American Journal of Clinical Dermatology最新文献

{"title":"Bimekizumab Complete Clearance of Both Skin and Nail Psoriasis: Comparative Efficacy in Phase III/IIIb Studies.","authors":"Joseph F Merola, Richard B Warren, Diamant Thaçi, Kenneth B Gordon, Emi Nishida, Bruce Strober, Curdin Conrad, Sarah Kavanagh, José Manuel López Pinto, Bengt Hoepken, Paolo Gisondi","doi":"10.1007/s40257-025-00968-2","DOIUrl":"https://doi.org/10.1007/s40257-025-00968-2","url":null,"abstract":"<p><strong>Background: </strong>Nail psoriasis can have a substantial negative impact on both the physical and emotional well-being of patients, and is a risk factor for psoriatic arthritis. Achieving complete clearance of nails in addition to skin is therefore an important treatment goal.</p><p><strong>Objectives: </strong>We aimed to evaluate concurrent complete skin and nail clearance in patients with moderate-to-severe plaque psoriasis treated with bimekizumab or active comparators.</p><p><strong>Methods: </strong>Data were analyzed from the BE SURE and BE VIVID phase III trials, their open-label extension BE BRIGHT, and the BE RADIANT phase IIIb trial and its open-label extension. Included patients had baseline modified Nail Psoriasis Severity Index (mNAPSI) >0 and entered their respective open-label extension. Proportions of patients achieving complete skin (PASI 100; 100% improvement from baseline in Psoriasis Area and Severity Index) and nail (mNAPSI 0) clearance at the same time are reported for bimekizumab- and active comparator-treated patients during controlled trial periods, and in the long term for continuous bimekizumab-treated patients and those switching from comparators. Data are reported using modified non-responder imputation.</p><p><strong>Results: </strong>At the end of comparator-controlled periods, 45.8% of bimekizumab (N = 151) versus 18.3% of adalimumab (N = 91) patients (BE SURE week 24), 51.1% of bimekizumab (N = 169) versus 26.5% of ustekinumab (N = 92) patients (BE VIVID week 52), and 63.3% of bimekizumab (N = 182) versus 36.1% of secukinumab (N = 155) patients (BE RADIANT week 48) achieved PASI 100 and mNAPSI 0. Following long-term treatment, 57.7% of adalimumab switchers/49.1% of continuous bimekizumab patients (BE SURE/BE BRIGHT year 4), 52.2% of ustekinumab switchers/48.3% of continuous bimekizumab patients (BE VIVID/BE BRIGHT year 4), and 51.9% of secukinumab switchers/57.4% of continuous bimekizumab patients (BE RADIANT year 3) achieved PASI 100 and mNAPSI 0.</p><p><strong>Conclusions: </strong>Numerically higher proportions of bimekizumab-treated patients achieved concurrent complete skin and nail clearance versus adalimumab, ustekinumab, and secukinumab. Clearance rates increased following switch to bimekizumab, and were sustained long-term in both switchers to bimekizumab and continuous bimekizumab-treated patients. [Graphical abstract available.] CLINICAL TRIAL REGISTRATION: NCT03412747, NCT03370133, NCT03598790, NCT03536884.</p>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":" ","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939434","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":"Management of Erythrodermic Psoriasis with Systemic Therapies: A Systematic Review.","authors":"Luca Mastorino, Francesco Leo, Giada Frigatti, Nicole Macagno, Paolo Dapavo, Pietro Quaglino, Simone Ribero","doi":"10.1007/s40257-025-00977-1","DOIUrl":"https://doi.org/10.1007/s40257-025-00977-1","url":null,"abstract":"<p><strong>Background: </strong>Erythrodermic psoriasis (EP) is a severe and rare variant of psoriasis. Clinical features include scaling and erythema affecting more than 75% of body surface area, associated with systemic symptoms such as lymphadenopathy, arthralgia, fever, fatigue, dehydration, serum electrolyte disturbances, and tachycardia, making this condition a potentially life-threatening disease. Differential diagnosis can be challenging, encompasses atopic dermatitis, cutaneous adverse drug reaction, and advanced cutaneous lymphoma. Following a correct diagnostic framing, appropriate systemic treatment must be initiated. Unfortunately, there are no recent up-to-date guidelines and standardized treatment options for EP are still lacking.</p><p><strong>Objective: </strong>To review the current reported systemic treatment options for EP.