JAMA dermatology最新文献

{"title":"Variation in Coverage of Atopic Dermatitis Therapies Across Commercial Payers.","authors":"Claire H Brennan, Sophie E Knox, Molly T Beinfeld, Daniel E Enright, James D Chambers","doi":"10.1001/jamadermatol.2026.2912","DOIUrl":"https://doi.org/10.1001/jamadermatol.2026.2912","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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793235","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":"AI Screening for Subclinical Basal Cell Carcinoma-Early Detection or Overdiagnosis?","authors":"Veronica Rotemberg","doi":"10.1001/jamadermatol.2026.2988","DOIUrl":"https://doi.org/10.1001/jamadermatol.2026.2988","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":"148793240","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":"Fibrosing Skin Disorder Associated With Zilucoplan.","authors":"Alexandre Auroy, Eiryann Humbert, Julien Praline, Thibault Kervarrec, Mahtab Samimi","doi":"10.1001/jamadermatol.2026.2321","DOIUrl":"https://doi.org/10.1001/jamadermatol.2026.2321","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":"148793252","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":"Risk Stratification Models for Cutaneous Malignant Neoplasms After Blood or Marrow Transplant.","authors":"Kristy K Broman, Qingrui Meng, Joshua Richman, Lucy Zhou, Nora Balas, Wendy Landier, Lindsey Hageman, Alysia Bosworth, F Lennie Wong, Ravi Bhatia, Daniel J Weisdorf, Saro H Armenian, Smita Bhatia","doi":"10.1001/jamadermatol.2026.2763","DOIUrl":"10.1001/jamadermatol.2026.2763","url":null,"abstract":"<p><strong>Importance: </strong>Blood or marrow transplant (BMT) recipients are at increased risk of developing subsequent cutaneous malignant neoplasms. There is a need to develop risk stratification tools to identify those at highest risk to inform dermatologic surveillance and evaluate risk mitigation strategies.</p><p><strong>Objective: </strong>To develop and validate a risk stratification tool for subsequent cutaneous malignant neoplasms among BMT recipients that incorporates readily available patient and treatment information.</p><p><strong>Design, setting, and participants: </strong>This prognostic study included participants in the multi-institutional, longitudinal BMT Survivor Study (BMTSS), which included individuals who underwent autologous or allogeneic BMT from January 1, 1974, to December 31, 2014, at 1 of 3 participating sites in California, Minnesota, and Alabama and survived 2 or more years after BMT. The present cohort was restricted to individuals who underwent a single transplant and completed at least 1 BMTSS survey. Data were analyzed from December 3, 2024, to June 3, 2026.</p><p><strong>Exposures: </strong>Risk stratification models included the following candidate variables: age at BMT, sex, race, ethnicity, prior cutaneous malignant neoplasm, pretransplant exposure to monoclonal antibodies, total body irradiation, chronic graft vs host disease, and posttransplant immunosuppression.</p><p><strong>Main outcomes and measures: </strong>The main outcomes were incident basal cell carcinoma (BCC), squamous cell carcinoma (SCC), or melanoma after BMT, ascertained based on participant report with medical record validation when available. Models for risk stratification were developed and validated using time-dependent area under the receiver operating characteristic (AUC) curve with repeated random partitioning into training and testing cohorts. Results were averaged to make a final model. Individuals were classified into low or high risk for subsequent cutaneous malignant neoplasm based on clinically meaningful risk stratification score thresholds.</p><p><strong>Results: </strong>Of the 3448 included BMTSS participants (1917 [55.6%] male; mean [SD] age at BMT, 41.9 [19.2] years) who were alive without a cutaneous malignant neoplasm event 2 years after BMT, 282 (8.2%) were diagnosed with BCC, 183 (5.3%) with SCC, and 73 (2.1%) with melanoma. At 15 years after BMT, the test model AUCs were 0.81 (95% CI, 0.76-0.85) for BCC, 0.90 (95% CI, 0.86-0.93) for SCC, and 0.83 (95% CI, 0.74-0.90) for melanoma. The 15-year cumulative incidence of BCC, SCC, and melanoma in the low-risk group was 2.4% (95% CI, 1.5%-3.9%), 3.2% (95% CI, 2.4%-4.2%), and 0.8% (95% CI, 0.4%-1.5%), respectively. In the high-risk group, the 15-year cumulative incidence of BCC, SCC, and melanoma was 13.3% (95% CI, 11.6%-15.4%), 13.6% (95% CI, 11.2%-16.5%), and 4.4% (95% CI, 3.2%-6.1%), respectively.</p><p><strong>Conclusions and relevance: </strong>In this prognostic st","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13470427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148723918","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":"Upadacitinib for Severe Alopecia Areata in Adults and Adolescents: Two Phase 3 UP-AA Randomized Clinical Trials.","authors":"Arash Mostaghimi, Melinda J Gooderham, Charles Lynde, Rodney Sinclair, Brett King, Maria Hordinsky, Lidia Rudnicka, Emma Guttman-Yassky, Rocco Serrao, Manabu Ohyama, Xingqi Zhang, Nina Magnolo, Ohsang Kwon, Cristina Oddi, Sebastian Meerwein, Ahmed M Soliman, Xianwei Bu, Chenyang Duan, Tianshuang Wu, Henrique D Teixeira, Andreas Lazar, Thierry Passeron","doi":"10.1001/jamadermatol.2026.2853","DOIUrl":"10.1001/jamadermatol.2026.2853","url":null,"abstract":"<p><strong>Importance: </strong>Alopecia areata (AA) is a chronic, systemic immune-mediated disease characterized by nonscarring hair loss. Many patients do not experience improvements with available treatment options and only ritlecitinib is approved for adolescent patients; therefore, there remains a clear unmet need for additional and improved systemic therapies.