Janus Kinase (JAK) inhibitors are a growing class of medications with expanding FDA approvals for dermatologic conditions. This class of medications' immunosuppressive effects are well documented in the literature, as well as the associated side effects. Patients with atopic dermatitis (AD) and psoriasis have been shown to have increased rates of allergic contact dermatitis (ACD), traditionally diagnosed via cutaneous patch testing. With the increasing use of JAK inhibitors in this population, their interaction with patch testing is vital to ensuring accurate diagnosis of ACD and other allergic conditions. A systematic search of the databases MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Web of Science was conducted on 10/4/25. After screening for duplicates and excluding irrelevant studies, 8 studies were included in the review. The majority of patients were evaluated for ACD with concurrent AD (88.5%), with fewer evaluated for isolated ACD (5.7%) or mixed ACD and chronic actinic dermatitis (CAD) (2.8%). Upadacitinib was the most documented JAK inhibitor (60.0%), followed by abrocitinib (28.5%), tofacitinib (5.7%), and baricitinib (5.7%). 91.4% of patients received patch testing before and during JAK inhibitor use. Of this cohort, 71.9% converted to entirely negative patch test results during JAK inhibitor treatment, while the remaining 28.1% demonstrated a reduction in the number or grade of positive reactions. This review sheds light on the effects of JAK inhibitor use on patch testing results, with initial findings indicating potentially diminished readings with concurrent JAK inhibitor use.

JAK inhibitors are well-established for their utilization in the treatment of autoinflammatory diseases, with the JAK1 inhibitor abrocitinib primarily employed in the management of atopic dermatitis. To provide new clinical therapeutic experience for patients with chronic actinic dermatitis (CAD), reveal the inflammatory pathways that may be involved in the treatment of CAD with abrocitinib and to provide clues for exploring the pathogenesis of CAD. In a 3-month longitudinal study, we recorded and analyzed laboratory test data and clinical severity assessments in 16 patients diagnosed with chronic actinic dermatitis treated with abrocitinib. And the plasma samples of 6 patients before and after treatment were analyzed proteomically using Olink inflammation panel. After 12 weeks of treatment, there was a significant decrease in disease severity scores of 16 patients. No serious adverse events were identified throughout the course of treatment. Significant changes in several inflammatory factors such as EN-RAGE, MCP-3, MCP-4, IL-13, CCL4, FGF21 and TNFRSF9 were observed after treatment. The analysis of our data demonstrates that abrocitinib may be an effective therapeutic option in the management of CAD. IL-13 and CCL-4 might be the core effective factors after the therapy.

Far-UVC exhibits potent antimicrobial activity while limiting penetration into viable epidermis. Unlike conventional 254 nm UV-C, far-UVC induces DNA photodamage only in superficial keratinocytes, with no evidence of basal cell involvement or photocarcinogenesis in preclinical and pilot human studies. These features have established far-UVC as a promising tool for infection control in occupied environments. Beyond disinfection, far-UVC may also represent a novel therapeutic modality in dermatology. Several dermatoses, including atopic dermatitis, cutaneous T-cell lymphoma, and polymorphic light eruption, are characterized by cutaneous dysbiosis that drive inflammation. Far-UVC’s selective action on surface-associated pathogens could modulate microbial imbalance while sparing deeper commensals and host tissue. Early data suggest potential for ecological rebalancing and immune modulation. Translational studies are now needed to test whether controlled far-UVC exposures can reshape microbial communities and improve disease outcomes in dysbiosis-driven dermatoses.

Polymorphic light eruption (PLE) is a common photodermatosis which is believed to be attributable to an immune reaction to an unidentified photoantigen. The epidermal barrier deters skin entry of photoantigens, but its potential contribution to PLE pathogenesis is unexplored. Our objective was to examine the expression of key barrier proteins in PLE patients in vivo compared with healthy controls, both at baseline and after ultraviolet radiation (UVR) exposure. Seven PLE patients and 10 healthy volunteers were recruited. Small areas of buttock skin were exposed to 80mJ/cm2 erythemally-weighted UVR (Philips TL12 broadband UVB source, 280-400nm) and biopsies were taken at 24h post-UVR and from unexposed buttock skin. Skin sections were assessed by immunostaining for expression of barrier proteins (claudins-1, -4, -7, -12; occludin, filaggrin, loricrin and involucrin), and the proliferation marker Ki67. It was demonstrated that unexposed skin from PLE patients had remarkably lower claudin-1 expression versus healthy volunteers (P < 0.001), while expression of Ki67 was significantly increased. UVR-exposure of healthy volunteer skin reduced claudin-1 expression at 24h post-UVR (P < 0.01), while in contrast, UVR-exposure of PLE patients decreased the expression of claudin-7 and increased the expression of claudin-12 (both p < 0.05). Thus tight junction protein expression is altered in people with PLE, both in baseline skin and in their response to UVR exposure. These novel findings suggest a potential role for tight junction proteins in PLE pathogenesis and warrant further exploration.

