Journal of Dermatology最新文献

{"title":"Restraint-Free Initiation of Dupilumab in a Child With Autism Spectrum Disorder: Overcoming Procedural Barriers in Atopic Dermatitis","authors":"Takuma Yamai,&nbsp;Kiwako Yamamoto-Hanada,&nbsp;Hiroko Yonemichi,&nbsp;Shungo Yamamoto,&nbsp;Chisato Jimbo,&nbsp;Tomoki Yaguchi,&nbsp;Daichi Suzuki,&nbsp;Kotaro Umezawa,&nbsp;Seiko Hirai,&nbsp;Kenji Toyokuni,&nbsp;Mitsuru Kubota,&nbsp;Tatsuki Fukuie","doi":"10.1111/1346-8138.70394","DOIUrl":"10.1111/1346-8138.70394","url":null,"abstract":"<div>\u0000 \u0000 <p>Children with autism spectrum disorder (ASD) often experience significant distress during medical procedures, which can limit access to optimal treatments such as biologic therapy for atopic dermatitis (AD). However, practical strategies for initiating injectable biologic therapy without physical restraint in this population remain poorly described. We report a case demonstrating a structured and reproducible approach that enabled restraint-free initiation of dupilumab in a child with ASD. A 6-year-old boy with moderate-to-severe AD and comorbid ASD had a history of severe procedural avoidance requiring physical restraint for blood sampling and vaccinations. He was admitted for remission induction and consideration of dupilumab therapy. A Certified Child Life Specialist conducted an individualized intervention beginning early in hospitalization, including assessment of sensory sensitivities, visual preparation, environmental modification, and procedural rehearsal. On hospital Day 11, the first subcutaneous injection of dupilumab was successfully administered without physical restraint or additional staff assistance. A coordinated multidisciplinary strategy was implemented, including minimized sensory stimulation, predefined team roles, and distraction techniques. No adverse events occurred, and subsequent injections were performed smoothly in the outpatient setting without further specialized support. This case provides a practical and reproducible framework for overcoming procedural barriers and safely initiating biologic therapy in children with ASD.</p>\u0000 </div>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"53 9","pages":"1381-1384"},"PeriodicalIF":2.3,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics and Treatment Patterns of Hyperhidrosis in Northern Hokkaido: A Single-Center Retrospective Descriptive Study","authors":"Mari Kishibe,&nbsp;Aiko Noguchi,&nbsp;Marika Matsuya,&nbsp;Kou Matsumoto,&nbsp;Satomi Igawa,&nbsp;Yasuyuki Fujita","doi":"10.1111/1346-8138.70373","DOIUrl":"10.1111/1346-8138.70373","url":null,"abstract":"<p>Hyperhidrosis is a common condition associated with a substantial negative impact on the quality of life. Several studies have described the clinical characteristics and disease burden of patients with hyperhidrosis in Japan. However, comparable real-world clinical data on hyperhidrosis from Hokkaido remain limited. We therefore evaluated real-world clinical practice patterns at our institution before and after the establishment of a specialized outpatient clinic for hyperhidrosis. In this retrospective study, we analyzed the data of 144 patients who presented with hyperhidrosis between November 2013 and March 2025. Patient characteristics, pathways to care, treatment modalities, and treatment continuation were evaluated using data from electronic medical records. The sex distribution, age at presentation, and subtype distribution of hyperhidrosis in our cohort were largely consistent with those reported in a prior nationwide survey. Primary axillary and/or palmar hyperhidrosis accounted for 87.5% of all cases. After launching a specialized clinic in April 2023, we observed a substantial increase in the number of patients who consulted for hyperhidrosis during visits for other dermatologic conditions; this finding may suggest the presence of previously unrecognized patients. However, changes in hospital access policies may also have influenced consultation patterns. The treatment continuation rates for axillary and palmar hyperhidrosis were both approximately 40%. Among the treatments for axillary hyperhidrosis, sofpironium bromide gel was prescribed most frequently, whereas glycopyrronium tosylate hydrate wipes showed a higher treatment continuation rate. In conclusion, the presence of a specialized outpatient clinic may improve access to care for patients with primary focal hyperhidrosis and facilitate the identification of previously unrecognized patients. However, treatment continuation remained suboptimal, highlighting the importance of improving continuity of care in hyperhidrosis management at our institution.