Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 103 appraisals
Journal of tissue viability
Clinical decision support tools in wound management: A scoping review of existing and emerging tools.
AIM: This scoping review aimed to identify and map clinical decision support tools (both digital and non-digital) used by clinicians for wound management in acute, primary, and community health settings globally, with a focus on the use of artificial intelligence, and the barriers and enablers to implementation. MATERIALS AND METHODS: Studies published between January 2015, and August 2024 were identified through systematic searches of Scopus, Embase, MEDLINE, and CINAHL, conducted in accordance with JBI methodology and reported using the PRISMA-ScR guidelines. Eligible studies included quantitative, qualitative, and mixed-methods research examining non-digital and AI-supported clinical decision support tools for wound management across healthcare settings. RESULTS: Seventeen studies were included, two evaluating AI-supported clinical decision support tools. Most clinical decision support tools had structured wound assessment and treatment planning, though evidence of clinical effectiveness was limited, with only one tool fully validated. Adoption by nurses was influenced by experience, trust, training, and workflow integration, with senior nurses less likely to rely on clinical decision support tools. AI-enabled tools, and a convolutional neural network-based model, improved assessment consistency, documentation, and workflow efficiency. Key barriers included concerns about trust, clinical autonomy, and usability. CONCLUSIONS: Both traditional and AI-supported clinical decision support tools are used for chronic wound management across acute, primary, and community care, but evidence of effectiveness and validation remains limited. The absence of experimental studies highlights the need for rigorous evaluation, clinician education, and strategies to support integration of AI-enabled clinical decision support tool into routine practice.
2 Aug 2026
Read appraisal →Lasers in medical science
Facial contour modulation and skin tightening using 40.68-MHz unipolar radiofrequency
To evaluate changes in facial contour and skin elasticity following full-face treatment with 40.68-MHz unipolar radiofrequency (RF), and to assess its safety and tolerability in adults with mild-to-moderate facial laxity. This prospective single-arm interventional clinical study evaluated adults with mild-to-moderate facial laxity who underwent three full-face 40.68-MHz unipolar RF treatment sessions at 4-week intervals. The primary endpoint was the change in VECTRA-derived three-dimensional facial volumetric parameters from baseline to Week 20. Secondary outcomes included Cutometer-derived skin elasticity parameters (R2 and R5), Global Aesthetic Improvement Scale (GAIS), FACE-Q satisfaction scores, visual analog scale (VAS) pain scores, and adverse event monitoring. Of the 30 enrolled participants, 26 completed follow-up and were included in the final analysis. By Week 20, VECTRA 3D analysis demonstrated modest volume reductions in the cheek (- 2.2 mL), jowl (- 1.7 mL), and submental region (- 2.9 mL). Skin elasticity parameters increased over time, with R2 increasing from 0.62 to 0.69 and R5 from 0.53 to 0.59. GAIS improvement was observed in 88.5% of participants, and the mean FACE-Q score increased to 72.4 ± 10.1. Treatment was well tolerated, with low mean pain scores (VAS 1.2 ± 0.9). Only transient erythema and mild edema were reported, with no serious adverse events observed. Three sessions of 40.68-MHz unipolar RF were associated with modest measurable improvements in facial contour and skin elasticity that were maintained during the 20-week observation period, with good tolerability and no serious adverse events. Because this was an uncontrolled single-arm study, these findings should be interpreted as preliminary and require confirmation in controlled studies with longer follow-up.
27 July 2026
Read appraisal →Clinical and experimental dermatology
Pemphigus vegetans: insights from a systematic review of the literature.
BACKGROUND: Pemphigus vegetans (PVg) is a rare variant of pemphigus vulgaris with distinct clinical and histological features, with fewer than 200 cases of patients with the condition reported. OBJECTIVES: To systematically review cases of patients with PVg and summarize clinical, histopathological, immunological features, treatment and outcomes. METHODS: Following PRISMA guidelines, PubMed, Embase and Web of Science were searched (1889 to January 2025) using 'pemphigus AND vegetans'. Eligible studies included case reports, series and observational studies. Data on demographics, subtypes, histopathology, immunopathology, treatment and outcomes were extracted. RESULTS: In total, 197 patients with the condition from 148 studies were identified. The mean age was 52.2 (SD 20.2) years with near-equal sex distribution. Oral mucosa was the commonest initial site (44.7%, 73/163); flexural areas such as the groin and axilla were frequently involved. Reported triggers included drugs, infections and vaccination. In 89 patients where clinical subtypes were reported, the Hallopeau variant was found in 47 (53%). When treatment outcomes were reported by subtype, patients with the Hallopeau variant demonstrated higher sustained remission rates (68%, 28/41) and lower mortality (2%, 1/41) compared with those with the Neumann variant [52% (16/31) sustained remission; 16% (5/31) mortality]. Key histological findings included suprabasal acantholysis (84.9%, 158/186) and eosinophilic microabscesses (65.1%, 121/186). Direct immunofluorescence showed intercellular IgG (92.4%, 121/131) and C3 (53.4%, 70/131). Oral corticosteroids (89.5%, 145/162) were the most used therapy. Relapse occurred in 23.0% (35/152) of patients achieving remission. CONCLUSIONS: This review highlights the need for standardized diagnostic criteria, improved immunological profiling and collaborative data collection to guide evidence-based management.
25 July 2026
Read appraisal →Science advances
A wearable biomechanical system for medical evaluation of soft tissue disorders
Evaluating soft tissue elasticity provides critical biomechanical insights essential for the precise characterization of various physiological and pathological conditions. Here, we present the clinical validation of a wireless, compact wearable system designed for direct, location-specific monitoring of the elastic modulus of the skin and underlying tissues via vibro-rotational biomechanical dynamics. Validated by computational models and experiments, the device uses a tunable skin interface to enable depth-controlled measurements across diverse anatomical sites. Two human subject studies, one involving patients with cancer-related lymphedema and the other involving patients with systemic scleroderma, yield data that correlate with standard clinical metrics. This technology offers the potential for longitudinal assessments in these and other contexts, in both clinical and home settings.
20 July 2026
Read appraisal →Analytical chemistry
Biodegradable Self-Powered Electrotherapy Patch for Integrated Smart Wound Management
Smart patches based on multimodal wearable devices enable real-time physiologic monitoring and proactive interventions to promote wound healing. Herein, we describe a biodegradable wearable electrotherapy patch (E-patch) that integrates noninvasive self-powered electrical stimulation (ES) therapy for tissue regeneration and a multiplexed electrochemical biosensor array for continuous monitoring of wound status. Custom-developed supercapacitor arrays (SCs) supply stable energy for ES, and constructed wearable biosensors enable sensitive monitoring of biomarkers in the wound exudate. As-fabricated wearable E-patches degrade harmlessly after operation, significantly reducing the environmental pollution pressure associated with flexible electronics. In vitro studies demonstrated that an applied electric field (EF) significantly promotes cell-directed alignment, which is crucial for tissue regeneration and remodeling. In vivo investigations in the Sprague-Dawley (SD) rat model illustrate that combination therapy dramatically accelerates wound healing. Overall, this work provides a promising strategy toward integrated smart wound management and future feedback-assisted wearable therapeutic systems.
15 July 2026
Read appraisal →PloS one
Transcriptomic characterization of key psoriasis-associated genes based on single-cell RNA-seq and machine learning
BACKGROUND: Psoriasis is a multifaceted skin and systemic disorder driven by a complex interplay of genetic, immunological, and environmental factors. Genetic predisposition plays a pivotal role, with the IL-17/IL-23 immune axis recognized as a central pathogenic pathway. Ongoing research, however, continues to uncover additional critical drivers, cytokines, intracellular signaling networks, and potential therapeutic targets. METHODS: Single-cell RNA sequencing (scRNA-seq) datasets comprising both psoriatic and healthy samples were obtained from the Gene Expression Omnibus (GEO). Cell-type proportions were estimated using Cell-type Identification by Estimating Relative Subsets of RNA Transcripts (CIBERSORT), and weighted gene co-expression network analysis (WGCNA) was applied to explore correlations between cell types and gene signatures. Machine learning algorithms were subsequently employed to identify four psoriasis-associated key genes: DEFB4A, GJB2, SERPINB3, and SERPINB13. Their expression was validated in bulk RNA-seq datasets. Using scRNA-seq data, we further investigated the lesional regulatory roles of these genes and their associated pathway alterations, and we proposed targeted therapeutic strategies. RESULTS: A series of algorithms identified 271 hub genes significantly associated with psoriasis lesions and basal cells. Machine learning analysis refined this set to four key genes in psoriasis: DEFB4A, GJB2, SERPINB3, and SERPINB13. CONCLUSIONS: These four psoriasis-associated driver genes were upregulated in lesional skin. We also screened small-molecule compounds targeting these genes, offering potential therapeutic strategies.
14 July 2026
Read appraisal →Depression and anxiety
The Impact of Psoriasis Treatment on Depression and Suicide Risk: A Systematic Review
BACKGROUND: Psoriasis is a long-lasting inflammatory condition of the skin associated with various comorbidities, including depression and suicidal ideation. Management strategies for psoriasis include symptom alleviation, quality-of-life enhancement, and prevention of disease progression. Psoriasis treatments include topical therapies, phototherapy, oral systemic medications, and biologics. OBJECTIVES: In this review, we evaluate the impact of psoriasis treatments on depression and suicidal ideation in affected patients. METHODS: We systematically searched multiple databases, including PubMed, Scopus, and Web of Science, until September 30, 2024, to identify relevant articles. Studies that examined the effects of psoriasis therapies on depression and suicidal thoughts were included. Data on treatment modalities, psychological health outcomes, and psoriasis severity was obtained. Quality evaluation instruments, such as JBI, consolidated standards of reporting trials (CONSORTs), Center for Evidence-Based Management (CEMBa), and appraisal tool for cross-sectional studies (AXIS), were used to appraise study quality. RESULTS: Ten studies met inclusion criteria, predominantly focusing on biologic therapies. Biologics like guselkumab, brodalumab, and bimekizumab have shown notable reductions in depression symptoms, probably through the alleviation of psoriasis severity and the enhancement of quality-of-life. Suicidal ideation occurred in some cases, especially with brodalumab; however, a definitive causal relationship was not established. CONCLUSIONS: Treatments for psoriasis, especially biologics, have shown some advantages in reducing depression symptoms as well as relieving skin symptoms. However, cautious monitoring is required due to the possible hazards of suicidal thoughts with certain therapeutic options such as biologics. Addressing the complex issues of psoriasis requires comprehensive therapy that includes dermatologists and mental health specialists.
