Journal of the European Academy of Dermatology and Venereology最新文献

{"title":"Beyond clearance rates: Redefining success in photodynamic therapy for actinic keratosis","authors":"Lukas Kofler, Klaus Eisendle","doi":"10.1111/jdv.70627","DOIUrl":"https://doi.org/10.1111/jdv.70627","url":null,"abstract":"<p>Photodynamic therapy (PDT) has established itself as one of the most effective field-directed treatments for actinic keratosis (AK), uniquely combining eradication of clinically visible and subclinical disease with excellent cosmetic outcomes.<span><sup>1, 2</sup></span> Yet one major limitation has accompanied its success from the beginning: treatment-associated pain. For many patients, pain is not merely an adverse event but the decisive factor determining whether they will accept repeated treatment.</p><p>In this issue of the <i>Journal of the European Academy of Dermatology and Venereology</i>, Sjöholm et al. report the first adequately powered randomized non-inferiority trial comparing simulated daylight PDT (SDL-PDT) with conventional red-light PDT (C-PDT) using 5-aminolevulinic acid.<span><sup>3</sup></span> Importantly, the investigators provide 1-year follow-up data, filling a relevant evidence gap for SDL-PDT. The methodologically robust randomized intraindividual split-site design (69 patients, 1458 lesions) minimizes interpatient variability and allows direct comparison of objective efficacy and subjective treatment experience. Although lesion-level analyses do not fully account for clustering within individual patients, the magnitude of the observed efficacy difference makes it unlikely that this limitation would alter the overall conclusion.</p><p>As a primary finding SDL-PDT did not meet the predefined non-inferiority criterion. Lesion clearance after 1 year reached 71.0%, compared with 85.3% for C-PDT, a difference of 14% (<i>p</i> < 0.001), confirming that conventional PDT remains the benchmark whenever maximal efficacy is the therapeutic priority. However, these results deserve to be viewed from a broader perspective. Negative studies are valuable when they provide clarity, and this study shifts the discussion from a simple comparison of illumination techniques towards a more fundamental question: how should success in field-directed therapy be defined?</p><p>The remarkable difference in treatment tolerability is impossible to ignore. Mean numeric rating pain scales (NRS 0 no pain to 10 worst possible pain) differed almost ninefold (mean NRS 0.8 for SDL-PDT versus 6.6 for C-PDT, <i>p</i> < 0.001), and nearly every participant preferred SDL-PDT immediately after treatment.<span><sup>3</sup></span> These findings reinforce the growing recognition that patient-reported outcomes are not secondary endpoints but integral components of therapeutic value, particularly in chronic conditions requiring repeated interventions.</p><p>Similar findings of lower efficacy accompanied by lower pain scores have also been shown for superficial basal cell carcinoma comparing SDL-PDT to C-PDT<span><sup>4</sup></span> or daylight versus C-PDT for thick actinic keratoses.<span><sup>5</sup></span> These results can therefore not be interpreted as the end of SDL-PDT development. Instead, they define future research priorities, including optimize","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 10","pages":"1589-1590"},"PeriodicalIF":9.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70627","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's New in JEACP—Editor-in-Chief's Insights","authors":"Antonio Torrelo, (JEACP Editor-in-Chief)","doi":"10.1111/jdv.70618","DOIUrl":"https://doi.org/10.1111/jdv.70618","url":null,"abstract":"<p>The article ‘Characteristics of Sensitive Scalp in French Women and Comparison With Scalp Dermatoses’ by Ficheux et al.,<span><sup>1</sup></span> highlights a frequent but often overlooked complaint in dermatological practice. Sensitive scalp affects a substantial proportion of the population, yet its clinical characteristics and impact on patients have been incompletely defined. By comparing women with sensitive scalp to patients with scalp psoriasis or seborrheic dermatitis (Figure 1), the authors show that sensitive scalp should be regarded as a distinct syndrome rather than a mild form of inflammatory scalp disease.