</p>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"53 9","pages":"1267-1276"},"PeriodicalIF":2.3,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1346-8138.70373","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Effectiveness of Radiotherapy for Lymph Node Metastases of Cutaneous Squamous Cell Carcinoma: A Single-Center Retrospective Analysis","authors":"Tatsuhiko Mori,&nbsp;Mikio Otsuka,&nbsp;Toshiyuki Yamamoto","doi":"10.1111/1346-8138.70363","DOIUrl":"10.1111/1346-8138.70363","url":null,"abstract":"<div>\u0000 \u0000 <p>Cutaneous squamous cell carcinoma (cSCC) frequently affects older adults, and regional lymph node (LN) metastasis is associated with poor prognosis. Lymph node dissection (LND) is the standard treatment for LN metastasis; however, radiotherapy (RT) may represent an alternative option when surgery is not feasible. Although the effectiveness of RT for primary cSCC is well established, its effectiveness for LN metastases remains insufficiently evaluated. We conducted a single-center retrospective analysis of patients with cSCC and LN metastases treated between 2007 and 2024. Two cohorts were examined: (1) the RT cohort, comprising 21 patients treated with RT, in which objective response rate (ORR) and local progression-free survival (LPFS) were assessed; and (2) the LND versus RT cohort, comprising 24 patients with initial regional LN metastases treated with either LND or RT, in which LPFS, distant metastasis-free survival (DMFS), and disease-specific survival (DSS) were evaluated. In the RT cohort, ORR was 81% (complete response 52%, partial response 29%), and the median LPFS was 40.0 months. Patients with a sum of the diameters of the target lymph node (SDLN) of &lt; 40 mm demonstrated significantly better local control than those with an SDLN of ≥ 40 mm (median LPFS, 40.0 vs. 6.6 months; <i>p</i> = 0.029). In the LND versus RT cohort, no significant differences were observed between the LND and RT groups in LPFS, DMFS, or DSS. In exploratory multivariable analyses, a larger SDLN was consistently associated with poorer outcomes, whereas other covariates showed inconsistent associations and wide confidence intervals, reflecting model instability due to the limited sample size. These findings indicate that RT provides favorable local control of LN metastases of cSCC, particularly in smaller LN metastasis, and demonstrates survival outcomes comparable to those of LND. RT may be considered a reasonable alternative to surgery in selected patients who are ineligible for LND.</p>\u0000 </div>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"53 9","pages":"1305-1314"},"PeriodicalIF":2.3,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148311267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fractional CO2 Laser in Lichen Amyloidosis With Rapid Pruritus Resolution and Long-Term Remission: Serial PGP9.5 and Dylon Observations With Touch Sensitivity Assessment","authors":"Ko Kagoyama,&nbsp;Teruhiko Makino,&nbsp;Miyu Tsuritani,&nbsp;Fumina Furukawa,&nbsp;Tadamichi Shimizu","doi":"10.1111/1346-8138.70385","DOIUrl":"10.1111/1346-8138.70385","url":null,"abstract":"<div>\u0000 \u0000 <p>Lichen amyloidosis is a chronic pruritic dermatosis that can be refractory to topical and systemic therapies. We report a 76-year-old Japanese man with severe lichen amyloidosis on the right lower leg (itch numerical rating scale [NRS] 9) treated with a single session of fractional CO₂ laser (AcuPulse; combination mode) without anesthesia. Clinical symptoms and adverse events were followed for 2 years. Mechanical hypersensitivity was assessed using an innocuous von Frey filament (0.69 mN) at three predefined sites: the papule center (R1), papule edge (R2), and peripapular area (R3; 1.0 mm from the papule edge). Ten representative papules were tested, and tactile stimulation was applied 10 times per site; response rate was defined as the percentage of stimuli evoking itch or unpleasant sensation. Serial biopsies were obtained at baseline, immediately after irradiation, and at 6 months after treatment for histology (including Dylon staining) and PGP9.5 immunostaining. Pruritus resolved within 1 month (NRS 0) and remained in remission for 2 years without additional treatment. Touch-evoked hypersensitivity, which had been prominent at the papule edge (R2) and peripapular area (R3), was no longer elicited at 1 month (0% response rates at R1–R3). At baseline, PGP9.5 immunostaining showed elongated intraepidermal nerve fibers in the peripapular epidermis. Immediately after irradiation, PGP9.5-positive fibers appeared disrupted/fragmented within micro-ablative columns. At 6 months after treatment, PGP9.5-positive intraepidermal fibers were not evident in any of the examined serial sections. Dylon staining demonstrated that dermal amyloid deposits remained detectable at 6 months. This case illustrates rapid and durable pruritus remission after fractional CO₂ laser for lichen amyloidosis, accompanied by serial changes in PGP9.5 staining and improved touch hypersensitivity, despite persistent dermal amyloid deposits.