Chronic actinic dermatitis (CAD) is a photodermatosis associated with contact allergy. Changes in the contact allergen profile in patch-tested CAD patients from our department have been reported over several decades. To determine the frequency of positive patch tests and allergen profiles in recently investigated CAD patients and compare this to profiles in earlier decades. A retrospective cohort study was undertaken at a tertiary Cutaneous Allergy department between 2011 and 2021. Demographics and 10 allergens with highest positivity in CAD and non-CAD patients were compared. Patch testing was performed in 309 (88.3%) of 349 CAD patients, with 186 (60.2%) testing positive to any allergen and 8 (2.6%) positive on photo-patch testing. Patients aged > 40 and with Fitzpatrick skin type V-VI were statistically more likely to be patch test positive (age > 40: p = 0.0082; Fitzpatrick skin type: p = 0.0361). Sesquiterpene lactones (SQL) (6.8%) and formaldehyde (4.8%) were amongst the top 10 most frequently positive allergens in CAD but not in non-CAD patients. Allergic contact dermatitis remains prevalent amongst CAD patients, although sensitisation to allergens historically linked to CAD is decreasing. The cause of this is unclear but potentially due to changes in environmental exposures, particularly in younger CAD patients.

Polymorphic light eruption (PMLE) is mediated by a type IVc delayed-type hypersensitivity (DTH) reaction to ultraviolet radiation (UVR) induced neoantigens. While UVR normally exerts an immunosuppressive effect with increased regulatory T-cells (Tregs) and an accentuated T helper 2 (Th2) response, PMLE shows a heightened Th1 response. Existent data in PMLE suggests a Th1-skewed immune response with reduced Treg numbers and function, lack of Langerhans cells activity, and increased CD8+ resident memory T-cells. Keratinocytes (KCs) contribute to inflammation by releasing interleukin (IL)-1β, Vascular Endothelial Growth Factor-alpha (VEGF-α), and adhesion molecules, which facilitate various immune cell infiltration. The disturbed cytokine milieu with elevated IL-1, IL-12, IL-31, IL-36, IL-15, interferon-gamma (IFN-γ), and decreased IL-4 and IL-10, contributes to disease pathogenesis. IL-15 accounts for the recurrence of lesions. Various drugs, including immunosuppressive agents and antioxidants, have been tried in PMLE with limited evidence. Emerging therapies include cytokine-targeting agents and Janus kinase inhibitors such as tofacitinib, which modulate cytokine milieu via Janus kinase/signal transducers and activators of transcription (JAK/STAT) pathways. Eradication of microbiota is a novel concept that mitigates the cytokine imbalance. Photohardening with narrow band ultraviolet B (NBUVB) or ultraviolet A (UVA) is believed to be effective as it enhances Treg activity. We emphasise the need for further cytokine profiling in PMLE to tailor targeted therapies, as there is an increasing evidence of a Th1 cytokine overexpression which is not curtailed by Treg cells, and thus, drugs targeting the implicated cytokines would achieve long-term results.

