Inflammatory Skin Condition Research Articles

Molecular Subtypes of Vulvar Squamous Cell Carcinoma: The Significance of HPV-Independent/p53 Wild Type

Vulvar carcinoma is a rare disease, meeting the criteria for a “rare cancer”, but its incidence is increasing, especially in women <60 years of age. Squamous cell carcinoma (VSCC) accounts for the overwhelming majority of vulvar carcinomas and is the focus of this review. As with many cancers, the increased understanding of molecular events during tumorigenesis has led to the emergence of the molecular subclassification of VSCC, which is subclassified into tumors that arise secondary to high-risk human papillomavirus infection (HPV-associated, or HPVa) and those that arise independently of HPV (HPVi), most commonly in the setting of a chronic inflammatory condition of the vulvar skin. This latter group of HPVi VSCC arises in most cases secondary to mutations in TP53, but recently, attention has focused on the uncommon TP53 wild-type HPVi VSCC. These three molecular subtypes of VSCC (HPVa, HPVi p53 abnormal, and HPVi p53 wild type), as well as their precursor lesions, cannot be diagnosed based on a routine histopathological examination or immunostaining for p53 and p16 as surrogate markers for TP53 mutation and high-risk HPV infection, respectively, are required. The molecular subtyping of VSCC shows high reproducibility and provides important prognostic information. HPVa VSCC has the most favorable prognosis, while HPVi VSCC with TP53 mutations (p53abn) has the worst prognosis, and HPVi VSCC with wild-type TP53 (p53wt) has an intermediate prognosis. In this review, we discuss the evidence supporting this molecular subclassification and its implications for the diagnosis and treatment of VSCC and its precursors.

Natural Products as Modulators of Aryl Hydrocarbon Receptor Signaling in Atopic Dermatitis Management

Atopic dermatitis (AD) is a chronic inflammatory skin condition characterized by immune dysregulation, skin barrier dysfunction, and a significant patient burden. Recent studies have highlighted the aryl hydrocarbon receptor (AhR) as a promising therapeutic target for AD management because of its pivotal role in modulating immune responses and maintaining skin barrier integrity. The dysfunction of the AhR pathway has been linked to AD pathogenesis, emphasizing the need for therapies that can restore its regulatory functions. Natural products have emerged as potential modulators of the AhR and are effective and safe alternatives to conventional treatments. Compounds such as curcumin, resveratrol, quercetin, and microbial metabolites have demonstrated the ability to activate AhR, reduce inflammation, and promote skin barrier function. These natural agents have fewer side effects and enhance patient compliance compared with conventional therapies, making them attractive candidates for long-term AD management. The integration of natural products targeting the AhR pathway provides a multifaceted approach that alleviates symptoms, addresses underlying disease mechanisms, and promotes sustainable improvements in skin health. This review highlights the therapeutic potential of natural AhR modulators and their potential roles in enhancing patient outcomes through novel integrative treatment strategies.

The Beneficial Roles of Seaweed in Atopic Dermatitis

Atopic dermatitis (AD) is a chronic, inflammatory skin condition characterized by severe pruritus and recurrent flare-ups, significantly impacting patients’ quality of life. Current treatments, such as corticosteroids and immunomodulators, often provide symptomatic relief but can lead to adverse effects with prolonged use. Seaweed, a sustainable and nutrient-dense resource, has emerged as a promising alternative due to its rich bioactive compounds—polysaccharides, phlorotannins, polyphenols, and chlorophyll—that offer anti-inflammatory, antioxidant, and immunomodulatory properties. This review explores the therapeutic potential of brown, red, and green algae in alleviating AD symptoms, highlighting the effects of specific species, including Undaria pinnatifida, Laminaria japonica, Chlorella vulgaris, and Sargassum horneri. These seaweeds modulate immune responses, reduce epidermal thickness, and restore skin barrier function, presenting a novel, safe, and effective approach to AD management. Further clinical studies are needed to confirm their efficacy and establish dosing strategies, paving the way for seaweed-derived therapies as natural alternatives in AD treatment.