</p><p><strong>Methods: </strong>This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and based on a search in MEDLINE, PubMed, Scopus, and Cochrane Library for articles in English from first available publication to 9 November 2024.</p><p><strong>Results: </strong>In all, 145 studies were included in the review. Case reports and case series are the main available work, reporting heterogeneous outcomes and effectiveness with nonbiologic and biologic systemic agents. Among non-biologic systemic treatments, methotrexate and cyclosporin are the most widely reported as treatment for EP, showing clinical response in over 60% of cases, with cyclosporine offering a faster onset of action and being suitable for acute management. Available randomized controlled trials include patients with EP treated with etretinate, infliximab, certolizumab-pegol (CZP), Ixekizumab, guselkumab, risankizumab, and deucravacitinib. However, these trials were not specifically designed for erythrodermic psoriasis, and the sample size of EP patients included is limited, resulting in reduced statistical power and limiting the reliability of the findings. Among TNF-α inhibitors, infliximab is the most reported agent, with data on 103 patients. Certolizumab pegol (CZP) also showed promising results, with PASI 75 achieved in over 80% of patients at 52 weeks. A retrospective analysis comparing infliximab, adalimumab, etanercept, ustekinumab, and efalizumab found TNF-α inhibitors to be superior to other biologic classes. Regarding IL-17 inhibitors, secukinumab is the second most frequently studied biologic, with 93 patients reported. It demonstrated rapid efficacy, achieving PASI 75 in more than 80% of patients by week 8. A head-to-head comparison with ixekizumab showed comparable outcomes. Among IL-23 inhibitors, risankizumab led to PASI 90 in over 75% of patients at week 16, suggesting high efficacy despite more limited data.</p><p><strong>Conclusions: </strong>Non-biologic systemic drugs appear to be a rational first-line therapy, with cyclosporine ","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":" ","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939457","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":"Development and Validation of an Artificial Intelligence-Driven Model for Accurate Classification of Erythrodermic Psoriasis Severity: Erythrodermic Psoriasis Integrated Classification System (EPICS).","authors":"Yuyan Yang, Chao Wu, Xinyuan Zhang, Chenyang Yu, Hanlin Zhang, Hongzhong Jin","doi":"10.1007/s40257-025-00980-6","DOIUrl":"https://doi.org/10.1007/s40257-025-00980-6","url":null,"abstract":"<p><strong>Background: </strong>Erythrodermic psoriasis is a rare subtype of psoriasis with widespread skin lesions, with some patients experiencing severe systemic symptoms.</p><p><strong>Objective: </strong>We aimed to develop and validate an artificial intelligence-driven model for accurate classification of erythrodermic psoriasis severity by integrating clinical and laboratory indicators.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at Peking Union Medical College Hospital (2005-22). Patients were divided into mild and moderate-to-severe groups using k-means clustering. After imputing missing values, we trained seven candidate algorithms-K-Nearest Neighbors, Artificial Neural Network, Random Forest, Extreme Gradient Boosting, Support Vector Machine, Bayesian classifier, and logistic regression-using repeated, stratified ten-fold cross-validation with three repeats (10 × 3 CV); performance was summarized by the mean area under the receiver operating characteristic curve across folds. Feature importance was assessed using SHAP (Shapley Additive exPlanations), a game-theoretic approach that quantifies each features contribution to individual model predictions, ten indicators were incorporated into a diagnostic scoring system. The optimal cut-off for mild/moderate-to-severe cases classification was selected with the Youden index on the cross-validated receiver operating characteristic curve.