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Polymorphous Light Eruption (PLE) is a prevalent UV-induced photodermatosis characterized by abnormal immune responses, oxidative stress, and cutaneous inflammation. Alpha-glucosylrutin (AGR), a chemically modified flavonoid widely used for its antioxidant and photoprotective effects, has shown clinical efficacy; however, its synthetic origin and classification as a potential skin sensitizer and aquatic toxin raise safety and environmental concerns. These limitations underscore the need for safer, naturally derived alternatives. In this study, we investigated the comparative efficacy of quercetin (QC) and hesperidin (HPN)—two plant-based flavonoids—against AGR in in vitro and ex vivo models of sun-induced skin damage. An optimized QC:HPN 8:1 (w/w) complex significantly restored antioxidant enzyme activities (SOD: 4.11 ± 0.32 mU/mg; CAT: 1.88 ± 0.04 mU/mg) and suppressed inflammatory cytokine production (IL-6: 155.95 ± 3.17 pg/mL; TNF-α: 62.34 ± 0.72 pg/mL) more effectively than AGR. β-hexosaminidase secretion, a marker of allergic response, was reduced to 99.02 ± 1.45% with QC:HPN 8:1, compared to 121.33 ± 1.15% with AGR. QC alone exhibited dose-dependent cytotoxicity at ≥10 μg/mL, whereas HPN maintained >94% cell viability at all tested concentrations. These findings highlight the QC:HPN 8:1 complex as a safe, natural, and effective alternative to synthetic AGR for preventing and managing PLE and UV-induced dermal inflammation. Further research should focus on clinical validation and formulation development for topical use.

Abstract Introduction: Photodermatoses are diseases associated with abnormal reaction to ultraviolet (UV) light. We aimed to determine the minimal erythema dose (MED), factors affecting MED and photoprotection methods amongst patients with photodermatoses. Materials and Methods: A cross-sectional study was conducted. Patients aged 18 years with skin phototypes III, IV or V were included. Phototesting was performed with UVB wavelength of 311 nm. Sun exposure was quantified according to a sun exposure index (SEI). Results: A total of 36 patients with a mean age of 59.7 ± 13.02 years were recruited. There were 11 (30.6%), 19 (52.8%) and 6 (16.7%) patients with skin phototypes of III, IV and V, respectively. Thirteen patients had chronic actinic dermatitis (CAD), 1 polymorphic light eruption, 2 lupus erythematosus, 18 atopic dermatitis (AD) and 2 had rosacea. MED for patients with CAD was 510.0 ± 42.43, 578.6 ± 219.58 and 742.5 ± 258.51 for phototypes III, IV and V, respectively, while MED amongst patients with atopic dermatitis was 653.3 ± 176.82, 522.0 ± 239.25 and 720.0 ± 127.28. There was no difference in MED-narrowband UVB (NBUVB) between skin phototypes ( P = 0.165). MEDs in immune-mediated and photo-aggravated photodermatoses did not differ significantly. SEI was not correlated with MED-NBUVB. Clothing-based (66.7%–91.7%), sun avoidance (69.4%) and shade-seeking (63.9%) were the main photoprotection methods, and only 33.3% used sunscreen. Conclusion: MED of patients with photodermatoses was determined. MED was not affected by skin phototype and sun exposure. Photoprotection measures require further optimisation.

Abstract Polymorphic light eruption (PLE) is the most common photodermatosis. It is typically characterized by seasonal delayed-onset induction of rash of variable morphology after sunlight exposure. This study investigated the demographic, clinical and photobiological characteristics of patients diagnosed with PLE at a UK tertiary photodiagnostic service over a 10-year period. A retrospective review of case notes and an in-house photobiology database was conducted for patients diagnosed with PLE between 2014 and 2024. Data from 430 patients (74% female) were included, with mean age of symptom onset at 26 years (range &amp;lt; 1–81) and a mean age at photodiagnostic assessment of 35 years (range 2–85). Most patients had skin phototypes I (31%) and II (46%) and presented with a history of a sunlight-induced papular eruption. Rash was triggered by exposure ranging from minutes to hours, with latency periods to rash onset ranging from immediate to 48 h. Rash duration varied from &amp;lt; 12 h (n = 12) to months (n = 4). One-quarter of patients reported the priming phenomenon. Systemic symptoms during episodes, including fatigue, malaise and headache, were reported by 7%. Symptoms occurring with light through window glass were common (53%), and 24% were affected through clothing. One patient reported symptoms due to artificial light and 7% reported PLE induction by sunbeds. Seasonal symptoms occurred in 76%, with 13% experiencing PLE only abroad and 10% having perennial symptoms. A history of atopy was present in 37%, 27% had allergic contact dermatitis and 3% had photoallergic contact dermatitis diagnosed through patch testing and photopatch testing. Vitamin D deficiency or insufficiency occurred in 59% of patients tested (n = 188). Adverse impact on quality of life was important, with a median Dermatology Life Quality Index score of 11 in this cohort. Phototesting revealed abnormal monochromator photosensitivity in 35%, with the ultraviolet A waveband most frequently implicated. Iterative broadband ultraviolet A provocation testing induced a papular response in 35% of 392 patients tested. In conclusion, this study provides a detailed analysis of a large cohort of cases of PLE assessed through a tertiary photodiagnostic unit over a recent 10-year period. The results highlight the significant adverse impact of PLE on quality of life, possibly compounded by delays in referral time for assessment. The findings emphasize the need to enquire about the priming phenomenon and systemic symptoms and to address vitamin D status. Possible associations with allergic contact dermatitis and atopy are notable and require further study. Interestingly, even in this selected cohort of patients with PLE referred to a tertiary service, phototesting is normal in most, emphasizing the need for careful clinical assessment in parallel with photodiagnostic investigations, to ensure accurate diagnosis.

