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

{"title":"Editor’s Picks July 2025","authors":"","doi":"10.1111/jdv.20733","DOIUrl":"https://doi.org/10.1111/jdv.20733","url":null,"abstract":"<p></p><p>Carle Paul</p><p>Skin barrier homeostasis plays an important role in inflammatory skin diseases such as atopic dermatitis, psoriasis, Darier disease and rosacea.</p><p>In a comprehensive review, Dajnoki et al. analyse the topographic variations of the skin barrier: physical, chemical, immunological and microbiome (Figure 1). Regional differences in skin barrier components may play an important role in the pathogenesis of many inflammatory skin diseases and can also be the target of specific interventions. The authors conclude that location is key to understanding skin barrier function and pathology, as our skin is not uniform.</p><p>Dajnoki Z, Kapitány A, Eyerich K, et al. Topographical variations in the skin barrier and their role in disease pathogenesis. <i>J Eur Acad Dermatol Venereol</i> 2025; 39: 1228–1238. doi:10.1111/jdv.20463.</p><p>The mounting incidence of cutaneous melanoma in Europe poses a public health challenge. In this population study from Iceland, Thomas et al. show that the incidence of melanoma has risen from 1991 to 2006 both for in situ and invasive melanoma (Figure 2). Since 2007, invasive melanoma incidence has dramatically declined with melanoma-specific mortality falling since 2012, while in situ melanoma incidence has increased.</p><p>This suggests that sun protection campaigns, regulation of sunbeds and early detection of melanoma can change its detection and prognosis at the national level, hopefully stimulating discussion and courageous decision-making at the European level.</p><p>Matos TR, Walsh S, Stratigos AJ, et al. Regulating sunbed use: Skin cancer risks linked to tanning beds. <i>J Eur Acad Dermatol Venereol</i> 2025; 39: 1209–1211. doi:10.1111/jdv.20586</p><p>Thomas S, Hoyt D, Stoddard G, et al. Declining invasive and rising in situ melanoma incidence trends in Iceland: A nationwide cohort study. <i>J Eur Acad Dermatol Venereol</i> 2025; 39: 1278–1284. doi:10.1111/jdv.20386.</p><p>The appealing concept that earlier use of biological agents in psoriasis may improve disease control and its course needs to be formally tested.</p><p>In a carefully designed analysis of the Dermbio Danish registry, Thein et al. analysed the effect of the pre-biologic patient journey on biologic drug survival in nearly 2500 patients with psoriasis. They found that the number and duration of conventional treatments did not impact the first biologic drug survival and thus its efficacy, provided the patient's psoriasis was adequately controlled (Figure 3). A tailored patient-centric treatment approach is key.</p><p>Thein D, Nielsen ML, Maul JT, et al. Impact of the pre-biologic treatment journey on biologic drug survival in psoriasis: A nationwide cohort study. <i>J Eur Acad Dermatol Venereol</i> 2025; 39: 1315–1323. doi:10.1111/jdv.20259.</p><p>Penile leukokeratosis is a known precursor of epidermoid carcinoma in elderly patients with lichen sclerosus. Bennamou et al. describe benign leukokeratosis of the foreskin with occas","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"39 7","pages":"1203-1205"},"PeriodicalIF":8.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.20733","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473123","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":"Hidradenitis suppurativa: One step forward in timely diagnosis and appropriate treatment","authors":"Georgios Nikolakis, Thrasyvoulos Tzellos","doi":"10.1111/jdv.20575","DOIUrl":"10.1111/jdv.20575","url":null,"abstract":"<p>\u0000 \u0000 </p><p>Georgios Nikolakis</p><p>\u0000 \u0000 </p><p>Thrasyvoulos Tzellos</p><p>Hidradenitis suppurativa (HS) is a chronic skin disease with systemic inflammation, which is characterized by painful, deeply seated lesions in the folds of the body.<span><sup>1</sup></span> In contrast to psoriasis and atopic dermatitis, disease progression and delay of diagnosis are highly likely to result in a non-reversible phenotype with fistulation and scaring components. The development of sinus tracts and hypertrophic scars signals that the ‘window of opportunity’ for maximum effect of anti-inflammatory treatment may be lost<span><sup>2</sup></span> and that complex treatments are required to efficiently treat such patients.<span><sup>2</sup></span> Historically, the diagnostic delay in HS in an older report of 2020 was documented to be 10.0 ± 9.6 years,<span><sup>3</sup></span> with patients having to consult on average more than three physicians before being diagnosed with HS. This wandering results in a formidable socioeconomic burden, leading to increased number of surgical procedures, as well as development or progression of certain comorbidities, such as arthritis and inflammatory bowel disease. Moreover, older studies in USA highlight inpatient treatment as the most significant cost factor, covering for 37.4% of all costs<span><sup>4</sup></span> and more frequent emergency department visits and hospitalizations in comparison to psoriasis patients (ratio: 3.2:1).