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

{"title":"Multi-omics profiling of chronic immune-mediated skin diseases: SKINERGY protocol and strategic evaluation","authors":"N. G. Koster, J. M. P. A. van den Reek, E. M. G. J. de Jong, S. van Beugen, A. I. M. van Laarhoven, I. Haeck, M. de Bruin-Weller, M. L. Schuttelaar, B. Horvath, A. Gostyński, A. Knulst, M. H. Vermeer, L. Nguyen, L. Gerbens, P. Spuls, M. A. Middelkamp-Hup, V. Exadaktylos, T. Niemeyer-van der Kolk, A. R. Schrader, A. M. Sluijmers, J. Versteeg, B. W. M. Arents, I. van Ee, J. L. A. G. van der Zon, M. de Leeuw, T. de Leeuw, P. van den Broek, C. Berkhof, D. Vellinga, S. Weidinger, S. Dubrac, Y. Li, M. van Steensel, M. Marchetti-Deschmann, M. Maurer, H. van der Zee, J. Damman, D. J. Hijnen, F. Wijk, M. M. B. Seyger, H. Röckmann, D. M. W. Balak, M. B. A. van Doorn, R. Rissmann, The Next Generation ImmunoDermatology (NGID) consortium","doi":"10.1111/jdv.70311","DOIUrl":"10.1111/jdv.70311","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Dutch flagship project Next Generation ImmunoDermatology (NGID) aims to profile five chronic immune-mediated inflammatory skin diseases: atopic dermatitis (AD), plaque psoriasis (PSO), hidradenitis suppurativa (HS), chronic spontaneous urticaria (CSU) and cutaneous lupus erythematosus (CLE) in comparison with cutaneous T-cell lymphoma subtype mycosis fungoides (MF) and healthy volunteers. Within NGID, a clinical study entitled: ‘SKIN disease profiling by an Exploratory, pRospective, biomarker study in dermatoloGY practice (SKINERGY)’ will be conducted as a multicentre, parallel-cohort, open-label, observational, longitudinal basket study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Objectives include evaluation of disease-related characteristics in comparison to those of healthy volunteers and evaluation of biomarkers for disease stratification and (targeted) treatment response in patients in a real-world clinical setting. Additionally, differences and similarities in disease characteristics between diseases, changes over time, and profiles of responders versus non-responders will be evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with AD (<i>N</i> = 120), PSO (<i>N</i> = 160), HS (<i>N</i> = 80), CSU (N = 120) and CLE (N = 120) will be enrolled in groups of <i>N</i> ≤ 40 patients per treatment. Matched healthy volunteers (N = 120) and the MF cohort (N = 120) will serve as control groups. Assessments include blood sampling, skin punch biopsies, tape stripping, skin swabs, (multimodal) imaging, tele-health and patient- and physician-reported outcomes. This manuscript describes the study protocol prior to data collection and its strategic evaluation of multi-omics profiling. Patient advocacy groups co-defined the research agenda and contributed to study design and informed consent document development, ensuring alignment with patients' needs and real-world relevance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>SKINERGY will generate a machine learning-ready dataset with information about changes in various biomarkers over time, including histology, metabolomics, spatial proteomics, transcriptomics, lipidomics, microbiomics, imaging biomarkers, tele-health, patient-reported outcome measures (PROMs) and clinical parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Identified biomarker profiles within SKINERGY may guide targeted treatment selection, enhance targeted therapeuti","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 9","pages":"1490-1501"},"PeriodicalIF":9.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70311","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146129240","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":"Litifilimab efficacy on skin outcomes in cutaneous lupus erythematosus in the Phase 2 LILAC study","authors":"Victoria P. Werth,&nbsp;Joseph F. Merola,&nbsp;Richard Furie,&nbsp;Kenneth Kalunian,&nbsp;Ronald F. van Vollenhoven,&nbsp;Juanita Romero-Diaz,&nbsp;Qianyun Li,&nbsp;Weihong Yang,&nbsp;Catherine Barbey","doi":"10.1111/jdv.70291","DOIUrl":"10.1111/jdv.70291","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cutaneous lupus erythematosus (CLE) has no approved targeted therapies. In Part B of the randomized, double-blind, placebo-controlled, Phase 2 LILAC study, litifilimab demonstrated a dose–response relationship for percentage change in Cutaneous Lupus Erythematosus Disease Area and Severity Index–Activity (CLASI-A) score from baseline to Week 16.