Abstract Chronic actinic dermatitis (CAD) is a chronic photosensitivity disorder typically characterized by an eczematous eruption on photoexposed sites. Diagnosis relies on specialist phototesting, but there is no consensus on formal diagnostic criteria. As part of the efforts by the British Photodermatology Group to develop a set of diagnostic criteria for CAD, this study was undertaken to gain a deeper understanding of the clinical and photobiological disease characteristics of CAD in the UK. A retrospective review of medical records and in-house databases was undertaken for 5–25 patients diagnosed with CAD at each of six photobiology units in the UK. Data collected included patient demographics, disease characteristics and investigation findings. Data were available for 93 patients with CAD; 51% were male. The median age at diagnosis was 44 years (range 8–85), and the median age of photosensitivity onset was 33 years (range 4–80). Skin phototypes (SPTs) were I–IV in 62%, V–VI in 33%, and unrecorded in 4% of patients. Patients with SPT I–IV were predominantly male (59%), while those with SPT V–VI were mainly female (61%). The duration of sunlight exposure required to provoke symptoms was &amp;lt; 1 h in 59% of cases, and perennial symptoms were noted in 52%. Concurrent atopic diseases were common, with 46% having atopic dermatitis, 40% asthma, 46% hay fever and 53% elevated IgE levels. Only 32 (34%) patients were vitamin D sufficient, including 12 taking oral supplements. Monochromator phototesting revealed reduced minimal erythema doses (MEDs) in ultraviolet (UV)B wavebands (300–305 nm) in 83–84% of cases, mid-UVA (350–365 nm) in 70–74%, and longer UVA (380–400 nm) in 11–19%. Notably, the greatest reductions in MED occurred at 300 nm (28% of the lowest normal range). Broadband provocation testing was conducted in 77% of cases, with 81% showing abnormal reactions to broadband UVA and 94% to solar simulated radiation. Most patients who were patch or photopatch tested had positive reactions, with only 29% testing negative. In this national dataset, CAD was found to affect people with a wide range of ages and skin phototypes, and atopic disease and vitamin D deficiency were common. Patients with CAD exhibit significant photosensitivity, with flare-ups triggered by brief UV exposure. Phototesting plays a crucial role in identifying the disease’s action spectrum, revealing typically broad-spectrum UV waveband involvement, with marked UVB sensitivity and often also UVA involvement. These data help to further characterize this challenging condition and provide important insights, which will facilitate consensus practices in photodiagnosis.