</p><p>Pruritus was the predominant symptom, while tightness, prickling and burning were less frequent. Mechanical factors, such as tied or braided hairstyles, were among the most common triggers, alongside stress, perspiration and hair dyes. Conversely, scalp massage and hair brushing were often reported to alleviate symptoms, suggesting that the pathophysiology of scalp sensitivity differs from that of facial sensitive skin. The study also demonstrates a clear correlation between symptom severity and impaired quality of life; however, relatively few patients sought professional advice. Patients with inflammatory scalp diseases experienced more severe and frequent symptoms, reinforcing the need for careful differential diagnosis. Although based on questionnaire data, this work provides valuable insight for daily practice and should stimulate further research into the mechanisms and management of this common condition.</p><p>The article ‘Validated, Reliable, and Novel Skin Frailty Scale for Outpatient Usage and Its Association With Age, Sex, and Non-Melanoma Skin Cancer’ by Ho et al.,<span><sup>2</sup></span> addresses an important unmet need in dermatology: the lack of a standardized method for assessing age-associated skin frailty. As the ageing population continues to grow, practical tools capable of objectively documenting skin frailty are becoming increasingly relevant for both clinical care and research.</p><p>After identifying clinically meaningful variables through literature review and expert validation, the authors developed a nine-parameter Skin Frailty Score (SFS) based on visual clinical findings (Figure 2). The score demonstrated good intra-observer and moderate inter-observer reliability, and subsequent factor analysis simplified the instrument to six parameters while maintaining satisfactory performance. Higher scores were independently associated with increasing age, female sex and non-melanoma skin cancer, supporting the biological validity of the proposed scale. Unlike imaging techniques or biomechanical measurements, the SFS requires no additional equipment and can be easily incorporated into routine outpatient consultations. Although external validation in more diverse populations would be desirable, this study represents an important advance towards standardized assessment of skin frailty. The proposed scor","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 10","pages":"1566-1568"},"PeriodicalIF":9.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70618","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-surgical management of lentigo maligna: Why, when and how?","authors":"Pascale Guitera, Susan M. Swetter","doi":"10.1111/jdv.70520","DOIUrl":"https://doi.org/10.1111/jdv.70520","url":null,"abstract":"<p></p><p>Pascale Guitera</p><p></p><p>Susan M. Swetter</p><p>Lentigo maligna (LM) is an in situ melanoma affecting older populations, often on cosmetically sensitive areas of the head and neck. While surgical excision remains standard treatment, more conservative, non-invasive approaches may better serve patients with large lesions, local recurrence or medical frailty.</p><p>This treatment strategy has become feasible due to advances in the use of topical therapy with imiquimod 5% cream as well as diagnostic imaging, including in vivo reflectance confocal microscopy (RCM), which has enhanced the ability to distinguish LM from both atypical intraepidermal melanocytic proliferations and invasive LM melanoma.<span><sup>1</sup></span> A systematic review of 303 cases identified key RCM features predictive of invasion: widespread pagetoid cells, atypical junctional nests and dermal architectural disruption.<span><sup>2</sup></span> RCM also helps target biopsy at the right place and the right time.<span><sup>3</sup></span> However, its adoption remains limited due to training requirements and integration challenges, particularly in the United States.</p><p>Achieving clear margins in head and neck LM is challenging due to pathological subtleties and anatomical constraints. Wide excisions may be costly in terms of tissue loss and healthcare resources, especially for older patients with comorbidities. Non-surgical options like imiquimod have demonstrated efficacy with low failure rates. The RADICAL trial compared imiquimod to radiotherapy when surgery was challenging or failed, finding 10% recurrence in the imiquimod group versus 21% in the radiotherapy group within 27 months post randomization (OR 2.35, 95% CI 0.82–6.75, <i>p</i> = 0.11), though the trial was underpowered due to COVID-19 pandemic-related disruption.<span><sup>4</sup></span> Imiquimod's effectiveness was linked to titrated dosing that maximized the inflammatory response and the use of a patient diary that improved adherence during the 12-week protocol.<span><sup>5</sup></span> While 23% of patients reported temporary activity loss (mainly social impairment) during treatment, cosmetic outcomes and quality of life quickly normalized afterwards.<span><sup>4</sup></span> As a lower-cost alternative to surgery or radiotherapy—particularly for a non-life-threatening condition—topical treatment offers value.