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>These post hoc analyses of Part B of the LILAC study aimed to assess the efficacy of litifilimab on additional skin-specific outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adult participants with baseline CLASI-A score ≥8 and histologically confirmed CLE, with/without systemic manifestations, received litifilimab 50 mg, 150 mg or 450 mg, or placebo subcutaneously every 4 weeks through Week 16. Analyses included CLASI-20/50/70/90 responses (≥20%/50%/70%/90% decrease [improvement] from baseline in CLASI-A score), 7-point improvement from baseline in CLASI-A score, subgroup analyses of percentage change in CLASI-A scores by baseline characteristics and achievement of ‘clear’ (CLASI-A scores of 0–1) or ‘almost clear’ (0–3) skin status. Shifts from baseline in skin condition were evaluated by the Physician's Global Assessment (PGA) of CLE and the Physician's Global Impression (PGI) of change in CLE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Greater proportions of litifilimab-treated participants achieved CLASI-20/50/70/90 responses (3.8%–72.1%) than placebo-treated participants (0%–43.8%) at Week 16, with significant differences observed from Week 4 for CLASI-20/50. From Weeks 4 to 16, more litifilimab-treated participants had ≥7-point CLASI-A score decreases from baseline (13.8%–43.9%) compared with placebo (10.5%–21.1%). At Week 16, compared with placebo, more litifilimab-treated participants achieved ‘clear’ or ‘almost clear’ skin status; CLASI-A score improvements for subgroups were numerically higher with litifilimab, more litifilimab-treated participants shifted from ‘severe’ or ‘moderate’ to ‘almost clear’ skin status based on PGA of CLE, and more litifilimab-treated participants were ‘much improved’ based on PGI results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These analyses provide additional evidence to support litifilimab efficacy in clearing skin disease activity, as demonstrated in the LILAC study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 9","pages":"1481-1489"},"PeriodicalIF":9.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70291","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146032660","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":"Penicillamine-induced elastosis perforans serpiginosa","authors":"Moizza Tahir,&nbsp;Asma Malik","doi":"10.1111/jdv.70427","DOIUrl":"10.1111/jdv.70427","url":null,"abstract":"","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 9","pages":"e747-e748"},"PeriodicalIF":9.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518230","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":"Low compliance and polypharmacy as key negative predictors in highly effective anti-psoriatic treatments","authors":"Giovanni Damiani","doi":"10.1111/jdv.70604","DOIUrl":"https://doi.org/10.1111/jdv.70604","url":null,"abstract":"&lt;p&gt;Biomarkers capable of predicting high-cost anti-psoriatic treatments are becoming increasingly important from a pharmacoeconomic perspective, as well as for practically promoting precision medicine in a daily setting. Nowadays, extensive clinical databases and omics provide big data to train powerful AI models and decode complex biological problems. The interpretation of these models remains critical and is often addressed by physician-scientists who review AI-based results, identifying missing variables that are necessary to apply the model on a daily basis.&lt;/p&gt;&lt;p&gt;In the meta-analysis performed by Mao X and colleagues, they identified a higher comorbidity burden, obesity, special-site involvement (e.g. genitals and nails) and older age as ‘independent predictors of poorer response to biologic therapy in psoriasis’.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Interestingly, age at onset, baseline PASI and disease duration were not predictive of response to biologics, rejecting the hypothesis that disease severity may condition drug response. Conversely, all components of the ‘low responders’ group are linked to low compliance&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; and polypharmacy (defined as taking &gt;4 drugs).&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Forty-five percent of individuals aged over 65 years in Europe experience daily polypharmacy due to their concurrent comorbidities, compromising their mobility and triggering dysmetabolism (e.g. dyslipidaemia or diabetes). Furthermore, this cluster of patients also display lower compliance with therapies&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; and a greater likelihood of experiencing drug–drug interactions, adverse drug reactions and increased frailty. At the same time, several drugs are also linked to psoriasis exacerbation or even resistance to systemic anti-psoriatic agents&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; through mechanisms different from those directly antagonized by biologics (e.g. beta-blockers or lithium).