13 July 2026
Read appraisal →Science advances
A multifunctional porous interface bridging 3D architected electronics with skin
Skin-integrated flexible electronics are rapidly advancing from short-term use to continuous, long-term wear to meet the demands of health monitoring, wound healing, and skin disease treatment. While three-dimensionally (3D) architected devices offer sensing capabilities and outstanding mechanical performances, the development of a conformal interface between these 3D electronic devices and skin for long-term comfortable wear remains challenging due to their geometric complexity and mechanical fragility. Here, we introduce a multifunctional porous interface that bridges 3D flexible electronics with skin through engineered microporous networks. Such a porous design enhances elastic stretchability and electrical reliability while providing moisture permeability, thermal buffering, impact mitigation, and drug delivery capability. Stiffness reduction and localized pore-wall-shell buckling synergistically underpin the outstanding mechanical resilience under large deformations. The proposed multifunctional porous interface allows development of a 3D closed-loop wound administration patch capable of multimodal sensing and on-demand therapy, markedly accelerating scald wound healing in vivo.
12 July 2026
Read appraisal →Proceedings of the National Academy of Sciences of the United States of America
Analytical modeling for suction cup designs for skin-interfaced wearable devices
Stable mounting is a central requirement for skin-interfaced wearable biomedical devices, because accurate and long-term measurements with clinical utility typically demand intimate contact with the skin, whereas practical use also requires gentle removal to minimize skin irritation and damage. Existing mounting strategies often struggle to satisfy these competing requirements simultaneously, especially under prolonged wear or in the presence of sweat and moisture. Suction-based mounting has recently emerged as a promising alternative because it can provide strong, reversible, and adhesive-free attachment, yet its underlying mechanics remain insufficiently understood. Here, we establish analytical models for the deformation and force of suction cups in a fully explicit form, covering both the cone suction cup and an optimized ring suction cup design. Unlike previous approaches that rely on indirect quantities such as the pressure difference and contact radius, which are not available before experiments and therefore cannot serve as controllable design variables, the present framework yields direct relations between suction performance and geometry parameters, material properties, and loading conditions, including the maximum push down displacement and the subsequent pull up displacement. The resulting formulas agree closely with accurate numerical solutions and lead to compact scaling laws that clearly identify how geometry and material parameters govern suction performance. These results provide a quantitative and physically transparent foundation for the design of suction-based mounting strategies in wearable devices.
7 July 2026
Read appraisal →JMIR dermatology
The Rise in Homemade Sunscreen Trends and Future Impacts on Skin Cancer Risk: Systematic Review
BACKGROUND: The trend of homemade sunscreen recipes has rapidly gained popularity over the last decade, being largely fueled by social media influencers, natural health blogs, and the growing mistrust of large health organizations like the US Food and Drug Administration (FDA). Consumers are increasingly drawn to products labeled "natural," "organic," "vegan," and "cruelty-free," often conflating these terms with safety and effectiveness. However, when applied to sun protection, these assumptions can be dangerously misleading. According to the FDA, there is no verified mathematical formula that can be used to determine an accurate sun protection factor (SPF) rating for the amount of zinc oxide used in many of the recipes found online. OBJECTIVE: The objective of this review is to examine the rising popularity and efficacy of homemade sunscreens compared to commercial sunscreens and highlight the potential public health implications of skin cancer risk related to homemade sunscreen use. METHODS: Multiple databases were searched to find current and relevant literature analyzing the social media impact relating to homemade sunscreens and the efficacy of homemade sunscreens compared to commercially available products. Digital content that included or discussed homemade sunscreen recipes was included as well to provide examples of information trending online. RESULTS: One study analyzing social media trends found that many strong, unverified claims relating to homemade sunscreen versus commercial sunscreen use are being presented in the media, potentially influencing public knowledge. Additional studies analyzing the components of homemade sunscreen recipes compared to components in commercially available products found that homemade sunscreens offer little to no sun protection, therefore increasing the risk of UV damage for individuals using homemade products. CONCLUSIONS: Based on the presented evidence, the adoption of unregulated homemade sunscreens presents a substantial threat to public health. Misinformation spread through social media and influencer culture may unintentionally contribute to an increase in UV-related skin cancers. Greater efforts are needed from health care professionals, regulatory bodies, and online platforms to educate the public and promote the use of scientifically validated sun protection methods.
4 July 2026
Read appraisal →Medical image analysis
Medical hierarchical image classification via dual-geometry image-text learning
Hierarchical image classification is a fundamental challenge in medical image analysis, as tree-structured taxonomies inherently reflect biological and clinical relationships, spanning the general categorisation of disease entities and fine-grained cellular distinctions. Existing approaches primarily rely on multi-task learning and fine-grained detection, often requiring intricate model design and complex training strategies. In this paper, we aim to exploit the negative curvature property of hyperbolic space, which allows efficient representation of hierarchical structures. We propose a dual-geometry image-text framework, termed H2CL. Specifically, we introduce a lightweight classifier head on top of image backbones to extract both Euclidean and hyperbolic features, which are then combined to simultaneously preserve taxonomic consistency from an etiological perspective and enhance instance discrimination from a morphological perspective. Furthermore, a text branch is incorporated to integrate label semantics, where an entailment loss is employed to jointly model image-text alignment and inter-sample relationships. Extensive experiments on cervical cell, skin lesion, and gallbladder disease datasets demonstrate that our framework consistently outperforms advanced methods. Compared to the standard Swin Transformer, H2CL achieves an average accuracy improvement of 7% across all three datasets at the fine-grained level, with similarly consistent gains observed when integrated with other backbone models. The source code is publicly available at https://github.com/MCPathology/H2CL.
4 July 2026
Read appraisal →The Journal of dermatological treatment
Intralesional human papillomavirus vaccination for cutaneous verrucae: a systematic review and meta-analysis of therapeutic efficacy
OBJECTIVES: To evaluate the efficacy of intralesional human papillomavirus (HPV) vaccination in the management of cutaneous warts. METHODS: A comprehensive search of PubMed, MEDLINE, Embase, Scopus, and ClinicalTrials.gov was conducted in accordance with a registered PROSPERO protocol (CRD420251170324). Chronic or persistent warts were defined as lesions lasting more than six months or showing inadequate response to conventional therapies. The primary outcome was complete wart clearance, and pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. RESULTS: Six studies were included. Intralesional HPV vaccination was associated with a significantly higher rate of complete clearance compared with intralesional normal saline (RR 18.54; 95% CI 6.59-52.18). Subgroup analyses demonstrated comparable efficacy between bivalent and quadrivalent vaccines. Reported adverse events were mild and localized. CONCLUSION: Intralesional HPV vaccination demonstrated significant therapeutic efficacy in the treatment of cutaneous warts and represents a promising immunotherapeutic option for patients with persistent or treatment-refractory disease.
30 June 2026
Read appraisal →ACS sensors
Lignin-Regulated Amphiphilic Janus Membrane for Eco-Friendly Electronic Skin
Eco-friendly electronic skin fabricated from sustainable natural materials represents a pivotal technology for advancing healthcare and sports-oriented wearable electronics, yet balancing comfort and electronic functionality remains challenging due to inadequate moisture management. Herein, we report an eco-friendly lignin-regulated amphiphilic Janus membrane (LAJM)-based pressure sensor that synergistically integrates unidirectional water transport with exceptional sensing performance. Through sulfonation and fluorination modifications of lignin fractions with distinct hydrophilic and hydrophobic properties, we engineer an electrospun layer with controlled hydrophobic-hydrophilic gradients, enabling unidirectional water transport while maintaining a dry and comfortable microenvironment. Moreover, LAJM demonstrates notable biocompatibility, antibacterial efficacy, and antioxidant properties, positioning it as a promising candidate for intelligent wound care systems. The LAJM-based pressure sensor achieves integrated sensing capabilities through its hierarchical structure, exhibiting a high sensitivity of 23.97 kPa-1 in the 0-20 kPa range, an extended operational range (0-200 kPa), and ultrafast response dynamics (22 ms response/31 ms recovery). These metrics enable robust continuous monitoring of vital signs (e.g., radial pulse waveforms), discrimination of voice patterns, and precise motion trajectory mapping under dynamic conditions. This technological breakthrough in lignin valorization establishes a scalable platform for next-generation breathable epidermal electronics, with transformative implications for AI-driven healthcare diagnostics and adaptive human-machine interfaces.
28 June 2026
Read appraisal →ACS sensors
Flexible Wearable Closed-Loop Diagnostic and Therapeutic System: A New Paradigm for Skin Health Management
As the largest external barrier of the human body, the skin is essential to overall health and quality of life. Conventional skin health management faces limitations such as insufficient real-time monitoring and lack of personalization. Flexible wearable devices have recently emerged as a transformative technology, enabling non-invasive sensing and targeted therapy with high skin compatibility. This review comprehensively summarizes recent advances in flexible wearable closed-loop diagnostic and therapeutic systems for skin health management. It outlines the core technological components, including skin bioinformation collection, biosignal monitoring, signal transmission and data analysis, and targeted intervention. Key applications in physiological and pathological monitoring, wound healing, drug delivery, and physical therapy are discussed. Furthermore, the innovation trajectory of closed-loop systems is clarified, key challenges are analyzed, and targeted solutions are proposed. Future directions are prospected from cross-disciplinary views including digital twins and personalized medicine, establishing a new paradigm for real-time, personalized, and continuous skin health management.
28 June 2026
Read appraisal →PloS one
Few-shot skin lesion classification with Adaptive Multi-Scale Convolutional Attention Network
Computer-aided diagnosis of skin lesions faces core challenges, including scale diversity, blurred boundaries, intra-class morphological variations, and sparse data. Existing methods often rely on fixed receptive fields or generic attention mechanisms, struggling to fully adapt to the unique characteristics of skin lesions. To address this, we propose an Adaptive Multi-scale Convolutional Attention Network (AMCANet), which aims to achieve accurate and robust classification of skin lesions with limited data. AMCANet comprises three core modules: the adaptive multi-scale convolution module dynamically adjusts the receptive field to accommodate lesions of varying sizes; the hierarchical channel attention module integrates multi-level semantic information across different resolutions; and the skin spatial attention module leverages image gradient information to enhance lesion boundaries and local texture features. Extensive few-shot experiments on the HAM10000 and PAD-UFES-20 public datasets demonstrate that AMCANet significantly outperforms existing baseline models across multiple metrics, exhibiting promising generalization capabilities on the evaluated datasets. Qualitative and visual analyses further validate the model's ability to extract discriminative features and effectively focus on lesion regions. This study proposes a deep learning model, which demonstrates certain effectiveness in classifying skin lesions even with a small number of samples, providing a potential direction for future research.
