Editor’s Picks April 2025

Jo Lambert

Isotretinoin's use in rosacea remains limited, although it is known for its anti-inflammatory and sebum reduction properties. Low-dose isotretinoin (LDI; i.e., ≤0.5 mg/kg/day) may be preferred due to fewer adverse events. Here, King et al. reviewed 16 studies to evaluate the efficacy of LDI in rosacea. Their work is foundational for the practicing clinician to rely on when prescribing oral LDI, which has a good safety profile, even over topical monotherapy, as two considered outcome results are better (lesion counts [Figure 1], erythema). Ocular rosacea remains more difficult to treat, and there, oral doxycycline is the best option.

King, A, Tan, MG, Kirshen, C et al. Low-dose isotretinoin for the management of rosacea: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol. 2025; 39:785–792. 10.1111/jdv.20315.

Hsu et al. retrospectively evaluated rituximab treatment among 123 patients with pemphigus in terms of long-term remission. Concomitant azathioprine and repeated rituximab courses favoured long-term outcomes (Figure 2), while larger body surface areas, higher Pemphigus Disease Area Index, diabetes, and elevated platelets were negative prognostic factors.

Personally, I was surprised to see that serum anti-desmoglein titers were not deemed a remission-defining factor. Could thrombocytosis pose a negative predictive factor, as rituximab (often used in conditions like idiopathic thrombocytopenic purpura) may increase platelets? In clinic, it remains hard to predict how the treatment scheme for your pemphigus patient may evolve.

Hsu, HC, Huang, PW, Cho, YT et al. Factors associated with long-term complete remission in pemphigus patients receiving rituximab therapy. J Eur Acad Dermatol Venereol. 2025; 39:e313–e316. 10.1111/jdv.20290.

Bettoli et al. suggest that while ChatGPT provides basic information on acne, it requires expert supervision to ensure accuracy and comprehensiveness (Figure 3). Their study identified several terminological mistakes, which may lead to wrong treatment (e.g. a cyst is not identical to an abscess) and the treatments proposed were not exhaustive. The identified mistakes underline the importance of fact-checking AI-generated content before using it as a reference.

Future improvements in ChatGPT's performance and the development of more specialized tools may enhance its utility in medical education and patient information dissemination. It does not replace consultation with a healthcare professional.

Bettoli, V, Naldi, L, Santoro, E et al. ChatGPT and acne: accuracy and reliability of the information provided —the AI-check study. J Eur Acad Dermatol Venereol. 2025; 39:e359–e362. 10.1111/jdv.20324.

Dysmorphic concerns and body dysmorphic disorders (BDD) were found to be five times more frequent in patients with a skin disorder among 5290 patients from 22 European centres, particularly for alopecia, vitiligo, and psoriasis (Table 1). Females tended to experience more dysmorphic concerns; the underlying reason for this deserves qualitative study.

One can imagine that women are often subject to more intense scrutiny and societal expectations regarding appearance, which can amplify body image concerns. On the other hand, men may underreport body image concerns due to stigma, potentially underestimating and thereby skewing research findings.

Sampogna F, Samela T, Abeni D, et al. A cross-sectional study on gender differences in body dysmorphic concerns in patients with skin conditions in relation to sociodemographic, clinical, and psychological variables. J Eur Acad Dermatol Venereol. 2025; 39:823–832. 10.1111/jdv.20247.