Abstract Managing photosensitivity conditions, including polymorphic light eruption (PLE), chronic actinic dermatitis (CAD), solar urticaria (SU) and cutaneous porphyria, necessitates comprehensive photoprotection strategies. Sunscreens, a cornerstone of these strategies, can pose unique challenges for photosensitive individuals, who may not have an ultraviolet or visible light sensitivity that corresponds to the standard erythema curve. This can mean sunscreen effectiveness for these individuals is not adequately addressed by the product’s sun protection factor (SPF). However, if an individual has heightened visible light sensitivity, as typically seen in SU or porphyria, this does not necessarily mean a visible light-protecting sunscreen is the best choice. This was previously shown for a patient with visible light-sensitive SU who had greater effectiveness with an SPF 50+ formulation without visible light filters compared with one that did. It is thus challenging for people with photosensitivity to know how to select an appropriate sunscreen or for clinicians to advise on optimal choices. This study aimed to evaluate real-world sunscreen usage among photosensitive individuals, exploring factors involved in sunscreen choices, including the role and importance of UV and visible light protection. A structured questionnaire was developed and distributed through the Scottish Photobiology Service and the British Porphyria Association to individuals with a range of photosensitivity conditions, collecting data on sunscreen preferences, usage challenges and visible light protection awareness. There were 82 responses. Difficulties with sunscreen use were reported by 44%, with approximately half expressing dissatisfaction with certain products. Variations in adoption of visible light-protecting sunscreens were observed across conditions. For individuals with CAD, 17% used visible-protecting sunscreen and 50% did not; 33% were not ascertained (NA). For individuals with SU, only 8% used visible-protecting sunscreens and 58% did not (33% NA). With PLE, 43% used visible-protecting sunscreens and 43% did not (14% NA). For photosensitive porphyria, 56% confirmed visible-protecting sunscreen usage, while 32% did not (12% NA). Those without a clear photosensitivity diagnosis showed the lowest uptake of visible-protecting sunscreens (0%), with 65% not using them (35.3% NA). These findings highlight the complexity of sunscreen choices and usage for photosensitive individuals. Given that almost half of responders with porphyria, and &amp;gt; 90% of those with SU, were not using visible-protecting sunscreens, this also highlights the challenges for clinicians in recommending sunscreen choices based on diagnosis, although further detailed evaluation into the reasons behind sunscreen choices is required. Close collaboration with industry is needed to highlight the specific challenges of sunscreen choices for patients with photosensitivity diseases, with emphasis on individualized approaches as the mainstay of photoprotection.

Abstract Photodermatoses profoundly impact quality of life due to the visibility of photodistributed rashes, the burden of symptoms associated with them and the necessity of adherence to strict photoprotective methods, which can be very restrictive. Furthermore, it is thought that early recognition may be delayed for several reasons: misattribution to common skin conditions, the intermittent and seasonal nature of symptoms, a lack of awareness among nonspecialists, an overlap with other dermatological disorders, limited access to photodiagnostic centres, diagnostic challenges in darker skin tones, and insufficient patient awareness. This study aims to investigate whether these factors are contributing to diagnostic delays. This retrospective study reviewed electronic medical records of 70 adults with objective photosensitivity confirmed by monochromator and photoprovocation testing between 2021 and 2024. The cohort was predominantly female (79%) and White (84%), with a median age of photosensitivity onset of 25 years and a median age at diagnosis of 52 years. A history of atopic dermatitis was present in 47% of patients. The most prevalent diagnoses were photoaggravated dermatoses (44%), polymorphic light eruption (19%) and nonspecific photosensitivity (24%). The median diagnostic delay was 19 years (interquartile range 12–27), with 49% of patients experiencing delays &amp;gt; 20 years and 23% experiencing delays &amp;gt; 30 years. A progressive disease course was observed in 64% of patients, with only 11% reporting periods of remission. At the time of presentation, 37% of patients experienced near-continuous symptoms during the summer months, and 29% exhibited severe disease, as assessed by minimal erythemal thresholds and photoprovocation responses. The median annual Dermatology Life Quality Index (DLQI) score was 17 (interquartile range 12–21), indicating significant impairment in quality of life. This study reveals an alarming diagnostic delay in photodermatoses, often spanning decades, leading to significant disease burden. Early recognition remains a critical unmet need, necessitating improved awareness and targeted diagnostic strategies to improve patients’ health. Further research is required to address barriers to timely diagnosis and optimize patient outcomes.

