Journal of Drugs in Dermatology最新文献

{"title":"Pulsed Dye Laser for Sensory Dysesthesias Associated With Chronic Radiation Dermatitis.","authors":"Danny Linggonegoro, Bernice Kwong, Kelsey Elizabeth Hirotsu","doi":"10.36849/JDD.9619","DOIUrl":"10.36849/JDD.9619","url":null,"abstract":"<p><p>Chronic radiation dermatitis (CRD) is a long-term complication of radiation therapy, typically manifesting as scarred atrophic plaques with telangiectasias. In some cases, patients report persistent sensory dysesthesias such as burning, stinging, and pruritus. These symptoms are underrecognized and likely underreported but can significantly impair quality of life and are often refractory to conventional therapies. Pulsed dye laser (PDL) has demonstrated efficacy in treating CRD-associated telangiectasias, but its role in alleviating sensory symptoms has not been reported. We report 2 breast cancer patients with treatment-resistant CRD and debilitating dysesthesias who experienced substantial symptom improvement following PDL therapy. The first patient presented with a decade-long nonhealing chest wall wound and refractory pruritus. She underwent ten sessions of subpurpuric PDL at 6-week intervals, in combination with advanced wound care, and achieved complete wound healing and sustained relief of pruritus and skin fragility. The second patient presented with a burning erythematous axillary plaque present for three years. She underwent four PDL sessions at five-week intervals and reported her first meaningful reduction in burning immediately after the initial treatment, with nearly complete resolution of dysesthesia by her final session despite persistent telangiectasias. These cases suggest that PDL may offer a novel therapeutic option for CRD-associated dysesthesias, particularly when integrated with multidisciplinary care involving medical dermatology, laser specialists, and wound care. Larger, prospective studies are warranted to clarify PDL efficacy for CRD-related dysesthesias. &nbsp.</p>","PeriodicalId":15566,"journal":{"name":"Journal of Drugs in Dermatology","volume":"25 10","pages":"968-970"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"INDIVIDUAL ARTICLE: Tildrakizumab for Real-World Psoriasis Care: Clinical Lessons From Medically Complex and Underserved Patient Populations.","authors":"Julian A Cortes, Boni Elewski, Sam Awan, Michael O'Donoghue, Alex Glazer, Todd Schlesinger, Raj Chovatiya, Christopher G Bunick, Leon H Kircik, April W Armstrong","doi":"10.36849/JDD.435801","DOIUrl":"https://doi.org/10.36849/JDD.435801","url":null,"abstract":"<p><p>Tildrakizumab, a humanized monoclonal antibody targeting the p19 subunit of interleukin-23, has demonstrated durable efficacy and a favorable long-term safety profile in moderate-to-severe plaque psoriasis. However, patients encountered in clinical practice frequently have comorbidities, treatment barriers, and social circumstances that are underrepresented in randomized clinical trials. This case review describes 16 patients treated with tildrakizumab across clinically relevant populations, including older adults, patients with cardiometabolic disease or complex medical comorbidities, and individuals with unique treatment considerations. Across these cases, tildrakizumab was associated with substantial improvement in psoriasis, including involvement of high-impact sites such as the scalp, nails and intertriginous regions. Durable disease control was observed in patients with prior malignancy, chronic infection, hepatic disease, cardiovascular comorbidities, polypharmacy, and prior biologic failure, without treatment-limiting adverse events attributed to tildrakizumab. In-office administration and every-12-week maintenance dosing also offered practical advantages for patients facing Medicare-related access considerations, self-injection aversion, inconsistent healthcare access, or adherence challenges. These cases demonstrate how tildrakizumab may be integrated into individualized psoriasis management and highlight its potential as a practical, effective, and well-tolerated treatment option across diverse real-world clinical settings.</p>","PeriodicalId":15566,"journal":{"name":"Journal of Drugs in Dermatology","volume":"25 10","pages":"435801s4-435801s14"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Narrative Review of Seven Off-Label Treatment Options for Seborrheic Dermatitis.","authors":"Anthony Thompson, Adriana Morales-Rivera, Emily Patel, Alec Sevilla, Collins Langley, Jay Wolverton","doi":"10.36849/JDD.9507","DOIUrl":"https://doi.org/10.36849/JDD.9507","url":null,"abstract":"<p><strong>Background: </strong>Seborrheic dermatitis (SD) is a chronic inflammatory skin condition driven by overactive sebaceous glands, Malassezia colonization, immune dysfunction, and epidermal barrier disruption. While topical corticosteroids and antifungals are first-line treatments, rebound disease and adverse effects limit long-term use.