American Journal of Clinical Dermatology最新文献

{"title":"Defining Moderate Disease and Progression in Hidradenitis Suppurativa: An Expert Framework to Unlock the Window of Opportunity for Prompt Treatment","authors":"Antonio Martorell,&nbsp;John R. Ingram,&nbsp;Christopher J. Sayed,&nbsp;Falk G. Bechara,&nbsp;Martina L. Porter,&nbsp;Thrasyvoulos Tzellos,&nbsp;Haley B. Naik,&nbsp;Brian Kirby,&nbsp;Kelsey R. van Straalen,&nbsp;John W. Frew,&nbsp;Ivette Alarcon,&nbsp;Valeria Jordan M.,&nbsp;Amit Garg","doi":"10.1007/s40257-026-01011-8","DOIUrl":"10.1007/s40257-026-01011-8","url":null,"abstract":"<div><p>The concept of a therapeutic window of opportunity, defined as the period from symptom onset during which treatment initiation yields the most favorable patient outcomes, is applied in routine clinical practice across a range of inflammatory conditions. It has become an increasingly important area of interest in hidradenitis suppurativa (HS), a disease in which recurrent inflammation and accumulating damage can lead to irreversible destruction of skin architecture. Biologic therapies, aiming to suppress the inflammatory burden and prevent disease progression, are currently only permitted in moderate to severe HS. However, as there is no consensus definition of moderate disease, physicians may face uncertainty about when to consider or switch biologic therapy. To identify the boundaries of the window of opportunity within HS, global HS experts have developed frameworks for defining moderate HS and disease progression. It is proposed that prompt medical treatment should be administered to patients with moderate HS, defined as patients with inadequate control of HS symptoms on conventional therapies, or one inflamed skin tunnel (draining/non-draining), or four or more inflammatory lesions (including inflammatory nodules and abscesses) involving two or more anatomic areas. Furthermore, the proposed definition for disease progression is the development of one or more new tunnel(s) and/or the extension of existing tunnels, or development of one or more persistent HS lesions in an anatomical region not previously affected, or any increase in the number of persistent HS lesions in an affected anatomical region. The proposed frameworks aim to provide practical advice to physicians and support targeting the window of opportunity during routine clinical practice.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 2","pages":"217 - 226"},"PeriodicalIF":8.8,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-026-01011-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389229","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":"Mastering the Use of Systemic JAK Inhibitors for Atopic Dermatitis: A Dermatologist's Practical Guide","authors":"Ahmad Jalili,&nbsp;Sofia Labbouz,&nbsp;Melinda Gooderham,&nbsp;Michael Ziv,&nbsp;Roni P. Dodiuk-Gad","doi":"10.1007/s40257-025-00998-w","DOIUrl":"10.1007/s40257-025-00998-w","url":null,"abstract":"<div><p>Atopic dermatitis (AD) is one of the most frequent conditions treated by dermatologists. The therapeutic options for moderate-to-severe AD are rapidly expanding with the introduction of biologics and Janus kinase inhibitors (JAKis). There are currently three oral JAKis approved for the treatment of AD, namely abrocitinib, baricitinib and upadacitinib. Although JAKis are rapidly effective for treating AD and its symptoms, they require careful patient selection and monitoring due to a side-effect profile which includes an increased risk of major adverse cardiovascular events (MACE) and malignancies, especially in patients with pre-existing risk factors. The aim of this article is to provide practical recommendations on how to prescribe, monitor and manage potential adverse reactions of systemic JAKis for AD, and to assist dermatologists in navigating various scenarios that can be encountered in clinic.