27 June 2026
Read appraisal →Biofabrication
3D printed trichome-inspired permeable bioadhesive for wearable bioelectronics
Wearable bioelectronics that adhere directly to the skin have broad applications. However, achieving optimal breathability remains a significant challenge because of sweat accumulation at the device-skin interface. Conventional approaches, such as porous structures, often limit the functional versatility of wearable bioelectronics. To address this gap, we propose a sweat-removable skin sticker (SRSS) with a hierarchical trichome-inspired channel architecture that rapidly removes sweat from the interface while maintaining robust skin adhesion. The SRSS was fabricated through a hybrid process, in which the trichome-inspired hierarchical microchannel architecture was created by direct ink writing, enabling the controlled deposition of viscous ink with high structural fidelity. Through the multi-level ribs design, the SRSS demonstrated an effective area-normalized horizontal water removal rate (25.6 ml cm-2min-1) significantly higher than the human sweat secretion rate (0.38-2.85 × 10-3ml cm-2min-1)-approximately three orders of magnitude. This feature reduces sweat accumulation in wearable bioelectronics, thereby enhancing user comfort. Unlike conventional porous materials, the SRSS relies on channel based adhesive interface design that remains compatible with attached wearable bioelectronics, such as temperature sensors in real time. This work therefore presents a structurally engineered permeable bioadhesive interface for wearable bioelectronics.
27 June 2026
Read appraisal →Acta dermato-venereologica
Recurrent Cutaneous Eosinophilic Vasculitis: A Systematic Review of Clinicopathologic Features and Treatment Outcomes
Recurrent cutaneous eosinophilic vasculitis is a rare, predominantly cutaneous vasculitis described mainly in isolated reports. We aimed to systematically synthesize published evidence on its clinico-pathological features, treatment and outcomes. We reviewed case reports and case series of recurrent cutaneous eosinophilic vasculitis and related entities identified in PubMed, Scopus and reference lists (last searched 16 February 2026), using structured report and case-level extraction, duplicate handling, Joanna Briggs Institute critical appraisal and descriptive synthesis. Twenty reports comprising 24 unique cases were included. Most patients presented with relapsing pruritic purpura of the lower extremities. Peripheral eosinophilia was frequent, antineutrophil cytoplasmic antibodies were negative in all reported cases and histopathology consistently showed eosinophil-rich vasculitis, usually with fibrinoid and/or necrotizing change. Systemic corticosteroids often induced improvement, but relapse during tapering or after withdrawal was common. The evidence was limited by small, heterogeneous reports and incomplete follow-up. Overall, the findings support a recognizable cutaneous-predominant, relapse-prone pattern, highlight the importance of assessing extracutaneous involvement in differential diagnosis and support provisional refinement of the previously proposed diagnostic framework.
26 June 2026
Read appraisal →Rheumatology international
Pruritus associated with systemic sclerosis: a systematic review of treatment-based clinical trials
This paper aims to examine the latest research on treatments for itch (pruritus) in people with systemic sclerosis (SSc), identify areas where information is lacking, and propose suggestions for future studies.A comprehensive literature search was performed in PubMed and Scopus in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify studies evaluating therapeutic interventions for pruritus in SSc. Eligible studies included randomized controlled trials, cohort studies, and case series comprising a minimum of three patients. Data extraction encompassed study design, patient demographics, pruritus assessment instruments including validated and non-validated measures, and clinical outcomes. Studies were excluded if they concerned localized scleroderma, irrelevant populations, case reports, systematic reviews, lacking relevant outcome data, or incomplete trials. Ten studies met criteria, evaluating immunomodulatory agents, mast cell stabilizers, opioid receptor antagonist, and lysophosphatidic acid receptor antagonists. Pruritus assessment varied and was often secondary to fibrosis outcomes. Oral lenabasum improved pruritus in a phase II trial; low-dose opioid receptor modulators and rituximab also showed qualitative improvement. Pruritus is a frequently overlooked yet clinically significant symptom in systemic sclerosis (SSc) that negatively impacts patients' quality of life. Existing evidence regarding effective therapeutic options remains limited. Future research should prioritize pruritus as a predefined outcome and utilize validated assessment instruments to inform treatment strategies and enhance patient quality of life.
23 June 2026
Read appraisal →Science advances
Discovery of TYR inhibitors from de novo molecular generation to dual-track lead optimization: 'Competition' between AI and chemists.
This study introduces a unified framework combining artificial intelligence (AI)-directed de novo molecular generation with dual-track lead optimization-comprising expert-guided strategies and AI-driven pathways-to discover tyrosinase (TYR) inhibitors for hyperpigmentation disorders. Using a reinforcement learning (RL)-based generative model, the lead compound AI10 was identified. Subsequent optimization followed two parallel routes. The expert-guided approach yielded AI10-m15 as the most potent TYR inhibitor, with notable antipigmentation activity and excellent cellular safety profiles. In contrast, the AI-driven pathway explored broader chemical spaces, generating unconventional chemotypes, exemplified by the potent TYR inhibitor AI10-a2, highlighting AI's capacity to uncover nonintuitive activity cliffs despite greater output variability. Systematic comparison revealed that the AI model offers exploratory diversity, whereas expert-guided optimization provides predictable improvements in activity and developability. In summary, starting from an AI-generated lead and subsequently integrating both expert-guided and AI-driven structural optimization strategies, these findings further underscore that combining AI technologies with experts' medicinal chemistry insights can substantially accelerate the discovery of viable candidate compounds.
21 June 2026
Read appraisal →Journal of global health
Deep learning-based pressure injury staging: a multicentre study involving 59 hospitals
BACKGROUND: Accurate assessment of pressure injury staging is essential for guiding appropriate care, reducing patient suffering, alleviating the healthcare burden, and improving quality of life. We aimed to develop a deep learning-based model for pressure injury recognition and to translate the best-performing model into a preliminary smartphone application. METHODS: We conducted a multicentre retrospective study using pressure injury images collected from 59 hospitals. We applied to the data set three artificial intelligence-based image analysis models, Mask R-convolutional neural network (CNN) with ResNet-18, Mask R-CNN with Swin Transformer, and Segmenting Objects by Locations, version 2. We assessed model performance using standard evaluation metrics, including precision-recall curves, average recall (AR), average precision (AP), and mean average precision (mAP). The model achieving the best overall performance was selected for subsequent translation into a smartphone-based tool. RESULTS: We included a total of 1903 pressure injury images, with 1713 used for model training and 190 for validation. Among the models evaluated, Mask R-CNN with Swin Transformer demonstrated the highest overall performance (mAP = 0.894, AP50 = 0.900, AP = 0.757, AR100 = 0.792), surpassing the corresponding metrics of the other two models. The model, based on Mask R-CNN with a Swin Transformer, was integrated into a smartphone for preliminary translation. CONCLUSIONS: The proposed deep learning-based system showed promising performance in pressure injury staging and may provide meaningful support for clinical decision-making. Future studies should focus on further validation and refinement using larger and more diverse data sets to enhance their applicability in routine clinical practice.
20 June 2026
Read appraisal →Journal of medical systems
MEL-IA: An Interoperable AI System for Multimodal Skin Lesion Classification in Hospital Settings
UNLABELLED: Skin cancer represents a growing healthcare challenge, motivating the development of AI sytems that can support lesion assessment while integrating efficiently into clinical workflows. This study presents MEL-IA (MobilE skin Lesion dIAgnosis), an interoperable AI system designed for automated skin lesion classification and full integration with hospital information systems. METHODS: The system combines dermatoscopic images and structured clinical metadata using an EfficientNet-B4 - based multimodal model trained on the ISIC 2019 BCN_20000 and MSK subsets. Internal robustness was assessed through stratified 5-fold cross-validation, and external generalization was evaluated on the independent HAM10000 dataset. Interoperability and operational performance were validated through deployment in a real hospital environment using HL7, DICOM, PACS, and HIS/RIS systems. RESULTS: We evaluated internal robustness using stratified five‑fold cross‑validation, with global accuracy of 0.86, macro F1-score of 0.85, and AUC values above 0.97. The external evaluation showed that the model generalizes well under different acquisition conditions, achieving an accuracy of 0.84 and balanced accuracy of 0.65, with sensitivities of 0.60 for melanoma 0.72 for basal cell carcinoma. The multimodal model outperformed the image model baseline across all classes. Technical deployment confirmed full interoperability, > 99% successful study integration, and near real time processing. CONCLUSIONS: MEL-IA provides multimodal skin lesion classification capabilities and integrates smoothly into hospital infrastructures based on standards. The results demonstrate technical feasibility, interoperability, and operational viability for deployment within dermatology oriented clinical workflows. Further clinical validation studies are warranted to assess the system's impact on diagnostic decision-making and patient outcomes.
14 June 2026
Read appraisal →World journal of urology
The urologic impact of long-term finasteride 1-mg use for androgenic alopecia: a matched-cohort database analysis
INTRODUCTION AND OBJECTIVES: Since its approval in 1997, finasteride-1 mg (F1) can be taken daily to treat androgenic alopecia (AA) by reducing serum dihydrotestosterone (DHT). When finasteride is prescribed at the 5 mg dosage, the DHT reduction is known to affect sexual function, reduce serum prostate-specific antigen (PSA) levels and treat benign prostatic hyperplasia (BPH). However, there is no literature on the urologic function of men using long-term F1. Thus, we aimed to address this knowledge gap by analyzing a database for the impact of F1 on urologic function. METHODS: Using the Truveta database, we identified men aged 18 + diagnosed with AA per International Classification of Diseases (ICD) coding, with at least 90 days of F1 use and ≥ 5 years of follow-up. Exclusions included patients with a history of anti-depressant usage, prior diagnosis (Dx) or treatment (Tx) of erectile dysfunction (ED), BPH, or prostate cancer (PC). A control cohort with AA but no F1 use was matched based on age, race, ethnicity, and marital status. We compared Dx rates, Tx rates, and time to Dx or Tx using Chi-square and Kruskal-Wallis Rank sum tests. Survival analysis was performed with restricted mean survival time. RESULTS: We identified 3470 patients with long-term F1 use and 3470 matched patients with AA but no F1 use. The average age for the F1 group was 40.59 and 39.75 for the control. Average F1 use duration was 2011.5 days. Median follow-up was 2554.7 days for the F1 group, and 3129.5 days for the control. The F1 group had higher phosphodiesterase type 5 inhibitor (PDE5i) prescription rate (13.6% vs. 10.5%, p < 0.001) and earlier prescription by 238.6 days (95% CI -304.3, -172.9, p < 0.0001). The control group had a higher -blocker prescription rate (4.4% vs. 2.9%, p = 0.001). There were no significant differences in ED diagnosis, BPH Dx rates or time-to BPH diagnosis or α-blocker prescription. The F1 group had lower elevated PSA Dx and PC Dx rates (2.9% vs. 4.4%, p < 0.001; 0.9% vs. 1.8%, p = 0.001). CONCLUSIONS: Though ED diagnosis did not differ significantly, patients on long-term F1 for AA were more likely to be prescribed PDE5i and sooner by approximately 230 days, compared to non-F1 users. F1 did not significantly affect BPH Dx or Tx rates. F1 use was associated with decreased PC and elevated PSA Dx rates. More research on urologic effects of chronic F1 use in AA patients is needed.