</p><p><strong>Objective: </strong>To evaluate the efficacy and safety of upadacitinib-an oral selective Janus kinase inhibitor-in adult and adolescent patients with severe AA.</p><p><strong>Design, setting, and participants: </strong>This global clinical program included 2 parallel phase 3 replicate randomized clinical trials (UP-AA1 and UP-AA2) conducted from October 2023 to July 2025, to evaluate upadacitinib in adolescent and adult patients (age 12 to <64 years old) with severe AA, defined as a Severity of Alopecia Tool (SALT) score of 50 or greater. Both trials included a 24-week placebo-controlled, double-blinded treatment period (period A) and a 28-week blinded extension treatment period (period B). Data were analyzed from July 2025 to October 2025.</p><p><strong>Interventions: </strong>Eligible patients were randomized 2:2:1 to once daily 15- or 30-mg upadacitinib or matching placebo.</p><p><strong>Main outcomes and measures: </strong>Achievement of (multiplicity controlled) SALT score of 20 or less at week 24. Multiplicity-controlled secondary efficacy end points included achievement of improvements in clinician-reported outcomes for eyebrows and eyelashes; achievement of SALT scores of 20 or less at weeks 4, 8, and 12; achievement of SALT score of 10 or less; SALT score 0 at week 24; patients' global impression of change of AA score of much better or moderately better at weeks 4 and 24; and other AA-specific health-related quality of life measures at week 24.</p><p><strong>Results: </strong>A total of 1399 patients were randomized (mean [range] age, 36 [12-64] years; 826 female [59.0%]), 676 patients from the UP-AA1 and 723 patients from the UP-AA2, to either 15-mg upadacitinib (270 and 289 patients, respectively), 30-mg upadacitinib (271 and 289), or placebo (135 and 145). Their mean (SD) SALT score was 83.9 (18.9) at baseline. The proportion of patients who achieved SALT score of 20 or less at week 24 was significantly higher for the 15-mg upadacitinib (122 [45.2%] and 129 [44.6%]) and the 30-mg upadacitinib (149 [55.0%] and 157 [54.3%]) groups, respectively, than for the placebo (2 [1.5%] and 5 [3.4%]) group. The safety profile of both doses was similar in adults and adolescents and consistent with approved indications; no new safety findings were identified. Treatment-emergent adverse events reported by more than 5% of patients in any treatment group were upper respiratory tract infection, acne, elevated blood creatine phosphokinase, and nasopharyngitis. Across both studies, treatment-emergent serious adverse events occurred in 9 (1.6%), 13 (2.3%), and 1 (0.4%) of patient","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13470430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720851","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":"Recurrent Giant Tendinous Masses and Refractory Hypercholesterolemia in a Woman.","authors":"Yu Fan, Yuanyuan Li, Yiwen Wu","doi":"10.1001/jamadermatol.2026.2075","DOIUrl":"https://doi.org/10.1001/jamadermatol.2026.2075","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678572","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":"Pyoderma Gangrenosum Phenotype Classification.","authors":"Ahana Gaurav, Samantha Gregoire, Eric Xia, Basil Alex McIntosh, Afsaneh Alavi, Jean Bolognia, Edward Cowen, Arturo R Dominguez, Anthony P Fernandez, David Fivenson, Michael Heffernan, William Huang, Benjamin Kaffenberger, Lauren Madigan, Melissa Mauskar, Alexander D Means, Caroline Nelson, Aikaterini Patsatsi, Douglas Pugliese, Nathan W Rojek, Misha Rosenbach, Sheila Shaigany, Kanade Shinkai, Gideon Smith, Robert Swerlick, Alex Ortega-Loayza, Arash Mostaghimi","doi":"10.1001/jamadermatol.2026.2285","DOIUrl":"https://doi.org/10.1001/jamadermatol.2026.2285","url":null,"abstract":"<p><strong>Importance: </strong>Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis characterized by sterile ulcerative skin lesions. Multiple comorbidities and clinical features have been associated with PG, but no standardized guidelines exist for classifying PG phenotypes.</p><p><strong>Objective: </strong>To develop an expert-established classification framework for PG phenotypes to inform treatment guidelines and future research endeavors.