American Journal of Clinical Dermatology最新文献

{"title":"Clinical Mimickers Misdiagnosed as Pyoderma Gangrenosum.","authors":"Sarah L Becker, Ahmed H Badawi, Chase Thornton, Alex G Ortega-Loayza","doi":"10.1007/s40257-025-00941-z","DOIUrl":"https://doi.org/10.1007/s40257-025-00941-z","url":null,"abstract":"<p><p>Pyoderma gangrenosum (PG) is a rare, ulcerative, neutrophilic dermatosis that can be challenging to diagnose. Diagnosis of PG is clinical due to a lack of specific histopathologic, immunologic, or imaging findings associated with the disease, although several clinical frameworks exist to guide diagnosis. However, misdiagnosis of PG is frequent and leads to increased patient morbidity and mortality. This article highlights common mimickers of PG and offers clinical pearls to aid in accurate diagnosis with the goal of decreasing diagnostic delay and misdiagnosis and improving patient outcomes.</p>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":" ","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scratching the Surface: A Comprehensive Guide to Understanding and Managing Vulvovaginal Itching.","authors":"Kayla D Mashoudy, Ana F Tomlinson, Sarah Kim, Vanya Shivashankar, Gil Yosipovitch, Michelle Fletcher","doi":"10.1007/s40257-025-00939-7","DOIUrl":"https://doi.org/10.1007/s40257-025-00939-7","url":null,"abstract":"<p><p>Vulvovaginal itching is a common yet often under-recognized condition affecting women across all age groups. Despite its prevalence, many dermatologists receive minimal training in vulvar diseases, leading to delayed diagnoses and prolonged discomfort for patients. This review explores the broad spectrum of causes, including infections, inflammatory conditions, neuropathic disorders, and systemic illnesses. The complexity of vulvovaginal pruritus often requires a multidisciplinary approach to accurately diagnose and treat. Contributing factors such as hormonal changes, personal hygiene practices, and environmental exposures must also be considered. Treatment strategies typically begin with lifestyle modifications and topical therapies, such as corticosteroids and antifungals, but can extend to systemic medications and biologics for resistant cases. Additionally, nonpharmaceutical options such as sitz baths and psychological interventions can be crucial for managing chronic symptoms. However, there remains a significant gap in research, particularly regarding the characterization of female-specific pruritus and its long-term impact on quality of life. Despite some advances, the available studies largely focus on isolated causes rather than the holistic nature of the condition. Further research is urgently needed to develop comprehensive, evidence-based guidelines for diagnosing and treating vulvovaginal itching, a condition that has a profound effect on both physical and emotional well-being.</p>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":" ","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Guide to the Management of Hidradenitis Suppurativa in Pregnancy and Lactation.","authors":"Raveena Ghanshani, Katrina Lee, Ashley B Crew, Vivian Y Shi, Jennifer L Hsiao","doi":"10.1007/s40257-025-00935-x","DOIUrl":"https://doi.org/10.1007/s40257-025-00935-x","url":null,"abstract":"<p><p>Hidradenitis suppurativa is a chronic inflammatory condition characterized by recurrent abscesses, nodules, tunnels, and scarring. Fluctuations in disease activity are common during pregnancy, and more than half of women with hidradenitis suppurativa report experiencing post-partum flares. Both treatment efficacy and safety of the woman and fetus or infant must be considered when developing a treatment plan for pregnant and lactating women with hidradenitis suppurativa. Although certain commonly used hidradenitis suppurativa medications, such as tetracyclines and spironolactone, are contraindicated during pregnancy, there are still various medical therapies, including topicals, systemic antibiotics, metabolic modulators, and biologics, as well as procedural therapies that may be utilized during pregnancy. This paper aims to provide an updated evidence-based review of the management of hidradenitis suppurativa in pregnancy with an emphasis on safety data.