Effects of Triacetin on AMPK Activation and Immune Responses in Allergic Contact Dermatitis

Background/Objectives: Allergic contact dermatitis (ACD), an inflammatory skin condition, is commonly treated with topical corticosteroids; however, long-term use of these drugs is associated with various risks, such as skin atrophy and steroid resistance. Triacetin (TA), a triglyceride metabolized to acetate, exerts anti-inflammatory affects by activating AMP-activated protein kinase (AMPK) and suppressing mast cell degranulation. Here, we aimed to assess the immediate and long-term effects of TA on ACD suppression, focusing on AMPK activation, using a 2,4-dinitrofluorobenzene-induced rodent model. Methods: Various concentrations of TA were topically applied to rats with 2,4-dinitrofluorobenzene-induced dermatitis. Ear thickness was measured, and histological analysis was performed to assess the inflammation, mast cell infiltration, and degranulation in the established models. AMPK activation was analyzed via Western blotting, and TA degradation was assessed via gas chromatography-mass spectrometry. Dorsomorphin (an AMPK inhibitor) was used to evaluate the effects of AMPK on ACD. Results: TA significantly inhibited inflammation and mast cell degranulation in a dose-dependent manner, with 0.25 mmol/L showing the most potent effects. It also activated AMPK activation. Notably, AMPK inhibition reversed the effects of TA. Conclusions: Overall, TA exerted immediate and long-term anti-inflammatory effects via AMPK activation and inhibition of mast cell degranulation, showing potential as a non-steroidal therapeutic for ACD.

The additional effect of 5% atorvastatin shampoo in the treatment of adult patients with mild to moderate seborrheic dermatitis of the scalp: A prospective, randomised, double-blind trial

Background Seborrheic dermatitis (SD) is a long-lasting inflammatory skin condition that predominantly impacts regions abundant in sebaceous glands, including the scalp. Objectives To assess the efficacy and anti-inflammatory effect of atorvastatin as an additive treatment among SD patients. Materials and Methods In a prospective, randomised, double-blind trial, 46 patients over 18 years old with mild to moderate scalp SD were randomly assigned to receive either 2% ketoconazole shampoo or 2% ketoconazole shampoo plus 5% atorvastatin. The severity of dermatitis was assessed based on the symptom scale of seborrheic dermatitis (SSSD), and the variables of erythema, scaling, and itching, at baseline and 4 weeks after the intervention. Results Based on our analyses, both treatment methods significantly reduced the SSSD scores. However, the average SSSD score in patients using ketoconazole shampoo plus atorvastatin decreased by an average of five points after 1 month. This reduction was comparable to the average decline of 3.5 points observed in the group using ketoconazole shampoo alone. Specifically, the severity of dermatitis, as assessed by the SSSD score, significantly decreased by 1.92 points more, in individuals using the atorvastatin-containing shampoo compared to the comparison group (P = 0.02). Limitation This research was conducted at a single centre which limits the validity of the findings. Conclusion The results of this study suggest that shampoo containing atorvastatin provides a statistically significant effect compared to ketoconazole shampoo alone, indicating its potential as an alternative treatment for SD. The treatment notably alleviates symptoms associated with scaling and itching which are the common manifestations of the condition.

Can aged Camellia oleifera Abel oil truly be used to treat atopic dermatitis?