</p><p><strong>Evidence review: </strong>In this modified Delphi consensus study that included 23 board-certified dermatologists and Medical Dermatology Society members with expertise in PG, panelists completed 5 rounds of anonymous, iterative online surveys that were administered from December 2023 through July 2025. Before the beginning of the consensus exercise, a literature review was performed by nonvoting researchers to summarize existing data on PG clinical associations and comorbidities. A PubMed search from inception to September 2023 identified observational studies, narrative reviews, systematic reviews, and meta-analyses describing PG clinical associations and comorbidities that were published in English. Experts indicated their agreement with proposed PG phenotypes and disease modifiers with a consensus threshold of 70% or greater. Anonymous comments and aggregated results were presented in each subsequent round. In the final round, a framework of PG phenotypes and disease modifiers was proposed for agreement.</p><p><strong>Findings: </strong>Twenty-three board-certified dermatologists and Medical Dermatology Society members with expertise in PG completed 5 rounds of iterative surveys. Consensus was reached on the final set of PG phenotypes and disease modifiers, with 83% of experts in agreement. PG phenotypes were overall classified into 2 major groups: PG with autoinflammatory syndromes and nonsyndromic PG. Nonsyndromic PG included 4 phenotypes: inflammatory bowel disease-associated PG, PG in association with hematologic cancers and blood dyscrasias, drug-induced PG, and other (including idiopathic) PG. Disease modifiers of PG phenotype presentations included involvement of special sites (head/neck, genitals, or peristomal skin) and extracutaneous manifestations.</p><p><strong>Conclusions and relevance: </strong>This expert-established, descriptive framework provides a standardized classification system for distinct PG phenotypes and its modifiers. This nomenclature may inform upcoming clinical guidelines and allow for consistency in reporting epidemiological research and outcomes among patients with PG.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678543","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":"Approved Monoclonal Antibody Therapies for Hidradenitis Suppurativa.","authors":"James Pham, Tara Sholji, Marra Aghajani, Cindy Kok, John W Frew","doi":"10.1001/jamadermatol.2026.2633","DOIUrl":"10.1001/jamadermatol.2026.2633","url":null,"abstract":"<p><strong>Importance: </strong>Biologic therapies are increasingly used for moderate to severe hidradenitis suppurativa (HS), yet their high cost presents challenges for health systems and payers. Comparative economic evaluations of these therapies are limited.</p><p><strong>Objective: </strong>To evaluate the efficiency frontier of approved monoclonal antibody therapies for HS across multiple countries.</p><p><strong>Design and setting: </strong>This economic evaluation used publicly available clinical trial data and drug pricing data. Phase 3 trial efficacy data for adalimumab, secukinumab, and bimekizumab from 6 trials were combined with drug price data from the US, Canada, France, Germany, and Australia as of January 31, 2026. Data analysis was conducted between March 15 and May 22, 2026.</p><p><strong>Main outcomes and measures: </strong>Efficiency frontier analysis using Hidradenitis Suppurativa Clinical Response (HiSCR) 50 (indicating 50% reduction from baseline) and HiSCR-75 (indicating 75% reduction from baseline) metrics. Incremental cost-effectiveness ratios were calculated where multiple agents lay on the frontier.</p><p><strong>Results: </strong>Across all examined countries, adalimumab, 40 mg, weekly, consistently was on the efficiency frontier for both HiSCR-50 and HiSCR-75 outcomes. Secukinumab, 300 mg, every 4 weeks, appeared on the frontier only when US wholesale acquisition costs were used. Annual therapy costs ranged from $11 345 for adalimumab, 40 mg, weekly in Australia to $411 990 for bimekizumab, 320 mg, every 2 weeks in the US. Analyses using cost-efficiency estimates adjusted for baseline disease severity showed an efficiency frontier composition similar to unadjusted analyses.</p><p><strong>Conclusions and relevance: </strong>In this study, among currently approved monoclonal antibody therapies for HS, adalimumab showed dominant cost-efficiency performance across multiple health systems. These findings highlight substantial international variation in biologic drug pricing and provide a framework for value-based pricing in HS therapeutics.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13445090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678563","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":"Is Postinflammatory Hyperpigmentation Truly \"Post\" in People With Darker Skin Tones?","authors":"Jerry K L Tan, Iltefat H Hamzavi, Tasneem F Mohammad, Andrew F Alexis","doi":"10.1001/jamadermatol.2026.2641","DOIUrl":"https://doi.org/10.1001/jamadermatol.2026.2641","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678615","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":"Risk of Immunologic Reactions During Monthly Therapy for Hansen Disease.","authors":"Peyton V Warp, Minsoo Kim, Kimberly Williams, Andrew Miner, Andrea D Maderal","doi":"10.1001/jamadermatol.2026.1262","DOIUrl":"10.1001/jamadermatol.2026.1262","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"848-851"},"PeriodicalIF":10.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13234743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149814","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}