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

{"title":"Illuminating nail disorders: A comprehensive overview of advanced imaging techniques","authors":"Pauline Lecerf, Bertrand Richert","doi":"10.1111/jdv.20535","DOIUrl":"https://doi.org/10.1111/jdv.20535","url":null,"abstract":"<p>The nail apparatus is a heterogenous structure where soft and hard keratinized tissues meet over a bony phalanx. The distance between each of these structures is very small often less than a millimetre. For the non-expert, choosing the right and most informative medical imaging is difficult. This often leads to inadequate and expensive imaging. The article by Sechi et al., ‘Advances in Image-Based Diagnosis of Nail Disorders’, provides a comprehensive review of all available imaging technologies to explore the nail apparatus, X-rays excluded.<span><sup>1</sup></span> Practical tips and tables are included to help select the appropriate imaging techniques for various nail disorders, fostering an evidence-based approach to diagnosis and treatment.</p><p><i>Nail unit dermoscopy</i> magnifies nail disorders not visible with the naked eye and explores superficial structures. Its limitations are depth penetration and interpretation variability. The authors remind us of a useful trick, the smartphone flashlight fingertip transillumination, especially helpful in identifying myxoid cysts and glomus tumours<span><sup>2</sup></span> (Figure 1).</p><p><i>High-frequency ultrasound (HFUS)</i> is a widely available, non-radiating, real-time imaging technique that allows deep tissue penetration, effective for examining structures from the nail plate to the bony cortex of the distal phalanx, diagnosing and assessing and monitoring inflammatory nail diseases. It details tumour's location, size, shape, echogenicity and vascularization. It does not need the removal acrylic or prosthetic nails. HFUS is limited in detecting lesions smaller than 0.1 mm but is largely operator-dependant.</p><p>Physicians should be aware that exploring the nail unit with <i>magnetic resonance imaging (MRI)</i> has specific requirements: a dedicated coil for optimal spatial resolution is required. This device is not available in all centres. The use of other coils like wrist or knee coils are unable to provide correct images. MRI is particularly useful for detecting small or occult lesions, mostly liquid or vascular, and presurgical mapping. One of its best indications is recurrent glomus tumour, revealing a satellite lesion unnoticed during the surgery. A pilot study suggested that MRI could be proposed as preoperative imaging of squamous cell carcinoma for locoregional assessment and guide biopsy.<span><sup>3</sup></span> Recently, MRI images could be converted into 3D models for printing, which are valuable for creating customized nail prosthetics, educating healthcare professionals and assisting in surgical planning.<span><sup>4</sup></span></p><p><i>Optical coherence tomography (OCT)</i> is a non-invasive imaging technique that provides high resolution of biological tissues in real-time. It is not widely available. OCT allows a penetration depth of 1–2 mm of both the nail plate and bed with a resolution of 3–15 μm. OCT helps in monitoring nail psoriasis and distinguishing between ","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"39 4","pages":"709-710"},"PeriodicalIF":8.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.20535","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690051","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":"Low-dose isotretinoin for difficult-to-treat rosacea: Enough evidence to be convinced—What's next?","authors":"Olivier Chosidow, Esther J. van Zuuren","doi":"10.1111/jdv.20552","DOIUrl":"https://doi.org/10.1111/jdv.20552","url":null,"abstract":"<p>Rosacea is a chronic inflammatory skin condition principally affecting the centrofacial area and eyes, characterized by periods of remission and exacerbation. Its prevalence ranges from <1% to 22%, typically presenting in middle-aged adults. As a visible facial dermatosis, rosacea significantly impacts quality of life, with severity directly correlating to its effect on patients' well-being. The diagnosis and classification of rosacea now rely on presenting signs and symptoms, following a phenotype-based approach.<span><sup>1</sup></span> In real-life settings, severely affected patients, for example, those experiencing psychosocial distress, extensive signs, disabling symptoms, poor tolerance to or failure with topical treatments, often require more advanced management. Oral doxycycline is then the drug of choice for inflammatory papules/pustules, and ocular rosacea, either as a modified-release dose of 40 mg or standard dose of 100 mg daily.