9 June 2026
Read appraisal →PLoS neglected tropical diseases
Feasibility study of an AI-powered mobile app to support cutaneous leishmaniasis diagnosis in the Brazilian Amazon
BACKGROUND: Cutaneous leishmaniasis (CL) remains a major public health challenge, especially in Brazil's Amazon, where environmental and economic pressures sustain transmission. Delayed diagnosis drives morbidity, stigma, and costs. Community health workers are pivotal yet under-equipped for early triage. Artificial intelligence, effective in dermatologic imaging, is underused for CL; feasible, offline clinical tools could accelerate referral and timely care. This study aimed to evaluate the feasibility of an AI-assisted tool for early CL triage in the Brazilian Amazon by: (i) developing an AI model for CL identification from clinical skin lesion images; (ii) integrating the model into an offline-optimized mobile application for resource-limited settings; and (iii) conducting initial, real-world clinical validation. METHODS: Exploratory, IRB-approved feasibility study. Retrospective images from Brazilian Amazon sites informed a two-stage AI pipeline (lesion segmentation+classification) integrated into an offline mobile app. Multicenter validation in ideal- and real-world scenarios. Primary metric AUC-ROC; secondary sensitivity/specificity. One-sided tests: AUC-ROC [Formula: see text]0.70; ideal-world sensitivity [Formula: see text]0.75. RESULTS: For the Classification Model, 64 images were assigned to the test set while 1,160 were used for training and validation (80:20 split), with DenseNet121 yielding the highest accuracy of 0.88. The full AI pipeline (Segmentation and Classification models) achieved an accuracy of 0.81, an F1-score of 0.80, an AUC-ROC of 0.90, and a sensitivity of 0.76. In the ideal-world analysis, sensitivity reached 0.92, the F1-score was 0.84, and specificity was 0.42. CONCLUSIONS: We demonstrate the feasibility of an offline, AI-assisted mobile tool to support triage and referral for cutaneous leishmaniasis in the Brazilian Amazon. Performance reflects preliminary, descriptive point estimates from an initial diagnostic accuracy assessment and should be interpreted with caution; the tool is not intended for standalone diagnosis. Next steps include prospectively powered clinical validation, usability refinements, and regulatory evaluation, including alignment with ANVISA requirements in Brazil. Overall, this work represents an initial step toward closing the gap in clinically supported diagnostic tools for neglected tropical diseases in resource-constrained settings.
30 May 2026
Read appraisal →BMJ open
Protocol for evaluating the effects of the intelligent multimodal symptom assessment and response system in patients with pemphigus vulgaris: a randomised controlled trial
INTRODUCTION: Pemphigus vulgaris is a rare autoimmune blistering disease characterised by recurrent mucocutaneous erosions, high symptom burden and unpredictable relapse. Current management relies mainly on pharmacological therapy and hospital-based follow-up, with limited real-time monitoring and individualised support in home-based disease management. To address these challenges, this trial aims to evaluate the effectiveness of an Intelligent Multimodal Symptom Assessment and Response System, integrating patient-reported outcomes, wearable physiological data and image-based lesion assessments, to improve symptom management and quality of life in pemphigus vulgaris patients. Primary objective is to evaluate the effectiveness of the Intelligent Multimodal Symptom Assessment and Response System in improving symptom alerting and symptom management outcomes in patients with pemphigus vulgaris. Secondary objectives are to enhance patients' self-management ability in symptom monitoring and control, to improve treatment adherence throughout the follow-up period, to promote health-related quality of life among pemphigus vulgaris patients, to assess the usability and acceptability of the system from the patients' perspective. METHODS AND ANALYSIS: This is a multicentre, parallel-group, randomised controlled trial. 160 participants will be randomly assigned to either the intervention group (receiving the Intelligent Multimodal Symptom Assessment and Response System) or the control group (receiving standard care). Eligible participants will be adults aged 18 years or older with a confirmed diagnosis of pemphigus vulgaris and active skin or mucosal lesions, who are able to use digital devices and provide written informed consent. Individuals with severe comorbidities, concurrent participation in other clinical trials or cognitive impairments that may interfere with study adherence will be excluded. The intervention will be delivered via a digital platform, integrating electronic patient-reported outcomes, wearable physiological data and lesion images over a 12-week follow-up period. ETHICS AND DISSEMINATION: Ethical approval was obtained from the Institutional Review Board of the School of Nursing, Fudan University (IRB 2025-07-13), the Medical Ethics Committee of the Institute of Dermatology, Chinese Academy of Medical Sciences (2025-KY-034) and the Ethics Committee of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine (2025-452). Approvals were granted on 10 September, 18 July and 23 July 2025, respectively. This protocol is based on V1.0, 13 July 2025 of the protocol. The results of this study will be disseminated through peer-reviewed publications and academic conferences. TRIAL REGISTRATION NUMBER: ChiCTR2500109711.
29 May 2026
Read appraisal →Polish archives of internal medicine
Biologic and targeted synthetic treatment of SAPHO syndrome: systematic literature review
INTRODUCTION: SAPHO syndrome is a rare autoimmune / autoinflammatory disorder with no approved therapies or standardized management guidelines. Biologic and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) are increasingly used off‑label. OBJECTIVES: This review aimed to systematically evaluate the evidence for the efficacy of b/tsDMARDs in SAPHO. PATIENTS AND METHODS: A PRISMA‑guided search of PubMed database was conducted through March 31, 2025. Studies of any design reporting outcomes of b/tsDMARDs in patients with SAPHO fulfilling the modified Kahn criteria were included. Exclusion criteria were non‑English language, inaccessible full text, and insufficient treatment details. Data on patient characteristics, drug class, follow‑up duration, and treatment response were extracted. As all the included studies were case reports or case series, the risk of bias was not assessed. Treatment responses were summarized using descriptive statistics. RESULTS: Of 1610 screened records, 106 studies comprising 385 instances of b/tsDMARD use met the inclusion criteria; no randomized controlled trials were identified. Tumor necrosis factor inhibitors (TNFis) were used in 203 patients, with complete skeletal and skin responses in 81% and 72%, respectively. The use of Janus kinase inhibitors (JAKis) in 77 patients was associated with complete response rates of 89% (skeletal) and 94% (skin). Other b/tsDMARD classes-including interleukin 17 (IL‑17), IL‑23, IL‑1, and IL‑6 inhibitors, as well as phosphodiesterase‑4 inhibitors-demonstrated variable and generally lower efficacy. CONCLUSIONS: Evidence for b/tsDMARD efficacy in SAPHO remains limited to low‑quality, uncontrolled studies with substantial heterogeneity and probable publication bias. TNFis and JAKis are among the most consistently effective therapies reported in the available literature, but high‑quality research, including randomized trials or prospective registries, is urgently needed to inform evidence‑based management.
29 May 2026
Read appraisal →Autoimmunity
IgA Vasculitis with necrotizing arteritis: a multicenter retrospective study from the French Vasculitis Study Group and systematic review of the literature
IgA vasculitis (IgAV) primarily affects small vessels, but rare cases with necrotizing arteritis (NA) raise questions about overlap with polyarteritis nodosa (PAN). To characterize IgAV with necrotizing arteritis (IgAV-NA) and compare its phenotype with classical IgAV and PAN. We performed a multicenter retrospective study combined with a systematic literature review (1990-2025). Patients fulfilled EULAR/PRINTO/PRES IgAV criteria, had pathological or imaging evidence of NA in small or medium arteries, and were ANCA-negative. Thirty patients were included (7 from databases, 23 from the literature). NA was confirmed by biopsy (n = 16) or vascular imaging (n = 14). Clinical features, treatments, remission, and mortality were compared with 257 adult IgAV and 196 PAN patients. Median age was 54.5 years. IgAV-NA was characterized by severe manifestations, including gastrointestinal bleeding, perforation, surgical abdomen, neuropathy, pancreatitis, and livedo. Compared with classical IgAV, IgAV-NA showed significantly higher rates of multi-organ involvement and mortality. Compared with PAN, IgAV-NA shared vascular complications but had less fever and neuropathy. Despite arterial involvement, patients did not fulfil PAN criteria. IgAV-NA represents a rare, severe IgAV phenotype with life-threatening complications rather than an IgAV-PAN overlap. Severe or atypical IgAV presentations should prompt vascular imaging and intensified immunosuppression.
28 May 2026
Read appraisal →Indian journal of ophthalmology
Immune checkpoint inhibitor therapy for treatment of periocular Merkel cell carcinoma: A systematic review of clinical outcomes and safety
Merkel cell carcinoma (MCC) is a rare, aggressive neurocutaneous malignancy associated with ultraviolet damage, immunosuppression, and Merkel cell polyoma virus infection. Periocular MCC is uncommon but has high rates of local recurrence and metastasis and presents unique therapeutic challenges due to functional and cosmetic considerations. Immune checkpoint inhibitor (ICI) therapy has shown efficacy in systemic MCC; however, evidence for periocular use is limited to small case series and reports without consolidated evidence or consensus. Thus, this study summarizes and evaluates the effectiveness and safety of ICIs for periocular MCC. A systematic literature search across PubMed, Embase, and Web of Science was conducted according to PRISMA guidelines. Randomized and nonrandomized studies, case series, and case reports in English describing ICI use for periocular MCC were included. Non-human studies, non-periocular MCC, and reports without ICI treatment were excluded. Extracted data included patient demographics, tumor characteristics, treatment regimen, and patient outcomes. Seven studies reporting ten patients were included. Treatment regimens consisted of pembrolizumab (n = 6) and avelumab (n = 3), or both medications (n = 1). At a mean follow-up of 11.4 ± 9.0 months, nine patients had complete response (90%); only one patient developed subsequent distant progression despite local response. Patients with both localized periocular disease and metastatic involvement demonstrated favorable responses to ICI. Adverse effects were infrequent and typically mild; only one patient discontinued therapy due to adverse effects. ICIs may be an effective and well-tolerated treatment for local and advanced periocular MCC; however, larger, prospective studies are needed.
