The Journal of dermatological treatment最新文献

{"title":"Clinical characteristics, effectiveness, safety, and predictors of PASI75/90 responses to IL-17 biologics in psoriasis involving special sites: a large real-world cohort study revealing treatment response heterogeneity.","authors":"Fengming Hu, Xinglong Xiong, Yujie Lai, Xiaohua Tao, Lihua Zhang","doi":"10.1080/09546634.2026.2633794","DOIUrl":"10.1080/09546634.2026.2633794","url":null,"abstract":"<p><p>Psoriasis affecting special anatomical sites (scalp, face, intertriginous areas, and genitals) poses unique treatment challenges and often shows inadequate responses. This study evaluates the real-world efficacy and safety of IL-17 inhibitors in treating psoriasis affecting special sites, and identifies clinical determinants for achieving PASI75 and PASI90 responses.</p><p><p>A retrospective cohort of 1,469 patients receiving IL-17 therapy was analyzed.Generalized linear models, univariate and multivariate logistic regression analyses were used to identify clinical factors influencing the PASI75 and PASI90 response.</p><p><p>At week 12, significant improvements were observed in various measures of disease severity and quality of life (BSA, IGA, PASI, DLQI), with all comparisons yielding <i>P</i> < 0.0001. Treatment response rates were 74.0% for PASI50, 58.6% for PASI75, and 41.5% for PASI90, while adverse events were rare (0.75%). Prediction models for PASI75 and PASI90 responses exhibited moderate discriminative ability. Independent predictors for both PASI75 and PASI90 included clinical BMI, DLQI, BSA, and IGA (all <i>P</i> < 0.05), while job status was an independent predictor for PASI90 only (<i>P</i> < 0.05).</p><p><p>Overall, IL-17 inhibitors show substantial efficacy and a favorable safety profile for psoriasis in special sites, with treatment response variability influenced primarily by baseline clinical characteristics such as BMI and disease severity indices.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":"37 1","pages":"2633794"},"PeriodicalIF":3.9,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the IL-17 axis: an immunometabolic bridge between psoriasis and metabolic syndrome.","authors":"Paolo Gisondi, Zeno Fratton, Ralph Vighi da Rosa, Vittoria Bellini, Andrea Carugno","doi":"10.1080/09546634.2026.2673285","DOIUrl":"10.1080/09546634.2026.2673285","url":null,"abstract":"<p><strong>Aim of the review: </strong>Psoriasis is increasingly recognized as a systemic inflammatory disease frequently associated with a cluster of cardiometabolic comorbidities, including obesity, type 2 diabetes, and cardiovascular disease. Central to this association is the interleukin-17 (IL-17) signaling axis, a key driver of both cutaneous inflammation and systemic metabolic dysfunction.</p><p><strong>Materials and methods: </strong>This review examines the complex immunometabolic interactions mediated by IL-17 and synergistic cytokines such as TNF‑α, IL‑6, IL‑1β, IL‑23, and adipokines, which contribute to endothelial dysfunction, insulin resistance, and adipose-tissue inflammation.</p><p><strong>Results: </strong>Beyond its established role in psoriasis pathogenesis, the IL-17 pathway is implicated in the 'psoriatic march,' linking chronic skin inflammation to accelerated atherosclerosis. The advent of IL-17 inhibitors has transformed the management of moderate-to-severe psoriasis, achieving unprecedented skin clearance (PASI 90/100). Emerging evidence suggests that these agents may also exert potential beneficial effects on selected inflammatory and cardiometabolic markers. However, their direct impact on metabolic parameters remains under investigation.</p><p><strong>Conclusion: </strong>Understanding these shared molecular pathways is essential for adopting a holistic therapeutic approach that addresses both cutaneous disease and the systemic burden of psoriatic patients.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":"37 1","pages":"2673285"},"PeriodicalIF":3.9,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148140173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world effectiveness and safety of guselkumab in adult patients with facial and/or genital psoriasis: a 52-week analysis from the Italian multicentric GULLIVER study.","authors":"Claudio Bonifati, Giuseppe Argenziano, Serena Lembo, Antonio Giovanni Richetta, Marco Romanelli, Francesca Satolli, Monica Corazza, Laura Atzori, Claudia Lasagni, Concetta Potenza, Paola Savoia, Federico Bardazzi, Vito Giuseppe Di Lernia, Marco Galluzzo, Matteo Megna, Claudia Giofrè, Leonardo Zichichi, Claudio Guarneri, Sabatino Pallotta, Maria Concetta Fargnoli, Francesco Loconsole, Annamaria Offidani, Martina Burlando, Stefano Piaserico, Ketty Peris, Manuela Papini, Carlo Giovanni Carrera, Francesca Prignano, Maria Rita Bongiorno, Paolo Dapavo, Luca Stingeni, Massimo Donini, Giuseppe Micali, Franco Rongioletti, Giuseppe Stinco, Federico Saibene, Talia Gramiccia, Antonio Costanzo","doi":"10.1080/09546634.2025.2600241","DOIUrl":"10.1080/09546634.2025.2600241","url":null,"abstract":"<p><strong>Objectives: </strong>Facial and genital plaques are common manifestations of psoriasis, are challenging to treat, and significantly impact patients' quality of life (QoL).