<span><sup>6</sup></span> However, a prolonged course of local inflammation or potential long-term side effects from radiotherapy may not be desirable for all patients, and shared decision-making must become a priority, ensuring that patients and their families receive balanced information on the risks and benefits of different treatment strategies.</p><p>The progression risk from LM to invasive melanoma (LMM) is both low and slow. Statistical modelling suggests only up to 3.5% of LM cases progress to invasive LMM annually, with a median progression time of 28.3 years.<span><sup>7</sup></sp","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 10","pages":"1575-1576"},"PeriodicalIF":9.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70520","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Turning rarity into evidence: Eosinophilic fasciitis as a model for rare irAEs","authors":"Alisson Pugliesi","doi":"10.1111/jdv.70650","DOIUrl":"https://doi.org/10.1111/jdv.70650","url":null,"abstract":"<p>Generating robust clinical evidence for rare diseases, and even more so for rare toxicities, remains one of the most persistent challenges in medicine. Conventional prospective studies are often impracticable, leaving clinicians to make diagnostic and therapeutic decisions based on isolated case reports and individual experiences. As the use of immune checkpoint inhibitors (ICIs) expands, this problem has become increasingly relevant with the recognition of uncommon immune-related adverse events (irAEs), including eosinophilic fasciitis (EF). In this issue, Bruijn et al. move the field beyond isolated observations by integrating 121 cases identified through an international task force, two pharmacovigilance databases and a structured literature review.<span><sup>1</sup></span> Their main contribution is not simply the assembly of the largest series to date but the demonstration that collaborative networks and pharmacovigilance can convert dispersed clinical signals into clinically actionable evidence. Therefore, this study provides the most comprehensive characterization of ICI-associated EF and a pragmatic model for investigating other rare irAEs.</p><p>These findings also invite biological interpretations. PD-1 inhibitors accounted for >80% of the reported cases. Although this predominance may partly reflect exposure patterns, it is consistent with a central role of dysregulated adaptive immunity, particularly T-cell activation, in initiating fascial inflammation. Eosinophils, despite being a defining histopathological feature, may represent downstream effectors within a broader inflammatory cascade involving activated lymphocytes, macrophages and profibrotic mediators.<span><sup>2</sup></span> In this respect, irAEs may serve as natural human models of immune dysregulation, offering opportunities to explore the mechanisms that may also operate in idiopathic autoimmune diseases. This translational perspective is particularly relevant at the interface of dermatology, rheumatology and oncology, where observations from cancer immunotherapy have already provided new insights into inflammatory arthritis, myositis and systemic sclerosis-like syndromes, with EF now joining this expanding spectrum.<span><sup>2-4</sup></span></p><p>The immediate clinical relevance of this study is equally important. The predominance of melanoma, frequent association with anti-PD-1 monotherapy and a median latency of 10 months define a recognizable clinical context rather than a collection of unrelated cases. This delayed onset is particularly relevant because it may reduce clinical suspicion and postpone rheumatological assessment. Systemic corticosteroids remained the cornerstone of treatment, while methotrexate was the most frequently used steroid-sparing agent, broadly mirroring the current practice in idiopathic EF. However, the therapeutic evidence remains observational, and neither the optimal immunosuppressive strategy nor its duration can be established fr","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 10","pages":"1587-1588"},"PeriodicalIF":9.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70650","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editor’s Picks October 2026","authors":"","doi":"10.1111/jdv.70665","DOIUrl":"https://doi.org/10.1111/jdv.70665","url":null,"abstract":"<p></p><p>Christian Posch</p><p>In the Loire Sud basin of France, dermatologist density fell by 43% between 2004 to 2008 and 2017 to 2022, a period of rising melanoma incidence. In this population-based study, Boussetta and colleagues compared 1053 melanoma cases across the two periods (Figure 1).