&lt;/p&gt;&lt;p&gt;In the elderly population, dermatologists should focus more on strategies to increase patient compliance (e.g. recognizing and treating needle phobia) and decrease polypharmacy (e.g. deprescribing and chronomedicine). Drug delivery systems (pen vs. syringe vs. oral formulations) may also modulate long-term compliance, especially if patients undergo frequent injections (i.e. reactive needle phobia). Injection retraining, utilization of adherence aids (e.g. apps or blister packs) or even matching administration times to daily routines may sustain motivation over the long term and boost compliance.&lt;/p&gt;&lt;p&gt;Deprescribing represents a paramount step in psoriatic patients with polypharmacy because it forces all specialists to reconsider the patient's overall health status, going beyond organ-specific considerations. Remarkably, a chronomedical approach may also increase drug efficacy while minimizing side effects. In fact, any drug with a half-life shorter than 15 h should be administered in accordance with chronotype and chronomedical principles due ","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 9","pages":"1441-1442"},"PeriodicalIF":9.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70604","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811162","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":"Sex disparities in melanoma stage, recurrence and mortality: A Danish cohort study, 2004 to 2024","authors":"J. E. Lyngstrand,&nbsp;E. L. Røssell,&nbsp;M. L. Bønnelykke-Behrndtz,&nbsp;T. Laurberg","doi":"10.1111/jdv.70180","DOIUrl":"10.1111/jdv.70180","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Male sex appears to be associated with more advanced melanoma stage and inferior prognosis, but population-based data on sex disparities in stage-specific recurrence and mortality remain limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective of this study was to examine sex disparities in (1) melanoma stage at diagnosis and (2) stage-specific recurrence and long-term melanoma-specific mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This population-based cohort study included all Danes with melanoma from 2004 to 2022 identified in the Danish Cancer Register. The impact of sex on melanoma stage diagnosis (Breslow thickness, presence of ulceration, presence of lymph node metastases and presence of distant metastases) was investigated using multivariable logistic regression models. Furthermore, we examined melanoma recurrence, melanoma-specific and overall mortality for stage I + II (localized), stage III (locoregional) and stage IV (metastatic) melanoma in a competing risk model, adjusting for stage at diagnosis, comorbidity, age and calendar year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study included 30,497 individuals diagnosed with melanoma; the median follow-up time was 8 years, and 14,409 (47%) were male. Males had, compared to females, an increased adjusted odds ratio (aOR) of Breslow thickness &gt;4 mm (aOR 1.45, 95% CI: 1.31–1.59), presence of ulceration (aOR 1.28, 1.18–1.39), &gt;1 lymph node metastases (aOR: 1.58, 1.38–1.80) and distant metastases (aOR: 1.69, 1.48–1.94). In stage-adjusted analyses, males with localized melanoma had an increased adjusted hazard ratio (aHR) of melanoma recurrence (aHR: 1.38, 1.27–1.51) and melanoma-specific mortality (aHR: 1.51, 1.34–1.71). In patients with locoregional and metastatic melanoma, males had an inferior prognosis, but it was less pronounced.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This nationwide cohort study found that males were more likely to be diagnosed with more advanced stages of melanoma. Analyses stratified by stage at diagnosis, showed that males had a 20%–50% higher risk of melanoma recurrence, melanoma-specific and overall mortality across localized, locoregional and metastatic melanoma.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 9","pages":"1515-1524"},"PeriodicalIF":9.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145592762","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":"Mapping malignant T-cell states and immune circuits in Sézary syndrome by single-cell analysis","authors":"Beth A. Childs,&nbsp;Eslam A. Elghonaimy,&nbsp;Praveen Ramakrishnan Geethakumari,&nbsp;Kiran A. Kumar,&nbsp;Joseph F. Merola,&nbsp;Heather W. Goff,&nbsp;Todd A. Aguilera","doi":"10.1111/jdv.70368","DOIUrl":"10.1111/jdv.70368","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Sézary syndrome (SS) and leukaemic mycosis fungoides (MF) are aggressive cutaneous T-cell lymphomas (CTCLs) with poor prognosis and limited treatment options. Single-cell RNA sequencing (scRNA-seq) offers an opportunity to dissect malignant heterogeneity and immune dysregulation yet has been underutilized in leukaemic CTCL.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To define transcriptional heterogeneity within malignant T cells, identify immunomodulatory signals shaping the tumour microenvironment and uncover actionable vulnerabilities in SS and leukaemic MF.