Atopic dermatitis is an inflammatory skin condition characterized by erythema, eruption, lichenification, and pruritus. Aged Camellia oleifera Abel oil, an effective empirical plant oil utilized by the Gannan Hakka people in China to alleviate the symptoms of atopic dermatitis. However, no scientific studies have been reported to prove whether this oil is truly effective. We conducted this study to confirm whether aged C. oleifera oil could alleviate the symptoms of 2,4-dinitrochlorobenzene (DNCB)-induced atopic dermatitis in mice. Differences in the thickness and weight of the right and left ears were measured. ELISA was used to determine the serum levels of the inflammatory factors IL-4, IgE, IFN-γ, and TNF-α. HE staining was performed to observe inflammatory cell infiltration in the mouse skin lesions. In addition, the metabolites of aged C. oleifera oils were analyzed, and molecular docking was used to assess the binding affinity of the major metabolites to filaggrin, a protein involved in skin barrier function. Animal studies showed that aged C. oleifera oil significantly improved the symptoms of atopic dermatitis. HE staining and measurement of inflammatory factor levels revealed similar results. A total of 41 metabolites were tentatively identified in the oil, with fatty acids emerging as the major metabolites. Molecular docking confirmed that the three most abundant fatty acids, i.e., oleic acid, n-hexadecanoic acid, and octadecanoic acid, bind well to filaggrin. Our results suggest that aged C. oleifera oils can be used to ameliorate the symptoms of atopic dermatitis. Fatty acids may be the major active metabolites responsible for the observed therapeutic effects by reducing transdermal water loss, increasing skin hydration, alleviating DNCB-induced skin barrier alterations, and eliminating itchy scratching caused by dry skin.

Anti-acne preparations containing tetracycline, azelaic acid and azeloglycine: Optimization of stability and physicochemical properties.

Acne vulgaris is a common inflammatory skin condition affecting almost 85% of the adolescent and young adult population. The etiopathogenesis of this dermatosis involves an imbalance in the skin microbiome, leading to inflammation of both the skin and hair follicles. The aim of this study was to develop topical anti-acne formulations with increased therapeutic efficacy and reduced risk of developing antibiotic resistance. Six hydrogel formulations containing azelaic acid or its derivative, azeloglycine, in combination with tetracycline hydrochloride were prepared as part of the study. The investigated formulations were prepared using an Eprus U500 pharmaceutical mixer and the pH was determined using an ERH-11S electrode designed for dense substances and a CPC-505 Elmetron pH-meter. The formulations were analyzed for tetracycline stability in the presence of additional active ingredients and varying pH over a period of 35 days using high-performance liquid chromatography (HPLC). In addition, the effects of azeloglycine and azelaic acid on the viscosity of the prepared formulations were evaluated using a Brookfield DV2T rotational viscometer. Chromatographic analysis showed significant stability of tetracycline in most formulations, with azeloglycine-containing formulations showing less degradation of the antibiotic than azelaic acid-containing preparations. In addition, azeloglycine-containing gels exhibited more favorable rheological properties, which may facilitate better application and be more beneficial to patients. The results suggest that formulations containing azeloglycine and tetracycline may be a promising strategy for acne therapy, offering increased tetracycline stability and an optimal rheological profile, which may result in prolonged therapeutic effect and more effective drug delivery to the skin.

Role of Inflammation and Cytokine Dysregulation in Depression in Patients with Inflammatory Skin Conditions.

The growing field of psychodermatology examines the interplay between dermatological and psychiatric comorbidities. While current literature recognizes that cutaneous and psychiatric conditions often coexist within patients, the relationship between dysregulated inflammation and depression in patients with inflammatory skin conditions has not been thoroughly explored. This review seeks to describe the connection between cutaneous disease and depression via shared inflammatory cytokine pathways. A review of current literature was conducted, and studies addressing the co-occurrence of depression and inflammatory skin diseases were included. This review focuses on depression in patients with psoriasis, atopic dermatitis, and hidradenitis suppurativa. Studies that focused on the prevalence of depression in these populations, shared inflammatory pathways, and co-management of cutaneous and psychiatric disorders were chosen. The literature revealed a high prevalence of depression in individuals with inflammatory skin conditions compared with those without cutaneous disease. Recent studies described how proinflammatory cytokines in inflammatory skin diseases can elicit inflammation in the brain, leading to depressive symptoms. Certain subsets of cytokines that mediate inflammatory pathways were associated with both cutaneous inflammation and depression, highlighting shared pathology. Antiinflammatory medications targeting shared cytokines found reductions in both cutaneous and depressive symptoms. Practitioners have emphasized interdisciplinary approaches to treating both conditions, including psychotherapy and pharmacological methods. There is a clear association between inflammatory cutaneous diseases and depression. Co-management of these conditions, including interdisciplinary methods, is essential for patients' well-being. Future research addressing similar links between other cutaneous and psychiatric conditions could yield new treatment opportunities as well.