<span><sup>1</sup></span> Azithromycin may also be used. However, for ‘difficult-to-treat’ rosacea, that is, doxycycline-refractory or frequently relapsing cases, there has been unmet needs for years. Some authors advocated the value of minocycline. Due to its association with unpredictable life-threatening severe adverse reactions such as autoimmune hepatitis, drug-induced lupus erythematosus and DRESS, including severe myocarditis, the French health authorities restricted its prescription to specific infectious diseases in 2012.<span><sup>2</sup></span> High-quality evidence now shows that low-dose isotretinoin is a safe and effective alternative.<span><sup>3, 4</sup></span> This approach is further explored in the systematic review by King et al.<span><sup>5</sup></span></p><p>The systematic review addresses an important topic—the efficacy and safety of isotretinoin for rosacea—but suffers from significant methodological limitations. While the authors claimed to use GRADE for assessing study quality and certainty, they conflated risk of bias with certainty of evidence and provided no detailed assessments using the Cochrane risk of bias tool or ROBINS-I as outlined in their protocol. Additionally, the reported GRADE scores lack sufficient transparency, as the authors do not provide enough details regarding their methodology, which does not align with the GRADE working group's criteria. The data of the study by Ertl et al. were deemed flawed in another review.<span><sup>4</sup></span> Moreover, the 47% dropout rate in the Aksoy study further limits the reliability of the findings. When the effect is large and the sample size is small (or modest), the optimal information size should be calculated, and the certainty of evidence is likely to be downgraded for risk of bias, heterogeneity and imprecision resulting in very low certainty. Despite these concerns, the authors have organized substantial data in a structured manner and the fact remains that all studies support the results of included well-conduc","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"39 4","pages":"713-714"},"PeriodicalIF":8.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.20552","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690042","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 April 2025","authors":"","doi":"10.1111/jdv.20604","DOIUrl":"https://doi.org/10.1111/jdv.20604","url":null,"abstract":"<p></p><p>Jo Lambert</p><p>Isotretinoin's use in rosacea remains limited, although it is known for its anti-inflammatory and sebum reduction properties. Low-dose isotretinoin (LDI; i.e., ≤0.5 mg/kg/day) may be preferred due to fewer adverse events. Here, King et al. reviewed 16 studies to evaluate the efficacy of LDI in rosacea. Their work is foundational for the practicing clinician to rely on when prescribing oral LDI, which has a good safety profile, even over topical monotherapy, as two considered outcome results are better (lesion counts [Figure 1], erythema). Ocular rosacea remains more difficult to treat, and there, oral doxycycline is the best option.</p><p>King, A, Tan, MG, Kirshen, C et al. Low-dose isotretinoin for the management of rosacea: a systematic review and meta-analysis. <i>J Eur Acad Dermatol Venereol</i>. 2025; <b>39</b>:785–792. 10.1111/jdv.20315.</p><p>Hsu et al. retrospectively evaluated rituximab treatment among 123 patients with pemphigus in terms of long-term remission. Concomitant azathioprine and repeated rituximab courses favoured long-term outcomes (Figure 2), while larger body surface areas, higher Pemphigus Disease Area Index, diabetes, and elevated platelets were negative prognostic factors.</p><p>Personally, I was surprised to see that serum anti-desmoglein titers were not deemed a remission-defining factor. Could thrombocytosis pose a negative predictive factor, as rituximab (often used in conditions like idiopathic thrombocytopenic purpura) may increase platelets? In clinic, it remains hard to predict how the treatment scheme for your pemphigus patient may evolve.</p><p>Hsu, HC, Huang, PW, Cho, YT et al. Factors associated with long-term complete remission in pemphigus patients receiving rituximab therapy. <i>J Eur Acad Dermatol Venereol</i>. 2025; <b>39</b>:e313–e316. 10.1111/jdv.20290.</p><p>Bettoli et al. suggest that while ChatGPT provides basic information on acne, it requires expert supervision to ensure accuracy and comprehensiveness (Figure 3). Their study identified several terminological mistakes, which may lead to wrong treatment (e.g. a cyst is not identical to an abscess) and the treatments proposed were not exhaustive. The identified mistakes underline the importance of fact-checking AI-generated content before using it as a reference.