American Journal of Clinical Dermatology最新文献

{"title":"Acknowledgement to Referees","authors":"","doi":"10.1007/s40257-025-01001-2","DOIUrl":"10.1007/s40257-025-01001-2","url":null,"abstract":"","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 1","pages":"1 - 3"},"PeriodicalIF":8.8,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146008502","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":"Switching from Dupilumab to Upadacitinib in Adults and Adolescents with Moderate-to-Severe Atopic Dermatitis After Inadequate Response to Dupilumab: Efficacy and Safety Results from Period 2 of Phase 3b/4 Study (LEVEL UP)","authors":"Christopher G. Bunick,&nbsp;Nina Magnolo,&nbsp;Angela Moore,&nbsp;Masatoshi Abe,&nbsp;Xinghua Gao,&nbsp;Charles Lynde,&nbsp;Nadia Ibrahim,&nbsp;Gweneth Levy,&nbsp;Brian M. Calimlim,&nbsp;Xiaoqiang Wu,&nbsp;Yolanda Armendariz,&nbsp;Ayman Grada,&nbsp;Kilian Eyerich","doi":"10.1007/s40257-025-01003-0","DOIUrl":"10.1007/s40257-025-01003-0","url":null,"abstract":"<div><h3>Background</h3><p>Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by intense itch and eczematous skin lesions. Upadacitinib, a selective oral Janus kinase inhibitor, and dupilumab, a monoclonal antibody, are both approved treatments for moderate-to-severe AD. In period 1 of the LEVEL UP phase 3b/4 head-to-head study, upadacitinib-treated patients demonstrated higher simultaneous achievement of near complete skin clearance and little to no itch compared with dupilumab after 16 weeks of treatment in adults and adolescents with moderate-to-severe AD.</p><h3>Objective</h3><p>The objective of period 2 of the LEVEL UP study was to assess the efficacy and safety of switching from dupilumab to upadacitinib in patients with inadequate response to dupilumab.</p><h3>Methods</h3><p>Following period 1 of the LEVEL UP study, patients not achieving ≥ 75% improvement in the Eczema Area and Severity Index (EASI 75) from baseline at week 16 entered an additional 16-week extension phase (period 2). In period 2, patients receiving dupilumab were switched to upadacitinib 15 mg, with the potential to escalate to 30 mg based on clinical response. End points in period 2 included EASI 90, Worst Pruritus Numerical Rating Scale (WP-NRS) 0/1, and simultaneous achievement of both EASI 90 and WP-NRS 0/1 at week 20 and week 32.</p><h3>Results</h3><p>A total of 208 patients were switched from dupilumab to upadacitinib, entering period 2 of the study. At week 32, response rates for patients who switched were: 79.6%, 58.7%, and 19.9% achieving EASI 75, EASI 90, and EASI 100, respectively; 60.2% achieving Worst Pruritus Numerical Rating Scale improvement ≥ 4 among those with baseline WP-NRS ≥ 4; 37.0% achieving WP-NRS 0/1 among those with baseline WP-NRS &gt; 1; and 26.8% simultaneously achieving EASI 90 and WP-NRS 0/1. Clinically, meaningful outcomes were also observed at week 20. No new safety signals were identified compared with the established safety profile of upadacitinib.</p><h3>Conclusions</h3><p>The current findings suggest that switching from dupilumab to upadacitinib may be an effective treatment strategy for patients who do not meet moderate-to-optimal treatment targets with dupilumab.</p><h3>Clinical Trial Registration</h3><p>LEVEL UP (NCT05601882).</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 2","pages":"391 - 399"},"PeriodicalIF":8.8,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-025-01003-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965109","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":"Nicotinamide for Skin Cancer Chemoprevention: The Jury Was Out and Still is","authors":"Eugene Tan,&nbsp;Hywel C. Williams","doi":"10.1007/s40257-025-01005-y","DOIUrl":"10.1007/s40257-025-01005-y","url":null,"abstract":"<p>Nicotinamide has been widely promoted as a low-cost safe chemopreventive agent against non-melanoma skin cancer. A recent large retrospective study of more than 33,000 US veterans reported a 14% reduction in overall skin cancer risk and a 22% reduction in cutaneous squamous cell carcinoma with nicotinamide use, with greater benefit observed when initiated early. This critical appraisal identifies key methodological limitations of that study, including unmeasured confounders, immortal time bias, exposure misclassification, flexible analytical modelling and limited external validity. The findings are discussed in the context of two recent systematic reviews (2022 and 2023) to provide a balanced appraisal of the evidence and clarify whether nicotinamide should be recommended in routine practice. Current evidence does not yet confirm the chemopreventive efficacy of nicotinamide. Caution is warranted before its widespread clinical adoption—the jury, as it stands, is still out.