Mental Health Implications of Acne Vulgaris

Acne vulgaris, a prevalent chronic inflammatory skin condition, affects approximately 9.4% of the global population, with implications that extend beyond physical appearance to significantly impact mental health. While acne primarily manifests through visible skin lesions, such as comedones, papules, and pustules, the condition’s psychological toll can be profound. Many individuals with acne experience elevated levels of anxiety, depression, and reduced self-esteem, especially adolescents, for whom acne can disrupt self-identity formation. These mental health challenges are often exacerbated by the social stigma associated with visible skin conditions, leading to issues like social withdrawal, body image concerns, and, in severe cases, even suicidal thoughts. Effectively managing acne requires a holistic approach that addresses both physical symptoms and psychological well-being. Dermatological treatments, including topical retinoids, benzoyl peroxide, and oral isotretinoin, are commonly used to control acne symptoms. Dietary modifications, such as reducing high-glycemic foods and dairy, and the use of probiotics, have shown promise as supportive measures. However, addressing the psychological component is equally critical; integrating psychological interventions, such as counseling, cognitive-behavioral therapy, and patient education, can help alleviate the mental strain associated with acne, improve adherence to treatment, and enhance quality of life. Further research is essential to explore the long-term benefits of combined dermatological and psychological treatments and to develop personalized approaches that consider individual psychological profiles. A comprehensive treatment model that incorporates both physical and mental health support offers the potential for improved outcomes, fostering both dermatological recovery and mental resilience in individuals affected by acne vulgaris.

Clinical burden, treatment, and disease control in patients with chronic spontaneous urticaria: Real-world evidence.

Chronic spontaneous urticaria (CSU) is an unpredictable inflammatory skin condition with substantial clinical burden that affects 0.23-0.78% of the United States population. To describe the incidence and prevalence of patients with a record of CSU diagnosis, treatment patterns, disease control, and clinical and economic burden in a United States (US) cohort of patients with CSU. Adults with a record of CSU diagnosis within the US HealthVerity claims database were eligible. Age- and sex-adjusted prevalence/incidence rates were calculated for January 2017 to December 2022. Clinical characteristics were described during the 1 year prior to CSU diagnosis (baseline) and the time after (follow-up). Proxy events representing uncontrolled CSU (any record of prescriptions for corticosteroids, biologics, or immunosuppressants [excluding all antihistamines and over-the-counter medication] or any CSU-related inpatient admissions or emergency room or urgent care visits) were used to identify patients with uncontrolled CSU. Health care resource utilization (HCRU) and health care costs were described. Overall, 200,298 patients were followed-up for a median of 2.3 years after diagnosis. Estimated cumulative prevalence of diagnosed CSU was 0.57% (women: 0.80%; men: 0.32%). The average annual incidence rate was 0.08%. Corticosteroids were the most prescribed treatment during follow-up among the 166,195 patients prescribed ≥1 treatment (94.3%). Proxy events were observed in 59.1% of patients. HCRU and health care costs increased from baseline in patients with uncontrolled CSU during follow-up. Of patients with CSU who were prescribed treatment, >50% experienced uncontrolled CSU, which was associated with increased HCRU and health care costs.

The impact of insurance status on psoriasis patients’ healthcare-seeking behavior: a population-based study in the United States