Abstract Actinic prurigo (AP) is a rare chronic photosensitivity condition that typically presents in childhood and may resolve in adolescence. Although less frequent in adulthood, AP can present at this age and may be persistent. The aim of this study was to characterize the clinical presentation, investigation findings, disease course and prognosis of AP in Scotland. This was a retrospective review of patients with AP seen between March 2015 and December 2024 through the Scottish Photobiology Service (SPS). Data on disease characteristics, investigation findings and management were collected from the SPS database and patient records. In total 16 patients with AP were identified. Fifteen were female and one was male, and 11 were newly diagnosed. Ten (63%) had disease onset before age 16 years, with a median age of 10.5 years (range 1–50). Eight (50%) first presented in adulthood (&amp;gt; 16 years old). The most common acute eruption morphology was pruritic erythematous papules (70%). Among adult-onset cases, papulovesicular eruptions were most prevalent (67%). Half of the patients reported scarring. All patients had facial involvement, especially on the cheeks, nose and ears (44% each). Conjunctival involvement occurred in five (31%), and only three (19%) reported cheilitis. Nine (56%) were initially considered to have polymorphic light eruption (n = 5), hydroa vacciniforme (n = 2) or chronic actinic dermatitis (n = 2). Monochromator phototesting at presentation revealed normal action spectra in six (38%), with two developing monochromator ultraviolet (UV)A sensitivity over time. Four (25%) had UVA sensitivity only, four (25%) had UVB and UVA sensitivity and two (13%) had UVB, UVA and visible light sensitivity. Iterative UVA provocation testing showed papular reaction in six (38%), and abnormal erythema in another three (19%). Human leucocyte antigen (HLA) typing was available for 13 patients. Twelve (92%) were positive for HLA-DR4, with nine (75% with HLA-DR4) having the HLA-DRB1*0407 subtype. Twelve patients had follow-up visits, with a median follow-up of 10.8 years (range 1–28.4). Among seven young-onset cases, six (86%) showed marked improvement in clinical symptoms, with five (71%) having normalization of monochromator testing. In contrast, four of five patients (80%) with adult-onset AP remained symptomatic, with persistent abnormal phototesting. AP is a rare immunological photosensitivity disorder that is challenging to diagnose and must be kept in mind. The study found a higher than expected number of adult-onset cases, which tend to follow a more persistent course and are less likely to resolve spontaneously. HLA testing is a useful diagnostic marker, with particular utility in the more atypical adult-onset presentations of AP.

The role of UV-induced cutaneous matrix metalloproteinases and mi-RNAs in the pathogenesis of lupus erythematosus.

Photoprotective effects of various nutritional components and supplements have been demonstrated in animal and in vitro studies. The objective of this systematic review is to assess the photoprotective effects of various dietary supplements. A systematic review of studies assessing dietary supplements on photoprotective outcomes was performed. Human studies were retrieved from PubMed, Embase, and Cochrane in February 2023. Supplement keywords included "dietary supplements," "vitamins," "minerals," "carotenoids," "lutein," "isoflavones," "polyphenols," "Polypodium leucotomos," "heliocare," "herbal medicine," "probiotics," "prebiotics," "astaxanthin," "rosmarinic acid," "botanical," and "herb," and outcome keywords included "photoprotection," "ultraviolet rays," UVA," "UVB," and "blue light." A total of 47 studies were included in the systematic review. Studied supplements included carotenoids, polyphenols, Polypodium leucotomos (PL), melon concentrate, vitamins, coenzyme Q, squalene, and omega-3 and omega-6 fatty acids. Some studies evaluated mixed supplementation and incorporated other active ingredients such as selenium and probiotics. The greatest evidence of photoprotection exists for polyphenols, carotenoid-based, and PL supplementation. While flavanol supplementation exhibited dose-dependency, dose-dependency could not be consistently demonstrated for polyphenol supplementation. The weakest evidence exists for photoprotective effects of isolated vitamin or coenzyme Q supplementation. Dietary supplements may promote enhanced photoprotection, although current evidence is limited by small sample size and short duration. Supplementation with photoprotective active ingredients may be especially favorable for individuals with predisposed ultraviolet sensitivity, such as those with polymorphic light eruption. Future research is necessary to determine optimal dosing and supplementation duration for intended photoprotective outcomes.

