American Journal of Clinical Dermatology最新文献

{"title":"Understanding the Clinical Spectrum of the Cutaneous and Acute Hepatic Porphyrias","authors":"Toan N. Vu,&nbsp;Sahithi Talasila,&nbsp;George M. Jeha,&nbsp;Umer Nadir,&nbsp;Tasneem F. Mohammad,&nbsp;Henry W. Lim,&nbsp;Ivo Abraham,&nbsp;Daniel Grove,&nbsp;Stanislav N. Tolkachjov","doi":"10.1007/s40257-026-01046-x","DOIUrl":"10.1007/s40257-026-01046-x","url":null,"abstract":"<div><p>Porphyrias are rare metabolic disorders caused by inherited or acquired enzymatic defects in the heme biosynthesis pathway, resulting in the accumulation of heme precursors or toxic porphyrin intermediates. The cutaneous porphyrias arise from enzymatic defects in later steps of the heme biosynthesis pathway, which lead to the build-up of photoactive porphyrins in the skin and liver, such as coproporphyrins, protoporphyrins, and uroporphyrins. These photoactive porphyrins generate reactive oxygen species that drive the characteristic cutaneous manifestations, including painful photosensitivity, skin fragility, and blistering. The cutaneous porphyrias encompass both blistering and non-blistering subtypes, which include erythropoietic protoporphyria, X-linked protoporphyria, congenital erythropoietic porphyria, porphyria cutanea tarda, and hepatoerythropoietic porphyria, each distinguished by specific biochemical patterns and clinical features. Acute hepatic porphyrias, which include acute intermittent porphyria, variegate porphyria, hereditary coproporphyria, and aminolevulinic acid dehydratase deficiency porphyria, result in the accumulation of neurotoxic precursors, such as δ-aminolevulinic acid and porphobilinogen. While acute neurovisceral attacks predominate in acute hepatic porphyrias, certain subtypes, such as variegate porphyria and hereditary coproporphyria, may present with blistering photosensitivity, creating a significant diagnostic overlap between cutaneous porphyrias and other photodermatoses. This overlap underscores the importance of awareness of acute hepatic porphyrias among dermatologists, who may be the first clinicians to encounter patients with these disorders. In addition, recent treatment breakthroughs will likely bring patients with porphyrias to pursue care, changing the likely underestimated disease prevalence rates. This narrative review provides a comprehensive overview of the pathobiology, clinical features, diagnostic strategies, and management approaches for the cutaneous and acute hepatic porphyrias.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 4","pages":"745 - 764"},"PeriodicalIF":11.4,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-026-01046-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148052082","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":"Trichophyton indotineae: Rise, Diagnosis, Treatment, and Future Directions","authors":"Victoria R. V. Cox,&nbsp;Tatiana Zuluaga,&nbsp;Aditya K. Gupta,&nbsp;Shari R. Lipner,&nbsp;Ditte Marie Lindhardt Saunte,&nbsp;Pietro Nenoff,&nbsp;Eran Galili,&nbsp;Ananta Khurana,&nbsp;Boni Elewski,&nbsp;Arnaud Jabet,&nbsp;Avrom S. Caplan","doi":"10.1007/s40257-026-01042-1","DOIUrl":"10.1007/s40257-026-01042-1","url":null,"abstract":"<div><p>Dermatophytoses (synonymous with tinea) are superficial fungal infections of the skin, hair, and nails, typically caused by dermatophytes in the genera of <i>Trichophyton</i> and <i>Microsporum</i>. Dermatophyte infections are common and are estimated to affect roughly 20–25% of the global population. Historically, tinea infections have been treated with short courses of topical and/or oral antifungal therapies, however, the last decade has seen increasing antifungal treatment failure. <i>Trichophyton (T.) indotineae</i> (previously termed <i>Trichophyton mentagrophytes</i>—genotype VIII) has emerged as the primary species driving antifungal treatment failure worldwide. Clinically, <i>T. indotineae</i> infection may present as a typical dermatophyte infection, or atypically may mimic eczema, psoriasis, or other inflammatory dermatoses. Patients are often strikingly itchy and may be using topical steroid creams inappropriately in combination with antifungal and antibiotic agents. Terbinafine, once considered a first-line oral agent for tinea infections, often fails against <i>T. indotineae</i>, for which prolonged courses of itraconazole (often at higher than typical dermatophyte dosing) are now regarded as the treatment of choice. Fluconazole and griseofulvin demonstrate limited efficacy. Antifungal susceptibility testing may guide treatment choices but is not well established for dermatophytoses. Dermatologists should be aware of an approach to evaluating and treating refractory dermatophyte infections. Increased awareness among clinicians, including in infectious diseases, primary care, and the emergency room, is also important to facilitate early recognition, appropriate management, and timely referral. Dermatologists may play a key role in promoting antifungal stewardship and educating other clinician groups about emerging dermatophyte infections. In this review, we detail <i>T. indotineae</i> with a focus on clinical presentation, diagnostic confirmation, and treatment.