American Journal of Clinical Dermatology最新文献

{"title":"Impact of Biologic Therapies on the Risk of Progression from Psoriasis to Psoriatic Arthritis: A Systematic Review and Meta-Analysis of Cohort Studies.","authors":"Wenhui Xie, Tong Chen, Yuan Chen, Shiyu Xiao","doi":"10.1007/s40257-026-01065-8","DOIUrl":"https://doi.org/10.1007/s40257-026-01065-8","url":null,"abstract":"<p><strong>Background: </strong>Psoriasis progresses to psoriatic arthritis in up to 30% of patients, causing irreversible joint damage and substantial healthcare burden. Whether biologic therapy reduces psoriatic arthritis risk remains unclear.</p><p><strong>Objective: </strong>The aim of this paper was to evaluate the association between biologic therapy and psoriatic arthritis risk in psoriasis patients.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of cohort studies (PROSPERO: CRD420251240466), searching PubMed, EMBASE, and Cochrane Library from inception to December 2025. We included cohort studies of adults with psoriasis without prior psoriatic arthritis that reported adjusted risk estimates for incident psoriatic arthritis and used an 'on-drug' analytical framework to account for changes in treatment status over time. Pooled hazard ratio (HRs) with 95% confidence interval (CI) were calculated using fixed- or random-effects models.</p><p><strong>Results: </strong>In total, 15 cohort studies including 124,138 psoriasis patients with over 778,690 person-years of follow-up were included. Biologic use was associated with a 46% lower psoriatic arthritis risk versus non-biologic therapy (pooled HR 0.54, 95% CI 0.43-0.68), consistent versus non-systemic therapies (HR 0.57, 95% CI 0.33-0.97) and methotrexate (HR 0.48, 95% CI 0.45-0.51). Interleukin (IL)-17 inhibitors (HR 0.65, 95% CI 0.49-0.87; 3 studies) and IL-12/23 or IL-23 inhibitors (HR 0.46, 95% CI 0.36-0.60; 4 studies) were associated with lower psoriatic arthritis risk than tumor necrosis factor inhibitors. IL-23 inhibitors showed greater protection than IL-17 inhibitors (HR 0.67, 95% CI 0.58-0.77), while IL-23 inhibitors and IL-12/23 inhibitors did not differ (HR 0.88, 95% CI 0.69-1.13).</p><p><strong>Conclusions: </strong>Biologic therapy for psoriasis, particularly IL-23/IL-17-targeted agents, is associated with reduced incident psoriatic arthritis risk. These findings suggest early pathway suppression may delay clinical psoriatic arthritis diagnosis, though causal inference is limited by the observational data.</p>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":" ","pages":""},"PeriodicalIF":11.4,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705119","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":"Deucravacitinib 5-Year Safety and Efficacy Results in Plaque Psoriasis: A Phase 3 Open-Label Extension of Randomized Clinical Trials","authors":"April W. Armstrong,&nbsp;Mark Lebwohl,&nbsp;Richard B. Warren,&nbsp;Akimichi Morita,&nbsp;Carle Paul,&nbsp;Diamant Thaçi,&nbsp;Matthias Augustin,&nbsp;Lluís Puig,&nbsp;Carolin Daamen,&nbsp;Janice Li,&nbsp;Alessandra Alió,&nbsp;Angela Aggrey-Amable,&nbsp;Julie Scotto,&nbsp;Zoran Popmihajlov,&nbsp;John Vaile,&nbsp;Bruce Strober","doi":"10.1007/s40257-026-01055-w","DOIUrl":"10.1007/s40257-026-01055-w","url":null,"abstract":"<div><h3>Background</h3><p>Deucravacitinib, an oral, selective, tyrosine kinase 2 inhibitor, is approved for adults with moderate to severe plaque psoriasis who are candidates for systemic therapy and for adults with active psoriatic arthritis.</p><h3>Objective</h3><p>We evaluated deucravacitinib safety and efficacy over 5 years in the phase 3 POETYK PSO-1, PSO-2, and long-term extension (LTE) trials in patients with moderate to severe plaque psoriasis.</p><h3>Methods</h3><p>PSO-1 and PSO-2 (parent trials) randomized patients 1:2:1 to oral placebo, deucravacitinib 6 mg once daily, or apremilast 30 mg twice daily. At 52 weeks, patients enrolled in the LTE trial received open-label deucravacitinib. Safety was reported as exposure-adjusted incidence rates (EAIRs) per 100 person-years (PY). Clinician- and patient-reported outcomes were analyzed using modified nonresponder imputation in patients receiving continuous deucravacitinib from day 1 (PSO-1/PSO-2) through 5 years.