</p><p>Thin melanomas (≤ 1 mm) declined by 38%, while thick melanomas (> 4 mm) more than quadrupled (<i>p</i> < 0.001). Dermatologist-detected melanomas fell by half, general practitioners became the leading detectors (6%–46%) and referral delays tripled from 16 to 46 days. The authors call for GP training in dermoscopy and AI-assisted diagnostic tools, alongside teledermatology, to counter diagnostic delays in underserved regions.</p><p>Boussetta B, Perrot JL, Velia K, et al. Impact of dermatologist shortage on melanoma diagnosis: A population-based study. <i>J Eur Acad Dermatol Venereol</i> 2026;40:e898–e900. https://doi.org/10.1111/jdv.70549.</p><p>The effect of JAK–STAT inhibitors on the JAK–STAT pathway continues to raise infection concerns. In this comprehensive meta-analysis, Krebs and colleagues pooled data from over 29,000 patients treated with systemic or topical JAK–STAT inhibitors. Compared with placebo, JAK–STAT inhibitors were associated with a higher risk of influenza (RR 2.12), bronchitis (RR 2.03) and herpes zoster (RR 1.67), and patients with atopic dermatitis (AD) were most affected (Table 1). No significant increase in serious, fungal or opportunistic infections was observed.</p><p>These findings support vaccination and preventive strategies against influenza and herpes zoster in patients with AD receiving JAK–STAT inhibitor therapy.</p><p>Krebs M, Gulyás L, Fazekas KK, et al. Large-scale meta-analysis of infection risk with JAK–STAT inhibitors in 29,000 patients. <i>J Eur Acad Dermatol Venereol</i> 2026;40:1662–1674. https://doi.org/10.1111/jdv.70508.</p><p>Luo and colleagues compared cancer-specific survival by marital status using SEER data among 579 patients with stage IV Merkel cell carcinoma (MCC), before and during the immune checkpoint inhibitors (ICI) era. Married patients showed significantly better outcomes indicating survival disparities exist in the ICI era (restricted mean survival time difference of 10.85 months), while mortality risk for unmarried patients rose (hazard ratio of 2.01 by 2019–2021) (Figure 2).</p><p>These findings point to marital status, likely via insurance access and treatment adherence, as an independent variable of survival in the immunotherapy era.</p><p>Luo Z, Guo Z, Li D, et al. Improved survival in married patients with metastatic Merkel cell carcinoma in the immunotherapy era. <i>J Eur Acad Dermatol Venereol</i> 2026;40:e901–e903. https://doi.org/10.1111/jdv.70581.</p><p>In this randomized split-site trial, Sjöholm and colleagues compared a single session of simulated daylight PDT (SDL-PDT) with more painful conventional (C)-PDT in 69 patients with 1458 mild to moderate actinic keratoses ","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 10","pages":"1563-1565"},"PeriodicalIF":9.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70665","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Dermoscopy Society consensus recommendations for the management of lentigo maligna","authors":"Ana-Maria Forsea,&nbsp;Riccardo Pampena,&nbsp;Bengu Nisa Akay,&nbsp;Zoe Apalla,&nbsp;Giuseppe Argenziano,&nbsp;Giulia Briatico,&nbsp;Ralph Braun,&nbsp;Horacio Cabo,&nbsp;Raul Cabrera,&nbsp;Cristina Carrera,&nbsp;Elisa Cinotti,&nbsp;Claudio Conforti,&nbsp;Enzo Errichetti,&nbsp;Gerardo Ferrara,&nbsp;Roberta Giuffrida,&nbsp;Stefania Guida,&nbsp;Pascale Guitera,&nbsp;Allan C. Halpern,&nbsp;Stephen Heyes,&nbsp;Rainer Hofmann-Wellenhof,&nbsp;Angela M. Hong,&nbsp;Natalia Jaimes,&nbsp;Raimonds Karls,&nbsp;Harald Kittler,&nbsp;Teresa Kränke,&nbsp;Konstantinos Liopyris,&nbsp;Jie Liu,&nbsp;Caterina Longo,&nbsp;Josep Malvehy,&nbsp;Ashfaq A. Marghoob,&nbsp;Hoda Moneib,&nbsp;David Moreno Ramirez,&nbsp;Elvira Moscarella,&nbsp;Eduardo Nagore,&nbsp;Cristian Navarrete-Dechent,&nbsp;John Paoli,&nbsp;Giovanni Pellacani,&nbsp;Ketty Peris,&nbsp;Susana Puig,&nbsp;Cliff Rosendahl,&nbsp;Lidia Rudnicka,&nbsp;Ahmed Sadek,&nbsp;Philippe Saiag,&nbsp;Gabriel Salerni,&nbsp;Alon Scope,&nbsp;Hans Peter Soyer,&nbsp;Michela V. Starace,&nbsp;Wilhelm Stolz,&nbsp;David L. Swanson,&nbsp;Luc Thomas,&nbsp;Philipp Tschandl,&nbsp;Iris Zalaudek,&nbsp;Aimilios Lallas","doi":"10.1111/jdv.70406","DOIUrl":"10.1111/jdv.70406","url":null,"abstract":"<p>Lentigo maligna (LM) is a subtype of cutaneous melanoma in situ that develops on chronically sun-damaged skin in elderly individuals. Its diagnosis and management remain challenging due to its slow progression, frequent occurrence on cosmetically sensitive areas in frail individuals, and tendency for subclinical peripheral extension. Despite its potential for invasive transformation, the natural history of LM remains incompletely understood and evidence-based management strategies for this specific entity remain limited. This work aims to bridge the gap between scarce high-quality evidence and the clinicians' need for practical guidance on LM management by formulating evidence-based and expert consensus-driven