</p><p><strong>Methods: </strong>GULLIVER is a prospective, non-interventional study conducted in 2020-2023 in Italy, aimed at examining the effectiveness, safety and QoL impact of guselkumab through 52 weeks of treatment in patients with facial and/or genital psoriasis. The primary endpoint was the percentage of patients achieving a static Physician Global Assessment (sPGA) score of ≤1 and a minimum 2-grade improvement in sPGA score at Week 52.</p><p><strong>Results: </strong>Of 351 enrolled patients, 88.6% remained on guselkumab treatment at Week 52. The proportions of patients achieving the sPGA targets in the facial and genital groups, respectively, were 83.3% and 76.5% at week 12, increasing to 93.8% and 97.9% at Week 52. Mean Dermatology Life Quality Index score improved from 12.0 ± 7.5 at baseline to 1.1 ± 2.0 at Week 52 for patients with facial psoriasis (<i>p</i>-value <0.001) and from 12.0 ± 6.9 to 1.6 ± 3.5 for those with genital psoriasis (<i>p</i>-value <0.001). Guselkumab was well-tolerated and no new safety signals were identified.</p><p><strong>Conclusions: </strong>This Italian real-world study demonstrated the high effectiveness and a good safety profile of guselkumab in treating facial and genital psoriasis.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":"37 1","pages":"2600241"},"PeriodicalIF":3.9,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146128123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness and safety of phototherapy, cytotoxic agents, and biologics in adults with atopic dermatitis: real-world multicenter cohort data.","authors":"Amr Molla, Raed Jannadi","doi":"10.1080/09546634.2026.2639945","DOIUrl":"10.1080/09546634.2026.2639945","url":null,"abstract":"<p><strong>Background: </strong>Real-world comparative evidence on systemic agents, phototherapy, and biologics for atopic dermatitis (AD) remains limited.</p><p><strong>Objective: </strong>To compare 24-week effectiveness and safety of methotrexate (MTX), cyclosporine, narrowband ultraviolet B (NB-UVB) phototherapy, upadacitinib, and dupilumab in adults with AD.</p><p><strong>Methods: </strong>In this multicenter retrospective cohort (<i>N</i> = 1000; 200 per monotherapy group) across Saudi Arabia, SCORAD was extracted at baseline and mapped to prespecified weeks 2, 6, 12, and 24. Confounding was addressed using a multinomial propensity score (baseline SCORAD, age, sex, nationality) with overlap weighting; balance was assessed using Max |SMD|. Longitudinal change from baseline (ΔSCORAD) was analyzed using overlap-weighted generalized estimating equations with a treatment-by-time interaction, reporting adjusted marginal mean ΔSCORAD (95% CI).</p><p><strong>Results: </strong>Unadjusted 24-week improvement was highest with dupilumab (75.8%) and upadacitinib (74.1%) (<i>p</i> < 0.001). In overlap-weighted models, both were associated with the largest week-24 improvements (ΔSCORAD -27.04 and -26.68). NB-UVB and methotrexate were intermediate, whereas cyclosporine had smaller sustained improvement. Upadacitinib had the highest recorded adverse-event frequency (68.5%), whereas dupilumab had the lowest (9%).</p><p><strong>Conclusion: </strong>Dupilumab and upadacitinib were associated with larger 24-week SCORAD improvements than conventional systemic therapies and NB-UVB within this stratified analytic cohort. Results are associative and may be affected by residual confounding.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":"37 1","pages":"2639945"},"PeriodicalIF":3.9,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147380372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A safety checklist before initiating second-generation immunomodulating drugs for inflammatory dermatoses: a systematic review.","authors":"Stine R Haysen, Lykke Skaarup, Simon Poulsen, Tue W Kragstrup, Christian Vestergaard, Kenneth Thomsen","doi":"10.1080/09546634.2026.2665068","DOIUrl":"10.1080/09546634.2026.2665068","url":null,"abstract":"<p><strong>Background/aim: </strong>Second-generation immunomodulating drugs for inflammatory dermatoses have expanded over the past decades. Contraindications and special warnings must be considered before starting any treatment, but identifying all relevant safety information can be time-consuming. The objective is to provide an overview of contraindications, special warnings, and boxed warnings with the aim to establish a safety checklist, covering second-generation immunomodulatory therapies.</p><p><strong>Methods: </strong>We identified contraindications, special warnings and boxed warnings provided by the European Medicines Agency and the US Food and Drug Administration, for second-generation immunomodulating drugs approved for inflammatory dermatoses. Both topical and systemic therapies were included.