</p><p><strong>Objective: </strong>To evaluate seven off-label therapies for SD: topical calcineurin inhibitors (TCI), metronidazole, phosphodiesterase-4 inhibitors (PDE4), systemic antifungals, isotretinoin, natural remedies, and microbiome-directed therapies.</p><p><strong>Methods: </strong>A PubMed-based narrative review included clinical trials, observational studies, and case reports when higher-level data were lacking.</p><p><strong>Results: </strong>TCIs and PDE4 inhibitors demonstrated consistent efficacy for facial SD as steroid-sparing options. Metronidazole provided modest benefit, mainly in patients with concomitant rosacea. Both systemic antifungals and low-dose isotretinoin were effective for moderate-to-severe disease, though systemic therapy requires monitoring for hepatotoxicity. Natural agents (eg, honey, tea tree oil) and microbiome-targeted therapies (eg, probiotics, Triphala) showed variable improvement.</p><p><strong>Conclusion: </strong>These therapies serve as promising treatment options for SD, particularly in refractory cases or when standard treatments are unsuitable. Larger comparative trials with standardized outcomes and long-term follow-up are needed to clarify their role.</p>","PeriodicalId":15566,"journal":{"name":"Journal of Drugs in Dermatology","volume":"25 10","pages":"943-948"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Off-Label Uses of Nemolizumab: A Narrative Review.","authors":"Hermon Feron, Alice B Gottlieb","doi":"10.36849/JDD.9880","DOIUrl":"https://doi.org/10.36849/JDD.9880","url":null,"abstract":"<p><strong>Background: </strong>Nemolizumab, a humanized monoclonal antibody targeting interleukin-31 receptor &alpha; (IL-31R&alpha;), is approved for atopic dermatitis (AD) and prurigo nodularis (PN) in adults and pediatric patients 12 years and older, following phase 3 trials demonstrating significant reductions in pruritus and disease severity in patients inadequately controlled with topical therapies. Emerging evidence has demonstrated rapid and sustained pruritus reduction in diverse pruritic conditions beyond its approved indications.</p><p><strong>Methods: </strong>We reviewed the literature from 2021 to 2025 examining off label nemolizumab use, analyzing case reports, case series, randomized controlled trials, and meta-analyses across dermatologic and systemic pruritic conditions.</p><p><strong>Results: </strong>Across 16 studies with diverse diagnoses, nemolizumab demonstrated consistent efficacy in multiple off-label conditions including cutaneous amyloidosis, lichen simplex chronicus, uremic and dialysis-associated pruritus, cholestatic pruritus, and refractory dermatologic conditions. Adverse events were consistent with those described in its package insert.</p><p><strong>Conclusions: </strong>Current evidence supports nemolizumab as a promising therapeutic option for treatment-refractory pruritic conditions. The rapid onset, favorable tolerability, and broad efficacy across conditions with elevated IL-31 signaling suggest significant clinical utility, though larger randomized trials are needed for definitive recommendations. &nbsp.</p>","PeriodicalId":15566,"journal":{"name":"Journal of Drugs in Dermatology","volume":"25 10","pages":"956-961"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contact Allergens Associated With Nummular Eczema: A Systematic Review.","authors":"Lucie Joerg, Julia Stolyar, Jared Jagdeo","doi":"10.36849/JDD.10209","DOIUrl":"https://doi.org/10.36849/JDD.10209","url":null,"abstract":"<p><strong>Background: </strong>Nummular eczema (NE) is a prevalent and chronic inflammatory dermatosis marked by pruritic, coin-shaped eczematous plaques. Contact allergen sensitization may play a role in NE etiology.</p><p><strong>Methods: </strong>On April 30, 2026, PubMed, Embase, and the Cochrane Library were searched per PRISMA guidelines for studies investigating triggers or aggravators of NE through patch testing.</p><p><strong>Results: </strong>Of 287 studies identified, 10 observational studies met the inclusion criteria. The median overall patch test positivity among patients with NE was 47.8% (range: 26.7% to 56.0%). The most frequently reported allergens included nickel and nickel sulfate, potassium dichromate, cobalt chloride, fragrance mix, neomycin, colophony, formaldehyde, paraphenylenediamine, and rubber-related allergens. Among studies reporting concomitant allergic contact dermatitis (ACD), a median of 33.5% of patients with NE had concurrent or prior ACD.</p><p><strong>Conclusions: </strong>Available observational evidence suggests that contact allergen positivity is common among patients with NE. Patch testing should be considered for patients with severe or treatment-refractory NE to identify clinically relevant allergens and guide trigger-avoidance strategies. Further studies using standardized patch testing protocols and assessments of clinical relevance are needed to clarify whether contact sensitization is an etiologic factor, a disease aggravator, or a comorbid finding in NE. &nbsp.