28 May 2026
Read appraisal →ChemMedChem
A 24-Day MicroCycle Journey to Interleukin-17 Inhibitors: From Library Design to Central Core Prioritization and Capping Group Identification
We herein report an application of the MicroCycle platform, which leverages advanced machine learning models, automation, and miniaturization of processes to accelerate the exploration of chemical space through libraries. This approach was applied to a novel thiazole-based series targeting interleukin-17, enabling rapid prioritization of central cores and identification of compelling new capping groups, thereby guiding further optimization efforts.
27 May 2026
Read appraisal →Clinical and experimental dermatology
The role of dermoscopy in optimizing surgical margins for keratinocyte cancers: updated evidence from a systematic review and meta-analysis
BACKGROUND: Keratinocyte cancer (KC) is the most common malignancy worldwide. Surgical excision is the primary treatment, with clear margin delineation critical for oncological and cosmetic outcomes. Dermoscopy, well established for diagnosis, has recently been included in updated British guidelines as an alternative method for surgical margin planning and may offer improved border visualization. OBJECTIVES: To update the existing evidence on dermoscopy-guided excision of KC, focusing on margin control and recurrence risk and incorporating newly published studies and re-evaluating its use considering evolving guideline recommendations. METHODS: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. PubMed, EMBASE and CENTRAL were searched to October 2024. Eligible studies compared dermoscopy-guided with conventional surgical excision of histologically confirmed KC. The primary outcome was the incomplete excision rate. Risk of bias was assessed using ROBINS-I, and meta-analysis was conducted using a DerSimonian-Laird random-effects model. RESULTS: Ten studies (1151 patients; 1186 lesions) were included; 4 contributed to meta-analysis. Most focused on basal cell carcinoma; squamous cell carcinoma data were limited. Dermoscopy was associated with improved surgical precision and reduced incomplete excision (pooled odds ratio 0.30, 95% confidence intervals 0.27-0.34, P < 0.001; I² = 0%, P > 0.99), although all studies were observational and at moderate to serious risk of bias. Narrower margins were often achieved without compromising recurrence outcomes. CONCLUSIONS: Dermoscopy may enhance preoperative planning in KC excision, but evidence remains limited by methodological constraints. These findings support further high-quality trials to confirm clinical utility and define its role in future surgical guidelines.
27 May 2026
Read appraisal →Clinical and experimental dermatology
An open-label phase II study of bitopertin in adults and adolescents with erythropoietic protoporphyria or X-linked protoporphyria
BACKGROUND: Erythropoietic protoporphyria (EPP) and X-linked protoporphyria (XLP) are rare genetic disorders characterized by accumulation of protoporphyrin IX (PPIX), painful phototoxic reactions and hepatobiliary disease. No disease-modifying therapies are approved for these conditions. OBJECTIVES: To evaluate the safety and efficacy of bitopertin in adults and adolescents with EPP or XLP. METHODS: BEACON (ACTRN12622000799752) was a phase II, randomized, open-label, parallel-arm study in adult and adolescent participants with EPP or XLP. Participants received an oral, once-daily administration of bitopertin 20 mg or 60 mg for 24 weeks. RESULTS: Twenty-six participants were randomized to 20 mg (n = 14) or 60 mg (n = 12) of bitopertin. The study met its primary efficacy endpoint. Treatment with bitopertin resulted in significant, dose-dependent reductions in PPIX levels compared with baseline at both the 20-mg and 60-mg dose levels (mean -31.7%, SE 7.0; P < 0.001 vs. baseline and mean -57.7%, SE 7.4; P < 0.001 vs. baseline, respectively). Similar efficacy was observed across the adult and adolescent populations. No serious adverse events were reported. Dizziness was the most common adverse event reported with bitopertin, in 9 (64%) and 8 (67%) participants completing the study in the 20-mg and 60-mg dose groups, respectively. CONCLUSIONS: By reducing whole-blood PPIX levels, bitopertin targets the underlying pathophysiology of EPP, resulting in consistent improvements in multiple measures of light tolerance and quality of life. Bitopertin was well tolerated, and most adverse events were mild or moderate in severity.
27 May 2026
Read appraisal →Clinical and experimental dermatology
A systematic review of the barriers to diagnosis of vulval lichen sclerosus in primary care
BACKGROUND: Vulval lichen sclerosus (VLS) is a chronic, inflammatory genital skin condition causing itch, pain, anatomical changes and increased risk of vulval cancer. Diagnostic delay and misdiagnosis are common. Once diagnosed, VLS can be effectively treated using very strong topical corticosteroids. Most women with symptoms of VLS first present to primary care in the UK. OBJECTIVES: To identify patient and professional perspectives on barriers to diagnosis of VLS in primary care through systematic review and thematic synthesis of the literature. METHODS: Separate literature searches of seven databases relevant to patient and professional perspectives were conducted. Two reviewers screened titles and abstracts, with one performing a full text review. Data extracted were coded 'line by line', codes were organized into descriptive themes and subsequently developed into analytical themes. RESULTS: We identified 2468 references; a total of 56 studies met inclusion criteria. Six analytical themes were developed: (i) a medically challenging diagnosis; (ii) cultural and social taboos; (iii) education and knowledge gaps; (iv) feelings and attitudes; (v) inadequate health systems; and (vi) challenges in female genital examination. CONCLUSIONS: This review highlights obstacles for women in achieving a diagnosis of VLS. Education and knowledge gaps were reported by clinicians and patients. Clinicians lack knowledge of vulval skin disease and patients lack knowledge of vulval anatomy. Targeted, comprehensive education for clinicians could expedite diagnosis. Dismissive clinician attitudes compound patient feelings of anxiety and embarrassment, reinforcing taboos and stigma. Acknowledgement of embarrassment and stigma validates feelings, improving patient interactions. Future research priorities should include the development of a diagnostic tool and implementation of a complex intervention to expedite diagnosis.
27 May 2026
Read appraisal →Clinical and experimental dermatology
Novel and existing therapeutic interventions in psychogenic pruritus.
Psychogenic pruritus (PP) is a chronic itch disorder associated with psychological conditions lacking any dermatological or systemic cause. Diagnosis relies on excluding other aetiologies and identifying psychological stressors. Treatments include dermatological and psychiatric interventions such as topical steroids, selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, antihistamines, antipsychotics and psychotherapy. However, efficacy remains inconsistent, necessitating a systematic review of current and emerging pharmacological options. This study reviews pharmacological treatments for PP published in the past decade, evaluating efficacy and therapeutic potential. A systematic literature search was conducted using PubMed, Embase and Google Scholar (November 2014 to November 2024) following the PRISMA guidelines (PROSPERO: 1000201). In total, 1034 articles were screened by two independent reviewers. Inclusion criteria focused on human studies evaluating pharmacological treatments for PP. Seven studies met the inclusion criteria. Levels of evidence were assessed using the Joanna Briggs Institute critical appraisal checklist. SSRIs, particularly escitalopram, showed symptom improvement in case reports. Naltrexone (an opioid antagonist) led to complete itch resolution in a patient refractory to SSRIs. Gabapentin reduced pruritus severity. A neurokinin-1 receptor (NK-1R) antagonist (serlopitant) demonstrated significant efficacy in a phase II trial. Biologics such as dupilumab showed promise in chronic pruritus. Targeted therapies, including SSRIs, naltrexone, opioid pathway modulators, NK-1R antagonists and biologics, show promise in the clinical management of PP, but further research through randomized controlled trials is necessary to establish their efficacy and optimize treatment strategies.
27 May 2026
Read appraisal →Clinical and experimental dermatology
Topical statins in the treatment of porokeratosis: a systematic review
Porokeratosis is a chronic disorder of keratinization associated with significant morbidity and no spontaneous resolution. Currently, there are no therapies approved by the US Food and Drug Administration (FDA). However, the off-label use of topical statins - targeting the mevalonate pathway - has shown promise as a novel therapeutic strategy. This systematic review aims to evaluate the efficacy and safety of topical statins in the treatment of porokeratosis. We conducted a systematic review of the PubMed, Semantic Scholar and Cochrane databases from 1 January 2015 to 15 February 2025, identifying clinical studies evaluating topical statin therapy (atorvastatin, fluvastatin, lovastatin, rosuvastatin or simvastatin) in patients with any subtype of porokeratosis. Twenty-four studies encompassing 95 patients met the inclusion criteria. Most publications (88%) were case reports. The majority of patients (79%) received compounded topical lovastatin 2% or simvastatin 2%, typically in combination with cholesterol 2%. Clinical improvement - defined as partial resolution of symptoms or reduction in lesion size - was observed in 92% of patients (87 of 95), with onset of response reported as early as 4 weeks. Adverse events were reported in 15% of patients, primarily mild, localized dermatological reactions. Two patients discontinued treatment due to side effects. Topical statins appear to provide preliminary evidence of some clinical benefits in porokeratosis by inhibiting the mevalonate pathway, supporting a promising and plausible mechanism-based approach. However, the use of off-label compounded formulations introduces variability in efficacy and safety due to lack of quality control. The absence of FDA-approved therapies for porokeratosis represents an ongoing unmet therapeutic need warranting further investigation in prospective, controlled studies. Together, these preliminary case reports indicating clinical benefit encourage the development of an FDA-approved, Good Manufacturing Practice-quality topical statin formulation that is carefully evaluated in rigorous, well-designed clinical trials that demonstrate safety and substantial evidence of effectiveness.
27 May 2026
Read appraisal →Journal of neuro-oncology
Therapeutic effects of selumetinib on diffuse neurofibroma and optic pathway glioma in neurofibromatosis type 1.
