The Journal of dermatology最新文献

{"title":"Refractory Psoriatic Lesions in Japanese Patients Before and After Switching Biologics.","authors":"Takayo Ando, Koji Kamiya, Megumi Kishimoto, Natsuko Sugihara, Junichi Sugai, Makiko Mieno, Mamitaro Ohtsuki, Mayumi Komine","doi":"10.1111/1346-8138.70532","DOIUrl":"https://doi.org/10.1111/1346-8138.70532","url":null,"abstract":"<p><p>Biologics can improve disease control in patients with psoriasis vulgaris (PsO) and psoriatic arthritis (PsA); however, refractory regions may persist despite biologic therapy. This study aimed to evaluate refractory anatomical regions in patients with PsO and PsA who underwent biologic switching. We retrospectively analyzed 71 biologic-switching episodes from 50 patients treated at Jichi Medical University Hospital between January 1, 2010 and December 31, 2019. Patients who underwent more than one biologic switch contributed multiple switching episodes. Refractory regions were assessed across 13 anatomical regions at the time of biological switching and at the end of the observation period. The lower extremities were the most frequently affected refractory region in both PsO and PsA, followed by the upper extremities in PsO and the scalp in PsA. Overall, the distribution of refractory regions was broadly similar before and after biologic switching. Improvement was defined as complete disappearance of a lesion that had been explicitly documented as present before biologic switching. Regions explicitly documented as lesion-free before switching were classified as non-improved, whereas regions without documentation regarding the presence or absence of a lesion before switching were excluded from the analysis. A logistic generalized linear mixed-effects model with a random intercept for switching episode was used to account for within-episode correlation among anatomical regions. The oral-to-biologic group had higher odds of documented lesion improvement than the biologic-to-biologic group (odds ratio, 2.12; p < 0.001), whereas disease subtype was not significantly associated with documented lesion improvement (PsO vs. PsA: odds ratio, 1.03; p = 0.876). These findings suggest that patients requiring biologic-to-biologic switching may represent a more treatment-refractory population. The lower extremities remained a particularly challenging anatomical region after biologic switching. Further prospective studies are warranted to clarify the factors associated with site-specific treatment response.</p>","PeriodicalId":94236,"journal":{"name":"The Journal of dermatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187180","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 Sequencing With Biologic Switching, Staged Excision, and Split-Thickness Skin Grafting for Extensive Hidradenitis Suppurativa.","authors":"Shunki Hashizumi, Ko Kagoyama, Hiroaki Ishida, Teruhiko Makino, Tadamichi Shimizu","doi":"10.1111/1346-8138.70538","DOIUrl":"https://doi.org/10.1111/1346-8138.70538","url":null,"abstract":"<p><p>Treatment of extensive multiregional hidradenitis suppurativa requires sequencing biologic therapy and surgery when active inflammation and irreversible structural disease coexist. A 58-year-old Japanese man with Hurley Stage III disease had inadequate overall control with adalimumab. At the assessment before medial-thigh surgery, the International Hidradenitis Suppurativa Severity Score System score was 48. Because he sought prompt relief from painful drainage and daily wound care, bilateral scarred and tunnel-bearing lesions were excised and reconstructed by staged split-thickness skin grafting while adalimumab was continued. Local control was achieved, but disease persisted elsewhere, prompting a switch to bimekizumab. Inflammatory lesion counts decreased, but Hidradenitis Suppurativa Clinical Response was not achieved at week 16 and extensive gluteal scars and draining tunnels remained. Bilateral gluteal excision and staged grafting were therefore performed during continued bimekizumab treatment, without postoperative infection, bleeding, or graft failure. Six months after reconstruction, the severity score was 9 and the clinical response criterion was met, reflecting both decreased inflammatory activity during bimekizumab treatment and surgical removal of structural lesions. Gluteal local control persisted through 15 months. This case illustrates sequencing biologic switching and regional surgery according to inflammatory activity, persistent structural disease, and the need for prompt symptom relief.