</p>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":" ","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maximal Usage Trial of Tapinarof Cream 1% Once Daily in Pediatric Patients Down to 2 Years of Age with Extensive Atopic Dermatitis.","authors":"Amy S Paller, Adelaide A Hebert, Mercedes E Gonzalez, Victoria Butners, Nancy Fitzgerald, Glenn Tabolt, David S Rubenstein, Stephen C Piscitelli","doi":"10.1007/s40257-025-00929-9","DOIUrl":"https://doi.org/10.1007/s40257-025-00929-9","url":null,"abstract":"<p><strong>Background: </strong>Tapinarof cream 1% is an aryl hydrocarbon receptor agonist approved by the US Food and Drug Administration to treat atopic dermatitis (AD) in patients down to age 2 years.</p><p><strong>Objective: </strong>The aim of this study was to evaluate the safety and pharmacokinetics of tapinarof cream 1% once daily (QD) in adolescents and children with extensive AD under maximal usage conditions.</p><p><strong>Methods: </strong>Patients with a validated Investigator Global Assessment scale for Atopic Dermatitis™ (vIGA-AD™) score ≥ 3 and body surface area (BSA) involvement ≥ 25% (ages 12-17 years) or ≥ 35% (ages 2-11 years) were enrolled into three age cohorts (2-6, 7-11, and 12-17 years) and received tapinarof cream 1% QD for 4 weeks.</p><p><strong>Results: </strong>Overall, 36 patients (12 per cohort) were enrolled; mean BSA affected was 42.8% (range 26.0-90.0) and mean Eczema Area and Severity Index (EASI) score was 23.8. At baseline, 28 patients (77.8%) had a vIGA-AD™ score of 3 (moderate). No-to-minimal tapinarof systemic exposure was observed (25% of post-treatment plasma samples were below the quantifiable limit of a highly sensitive assay [< 50 pg/mL]). Mean maximum plasma concentration (C_max) was 2.44 ng/mL, and median time to C_max was 2.9 h. Eight patients (22.2%) reported treatment-emergent adverse events (TEAEs), which were mild or moderate; only one patient discontinued due to two unrelated TEAEs. One case of mild folliculitis and no contact dermatitis occurred. Tapinarof was well tolerated, including on sensitive skin and extensor/flexural surfaces.</p><p><strong>Conclusion: </strong>Tapinarof cream exhibits highly favorable safety and pharmacokinetics in adolescents and children down to age 2 years with extensive AD.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov: NCT05186805.</p>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":" ","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Agreement Between Nail Psoriasis Severity Index Scores by a Convolutional Neural Network and Dermatologists: A Retrospective Study at an Academic New York City Institution.","authors":"Jose W Ricardo, Rhiannon Miller, Matilde Iorizzo, Bianca M Piraccini, Michela Starace, Chander Grover, Dimitris Rigopoulos, Nilton Di Chiacchio, Nilton G Di Chiacchio, Hang Nguyen, Nga Nguyen, Zung Nguyen, Clifford Perlis, Jonathan Wolfe, Shari R Lipner","doi":"10.1007/s40257-025-00934-y","DOIUrl":"https://doi.org/10.1007/s40257-025-00934-y","url":null,"abstract":"<p><strong>Background: </strong>Nail psoriasis (NP) affects up to 90% and 86% of patients with cutaneous psoriasis and psoriatic arthritis, respectively, with a significant impact on quality-of-life. The Nail Psoriasis Severity Index (NAPSI) is infrequently used in clinical practice owing to its labor-intensive nature and variable interobserver reliability.</p><p><strong>Objective: </strong>The objective of this study was to assess performance and inter-reader agreement between artificial intelligence (AI)-determined NAPSI scores and dermatologist-assigned scores.</p><p><strong>Methods: </strong>This cross-sectional study used clinical images of psoriatic fingernails captured retrospectively at a specialized nail clinic in New York City. A convolutional neural network (CNN) model was trained and utilized for NAPSI classification of psoriatic fingernail clinical images, with seven dermatologist nail experts scoring identical images. The primary outcome was the interclass correlation coefficient (ICC), using a one-way analysis of variance (ANOVA) fixed effects model for the single-rater absolute agreement, between the average NAPSI score determined by the dermatologists and the AI.</p><p><strong>Results: </strong>In total, 240 images of psoriatic fingernails were included. The ICC for overall NAPSI, matrix (NAPSIm), and bed (NAPSIb) scores among the dermatologists were 0.43 (95% confidence interval [CI] 0.33-0.55), 0.56 (95% CI 0.46-0.67), and 0.53 (95% CI 0.43-0.65), respectively. Comparing the AI algorithm-assigned NAPSI, NAPSIm, and NAPSIb scores with the average dermatologist-assigned scores, ICCs were 0.81 (95% CI 0.74-0.86), 0.75 (95% CI 0.65-0.82), and 0.81 (95% CI 0.74-0.86), respectively.