PURPOSE: Selumetinib is approved for the treatment of inoperable plexiform neurofibromas (PN) in patients with neurofibromatosis type 1 (NF1). However, its efficacy in treating NF1-associated diffuse neurofibromas (NF1-DN) or optic pathway gliomas (NF1-OPG) remains unclear. We evaluated the efficacy and safety of selumetinib in these subgroups. METHODS: This was a sub-analysis of a Korean phase II open-label trial focusing on non-target treatment effects on NF1-DN and NF1-OPG. A total of 88 pediatric and adult patients with NF1-PN (59 children and 29 adults) in this trial had been treated for at least 2 years (~ 26 cycles, 28-day cycle) with oral selumetinib (20 or 25 mg/m², or 50 mg/dose every 12 h). Tumor volume, quality of life (QoL), and visual acuity were assessed. RESULTS: Among the 88 included patients, NF1-DN was diagnosed in 25 (28%), and NF1-OPG in 3 (3%). All NF1-DN patients exhibited disfigurement, two experienced pain, and a partial response (PR; ≥20% tumor reduction at a single time) was achieved in 9 of these cases (36%). The median time to PR was 6 cycles (range, 6-12), and the median time to best response was 18 cycles (range, 6-26), with a median volume change of - 11.9% (range, - 55.4% to + 36.3%). Confirmed PR (cPR; PR sustained for > 6 cycles) was observed in 6 NF1-DN patients (24%), stable disease (SD) was observed in 9 of these patients (36%), and progressive disease (PD) in 10 cases (40%). In a paired comparison, cPR was significantly lower for NF1-DN than for NF1-PN (24% vs. 88%, P < 0.001), and the median best volume reduction was also smaller (- 11.9% vs. -42.1%, P < 0.001). For the 3 NF1-OPG patients, visual impairment was present in all cases at baseline. One patient achieved PR at cycle 12 (- 36.1% from baseline) and complete response (CR) at cycle 26 but the visual acuity did not improve in this case. SD was maintained in the other two patients. Within these subgroups, QoL improved in 16 patients (57%) by cycle 26. No serious adverse events or treatment discontinuations were reported. CONCLUSIONS: Selumetinib shows therapeutic potential against NF1-DN, although with a lower response than that observed against NF1-PN. The NF1-OPG findings herein for this drug were exploratory only because of the small number of cases, but they may provide an additional clinical context for evaluating the broader effects of selumetinib across NF1-associated lesions. TRIAL REGISTRATION INFORMATION: KCT0003700, cris.nih.go.kr/cris/search/detailSearch.do/19,080, first submission March 4, 2019; first patient enrolled May 14, 2019.
25 May 2026
Read appraisal →Lasers in medical science
Efficacy and safety of recombinant human epidermal growth factor combined with fractional carbon dioxide laser for facial atrophic acne scars: a systematic review and meta-analysis of randomized trials
BACKGROUND: The combination of recombinant human epidermal growth factor (rhEGF) and fractional carbon dioxide (CO2) laser therapy is increasingly used in the treatment of facial atrophic acne scars. OBJECTIVE: This study aimed to systematically assess the efficacy and safety of rhEGF combined with fractional CO2 laser therapy for managing facial atrophic acne scars. METHODS: PubMed, Embase, the Cochrane Library, Web of Science, CNKI (China National Knowledge Infrastructure), Wanfang, SinoMed, and VIP were searched from inception to July 29, 2025. Parallel-group or split-face randomized controlled trials (RCTs) comparing fractional CO2 laser therapy + rhEGF with fractional CO2 laser therapy for treating atrophic acne scars were considered for inclusion. Risk of bias was assessed using the Cochrane Collaboration's risk-of-bias tool. The meta-analysis based on fixed or random effects models was carried out for Echelle d'Evaluation Clinique des Cicatrices d'acne (ECCA) scores, Vancouver Scar Scale (VSS) scores, transepidermal water loss (TEWL), etc. It was registered on PROSPERO (ID: CRD42024599311). RESULTS: Twelve RCTs involving 1,044 patients were included, and all trials were conducted in China. Follow-up durations across studies ranged from 1 week to 12 months. Compared with fractional CO₂ laser therapy alone, the combination therapy significantly reduced ECCA scores by a mean of 11.14 points (95% CI: -16.82 to -5.45, P = 0.0001) and VSS scores by a mean of 1.54 points (95% CI: -2.55 to -0.54, P = 0.003). The combination therapy demonstrated advantages in improving the durations of crust formation. The incidence of adverse events, particularly hyperpigmentation (RR = 0.41, 95% CI: 0.20 to 0.86; P = 0.02), was significantly lower in the combination therapy group. According to the GRADE assessment, the certainty of evidence ranged from very low to moderate for most outcomes. CONCLUSION: This study suggests that rhEGF combined with fractional CO₂ laser therapy may be beneficial for treating atrophic acne scars. However, because of the low to moderate certainty of evidence according to GRADE assessment, more robust, large-scale RCTs are needed to confirm these findings and define optimal treatment parameters.
23 May 2026
Read appraisal →The Journal of dermatological treatment
Sustained on/off-treatment disease control with abrocitinib for moderate-to-severe atopic dermatitis.
PURPOSE: Achieving sustained on- and off-treatment disease control is an important therapeutic goal in atopic dermatitis (AD). This study evaluated achievement of off-treatment disease control in patients randomized to placebo following 12 weeks of abrocitinib 200 mg. MATERIALS AND METHODS: In the phase 3 JADE REGIMEN study, patients with moderate-to-severe AD who achieved Investigator's Global Assessment (IGA) of 0/1 (with ≥2 grades of improvement) and ≥75% improvement in Eczema Area and Severity Index (EASI) after 12 weeks of abrocitinib 200 mg were randomized (1:1:1) to placebo, abrocitinib 100 mg, or abrocitinib 200 mg for 40 weeks. This post-hoc analysis evaluated patients by flare status (protocol flare definition: ≥50% loss of initial EASI post-randomization response and IGA score ≥2). EASI, IGA, Peak Pruritus Numerical Rating Scale (PP-NRS), and Dermatology Life Quality Index (DLQI) were evaluated. RESULTS: There were no off-treatment flares in 21.3% of patients in the placebo arm. The no-flare group had EASI, IGA, PP-NRS, and DLQI mean scores indicating clear/mild AD at week 52 (2.9, 1.0, 2.6, and 3.5, respectively). CONCLUSIONS: After 12 weeks of abrocitinib 200 mg, some patients achieved 40 weeks of sustained off-treatment disease control, with assessments demonstrating clear/mild AD, suggesting attainment of disease remission. TRIAL REGISTRATION: NCT03627767.
22 May 2026
Read appraisal →Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
Evaluating Personal and Environmental Decolonization Strategies for Children With Skin and Soft Tissue Infection and Their Households - A Randomized Clinical Trial
BACKGROUND: Staphylococcus aureus colonization predisposes to skin and soft tissue infection (SSTI). Given the waning effectiveness of decolonization, we evaluated periodic-personal decolonization and household environmental decontamination to reduce SSTIs among households affected by S. aureus. METHODS: Households of children with community-associated S. aureus SSTI participated in an open-label randomized trial. After baseline decolonization, households were randomized 1:1:1 to a 3-month decolonization intervention: (1) periodic-personal (twice weekly chlorhexidine bathing and monthly intranasal mupirocin application); (2) environmental-hygiene (weekly household surface disinfection and enhanced laundry measures); or (3) integrated-approach of both periodic-personal and environmental-hygiene. Over 9 months, participants and household surfaces were sampled at 5 study visits to detect S. aureus; SSTI incidence was recorded. The primary outcome was household-level cumulative SSTI at 3 months, comparing the integrated-approach to the combined personal-periodic and environmental-hygiene groups. RESULTS: Between 2015 and 2021, 196 index patients and their household contacts (n = 623) were enrolled. Cumulative SSTI incidence did not differ between groups during the 3-month intervention. In index patients and household contacts with SSTI in the year prior to enrollment, SSTI incidence was lower among the integrated-approach at 6- and 9-months compared to the combined periodic-personal and environmental-hygiene groups. In multivariable analyses, prior year SSTI was associated with subsequent SSTI; intervention group was not significant. All interventions reduced methicillin-resistant S. aureus, but not methicillin-susceptible S. aureus, personal colonization over 9 months. CONCLUSIONS: While an integrated-approach of prolonged personal and environmental decolonization reduced SSTIs among participants with prior year SSTI, prior SSTI strongly predicted SSTI incidence longitudinally. Novel prevention strategies are needed.
22 May 2026
Read appraisal →Rheumatology international
Targeting type I interferon in lupus panniculitis: a case-based systematic literature review
Lupus panniculitis (LEP) is a rare form of cutaneous lupus (CLE) characterised by progressive, often disfiguring course and poor response to treatment. Type I interferon inhibition through anifrolumab (ANF) is effective in CLE but limited data are available for its use in LEP. To address this issue, we screened patients with CLE and/or systemic lupus erythematosus (SLE) for biopsy-proven diagnoses of LEP and treatment with ANF. Besides demographics, general clinical features, concomitant treatments before and after ANF and safety signals, we measured disease activity and damage with the SLE disease activity index 2000 (SLEDAI-2 K), the CLE Disease Area and Severity Index activity (CLASI-A) and damage scores and the SLE International collaborating clinics/American College of Rheumatology damage index. The same data were retrieved, when available, from existing cases extracted from systematic literature review. Sixteen cases were identified, including 3/421 newly described patients, with two receiving ANF as first-line immunosuppressant and one as an early treatment devoid of oral corticosteroids. All patients had a good response to treatment and most of them could taper or discontinue corticosteroids. CLASI-A scores were markedly reduced after ANF treatment [11.5 (7-29)] to 0 (0-2); p = 0.005]. The time to response was within five months in most cases. No significant adverse events were reported. Taken together, our data suggest that ANF might be effective in LEP and used as a first-line treatment to prevent LEP-related damage accrual.
21 May 2026
Read appraisal →The British journal of dermatology
Artificial intelligence-based smartphone application for skin cancer detection: a prospective diagnostic accuracy study
BACKGROUND: Smartphone applications ('apps') that use artificial intelligence (AI) for skin cancer diagnosis may help with early detection. However, prospective studies assessing real-world performance are scarce. OBJECTIVES: To evaluate in an independent prospective study the diagnostic accuracy of a widely used skin cancer detection app and the effect of photographic conditions in a user-representative cohort of patients consulting for lesions of concern. METHODS: Between 1 February 2021 and 30 June 2023, participants presenting at an early-access consultation with a lesion of concern were consecutively enrolled. Following dermatological assessment, each lesion was photographed using the app. The app's convolutional neural network (CNN) generates a binary risk output and advice. A teledermatology review was performed in a subset of cases. The diagnostic accuracy of the CNN combined with teledermatology review was compared with final clinical or histopathological diagnosis. Performance was tested under different photographic conditions (angle, lighting, user) and with different smartphone models. The trial was registered with ClinicalTrials.gov (NCT05246163). RESULTS: A total of 1458 participants with 1904 lesions of concern were included. Of these, 185 (9.7%) were skin cancers, with 32 melanomas. Image capture was unsuccessful in 16.6% of lesions (n = 317/1904), despite optimal conditions. For successfully captured lesions, the CNN achieved a sensitivity of 82.5% and specificity of 76.8% for skin cancer detection. In-app teledermatology review was available for 65.7% (n = 1042/1587) of images. Combined CNN and teledermatology review resulted in increased specificity (86.8%; P < 0.001), with a sensitivity of 75.3%. Overall sensitivity in melanocytic lesions was lower than in nonmelanocytic lesions (71.0% vs. 76.3%; P < 0.001), whereas specificity was higher (90.0% vs. 84.9%; P < 0.001). A substudy demonstrated low image-capture success in user hands (28.9%) and variation in diagnostic performance between smartphone models. CONCLUSIONS: This independent, prospective study evaluated diagnostic performance of a widely used skin cancer detection app in a user-representative cohort. The findings highlight the importance of independent clinical validation of AI-based healthcare tools in real-world settings. Skin cancer is one of the most common cancers that affects people worldwide. Finding cancer early is important, especially for melanoma, a serious form of skin cancer. There is potential for smartphone apps to use AI to help people identify skin spots that may need medical attention. In this study, we evaluated a widely used app called SkinVision. People presenting with a worrisome spot at a dermatology appointment were invited to take part in this study. Altogether, 1458 people were included. The skin area of concern was assessed with the app. Using AI, the app produced a risk score. It also gave a final score. The final score was the AI risk score that may be combined with dermatology advice delivered remotely (‘teledermatology’). We compared the app scores with the doctor’s final diagnosis. We also studied the impact of things such as photo angle, lighting, type of smartphone and the person who took the photo. We found that over 16% of worrisome skin areas could not be captured by the app under ideal conditions. If participants were asked to take the photo themselves, this increased to over 70%. The app correctly identified skin cancers in 83% of cases but gave false alarms in 23%. The in-app teledermatology review reduced the number of false alarms, but this increased the number of missed skin cancers. Finally, we found important differences between different smartphones. Our findings highlight the importance of trialling apps like this with real patients in real-life setting before they are fully introduced to the public.