<span><sup>5</sup></span> The study of Sholji et al.<span><sup>6</sup></span> revealed that less than 3% of patients with HS were treated with biologics, while only 17% of patients with pilonidal sinus disease underwent surgery over a 10-year period. These data confirm the deleterious consequences of patient wandering with hallmark being the overall poor access to indicated evidence-based treatment at an early time point, when anti-inflammatory treatment may prevent or even revert disease progression.</p><p>The French study of Fite et al.<span><sup>7</sup></span> attempted to capture the patient's wandering to diagnosis after collecting the results from questionnaires distributed to HS patients from 26 French centers in 2024. Interestingly, diagnostic wandering was reported in two thirds of the cases and the average diagnostic delay was estimated to 4.5 years for women and 4.1 years of men. This highlights an overall formidable improvement in timely diagnosis for HS with a significant decrease in average duration over 50% in comparison to the initial reports. This is a very important documented first step in the right direction and can have multiple interpretations. The recent understanding of the pathophysiology of the disease over the last 5 years led to further breakthroughs and two further biologics targeting the cytokines IL-17A (secukinumab) and IL17A/F (bimekizumab) were approved for the treatment of moderate to severe disease. The crucial role of","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"39 8","pages":"1366-1367"},"PeriodicalIF":8.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.20575","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103495","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":"Revisiting the evidence: UV exposure, melanoma and the need for smarter public health strategies","authors":"Efthymia Soura, Christoffer Gebhardt","doi":"10.1111/jdv.20723","DOIUrl":"10.1111/jdv.20723","url":null,"abstract":"<p>The association between melanoma and exposure to ultraviolet radiation (UV) has been thoroughly investigated throughout the years. Notably, the three-part meta-analysis by Gandini et al., which dedicated its second part specifically to UV radiation, has shaped the way that we evaluate risk factors for melanoma.<span><sup>1</sup></span> Despite the multifaceted pathogenesis of melanoma, several global campaigns promoting sun protection have been implemented in response to these findings. The SunSmart campaign in Australia, for example, recently published a cost-effectiveness and return-on-investment analysis, reporting an impressive return of $8.70 for every $1 spent.<span><sup>2</sup></span> This benefit is reflected in the prevention of melanoma, melanoma-related deaths and gains in quality-adjusted life years. However, despite the apparent simplicity of the solution, there remains a critical need for ongoing epidemiological research. This is essential to capture shifts in trends and behaviours over time and necessitates the continuous collection of accurate and robust data.</p><p>The paper by Kwa et al.<span><sup>3</sup></span> effectively synthesizes data from studies published over the past two decades on sun exposure and melanoma. Findings highlight that both a history of sunburn and cumulative sun exposure are significant contributors to melanoma development. However, this paper also aggregates data across Fitzpatrick skin phototypes I–IV, which is noteworthy given that most research and public health messaging tend to focus predominantly on phototypes I and II. This narrow emphasis may influence patient perceptions and behaviours, potentially leading individuals with darker skin phototypes to underestimate their risk. A recent survey paper reported that although up to 90% of patients were aware that sun exposure could be harmful, over 83% (including patients with dark phototypes) had experienced at least one sunburn in their lifetime.<span><sup>4</sup></span> In addition, 13% and 26% (phototypes I and VI, respectively) did not use any form of photoprotection.<span><sup>4</sup></span></p><p>Another interesting observation from the paper by Kwa et al.