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

{"title":"Preferences in atopic dermatitis: A systematic review","authors":"E. H. Pinborg,&nbsp;S. B. Laursen,&nbsp;D. Thein,&nbsp;I. Vittrup,&nbsp;C. Schlapbach,&nbsp;J. T. Maul,&nbsp;B. Dégboé,&nbsp;A. Egeberg,&nbsp;S. F. Thomsen,&nbsp;J. P. Thyssen,&nbsp;M. O. Christensen","doi":"10.1111/jdv.20753","DOIUrl":"10.1111/jdv.20753","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Numerous new treatments for atopic dermatitis (AD) have been approved in recent years, but it is unknown whether published patient, caregiver and healthcare provider preferences are biased by industry funding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To investigate funding sources and their putative influence on patients, caregivers and healthcare providers' reported preferences with regard to different properties of therapies and treatment outcomes of AD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This descriptive systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines. PubMed and EMBASE were searched. Studies were included if they reported data on AD patients', caregivers' and/or healthcare providers' preferences of therapy and/or treatment outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 8346 studies were identified, and 42 were included for data synthesis (participants, 19,839; females, 62.2%). Nineteen and twenty-three studies were pharma-sponsored and non-pharma-sponsored, respectively. The pharma-sponsored studies were of recent dates, had larger patient populations and included discrete choice experiments. Efficacy was of great importance to patients, caregivers and healthcare providers, and this finding was mainly driven by pharma-sponsored studies. Moreover, patients were more willing to accept the risk of side effects or adverse events to achieve other treatment goals in pharma-sponsored studies. Studies sponsored by companies producing Janus kinase inhibitors showed that patients preferred the least invasive administration route despite increased administration frequency. Studies evaluating preferred topical treatment attributes were often non-pharma-sponsored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings of this study indicate that preference research may be biased. Therefore, healthcare providers should be cautious when employing treatment needs and preferences research to support decision-making.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"39 9","pages":"1567-1575"},"PeriodicalIF":8.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113326","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":"Adding layers: Environmental and internal modulation of regional skin barrier functions","authors":"Joachim W. Fluhr,&nbsp;Razvigor Darlenski","doi":"10.1111/jdv.20734","DOIUrl":"10.1111/jdv.20734","url":null,"abstract":"&lt;p&gt;The review by Dajnoki et al.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; offers a comprehensive synthesis of current insights into the topographical variability of skin barrier functions. The authors emphasize the complex interplay among chemical, microbial, physical and immunological barriers and explain how these interactions contribute to region-specific skin vulnerability and disease patterns. To complement and extend the discussion, we propose five key dimensions that could be further integrated into the concept of skin barrier variability.&lt;/p&gt;&lt;p&gt;Environmental conditions such as UV radiation, temperature, humidity, ozone, fine dust and airborne allergens (e.g. pollen) affect skin barrier integrity.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Recent studies confirm that pollution, particularly ozone and pollen exposure, can induce barrier impairment.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; These factors vary by region, climate and season and directly interact with the skin's surface.&lt;/p&gt;&lt;p&gt;Lifestyle factors—such as engagement in sports, occupational exposure, cultural practices in hygiene and clothing and repetitive mechanical friction—further modulate the barrier. Psychological stress has also been shown to disrupt barrier homeostasis via neuroendocrine pathways.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The neuronal (sensory) barrier should be considered as active player in barrier function. Sensory nerve fibres influence not only perception but also barrier function, regeneration, inflammation and immune response. Their role is especially relevant in conditions such as sensitive skin and atopic dermatitis.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The ‘inside-out’ modulation emphasizes the importance of internal factors in maintaining barrier homeostasis.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; Systemic hydration, nutrition, metabolism and hormonal regulation shape skin reactions to external exposures. Understanding skin function as part of a whole-body network opens new perspectives for clinical intervention.&lt;/p&gt;&lt;p&gt;Anatomical regions differ functionally and in terms of microenvironmental conditions.&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt; Corneodesmosomes, vital for the cohesion of the upper stratum corneum, vary in stability and distribution. Occluded areas such as the axillae, groin, anogenital region, submammary folds and plantar surfaces experience elevated moisture, reduced ventilation and altered pH.