</p>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 2","pages":"209 - 215"},"PeriodicalIF":8.8,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-025-01005-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931404","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":"Emerging Treatments in Pemphigus: Is Healing an Achievable Goal?","authors":"Barbara Horváth,&nbsp;Marjolein A. J. Hiel,&nbsp;Anne-Lise Strandmoe,&nbsp;Joost M. Meijer","doi":"10.1007/s40257-025-01002-1","DOIUrl":"10.1007/s40257-025-01002-1","url":null,"abstract":"<div><p>Pemphigus is a group of rare autoimmune blistering disorders affecting the skin and mucosal surfaces, caused by pathogenic immunoglobulin G (IgG) autoantibodies targeting desmosomal cadherins, specifically desmoglein-1 and desmoglein-3, which are key components of desmosomes. There are two main forms of pemphigus: pemphigus vulgaris (PV) and pemphigus foliaceus (PF), with PV being the most common. Pemphigus can be life-threatening owing to the progressive loss of the epidermal and epithelial barrier function. However, the introduction of rituximab, an anti-CD20 monoclonal antibody, has significantly improved treatment outcomes in pemphigus. This review provides a comprehensive overview of the current treatment landscape for pemphigus, highlighting both established and emerging therapeutic approaches.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 2","pages":"317 - 327"},"PeriodicalIF":8.8,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145848794","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":"Past, Present, and Future of Sodium Hypochlorite in Dermatology: A Scoping Review","authors":"Christy H. Chang,&nbsp;Maura Devine,&nbsp;Deborah Woo,&nbsp;Theresa Hopkins,&nbsp;Tiago Torres,&nbsp;Raj Chovatiya","doi":"10.1007/s40257-025-00999-9","DOIUrl":"10.1007/s40257-025-00999-9","url":null,"abstract":"<div><h3>Background</h3><p>For over a century, dilute sodium hypochlorite (NaOCl), historically recognized as the antiseptic component of bleach, has been well established in wound care, primarily owing to its broad antimicrobial activity and ability to penetrate soft tissue and necrotic debris. NaOCl has been increasingly utilized and studied in clinical dermatology owing to its broad ranging antimicrobial, skin healing, and more recently described anti-inflammatory properties.</p><h3>Objectives</h3><p>This scoping review (Open Science Network; osf.io/6hyru) synthesizes current evidence of NaOCl’s applications in skin care, highlighting mechanistic insights, clinical trends, and knowledge gaps.</p><h3>Methods</h3><p>A comprehensive search of PubMed, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov was conducted from inception through November 2024. This review was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines.</p><h3>Results</h3><p>From 6959 deduplicated records, 222 studies published between 1915 and 2024 were identified for final inclusion. Four key clinical themes for NaOCl use emerged upon analysis of these publications: antimicrobial properties (<i>n</i> = 57), wound care (<i>n</i> = 64), eczematous skin disease (<i>n</i> = 78), and noneczematous inflammatory skin conditions (<i>n</i> = 23). NaOCl exhibits broad-spectrum activity against various organisms, notably <i>Staphylococcus aureus</i> and <i>Pseudomonas aeruginosa</i>, contributing to its effectiveness in treating chronically infected burns, ulcers, and other wounds. Limited studies also suggest NaOCl’s potential role in modulating critical processes that support wound repair. In addition, the anti-inflammatory effects of NaOCl have supported its utility in treating eczematous and noneczematous skin disorders.