BackgroundPsoriasis is a chronic, inflammatory skin condition requiring long-term care. However, many psoriasis patients may not regularly receive care. Several factors affect access to care in the United States, including health insurance status. Additionally, it is unknown how health insurance status impacts the healthcare-seeking behavior of psoriasis patients. Healthcare-seeking behavior is broadly defined as an individual’s actions to prevent or treat a perceived health problem, such as visiting a physician’s office. Because early diagnosis and timely treatment improve patient outcomes, determining how insurance status impacts psoriasis patients’ healthcare-seeking behavior and their ability to get care is important. This allows us to identify patients at risk for being untreated or undertreated. In this study, we aimed to assess the relationship between insurance status and (1) the degree to which psoriasis patients delay seeking or receiving care and (2) the degree to which psoriasis patients are unable to obtain care.MethodsThis population-based study used 20 years of data from the Medical Expenditure Panel Survey from 2002 to 2021. We calculated descriptive statistics and performed adjusted multivariable logistic regression analyses.ResultsWe identified a weighted total of 4,506,850 psoriasis patients. Compared to those with private insurance, psoriasis patients with public-only insurance were 2.7 times more likely to delay seeking or receiving care (95% CI, 1.26–5.87). Compared to private insurance patients, uninsured psoriasis patients were 3.4 times more likely to be unable to obtain care (95% CI, 1.31–8.92). Compared to those with public-only insurance, uninsured psoriasis patients were 3.7 times more likely to be unable to obtain care (95% CI, 1.32–10.38).ConclusionsThis study found that psoriasis patients with public-only insurance were significantly more likely to delay seeking or receiving care compared to those with private insurance. This study also found that uninsured psoriasis patients were significantly more likely to be unable to obtain care than psoriasis patients with private insurance and those with public-only insurance. Developing strategies to increase healthcare access is necessary to ensure equitable, timely, and appropriate care for all psoriasis patients, regardless of their insurance status.

Relationship of interoceptive accuracy in acne vulgaris patients: A prospective, controlled study.

Acne vulgaris (AV) is a chronic inflammatory skin condition predominantly observed during adolescence. Interoception accuracy (IAc) refers to the ability to perceive internal bodily states such as hunger and thirst. Since the brain and skin originate from the same embryological layer, the ectoderm, it is hypothesized that skin changes and disorders might affect individual perceptions. The purpose of this study is to evaluate the relationship between IAc and AV. This study included 94 AV patients and 94 sex- and age-matched healthy controls. The participants completed the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Dermatology Life Quality Index (DLQI), and heartbeat perception task to assess IAc. The severity of acne was assessed using the Global Acne Grading System (GAGS). Acne patients had lower IAc scores than controls did (P = 0.026). Severe depression or anxiety symptoms were associated with lower IAc scores (P = 0.027, P = 0.046). Acne severity did not significantly affect IAc scores. There was a weak negative connection between the DLQI score and IAc (r = -0.208, P = 0.022), suggesting that lower quality of life is correlated with reduced IAc. Gender significantly influenced IAc. As a result, individuals with acne may have a reduced capacity to accurately perceive internal bodily states, potentially impacting overall well-being. Enhancing interoception might positively contribute to AV treatment and management.

Epidemiological Analysis of Psoriasis in China from 2020 to 2022.

Psoriasis is a persistent inflammatory skin condition driven by an immune response and influenced by both genetic and environmental factors. The high likelihood of disease recurrence has been a major concern for many patients, while the concurrent presence of other conditions has significantly impacted their quality of life. To improve early detection of and treatment for patients by studying the epidemiological characteristics of patients with psoriasis in China. The Psoriasis Real-World Big Data Collection Platform was initiated by the National Skin and Immune Diseases Clinical Medical Research Center (Beijing First Hospital of Peking University) in August 2020. During the period from August 2020 to June 2022, a total of 1012 hospitals across the nation participated in data entry. This article presents an epidemiological feature analysis based on the real case questionnaire survey form collected over the past 2 years. The prevalence of psoriasis is highest among young and middle-aged men, affecting largely the skin area. Factors such as smoking, obesity, and family history are likely to influence disease onset. In this study's data, the limbs and trunk were the most common sites for psoriasis onset, with cardiovascular disease being the most prevalent comorbidity. Topical corticosteroid creams are frequently used in treatment by Chinese patients, along with a notable proportion opting for oral Chinese medicine for systemic treatment. Secukinumab is the primary choice when utilizing biological agents. The actual data of patients with psoriasis from 2020 to 2022 offer crucial insights into the disease progression among the Chinese psoriasis population in recent years. Through an analysis of patient characteristics and treatment modalities, it furnishes valuable guidance for the prevention, early detection, and management of psoriasis.