</p>","PeriodicalId":94236,"journal":{"name":"The Journal of dermatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187196","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":"Acral Melanoma Developing at the Site of a Regressed Nevus-Like Lesion.","authors":"Tatsuro Ogiso, Yukiko Kiniwa, Asuka Mikoshiba, Shiho Shirota, Ryuhei Okuyama","doi":"10.1111/1346-8138.70534","DOIUrl":"https://doi.org/10.1111/1346-8138.70534","url":null,"abstract":"","PeriodicalId":94236,"journal":{"name":"The Journal of dermatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187167","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":"Upregulated ST2L-Dependent IL-33 Signaling in Dermal Fibroblasts Contributes to IL-6 Induction and Skin Fibrosis in Systemic Sclerosis.","authors":"Miyuki Hayashi, Katsunari Makino, Maho Ide, Narantuya Dashdemberel, Tomoka Yamashita, Shuichi Shimada, Soichiro Sawamura, Ikko Kajihara, Satoshi Fukushima","doi":"10.1111/1346-8138.70536","DOIUrl":"https://doi.org/10.1111/1346-8138.70536","url":null,"abstract":"<p><p>Persistent activation of dermal fibroblasts drives progressive skin fibrosis in systemic sclerosis (SSc), a connective tissue disease. However, the mechanisms sustaining fibroblast activation remain incompletely defined. Interleukin-33 (IL-33), an alarmin-like IL-1 family cytokine, signals via the membrane receptor ST2L along with IL1RAP to activate pathways such as NF-κB, whereas soluble ST2 (sST2) acts as a decoy. The contribution of this axis to skin fibrosis in SSc is unclear. This study was aimed at defining the expression and functional significance of IL-33/ST2L signaling in SSc dermal fibroblasts and experimental dermal fibrosis. IL-33, ST2L, sST2, and IL1RAP expression in cultured dermal fibroblasts and skin samples from patients with diffuse cutaneous SSc and healthy donors was estimated via quantitative real-time PCR and immunoblotting. In vivo relevance of the findings was assessed using a bleomycin-induced skin fibrosis model in IL-33 knockout mice, via histology (hematoxylin and eosin and Masson's trichrome staining), dermal thickness measurements, collagen quantification (Sircol assay), and IL-6 mRNA analysis. At the cellular level, causality was examined by lentiviral overexpression of ST2L in control fibroblasts and its small interfering RNA-mediated knockdown in SSc fibroblasts, with recombinant IL-33 stimulation and readouts, including IL-6 induction and IκBα phosphorylation. IL-33 and ST2L were significantly upregulated in cultured SSc fibroblasts, whereas sST2 and IL1RAP expression was unchanged. Bleomycin increased IL-33 and ST2L expression in mouse skin, and IL-33 deficiency attenuated dermal thickening, collagen accumulation, and IL-6 induction. Mechanistically, ST2L overexpression rendered control fibroblasts IL-33-responsive, inducing IL-6 and transient IκBα phosphorylation, whereas ST2L knockdown reduced basal IL-6 levels and blunted IL-33-induced IL-6 expression in SSc fibroblasts. These results indicate that elevated ST2L expression amplifies IL-33 responsiveness in SSc dermal fibroblasts and promotes IL-6 production via NF-κB signaling, implicating the IL-33/ST2L axis as a contributor to fibrotic skin remodeling and a potential therapeutic target in SSc.</p>","PeriodicalId":94236,"journal":{"name":"The Journal of dermatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187133","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":"Psychological Distress in Vitiligo Requires an Action-Linked Pathway Beyond HADS Classification.","authors":"Po-Jung Hsueh, Lien-Chung Wei","doi":"10.1111/1346-8138.70527","DOIUrl":"https://doi.org/10.1111/1346-8138.70527","url":null,"abstract":"","PeriodicalId":94236,"journal":{"name":"The Journal of dermatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187144","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":"Diagnostic Utility of Full-Length BP180 and Native BP180-α6β4 Integrin Complex ELISAs in Serologically Inconclusive Mucous Membrane Pemphigoid.","authors":"Yukiko Ishizuka, Toshiya Takahashi, Momoko Enoki, Manami Takahashi-Watanabe, Toshiki Okazaki, Takuya Takahashi, Taku Fujimura, Akira Hashimoto, Shoko Mai, Kentaro Izumi, Yoshihide Asano","doi":"10.1111/1346-8138.70529","DOIUrl":"https://doi.org/10.1111/1346-8138.70529","url":null,"abstract":"<p><p>Mucous membrane pemphigoid (MMP) is a chronic autoimmune subepithelial blistering disorder of mucosal surfaces that can cause irreversible scarring, blindness, or dysphagia. Early diagnosis is challenging because histopathology is nonspecific and conventional BP180 NC16A ELISAs have limited sensitivity. We evaluated ELISAs using full-length recombinant BP180 and a native BP180-α6β4 integrin complex in six patients with suspected oral or ocular MMP. The conventional NC16A ELISA was negative in four of six patients, and biopsy alone was often insufficient. Both assays provided useful serological support in a subset of cases when interpreted alongside direct immunofluorescence (DIF) and clinical phenotype, whereas in others DIF remained the primary basis for diagnosis. These assays can therefore complement, but not replace, clinicopathological assessment in suspected MMP.