</p><p><strong>Results: </strong>Most drug classes had warnings related to infections. Herpes zoster was listed for anti-CD20, IL-12/23i, INFi, JAKi and TYK2i, where hepatitis reactivation was reported for anti-CD20, TNFi, IL-17i, anti-BAFF, JAKi and TYK2i. Malignancy risk including skin cancer was mentioned for most classes, except IL-23i, IL-17i, IL-13i, IL-4/13i, IL-31i, IL-36i and PDE4i. Other serious warnings included neurological, cardiovascular, thrombotic, hepatic, renal, gastrointestinal, and psychiatric adverse events.</p><p><strong>Conclusion: </strong>This work provides a simple stepwise approach to managing contraindications and special warnings. Our safety checklist gives clinicians a rapid overview of contraindications, special warnings, and boxed warnings for the available drug classes approved for inflammatory dermatoses.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":"37 1","pages":"2665068"},"PeriodicalIF":3.9,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world effectiveness of abrocitinib and upadacitinib in atopic dermatitis: a propensity-matched analysis.","authors":"Ruojun Wang, Zhihui Yang, Hang Li, Yang Wang","doi":"10.1080/09546634.2026.2713289","DOIUrl":"10.1080/09546634.2026.2713289","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to compare the real-world efficacy of abrocitinib versus upadacitinib in patients with atopic dermatitis (AD).</p><p><strong>Methods: </strong>We conducted a retrospective analysis of multicenter data from the CORNERSTONE database. Patients with AD treated with abrocitinib or upadacitinib were included. Propensity score matching (PSM) was performed to balance baseline characteristics between groups.</p><p><strong>Results: </strong>After PSM, 282 patients were included in each cohort for outcome comparisons. No between-group differences in EASI-75 and EASI-90 responses were observed from week 2 through week 12. The proportion of patients achieving PP-NRS4 response was higher in the upadacitinib group than in the abrocitinib group at week 2 (<i>p</i> < 0.001). When stratified by body sites, the two medications showed comparable efficacy in skin lesion clearance across all body sites. However, patients receiving upadacitinib and abrocitinib exhibited lower EASI-75 response rates in the head and neck region than in other body regions at week 12.</p><p><strong>Conclusion: </strong>This study demonstrated that upadacitinib provided greater pruritus relief at early treatment phase compared with abrocitinib in AD patients. Additionally, selective JAK inhibitors showed a lower response rate in the head and neck region than in other body regions.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":"37 1","pages":"2713289"},"PeriodicalIF":3.9,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment priorities and unmet needs according to adults and adolescents with nonsegmental vitiligo in the United States.","authors":"Iltefat Hamzavi, Josh Coulter, Savanna Darnell, Arun Balaji, Ernest H Law, Samantha K Kurosky, Roni Adiri, Nada M Elbuluk, Stephen J Watt, Brett Hauber","doi":"10.1080/09546634.2026.2645479","DOIUrl":"10.1080/09546634.2026.2645479","url":null,"abstract":"<p><strong>Objectives: </strong>Understanding patient priorities in nonsegmental vitiligo is essential for developing therapies that address unmet needs. This study used a modified Outcome-Driven Innovation approach to quantify unmet need by considering patients' perspectives on the importance of, and their satisfaction with, treatment attributes.</p><p><strong>Methods: </strong>A cross-sectional survey of 522 patients with nonsegmental vitiligo in the United States quantified the relative importance participants placed on 26 treatment attributes. Participants also rated their satisfaction with how well available treatments performed on those attributes. K-means clustering was used to segment participants based on priorities.</p><p><strong>Results: </strong>Three segments, focusing on efficacy, administration and dosing, or safety, were identified. The two most underserved attributes, identified by >10% of participants as important for which satisfaction was low, were improvement in emotional well-being from repigmentation (15.6% of participants) and access to systemic therapy (15.1% of participants). Participants with ≥5% body surface area affected, including the face, more often identified efficacy and systemic treatment that targets the entire body as unmet needs than did those reporting facial involvement only.</p><p><strong>Conclusions: </strong>These findings highlight substantial unmet needs in nonsegmental vitiligo treatment, underscoring the importance of developing systemic therapies that align with patients' priorities to deliver meaningful repigmentation that improves emotional well-being.