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 2","pages":"247 - 260"},"PeriodicalIF":8.8,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-025-00998-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343521","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":"Skin Cancer in Solid Organ Transplant Recipients: A Review","authors":"Milan van Ammers,&nbsp;Alvin H. Chong","doi":"10.1007/s40257-026-01016-3","DOIUrl":"10.1007/s40257-026-01016-3","url":null,"abstract":"<div><p>Solid organ transplant recipients (SOTRs) experience a significantly elevated risk of skin cancer, primarily due to the immunosuppressive and carcinogenic effects of anti-rejection medications. Both incidence and mortality are substantially higher than in the general population, necessitating a tailored approach to prevention, surveillance and management. This comprehensive review synthesises the field of transplant dermatology and highlights key advancements. Recent epidemiological studies are explored, comparing incidence rates with those in the general population and other immunosuppressed groups. We also review the significance of risk factors, including those shared with the general population and those unique to SOTRs. Current prevention strategies are discussed, with a focus on the evidence behind chemoprophylactic agents. We also summarise current guidelines regarding screening and management of skin cancer in SOTRs. While the general approach to skin cancer in SOTRs has remained similar over the past decades, a broad range of consensus statements are now available, providing clearer guidance for clinicians managing these high-risk patients.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 2","pages":"329 - 347"},"PeriodicalIF":8.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147321210","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 Matched Pairs Analysis of GLP-1 Receptor Agonists in Hidradenitis Suppurativa","authors":"Thao Lam,&nbsp;Jeffrey N. Li,&nbsp;Hadar Lev-Tov","doi":"10.1007/s40257-026-01014-5","DOIUrl":"10.1007/s40257-026-01014-5","url":null,"abstract":"","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 2","pages":"411 - 413"},"PeriodicalIF":8.8,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147281832","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":"Radiotherapy-Induced Skin Fibrosis: Pathophysiology, Emerging Therapeutics, and the Role of Dermatology","authors":"Olivia M. Burke,&nbsp;Sophie M. Bilik,&nbsp;Caroline Dodson,&nbsp;Jordan Johnson,&nbsp;Lina Ferrari,&nbsp;Karina Imisheva,&nbsp;Hannah Pachalis,&nbsp;Victoria Rose Frerichs,&nbsp;Angela Jeffrey,&nbsp;Andrew P. Sawaya,&nbsp;Stuart E. Samuels,&nbsp;Rivka C. Stone","doi":"10.1007/s40257-026-01007-4","DOIUrl":"10.1007/s40257-026-01007-4","url":null,"abstract":"<div><p>Radiotherapy-induced skin fibrosis is a chronic progressive complication of radiotherapy that impairs function, aesthetics, and quality of life yet remains under-recognized and undertreated. While acute cutaneous toxicities are typically transient, chronic sequelae such as fibrosis, lymphedema, atrophy, telangiectasia, and dyspigmentation reflect uncontrolled tissue remodeling driven by sustained inflammation and fibroblast activation. Ionizing radiation generates reactive oxygen species that initiate vascular and epithelial injury, trigger immune infiltration, and perpetuate a cycle of transforming growth factor-β-driven myofibroblast differentiation, epithelial-to-mesenchymal transition, extracellular matrix deposition, and epigenetic reprogramming. Predicting and grading radiotherapy-induced skin fibrosis remains difficult: physician-reported scales lack sensitivity, and emerging imaging modalities and candidate tissue biomarkers require validation. Therapeutic strategies include pentoxifylline with vitamin E, oral statins, corticosteroids, fractional CO₂ and pulsed dye lasers, autologous fat grafting with adipose-derived stem cells, and manual therapies, each with varying efficacy. Investigational approaches such as deferoxamine, microneedling, and mesenchymal stem cell-based interventions show antifibrotic and regenerative potential, while candidate therapies including topical statins, antioxidants, timolol, tamoxifen, and colchicine remain untested. Despite the rising burden among cancer survivors, many patients do not receive a dermatologic evaluation, and consensus guidelines are limited. Dermatology should lead multi-modal efforts to integrate systemic, topical, and procedural interventions, develop standardized diagnostic frameworks, validate biomarkers, and conduct skin-specific clinical trials. Greater involvement of dermatologists in survivorship care, early referral, and advocacy for policy and funding will be essential to address radiotherapy-induced skin fibrosis and improve patient outcomes.