</p><h3>Conclusions</h3><p>Current literature provides broad and extensive evidence supporting NaOCl’s role in wound-healing, antimicrobial, and anti-inflammatory activity. However, considerable heterogeneity exists in recommended concentrations, preparation methods, and usage instructions across studies. There is a need for more randomized controlled trials and standardized protocols to better define the efficacy, safety, and optimal use of NaOCl in dermatologic practice.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 3","pages":"415 - 463"},"PeriodicalIF":8.8,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-025-00999-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145803009","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":"Nutrition and Psoriasis: The Latest Evidence and How to Approach Nutrition in Clinical Practice","authors":"Andrea Leung,&nbsp;Allison Kranyak,&nbsp;Georgia Marquez-Grap,&nbsp;Tina Bhutani","doi":"10.1007/s40257-025-00992-2","DOIUrl":"10.1007/s40257-025-00992-2","url":null,"abstract":"<div><p>Psoriasis is a chronic immune-mediated skin condition that is associated with cardiovascular disease, obesity, and other comorbidities. While highly linked to genetics, psoriasis is also significantly impacted by environmental and lifestyle factors. Nutrition and diet are areas of considerable interest for patients, providers, and researchers alike, as patient diets may have a significant impact on disease activity and severity. Diet is also a major modifiable lifestyle factor that patients are empowered to explore and optimize in the management of their psoriasis. In this Therapy in Practice, we summarize the most up-to-date research on various diets proposed to have benefits for patients with psoriasis and conclude with a discussion on how providers may integrate nutrition into clinical practice. The Mediterranean diet emphasizes whole fruits, vegetables, grains, and healthy fats. Given the anti-inflammatory effects and cardiovascular benefits of the Mediterranean diet, it is a good option for patients with psoriasis. A low-calorie diet is often recommended for individuals who are overweight or obese, and there is a strong association between obesity and psoriatic disease activity and progression. For patients with a diagnosis of celiac disease or seropositivity of immunoglobulin A or immunoglobulin G antigliadin antibodies, a gluten-free diet could be beneficial in reducing psoriasis severity. Diet can have a significant role in the management of psoriasis, and patients and providers should work collaboratively to create a sustainable, safe, and effective diet.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 1","pages":"9 - 16"},"PeriodicalIF":8.8,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-025-00992-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712951","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":"Menopause and Common Dermatoses: A Systematic Review","authors":"Katie Roster,&nbsp;Lauren Fleshner,&nbsp;Turkan Banu Karatas,&nbsp;Anna Ecanow,&nbsp;Alyssa Sayegh,&nbsp;Banu Farabi,&nbsp;Shoshana Marmon","doi":"10.1007/s40257-025-00994-0","DOIUrl":"10.1007/s40257-025-00994-0","url":null,"abstract":"<div><h3>Background</h3><p>Menopause is a universal physiological transition, marked by a decline in estrogen, which has important effects on skin and mucosal health. The impact of menopause and menopausal hormone therapy (MHT) on chronic dermatoses remains incompletely defined.</p><h3>Objective</h3><p>The aim was to investigate the relationship between menopause, MHT, and common dermatological conditions.</p><h3>Methods</h3><p>PubMed, Embase, and Web of Science were searched from inception to September 2024 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies evaluated menopause or MHT in relation to alopecia, psoriasis, acne, rosacea, melasma, and hidradenitis suppurativa (HS). Investigational cohorts largely consisted of menopausal women, although participant characteristics varied. Data on study design, population, hormonal status, and dermatological outcomes were extracted and synthesized.