</p>\u0000 </div>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"53 9","pages":"1376-1380"},"PeriodicalIF":2.3,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Intervention Effects and Risk Factors for Residual Skin Changes in Infantile Hemangiomas","authors":"Kayoko Okuda,&nbsp;Motoki Nakamura,&nbsp;Reiko Nakamura,&nbsp;Sachiyo Takagi,&nbsp;Akimichi Morita","doi":"10.1111/1346-8138.70388","DOIUrl":"10.1111/1346-8138.70388","url":null,"abstract":"<p>Infantile hemangioma (IH) characteristically progresses through proliferative, involuting, and involuted phases, and typically undergoes spontaneous regression after the age of five. Therefore, the traditional management strategy has been based on a “wait-and-see policy”. However, the degree and tempo of proliferation vary considerably among individuals, and rapid enlargement can lead to functional impairment or ulceration. Moreover, in some cases, significant residual skin changes may persist even after involution. In Japan, pulsed dye laser (PDL) therapy was approved for insurance coverage in 1996, and early intervention during the proliferative phase has since become the standard approach to prevent such complications. At our institution, we have also actively implemented early PDL therapy, with oral propranolol added in selected cases. We conducted a retrospective analysis of 92 patients with 107 IH lesions who initiated PDL therapy at our dermatology department between January 2014 and December 2022. Earlier initiation of laser treatment was significantly associated with an earlier peak in tumor size (<i>r</i> = 0.80, <i>p</i> &lt; 0.0001). Furthermore, evaluation of residual skin changes after treatment completion revealed that the nodular type exhibited significantly more severe residual skin changes than the other morphological subtypes (Fisher's exact test, <i>p</i> &lt; 0.0001). A peak size ≥ 3 cm² was also identified as a risk factor for severe residual skin changes (multivariate logistic regression analysis, odds ratio 21.6, 95% confidence interval 2.93–358, <i>p</i> = 0.0090). In contrast, low birth weight and prematurity were not associated with an increased risk of severe residual skin changes when laser treatment was initiated. In conclusion, early PDL initiation was associated with earlier peak lesion size in IHs. Nodular-type lesions and peak size ≥ 3 cm² predicted severe long-term residual skin changes, supporting early risk stratification and timely consideration of systemic therapy in high-risk cases.</p>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"53 9","pages":"1296-1304"},"PeriodicalIF":2.3,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1346-8138.70388","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148475162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI-Based Surgical Margin Assessment in Dermatofibrosarcoma Protuberans: Correlation With Pathological Extent","authors":"Munehisa Kito,&nbsp;Mai Iwaya,&nbsp;Toshikazu Omodaka,&nbsp;Shunsuke Yuzuriha,&nbsp;Masanori Okamoto,&nbsp;Atsushi Tanaka,&nbsp;Akira Takazawa,&nbsp;Hirokazu Ideta,&nbsp;Daiki Taruta,&nbsp;Kazuaki Nemoto,&nbsp;Kaoru Aoki,&nbsp;Jun Takahashi","doi":"10.1111/1346-8138.70377","DOIUrl":"10.1111/1346-8138.70377","url":null,"abstract":"<p>Dermatofibrosarcoma protuberans (DFSP) is a locally aggressive cutaneous tumor characterized by infiltrative growth and a high risk of local recurrence if incompletely excised. Although Mohs micrographic surgery is recommended, wide local excision (WLE) remains widely used in clinical practice; however, the clinical utility of preoperative imaging for surgical margin assessment has not been fully established. We retrospectively analyzed 42 patients with DFSP, including fibrosarcomatous DFSP (FS-DFSP), who underwent MRI-based surgical planning followed by WLE between 2009 and 2023. Lateral margins were defined based on preoperative MRI, and deep tumor extent was assessed according to the relationship with the fascia. Analyses were performed in 36 patients after excluding cases without identifiable pathological tumor. The median planned lateral margin was 20 mm, whereas the median pathological margin was 16.5 mm. The median difference (pathological − planned) was −5 mm (interquartile range −10.25 to −1 mm; range −18 to +15 mm), with planned margins significantly larger (<i>p</i> &lt; 0.001). A weak positive correlation was observed between planned and pathological margins (<i>ρ</i> = 0.32), but it did not reach statistical significance (<i>p</i> = 0.060). Importantly, the maximum underestimation of tumor extent was 18 mm, indicating that the discrepancy between imaging-based planning and pathological findings did not exceed 20 mm in any case. Lesions classified as fascia-contacting or beyond on MRI showed a higher likelihood of deep invasion (OR 27.0, 95% CI 1.5–483). Residual tumor was identified in 71% of patients undergoing additional resection after unplanned excision. All patients achieved R0 resection without local recurrence, and distant metastases occurred only in FS-DFSP. Preoperative MRI provides clinically useful information for surgical margin assessment in DFSP. A lateral margin of approximately 20 mm appears sufficient to achieve complete resection, and fascia-based evaluation may help stratify the risk of deep invasion.