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":"37 1","pages":"2645479"},"PeriodicalIF":3.9,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147501273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should we be monitoring patients on systemic dermatologic therapies for psychiatric adverse effects?: a proposed clinical framework.","authors":"Nina Modanlo, Mohnish Alishala, Hira Ghani, Sasha Ghofrani, Mohammad Jafferany","doi":"10.1080/09546634.2026.2734960","DOIUrl":"https://doi.org/10.1080/09546634.2026.2734960","url":null,"abstract":"<p><strong>Objectives: </strong>Systemic therapies have transformed dermatologic practice by providing effective treatment for several conditions, including autoimmune diseases, inflammatory disorders, and severe cutaneous emergencies. Despite their therapeutic benefits, these agents may cause psychiatric adverse effects that complicate clinical management.</p><p><strong>Methods: </strong>We conducted an initial literature review synthesizing psychiatric adverse effects of systemic dermatologic medications-including corticosteroids, immunosuppressants, Janus kinase inhibitors, antihistamines, antimalarials, dapsone, isotretinoin, and biologics-and proposed a clinical framework for the screening and monitoring of these complications.</p><p><strong>Results: </strong>Psychiatric adverse effects vary across systemic therapies. Corticosteroids are associated with mood disturbances, psychosis, and delirium, with psychiatric symptoms occurring in nearly 20% of patients receiving high-dose therapy. Isotretinoin remains controversial because of its potential association with depression and suicidality. Other systemic agents have been reported to cause a range of neuropsychiatric effects, although the frequency and strength of evidence differ among medications.</p><p><strong>Conclusions: </strong>Overall, psychiatric adverse effects represent an important consideration in the use of systemic dermatologic therapies. Awareness of these potential complications, coupled with appropriate screening and monitoring, is essential for early recognition and effective management. Improved understanding of medication-related psychiatric effects can help dermatologists optimize treatment outcomes while enhancing patient safety.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":"37 1","pages":"2734960"},"PeriodicalIF":3.9,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of optimal disease control in atopic dermatitis with abrocitinib: a real-world study.","authors":"Andrea Isabel Rodriguez-Sanna, Jorge Alonso Suárez-Pérez, Juan Luis Sanz-Cabanillas, Carolina Vila-Sava, Julia Castro-Martín, Enrique Herrera-Acosta, Salvador Arias-Santiago, Trinidad Montero-Vilchez","doi":"10.1080/09546634.2026.2672801","DOIUrl":"10.1080/09546634.2026.2672801","url":null,"abstract":"<p><strong>Objectives: </strong>Abrocitinib is approved for moderate-to-severe atopic dermatitis (AD); however, real-world data evaluating its efficacy in AD control using multidimensional-treatment-targets like optimal-disease-control (ODC) and moderate-disease-control (MDC) remain limited. This study aimed to assess the proportion of patients with moderate-to-severe AD achieving ODC and MDC during abrocitinib-treatment and to explore associated factors.</p><p><strong>Materials and methods: </strong>Retrospective multicentric study including patients with moderate-to-severe AD receiving abrocitinib across five hospitals. Disease severity was assessed using clinician-reported-outcomes (EASI, SCORAD, IGA, BSA) and patient-reported-outcomes (peak-pruritus and sleep-disturbance NRS) at baseline and follow-ups. ODC and MDC were defined according to consensus-based criteria, integrating clinician- and patient-reported outcomes.</p><p><strong>Results: </strong>Fifty-four patients were included (35.1 years; 68.5% men; baseline EASI 25.7 and peak-pruritus NRS 7.5). At final visit (variable follow-up across patients; mean 20.9 weeks), EASI and peak-pruritus NRS decreased to 8.7 and 3.3, respectively. ODC was achieved by 43.8% of patients and MDC by 59.4%. ODC was associated with lower baseline BSA and SCORAD, lower prevalence of allergic conjunctivitis, fewer prior systemic treatments, and less frequent facial involvement.</p><p><strong>Conclusions: </strong>In real-world practice, a substantial proportion of patients treated with abrocitinib achieved ODC and MDC. Lower baseline severity and fewer prior systemic therapies were associated with ODC.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":"37 1","pages":"2672801"},"PeriodicalIF":3.9,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148298105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recalcitrant tinea infections due to Trichophyton indotineae in the United States (2025-2026): a retrospective case series identified by real-time PCR.","authors":"","doi":"10.1080/09546634.2026.2672810","DOIUrl":"10.1080/09546634.2026.2672810","url":null,"abstract":"","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":"37 1","pages":"2672810"},"PeriodicalIF":3.9,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}