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 4","pages":"659 - 672"},"PeriodicalIF":11.4,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148040786","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 Tolerability of Ruxolitinib Cream in Adolescents with Mild-to-Moderate Atopic Dermatitis: Results From a 1-Year, Phase III, Open-Label Study","authors":"Joel C. Joyce,&nbsp;H. Chih-ho Hong,&nbsp;Dareen D. Siri,&nbsp;Darryl Toth,&nbsp;Howard Kallender,&nbsp;YuTzu Kuo,&nbsp;Diana Stefani-Hunyady,&nbsp;Kim A. Papp","doi":"10.1007/s40257-026-01043-0","DOIUrl":"10.1007/s40257-026-01043-0","url":null,"abstract":"<div><h3>Background</h3><p>Ruxolitinib cream (1.5%) has demonstrated efficacy and safety in patients aged ≥ 2 years with mild-to-moderate atopic dermatitis.</p><h3>Objective</h3><p>We aimed to further investigate the safety and efficacy of ruxolitinib cream in adolescents with atopic dermatitis in an open-label study.</p><h3>Methods</h3><p>Patients aged 12–17 years with atopic dermatitis, an Investigator’s Global Assessment score of 2/3, and 3–20% affected body surface area applied twice-daily 1.5% ruxolitinib cream for an 8-week continuous treatment period, followed by a 44-week long-term safety period in which ruxolitinib cream was applied twice daily as needed. Safety was the primary endpoint. Secondary endpoints included plasma trough concentrations of ruxolitinib. Affected body surface area, ≥ 75% improvement from baseline in Eczema Area and Severity Index, achievement of Investigator’s Global Assessment score of 0/1, and ≥ 4-point improvement from baseline in the itch Numerical Rating Scale were exploratory endpoints.</p><h3>Results</h3><p>Of 103 patients, 59.2% had a baseline Investigator’s Global Assessment of 3. Mean baseline body surface area and Eczema Area and Severity Index scores were 8.9% and 6.4, respectively. Over 52 weeks, 42 patients (40.8%) had treatment-emergent adverse events, most commonly upper respiratory tract infection (10.7%) and nasopharyngitis (8.7%). Three patients (2.9%) had grade ≥ 3 treatment-emergent adverse events; all were considered unrelated to treatment by the investigator. Steady-state ruxolitinib plasma concentrations during the continuous treatment period were low (geometric mean [geometric coefficient of variation], 14.2 [169] nM), consistent with the lack of observed treatment-emergent adverse events associated with systemic Janus kinase inhibition. Clinical improvements occurred during the continuous treatment period and were maintained or improved with as-needed treatment through the long-term safety period to week 52 (mean affected body surface area, 1.3%; ≥ 75% improvement from baseline in Eczema Area and Severity Index, 87.0%; Investigator’s Global Assessment 0/1, 82.6%; ≥ 4-point improvement from baseline in itch Numerical Rating Scale, 41.7%).</p><h3>Conclusions</h3><p>Ruxolitinib cream (1.5%) was well tolerated and efficacious with long-term as-needed use in adolescents with mild-to-moderate atopic dermatitis, consistent with safety and efficacy findings reported in previous phase III studies in adolescents and adults.</p><h3>Clinical Trial Registration</h3><p>Clinicaltrials.gov identifier, NCT05456529 (registered 13 July, 2022).</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 4","pages":"841 - 849"},"PeriodicalIF":11.4,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148025737","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":"Evaluating the Performance of Artificial Intelligence in Accurately Detecting Skin Cancer: An Umbrella Review of Systematic Reviews and Meta-analyses","authors":"Jae Joon Jeon,&nbsp;Hayoon Chun,&nbsp;Judith Lee,&nbsp;Hyunsoo Son,&nbsp;Changyoon Lee,&nbsp;Keeheon Lee,&nbsp;Sarah Soyeon Oh,&nbsp;Shinwon Hwang,&nbsp;Chul S. Hyun,&nbsp;Myung Ha Kim,&nbsp;Eunyoung Cho,&nbsp;Solam Lee,&nbsp;Jae Il Shin","doi":"10.1007/s40257-026-01034-1","DOIUrl":"10.1007/s40257-026-01034-1","url":null,"abstract":"<div><h3>Background</h3><p>Artificial intelligence technology is being widely developed in dermatology. However, there remains a lack of comprehensive data analyzing the diagnostic performance of artificial intelligence in skin cancer.