</p>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"53 9","pages":"1287-1295"},"PeriodicalIF":2.3,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1346-8138.70377","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148383468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of dWAT-Immune Crosstalk in Hair Follicle Microenvironment in Hair Regeneration","authors":"Rongtian Ye,&nbsp;Xiuzu Song","doi":"10.1111/1346-8138.70393","DOIUrl":"10.1111/1346-8138.70393","url":null,"abstract":"<div>\u0000 \u0000 <p>The hair follicle microenvironment is the core functional unit of hair regeneration. dWAT (Dermal white adipose tissue) is an indispensable component of this microenvironment. Rather than serving as a passive filler, dWAT, through multidimensional mechanisms including cytokines, metabolites, extracellular vesicles, and cell–cell interactions, forms a complex regulatory network with local immune cells and exerts unique immune functions. It is deeply involved in the maintenance of local immune homeostasis, the regulation of the inflammatory response, and hair regeneration. In this review, we summarize the latest research on the effect of adipose-immune interactions on hair growth within the hair follicle microenvironment, focusing on how the dWAT surrounding the hair follicle serves as the foundation of the local adipose-immune interaction microenvironment, and on the regulatory mechanisms by which the immune function of hair follicle dWAT influences hair follicle regeneration. The dynamic remodeling of dWAT along the hair follicle cycle provides key metabolic support for the formation and regulation of the immune microenvironment around the hair follicle, and also constitutes the material basis for the crosstalk among immune cells within the hair follicle. The interaction between dWAT and immune cells affects the hair follicle growth process by regulating the local inflammatory response, immune cell phenotypic switching, and associated signaling pathways.</p>\u0000 </div>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"53 9","pages":"1227-1235"},"PeriodicalIF":2.3,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148665441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hand Eczema Referred for Patch Testing: Retrospective Study in Shanghai, China From 2018 to 2023","authors":"Chengbin Ye,&nbsp;Xiandong Gu,&nbsp;Chengwen Fei,&nbsp;Xuyang Zhou,&nbsp;Ting Cao,&nbsp;Xingbiao Wu,&nbsp;Yingfang Li,&nbsp;Ying Zou","doi":"10.1111/1346-8138.70378","DOIUrl":"10.1111/1346-8138.70378","url":null,"abstract":"<div>\u0000 \u0000 <p>Hand eczema (HE) imposes a significant socioeconomic burden, particularly in severe and occupational cases. To identify major allergens and associated factors in Chinese patients with HE referred for patch testing, we conducted a retrospective cohort study included 788 cases of HE detected from 4438 patients who were patch-tested in Shanghai, China, between 2018 and 2023. The HE group had an 82.23% patch-test positivity rate. N-Isopropyl-N-Phenyl-4-Phenylenediamine were more common in the HE than in the non-HE group after false discovery rate (FDR) correction (FDR-adjusted <i>p</i> &lt; 0.05), while other rubber allergens showed similar trends (multivariable-adjusted <i>p</i> &lt; 0.05). The top five allergens associated with HE were nickel sulfate, dodecyl gallate, methylisothiazolinone, cobalt chloride, and methylisothiazolinone/methylchloroisothiazolinone. Polysensitization was more common in females than in males, while sensitivity to occupation-related allergens was more common in males. Fragrance allergies were more frequent in patients over 40 years old, and those with a history of atopic dermatitis showed no significant allergen trends. Among occupational exposures, hairdressers and beauticians showed heightened hand sensitivity to preservatives and p-phenylenediamine. Although few allergens reached significance after FDR correction in other occupations, multivariable-adjusted analyses suggested certain allergens as potentially occupational, warranting further surveillance. These findings highlight the notable difference in positive patch test reactions between individuals with HE and without HE and emphasize the role of allergens in HE, as well as the risks posed by sex, age, history of allergic dermatitis, and occupation. Further studies with balanced samples are warranted.