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 2","pages":"297 - 316"},"PeriodicalIF":8.8,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-026-01007-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269501","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":"Androgenetic Alopecia in Women: A Narrative Review of Pathophysiology, Clinical Evaluation, and Treatments","authors":"Caitlin A. Kearney,&nbsp;Anna L. Brinks,&nbsp;Carli Needle Lawrence,&nbsp;Derek E. Maas,&nbsp;Archie J. Spindler,&nbsp;Christina Coric,&nbsp;Liezel A. Gener-Pangilinan,&nbsp;Miguel Antonio Lasheras-Pérez,&nbsp;Jerry Shapiro,&nbsp;Kristen I. Lo Sicco","doi":"10.1007/s40257-026-01009-2","DOIUrl":"10.1007/s40257-026-01009-2","url":null,"abstract":"<div><p>Androgenetic alopecia (AGA) affects nearly 50% of women during their lifetime, representing the most prevalent form of chronic hair loss in this population. Despite its high incidence, AGA in women remains underdiagnosed and undertreated, with significant psychosocial consequences including diminished self-esteem, impaired social functioning, and reduced quality of life that often exceed impacts observed in men. AGA pathophysiology involves complex interactions between hormonal, genetic, and environmental factors. Androgens promote follicular miniaturization through progressive shortening of the anagen phase, while estrogens may provide protective effects. Genetic studies reveal sex-specific differences in disease mechanisms, and environmental factors like oxidative stress and pollution may contribute to disease progression. Clinical evaluation requires careful consideration of differential diagnoses including chronic telogen effluvium, diffuse alopecia areata, and scarring alopecias. Diagnostic tools include trichoscopy, pull testing, and trichometric measurements to assess hair density and miniaturization patterns. Currently, topical minoxidil is the only FDA-approved treatment for female AGA, also referred to as female pattern hair loss (FPHL). Off-label therapies include low-dose oral minoxidil, anti-androgens such as spironolactone and 5-alpha reductase inhibitors (finasteride and dutasteride), and hair transplantation. Adjunctive treatments like low-level light therapy and platelet-rich plasma may further augment improvement and are often best used in conjunction with medical therapies. Critical research gaps persist, including the paucity of randomized controlled trials for AGA that include female patients. There is an urgent need for additional FDA-approved therapies for AGA in women to increase treatment access and reduce its psychosocial burden.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 2","pages":"363 - 389"},"PeriodicalIF":8.8,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225383","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":"Expert Recommendations for the Diagnosis and Management of Chronic Hand Eczema in the United States","authors":"Jonathan I. Silverberg,&nbsp;David Cohen,&nbsp;Emma Guttman-Yassky,&nbsp;Lawrence F. Eichenfield,&nbsp;Eric L. Simpson,&nbsp;April Armstrong,&nbsp;JiaDe Yu,&nbsp;Linda Stein-Gold,&nbsp;Benjamin D. Ehst,&nbsp;Wendy Smith Begolka,&nbsp;Christopher G. Bunick,&nbsp;Raj Chovatiya","doi":"10.1007/s40257-026-01008-3","DOIUrl":"10.1007/s40257-026-01008-3","url":null,"abstract":"<div><p>Chronic hand eczema (CHE) is an inflammatory skin disease localized to the hands and wrists that lasts for more than 3 months or relapses at least twice per year. The diagnosis, treatment, and management of CHE presents clinical challenges owing to its multifactorial etiology, heterogeneous presentation, and the absence of a standardized classification system. In the USA there are no specific International Classification of Disease-10 (ICD-10) diagnostic codes, which makes tracking the diagnosis and resultant treatments difficult. Topical delgocitinib is currently the only Food and Drug Administration approved medication for CHE, for patients who have not responded adequately to, or are unable to use, topical corticosteroids. This article provides an overview of the diagnostic and therapeutic considerations of CHE, while presenting practical recommendations to help improve management of the disease within the USA. Diagnostic assessments focusing on detailed patient history and physical examination are proposed, followed by a multi-step approach to treatment. The importance of both clinician, and patient, reported outcome measures are emphasized, to encompass not only disease presentation and severity, but also the impact on patient quality of life.