</p><h3>Objective</h3><p>We aimed to evaluate the diagnostic accuracy of artificial intelligence in skin cancer detection.</p><h3>Methods</h3><p>MEDLINE, Embase, Cochrane library, Web of Science, and Scopus were searched from database inception to 9 April, 2025. Studies were included if they exclusively assessed the diagnostic accuracy of artificial intelligence for primary cutaneous malignancies. The artificial intelligence performance in skin cancer diagnosis was evaluated using accuracy, area under the curve value, sensitivity, and specificity.</p><h3>Results</h3><p>Twenty-eight systematic reviews and meta-analyses were included. Across the studies, reported sensitivity ranged from 83.7 to 94.4% for basal cell carcinoma, 57.0–90.1% for squamous cell carcinoma, and 48–100% for melanoma. Specificity ranged from 77.9 to 96% for basal cell carcinoma, 92.6–98% for squamous cell carcinoma, and 36–100% for melanoma. Area under the curve values extracted from the reviews varied widely, generally ranged from 0.61 to 0.99. Narrative comparisons within the included studies suggested that deep learning models frequently demonstrated diagnostic performance non-inferior or superior to human clinicians, although prospective validation in real-world clinical workflows remains limited.</p><h3>Conclusions</h3><p>Current evidence suggests that artificial intelligence technologies have demonstrated potential for skin cancer diagnosis, but with important limitations. Variability in diagnostic metrics, driven largely by data heterogeneity and differing validation strategies, poses significant challenges. Emerging evidence suggests future research should transition toward multimodal artificial intelligence systems that integrate structured clinical metadata with image analysis. This will require methodological standardization and validation in real-world settings.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 4","pages":"709 - 724"},"PeriodicalIF":11.4,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148025685","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":"Dermatologic Toxicities Induced by JAK Inhibitors","authors":"Luca Rapparini,&nbsp;Michela Starace,&nbsp;Zoe Apalla,&nbsp;Maha El Barch,&nbsp;Antoine Delpuech,&nbsp;Sarah Baali,&nbsp;Vincent Sibaud","doi":"10.1007/s40257-026-01038-x","DOIUrl":"10.1007/s40257-026-01038-x","url":null,"abstract":"<div><p>Janus kinase inhibitors are increasingly used for the treatment of a wide range of dermatologic and non-dermatologic immune-mediated diseases, leading to growing interest in their safety profile, particularly with respect to cutaneous adverse events. This narrative review summarizes current evidence on dermatologic toxicities associated with both systemic and topical Janus kinase inhibitors. The most frequently reported cutaneous adverse event is an acne-like eruption, which shows a clear dose-dependent pattern and typically occurs early after treatment initiation. Cutaneous infections represent another major group of adverse events, with herpes zoster being the most clinically relevant. Less frequently, cutaneous malignancies have been reported, predominantly non-melanoma skin cancers, with a stronger signal observed in hematologic populations and in patients treated with ruxolitinib. Overall, dermatologic adverse events associated with Janus kinase inhibitors are usually manageable and rarely require permanent treatment discontinuation. Increased awareness, early recognition, and appropriate dermatologic management are essential to minimize morbidity and to support long-term treatment adherence across clinical settings.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 4","pages":"725 - 744"},"PeriodicalIF":11.4,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-026-01038-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147939851","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":"Genomics of Primary and Metastatic Cutaneous Melanoma: A Systematic Review and Meta-Analysis","authors":"Manh Duc Hoang,&nbsp;Thi Oanh Bui,&nbsp;Van Tu Dao,&nbsp;Van Quang Le,&nbsp;Céleste Lebbé,&nbsp;Guilhem Bousquet","doi":"10.1007/s40257-026-01031-4","DOIUrl":"10.1007/s40257-026-01031-4","url":null,"abstract":"<div><h3>Background</h3><p>Melanoma is an aggressive skin cancer with limited durable responses despite therapeutic advances. Comprehensive characterization of genomic alterations may improve understanding of disease progression and inform therapeutic strategies.</p><h3>Objective</h3><p>We aimed to characterize genomic alterations in cutaneous melanoma and compare mutation prevalences between primary and metastatic tumors to improve therapeutic strategies.