Educational video assistance in shared decision-making for psoriasis: Effectiveness and outcomes.

Psoriasis is a chronic inflammatory skin condition associated with significant comorbidities that impact quality of life. Effective patient engagement through shared decision-making (SDM) is crucial for optimal management. This study aimed to evaluate the effectiveness of adding clinician-created educational videos in enhancing patient knowledge and engagement during SDM for psoriasis treatment. Forty-eight patients with moderate to severe psoriasis participated in this single-center study. After reading an educational pamphlet, patients took a knowledge assessment test. Subsequently, they watched an educational video and completed a second test using the same questions. Feedback questionnaires on the video and the SDM process were also administered. Paired t tests revealed that postpamphlet plus video test scores (mean ± SD: 86.25 ± 17.58) were significantly higher than postpamphlet scores (72.08 ± 26.33, p < 0.0001). Older patients, in particular, showed greater improvement in comprehension after watching the video. Descriptive analysis of the feedback questionnaire on the video indicated strong agreement (average score: 4.240 ± 0.816 on a five-point Likert scale) regarding its greater effectiveness compared with the pamphlet in aiding SDM. Patients also rated the video-assisted SDM process positively (average score: 4.521 ± 0.5443 on a five-point Likert scale), highlighting increased trust and improved communication with healthcare providers. These findings underscore the value of video-assisted SDM in patient education and decision-making processes, potentially improving treatment outcomes and patient satisfaction in dermatologic care.

Exploring the relationship between psoriasis and vitamin D

Introduction and purpose: Psoriasis is a chronic, inflammatory skin condition that affects millions of individuals worldwide. Recent research has suggested a potential link between psoriasis and vitamin D deficiency. This review paper aims to examine the existing literature on the relationship between psoriasis and vitamin D, exploring the potential role of vitamin D in the pathogenesis and management of this debilitating skin disorder. Materials and method: An extensive examination of articles published in scientific journals was carried out through online research platforms PubMed and Google Scholar. We searched articles by entering keywords in appropriate configuration: “psoriasis”, “vitamin D”, “obesity”. Description of the state of knowledge: Emerging research has identified a connection between vitamin D and the development of various skin conditions, including psoriasis. Consistent findings have shown a significant association between low vitamin D levels and the presence of psoriasis. Furthermore, due to vitamin D's influence on the proliferation and maturation of keratinocytes, it has become an important local treatment option for managing psoriasis. Summary: Although there is no clear consensus on whether sufficient dietary vitamin D or oral vitamin D supplements effectively treat psoriasis, the available evidence is still inconclusive. However, healthcare providers like nutritionists should consider recommending general vitamin D supplementation for populations at high risk of vitamin D deficiency, such as those with psoriasis or obesity.

Effectiveness of wide local excision and secondary intention healing in Hidradenitis Suppurativa: a single-center study on quality of life and mental health outcomes.

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that significantly impacts patients' quality of life and mental health. Effective management often involves both medical and surgical interventions. The aim of the study was to assess the effectiveness of wide local excision and secondary intention healing in improving quality of life and mental health in patients with moderate to severe HS. A single-center prospective study was conducted with 40 patients suffering from moderate to severe HS, refractory to prior treatments. Pre-surgical ultrasound mapping of lesions was performed using Ultra High-Frequency Ultrasound (UHFUS). Patients underwent wide surgical excision followed by secondary intention healing based on HS-TIME principles. Quality of life was measured using Skindex-16, and mental health was assessed using the Hospital Anxiety and Depression Scale (HADS), with subscales for anxiety (HADS-A) and depression (HADS-D). Assessments were conducted at baseline, 4 weeks post-surgery, and after complete wound healing. Statistical analyses included paired t-tests and multiple linear regression to determine factors influencing outcomes. The study included 14 males and 26 females with a mean age of 39 years. Significant improvements were observed in Skindex-16 scores (pre: 57.92, post: 16.03) and HADS scores (HADS-A: pre: 6.13, post: 2.63; HADS-D: pre: 5.50, post: 3.21), indicating reduced pain, discomfort, and psychological distress. Multivariate analysis revealed that improvements were associated with male sex, HS stage II, longer disease duration, and lower BMI. Wide local excision combined with secondary intention healing significantly improves quality of life and mental health in HS patients. The findings suggest that a comprehensive approach addressing both surgical and psychological aspects can enhance patient outcomes. Future research should focus on long-term benefits and the development of standardized postoperative care protocols.