</p><h3>Results</h3><p>A total of 40 studies met inclusion criteria. Alopecia, particularly frontal fibrosing alopecia (FFA) and female pattern hair loss (FPHL), showed the strongest postmenopausal associations, with most cases presenting after menopause and earlier or surgical menopause conferring greater risk. Psoriasis frequently persisted or worsened after menopause, though objective assessments are limited. Acne and rosacea generally improved, whereas melasma showed mixed outcomes, including greater extra-facial involvement post menopause. HS responses to menopause were inconsistent. MHT was linked to increased risk of FFA and rosacea, whereas findings for other dermatoses were more variable or absent. Most of the studies involved MHT formulations that are less commonly used in current clinical practice.</p><h3>Conclusion</h3><p>Menopause influences the onset and course of several chronic dermatoses, while data on MHT remain more limited and inconsistent. Dermatologists should consider menopausal status and hormone therapy exposure when evaluating skin disease. Longitudinal, dermatology-focused studies—particularly those integrating diverse populations and updated hormone therapies—are needed to inform individualized care.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 1","pages":"67 - 84"},"PeriodicalIF":8.8,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-025-00994-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660001","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":"Cardiovascular Imaging in Psoriasis: A Critical Review of Current Evidence, Techniques, and Therapeutic Implications","authors":"Jacopo Tartaglia,&nbsp;Monica Ponzano,&nbsp;Roberto Mazzetto,&nbsp;Alvise Sernicola,&nbsp;Christian Ciolfi,&nbsp;Francesco Tona,&nbsp;Stefano Piaserico","doi":"10.1007/s40257-025-00996-y","DOIUrl":"10.1007/s40257-025-00996-y","url":null,"abstract":"<div><p>Psoriasis is a systemic inflammatory disease increasingly recognized for its association with elevated cardiovascular risk, driven by immune-mediated endothelial dysfunction and accelerated atherosclerosis. Non-invasive cardiovascular imaging has consistently demonstrated a spectrum of subclinical abnormalities in patients with moderate-to-severe psoriasis, including coronary microvascular dysfunction, high-risk plaque burden, vascular inflammation, myocardial remodeling, and increased arterial stiffness. This critical review summarizes the role of different imaging modalities in detecting psoriasis-associated cardiovascular alterations and evaluates emerging data on the impact of systemic therapies. Imaging abnormalities in psoriasis often precede clinical events and can support early risk reclassification and referral. Biologic therapy is associated with improved coronary microvascular function and with reductions in noncalcified plaque burden and high-risk plaque features on coronary computed tomography angiography (CCTA), and statins reduce vascular ¹⁸F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) in psoriasis cohorts. Outcome data that link these imaging changes to reduced events remain limited. Imaging should be used selectively, with coronary calcium scoring or carotid ultrasound for risk refinement in asymptomatic adults and targeted CCTA or transthoracic echocardiography (TTE) when symptoms, examination, or screening suggest cardiovascular involvement.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 1","pages":"85 - 100"},"PeriodicalIF":8.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-025-00996-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145647003","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":"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/s40257-025-00997-x","DOIUrl":"10.1007/s40257-025-00997-x","url":null,"abstract":"<div><h3>Background</h3><p>Oral Janus kinase inhibitors (JAKi) have proven effective in the treatment of atopic dermatitis (AD) in multiple clinical trials, providing rapid response, deep efficacy when given at the highest formulated dose, and in the case of abrocitinib and upadacitinib, superiority to biologics treatments in the first 4–16 weeks. However, it is unclear how this translates to real-world efficacy and safety.</p><h3>Objectives</h3><p>To assess the real-world effectiveness and safety of abrocitinib, baricitinib and upadacitinib in the treatment of AD.