</p><h3>Methods</h3><p>We conducted a systematic review and meta-analysis of genomic data from primary and metastatic cutaneous melanomas to assess the prevalence of gene mutations and copy number alterations. Relevant studies were identified in MEDLINE and Embase up to October 2024 using the search algorithm ((Mutation) OR “Genomics”[Mesh]) AND (“Melanoma”[Mesh]). Data were synthesized using random-effects meta-analyses to estimate the pooled prevalence of gene mutations and copy number variations, with heterogeneity assessed using I² statistics. This study was reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.</p><h3>Results</h3><p>Ninety-nine publications were included, encompassing 10,386 primary cutaneous melanoma samples and 4273 metastatic samples. The most frequently mutated genes in both settings were <i>BRAF</i>, <i>TERT</i>, <i>TP53</i>, <i>NRAS</i>, and <i>NF1</i>. The prevalence of <i>BRAF</i>, <i>NRAS</i>, <i>TERT</i>, <i>CDKN2A</i>, and <i>PTEN</i> mutations was significantly higher in metastatic lesions. <i>NRAS</i> mutations were more common in central nervous system metastases than in other metastatic sites. In contrast, <i>KIT</i> mutations were more common in primary tumors. Acral melanoma exhibited a distinct molecular profile, with an overall lower mutation prevalence, particularly involving <i>BRAF</i>. Chromosomal losses at 9p21.3 and 9p21 were commonly observed in both primary and metastatic tumors, with higher prevalence in primary tumors.</p><h3>Conclusions</h3><p>Our findings highlight distinct genomic differences between primary and metastatic melanoma, underscoring the value of metastatic tumor biopsies in informing molecularly guided treatment decisions.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 5","pages":"887 - 907"},"PeriodicalIF":11.4,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-026-01031-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147939868","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":"Considerations for Genital Psoriasis Care Across Age Groups: A Modified Delphi Consensus Initiative from the Genital Psoriasis Wellness Consortium","authors":"Michael Payette,&nbsp;Tina Bhutani,&nbsp;Melodie Young,&nbsp;Muriel Boreham,&nbsp;Lucinda Whitney,&nbsp;John Koo,&nbsp;Richard Fried,&nbsp;Sandra Johnson,&nbsp;Shehla Admani,&nbsp;Jeannette Jakus,&nbsp;Tiffany Mayo,&nbsp;John G. Zampella,&nbsp;Melissa S. Seal,&nbsp;Diane Hanna,&nbsp;Krista Bohnert,&nbsp;Jennifer Cather","doi":"10.1007/s40257-026-01035-0","DOIUrl":"10.1007/s40257-026-01035-0","url":null,"abstract":"<div><h3>Background</h3><p>Genital psoriasis remains underdiagnosed and undertreated despite its substantial impact on quality of life. The sensitive nature of genital involvement contributes to diagnostic delays, patient distress, and treatment challenges. The Genital Psoriasis Wellness Consortium, a multidisciplinary panel of US-based clinicians, previously developed consensus statements on physical diagnosis, patient conversations, quality of life impacts, and treatment.</p><h3>Objective</h3><p>We aimed to build on prior work by providing additional considerations to refine best practices across three areas: physical exam and diagnosis; pediatric and adolescent treatment; and adult and geriatric treatment.</p><h3>Methods</h3><p>The panel used the modified Delphi process and nominal group technique, informed by a systematic literature review, with consensus defined as ≥ 75% agreement on a 7-point Likert scale.</p><h3>Results</h3><p>The panel emphasized routine genital assessment within comprehensive skin exams and proactive empathetic communication to reduce stigma, with verbal consent and the offer of a chaperone as standard practice. In pediatric care, shared decision making among clinicians, caregivers, and patients fosters adherence. In adults and older patients, treatment decisions should consider comorbidities, polypharmacy, and individual goals; prioritizing therapies with established safety in intertriginous areas and minimizing long-term corticosteroid use. Simple regimens and attention to access barriers were identified as important to support adherence.</p><h3>Conclusions</h3><p>These considerations aim to enhance diagnosis, optimize treatment, and improve outcomes through personalized empathetic care.