</p>","PeriodicalId":15566,"journal":{"name":"Journal of Drugs in Dermatology","volume":"25 10","pages":"914-918"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nordic European Countries Atopic Dermatitis (NECAD) I: Importance of Concordance With Skincare for Atopic Dermatitis.","authors":"Mette Deleuran, Peter Bjerring, Anneke Andriessen, Sampsa Kauppi, Cristina Oprica, Anne Wetter, Gabriela Lladó Grove, Michael J Cork","doi":"10.36849/JDD.9660","DOIUrl":"https://doi.org/10.36849/JDD.9660","url":null,"abstract":"<p><strong>Background: </strong>Atopic dermatitis (AD) is a chronic disease with a dysfunctional skin barrier, requiring continuous management to reduce symptoms and prevent flares. Topical treatment comprises the cornerstone of AD management. The paper&rsquo;s objective was to summarize current recommendations for skincare in AD, addressing challenges and possible interventions for improved concordance.</p><p><strong>Method: </strong>The Nordic European Countries Atopic Dermatitis (NECAD) panel of dermatologists discussed surveys, literature, and professional experiences regarding skincare in AD management. Five consensus statements were established to share general insights and suggestions to improve treatment concordance.</p><p><strong>Results: </strong>Skincare with emollients is the recommended basis of AD management. Concordance to topical treatment is considered a significant challenge in AD. Evidence suggests that newer, more comprehensive emollients are superior to basic emollients regarding both clinical effect and convenience in patients' daily routine. Interventional tools such as evidence-based patient education, AD action plans, and closer physical and/or digital follow-up were suggested.</p><p><strong>Conclusion: </strong>The effectiveness of topical treatment in AD is highly dependent on the type of emollient used as well as patient concordance. With increasing evidence and focus on patient education, concordance and, thus, treatment outcomes can be improved. &nbsp.</p>","PeriodicalId":15566,"journal":{"name":"Journal of Drugs in Dermatology","volume":"25 10","pages":"949-955"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cicatricial Ectropion in the Setting of IL-13 Inhibition.","authors":"Marley Cutrona, Rabail Aslam, Ahmed Zakik, Ahuva Cices","doi":"10.36849/JDD.9957","DOIUrl":"https://doi.org/10.36849/JDD.9957","url":null,"abstract":"<p><strong>Introduction: </strong>Interleukin (IL)-13 is a key mediator of type 2 inflammation and an important therapeutic target in atopic dermatitis (AD). Although IL-4/IL-13 and IL-13 inhibitors demonstrate favorable safety profiles, ocular adverse events are recognized complications. Conjunctivitis is most commonly reported, and cicatricial ectropion has been described with IL-4/IL-13 inhibition. We report what is, to our knowledge, the first reported case of cicatricial ectropion associated with inhibition of soluble IL-13.</p><p><strong>Case presentation: </strong>An 81-year-old man with longstanding AD involving 60% body surface area was treated with dupilumab with marked improvement. Seven months later, he developed ocular pruritus and tearing and was diagnosed with atopic keratoconjunctivitis. One month later, ophthalmologic examination revealed inferior cicatricial ectropion of the left lower eyelid. Discontinuation of dupilumab and treatment with oral prednisone and topical tacrolimus led to resolution. Subsequent treatment with tralokinumab resulted in recurrence of cicatricial ectropion within one month, prompting discontinuation and treatment with topical polymyxin B-trimethoprim and oral prednisone. Upadacitinib was initiated with sustained clearance of AD and no recurrence of ocular symptoms.</p><p><strong>Discussion: </strong>Cicatricial ectropion has been rarely reported with dupilumab but has not previously been described with soluble IL-13 inhibition. In this case, ectropion developed with dupilumab, resolved after discontinuation, and recurred with tralokinumab, suggesting a direct effect of IL-13 inhibition. This case highlights the need for awareness of rare ocular complications associated with targeted therapies for AD and underscores the importance of multidisciplinary management. &nbsp.