</p><p><strong>Results: </strong>Of 260 screened records, 242 erythrodermic patients met the study criteria. Histology confirmed psoriasis in 108 cases, while the remaining patients were diagnosed based on clinical presentation and medical history. K-means clustering assigned 94 patients to the moderate-to-severe group and 148 to the mild group. Moderate-to-severe erythrodermic psoriasis was characterized by a higher inflammatory burden (median neutrophil-to-lymphocyte ratio 4.11 vs 2.70, p < 0.001), more frequent fever (88% vs 41%, p < 0.001), greater edema severity (16% vs 1.4%, p < 0.001), lower albumin and higher calcium levels (both p < 0.001), and longer hospitalization (median 26 vs 20 days, p = 0.005). After adjustment for age and sex, moderate-to-severe cases required systemic therapy roughly twice as often as mild cases (odds ratio 2.21, p < 0.05). Of seven machine-learning algorithms, the Artificial Neural Network yielded the highest mean validation area under the curve. The SHAP analysis highlighted the ten most influential predictors adopted from the Artificial Neural Network-edema, edematous erythema (defined as the combination of both redness and swelling of the skin), fever, albumin, neutrophil-to-lymphocyte ratio, serum calcium, white blood cell count, acute-phase reactants (C-reactive protein or erythrocyte sedimentation rate), pruritus, and superficial lymphadenopathy-and these were converted to integer points to form the bedside score. The receiver operating characteristic analysis identified 33.5 points as th","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":" ","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939421","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":"Lichen Simplex Chronicus: Clinical Perspectives and Emerging Therapeutic Strategies.","authors":"Michal Moshkovich, Luis F Andrade, Mike Anderson, Gil Yosipovitch","doi":"10.1007/s40257-025-00979-z","DOIUrl":"https://doi.org/10.1007/s40257-025-00979-z","url":null,"abstract":"<p><p>Lichen simplex chronicus (LSC), also known as neurodermatitis, is a common chronic pruritic dermatosis defined by lichenified plaques resulting from persistent scratching. Though often secondary to underlying dermatologic, systemic, or psychological triggers, LSC represents a distinct clinical entity with significant morbidity. The hallmark itch-scratch cycle contributes not only to visible skin changes but also to substantial sleep disruption, emotional distress, and functional impairment. Psychological stress, anxiety, and depression are frequent comorbidities and can further perpetuate disease chronicity. This review provides a comprehensive summary of the evolving understanding of LSC, from its neuroimmune-driven pathogenesis to the wide spectrum of therapeutic strategies currently available. In addition to topical corticosteroids, novel approaches including immunomodulators, neuromodulators, Janus kinase (JAK) inhibitors, and biologics are being increasingly explored. Procedural therapies such as cryotherapy, fractional laser resurfacing, and botulinum toxin injections, have also emerged as valuable tools, particularly in treatment-refractory cases. Recent insights into type 2 inflammation and dysregulated sensory pathways have informed the rationale for these targeted strategies. In anatomically sensitive areas such as the genital region, where topical agents may be poorly tolerated, systemic treatments may be required. Given this complexity, individualized, multimodal treatment plans are critical to optimizing management and improving quality of life (QoL) in patients with LSC. By synthesizing current data on pathophysiology, diagnosis, and both established and emerging therapies, this review aims to guide clinicians in optimizing care for patients with LSC and addressing its far-reaching psychosocial burden.</p>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":" ","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939410","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":"Advancing Precision Medicine in Inflammatory Skin Disease.","authors":"Michelle Yuan, Jinwoo Lee, Mark Taylor, Raymond J Cho, Jeffrey B Cheng","doi":"10.1007/s40257-025-00963-7","DOIUrl":"https://doi.org/10.1007/s40257-025-00963-7","url":null,"abstract":"<p><p>The growing availability of targeted immunomodulatory therapies has transformed the treatment landscape for chronic inflammatory skin diseases. However, treatment selection remains largely empirical, often guided more by trial-and-error and insurance mandates than by an individual patient's underlying disease biology. This disconnect between therapeutic