recommendations for diagnosis, treatment and follow-up. Under the coordination of the International Dermoscopy Society, a global, multidisciplinary consortium of 53 experts—including dermatologists, dermato-oncologists, dermatologic surgeons, radiologists, radiotherapists, pathologists and epidemiologists—formulated recommendations through structured consensus, informed by a comprehensive review of current scientific evidence and clinical practice standards. Optimal management of LM requires accurate diagnosis and individualized treatment planning. Non-invasive skin imaging techniques, especially dermoscopy and reflectance confocal microscopy, aid in diagnosis, biopsy orientation, lesion delineation and post-treatment monitoring. Multiple partial biopsies help confirm diagnosis and rule out invasion. Complete surgical excision remains the first treatment option. No definitive safety margins can be recommended for standard surgery; margin-controlled techniques are preferable for large or ill-defined lesions. Topical imiquimod and radiotherapy are effective alternatives where surgery is unsuitable. Topical imiquimod is useful as primary, adjuvant or neoadjuvant therapy. Blind destructive methods should be avoided. Close clinical and imaging follow-up is needed. Patient-centred care, shared decision-making, and a multidisciplinary approach are critical for optimal outcomes. These international consensus recommendations summarize current best practices for LM management, offering practical, evidence-informed guidance to clinicians while acknowledging the potential of future research in refining these conclusions.</p>","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 10","pages":"1600-1617"},"PeriodicalIF":9.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70406","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting IL-6 beyond conventional immunosuppression: Tocilizumab in mucous membrane pemphigoid","authors":"Christoph M. Hammers,&nbsp;Aikaterini Patsatsi","doi":"10.1111/jdv.70633","DOIUrl":"https://doi.org/10.1111/jdv.70633","url":null,"abstract":"&lt;p&gt;Mucous membrane pemphigoid (MMP) represents one of the most challenging autoimmune blistering diseases in clinical dermatology. Although rare, its consequences can be severe and even life-threatening, if not diagnosed and managed properly to prevent progressive scarring of ocular, oral, laryngeal, oesophageal or genital mucosa. Patients with severe MMP are often exposed to prolonged courses of systemic corticosteroids and other immunosuppressive agents, frequently resulting in incomplete disease control and substantial treatment-related toxicity.&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; In this setting, the French study by Tedbirt et al. is both timely and important.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The novelty of this work lies not only in the clinical observation that tocilizumab may be effective in severe, refractory MMP, but also in its translational, biomarker-driven approach. The authors set out to first characterize the cytokine milieu of MMP and identified evidence supporting a role for interleukin-6 (IL-6) signalling, providing a biologically plausible rationale for IL-6 receptor blockade. They specifically used proteomic analyses and succeeded in identifying a distinct cytokine profile in MMP patients with increased IL-6, IL-8, MIP-1α/CCL3 and MIP-1β/CCL4, supporting IL-6 targeting as a potential option in severe refractory disease. Consequently, the authors demonstrated encouraging outcomes with the administration of tocilizumab in a series of patients with particularly severe MMP who had failed previous therapies.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Tocilizumab itself has an interesting history. Developed in Japan through the pioneering work on IL-6 biology by Tadamitsu Kishimoto and colleagues, it became the first clinically successful monoclonal antibody targeting the IL-6 receptor.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Initially approved for rheumatoid arthritis and later for juvenile idiopathic arthritis, giant cell arteritis, cytokine release syndrome and other inflammatory conditions, tocilizumab helped establish IL-6 as a central therapeutic target in immune-mediated disease.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Within dermatology, experience with tocilizumab has historically been limited to selected refractory inflammatory and fibrosing disorders. However, growing appreciation of IL-6-driven tissue inflammation and fibrosis has sparked interest in its application to difficult-to-treat dermatologic diseases,&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; and MMP, characterized by chronic inflammation followed by irreversible scarring, appears particularly attractive in this regard. The present study therefore represents an important milestone, moving IL-6 inhibition from anecdotal reports towards a more structured, biologically informed therapeutic concept in autoimmune blistering disease.