</p>","PeriodicalId":15566,"journal":{"name":"Journal of Drugs in Dermatology","volume":"25 10","pages":"971-973"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fundamentals of Hyperpigmentation Disorders: Causes, Concerns, and Treatment Strategies, Particularly in Skin of Color Patients.","authors":"Susan Taylor, Seemal R Desai, Cheri Frey, Nada Elbuluk, Pearl E Grimes, Andrew Alexis","doi":"10.36849/JDD.10255","DOIUrl":"https://doi.org/10.36849/JDD.10255","url":null,"abstract":"<p><strong>Background: </strong>Pigmentary disorders, including hyperpigmentation, are among the most common dermatologic diagnoses in individuals with skin of color (SOC), particularly individuals with African, Asian, or Hispanic heritage, and often carry a significant quality-of-life burden. Although the evidence base has grown, gaps persist in epidemiology, in pathophysiology-driven treatment selection, and in the appropriate representation of Fitzpatrick skin types III to VI in clinical studies.</p><p><strong>Methods: </strong>A comprehensive review of PubMed and Medline-indexed hyperpigmentation literature published between 2000 and 2026 was reviewed, with priority given to randomized controlled trials, meta-analyses, large epidemiologic series, and consensus statements.</p><p><strong>Results: </strong>Our current understanding of hyperpigmentation has extended well beyond melanocyte hyperactivity alone. Across the major hyperpigmentation disorders, visible light acting through opsin-3 (OPN3), inflammatory and hormonal signaling, and, in melasma, basement-membrane disruption with a senescent dermal microenvironment contribute to pigment formation and treatment resistance, findings that highlight the importance of both UV radiation and visible-light photoprotection. Clinical and meta-analytic evidence supports a multimodal therapeutic approach, consistent with recent international consensus recommendations. Quality-of-life impairment is consistent across populations, a pattern that should inform counseling, while commonly used diagnostic tools and machine-learning algorithms continue to underperform in skin of color.</p><p><strong>Discussion: </strong>Treatment of hyperpigmentation remains a multimodal therapy with the need for routine assessment of patient-reported quality of life impact.</p><p><strong>Conclusion: </strong>Closing the evidence gap for skin of color is the next priority in treatment of hyperpigmentation and will require inclusive trial design, validated diagnostic tools, and standardized outcome measures. &nbsp.</p>","PeriodicalId":15566,"journal":{"name":"Journal of Drugs in Dermatology","volume":"25 10","pages":"926-933"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Variability of Dermatologic Needs in American Indian/Alaskan Native Populations: A Single-Center Retrospective Analysis.","authors":"Jasmine Hawkins, Janiene Luke","doi":"10.36849/JDD.9347","DOIUrl":"https://doi.org/10.36849/JDD.9347","url":null,"abstract":"","PeriodicalId":15566,"journal":{"name":"Journal of Drugs in Dermatology","volume":"25 10","pages":"e59"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SAIGE III: The Role of Environmental Factors in the Development and Severity of Atopic Dermatitis in Young Children.","authors":"Lawrence A Schachner, Anneke Andriessen, Latanya Benjamin, Mercedes E Gonzalez, Pearl Kwong, Peter Lio, Robert Sidbury, Vanja Adzovic, Nanette B Silverberg","doi":"10.36849/JDD.10029","DOIUrl":"https://doi.org/10.36849/JDD.10029","url":null,"abstract":"<p><strong>Background: </strong>Atopic dermatitis (AD) often manifests in infancy or early childhood, with significant impacts on quality of life and potential persistence into adulthood. Environmental factors are key contributors to pruritus, barrier dysfunction, and inflammation associated with AD.</p><p><strong>Methods: </strong>A panel of 7 pediatric dermatology experts employed a modified Delphi process, including a face-to-face meeting and online follow-up, to evaluate current evidence and formulate consensus recommendations for managing pediatric AD.</p><p><strong>Results: </strong>The panel identified environmental factors that affect skin barrier function and contribute to the development and severity of pediatric AD. Consensus recommendations emphasize minimizing environmental exposures and highlight strategies to reduce skin barrier disruption. Early and continuous use of gentle, non-alkaline cleansers and ceramide-containing moisturizers, initiated from birth, may help mitigate AD risk and severity, particularly in high-risk children.</p><p><strong>Conclusions: </strong>Recognizing and addressing environmental factors is an important component of pediatric AD management. Addressing modifiable environmental factors and initiating early barrier-supportive skincare, including ceramide-containing moisturizers, represents a practical approach to reducing disease severity and flare development. These findings highlight the importance of clinician education to improve awareness of environmental risk factors and effective mitigation strategies. &nbsp.</p>","PeriodicalId":15566,"journal":{"name":"Journal of Drugs in Dermatology","volume":"25 10","pages":"935-941"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}