strategy and the need to address and calibrate for patient molecular heterogeneity undermines clinical outcomes and contributes to inefficiency in care delivery. Precision medicine offers a solution by tailoring diagnosis and treatment to the molecular and cellular features of each patient's skin disease. In this Current Opinion, we outline key clinical contexts where precision approaches can be transformative: diagnostic ambiguity, selecting treatments for an established diagnosis, and selecting treatments without a defined diagnosis or disease mechanism. We highlight advances in precision techniques such as single-cell RNA sequencing and spatial transcriptomics that enable more refined skin disease classification and accurate prediction of drug response. Although several challenges remain before these techniques can be widely adopted, such as limited biomarker validation, high costs, and a lack of breadth in research cohorts, we argue that their potential benefits, for patients, clinicians, and the broader field of dermatologic care, substantially outweigh the associated costs. We advocate for expanded funding, population-based research, and scalable diagnostics to successfully integrate precision medicine into dermatology. By combining molecular phenotyping with traditional clinicopathologic diagnosis, precision medicine can reduce therapeutic inefficiency, improve patient outcomes, and redefine care paradigms in chronic inflammatory skin disease.</p>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":" ","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862016","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":"Psoriasis: Considerations for the Management of Women of Childbearing Potential.","authors":"Signe Agnete Rønde Kristensen, Amanda Kvist-Hansen, Lone Skov","doi":"10.1007/s40257-025-00978-0","DOIUrl":"https://doi.org/10.1007/s40257-025-00978-0","url":null,"abstract":"<p><p>As women of childbearing potential constitute a considerable portion of the total psoriasis population, dermatologists must consider both the clinical and psychosocial implications of psoriasis when treating these patients. This review summarizes key clinical considerations when treating women of childbearing potential with psoriasis, regarding family planning, pregnancy, and the postpartum period, aiming to assist in identifying common concerns within this population. Many women report initiating the discussion on family planning but having limited access to information. Concerns about the impact of psoriasis and its treatment on fertility, pregnancy, and lactation are common, and lack of adequate information can lead to irrevocable decisions. Despite conflicting results, current evidence suggests a potential negative correlation between moderate-to-severe psoriasis and fertility. Studies on adverse maternal and neonatal events associated with psoriasis show inconsistent outcomes and should be communicated with caution. With the increase in available treatment options during pregnancy and lactation, particularly in cases of severe psoriasis, personalized treatment plans are becoming more achievable, allowing dermatologists to better address the needs of their patients. The majority of patients can be treated during pregnancy with topical treatments or ultraviolet-B irradiation. While the general recommendation is to stop systemic treatment before conception, decisions should be made on an individualized basis. If treatment cannot be discontinued, tumor necrosis factor-α inhibitors and cyclosporine can be used. It is essential to inform parents of the additional risks associated with live or live-attenuated vaccines in cases where the mother has received systemic treatment during pregnancy and to delay vaccinations accordingly.