</p><p>Future improvements in ChatGPT's performance and the development of more specialized tools may enhance its utility in medical education and patient information dissemination. It does not replace consultation with a healthcare professional.</p><p>Bettoli, V, Naldi, L, Santoro, E et al. ChatGPT and acne: accuracy and reliability of the information provided —the AI-check study. <i>J Eur Acad Dermatol Venereol</i>. 2025; <b>39</b>:e359–e362. 10.1111/jdv.20324.</p><p>Dysmorphic concerns and body dysmorphic disorders (BDD) were found to be five times more frequent in patients with a skin disorder among 5290 patients from 22 European centres, particularly for alope","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"39 4","pages":"707-708"},"PeriodicalIF":8.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.20604","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690050","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":"Will targeted microbiome modulation in the skin be the future of acne vulgaris treatment?","authors":"Kornélia Szabó, Lajos Kemény","doi":"10.1111/jdv.20587","DOIUrl":"https://doi.org/10.1111/jdv.20587","url":null,"abstract":"<p>Throughout our lives, we encounter a multitude of microbes, but only a limited number of them become integral components of the specialized ecosystem that makes up our bodies. In particular, members of the skin microbiota play a key role in maintaining homeostasis and ensuring optimal skin function. Changes in its composition and the specific species present are often associated with the onset of various disease states. A prime example of this phenomenon is acne vulgaris, where the skin microbiota, in particularly the role of <i>C. acnes</i>, has long been suspected.<span><sup>1</sup></span></p><p>The recent systematic review by Podwojniak et al.<span><sup>2</sup></span> sought to critically evaluate this question through a systematic review, to summarize the related knowledge published to date, and to raise awareness of the possibility of targeted and systematic microbiota modulation as a potential therapeutic approach to treat this condition.</p><p>The authors conducted a systematic search of the PubMed and SCOPUS databases, selecting 26 high-quality studies for inclusion in their analysis. One of the contributions of this study is its comprehensive review of the key microbial players in acne pathogenesis. They provide data that the majority of available studies indeed confirm that either <i>C. acnes</i>, or certain ribotypes within the species, are associated with the disease compared to healthy skin.<span><sup>3</sup></span> This reinforces the notion of a pathogenic role for <i>C. acnes</i>, despite the fact that the bacterium also plays an important role as a member of the healthy skin microflora.<span><sup>4</sup></span></p><p>In diseases where the microbiota changes are important factors, dysbiosis is frequently linked to changes in alpha diversity, which quantifies the species richness in a particular sample. Currently, there is a paucity of data regarding the variation of alpha diversity with the development of acne lesions, thus it is evident that systematic, large, well-controlled studies are imperative for the advancement of this field in the near future.</p><p>Available therapeutic modalities employed in the treatment of acne principally target the inflammatory processes associated with lesion development, the microbial component and sebum production.<span><sup>5</sup></span> The latter, in turn, exerts an indirect influence on lipophilic microbes by modulating sebum levels. This article summarizes acne treatments that are known to affect the cutaneous microbiome, and summarizes their findings. While the analysis indicated that only benzoyl peroxide exhibited a substantial impact on microbiota composition, this may be attributable to the limited amount of data available for other treatments currently in use. However, given the established efficacy of this molecule in the treatment of acne, these results substantiate the notion that modifying the composition of the microbiota constitutes a promising approach in the management of t","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"39 4","pages":"715-716"},"PeriodicalIF":8.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.20587","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690043","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":"Diagnostic workup in paradoxical urticaria induced by H1-antihistamines","authors":"Yi-Kui Xiang, Emek Kocatürk","doi":"10.1111/jdv.20523","DOIUrl":"https://doi.org/10.1111/jdv.20523","url":null,"abstract":"<p>The recent study published by Soria et al.