</p>","PeriodicalId":94236,"journal":{"name":"The Journal of dermatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170603","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":"Long-Term Follow-Up of Epidermolysis Bullosa Acquisita with Fluctuations in Serum Cytokine Levels: A Case Report.","authors":"Masayuki Suzuki, Naomi Nakano, Satoru Murata, Koji Kamiya, Mamitaro Ohtsuki, Mayumi Komine","doi":"10.1111/1346-8138.70519","DOIUrl":"https://doi.org/10.1111/1346-8138.70519","url":null,"abstract":"<p><p>We report a case of epidermolysis bullosa acquisita (EBA) in a 47-year-old man who suffered for more than 10 years. To evaluate the longitudinal immunological changes, we measured serum levels of anti-basement membrane zone (BMZ) IgG antibodies by indirect immunofluorescence and anti-type VII collagen antibodies by enzyme-linked immunosorbent assay throughout the clinical course. In addition, serum concentrations of B-cell activating factor (BAFF), interleukin (IL)-9, and IL-10 were measured. Titers of anti-BMZ antibodies and anti-type VII collagen antibodies fluctuated during the follow-up period and corresponded broadly with clinical disease activity. Serum BAFF levels increased before the marked elevation of anti-type VII collagen antibody titers, although they did not closely parallel disease activity. Serum IL-9 showed a transient peak around the time when the anti-type VII collagen antibody titer reached its maximum. Serum IL-10 increased after the peak of the anti-type VII collagen antibody titer. These temporal changes in BAFF, IL-9, and IL-10 observed may provide useful information for understanding the immunological phases of EBA.</p>","PeriodicalId":94236,"journal":{"name":"The Journal of dermatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168910","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":"Dermatological Needs After the 2026 Kumamoto Earthquake.","authors":"Hiromitsu Noguchi, Masahide Kubo, Yoshihiro Mimura, Kayo Kashiwada-Nakamura, Satoshi Fukushima","doi":"10.1111/1346-8138.70528","DOIUrl":"https://doi.org/10.1111/1346-8138.70528","url":null,"abstract":"<p><p>Major earthquakes may alter dermatological needs through physical injury, disruption of living conditions, and psychological stress. We investigated dermatological needs after the 2026 Kumamoto earthquake. This retrospective observational study included patients from eight severely affected municipalities who visited our dermatology clinic during the first 10 clinic days after the earthquake and a subsequent 12-clinic-days period. Outpatient attendance and selected dermatologic conditions were compared with those during the corresponding periods in 2025. During the first 10 clinic days, the number of patients from the eight municipalities decreased from 1670 in 2025 to 1030 in 2026 (38.3% reduction). Forty patients presented with earthquake-related traumatic injuries, and 19 presented with burns. Acute urticaria (2.5% vs. 1.3%, p = 0.021), herpes zoster (1.7% vs. 0.5%, p = 0.001), and exacerbations of atopic dermatitis (3.1% vs. 0.9%, p < 0.001) were significantly more frequent in 2026 than in 2025, whereas herpes simplex showed no significant difference. These findings indicate that the post-earthquake dermatologic needs include not only traumatic injuries and burns but also stress-related dermatoses, thus highlighting the potential role of dermatologists in multidisciplinary disaster medical care.</p>","PeriodicalId":94236,"journal":{"name":"The Journal of dermatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170669","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":"Bullous Pemphigoid Probably Caused by Bone Fracture and Invasive Bone Reset Surgery.","authors":"Chiharu Kido, Keiko Watanabe, Yushiro Ohara, Mako Mine, Sho Hiroyasu, Daisuke Tsuruta, Takashi Hashimoto, Naoki Oiso","doi":"10.1111/1346-8138.70530","DOIUrl":"https://doi.org/10.1111/1346-8138.70530","url":null,"abstract":"","PeriodicalId":94236,"journal":{"name":"The Journal of dermatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170525","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":"Comment on \"Achieving Targeted Combined Endpoints in Patients With Atopic Dermatitis: A Real-World Study\".","authors":"Chenshu Pan, Liming Wu","doi":"10.1111/1346-8138.70479","DOIUrl":"https://doi.org/10.1111/1346-8138.70479","url":null,"abstract":"","PeriodicalId":94236,"journal":{"name":"The Journal of dermatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149818","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}