&lt;/p&gt;&lt;p&gt;The potential implications for patients are substantial. Severe MMP is a prototypical rare disease with high unmet medical need. Despite advances such as rituximab and IVIg, many patients continue t","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 10","pages":"1583-1584"},"PeriodicalIF":9.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70633","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"JEADV ‘the fire in their bellies’","authors":"Derek Freedman,&nbsp;Torello Lotti","doi":"10.1111/jdv.70628","DOIUrl":"https://doi.org/10.1111/jdv.70628","url":null,"abstract":"&lt;p&gt;&lt;/p&gt;&lt;p&gt;Derek Freedman&lt;/p&gt;&lt;p&gt;&lt;/p&gt;&lt;p&gt;Torello Lotti&lt;/p&gt;&lt;p&gt;At the end of the 1980's, the European Union was in gestation. It comprised only 12 countries; there was no Nice Treaty, and the Euro was a distant aspiration. But, to our generation, it held the prospect of a future of peace, togetherness, and progress. The EADV represented this for our speciality and generated excitement as a vehicle to bring the European ideals into fruition.&lt;/p&gt;&lt;p&gt;Like all things in the Academy's foundation, the concept of a Journal came from Dr. Hans Rothenborg, who foresaw a Journal as an essential pillar of the Academy. His vision was met with enthusiasm at the EADV General Assembly in Lisbon, 1990.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;To begin the search for a publisher, Derek wrote a tender document. The EADV Executive Committee chose Elsevier.&lt;/p&gt;&lt;p&gt;The importance of the JEADV to the Academy was evidenced by the inclusion of the Editors in the Executive Committee. Derek was appointed Venereology and Managing Editor and the search for a Dermatology Editor began.&lt;/p&gt;&lt;p&gt;Producing a pilot issue in time for the second EADV Congress in Athens, 1991, was considered a priority. Derek, as founding editor, met the deadline and remembers, with immense gratitude, those contributors whose first articles lifted JEADV off the ground.&lt;/p&gt;&lt;p&gt;For the pilot issue, Derek wrote ‘&lt;i&gt;The emphasis will be on clear and concise articles of practical relevance. We do not intend to fill acres of paper: we want the content of this journal to be relevant to the needs of our members and subscribers, to enhance the practice of our specialty throughout Europe, and to promote harmonisation’&lt;/i&gt;.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Around that time, Derek was introduced, by Emiliano Panconesi, to Torello Lotti, a young dermatologist. Torello was a Professor of Dermatology in the University of Siena, lively and energetic. He displayed a spirited interest in the Academy and the forthcoming Journal. He was proposed and accepted as Dermatology Editor and Editor in Chief of the JEADV at the Athens Congress.&lt;/p&gt;&lt;p&gt;Publication commenced with six issues per annum, with a mainly clinical focus. Torello, as Editor in Chief, developed the Dermatology section with the extraordinary support and advice of Diana Panconesi and subsequently Elisabetta Bodri. Derek focused on the Venereology section and administration of the Journal overall and was hugely assisted by Janet McConnell.&lt;/p&gt;&lt;p&gt;The guideline at that time was the same as for the Academy: 80% Dermatology and 20% Venereology. We were delighted with and grateful for the response of the DermatoVenerology community who submitted papers, and the authors who wrote review articles. It was a privilege to be at the helm of a rapidly developing Journal, and to be so involved in the evolution of the Academy.&lt;/p&gt;&lt;p&gt;The newborn JEADV was not initially indexed, and we were very grateful to receive the many papers from our colleagues, who also willingly acted as reviewers. Torello","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 10","pages":"1569-1570"},"PeriodicalIF":9.