<span><sup>1</sup></span> in JEADV effectively summarizes 16 rare cases of paradoxical urticaria (PU) to H1-antihistamines (H1A), highlighting the complexities involved when urticaria cases respond atypically to H1A treatment. The authors stress the knowledge gaps in clinical features of PU as well as its mechanisms, and the need for further research to guide dermatology and allergy specialists.</p><p>H1-antihistamines are the recommended cornerstone treatment for all forms of urticaria.<span><sup>2</sup></span> However, it is noteworthy that some urticaria cases are paradoxically triggered by H1A themselves, a phenomenon termed PU. Diagnosing PU presents a significant challenge, particularly in patients with pre-existing chronic spontaneous urticaria (CSU), as it is difficult to discern whether the flare of wheals and/or angioedema are attributable to an exacerbation of the underlying CSU or to a reaction to H1A. To address this, the study proposes diagnostic criteria: the occurrence of hives at least with two different classes of H1A within 5 h of intake, as all of the 16 reported cases had reactions with ≥2 different H1A and the onset occurred mostly within 2–5 h. This timing criterion may not be entirely precise, and further studies with larger cohorts and more detailed documentation of PU cases are needed to refine and validate it.</p><p>Another challenge in diagnosing PU is the need to rule out H1A-induced anaphylaxis or immediate hypersensitivity presenting with urticarial symptoms. This is accomplished through negative skin testing, including prick tests, intradermal testing and patch tests. This is based on the finding that most reported cases of H1A-induced anaphylaxis or immediate hypersensitivity present with urticaria have positive skin tests.<span><sup>3, 4</sup></span> As part of the diagnostic workup for PU, skin testing should also be conducted on the drugs selected for oral provocation testing or oral substitution testing prior to their administration.</p><p>Despite the rarity of PU and the limited reports and evidence elucidating the mechanisms by how H1A trigger PU, certain clinical characteristics can still be observed. PU predominantly occurs in patients with CSU, often in those with an atopic background, additionally, a subset of these patients exhibits cross-intolerance to NSAIDs, raising the question of whether PU may be associated with Type 1 autoallergic CSU where an association with NSAID intolerance has been reported.<span><sup>5</sup></span> Further studies should investigate immunological parameters including levels of total IgE, thyroid antibodies and especially autoreactive IgE in patients with PU to better understand its underlying mechanisms and potential associations with CSU endotypes.<span><sup>6</sup></span></p><p>PUs occurred almost with every class and type of H1As including cetirizine, desloratadine, chlorpheniramine, ebastine, olapataine, fexofenadine, hydroxy","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"39 4","pages":"723-724"},"PeriodicalIF":8.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.20523","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690126","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":"Single-cell transcriptomic analysis of GPP patients treated with IL-12/23 or IL-17A blockade.","authors":"Soyoung Jeong, Christine Suh-Yun Joh, Seungbok Lee, James G Krueger, Jong-Hee Chae, Hyun Je Kim, Seong Jin Jo","doi":"10.1111/jdv.20659","DOIUrl":"https://doi.org/10.1111/jdv.20659","url":null,"abstract":"","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidenced-based approach facilitates choosing between different topical compounds in acne vulgaris","authors":"Georgios Nikolakis, Christos C. Zouboulis","doi":"10.1111/jdv.20590","DOIUrl":"https://doi.org/10.1111/jdv.20590","url":null,"abstract":"<p>Acne vulgaris is the most common skin disease, and its pathogenesis has been the subject of extensive research over the last 3 to 4 decades. Its most important pathophysiologic pillars include a dysfunction in the keratinization of the follicular epithelium, which is tightly intertwined with an aberrant immunologic response, both innate and adaptive.<span><sup>1</sup></span> The interplay between epithelial cells and commensal bacteria such as <i>Cutibacterium acnes</i> leads to a proinflammatory microenvironment. Other factors, such as seborrhea, altered fatty acid composition and hormonal imbalance also contribute to the pathogenesis of this complex disease.<span><sup>2</sup></span></p><p>Several topical compounds have been developed and are effectively used for the treatment of mild-to-moderate acne, targeting one or more of the aforementioned factors. Retinoids exhibit both antiproliferative, comedolytic (keratolytic) and anti-inflammatory effects. Benzoyl peroxide (BPO) has bactericidal properties against <i>C. acnes</i> as well as mild comedolytic and anti-inflammatory properties. As for antibiotics, topical clindamycin is particularly effective against inflammatory acne lesions, but it can also affect biofilm and follicular microcomedone formation.