</p><h3>Results</h3><p>Overall, 1519 patients received one or more deucravacitinib dose; total exposure was 5046.7 PY through data cutoff (September 2, 2024). EAIRs/100 PY were comparable or decreased from the 1-year to 5-year cumulative period for adverse events (AEs) (229.23, 127.40, respectively), serious AEs (5.68, 5.06), discontinuation due to AEs (4.38, 2.09), deaths (0.20, 0.22), serious infections excluding coronavirus disease 2019 (COVID-19) (1.53, 0.94), malignancies (1.02, 0.92), major adverse cardiovascular events (0.30, 0.34), and venous thromboembolism (0.20, 0.06). Clinical outcomes were well-maintained in patients receiving continuous deucravacitinib (<i>n</i> = 513) from 1 through 5 years, including achievement of a ≥ 75% reduction from baseline in the Psoriasis Area and Severity Index (1 year, 72.1% [95% CI 68.2–76.1]; 5 years, 67.3% [62.0–72.6]) and a static Physician Global Assessment score of 0 (clear) or 1 (almost clear) (1 year, 57.5% [53.1–61.9]; 5 years, 52.6% [47.0–58.1]). Dermatology Life Quality Index 0 or 1 was well-maintained from 1 year (52.5% [48.0–57.1]) through 5 years (45.4% [40.0–50.8]).</p><h3>Conclusions</h3><p>These findings demonstrate a consistent safety profile with no new safety signals and durable clinical response through 5 years of treatment with deucravacitinib.</p><h3>Clinical Trial Registration</h3><p>NCT03624127, NCT03611751, NCT04036435.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 5","pages":"1071 - 1089"},"PeriodicalIF":11.4,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-026-01055-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683174","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":"Systemic Comorbidities of Keloid and Hypertrophic Scars: A Phenome-Wide Association Study in a Multiethnic U.S. Pediatric Cohort","authors":"Fatemeh Vahidnezhad,&nbsp;Noosha Samieefar,&nbsp;Mahdi Akbarzadeh,&nbsp;Parisa Safari,&nbsp;Frank Mentch,&nbsp;Michael March,&nbsp;Lam C. Tsoi,&nbsp;David J. Margolis,&nbsp;Johann E. Gudjonsson,&nbsp;Hakon Hakonarson,&nbsp;Hassan Vahidnezhad","doi":"10.1007/s40257-026-01063-w","DOIUrl":"10.1007/s40257-026-01063-w","url":null,"abstract":"<div><h3>Background</h3><p>Excessive scarring (ES), including keloids and hypertrophic scars, impairs function, appearance, and quality of life in children. Its pediatric comorbidity spectrum is not well defined, limiting anticipatory guidance and multidisciplinary care. This research aims to investigate comorbidities of ES in a diverse pediatric cohort using a phenome-wide association study (PheWAS).</p><h3>Methods</h3><p>This population-based study leveraged longitudinal electronic health record (EHR) data from participants enrolled in the Children’s Hospital of Philadelphia (CHOP) from 2006. Diagnosis codes (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] and Tenth Revision [ICD-10-CM]) were mapped to 3109 phenotype codes (PheCodes). PheWAS analyses were conducted using logistic regression, with Bonferroni correction applied to account for multiple testing.</p><h3>Results</h3><p>Among 86,092 pediatric participants, 662 (0.77%) were identified with ES; the remaining served as controls. Multivariable PheWAS screening identified 154 significant associations across 16 disease categories, of which 105 were not reported previously to our knowledge. Dermatologic phenotypes (<i>n</i> = 28; 18%) were most enriched, including acne and other follicular disorders, eczema, pigmentary changes, papulosquamous and granulomatous disorders, and cutaneous infections. Respiratory phenotypes (<i>n</i> = 21; 14%) included respiratory failure, pneumonia, asthma, allergic rhinitis, pharyngitis, and tonsillar hypertrophy. Sense organ disorders (<i>n</i> = 19; 12%) comprised conjunctivitis, refractive errors, otitis, and hearing impairment. Infection-related phenotypes (<i>n</i> = 14; 9%) highlighted susceptibility to viral (influenza, human papillomavirus [HPV], molluscum contagiosum), fungal (candidiasis, dermatophytosis), and bacterial infections.</p><h3>Conclusions</h3><p>These findings suggest that ES in children indicates not only localized wound-healing impairment, but also systemic immune, developmental, and proliferative dysregulations, emphasizing the need for genetic and mechanistic studies to clarify causal pathways and multidisciplinary surveillance beyond dermatologic care.