</p><p><strong>Conclusions: </strong>We found an excellent correlation between AI-derived NAPSI scores and dermatologist-assigned scores, underscoring the potential of CNNs to improve accuracy and reliability in NAPSI scoring. The limitations of this study include the small sample size, undetermined CNN diagnostic accuracy, incomplete data, and potential racial/ethnic minority group underrepresentation.</p>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":" ","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Disease Control and Minimal Disease Activity of Head and Neck Atopic Dermatitis in Patients Treated with Tralokinumab up to 4 Years.","authors":"Raj Chovatiya, Simone Ribero, Andreas Wollenberg, Chang Ook Park, Juan Francisco Silvestre, H Chih-Ho Hong, Julien Seneschal, Hidehisa Saeki, Jacob P Thyssen, Christian Bjerregård Øland, Le Gjerum, Douglas Maslin, Andrew Blauvelt","doi":"10.1007/s40257-025-00931-1","DOIUrl":"https://doi.org/10.1007/s40257-025-00931-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and objective: &lt;/strong&gt;There is a need for long-term atopic dermatitis (AD) treatments that can effectively improve AD involvement of the head and neck (H&N) region (referred to as H&N AD). Tralokinumab, a high-affinity monoclonal antibody that neutralizes interleukin-13, is approved for the treatment of moderate-to-severe AD. Recent real-world studies have observed the effectiveness of tralokinumab for H&N AD. Here, data from phase III parent trials, ECZTRA 1 and ECZTRA 2, and the long-term extension trial, ECZTEND, were used to assess impacts of long-term tralokinumab treatment on H&N AD and the association between improvements in H&N AD and patient quality of life, and to evaluate whether a proportion of patients developed paradoxical H&N erythema.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;These post hoc analyses included data from all patients initiated on tralokinumab in ECZTRA 1 or ECZTRA 2. Patients were treated up to 4 years (i.e., up to 52 weeks in ECZTRA 1 or ECZTRA 2 plus up to 152 weeks in ECZTEND). Outcomes included body region subscores of the Eczema Area and Severity Index (EASI; H&N, upper limbs, trunk, lower limbs) and the Dermatology Life Quality Index (DLQI). Correlations between H&N EASI and DLQI were assessed with Spearman's correlation coefficient (ρ). The incidence of paradoxical H&N erythema (defined as H&N EASI erythema increasing from baseline to a score of 3, while all other regional EASI subscores are 0 or 1, during two or more consecutive visits) was also assessed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, 1192 patients who were initiated on tralokinumab in ECZTRA 1 and ECZTRA 2, of whom 523 patients opted to continue in ECZTEND, were analyzed. Percentages of patients who had H&N EASI ≤ 1 increased from 12.2% at parent trial baseline to 87.2% by week 152 of ECZTEND. Improvements in EASI subscore outcomes from parent trial baseline were comparable across body regions throughout all timepoints of the study. At parent trial week 16, H&N EASI was moderately correlated with total DLQI (ρ = 0.47), with the strongest numerical correlations observed for DLQI questions regarding skin discomfort (ρ = 0.43) and embarrassment due to skin (ρ = 0.40). During up to 4 years of treatment, seven tralokinumab-treated patients exhibited paradoxical H&N erythema, five of whom improved to absent or mild H&N EASI erythema with continued tralokinumab treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Tralokinumab provided progressive and sustained improvements in H&N AD, with H&N EASI 0/1 observed in nearly 90% of patients treated up to 4 years. Improvements in H&N EASI were similar to improvements observed for other body regions and were associated with improvements in patient quality of life, particularly for skin discomfort and self-consciousness/embarrassment due to skin.