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 4","pages":"803 - 818"},"PeriodicalIF":11.4,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-026-01035-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147925630","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":"High-Frequency Ultrasound in Hidradenitis Suppurativa: From Lesion Detection to Iconographic Lesion-Level Management","authors":"Cláudia Fontan,&nbsp;Antonio Martorell,&nbsp;Cláudia Elise Ferraz,&nbsp;Vanessa Lucilia Silveira de Medeiros,&nbsp;Lucas André Cavalcanti Brandão,&nbsp;Roberta Siqueira","doi":"10.1007/s40257-026-01040-3","DOIUrl":"10.1007/s40257-026-01040-3","url":null,"abstract":"<div><p>Hidradenitis suppurativa is a chronic recurrent inflammatory disease in which conventional clinical examination frequently underestimates subclinical extension and fails to distinguish between lesion types that carry different therapeutic implications. High-frequency ultrasound has emerged as a valuable adjunct, enabling detection of deep and occult disease, more granular assessment of inflammatory activity, and refined classification beyond traditional Hurley staging and the International Hidradenitis Suppurativa Severity Score System (IHS4). Over the last decade, multicenter studies and expert consensus have progressively defined high-frequency ultrasound lesion phenotypes, sonographic scoring systems, and workflow recommendations, positioning ultrasound as a practical bedside imaging tool for hidradenitis suppurativa. This Leading Article provides a concise balanced overview of high-frequency ultrasound in hidradenitis suppurativa, with an emphasis on unified lesion terminology, Doppler-based activity assessment, and an iconographic color-coded mapping strategy that links each ultrasound-defined lesion to its exact clinical location. The article highlights how such approaches can bridge communication between dermatologists, sonographers, and surgeons, support lesion-level decision making, and guide surgical planning, while also discussing current limitations, implementation barriers, and priorities for future research.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 4","pages":"673 - 682"},"PeriodicalIF":11.4,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147873054","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":"Transforming Outcomes in Advanced Basal Cell Carcinoma: The Evolving Role of Systemic Therapy","authors":"Anna A. L. Massella Patsea,&nbsp;Babette J. A. Verkouteren,&nbsp;Klara Mosterd","doi":"10.1007/s40257-026-01037-y","DOIUrl":"10.1007/s40257-026-01037-y","url":null,"abstract":"<div><p>Advanced basal cell carcinoma (aBCC) is an uncommon but severe presentation of basal cell carcinoma, including those with extensive local invasion and metastasis. Curative local treatments are often not feasible for patients with aBCC and the introduction of Hedgehog pathway inhibitors (HHIs) expanded the therapeutic landscape. First-line therapy with the HHIs, vismodegib and sonidegib, provides effective disease control, and may enable the preservation of function in locally complex cases. Also, it offers the possibility to simultaneously treat multiple tumors, such as in patients with basal cell nevus syndrome. However, long-term HHI therapy is limited by toxicity, heterogeneous responses and the emergence of resistance or tolerance. For selected patients with progression or limited tolerability under HHIs, immune checkpoint inhibition has emerged as an established second-line option, offering durable responses in a subset of patients. However, immune-related adverse events remain a concern. To address the shortcomings of systemic therapy and improve the long-term disease control of patients with aBCC, ongoing research focuses on alternative dosing strategies, integration of combination or novel systemic agents and the development of predictive biomarkers. This review provides a comprehensive, clinically oriented overview of the evidence on systemic treatment for aBCC, emphasizing efficacy, safety, resistance mechanisms, and therapeutic strategies.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 4","pages":"765 - 777"},"PeriodicalIF":11.4,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-026-01037-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147925593","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: Real-World Evidence of Effectiveness and Safety of Abrocitinib, Baricitinib and Upadacitinib in Atopic Dermatitis: A Systematic Review and Meta-Analysis","authors":"Amalie Thorsti Møller Rønnstad,&nbsp;Daniel Isufi,&nbsp;Christopher G. Bunick,&nbsp;Raj Chovatiya,&nbsp;Mia-Louise Nielsen,&nbsp;Farzad Alinaghi,&nbsp;Simon F. Thomsen,&nbsp;Christian Vestergaard,&nbsp;Andreas Wollenberg,&nbsp;Alexander Egeberg,&nbsp;Jacob P. Thyssen,&nbsp;Nikolai Loft","doi":"10.1007/s40257-026-01025-2","DOIUrl":"10.1007/s40257-026-01025-2","url":null,"abstract":"","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 4","pages":"855 - 856"},"PeriodicalIF":11.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832473","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}