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 2","pages":"227 - 245"},"PeriodicalIF":8.8,"publicationDate":"2026-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-026-01008-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146140913","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":"Air Pollution and Skin Diseases: A Systematic Review of Epidemiological Evidence","authors":"Nidhi Singh,&nbsp;Tamara Schikowski,&nbsp;Jean Krutmann","doi":"10.1007/s40257-026-01006-5","DOIUrl":"10.1007/s40257-026-01006-5","url":null,"abstract":"<div><h3>Background</h3><p>A growing number of epidemiological studies have suggested a causal link between air pollution and several common skin diseases. However, considerable variation in study design and heterogeneous results make it difficult for clinical dermatologists to judge the true relevance of air pollution as a risk factor for skin diseases.</p><h3>Objective</h3><p>We therefore conducted a systematic review of epidemiological studies to investigate the associations of short- and long-term exposure to ambient air pollutants with atopic dermatitis, psoriasis, urticaria, acne, melanoma skin cancer, non-melanoma skin cancer, and skin aging.</p><h3>Methods</h3><p>We systematically searched two comprehensive databases, SCOPUS and PubMed, from 1 January, 1990 to 30 April, 2025 for relevant observational studies. After screening 1393 eligible studies, 77 studies were selected. We defined the level of evidence for causality by assessing the risk of bias in such studies. Ambient air pollutants included particulate matter with an aerodynamic diameter of 10 µm or smaller, particulate matter with an aerodynamic diameter of 2.5 µm or smaller, and gaseous pollutants (nitrogen dioxide, sulfur dioxide, ozone, and carbon monoxide).</p><h3>Results</h3><p>We obtained five major results: (i) the majority of studies strongly advocated the harmful effects of air pollution on the above-mentioned skin diseases, but results across studies were heterogeneous in terms of direction and magnitude. (ii) For all skin diseases, the risk of bias assessment resulted in high risk, which was mainly observed in the domains of confounding, selection bias, and exposure assessment. Consequently, certainty in evidence or causal inference was usually low to very low. (iii) In most studies, high air pollution had a more immediate effect (same day) and lasted up to a week after exposure. (iv) The results on vulnerable subpopulations such as children, older people, or women were inconclusive. (v) Studies were mostly from the upper-middle and higher income countries.</p><h3>Conclusions</h3><p>Despite numerous epidemiological studies on air pollution and skin diseases, the overall quality of evidence is low. We encourage more longitudinal studies, such as cohort studies or panel studies, to support causality and study change in disease severity over time and improved exposure assessments, and adjustment for critical confounding factors. Importantly, more studies are needed from low- to middle-income countries and on susceptible groups who are most vulnerable to climate change.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 2","pages":"261 - 276"},"PeriodicalIF":8.8,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-026-01006-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146130827","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":"Long-Term Real-World Evaluation of Abrocitinib in Moderate-to-Severe Atopic Dermatitis Across a Diverse Patient Population in a Multi-site Hospital System","authors":"Megan Lau,&nbsp;Joseph Largen,&nbsp;Jasmine Levine,&nbsp;Ester Del Duca,&nbsp;Lillian Mo,&nbsp;Kathryn Jayne Tan,&nbsp;Daniel Liu,&nbsp;Akbobek Amangeldiyeva,&nbsp;Joel Correa da Rosa,&nbsp;Princess Edemobi,&nbsp;Benjamin Ungar,&nbsp;Emma Guttman-Yassky","doi":"10.1007/s40257-025-01004-z","DOIUrl":"10.1007/s40257-025-01004-z","url":null,"abstract":"<div><h3>Background</h3><p>Although clinical trials have demonstrated the efficacy and safety of abrocitinib in atopic dermatitis, there remains a lack of comprehensive long-term real-world studies across diverse patient populations.