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical trial registration: &lt;/strong&gt;NCT03131648 (ECZTRA 1); study start date: 30 May, 2017; primary completion date: 7 August, 2018; study compl","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":" ","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photoaging: Current Concepts on Molecular Mechanisms, Prevention, and Treatment.","authors":"Maria V Kaltchenko, Anna L Chien","doi":"10.1007/s40257-025-00933-z","DOIUrl":"https://doi.org/10.1007/s40257-025-00933-z","url":null,"abstract":"<p><p>Photoaging is the consequence of chronic exposure to solar irradiation, encompassing ultraviolet (UV), visible, and infrared wavelengths. Over time, this exposure causes cumulative damage, leading to both aesthetic changes and structural degradation of the skin. These effects manifest as rhytids, dyschromia, textural changes, elastosis, volume loss, telangiectasias, and hyperkeratosis, collectively contributing to a prematurely aged appearance that exceeds the skin's chronological age. The hallmarks of photoaging vary significantly by skin phototype. Skin of color tends to exhibit dyschromia and features associated with \"intrinsic\" aging, such as volume loss, while white skin is more prone to \"extrinsic\" aging characteristics, including rhytids and elastosis. Moreover, susceptibility to different wavelengths within the electromagnetic spectrum also differs by skin phototype, influencing the clinical presentation of photoaging, as well as prevention and treatment strategies. Fortunately, photoaging-and its associated adverse effects-is largely preventable and, to some extent, reversible. However, effective prevention and treatment strategies require careful tailoring to an individual's skin type. In this review, we summarize molecular mechanisms underlying photoaging, examine its clinical manifestations, outline risk factors and prevention strategies, and highlight recent advancements in its treatment.</p>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":" ","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes and Prognostic Factors in Bullous Pemphigoid Patients: A 15-Year Review in China.","authors":"Shan Cao, Wenchao Li, Zhenzhen Wang, Hongda Li, Pengcheng Huai, Tongsheng Chu, Baoqi Yang, Yonghu Sun, Peiye Xing, Guizhi Zhou, Yongxia Liu, Shengli Chen, Qing Yang, Mei Wu, Zhongxiang Shi, Hong Liu, Furen Zhang","doi":"10.1007/s40257-025-00925-z","DOIUrl":"https://doi.org/10.1007/s40257-025-00925-z","url":null,"abstract":"<p><strong>Background: </strong>There are limited data on clinical outcomes and prognosis factors for bullous pemphigoid (BP) at long-term follow-up.</p><p><strong>Objective: </strong>We aimed to investigate the clinical outcomes and prognostic factors in BP patients.</p><p><strong>Methods: </strong>This retrospective study was performed between January 1, 2009 and December 31, 2023 in Shandong Province, China. The primary outcomes were the rates and predictive factors of mortality, complete remission off-therapy (CROT), and relapse by Cox proportional hazards models or logistic regression analyses. Nomograms for BP mortality and CROT were also described.</p><p><strong>Results: </strong>Of the 1063 BP patients enrolled, 45 were excluded due to loss to follow-up. The cohort comprised 1018 BP patients to analyze. A total of 344 (33.8%) patients died, with cumulative 1-, 3-, and 5-year mortality rates of 22.8%, 31.2%, and 34.5%, respectively. Increased age at onset (HR = 1.08), body surface area (BSA) involvement 10-30%, BSA involvement > 30% (HR = 7.19; HR = 9.84, respectively), double-positive IgG and C3 on DIF (HR = 1.37), and systemic corticosteroid in combination  with immunosuppressants treatments (HR = 0.50) were associated with mortality. A total of 321 (31.5%) patients achieved CROT. Cumulative CROT rates at 1, 3, and 5 years were 10.9%, 32.9%, and 47.5%, respectively. Shorter diagnosis delay time (HR = 1.01), baseline anti-BP180 antibody < 50 IU/mL (HR = 1.48) and systemic drugs other than corticosteroid treatment (HR = 1.68) were associated with CROT. Predictive models demonstrated outstanding performance in classifying mortality at 1, 3, and 5 years (AUCs 0.83, 0.86, 0.88), but moderate classification for CROT (AUCs 0.67, 0.62, 0.63). A total of 749 (73.6%) patients experienced relapses.</p><p><strong>Conclusions: </strong>This study, the first large cohort to examine long-term outcomes in BP patients, identifies risk factors for mortality and CROT, offering key insights for clinicians to improve prognosis and reduce relapse rates.</p>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":" ","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Evidence of Tralokinumab Effectiveness and Safety: A Systematic Review and Meta-analysis.","authors":"Amalie Thorsti Møller Rønnstad, Christopher G Bunick, Raj Chovatiya, Masahiro Kamata, Mia-Louise Nielsen, Daniel Isufi, Simon F Thomsen, Christian Vestergaard, Andreas Wollenberg, Alexander Egeberg, Jacob P Thyssen, Nikolai Loft","doi":"10.1007/s40257-025-00927-x","DOIUrl":"https://doi.org/10.1007/s40257-025-00927-x","url":null,"abstract":"<p><strong>Background: </strong>Tralokinumab, a first-in-class and second biologic approved for treating moderate-to-severe atopic dermatitis in adolescents and adults, has demonstrated consistent efficacy and safety across multiple clinical trials.