</p>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":" ","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862017","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 Assessment of Alopecia Areata Severity and Validating the Patient Experience: A Vodcast.","authors":"Zoe Apalla, Katya Harfmann","doi":"10.1007/s40257-025-00973-5","DOIUrl":"https://doi.org/10.1007/s40257-025-00973-5","url":null,"abstract":"<p><p>Alopecia areata (AA) is an autoimmune disease that is characterized by nonscarring hair loss of the scalp, face, and/or body. Three therapies have been approved for the treatment of severe AA; however, there are several different approaches for defining disease severity. Therefore, severity assessment tools are helpful in determining the appropriate treatment approach and evaluating treatment response in patients with AA. This vodcast discusses tools for assessing AA severity, including the Severity of Alopecia Tool, AA Scale, and AA Severity and Morbidity Index. It is suggested that severity assessments should include factors beyond just scalp hair loss, with the AA Scale including secondary clinical features, such as involvement of eyebrows and eyelashes. Moreover, AA can significantly impact patient's quality of life; therefore, measuring the psychosocial impacts of AA is as important as measuring the physical effects. Some of the measures to assess the negative impact on the quality of life of patients with AA include the Dermatology Life Quality Index, Alopecia Areata Symptom Impact Scale, and Children's Dermatology Life Quality Index. Behavioral changes due to AA could also be considered when assessing psychosocial impacts, particularly for adolescents, who may experience bullying, which can lead to school avoidance, anxiety, and depression. In summary, when assessing severity of AA to inform treatment decisions, clinicians should be guided by evidence-based tools, with additional consideration of factors beyond scalp hair loss, such as impairment in activity, mental health, and wellbeing. Supplementary file1 (MP4 383174 KB).</p>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":" ","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854255","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 Safety and Efficacy of Risankizumab to Treat Moderate-to-Severe Plaque Psoriasis: Final LIMMitless Phase 3, Open-Label Extension Trial Results","authors":"Kim A. Papp,&nbsp;Mark G. Lebwohl,&nbsp;Lluís Puig,&nbsp;Mamitaro Ohtsuki,&nbsp;Stefan Beissert,&nbsp;Melinda Gooderham,&nbsp;Ahmad Z. Amin,&nbsp;Tianshuang Wu,&nbsp;Simone Rubant,&nbsp;Brenton Bialik,&nbsp;Doug Ashley,&nbsp;Ahmed M. Soliman,&nbsp;Michael M. Chen,&nbsp;Andrew Blauvelt","doi":"10.1007/s40257-025-00964-6","DOIUrl":"10.1007/s40257-025-00964-6","url":null,"abstract":"<div><h3>Background</h3><p>Psoriasis is a chronic, inflammatory disease requiring long-term therapy. Risankizumab, an anti–interleukin-23 monoclonal antibody, is approved to treat moderate-to-severe plaque psoriasis in adults.</p><h3>Objective</h3><p>The aim was to assess the long-term safety and efficacy of continuous risankizumab treatment through 6 years in adults with moderate-to-severe plaque psoriasis.</p><h3>Methods</h3><p>LIMMitless, a phase 3, open-label extension study, evaluated the long-term safety and efficacy of risankizumab in patients with moderate-to-severe plaque psoriasis following multiple phase 2/3 base studies. Patients randomized to risankizumab 150 mg at baseline of the base studies (≤ 52 weeks) were eligible to enroll in the LIMMitless study, in which they received risankizumab 150 mg subcutaneously every 12 weeks for an additional 252 weeks. This final analysis assessed safety (treatment-emergent adverse events [TEAEs]) through 324 weeks and efficacy (including proportions of patients who achieved ≥ 90%/100% improvement from baseline in Psoriasis Area and Severity Index [PASI 90/PASI 100], static Physician’s Global Assessment of clear or almost clear [sPGA 0/1], or Dermatology Life Quality Index of no effect on patient’s quality of life [DLQI 0/1]) through 304 weeks.</p><h3>Results</h3><p>Of 897 patients enrolled in the LIMMitless study, 661 completed the study for a total of 4921.2 patient years of exposure to risankizumab. Rates of TEAEs, TEAEs leading to discontinuation, and TEAEs of safety interest were low and consistent with rates observed in previous studies. During the base studies, risankizumab treatment demonstrated high rates of rapid and durable efficacy through 52 weeks; risankizumab treatment also maintained or further improved efficacy and quality-of-life outcomes in the LIMMitless study. At week 304, 86.0% of patients achieved PASI 90, 54.2% achieved PASI 100, 84.7% achieved sPGA 0/1, and 76.3% achieved DLQI 0/1 (using modified nonresponder imputation).</p><h3>Conclusions</h3><p>Long-term risankizumab was well tolerated and demonstrated high and durable efficacy through 6 years of continuous treatment.