<span><sup>3</sup></span> is the significant disparity in epidemiologic data collection across different contexts and regions. These disparities encompass a wide range of issues, from patient recall bias to inconsistencies in the definition of terms such as ‘sunburn’. While attempts have been made in the past to standardize melanoma-related data collection—such as through the development of the Melanostrum questionnaire<span><sup>5</sup></span>—data heterogeneity continues to pose a challenge. This variation can dilute the strength of epidemiologic findings and lead to conflicting reports and inconclusive findings. For instance, in this meta-analysis,<span><sup>3</sup></span> some of the included studies reported no association between the use of UV tanning beds and melanoma, while others did","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"39 7","pages":"1214-1215"},"PeriodicalIF":8.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.20723","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103496","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":"Filtering for skin cancer diagnosis","authors":"Lukas Kofler, Klaus Eisendle","doi":"10.1111/jdv.20721","DOIUrl":"10.1111/jdv.20721","url":null,"abstract":"<p>The study by Nervil et al. provides a comprehensive epidemiological analysis of skin biopsy practice in Denmark over a 15-year period.<span><sup>1</sup></span> With over 4.4 million biopsies analysed, the work provides not only a unique insight into the reality of care, but also a differentiated view of diagnostic efficiency in different sectors of the healthcare system. Of particular note are the Number Needed to Biopsy for Melanoma (NNB) and the Benign to Malignant Ratio (BMR).</p><p>A key finding of the study is the clear discrepancy in diagnostic accuracy between specialty groups and between cancer and routine pathways. While the NNB for hospital-based plastic surgeons was a remarkably low 2.8 in the cancer pathway, it was a surprisingly high 127.2 in the routine primary care pathway. These figures do not primarily reflect differences in diagnostic expertise, but rather the structural implications of a stratified healthcare system with effective filtering triage.</p><p>It is particularly important that the authors include a health economic perspective. The estimated direct costs for biopsies of benign lesions in the cancer pathway alone were more than €6.6 million in 2021 – a significant proportion for a publicly funded system. This highlights the importance of structured decision making and the potential for optimization in the management of patient pathways.</p><p>The low 1.5:1 NNB in the Danish cancer pathway illustrates the potential of stepped care systems with clearly defined filter functions. At the same time, however, it also shows that this diagnostic gain comes at a considerable cost – especially as most benign biopsies (69%) are performed in high-cost hospital structures. This raises the question of whether this allocation of resources is sustainable in the long term, especially in view of demographic trends and the increasing incidence of skin tumours. Indeed, the authors' modelling showed that the greatest cost savings could be achieved by treating suspicious lesions directly in primary care.</p><p>The remarkably low benign to malignant ratio (BMR), which appears to be exceptionally favourable in the cancer pathway, deserves particular attention. Critically, this ratio is not limited to melanoma but includes all malignant lesions, including all non-melanoma skin cancers. This relativizes the significance of the BMR in relation to melanoma-specific diagnostics. In addition, the analysis shows that, overall, significantly more biopsies were performed in the private sector and that most malignant tumours were diagnosed outside the cancer pathway. This raises further questions about the efficiency of current triage structures. The strict separation between the cancer pathway and the routine pathway also makes a direct international comparison difficult, as the Danish system is largely unique in its structure.</p><p>A pioneering aspect could be the use of AI-supported systems in monitoring skin lesions.<span><sup>2</sup></span> In ","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"39 7","pages":"1218-1219"},"PeriodicalIF":8.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.20721","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103494","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":"Acral melanoma: Molecular subtyping as a gateway to precision medicine","authors":"Emi Dika, Elisabetta Magnaterra","doi":"10.1111/jdv.20736","DOIUrl":"10.1111/jdv.20736","url":null,"abstract":"<p>Acral melanoma (AM) is a uniquely challenging subtype of melanoma, often diagnosed at advanced stages and with limited therapeutic options.<span><sup>1, 2</sup></span> Its distinct biological and clinical behaviour, as well as its rarity in Caucasian populations, have long hindered large-scale molecular studies. Prior limited single-center studies have shown variable somatic mutational patterns of AM and have not concluded towards any correlation with prognosis or clinical behaviour.<span><sup>3</sup></span> This inconsistency has underscored the need for alternative strategies to characterize AM at the molecular level.