</p><h3>Objective</h3><p>We aimed to characterize long-term treatment responses and adverse events of abrocitinib in adults with moderate-to-severe atopic dermatitis in real-world daily practice.</p><h3>Methods</h3><p>We conducted a retrospective observational study of adults with moderate-to-severe atopic dermatitis who were treated with abrocitinib between 1 January, 2022 and 1 January, 2025 at a multi-site hospital system. Final follow-up was defined as each patient’s last documented clinic visit before 1 January, 2025. Primary outcomes were changes in clinical severity scores from baseline to the final follow-up. Secondary outcomes included 1-year clinical response rates, laboratory trends, adverse events, and treatment discontinuations.</p><h3>Results</h3><p>We identified 50 adults with moderate-to-severe atopic dermatitis (mean age 40 ± 14 years; 56% female) who had been treated with abrocitinib. Most (96%) had not responded to prior systemic therapies, including dupilumab (80%) and prednisone (36%). Clinical response improved over time: at 12–24 weeks (<i>n</i> = 33), 43.5% achieved an improvement of 75% or more in the Eczema Area and Severity Index (EASI-75) and 42.9% achieved an Investigator’s Global Assessment (IGA) 0/1; by 36–48 weeks (<i>n</i> = 18), these rates rose to 53.9% and 45.5%, respectively. After 1 year (<i>n</i> = 29), 52.6% maintained EASI-75 and 56.5% achieved IGA 0/1. Final follow-up showed significant reductions from baseline in IGA (− 48.5%), body surface area (− 60.3%), and EASI (− 58.6%) [all <i>p</i> &lt; 0.0001]. Adverse events were mild, the most common were acne (8%) and nausea (6%).</p><h3>Conclusions</h3><p>In our real-world study, adults with moderate-to-severe atopic dermatitis treated with abrocitinib had a progressive sustained clinical improvement across various races, ages, doses, disease onsets, atopic comorbidities, and body mass index ranges.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 2","pages":"401 - 410"},"PeriodicalIF":8.8,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049898","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":"Cutaneous Manifestations of Emerging Arbovirus Infections Including West Nile, Dengue, Zika, Chikungunya, Usutu, and Toscana Viruses: A Clinical Overview for Dermatologists","authors":"Franco Rongioletti,&nbsp;Francesco Drago","doi":"10.1007/s40257-025-01000-3","DOIUrl":"10.1007/s40257-025-01000-3","url":null,"abstract":"<div><p>Arboviral infections, notably those caused by West Nile virus (WNV), Dengue virus (DENV), Zika virus (ZIKV), and Chikungunya virus (CHIKV), represent a growing global health concern due to their expanding geographic distribution and evolving clinical spectrum. While systemic and neurologic complications are well recognized, cutaneous manifestations are frequently overlooked despite their diagnostic and prognostic value. These viruses, transmitted primarily by <i>Aedes</i> or <i>Culex</i> mosquitoes, share overlapping symptoms such as fever, headache, arthralgia, myalgia, and malaise but can often be distinguished by specific dermatologic features. WNV may present with a subtle truncal exanthem; DENV is characterized by flushing, petechiae, and the ‘white islands in a sea of red’ pattern; ZIKV typically is associated with a fine, pruritic maculopapular rash with palmar-plantar involvement, edema and erythema of the malar region of the face, and conjunctival injection; CHIKV frequently shows an asymptomatic or pruritic macular or maculopapular rash that can result in pigmentary changes mostly on the face and mucocutaneous involvement. Other arboviral infections such as Usutu virus (USUV) and Toscana virus (TOSV) more rarely exhibit cutaneous signs. These include transient macular or urticarial rashes, conjunctivitis, and aphthous-like ulcers on the palate during early or prodromal phases. This review synthesizes current clinical, virologic, and pathophysiologic insights into these cutaneous presentations, highlighting their diagnostic relevance, underlying mechanisms, and implications for dermatologic and interdisciplinary care. Recognizing these dermatologic signs can significantly aid early diagnosis and improve patient management in endemic and outbreak settings.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 2","pages":"349 - 361"},"PeriodicalIF":8.8,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040375","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}