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We analysed 144,321 peripheral blood mononuclear cells from 22 patients (SS or leukaemic MF) and 7 healthy controls using scRNA-seq, with CITE-seq and TCR-seq in subsets. Public and prospectively collected datasets were integrated after rigorous per-sample quality control, batch correction and malignancy assignment. Differential gene expression and cell–cell communication analyses were performed using complementary modelling approaches with correction for sparsity and multiple testing.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Three transcriptionally distinct malignant T-cell (MTC) subtypes were identified: central memory-like (MTC CM), effector/effector memory-like (MTC E/EM) and regulatory-like (MTC Reg), each with unique expression programmes and putative vulnerabilities. MTC CM, the dominant population, expressed central memory markers, Th2/Th22 skewing and a broader KIR repertoire (&lt;i&gt;KIR3DL2, KIR3DL1, KIR2DL3&lt;/i&gt;) than previously reported. MTC E/EM and MTC Reg were enriched for &lt;i&gt;NR4A1&lt;/i&gt; and &lt;i&gt;ITGB1&lt;/i&gt;, respectively. Cell–cell communication analysis revealed KIR–MHC-I signalling and suggested that MTC-derived TNF and IL-10 may drive JAK/STAT pathway activity in non-T cells, indicating an underrecognized dimension of tumour-induced immune reprogramming.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This is one of the most comprehensive single-cell studies of leukaemic CTCL to date. We uncover new malignant T-cell states, broaden the known repertoire of KIR expression, and propose mechanisms of immune evasion that may contribute to treatment resistance. These findings lay the groundwork for subtype-specific and microenvironment-informed therapeutic strategies in Sézary syndrome, with potential implications for guiding targeted therapy selection but require validation in larger, indepe","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 9","pages":"1535-1549"},"PeriodicalIF":9.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70368","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147346147","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 September 2026","authors":"","doi":"10.1111/jdv.70607","DOIUrl":"https://doi.org/10.1111/jdv.70607","url":null,"abstract":"&lt;p&gt;&lt;/p&gt;&lt;p&gt;Carle Paul&lt;/p&gt;&lt;p&gt;Biologics have transformed the management of moderate to severe psoriasis, offering long-term disease control. Dose reduction becomes relevant with clearance/almost clearance of cutaneous lesions. Van Riel et al. report on a consensus Delphi approach including 62 dermatologists addressing this issue (Figure 1). They advocate a two-step dose reduction after 6 months of disease control that considers the patient's perspective: reducing the dose by one-third, then by 50% if disease control is maintained 3 months later. These recommendations will certainly help clinicians and patients plan for dose reduction of biologics when sustained psoriasis control is achieved.&lt;/p&gt;&lt;p&gt;van Riel CAM, Boehncke WH, Lambert JLW, et al. International consensus on dose reduction of biologics for patients with psoriasis: The DR. Delphi study. &lt;i&gt;J Eur Acad Dermatol Venereol&lt;/i&gt; 2026; 40:1449–1459. doi:10.1111/jdv.70447.&lt;/p&gt;&lt;p&gt;Treatment options targeting the type I interferon pathway in cutaneous lupus are limited. Werth et al. report on a secondary analysis of a dose-finding trial of litifilimab, a monoclonal antibody binding blood dendritic cell antigen 2 (BDCA2) and thereby downregulating type I interferon production (Figure 2). Its benefits on CLASI-A over placebo were observed at 16 weeks. One-third of patients achieved 70% improvement in CLASI-A at 16 weeks with the two highest doses of litifilimab. If confirmed, these results could allow clinicians to propose additional targeted systemic therapy as an alternative to anifrolumab when antimalarials are insufficient to control skin lesions of cutaneous lupus.&lt;/p&gt;&lt;p&gt;Werth VP, Merola JF, Furie R, et al. Litifilimab efficacy on skin outcomes in cutaneous lupus erythematosus in the Phase 2 LILAC study. &lt;i&gt;J Eur Acad Dermatol Venereol&lt;/i&gt; 2026; 40:1481–1489. doi:10.1111/jdv.70291.&lt;/p&gt;&lt;p&gt;Icotrokinra is the first FDA-approved oral IL23-R inhibitor for psoriasis, particularly studied in plaque psoriasis. In a phase III study, Warren et al. examined the long-term efficacy of icotrokinra for scalp, genital and palmar plantar psoriasis which are known difficult-to-treat locations impacting patients' quality of life. After 52 weeks of treatment, the total clearance rate (IGA 0) of psoriasis was about 60% for scalp, hand and feet psoriasis and about 80% for genital psoriasis (Figure 3). For patients who prefer oral treatment, icotrokinra may offer benefits matching those of injectable biologics in the long term.