AbstractBackgroundChronic plaque psoriasis (CPP) is underdiagnosed, undertreated and mistaken for other skin conditions such as eczema, tinea corporis and pityriasis rosea.ObjectivesTo develop and evaluate an online training tool to improve the diagnostic skills of nondermatologists for CPP.MethodsThe study involved: (i) developing an online training tool to improve CPP diagnosis by nondermatologists; and (ii) evaluating the performance of the newly developed training tool by conducting a before‐and‐after exploratory investigation. Participants included three groups of primary care health professionals: general practitioners (GPs); nurses; and pharmacists. The tool contained written recommendations for the diagnosis of CPP in different skin colours and a medical artist's illustrations of psoriasis to overcome the lack of representative images of the disease in skin of colour and to illustrate the salient features more clearly than clinical photographs.ResultsIn total, 60 participants completed the study (20 per participant group). The training tool improved participants' diagnostic skills for CPP. The diagnostic ability of GPs was, on average, higher than nurses and pharmacists before and after training. Participants found the training valuable and relevant to CPP diagnosis in primary care settings.ConclusionsOur findings show that a training tool, using medical illustrations, for nondermatologists can be beneficial in terms of recognition of CPP. This may lead to more timely diagnosis and treatment of psoriasis and support relevant and faster referral to specialist dermatology clinics.

AbstractHidradenitis suppurativa, a chronic inflammatory skin condition, disproportionately affects individuals with skin of colour (SOC), particularly African Americans. Despite the increased prevalence in SOC, racial minorities are underrepresented in HS clinical trials, limiting our understanding of treatment efficacy. The purpose of this narrative review is to discuss the current literature regarding the clinical presentation, comorbidities, and management of HS in SOC individuals. A PubMed search was conducted using the terms Hidradenitis suppurativa, comorbidities, skin of colour, African–American, Hispanic, and quality of life with relevant studies written in English and pertaining to the demographics and clinical trials were included. African American patients with HS tend to experience more severe disease manifestations, higher rates of comorbidities like inflammatory bowel disease and anaemia, increased healthcare utilisation, and a greater likelihood of surgical interventions. While the current literature provides extensive information about African Americans regarding comorbidities and disease prevalence, there is a lack of research on Hispanic and other ethnic groups. For future research, it is important to broaden our focus to include various ethnic groups. Addressing these disparities requires focused interventions, inclusive clinical research initiatives, and healthcare policies tailored to the specific needs of patients with skin of colour.

AbstractGuselkumab, a monoclonal antibody known for its effective inhibition of T‐cell‐immunoactivity through specific binding to interleukin‐23 (IL‐23)‐cytokines, may be used for off‐label treatment of pyoderma gangrenosum (PG). Herein, we report two successful cases of off‐label treatment for PG, using guselkumab, after unsuccessful treatments with standard regimens of corticosteroids, immunomodulating therapy and other biological agents. Case 1 involves a 39‐year‐old female with treatment‐resistant peristomal PG post‐colectomy and ileostomy. Case 2 features a 35‐year‐oldfemale with treatment‐resistant PG, presenting with deep necrotic lower extremity ulcers. In both cases, we observed remarkable healing within months to a year. These two cases support the potential use of systemic IL‐23‐targetedtherapy for treatment‐resistant PG.

AbstractBackgroundTopical corticosteroids (TCS) are efficacious treatments for inflammatory skin conditions, however, there is a risk of adverse effects; understanding how best to use these treatments is an unmet research priority shared by patients and healthcare professionals.ObjectivesTo develop non‐invasive biomarkers of local adverse effects to facilitate the optimisation of topical therapy.MethodsAn observer‐blind randomised within‐subject controlled trial in atopic dermatitis patients was undertaken (NCT04194814) comparing betamethasone valerate 0.1% cream (BMV) to a non‐steroidal anti‐inflammatory treatment, crisaborole 2% ointment (CRB). Participants underwent 4 weeks twice‐daily treatment with CRB on one forearm and BMV on the other (left/right randomised). Skin properties were assessed on days 1, 15, 29 of treatment and again on day 57, including imaging of skin microstructure using Optical Coherence Tomography (OCT) and Attenuated Total Reflectance (ATR)‐Fourier Transform Infrared (FTIR) spectroscopic assessment of stratum corneum molecular structure. The primary outcome was the difference in the change in epidermal thickness from days 1 to 29.ResultsThirty‐seven participants received the first dose, of which 32 completed the study (all 37 were included in the analysis). Pathologic epidermal thinning at day 29 was significantly greater (p < 0.0001) at sites treated with BMV (−31.66; 95% confidence interval: −35.31, −28.01 µm) compared to CRB (−13.76; −17.42, −10.10 µm). From a panel of exploratory biomarkers, superficial plexus depth and stratum corneum carboxyl group levels had the greatest ability to discriminate the effects of the TCS treatment (p < 0.0001).ConclusionsBMV induced 2.3x more pathologic epidermal thinning than CRB after 4 weeks of treatment, suggesting that CRB may be more appropriate for longer‐term, proactive‐based, treatment strategies where the risks of adverse effects are greatest. By monitoring treatment effects using OCT and ATR‐FTIR spectroscopy, two new non‐invasive biomarkers of skin health have been identified with the potential to help optimise future safe treatment strategies.