</p><p><strong>Objective: </strong>We aimed to assess the real-world effectiveness and safety of tralokinumab by performing a systematic review and meta-analysis on the real-world evidence of tralokinumab.</p><p><strong>Methods: </strong>We systematically searched PubMed and EMBASE from inception until 28 July, 2024 for observational studies describing the effectiveness and safety of tralokinumab for the treatment of atopic dermatitis. The primary outcome was the proportion of patients achieving a ≥75% improvement in the Eczema Area and Severity Index (EASI-75) after 16 weeks and secondary outcomes included the proportion of patients achieving EASI-50 and EASI-90 and the proportion of patients experiencing adverse events.</p><p><strong>Results: </strong>Nineteen unique studies encompassing 911 bio-naïve and bio-experienced patients with atopic dermatitis treated with tralokinumab were included. After 16 weeks of treatment, 82%, 59% and 26% of patients achieved EASI-50, EASI-75 and EASI-90, respectively, and the proportion of patients developing conjunctivitis was 3.2%.</p><p><strong>Conclusions: </strong>Tralokinumab demonstrates strong effectiveness and good tolerability in real-world settings, with a high proportion of patients achieving a clinical response and adverse events being observed only infrequently.</p>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":" ","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Effectiveness of Upadacitinib in Patients with Moderate-to-Severe Atopic Dermatitis Who Smoke: a 2-Year Real-Life Multicenter Study.","authors":"Francesco Leo, Michela Ortoncelli, Ruggero Cascio Ingurgio, Benedetta Galli, Laura Grigolato, Claudia Paganini, Martina Maurelli, Eugenia Veronica Di Brizzi, Giuseppe Lauletta, Francesca Barei, Chiara Anna Fiasconaro, Marta Casale Alloa, Mario Bruno Guanti, Niccolò Gori, Andrea Chiricozzi, Maddalena Napolitano, Cataldo Patruno, Marco Galluzzo, Mariateresa Rossi, Anna Balato, Silvia Mariel Ferrucci, Angelo Valerio Marzano, Elena Pezzolo, Caterina Foti, Giampiero Girolomoni, Luigi Gargiulo, Alessandra Narcisi, Pietro Quaglino, Simone Ribero, Luca Mastorino","doi":"10.1007/s40257-025-00926-y","DOIUrl":"https://doi.org/10.1007/s40257-025-00926-y","url":null,"abstract":"<p><strong>Background: </strong>Atopic dermatitis (AD) is a chronic inflammatory skin condition that significantly impairs the quality of life. Recent advancements in systemic therapies, such as Janus kinase (JAK) inhibitors, offer very effective new treatment options. However, concerns regarding potential adverse events, including cardiovascular and thromboembolic risk, have emerged from clinical studies and call for further real-life investigations. This has highlighted the need to establish specific risk categories, such as tobacco smokers.</p><p><strong>Objective: </strong>This study aims to evaluate the safety and effectiveness of upadacitinib, a JAK1 inhibitor, in patients who smoke with moderate-to-severe AD over a 2-year treatment period, comparing outcomes with patients who do not smoke.</p><p><strong>Patients and methods: </strong>A retrospective multicenter study was conducted across 12 dermatology departments in Italy, including 375 patients treated with upadacitinib. The presence and intensity of smoking habits as well as effectiveness scores and safety data were collected.</p><p><strong>Results: </strong>Patients who smoke accounted for 36.8% of the sample. Two thromboembolic events in patients who do not smoke were recorded in the 2-year (median follow up of 52.6 weeks) observation period. The most common adverse event was acneiform eruption (12.4% of patients after 104 weeks). No significant differences related to safety emerged regarding the presence or absence of a smoking habit. Drug survival was very high with no differences between the two cohorts (83.5% after 104 weeks for patients who smoke).</p><p><strong>Conclusions: </strong>This study suggests that upadacitinib is a safe and effective treatment for moderate-to-severe AD in presence of tobacco smoke, with no significant differences in safety or effectiveness compared with patients who do not smoke.</p>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":" ","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}