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 5","pages":"1107 - 1122"},"PeriodicalIF":11.4,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663327","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":"Efficacy and Safety of Oral Janus Kinase Inhibitors in Adults and Adolescents with Alopecia Areata: A Systematic Review and Meta-Analysis of Randomised Controlled Trials","authors":"Samuel Morriss,&nbsp;Chuan Hui Foo,&nbsp;Emily Lin,&nbsp;Flavia Rodrigues Dias,&nbsp;Daniella Kushnir-Grinbaum,&nbsp;Holly FitzGerald,&nbsp;Shalem Leemaqz,&nbsp;Sharon Lee,&nbsp;Bevin Bhoyrul","doi":"10.1007/s40257-026-01060-z","DOIUrl":"10.1007/s40257-026-01060-z","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Alopecia areata is an autoimmune disorder characterised by T-cell-mediated damage of hair follicles, resulting in non-scarring hair loss that can progress to complete scalp (alopecia totalis) or body hair loss (alopecia universalis). While long-term systemic options were historically limited, the emergence of Janus kinase (JAK) inhibitors has revolutionised the treatment of alopecia areata, even in patients with moderate-to-severe disease.&lt;/p&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;p&gt;We aimed to evaluate the efficacy and safety of oral JAK inhibitors compared with placebo in adults and adolescents with moderate-to-severe alopecia areata.&lt;/p&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;MEDLINE, Embase and the Cochrane Central Register of Controlled Trials databases were searched from inception to 28 November, 2025. Randomised controlled trials evaluating oral JAK inhibitors in adolescents and adults (aged ≥12 years) with alopecia areata were included. Data extraction and risk of bias assessment were performed independently by multiple reviewers. Primary outcomes were the proportion of patients who achieved Severity of Alopecia Tool (SALT) scores of ≤10 and ≤20, and 50%, 75% and 90% reductions in SALT scores from baseline, as well as treatment-related adverse events (AEs). Data were synthesised using random-effects models to calculate odds ratios (ORs) and mean differences with 95% confidence intervals (CIs).&lt;/p&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;Twelve randomised controlled trials involving 4141 participants (mean age 35.8 years, mean baseline SALT score 86.0) met the inclusion criteria. All trials enrolled adult participants, with the exception of one randomised controlled trial in which adolescents comprised 15% of the study population. Six trials were rated as having a low risk of bias, while six had “some concerns” primarily because of missing outcome data. Oral JAK inhibitors were significantly more effective than placebo across all primary efficacy endpoints. At week 24, the odds of achieving SALT ≤10 were 5.69 times higher for JAK inhibitors than placebo (95% CI 3.58–9.03); by week 36, this effect increased to an OR of 9.40 (95% CI 4.58–19.29). For SALT ≤20, the OR was 7.99 (95% CI 5.13–12.44) at week 24. Patients treated with oral JAK inhibitors were significantly more likely to achieve SALT50, SALT75 and SALT90 across all timepoints (weeks 12–36). Regarding safety, JAK inhibitors were associated with a higher risk of total AEs (OR 1.60; 95% CI 1.33–1.94), but no statistically significant difference was found for serious AEs (OR 1.04; 95% CI 0.69–1.57) or treatment discontinuation because of AEs (OR 1.22; 95% CI 0.84–1.76).&lt;/p&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;p&gt;Oral JAK inhibitors are effective in promoting scalp, eyebrow and eyelash hair regrowth in adults and adolescents with moderate-to-severe alopecia areata, with a trend of higher response rates at later timepoints across studies. The favourable safety profile of these agents is reassuring. Future research should prioritise head-to","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 5","pages":"925 - 943"},"PeriodicalIF":11.4,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-026-01060-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148597705","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":"Correction to: Long-Term Efficacy and Safety of Ritlecitinib in Adults and Adolescents with Alopecia Areata: 3-Year Results from the ALLEGRO Phase 2b/3 and ALLEGRO-LT Phase 3 Clinical Studies","authors":"Maryanne Senna,&nbsp;Jennifer Soung,&nbsp;Ignasi Figueras,&nbsp;Brett King,&nbsp;Misaki Kinoshita-Ise,&nbsp;Sameh Hanna,&nbsp;Wenyu Wu,&nbsp;Dalia Wajsbrot,&nbsp;Deborah Woodworth,&nbsp;Robert Wolk,&nbsp;Alanna Chaudhry,&nbsp;Alexandre Lejeune,&nbsp;Helen Tran","doi":"10.1007/s40257-026-01059-6","DOIUrl":"10.1007/s40257-026-01059-6","url":null,"abstract":"","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 5","pages":"1127 - 