20 May 2026
Read appraisal →The British journal of dermatology
Efficacy and safety of stapokibart in adolescents with moderate-to-severe atopic dermatitis: a multicentre randomized double-blind placebo-controlled phase III trial
BACKGROUND: Moderate-to-severe atopic dermatitis (AD) imposes a significant burden on adolescents and their families, leading to a substantial reduction in quality of life. Treatment options remain limited. Stapokibart, a novel humanized monoclonal antibody that targets interleukin-4Rα, has been approved in China for the treatment of adults with moderate-to-severe AD. OBJECTIVES: To evaluate the efficacy and safety of stapokibart in adolescents with moderate-to-severe AD. METHODS: In this randomized double-blind placebo-controlled phase III trial (NCT06277765), eligible patients were randomized (2 : 1) to stapokibart 300 mg (loading dose 600 mg) or placebo for 18 weeks. Patients with a baseline weight ≥ 60 kg received subcutaneous stapokibart or placebo every 2 weeks (Q2W), while those weighing 30 to < 60 kg received treatment every 3 weeks (Q3W). All patients were given moisturizers during the entire study period. Co-primary endpoints were the proportions of patients achieving a ≥ 75% improvement from baseline in Eczema Area and Severity Index (EASI 75) and an Investigator's Global Assessment (IGA) score of clear or almost clear (IGA 0 or 1) with ≥ 2-point reduction from baseline (IGA response) at week 18. Safety was also assessed. RESULTS: Of the 180 enrolled patients, 120 received stapokibart (Q2W, n = 54; Q3W, n = 66) and 60 received placebo (Q2W, n = 26; Q3W, n = 34). In total, 178 (98.9%) patients completed the double-blind treatment. At week 18, higher proportions of patients treated with stapokibart than those treated with placebo achieved EASI 75 [73.9% (n = 88/119) vs. 43% (n = 26/60); difference: 30.5% (95% confidence interval 15.3-44.3; P < 0.001)] and an IGA response [57.1% (n = 68/119) vs. 25% (n = 15/60); difference: 31.8% (95% confidence interval 16.6-44.4; P < 0.001)]. The proportion of patients achieving ≥ 4-point reductions in weekly average of daily Peak Pruritus Numerical Rating Scale score was also significantly higher in the stapokibart group than in the placebo group [36.1% (n = 43/119) vs. 15% (n = 9/60); difference: 21.1% (95% confidence interval 7.4-32.4; P = 0.004)]. The incidence of adverse events was similar between the stapokibart (62.5%; n = 75/120) and placebo (62%; n = 37/60) groups. No conjunctivitis was seen. CONCLUSIONS: Stapokibart has a high efficacy and favourable safety in adolescents with moderate-to-severe AD. An author video to accompany this article is available online. Atopic dermatitis is a long-term skin condition. It causes intense itching and painful patches of dry skin. It is more commonly known as eczema. Adolescents with moderate or severe eczema often need long-term treatment to control the symptoms. In China, a drug called ‘stapokibart’ has recently been approved to treat adults with moderate or severe eczema. This study was done in 32 hospitals in China. We included adolescents with moderate or severe eczema. We treated them with stapokibart or placebo (an inactive or ‘dummy’ medication) for 18 weeks. The patients received their treatment via an injection under their skin. Depending on their weight at the start of the study, patients received treatment every 2 or every 3 weeks. After 18 weeks, patients treated with stapokibart were less itchy and had more of an improvement in their skin than those treated with the placebo. Over half of the patients achieved clear (or almost clear) skin. Finally, we found that stapokibart was safe to take. Undesired results from taking the medication (called ‘adverse events’) were mild or moderate. Our results suggest that stapokibart is an effective and safe treatment option for adolescents with moderate or severe eczema.
20 May 2026
Read appraisal →The British journal of dermatology
Burden and risk of asthma and rhinitis in people with atopic dermatitis: global estimates from a hierarchical Bayesian model
BACKGROUND: Atopic dermatitis (AD) is a chronic inflammatory skin disease often associated with asthma and rhinitis. However, epidemiological evidence on these comorbidities remains fragmented and is largely limited to high-income countries. OBJECTIVES: To provide comprehensive global, regional and country-level estimates of the prevalence and odds ratios (ORs) of asthma, rhinitis and their subtypes among individuals with AD. METHODS: We systematically reviewed 278 studies retrieved from PubMed, Embase, Web of Science and CNKI (China National Knowledge Infrastructure). Standardized prevalence estimates and ORs were derived using a Bayesian hierarchical linear mixed-effects model. RESULTS: Among individuals with AD, the global prevalence estimate of asthma, rhinitis, allergic rhinitis, rhinoconjunctivitis, and coexisting asthma and rhinitis was 20.1% (ranging from 2.5% in Israel to 59.4% in India), 45.1% (ranging from 7.8% in Israel to 82.7% in India), 41.4% (ranging from 6.8% in Israel to 80.3% in India), 30.7% (ranging from 4.3% in Israel to 71.9% in India) and 10.4% (ranging from 1.1% in Israel to 40.8% in India), respectively. Estimates were higher when restricted to patients with AD diagnosed by dermatologists or physicians. The highest comorbid prevalence rates were found for India, Cuba, Finland and Puerto Rico. Compared with healthy control individuals, AD was associated with higher odds of asthma (OR 2.73; ranging from 1.59 in China to 6.64 in Ethiopia), rhinitis (OR 2.98; ranging from 1.73 in China to 7.23 in Ethiopia), allergic rhinitis (OR 2.42; ranging from 1.41 in China to 5.89 in Ethiopia), rhinoconjunctivitis (OR 4.21; ranging from 2.45 in China to 10.19 in Ethiopia), and coexisting asthma and rhinitis (OR 2.42; ranging from 1.41 in China to 5.89 in Ethiopia). CONCLUSIONS: This study provides the first globally standardized estimates of respiratory comorbidities in AD, and can inform clinical practice and public health policy. Atopic dermatitis is a common long-term inflammatory skin disease. It is also called eczema. It affects more than 200 million children and adults worldwide. People with the disease often have other conditions, particularly asthma and rhinitis. Asthma affects breathing and rhinitis causes sneezing or congestion. Most studies on these conditions have been in wealthy countries. They have also used a range of different research methods. This makes it difficult to compare and understand the global situation. In this study, researchers in China and the USA analysed data from 278 studies from around the world. We estimated how common asthma and rhinitis are in people with eczema in different regions and countries. We found that about 1 in 5 people with eczema have asthma and almost half have rhinitis. We also found that people with eczema are 2 to 4 times more likely to have these conditions than people without eczema. Some countries showed particularly high rates of these conditions. Our findings suggest that asthma and rhinitis are common problems for people with eczema. This is true no matter where they live. The information from this study may help doctors recognize and manage these conditions in people with eczema. These findings could also support future research to improve disease prevention and patient care.
20 May 2026
Read appraisal →The British journal of dermatology
Evaluation and enhancement of the prognostic ability of the eighth edition of TNM staging in cutaneous malignant melanoma: a population-based study, using machine learning, of 111 871 patients
BACKGROUND: Melanoma is the fifth most common cancer in the USA and the UK, with global incidence on the rise. The TNM staging system guides treatment decisions and predicts patients' outcomes. OBJECTIVES: To evaluate the prognostic ability of the eighth edition TNM (TNM-8) staging system to predict overall (OS) and melanoma-specific survival (MSS) in cutaneous malignant melanoma (CMM), and to explore the potential of machine learning (ML) methods to enhance melanoma prognostication. METHODS: The records of adult patients diagnosed with CMM from 2018 to 2022 were extracted from the Surveillance, Epidemiology, and End Results (SEER) Program database. TNM-8 was evaluated using Kaplan-Meier plots and OS and MSS probabilities. Fine-Gray competing risk and accelerated failure time (AFT) models evaluated factors affecting MSS and OS, respectively. ML models were used to evaluate the predictive ability of TNM stages for OS and MSS, compared with that of multiple clinically important prognostic variables. RESULTS: Altogether, 111 871 patients with CMM were included in the analysis, with OS and MSS as survival endpoints. Most T (tumour), N (node), M (metastasis) and TNM-8 stage categories had distinct MSS and OS probabilities, except in the N1 and N2 stages at 12 months and in OS for TNM-8 stages 2 and 3 at 12, 36, 48 and 59 months. Fine-Gray and AFT models showed that age, sex, race/origin, tumour site, histological type, ulceration, Breslow thickness, mitotic rate, number of positive lymph nodes and M stage were important prognostic variables for MSS and OS. ML models showed that TNM had a higher predictive prognostic ability for MSS than OS and that including clinically important prognostic variables in addition to TNM stage has higher discriminative prognostic ability for OS and MSS (testing C-indices range 0.84-0.85 and 0.89-0.92, respectively) than using TNM staging alone (testing C-indices range 0.67-0.72 and 0.82-0.87, respectively). CONCLUSIONS: This proof-of-concept study demonstrated that although TNM staging retains prognostic value, adding important prognostic variables and using ML could improve prognostication for patients with melanoma. ML could be used to develop interactive clinical decision-support tools to improve the prognostication of individuals with melanoma. Cutaneous malignant melanoma is a common type of skin cancer. A guide called the ‘TNM’ is often used to decide what treatment patients should get. It also helps doctors decide how long patients need specialist care for. The guide is also used to help determine what the outlook for a patient might be. Lots of factors can affect the outcome for a person with the disease. These include a person’s age, sex and race. They also include factors related to the tumour, whether lymph glands are involved and whether the cancer has spread to other organs. Not all these factors are included in the current TNM guide. An accurate staging system is important. It will ensure that patients are followed-up and treated appropriately. This will help avoid unnecessary treatment or surveillance. In this study, we used a type of artificial intelligence (AI) to test how well the latest edition of the TNM can determine what the outlook for patients with melanoma is. We also used it to see if adding other important factors could improve its ability to predict the outlook for these patients. We included over 100,000 patients with melanoma from a large database called SEER. We found that using AI in addition to the current TNM guide could enhance the prediction of outcomes for patients with melanoma. The findings suggest that AI could be useful in helping health professionals predict outcomes for patients with melanoma.