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70628","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149028995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic effects of sunlight: 10-year review of cardiovascular, infection and cancer outcomes","authors":"Jasira A. Ziglar,&nbsp;Rebecca L. Quiñonez,&nbsp;Lydiah Fridah M. Mpyisi,&nbsp;Indermeet Kohli,&nbsp;Yolanda Gilaberte,&nbsp;Henry W. Lim","doi":"10.1111/jdv.70461","DOIUrl":"10.1111/jdv.70461","url":null,"abstract":"<p>Sunlight is an important environmental determinant of human physiology, though its effects on health have been studied predominantly in the context of skin disease. While ultraviolet (UV) radiation is a well-established risk factor for skin cancer, evidence suggests that it may also have beneficial systemic effects. This narrative review synthesizes evidence from the past decade on the associations between sunlight and UV radiation exposure and mortality-related outcomes, with a focus on internal malignancies, cardiovascular disease and infectious diseases. A comprehensive search of PubMed and Embase was conducted for English-language articles published between January 2015 and June 2025. Of 148 articles identified, two duplicates were removed. After title and abstract screening, 64 full-text articles were assessed for eligibility; a total of 28 studies met the inclusion criteria and were included in the final review. Among the included studies, four examined cardiovascular outcomes, 12 evaluated infectious diseases, six focused on malignancies and six assessed all-cause mortality. Overall, most studies reported inverse associations between UV exposure and adverse health outcomes, suggesting potential protective effects. For example, a large cohort study found that individuals with 2000 kJ/m² higher annual solar radiation exposure had a 12% lower risk of all-cause mortality. The comparator group had an average of 26 days of life lost over the 15.7-year follow-up period. This review identifies a pattern of potential beneficial associations between UV radiation exposure and systemic health outcomes, although confounding by various parameters including the healthy user effect and socioeconomic differences. When the benefits are considered alongside the well-established deleterious cutaneous effects of UV exposure, these findings underscore the need for balanced public health messaging that acknowledges the risks and potential benefits of sunlight exposure.</p>","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 10","pages":"1618-1625"},"PeriodicalIF":9.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70461","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147725480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of P200 pemphigoid: A nationwide study","authors":"Fabienne Jouen,&nbsp;Marion Carrette,&nbsp;Marie-Laure Golinski,&nbsp;Maud Maho-Vaillant,&nbsp;Alexis Lefebvre,&nbsp;André Gillibert,&nbsp;Pascal Joly,&nbsp;Vivien Hébert","doi":"10.1111/jdv.70370","DOIUrl":"10.1111/jdv.70370","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Anti-p200 pemphigoid (P200) is a rare subepidermal autoimmune blistering disease (AIBD) related to anti-laminin γ1 autoantibodies (Abs). It has been recently reported that laminin β4 was frequently recognized by sera from patients with P200.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the incidence of P200 in France using a new recombinant anti-laminin β4 serological assay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicentre retrospective study was conducted in the Immunology Laboratory of the French reference centre for AIBD from January 2018 to March 2023. Sera suspected of corresponding to P200 were tested using the new anti-LAMB4 cell-based immunoassay (CBIA) and/or immunoblotting (IB) on dermal extract. The incidence of P200 was then estimated based on its incidence rate relative to those of BP and pemphigus over the same period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>116 patients with sera labelling the dermal side of salt-split skin by IIF and negative for other junctional AIBD were recorded. Among them, 23 patients' sera had already been tested positive for P200 by dermal IB. Thus, 93 patients' sera were tested with both the anti-LAMB4 CBIA and IB: 85 were positive with the CBIA (91%) vs. 44 with IB (47%, <i>p</i> &lt; 0.0001). Only two were positive with IB alone. Overall, 110 patients had anti-p200 Abs. Subsequently, we compared the frequency of serological detection of P200 to that of BP and pemphigus based on data from centres that exhaustively submitted their sera to our reference laboratory. According to the incidence of BP and pemphigus in France (21.7 and 1.85 cases per million inhabitants per year, respectively), the incidence of P200 was estimated to range from 0.23 to 0.83 cases per million inhabitants per year. This corresponds to approximately 16–57 new cases annually in France, which is approximately 2- to 4-fold more frequent than <i>epidermolysis bullosa acquisita</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study shows that P200 may be much more frequent than initially estimated.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 10","pages":"1675-1681"},"PeriodicalIF":9.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70370","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}