&lt;/p&gt;&lt;p&gt;Warren RB, Gooderham M, Lain E, et al. Durability of response to icotrokinra for high-impact site psoriasis: 1-year ICONIC-TOTAL findings. &lt;i&gt;J Eur Acad Dermatol Venereol&lt;/i&gt; 2026; 40:1502–1514. doi:10.1111/jdv.70471.&lt;/p&gt;&lt;p&gt;Immune checkpoint inhibitors have improved the management of metastatic and unresectable squamous-cell carcinoma. The effect of comorbidities on response to immune checkpoint inhibitors has not been extensively studied. Geidel et al. analysed data from the cancer registr","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 9","pages":"1435-1438"},"PeriodicalIF":9.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70607","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811126","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":"Less is more? Dose reduction of biologics in psoriasis","authors":"Cristian Papara,&nbsp;Rolland Gyulai","doi":"10.1111/jdv.70482","DOIUrl":"https://doi.org/10.1111/jdv.70482","url":null,"abstract":"&lt;p&gt;Biologic therapies have fundamentally transformed the management of psoriasis, enabling unprecedented levels of disease control. However, therapeutic success has introduced a new and increasingly relevant clinical enigma: is long-term full-dose therapy always necessary once sustained remission has been achieved? In routine practice, dose reduction (DR) is frequently considered, yet its implementation remains largely empirical due to the lack of robust scientific evidence and clear guideline recommendations.&lt;/p&gt;&lt;p&gt;In this issue, the results of an international consensus based on a modified eDelphi process by van der Reek et al.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; represents an important and timely effort to address this unmet need. The authors, while appropriately emphasizing that DR must remain individualized, propose a structured framework for it in adult patients with psoriasis. (1) Patient selection: consider DR only in patients with sustained low disease activity, defined by both physician- and patient-reported outcomes (PASI and DLQI ≤3 for at least 6 months) and shared decision-making. (2) Two-step dose reduction strategy: extend dosing intervals by 1.5-fold, with reassessment after three or six months for biologics with shorter or longer intervals, respectively. If disease control is sustained, further extension to 2-fold of the standard interval may be pursued. (3) Re-escalate if worsening disease activity (e.g. PASI ≥ 2–5 and/or DLQI ≥ 5) or patient preference.&lt;/p&gt;&lt;p&gt;While robust data support the use of DR for TNF inhibitors and ustekinumab, evidence for IL-17 and IL-23 inhibitors remains limited and heterogeneous.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; For IL-17 inhibitors, particularly secukinumab, dose-spacing strategies have demonstrated sustained efficacy for up to 2 years without compromising safety or drug survival. On the other hand, brodalumab appears to show reduced durability, suggesting that DR may need to be tailored not only by class but also by mechanism of action.&lt;span&gt;&lt;sup&gt;2, 3&lt;/sup&gt;&lt;/span&gt; The evidence is particularly compelling for IL-23 inhibitors such as guselkumab and risankizumab. Clinical and real-world data indicate that extended dosing intervals can maintain disease control in selected patients, with high drug survival and only minimal need for re-escalation.&lt;span&gt;&lt;sup&gt;2-4&lt;/sup&gt;&lt;/span&gt; These findings, together with the generally favourable long-term persistence of IL-23 inhibitors, position this class as especially suitable for DR strategies. Taken together, current evidence suggests that DR for IL-17 and IL-23 inhibitors is not only feasible but increasingly supported, albeit not yet sufficiently standardized.&lt;/p&gt;&lt;p&gt;On-demand approaches, where treatment is resumed only upon early signs of disease recurrence (e.g. PASI ≥ 1), have also shown promising results for IL-23 and IL-17 inhibitors. While conceptually appealing and potentially cost-effective, current application is limited by poor standardization, reduced reproducibility and t","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 9","pages":"1439-1440"},"PeriodicalIF":9.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70482","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811133","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":"Correction to ‘Safety of upadacitinib in atopic dermatitis in randomized clinical trials across 6 years’","authors":"","doi":"10.1111/jdv.70587","DOIUrl":"10.1111/jdv.70587","url":null,"abstract":"<p>Bunick CG, Irvine AD, Silverberg JI, et al. Safety of upadacitinib in atopic dermatitis in randomized clinical trials across 6 years. J Eur Acad Dermatol Venereol. 