&lt;span&gt;&lt;sup&gt;8&lt;/sup&gt;&lt;/span&gt; These conditions affect microbiome composition and predispose individuals to infections and maceration.&lt;/p&gt;&lt;p&gt;Hormonal regulation, especially by sex hormones, affects sebaceous gland activity and modifies barrier characteristics in specific regions. Fluctuations during puberty, menstrual cycles and endocrine disorders all contribute to localized barrier behaviour.&lt;/p&gt;&lt;p&gt;In parallel, bacterial adhesion and microbiome diversity vary by site, influencing the establishment and function of local microbial communities. These interactions are key to understanding region-specific disease patterns.&lt;/p&gt;&lt;p&gt;Building on the ","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"39 7","pages":"1212-1213"},"PeriodicalIF":8.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.20734","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103493","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 July 2025","authors":"","doi":"10.1111/jdv.20733","DOIUrl":"https://doi.org/10.1111/jdv.20733","url":null,"abstract":"&lt;p&gt;&lt;/p&gt;&lt;p&gt;Carle Paul&lt;/p&gt;&lt;p&gt;Skin barrier homeostasis plays an important role in inflammatory skin diseases such as atopic dermatitis, psoriasis, Darier disease and rosacea.&lt;/p&gt;&lt;p&gt;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.&lt;/p&gt;&lt;p&gt;Dajnoki Z, Kapitány A, Eyerich K, et al. Topographical variations in the skin barrier and their role in disease pathogenesis. &lt;i&gt;J Eur Acad Dermatol Venereol&lt;/i&gt; 2025; 39: 1228–1238. doi:10.1111/jdv.20463.&lt;/p&gt;&lt;p&gt;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.&lt;/p&gt;&lt;p&gt;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.&lt;/p&gt;&lt;p&gt;Matos TR, Walsh S, Stratigos AJ, et al. Regulating sunbed use: Skin cancer risks linked to tanning beds. &lt;i&gt;J Eur Acad Dermatol Venereol&lt;/i&gt; 2025; 39: 1209–1211. doi:10.1111/jdv.20586&lt;/p&gt;&lt;p&gt;Thomas S, Hoyt D, Stoddard G, et al. Declining invasive and rising in situ melanoma incidence trends in Iceland: A nationwide cohort study. &lt;i&gt;J Eur Acad Dermatol Venereol&lt;/i&gt; 2025; 39: 1278–1284. doi:10.1111/jdv.20386.&lt;/p&gt;&lt;p&gt;The appealing concept that earlier use of biological agents in psoriasis may improve disease control and its course needs to be formally tested.&lt;/p&gt;&lt;p&gt;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.&lt;/p&gt;&lt;p&gt;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. &lt;i&gt;J Eur Acad Dermatol Venereol&lt;/i&gt; 2025; 39: 1315–1323. doi:10.1111/jdv.20259.&lt;/p&gt;&lt;p&gt;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,&nbsp;Thrasyvoulos Tzellos","doi":"10.1111/jdv.20575","DOIUrl":"10.1111/jdv.20575","url":null,"abstract":"&lt;p&gt;\u0000 \u0000 &lt;/p&gt;&lt;p&gt;Georgios Nikolakis&lt;/p&gt;&lt;p&gt;\u0000 \u0000 &lt;/p&gt;&lt;p&gt;Thrasyvoulos Tzellos&lt;/p&gt;&lt;p&gt;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.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; 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&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; and that complex treatments are required to efficiently treat such patients.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Historically, the diagnostic delay in HS in an older report of 2020 was documented to be 10.0 ± 9.6 years,&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; 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&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; and more frequent emergency department visits and hospitalizations in comparison to psoriasis patients (ratio: 3.2:1).&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; The study of Sholji et al.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; 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.&lt;/p&gt;&lt;p&gt;The French study of Fite et al.&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt; 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,&nbsp;Christoffer Gebhardt","doi":"10.1111/jdv.20723","DOIUrl":"10.1111/jdv.20723","url":null,"abstract":"&lt;p&gt;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.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; 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.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; 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.&lt;/p&gt;&lt;p&gt;The paper by Kwa et al.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; 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.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; In addition, 13% and 26% (phototypes I and VI, respectively) did not use any form of photoprotection.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Another interesting observation from the paper by Kwa et al.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; 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&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt;—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,&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; 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,&nbsp;Klaus Eisendle","doi":"10.1111/jdv.20721","DOIUrl":"10.1111/jdv.20721","url":null,"abstract":"&lt;p&gt;The study by Nervil et al. provides a comprehensive epidemiological analysis of skin biopsy practice in Denmark over a 15-year period.