</p><h3>Methods</h3><p>PubMed and EMBASE were systematically searched from inception until 3 January 2025 for observational studies investigating effectiveness and safety of abrocitinib, baricitinib and upadacitinib for the treatment of AD. The primary outcomes were the proportion of patients achieving a ≥ 75% improvement in the Eczema Area and Severity Index (EASI-75) following treatment with abrocitinib, baricitinib or upadacitinib after 12 and 16 weeks. Secondary outcomes included the proportion of patients achieving EASI-50, EASI-90 and the proportion of patients experiencing adverse events (AE). Tertiary outcomes included the Dermatology Life Quality Index (DLQI) and the Peak-Pruritus Numerical rating scale (PP-NRS).</p><h3>Results</h3><p>A total of 63 studies including 517 patients treated with abrocitinib (50 mg [0.2%], 100 mg [50.9%], 200 mg [34.2%], mixed/unknown [14.7%]), 574 with baricitinib (2 mg [14.8%], 4 mg [71.9%], mixed/unknown [13.3%]) and 2779 with upadacitinib were included (15 mg [46.6%], 30 mg [33.3%], mixed/unknown [20.0%]). Most studies reported outcomes for doses combined. Across all doses, the proportion of patients achieving EASI-75 and -90 was 75% and 38% for abrocitinib, 51% and 24% for baricitinib and 83% and 55% for upadacitinib after 16 weeks, respectively. Acne and herpes simplex virus (HSV) were frequently reported across all doses of abrocitinib (21%, 2%), baricitinib (8%, 6%) and upadacitinib (15%, 6%), but patients treated with 100 mg abrocitinib and 30 mg upadacitinib reported the highest prevalence of acne and HSV, respectively. Few studies reported serious AEs across all treatments and doses.</p><h3>Conclusions</h3><p>Data from real-world studies of JAKis in AD show effectiveness and safety similar to clinical trials using the highest treatment doses. It is important to be aware of HSV and acne risk as these AEs are the most common reasons for discontinuation. Interpretation of results was complicated by the lack of studies reporting dosage information.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 1","pages":"49 - 66"},"PeriodicalIF":8.8,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145601666","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":"Perioperative Systemic Therapy for High-Risk Cutaneous Squamous Cell Carcinoma","authors":"Kelly M. Kimball,&nbsp;Rachel E. Politi,&nbsp;Kathryn T. Shahwan","doi":"10.1007/s40257-025-00995-z","DOIUrl":"10.1007/s40257-025-00995-z","url":null,"abstract":"<div><p>The incidence of cutaneous squamous cell carcinoma (CSCC) is on the rise. While the majority of cases are curable with surgery alone, the burden of high-risk tumors that require additional therapies is increasing. While systemic therapy has long been used to treat locally advanced and metastatic CSCC, immunotherapy is a more recent advancement, and use of neoadjuvant and adjuvant systemic therapy in the perioperative setting is an area of ongoing study. While chemotherapy, epidermal growth factor inhibitors, and chemoradiation have all been studied in the perioperative setting, the response is highly variable, and side effects are common. Immunotherapy, in particular programmed cell death protein/ligand-1 inhibitors, have revolutionized treatment of advanced CSCC. Cemiplimab and pembrolizumab have been studied for neoadjuvant and adjuvant use, and atezolizumab for neoadjuvant use. Cemiplimab has shown the most promise, with a 64–75% major or complete pathologic response rate in the neoadjuvant setting, and significantly improved recurrence, metastasis, and disease-free survival rates over placebo in the adjuvant setting. While neoadjuvant and adjuvant immunotherapy has evolved as a promising treatment option for high-risk CSCC, several questions remain unanswered and are subject to ongoing research. This includes investigating optimal treatment regimens, duration, and timing; developing methods to better predict and identify responders; establishing long-term outcomes and safety data; and carrying out further studies in special populations such as organ transplant recipients.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"27 1","pages":"137 - 143"},"PeriodicalIF":8.8,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145538127","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}