2026;40(5):856-866. doi:https://doi.org/10.1111/jdv.70172.</p><p>On Page 5, the sentence that reads ‘There were two fatal VTE events across all studies, both a result of pulmonary embolism (Table 3)’ is incorrect. The sentence should read: ‘A total of 11 cases of venous thromboembolic events were reported; six of these were SAEs and none were fatal’.</p><p>There is also an error in Table 3 in the second row of the ‘~1 year’ column. The data for the ~1-year columns for ‘Any AE leading to discontinuation of study drug’ should read 4.4 [3.3, 5.6] for UPA 15 mg (in place of 95.2 [90.1, 100.5]) and 5.7 [4.5, 7.1] for UPA 30 mg (in place of 117.6 [112.0, 123.4]). The revised Table 3 is provided below.</p><p>We apologize for these errors.</p>","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 9","pages":""},"PeriodicalIF":9.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70587","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148341788","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":"Role of comorbidities and medication on immunotherapy efficacy in cSCC: A DeCOG multicentre analysis","authors":"Glenn Geidel,&nbsp;Sabrina Bänsch,&nbsp;Laura Adam,&nbsp;Nathan Fekade,&nbsp;Alessandra Rünger,&nbsp;Tim Zell,&nbsp;Daniel J. Smit,&nbsp;Julian Kött,&nbsp;Isabel Heidrich,&nbsp;Michael Weichenthal,&nbsp;Selma Ugurel,&nbsp;Ulrike Leiter,&nbsp;Peter Mohr,&nbsp;Alexandra Geusau,&nbsp;Stephan Grabbe,&nbsp;Markus V. Heppt,&nbsp;Ralf Gutzmer,&nbsp;Jochen Utikal,&nbsp;Jan-Christoph Simon,&nbsp;Sebastian Haferkamp,&nbsp;Laura Susok,&nbsp;Bastian Schilling,&nbsp;Edgar Dippel,&nbsp;Imke von Wasielewski,&nbsp;Jessica C. Hassel,&nbsp;Carola Berking,&nbsp;Stefan W. Schneider,&nbsp;Christoffer Gebhardt","doi":"10.1111/jdv.70307","DOIUrl":"10.1111/jdv.70307","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Immune checkpoint inhibitors (ICI) have transformed the treatment landscape of advanced cutaneous squamous cell carcinoma (cSCC). The influence of comorbidities and concomitant medications on treatment efficacy remains incompletely defined.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To evaluate the impact of comorbid conditions and commonly prescribed medications on progression-free survival (PFS) and overall survival (OS) in patients with advanced cSCC receiving ICI.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In this multicentre cohort study, 273 patients with unresectable or metastatic cSCC treated with ICI were identified from the prospective ADOReg skin cancer registry. Data on comorbidities, such as haematologic malignancies, immunosuppressive conditions, cardiovascular disease and concomitant medications, such as immunosuppressive agents and anticoagulants, were analysed. Treatment outcomes were measured as PFS and OS.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Among first-line patients (&lt;i&gt;n&lt;/i&gt; = 253), immunosuppressive conditions were associated with shorter PFS (5.5 vs. 24.4 months, &lt;i&gt;p&lt;/i&gt; = 0.012) and OS (16.6 vs. 34.1 months, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Haematologic malignancies were likewise linked to poorer PFS (18.6 vs. 27.0 months, &lt;i&gt;p&lt;/i&gt; = 0.032) and OS (17.0 vs. 33.6 months, &lt;i&gt;p&lt;/i&gt; = 0.0067). Concomitant anticoagulant therapy correlated with longer PFS (49.3 vs. 17.4 months, &lt;i&gt;p&lt;/i&gt; = 0.032), but not OS (&lt;i&gt;p&lt;/i&gt; = 0.22). In multivariate analysis, immunosuppressive disease remained independently associated with shorter OS (HR = 9.88, 95% CI: 1.11–87.5, &lt;i&gt;p&lt;/i&gt; = 0.040) and anticoagulant use with longer PFS (HR = 0.34, 95% CI: 0.15–0.80, &lt;i&gt;p&lt;/i&gt; = 0.014). These associations were confirmed in Cox models weighted by inverse probability of treatment (IPTW), supporting robustness to confounding. No effect was attributable to any specific anticoagulant subclass.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Our analyses suggest that immunosuppressive disease is an independent predictor of shortened OS, underscoring the critical role of host immune competence. We further report a novel, independently significant association between anticoagulant use and prolonged PFS. Other associations should be regarded as exploratory. These findings highlight host-related factors as potential modulators of ICI efficacy and merit prospective validation.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 ","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 9","pages":"1525-1534"},"PeriodicalIF":9.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70307","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088817","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}