The purpose of this study is to analyze FAERS data to identify cases of drug-induced photosensitivity (DIP), examine demographic patterns, determine the drug classes involved, and highlight emerging trends in these reactions. Additionally, we explore potential signal drugs by mining the relevant reported data, aiming to provide insights for safer clinical use of medications. We reviewed the publicly available FAERS database from 2004 to 2023. Using DIP-related search terms such as “photosensitivity reaction,” “polymorphic light eruption,” or et al., we identified reports of DIP. The frequency and trends of these reports were then analyzed. Between 2004 and 2023, the FDA received 17,384,824 reports of adverse reactions, with 20,236 of these linked to DIP. After excluding cases with incomplete data on age, gender, or country of origin, the median patient age was 52 years (IQR = 66). Females comprised 55.71% of the cases (11,274), and 66.96% (12,459) of the reports originated from the United States. The top 45 drugs were responsible for 9,810 cases (48.48%). The three drug classes most commonly associated with DIP in the FAERS database were immunosuppressants, monoclonal antibodies, and antineoplastic agents. A disproportionality analysis of the top drugs revealed several newly identified drugs with signals for photosensitivity, including adalimumab, adapalene, secukinumab, and fingolimod. By analyzing publicly available FAERS data, we identified key themes and trends in DIP reactions. Immunosuppressants and monoclonal antibodies show mild trends in DIP occurrence. Additionally, adalimumab, adapalene, secukinumab, and fingolimod are novel drug signals of DIP.

Background: Chronic actinic dermatitis causes persistent, itchy plaques in sun-exposed areas; systemic treatments are used, but comparative data remain limited. Objective: to evaluate methotrexate's and azathioprine's effectiveness and tolerability in treating chronic actinic dermatitis, with an emphasis on symptom relief, photosensitivity reduction, side effects, patient satisfaction, and treatment compliance. Methodology: This six-month qualitative study was carried out at a Quetta tertiary care facility. Purposively sampled, 200 adult patients with moderate-to-severe CAD who were not responding to topical therapy were split into two groups: 100 were given azathioprine and 100 were given methotrexate. Through patient interviews, medical records, and clinical examinations, clinical outcomes, side effects, and patient-reported improvements were evaluated. Thematic content analysis was used for analysis. Results: 72% of methotrexate patients reported a significant improvement, compared to 65% in the azathioprine group. Clinical results showed that methotrexate was superior, with shorter time to respond (4–6 weeks vs. 6–8 weeks), higher reductions in skin lesions (85% vs. 78%), increases in quality of life (82% vs. 76%), and decreased photosensitivity (80% vs. 75%). While azathioprine induced more gastrointestinal distress (20% vs. 12%), methotrexate was linked to higher levels of nausea (22% vs. 18%) and increased liver enzymes (10% vs. 8%). The methotrexate group had somewhat greater patient satisfaction and adherence rates (70% highly satisfied; 88% adherence) than the azathioprine group (62% highly satisfied; 85% adherence). Conclusion: Methotrexate offers quicker relief and higher satisfaction in CAD, but both drugs are effective; azathioprine suits methotrexate-intolerant patients.

JAK inhibitors as a promising therapy for immune-mediated photodermatoses.

Introduction Photodermatoses (PD) encompass a spectrum of skin conditions induced or exacerbated by sunlight. There is limited data on their clinico-epidemiological profile in Nepal. This study aimed to assess the prevalence and study the clinic-epidemiological profile and photoprotective behaviour among patients with photodermatoses. MethodsThis hospital-based descriptive cross-sectional study was conducted between September 2023 to August 2024 in the outpatient department of dermatology of a tertiary care centre. Ethical approval was obtained from the Institutional Review Committee. The number of patients diagnosed with PD were determined using Sukraa Hospital Information Management System software, V1.2.24.5 for the calculation of prevalence. Non-probability convenience sampling was used. A total of 69 patients clinically diagnosed with photodermatoses were included in study. Data were collected using a structured proforma and analyzed using Statistical Package for Social Sciences (SPSS) version 16. ResultsPrevalence of photodermatitis was 2.24% (338/15116). Polymorphic light eruption was the most common diagnosis 48 (69.57%), followed by photo-contact dermatitis. The prevalence was higher among females 41 (59.42%), with a mean age of 37.21±18.18 years. Most patients were in the 21–30 years age group. The neck 28 (28.28%) and face 20 (20.20%) were the most commonly affected sites, and papules were the predominant lesion morphology 41(42.27%). Only 15 (21.74%) used photoprotective measures, of which sunscreen was the most common 10 (66.67%). ConclusionPolymorphic light eruption was the most common type of photodermatosis, particularly among females and younger individuals. There was a notably low use of photoprotective measures among patients with PD, particularly sunscreen usage.