<span><sup>3</sup></span> Erythromycin is also an effective alternative, but concerns have been raised regarding its potential to easily promote <i>C. acnes</i> resistance.</p><p>In a recent meta-analysis by Kakpovbia et al.<span><sup>4</sup></span> different topical treatments were compared by evaluating randomized control trials for topical treatments in acne with focus on efficacy. Publications based on absolute inflammatory and non-inflammatory lesion counts and the semiquantitative method of assessing treatment success based on the Investigator's Global assessment scale were included. Despite the dual targets of several compounds, the authors did not notice any significant differences among adapalene, azelaic acid, BPO, dapsone, erythromycin, clindamycin, salicylic acid, tretinoin and tazarotene.</p><p>Combination treatments with retinoid or topical antibiotic with BPO were the most effective among all treatments for inflammatory acne, while for non-inflammatory acne combination treatments with BPO and clindamycin did not outperform BPO<span><sup>4</sup></span>: The authors provide evidence supporting a differentiation of the therapeutic approach in patients according to their acne phenotype in order to achieve the maximal efficacy and contribute in avoiding unnecessary prescription of topical clindamycin for chronic skin disorders, which raises antibiotic resistance concerns.<span><sup>5</sup></span> The compound is ranked 125th most commonly prescribed medicine in the US and remains on the World Health Organization list of Essential Medicines, while its use is very often not limited to “in label” indications. Dermatologists frequently face constructive criticism concerning antibiotic st","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"39 4","pages":"711-712"},"PeriodicalIF":8.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.20590","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690041","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":"The impact of providing clinical images and dermoscopy reports on the diagnosis of melanocytic skin lesions","authors":"Belinda Lai, Hans Peter Soyer, Lin Zhu, Peter M. Ferguson, Blake O'Brien, Tristan Dodds, Richard A. Scolyer, Gerardo Ferrara, Katy J. L. Bell","doi":"10.1111/jdv.20655","DOIUrl":"10.1111/jdv.20655","url":null,"abstract":"","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"39 7","pages":"e634-e637"},"PeriodicalIF":8.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antipsychotics in dermatology: Optimal choice of drugs for the treatment of delusional infestation and other potential uses for skin conditions","authors":"Katlein França","doi":"10.1111/jdv.20583","DOIUrl":"https://doi.org/10.1111/jdv.20583","url":null,"abstract":"<p>Delusional infestation (DI) is a psychiatric disorder defined by a fixed, false belief that one became infested by an organism without evidence to support this. Patients may report abnormal cutaneous sensations and present with excoriations, skin erosions, ulcerations and other skin lesions. In addition to a comprehensive history and detailed physical examination, laboratory workup should be considered depending on the clinical picture. DI can be categorized into primary or secondary. In primary DI, the patient has the delusion of being infested, but no other psychiatric or organic disorders are present. While the secondary forms of DI occur secondarily to other disorders such as psychiatric and organic diseases. Proper diagnostic workup for these patients is essential to rule out other explanations for symptoms and to investigate potential secondary causes of DI.<span>¹</span> Antipsychotic medications are the most common drugs used in the management of patients with primary DI.<span>²</span></p><p>Tang et al.<span>³</span> performed a multicentre, retrospective observational study with patients diagnosed with DI using anonymized electronic patient records from two hospitals in the United Kingdom. These authors found that amisulpride and risperidone were associated with a higher treatment response than other antipsychotics, such as quetiapine, aripiprazole and olanzapine. According to this study, amisulpride and risperidone should be considered the first-line treatment options for patients with DI. This important study provides insight into the optimal choice of antipsychotics for patients experiencing this challenging condition. The use of antipsychotic drugs for other dermatological conditions has been investigated in the past years. Gupta et al.