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; 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).&lt;/p&gt;&lt;p&gt;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.&lt;/p&gt;&lt;p&gt;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.&lt;/p&gt;&lt;p&gt;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.&lt;/p&gt;&lt;p&gt;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.&lt;/p&gt;&lt;p&gt;A pioneering aspect could be the use of AI-supported systems in monitoring skin lesions.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; 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,&nbsp;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>^{1, 2}</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>³</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>⁴</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⁺ and SPP1⁺ macrophages—open new avenues for therapeutic intervention, including macrophage modulation strategies.<span>⁵</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":"Risk of adverse events of psoriasis treatment with biologic agents and new small molecules—BIOBADADERM Registry","authors":"María Olivares-Guerrero,&nbsp;Esteban Daudén,&nbsp;Josep Riera-Monroig,&nbsp;Alicia González-Quesada,&nbsp;Antonio Sahuquillo-Torralba,&nbsp;Raquel Rivera-Díaz,&nbsp;José Manuel Carrascosa,&nbsp;Isabel Belinchón,&nbsp;Francisco José Gómez-García,&nbsp;Enrique Herrera-Acosta,&nbsp;Diana P. Ruiz-Genao,&nbsp;Ofelia Baniandrés-Rodríguez,&nbsp;Marta Ferrán,&nbsp;Pablo de la Cueva,&nbsp;Lourdes Rodríguez,&nbsp;Almudena Mateu,&nbsp;José Carlos Ruiz-Carrascosa,&nbsp;Mariano Ara-Martín,&nbsp;María Teresa Abalde-Pintos,&nbsp;Mónica Roncero-Riesco,&nbsp;Conrad Pujol-Marco,&nbsp;Carmen García-Donoso,&nbsp;Mar Llamas-Velasco,&nbsp;Elena Del Alcázar,&nbsp;Jorge Suárez-Pérez,&nbsp;Belén Rodríguez-Sánchez,&nbsp;Kevin Díez-Madueño,&nbsp;Ricardo Ruiz-Villaverde,&nbsp;Victoria Lezcano-Biosca,&nbsp;Beatriz González-Sixto,&nbsp;Miguel Ángel Descalzo,&nbsp;Ignacio García-Doval","doi":"10.1111/jdv.20738","DOIUrl":"10.1111/jdv.20738","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Registry studies are needed to provide comprehensive and updated assessments of the long-term safety profiles of systemic drugs in psoriasis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To analyse the safety of biologic drugs and new oral molecules used for the treatment of moderate-to-severe psoriasis in patients included in the Spanish Registry of Adverse Events of Biological Therapy (BIOBADADERM), compared to that of adalimumab.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Prospective, multicentre cohort of patients with psoriasis. The safety profiles of biologic agents (etanercept, infliximab, adalimumab, certolizumab, ustekinumab, secukinumab, ixekizumab, brodalumab, guselkumab, risankizumab and tildrakizumab), apremilast and dimethyl fumarate were studied. The incidence rate ratio (IRR) and adjusted IRR of specific adverse events were assessed for each drug, using adalimumab as a reference. Propensity scores were used to adjust for selection bias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our study included 4212 patients (7590 treatment cycles; 17,284 patient-years of follow-up). Adalimumab had an incidence rate for all adverse events of 614 per 1000 patient-years (95% confidence interval [CI] (591; 637)). The risk of all adverse events was significantly lower for guselkumab (adjusted IRR [aIRR] 0.56, 95% CI (0.47; 0.67)), risankizumab (aIRR 0.59, 95% CI (0.48; 0.71)), tildrakizumab [aIRR 0.6, 95% CI (0.46; 0.8)], ixekizumab (aIRR 0.65, 95% CI (0.56; 0.76)) and ustekinumab (aIRR 0.73 95% CI (0.65; 0.82)) compared to adalimumab (<i>p</i> ≤ 0.002), as well as the risk for some specific organ-based groups of adverse events. Conversely, the risk for all adverse events was significantly higher for dimethyl fumarate (aIRR 3.67, 95% CI (2.71; 4.97)), infliximab (aIRR 1.88, 95% CI (1.45; 2.43)) (<i>p</i> ≤ 0.002) and apremilast (aIRR 1.27, 95% CI (1.05; 1.53)) (<i>p</i> 0.012). The risk of malignant neoplasms was significantly reduced in the group treated with ixekizumab (aIRR 0.14 95% CI (0.04; 0.47)).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our data support that, overall, the new biologic treatments have a superior safety profile in real-world practice compared to adalimumab and its biosimilars.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"39 9","pages":"1643-1655"},"PeriodicalIF":8.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096790","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":"Frequency of venous thromboembolism in immunobullous disease patients treated with IVIG: A systematic review","authors":"Kevin Truong-Balderas,&nbsp;Nicole Nowak,&nbsp;Paige Adams,&nbsp;Jennifer Westrick,&nbsp;Lorena Juarez,&nbsp;Schuyler Hilton,&nbsp;Kyle T. Amber","doi":"10.1111/jdv.20750","DOIUrl":"10.1111/jdv.20750","url":null,"abstract":"","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"39 9","pages":"e824-e827"},"PeriodicalIF":8.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096787","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":"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}