Dermatology — Weekly Evidence Brief

Dupilumab has demonstrated significant efficacy and a consistent safety profile in treating prurigo nodularis (PN), improving itch, skin lesions, pain, and quality of life for adults, regardless of their atopic comorbidity status 1. For severe erythrodermic psoriasis, IL-17-targeted biologics achieved higher PASI 75 response rates (peaking at 82% by week 16) for improving skin lesions, while IL-23-targeted biologics showed superior safety with the lowest incidence of adverse events (5%) 2. In a cautionary note, the retinoid tamibarotene was found to aggravate skin inflammation in a model of bullous pemphigoid-like epidermolysis bullosa acquisita, by reducing regulatory T cell recruitment, suggesting caution for its use in patients with pemphigoid diseases 3.

High-intensity focused ultrasound (HIFU) is emerging as a non-invasive treatment for actinic keratoses and basal cell carcinomas, showing clearance rates of 70-97% with excellent cosmetic outcomes and benefits such as reduced pain and faster healing compared to conventional therapies 4. However, for cutaneous squamous cell carcinoma (cSCC) in immunocompromised patients, who face an increased risk of aggressive disease and mortality, standardized management protocols remain critically limited, highlighting an urgent need for dedicated research 5. In the realm of scarring, four immune-inflammation related signature genes (COL1A1, A2M, TIMP1, COL1A2) have been identified with prognostic value in hypertrophic scars, and COL1A1's role in promoting fibroblast proliferation and inhibiting apoptosis suggests it as a potential therapeutic target 6.

A novel murine model of prurigo nodularis has been successfully developed, mimicking human PN histologically and immunologically with a Th17/Th22 skewing, providing a crucial platform for accelerating research into disease pathogenesis and new therapies 7. Additionally, dysregulation of the pro-opiomelanocortin-melanocortin 1 receptor (POMC-MC1R) axis is a common feature in human pressure, venous, and diabetic ulcers, with topical application of an MC1R-selective agonist showing promise in restoring healing in murine chronic wound models by stimulating vascularization and reepithelialization 8. Understanding the differential wound healing and scarring across anatomical sites, where extremities and the trunk are more prone to scarring than the face and mucosa, is also advancing, with fibroblast-intrinsic signaling pathways being implicated 9.

Sexual health disorders are highly prevalent in atopic dermatitis (AD) patients across all severities, but improving AD clinical control with pharmacotherapy can significantly reduce their frequency, underscoring the need for clinicians to address sexual health proactively 10. Despite patients finding AD information relatively easy to access, there remains a strong interest in improved educational content, particularly regarding triggers, questions for doctor's appointments, and clearer explanations of new medication safety and mechanism of action 11. Suboptimal skin care practices are prevalent among both AD patients and the general population, with only 59.2% of AD patients demonstrating proactive care, highlighting the need for targeted educational interventions tailored to demographic and socioeconomic factors 12.