<span>⁴</span> reviewed this topic and explained that these drugs can benefit dermatological patients due to their central nervous system and peripheral effects. They can be used as augmentation therapy of antidepressants, such as selective serotonin reuptake inhibitors (SSRI), for the management of trichotillomania (hair pulling disorder) and skin-picking disorder. Moreover, these drugs have a central postsynaptic dopamine D2 receptor-blocking effect with varying degrees of histamine H1 receptor, cholinergic muscarinic receptor and α1-adrenergic receptor-blocking effects, which could be potentially beneficial in the management of specific histamine or sympathetically mediated dermatological conditions. These drugs could have a potential role in treating other diseases, such as urticaria, pruritus and hyperhidrosis, but further research is warranted to confirm these benefits.</p><p>No conflict of interest with this paper content.</p>","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"39 4","pages":"717-718"},"PeriodicalIF":8.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.20583","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690036","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":"On the importance of assessing stigma in dermatological research","authors":"Fanny C. Kpenou,&nbsp;Khaled Ezzedine","doi":"10.1111/jdv.20606","DOIUrl":"https://doi.org/10.1111/jdv.20606","url":null,"abstract":"&lt;p&gt;In this issue of the JEADV, an article by Butt et al.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; studied the psychometric properties of the revised internalized skin bias questionnaire. As the scientific literature accumulates evidence on the mental burden of skin diseases and the influence of psychological stress on their development, it has prompted a need for dermatological research to increasingly—and inevitably—consider complex psychosocial factors in order to further understand the hidden impact of these visible diseases. Indeed, in addition to being the largest organ, the skin is also the most exposed, and as such, any change in its appearance is likely to be visible. Thus, unlike many other conditions, skin diseases are often immediately noticeable, thereby impacting interactions with others and the environment. This inherent key effect makes the concept of stigma particularly relevant to skin diseases. In a recently published study,&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; we and others have invested efforts in developing a specific instrument aimed at assessing stigmatization across a relatively wide range of skin diseases in France. Within this context, it is important to recognize the intricacy of stigma. As a result, no single instrument can fully capture all relevant aspects of stigma, making it more challenging to assess this complex psychological construct.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Furthermore, one should acknowledge that social circumstances and cultural differences pose an additional challenge to the dissemination of these types of instruments on a larger scale, among other barriers that researchers may face.&lt;/p&gt;&lt;p&gt;While integrating these critical processes in health studies is a difficult task, it naturally follows from the obligation to improve therapeutic strategies for (and with) patients according to a more holistic perspective. People with skin diseases were historically excluded from these efforts because common dermatoses were often neglected, but it is now well established that such disorders can lead to significant psychological and social impairments. The current conundrum highlights the necessity of adopting a more person-centred approach in therapeutic planning for skin diseases,&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; thus widening healthcare providers' perspectives to more than strictly medical interventions. The work of Butt et al. on internalized stigma, or self-stigma, is a needed step towards highlighting the importance of incorporating this critical yet underexplored dimension of stigmatization into everyday clinical practice. Although the authors have explored one of the many facets of stigmatization, there remains a need to explore other dimensions of this important concept, such as enacted stigma. These initiatives should be supported to continue delving into the complex relationships between psychosocial factors and skin diseases. This growing interest in integrating these layered psychological concepts into dermatological assessment will set a new g","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"39 4","pages":"721-722"},"PeriodicalIF":8.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.20606","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690038","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}