1129"},"PeriodicalIF":11.4,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-026-01059-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148597548","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":"Is Acanthosis Nigricans a Marker for Metabolic Syndrome? A Systematic Review","authors":"Jordan Gillespie,&nbsp;Jaclyn Roland-McGowan,&nbsp;Kyra Diehl,&nbsp;Emile Latour,&nbsp;Jacob Nelson,&nbsp;Tayler Tobey,&nbsp;Elena Paz-Munoz,&nbsp;Kira Champelli,&nbsp;Molly Joyce,&nbsp;Katie Norris,&nbsp;Somya Khare,&nbsp;Michael Bonazzola,&nbsp;Oliver Wisco,&nbsp;Alex Ortega-Loayza,&nbsp;Guang Fan,&nbsp;Sancy Leachman","doi":"10.1007/s40257-026-01058-7","DOIUrl":"10.1007/s40257-026-01058-7","url":null,"abstract":"<div><h3>Background/Objective</h3><p>Certain skin conditions are proven indicators of underlying systemic disease. Specifically, acanthosis nigricans (AN) is commonly associated with type 2 diabetes and insulin resistance. However, AN may also be a marker of metabolic syndrome (MS). MS is linked to several health conditions leading to death. Therefore, early identification of MS is crucial in preventing disease progression. While AN may provide a visual cue for MS risk, its utility as a clinical screening tool remains underexplored. To address this, we conducted a systematic review to evaluate the association between AN and MS.</p><h3>Methods</h3><p>We systematically searched PubMed, Embase, and Cochrane Review using the term “acanthosis nigricans,” identifying 656 articles, including 322 case reports, that reported AN in association with at least one MS criteria, as defined by the American Heart Association. Article quality was determined using the Strength of Recommendation Taxonomy (SORT) grading system.</p><h3>Results</h3><p>Across the 656 included articles, the unweighted mean proportion of study participants with AN was 70.8% (standard deviation of 34.9%), reflecting that many studies evaluated broader patient populations in which AN was one of several conditions assessed. Of all MS criteria, insulin resistance showed the highest mean prevalence of AN at 72.6%. Within all articles, 65.9% met more than one MS criterion, with co-occurrence of insulin resistance and increased body mass being the most common combination (25.5%). In a subanalysis of non-case-report studies in which all participants had AN, 67.4% met the full criteria for MS, with increased body mass being the most frequently reported individual criterion (89.7% of cases).</p><h3>Conclusions</h3><p>This review provides a better estimate of AN observed in individuals with MS or in those at risk for MS. Integrating dermatologic examination for AN into primary care and preventive health may improve early detection of MS, reduce costs and unnecessary testing, and promote targeted interventions. Educational efforts are needed to increase clinician awareness of the association between AN and MS.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 5","pages":"945 - 957"},"PeriodicalIF":11.4,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-026-01058-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148589480","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":"The Role of Skin Surface pH in Age Associated Pruritus: Mechanistic and Clinical Insights","authors":"Rafal M. Pielak,&nbsp;Daniel C. Butler","doi":"10.1007/s40257-026-01061-y","DOIUrl":"10.1007/s40257-026-01061-y","url":null,"abstract":"<div><p>Skin aging is characterized by progressive structural and biochemical changes that impair epidermal barrier function, alter the cutaneous microbiome, and predispose to chronic pruritus. Epidermal thinning, reduced lipid synthesis, and slowed barrier repair increase transepidermal water loss and vulnerability to irritation. Concurrently, age-related disruption of the acid mantle leads to elevation of skin surface pH, impairing acid-dependent lipid-processing enzymes while enhancing serine protease activity. These changes disrupt lamellar organization, weaken stratum corneum cohesion, and further compromise barrier integrity. Elevated pH and barrier dysfunction also reshape the skin microbiome. These changes favor alkalinity-tolerant and proinflammatory species while reducing protective commensals, thereby reinforcing inflammation and sensory irritation. Barrier impairment, dysbiosis, and pH-driven protease activation converge with neuroimmune dysregulation to sensitize peripheral nerves and promote chronic itch. Important contributors include kallikrein–protease-activated receptor-2 (PAR2) signaling and cytokines such as interleukin-31. This review highlights the pH–protease–itch axis as a unifying framework for pruritus in aging skin and discusses restoration of physiological acidity as a rational therapeutic strategy.