Targeted 308-nm Excimer Laser A Safe and Effective Solution for Inflammatory Skin Disorders

Background: The 308-nanometer excimer laser is a targeted ultraviolet B (UVB) light therapy that delivers high-intensity UVB rays directly to affected skin. It has shown considerable efficacy in managing various inflammatory skin conditions, including Psoriasis, Vitiligo, Atopic dermatitis (Eczema), Leukoderma, Alopecia Areata, Chronic recalcitrant dermatitis, Lichen planus, Cutaneous T-cell Lymphoma (e.g. Mycosis fungoides/ Sezary Syndrome), Parapsoriasis, Pityriasis lichenoides chronica, Pruritus, Urticaria pigmentosa, Superficial mycoses (e.g., dermatophytosis [ringworm]. The patient demographic of some of these conditions (e.g. Vitiligo) tends to skew towards patients with darker skin tones. Results: The excimer laser is particularly effective for treating resistant areas, such as the scalp, palmoplantar psoriasis, and hand and foot dermatitis, which often do not respond well to conventional therapies. It has also demonstrated notable success in promoting repigmentation in facial vitiligo, especially in patients with Fitzpatrick skin types IV–VI. Treatment results are typically observed quickly after 5-10 sessions, with sustained improvement and psoriasis clearance evident even at 1-year follow-up. Over the years, access to the Excimer laser procedures has expanded with the availability of these procedures in many private clinics as well as academic facilities. That has increased the availability of the treatment modality and patient choice of therapy. Conclusions: The excimer laser provides a safe, non-invasive treatment option with a strong record of efficacy for multiple inflammatory skin conditions. It is a viable alternative to systemic therapies and can be used either alone or in conjunction with other treatments for optimal patient outcomes.

Pharmacodynamic effects and exploratory efficacy of afimetoran, a TLR7/8 inhibitor, in patients with cutaneous lupus erythematosus

Background: Cutaneous lupus erythematosus (CLE) is a chronic inflammatory skin condition occurring alone or as a manifestation of systemic lupus erythematosus (SLE). There is an unmet need for safe and effective CLE-focused treatments. Afimetoran is an investigational, first-in-class, potent oral inhibitor of toll-like receptors (TLRs) 7/8. Given the involvement of TLRs 7/8 in SLE, afimetoran may have therapeutic potential for CLE. A phase 1b randomized, double-blind, placebo-controlled study (NCT04493541) demonstrated preliminary safety and efficacy of afimetoran in patients with active CLE. We assessed the pharmacodynamics, safety, and efficacy of afimetoran and its impact on CLE pathobiology. Methods: Patients aged 18–65 years with SLE and cutaneous manifestations by EULAR/ACR 2019 classification criteria or biopsy-proven CLE, and modified CLE Disease Area and Severity Index-Activity (CLASI-A) score ≥6, were randomized 2:1 to once-daily afimetoran (30 mg) or placebo for 16 weeks with a 4-week post-treatment follow-up period. The primary endpoints were safety and tolerability; efficacy was exploratory. Transcriptomics and cytokine analyses were performed using peripheral whole blood and serum, respectively, at baseline (pre-dose) and each study visit (weeks 1, 2, 4, 8, 12, 16, and 20 [post-dose]). Statistical analyses compared data from the 13 randomized patients with thirteen age-, ethnicity-, and gender-matched healthy volunteers. Treatment responses were evaluated longitudinally in each treatment arm. The dataset was analyzed using a linear regression model. Gene set variation analysis (GSVA) was performed for pathway enrichment. Results: 13 patients with CLE were randomized (afimetoran, n=8; placebo, n=5); 12 patients completed 16 weeks of treatment and 1 discontinued after 6 weeks due to COVID-19. Compared with placebo, afimetoran demonstrated a favorable safety profile with no serious adverse events, and showed a greater reduction in CLASI-A scores as early as week 4, which persisted to week 20. Improvement in the molecular disease profile was rapid (week 1), sustained through the 16-week treatment period, and the 4-week post-treatment follow-up period. Expression of interferon (IFN) pathway genes was significantly reduced with afimetoran compared with baseline (ΔGSVA enrichment score [ES]=1.57, P&lt;0.0001) and placebo (ΔGSVA ES=0.56, P&lt;0.01); this effect was maintained through week 16 and ≥4 weeks post-treatment. Expression of TLR7 and TLR8 pathway genes and key cytokines (interleukin [IL]-6, tumor necrosis factor α, IL-18, IFNγ, macrophage inflammatory protein-1 alpha [CCL3/MiP1α] or beta [CCL4/MiP1β]) were greatly reduced with afimetoran treatment. GSVA demonstrated robust pharmacodynamic activity on immune cell populations, including immature and activated dendritic cells, macrophages, and inflammatory pathway signatures. Conclusion: In patients with CLE, afimetoran was safe, well tolerated, and demonstrated durable efficacy beyond the treatment period. Afimetoran’s clinical effects and potent pharmacodynamic impact on the molecular disease profile suggest a substantial therapeutic benefit for patients with CLE.

