mitogen-activated protein kinase pathway activation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 259 participants (125 female individuals [48.3%]), 102 (39.4%) individuals had NF1 (median [range] age, 34 [18-70] years) and 157 (60.6%) were controls (median [range] age, 40 [15-91] years). CAs were more frequent in individuals with NF1 than controls (48% vs 18%; odds ratio, 4.26; 95% CI, 2.44-7.56) and occurred at a younger age. This association persisted after adjustment for age and sex and in propensity score-matched analyses. Somatic NF1 loss-of-function second hits were identified in 26 of 39 of NF1-associated CAs (67%) and none from controls, indicating biallelic NF1 inactivation. Comprehensive genomic profiling revealed frequent co-occurring activating variants, most commonly in GNAQ. Cell-specific sequencing showed that NF1 second hits arose predominantly in endothelial cells and telocytes, with higher variant allele frequencies in endothelial cells. Immunofluorescence demonstrated increased phosphoextracellular signal-regulated kinase signaling in these vascular cell populations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;The results of this cross-sectional study suggest that CAs represent a frequent and previously unrecognized vascular manifestation of NF1, which is supported by epidemiological enrichment and mechanistic evidence of biallelic NF1 inactivation in vascular cells. These findings potentially expand the spectrum of NF1-associated neoplas","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793305","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":"Zilucoplan-Associated Morpheaform Skin Changes and Methotrexate and UVA1 Phototherapy.","authors":"Michelle M Huynh, Miriam Freimer, Abraham M Korman","doi":"10.1001/jamadermatol.2026.2314","DOIUrl":"https://doi.org/10.1001/jamadermatol.2026.2314","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793296","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}