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 5","pages":"1045 - 1055"},"PeriodicalIF":11.4,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576779","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":"Shared Mechanistic Pathways in Bullous Pemphigoid, Chronic Spontaneous Urticaria, Prurigo Nodularis, and Chronic Prurigo of Unknown Origin: Implications for Targeted Therapies","authors":"Enno Schmidt,&nbsp;Marta Ferrer Puga,&nbsp;Brian S. Kim,&nbsp;Eric L. Simpson","doi":"10.1007/s40257-026-01052-z","DOIUrl":"10.1007/s40257-026-01052-z","url":null,"abstract":"<div><p>Bullous pemphigoid, chronic spontaneous urticaria, prurigo nodularis, and chronic prurigo of unknown origin are distinct chronic skin diseases with a high disease burden and an ongoing need for safe and effective therapies. Advances in our understanding of disease mechanisms have highlighted convergent type 2-associated neuroimmune pathways that may contribute to chronic itch and skin lesions across these conditions. In bullous pemphigoid, autoantibody binding of two dermal–epidermal junction proteins followed by complement system activation shapes the local immune environment to favor T helper cell 2 polarization and perpetuation of type 2 inflammation. In chronic spontaneous urticaria, mast cell activation and downstream mediators, including type 2 cytokines, may contribute to amplification of inflammation and itch. In prurigo nodularis, chronically activated itch sensory neurons induce an itch-scratch cycle with T-cell activation in parallel to mast cell degranulation, resulting in neurogenic inflammation that sustains the itch-scratch cycle. The pathogenesis of chronic prurigo of unknown origin is not well understood, but evidence to date points to interactions between skin barrier defects and immune and neural dysregulation triggering T helper cell 2 polarization. In this review, we discuss the role of type 2 inflammation in bullous pemphigoid, chronic spontaneous urticaria, prurigo nodularis, and chronic prurigo of unknown origin, and how this understanding is currently translated into new targeted therapeutic options.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 5","pages":"859 - 877"},"PeriodicalIF":11.4,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-026-01052-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576783","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":"Updated Integrated Safety Analysis of Ritlecitinib up to ~ 5 Years in Patients with Alopecia Areata from the ALLEGRO Clinical Trial Program","authors":"Maryanne Senna,&nbsp;Sameh Hanna,&nbsp;Rie Ueki,&nbsp;Xingqi Zhang,&nbsp;Crystal Aguh,&nbsp;Bianca Maria Piraccini,&nbsp;Dalia Wajsbrot,&nbsp;Edward Nagy,&nbsp;Mojgan Sadrarhami,&nbsp;Simon Chen,&nbsp;Robert Wolk,&nbsp;Helen Tran,&nbsp;Alexandre Lejeune","doi":"10.1007/s40257-026-01062-x","DOIUrl":"10.1007/s40257-026-01062-x","url":null,"abstract":"<div><h3>Background</h3><p>Ritlecitinib, an oral Janus kinase (JAK) 3/tyrosine kinase expressed in hepatocellular carcinoma (TEC) family kinase inhibitor, demonstrated safety in patients aged 12 years and older with alopecia areata (AA) in an initial integrated analysis of 4 clinical studies for up to 2 years.</p><h3>Objective</h3><p>This updated integrated safety analysis evaluated the safety of ritlecitinib up to ~ 5 years in patients aged ≥ 12 years with AA from the ALLEGRO clinical trial program.</p><h3>Methods</h3><p>Safety data were pooled from 4 studies. Two groups were analyzed: patients who received any dose of ritlecitinib (30 mg or 50 mg with or without a 4-week 200 mg loading dose, or 10 mg daily) (“any-ritlecitinib” group) and a subset of the any-ritlecitinib group including only patients who received ritlecitinib 50 mg daily with or without a 4-week 200 mg daily loading dose (ritlecitinib 50 mg ± 200-mg group). Safety data were summarized descriptively. Proportions and incidence rates (IRs; IR/100 patient-years [PYs]) of adverse events (AEs) were evaluated.