</p>\u0000 </div>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"53 9","pages":"1342-1352"},"PeriodicalIF":2.3,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Achieving Targeted Combined Endpoints in Patients With Atopic Dermatitis: A Real-World Study","authors":"Yun-Wen Chen,&nbsp;Yi-Hsing Chen,&nbsp;Tsai-Hung Yen,&nbsp;Yen-Ju Chen,&nbsp;Yi-Da Wu,&nbsp;Yi-Ming Chen,&nbsp;Ching-Tsai Lin,&nbsp;Tsu-Yi Hsieh,&nbsp;Wen-Nan Huang,&nbsp;Kuo-Tung Tang","doi":"10.1111/1346-8138.70369","DOIUrl":"10.1111/1346-8138.70369","url":null,"abstract":"<div>\u0000 \u0000 <p>Real-world evidence on the treat-to-target strategy in atopic dermatitis (AD) remains limited. To evaluate targeted combined endpoints in AD, we conducted a cross-sectional study that included 100 adults with AD receiving treatment ≥ 6 months. Targeted endpoints included Patient Global Assessment (PGA) ≤ 2, Eczema Area and Severity Index (EASI) ≤ 7, visual analog scale (VAS) of pruritus ≤ 4, Patient Oriented Eczema Measure (POEM) ≤ 7, and Dermatology Life Quality Index (DLQI) ≤ 5. Logistic regression and receiver operating characteristic (ROC) curve analysis were performed to identify factors associated with achieving treatment targets. Latent class analysis (LCA) and principal component analysis (PCA) were performed to identify patient subgroups and data components. Only 30% met all five targeted endpoints. An increased age was associated with a higher probability of achieving all treatment targets (aOR: 1.04; 95% CI: 1.00–1.09). DLQI could favorably predict the achievement of all 5 treatment targets (AUROC: 0.93; 95% CI: 0.88, 0.97). Despite no significant differences across treatment groups, the proportion of patients achieving all targets was the highest in the dupilumab group, followed by the Janus kinase inhibitor (JAKi) group. LCA identified one subgroup of patients achieving favorable skin control but poor life quality. PCA showed that life quality-related factors other than the severity of skin lesions explained the majority of variance. In conclusion, achievement of targeted combined endpoints in AD remains suboptimal, partly due to life quality-related factors.</p>\u0000 </div>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"53 9","pages":"1315-1320"},"PeriodicalIF":2.3,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148383477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Etoposide as Late-Line Therapy for Metastatic Extramammary Paget's Disease: A Case Series","authors":"Takanobu Kan,&nbsp;Saito Ryo,&nbsp;Kayoko Nomoto,&nbsp;Hayato Mizuno,&nbsp;Daiki Matsubara,&nbsp;Takumi Sakamoto,&nbsp;Masaya Moriwaki,&nbsp;Akio Tanaka","doi":"10.1111/1346-8138.70382","DOIUrl":"10.1111/1346-8138.70382","url":null,"abstract":"<div>\u0000 \u0000 <p>Extramammary Paget's disease (EMPD) is a rare cutaneous carcinoma that typically arises in apocrine gland–rich areas. Advanced or metastatic disease is associated with poor prognosis and limited therapeutic options. Due to its rarity, no standard chemotherapy regimen has been established. Agents such as docetaxel, cisplatin, and 5-fluorouracil have been used, but evidence supporting their efficacy remains limited. Etoposide has occasionally been reported to provide temporary benefit in advanced EMPD, although its effectiveness remains poorly characterized. We report a case series of three patients with metastatic EMPD treated with oral etoposide as third- or fourth-line therapy. They had experienced disease progression despite prior therapies, including docetaxel, S-1, and low-dose FP (5-fluorouracil and cisplatin) therapy. Oral etoposide was administered at 50 mg/day for 3–4 weeks followed by a 1–2 week rest period. Additional radiation therapy was provided for metastatic lesions in two patients. Two patients achieved a partial response on imaging, while one showed stable disease. Serum carcinoembryonic antigen levels decreased markedly in two evaluable patients, indicating a biological response. The average progression-free survival was 7.7 months. Adverse events included alopecia and neutropenia in one patient, both manageable. Although all patients eventually died from disease progression, etoposide provided disease control and symptomatic relief. These findings suggest that oral etoposide may represent a feasible and relatively well-tolerated late-line treatment option for metastatic EMPD.</p>\u0000 </div>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"53 9","pages":"1371-1375"},"PeriodicalIF":2.3,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}