</p><p>The recent work by Yin et al.<span><sup>4</sup></span> marks a significant advance in our understanding of AM by identifying two molecularly and prognostically distinct subtypes using an integrative multi-omics approach.</p><p>Using an integrative analysis of bulk and single-cell RNA sequencing data, enhanced by a network-based gene prioritization approach (CIPHER/CIPHER-SC), the authors classified AM into two biologically and clinically distinct subtypes. Subtype I was associated with thinner tumours, a more immune-inflamed microenvironment and better prognosis, while Subtype II showed macrophage-driven immunosuppression and worse outcomes. To support this classification, they identified a minimal gene panel composed of EREG, predominantly expressed in Subtype I and RAB20, FCGR3A and VSIG4, specifically upregulated in Subtype II. This four-gene signature demonstrated strong discriminatory power and may serve as a useful tool for patient stratification in future research and clinical applications.</p><p>Beyond its technical innovation, this study underscores a broader paradigm shift. Transcriptomic technologies—particularly at the single-cell level—are redefining our understanding of tumour biology, especially in underexplored entities like AM. As our knowledge of AM pathogenesis expands, so too does the opportunity to develop targeted therapies and predictive biomarkers of immunotherapy response. The distinct immune landscapes described—especially the divergent roles of FCN1<sup>+</sup> and SPP1<sup>+</sup> macrophages—open new avenues for therapeutic intervention, including macrophage modulation strategies.<span><sup>5</sup></span></p><p>Nonetheless, several questions remain open. The clinical relevance of AM warrants further exploration. Are there associations between subtypes and anatomical localization—for instance, a predilection of Subtype II for the nail apparatus melanoma, which has been associated with more aggressive behaviour in previous studies? Does histopathological subtype (acral lentiginous vs. nodular or superficial spreading) correlate with molecular classification? The authors do not stratify their analysis by histopathologic subtype, which could add important context given the known heterogeneity of AM even within acral sites.</p><p>Furthermore, while the use of high-throughput sequencing and computat","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"39 7","pages":"1216-1217"},"PeriodicalIF":8.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.20736","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103492","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":"Are we missing Mpox cases? Changes in clade IIb clinical phenotype in the post-vaccination era.","authors":"Taiana Silva Carvalho, Su Mei Goh, Luke Moore, Marcus Pond, Ruth Byrne, Joseph Heskin, Nicolo Girometti, Michael Rayment, Rachael Jones","doi":"10.1111/jdv.20746","DOIUrl":"https://doi.org/10.1111/jdv.20746","url":null,"abstract":"","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016699","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":"Sexual orientation and gender identity in clinical trials of atopic dermatitis and psoriasis.","authors":"Michael J Martinez, Corinne Rabbin-Birnbaum, Howa Yeung, John G Zampella","doi":"10.1111/jdv.20742","DOIUrl":"https://doi.org/10.1111/jdv.20742","url":null,"abstract":"","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969052","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":"Risk of adalimumab-induced psoriasis in hidradenitis suppurativa versus other inflammatory diseases.","authors":"Tung S Tran, Anh B Q Nguyen, Trang M Nguyen, Edward V Loftus, Courtney A Arment, Doanh H Le, Afsaneh Alavi, David A Wetter, Giang H Nguyen","doi":"10.1111/jdv.20743","DOIUrl":"https://doi.org/10.1111/jdv.20743","url":null,"abstract":"","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028591","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":"An adhesive magnetic tray for on-surgical-table needle management.","authors":"Guoqun Yu, Fan Yang, Liu Yang, Yamin Zhang, Juan Tao","doi":"10.1111/jdv.20749","DOIUrl":"https://doi.org/10.1111/jdv.20749","url":null,"abstract":"","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028186","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":"Inter- and intra-observer agreement among dermatologists in assessing suspected melanoma lesions captured by general practitioners with smartphones.","authors":"Edmond Démoulins, Heloïse Schmeltz, Aurélie Gaultier, Jean Michel Nguyen, Gaëlle Quereux, Brigitte Dreno, Ludovic Martin, Cédric Rat","doi":"10.1111/jdv.20726","DOIUrl":"https://doi.org/10.1111/jdv.20726","url":null,"abstract":"","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023880","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}