</p><h3>Results</h3><p>In the ritlecitinib 50-mg ± 200-mg (<i>N</i> = 1228) and any-ritlecitinib (<i>N</i> = 1294) groups, median duration of exposure was 1197 days (3261.5 PYs) and 1204 days (3539.5 PYs), respectively. AEs occurred in 1070 patients (87.1%; 148.1/100 PYs) in the 50-mg ± 200-mg group and 1158 patients (89.5%; 167.9/100 PYs) in the any-ritlecitinib group. The most common AEs included headache, positive SARS-CoV-2 test, and nasopharyngitis. Serious AEs were reported in 6.8% of patients (2.6/100 PYs) in the 50-mg ± 200-mg group and 6.8% of patients (2.5/100 PYs) in the any-ritlecitinib group. There were two deaths. Overall, 8.1% of patients (3.0/100 PYs) and 8.4% of patients (3.0/100 PYs) in the 50-mg ± 200-mg and any-ritlecitinib groups, respectively, had an AE that led to discontinuation from the study or study drug. IRs for both groups were 0.1/100 PYs for opportunistic infections, 1.0/100 PYs for herpes zoster, 0.3/100 PYs for malignancies (excluding nonmelanoma skin cancer), and 0.2/100 PYs for major adverse cardiovascular events.</p><h3>Conclusions</h3><p>In this updated integrated safety analysis of the ALLEGRO clinical trials, long-term ritlecitinib treatment was generally well tolerated up to ~ 5 years in patients aged ≥ 12 years with AA. The overall safety profile was consistent with previously reported data.</p><h3>Clinical Trial Registration</h3><p>NCT03732807, NCT04006457, NCT04517864, NCT02974868.</p><h3>Graphical Abstract</h3><div><figure><div><div><picture><source><img></source></picture></div></div></figure></div><h3>Video Abstract</h3>\u0000<div><div><div><iframe></iframe></div></div><div><p>Video Abstract</p><p>Updated integrated safety analysis of ritlecitinib up to ~ 5 years in patients with alopecia areata from the ALLEGRO clinical trial program (MP4 407314 KB)</p></div></div></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 5","pages":"1057 - 1070"},"PeriodicalIF":11.4,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-026-01062-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547159","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":"A Systematic Review of Factors Influencing Adult Adherence to Topical Medications in Atopic Dermatitis","authors":"Stacey N. Giuffre,&nbsp;Aditya Joshi,&nbsp;Camila R. Marquez,&nbsp;Caitlyn B. Dagenet,&nbsp;Lauren Gawey,&nbsp;Jennifer L. Hsiao,&nbsp;Vivian Y. Shi","doi":"10.1007/s40257-026-01053-y","DOIUrl":"10.1007/s40257-026-01053-y","url":null,"abstract":"<div><h3>Background</h3><p>Atopic dermatitis (AD) is a chronic inflammatory dermatosis requiring multifaceted treatment. Poor adherence to topical therapy hinders symptom management, highlighting the need to identify barriers influencing adherence among adults with AD.</p><h3>Objective</h3><p>Identify factors influencing adherence to topical therapy among adults with AD and outline strategies to improve adherence.</p><h3>Methods</h3><p>We conducted a systematic review following PRISMA guidelines and with PROSPERO registration (CRD42023488557). PubMed and EMBASE were searched in December 2023 for articles with relevant terms published from 2000 to 2023, and the search was updated in April 2025. Eligible studies reported original data on adherence to topical therapy in adults with AD and findings were categorized using the World Health Organization’s adherence dimensions.</p><h3>Results</h3><p>A total of 50 studies involving 17,124 adults across 17 countries were analyzed. Patient-related barriers included patient forgetfulness, knowledge about AD and treatment options, as well as topical corticosteroid phobia. Therapy-related factors included regimen complexity, vehicle preparation, and symptom perception. Cost and advice from family, friends, and the internet were frequent socioeconomic concerns. Healthcare system factors included clinician communication, time constraints, and inconsistent guidance. Condition-related factors including disease severity and chronicity also shaped adherence.</p><h3>Conclusions</h3><p>Topical therapy adherence among adults with AD is influenced by several modifiable barriers including patient forgetfulness, education, treatment duration, and vehicle preparation. Future work should standardize adherence measurement tools and definitions. Proposed strategies may integrate patient-centered education, simplified regimens, reminder tools, cost reduction, and strong therapeutic relationships to support sustained adherence and improve long-term outcomes.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 5","pages":"959 - 975"},"PeriodicalIF":11.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148417981","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}