</p><h3>Clinical Trial Registration</h3><p>NCT03047395.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"26 5","pages":"829 - 841"},"PeriodicalIF":8.8,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-025-00964-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of the Rash Appearance to Distinguish Cholinergic Urticaria Subtypes: A Retrospective Cohort Study.","authors":"M Nagai, T Fukumoto, S Imamura, Y Oda, M Mizuno, M Ohata, A Kubo, Atsushi Fukunaga","doi":"10.1007/s40257-025-00967-3","DOIUrl":"https://doi.org/10.1007/s40257-025-00967-3","url":null,"abstract":"<p><strong>Background: </strong>Cholinergic urticaria (CholU) is characterized by pruritic papular wheals induced by various temperature-elevating stimuli such as exercise, bathing, and emotional stress. Although it is considered important to classify CholU into subtype on the basis of the pathogenesis and clinical features for better management, few studies have evaluated the rash type as a clinical feature.</p><p><strong>Aim: </strong>This study aimed to investigate the associations between different types of rashes in CholU and their clinical phenotypes, and to consider the mechanisms underlying each type of rash.</p><p><strong>Methods: </strong>We conducted a retrospective study of 64 patients diagnosed with CholU who visited the Dermatological Institute of Kobe University Hospital. Clinical and photographic data obtained after exercise provocation and/or thermoregulatory sweat tests were reviewed and used to classify patients into the red wheal/erythema group (n = 44) or the goosebumps group (n = 20). Intradermal tests, namely the autologous sweat skin test (ASwST) and autologous serum skin test (ASST), were performed to assess sweat and serum reactivity, respectively. The presence of atopic dermatitis and hypohidrosis was evaluated in accordance with established guidelines. Univariable logistic analyses were conducted to assess the associations between rash types and clinical features, namely age, sex, ASwST and ASST results, atopic dermatitis, hypohidrosis, pruritus, and pain. Multivariable logistic analysis was performed using only sex and age. Statistical analyses were performed using GraphPad Prism 10, with significance set at P < 0.05.</p><p><strong>Results: </strong>The red wheal/erythema group had typical punctate or coalescent erythematous wheals, while the goosebumps group had follicular, goosebump-like rashes with or without erythema. Compared with the red wheal/erythema group, the goosebumps group had a higher proportion of males (85% versus 38.6%) and higher prevalences of hypohidrosis (89.4% versus 35.7%) and pain (89.5% versus 37.8%). In contrast, the red wheal/erythema group had significantly higher prevalences of ASwST positivity (68.4% versus 20%), atopic dermatitis (58.1% versus 5.3%), and pruritus (78.4% versus 10.5%). Univariable analysis revealed that ASwST positivity, atopic dermatitis, and pruritus were significantly associated with the red wheal/erythema group, while hypohidrosis and pain were significantly associated with the goosebumps group. Multivariable logistic analysis showed that male sex was significantly associated with the goosebumps group.</p><p><strong>Conclusions: </strong>Patients with CholU develop rashes with varying coloration and shapes. Goosebump-like rashes, which differ from typical wheals, were often accompanied by hypohidrosis. The type of rash may help to differentiate the clinical subtypes of CholU.</p>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":" ","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717318","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":"Correction to: Mastocytosis in the Skin: Approach to Diagnosis, Evaluation, and Management in Adult and Pediatric Patients","authors":"Lauren M. Madigan,&nbsp;Nathan A. Boggs,&nbsp;Anton V. Rets,&nbsp;Alejandro A. Gru,&nbsp;Tsewang Tashi,&nbsp;David A. Wada,&nbsp;Scott R. Florell,&nbsp;Melody C. Carter","doi":"10.1007/s40257-025-00972-6","DOIUrl":"10.1007/s40257-025-00972-6","url":null,"abstract":"","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"26 5","pages":"851 - 851"},"PeriodicalIF":8.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-025-00972-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}