Successful Treatment of Perioral Dermatitis with Upadacitinib

Perioral dermatitis (POD) is a benign, chronic inflammatory skin condition characterized by small papules, pustules, and erythematous scaly patches around the perioral region. Treatment is not reliably effective, and the condition can be prolonged. We herein report a case of the successful treatment of perioral dermatitis (POD) using upadacitinib. A 45-year-old female with a history of rosacea, presented to the clinic with a 2-3-year history of severely pruritic erythematous papules around the chin and mouth, consistent with POD. Our study demonstrates that Janus kinase inhibitors are a promising therapeutic modality for this condition.

A Retrospective Pragmatic Two‐Center Clinical Study to Evaluate the Clinical Outcome of Triple‐Frequency Ultrasound in the Treatment of Mild‐to‐Severe Acne Vulgaris

ABSTRACTObjectivesEarlier, quickly alternating dual‐frequency ultrasound waves (LDM technology) were successfully applied for the treatment of different inflammatory skin conditions such as rosacea and acne. In this retrospective pragmatic two‐center clinical study, we applied the triple‐frequency LDM (TF‐LDM) technology with frequencies of 1/3/10 and 3/10/19 MHz for the treatment of mild‐to‐severe acne skin to assess the effectivity and sustainability of the treatment outcomes.MethodsTwenty‐two patients with mild‐to‐severe acne were included in this study: 11 patients were treated with TF‐LDM (1/3/10 MHz), and other 11 patients—with TF‐LDM (3/10/19 MHz). Assessment of the acne severity was done using the bilateral facial photographs. The photos were evaluated at baseline (T1), on the day of the last treatment (T2), and during the follow‐up controls (T3). Assessment of the acne severity was provided in accordance with a modified Global Evaluation Acne (mGEA) scale by nine independent dermatologists who were blinded to treatment assignments.ResultsThe average improvement of the mGEA scoring between T1 and T2 across all patients was 73.69% ± 13.90% (p &lt; 0.01), whereas the skin improvement between T1 and T3 was 90.14% ± 8.35% (p &lt; 0.01). The state of the skin was also statistically significantly improved between T2 and T3 (53.26% ± 29.24%, p &lt; 0.02). There was no difference in treatment outcomes between the patients treated with TF‐LDM (1/3/10 MHz) and TF‐LDM (3/10/19 MHz).ConclusionsTF‐LDM is an effective method for the treatment of the mild‐to‐severe acne skin that provides a significant skin improvement and long‐lasting treatment results. The method demonstrates no significant side effects, is pain‐free, well tolerated, and highly accepted by patients.