20 May 2026
Read appraisal →Acta dermato-venereologica
Pregnancy in Women with Atopic Dermatitis: A Systematic Review of Concerns and Challenges
Atopic dermatitis (AD) has negative individual and societal implications. However, the potential impact of ADatopic dermatitis on reproduction has only been sporadically investigated. We aimed to provide an overview of pregnancy in ADatopic dermatitis, with a specific focus on concerns, challenges, the number of children, and adverse pregnancy and birth outcomes. A systematic literature search was performed using EMBASE and PubMed up until 19th January 2026 for original articles in relation to reproduction in female ADatopic dermatitis. Twenty-four highly heterogeneous studies were included. Concerns about ADatopic dermatitis in relation to pregnancy and family planning were reported in >50% of the patients in three3 out of four4 studies. Conflicting results were seen regarding fertility and disease severity during pregnancy. Pregnancy rates were similar or increased based on two2 studies. Eleven studies addressed adverse pregnancy and birth outcomes, of which five5 studies unanimously reported a protective or indifferent effect of ADatopic dermatitis on pre-term birth, gestational diabetes and stillbirth. Outcomes such as gestational hypertension, preeclampsia and miscarriage showed divergent results. Overall, ADatopic dermatitis causes considerable worries in relation to family planning. However, this review implies, that pregnancy rates as well as complications in pregnancy and during childbirth in women with ADatopic dermatitis overall are consistent with women without ADatopic dermatitis.
20 May 2026
Read appraisal →Aesthetic surgery journal
Therapeutic Efficacy and Safety of Recombinant Botulinum Toxin Type A for Moderate to Severe Glabellar Lines: A Randomized, Controlled, Double-blind, Phase III Trial in Chinese Adults
BACKGROUND: Conventional botulinum toxin type A (BoNT/A) products include non-therapeutic accessory proteins vary in composition and manufacturing processes, which may contribute to differences in purity and biochemical characteristics. YY001 (Retoxin®) is a novel recombinant BoNT/A manufactured via E. coli expression to reduce impurities, improve purity, and minimize immunogenic risk. OBJECTIVES: To evaluate the efficacy, safety, and immunogenicity of YY001, a recombinant botulinum toxin type A (Chongqing Claruvis Pharmaceutical Co., Ltd., Chongqing, China), in the treatment of moderate-to-severe glabellar lines. METHODS: In this multicenter, randomized, double-blind, vehicle- and active-controlled Phase III trial, 529 adults aged 18-65 with moderate to severe glabellar lines were randomized 4:2:1 to receive a single 20 U injection of YY001, Botox®(Allergan Pharmaceuticals Ireland, Westport, Ireland), or vehicle. The primary endpoint was composite response rate (CRR) at Week 4, defined as a ≥2-grade improvement of glabellar line severity assessed by both investigator and participant. Secondary endpoints included onset time, duration, satisfaction, and safety. RESULTS: YY001 achieved a CRR of 86.7% at Week 4, significantly outperforming Botox® (66.7%, P < .0001) and vehicle (1.3%, P < .0001). It showed faster onset, longer median duration (97 days), and high participant satisfaction. Adverse events were mild and comparable across groups. Only one case of anti-drug antibody was observed; no neutralizing antibodies were detected. A 12-week follow-up and ethnically homogenous population may limit generalizability. CONCLUSIONS: YY001 demonstrated strong efficacy and a favorable safety profile than Botox®. Longer-term and multicenter studies are needed to assess durability, immunogenicity, and applicability across broader populations. LEVEL OF EVIDENCE: 1 (THERAPEUTIC): For image description, please refer to the figure legend and surrounding text.
19 May 2026
Read appraisal →Current allergy and asthma reports
Impact of IL-4/IL-13 Blockade with Dupilumab on the Microbiome in Type 2 Inflammatory Diseases: A Systematic Review
PURPOSE OF REVIEW: To systematically review current evidence on microbiota changes associated with dupilumab treatment across different anatomical sites in type 2 inflammatory diseases. RECENT FINDINGS: Fifteen studies were included, comprising two randomized trials and thirteen observational studies, mostly in atopic dermatitis, with fewer data in chronic rhinosinusitis with nasal polyps and NSAID-exacerbated respiratory disease. The skin was the most frequently investigated site, followed by the sinonasal tract and gut. Across skin studies, dupilumab was consistently associated with reduced Staphylococcus aureus, increased microbial diversity, and enrichment of commensal taxa. Sinonasal studies suggested shifts toward more eubiotic microbial communities. Gut evidence was limited, although one study suggested modulation of tryptophan metabolism-related pathways. Dupilumab appears to exert compartment-specific and disease-dependent effects on the microbiome. The strongest evidence concerns the skin and sinonasal compartments, whereas gut microbiota changes remain poorly defined. Further prospective studies are needed to assess microbiota signatures as potential biomarkers of response.
18 May 2026
Read appraisal →Computers in biology and medicine
Imaging and machine learning reveal pigment ring spatial characteristics in vitiligo progression
BACKGROUND: Vitiligo is a chronic autoimmune disorder causing skin depigmentation due to melanocyte loss, with pigment ring dynamics being key to understanding and managing the disease. METHODS: Data from 105 vitiligo patients were collected using reflectance confocal microscopy (RCM) imaging to analyze pigment ring patterns across progressive and stable stages. A multi-task self-supervised learning framework was used to identify and classify pigment ring types (complete, depressed, incomplete, and absent). Graph-based structural analysis was applied to characterize the spatial and network dynamics of pigment rings, incorporating metrics such as clustering coefficients, centrality measures, and Ripley's statistics. RESULTS: Progressive-stage patients exhibited denser clustering and spatial propagation of absent and depressed pigment rings, which played dominant roles in the network. Stable-stage patients showed higher clustering coefficients for complete rings, indicating restored structural stability. The learning framework demonstrated high accuracy in identifying pigment ring types, with an AUC of 0.99 and PR score of 0.95. Ripley's K-function analysis highlighted significant clustering of absent and depressed rings in the progression stage, correlating with active disease. CONCLUSION: Integrating imaging, machine learning, and graph-based analysis offers key insights into vitiligo progression, enabling better staging and personalized treatments, with future research needed for broader validation and model refinement.
16 May 2026
Read appraisal →BMJ global health
Integrated mass drug administration for yaws eradication: evidence from a comparative observational study in Papua New Guinea and a systematic review with network meta-analysis
BACKGROUND: Yaws is a chronic infectious disease that disproportionately affects under-reached communities. In 2023, Papua New Guinea (PNG) reported 100 165 suspected yaws cases, accounting for 45% of cases reported worldwide. The WHO targets yaws eradication by 2030, primarily through mass drug administration (MDA) of azithromycin. This study evaluates the impact of an integrated MDA programme in PNG and reviews global evidence on optimal MDA strategies through a network meta-analysis (NMA). METHODS: A comparative observational study was undertaken analysing outpatient department (OPD) attendances between West New Britain province (WNB; intervention) and New Ireland province (NIP; comparator) from November 2023 to August 2024. The intervention in WNB involved a single-round, integrated four-drug MDA provided in December 2023, comprising azithromycin, ivermectin, diethylcarbamazine and albendazole. Temporal trends in OPD attendances were analysed using negative binomial regression. A Bayesian NMA of six studies identified through a systematic review compared the effectiveness of azithromycin-based regimens for yaws eradication. RESULTS: Between Q3 2023 and Q1 2024, yaws-related OPD attendances in WNB declined significantly, with a 41% (p<0.0001) reduction relative to the comparator province (NIP). This reduction was sustained for at least 6 months following MDA. Over the same period, a 33% decline in total skin-related outpatient attendances was observed. In the NMA, three rounds of azithromycin MDA were associated with lower odds of active yaws at follow-up than observation (OR 0.04, 95% CrI 0.005 to 0.24) and had the highest probability of being ranked most effective. Single-round azithromycin MDA was also associated with reduced odds of active yaws at follow-up (OR 0.15, 95% CrI 0.05 to 0.45). CONCLUSION: In a high-burden setting, a single round of integrated MDA was associated with substantial early reductions in yaws burden. Multi-round azithromycin strategies, particularly three-round regimens, were associated with larger and more sustained reductions in community prevalence. These findings inform considerations for yaws control efforts in settings with persistent transmission.
15 May 2026
Read appraisal →The New England journal of medicine
A Phase 3 Trial of Brepocitinib in Dermatomyositis
BACKGROUND: Brepocitinib is a first-in-class, oral, selective TYK2-JAK1 inhibitor that blocks cytokine signaling, which has been implicated in dermatomyositis. METHODS: In this phase 3, double-blind, randomized, placebo-controlled trial, adults with dermatomyositis were assigned in a 1:1:1 ratio to receive once-daily oral brepocitinib at a dose of 30 mg, brepocitinib at a dose of 15 mg, or placebo for 52 weeks. Standard therapies were continued, and glucocorticoids were tapered. The primary end point was the Total Improvement Score, a validated composite myositis index (with scores ranging from 0 to 100 and higher scores indicating greater improvement) at week 52. Key secondary end points, including skin disease activity, glucocorticoid tapering, and physical function, were tested in a multiplicity-controlled sequence. RESULTS: A total of 241 patients underwent randomization: 81 to receive brepocitinib 30 mg, 81 to receive brepocitinib 15 mg, and 79 to receive placebo. At week 52, the mean Total Improvement Score was 46.5, 37.5, and 31.2, respectively (difference with brepocitinib 30 mg vs. placebo, 15.3; 95% confidence interval [CI], 6.7 to 24.0; P<0.001; difference with brepocitinib 15 mg vs. placebo, 6.3; 95% CI, -2.4 to 14.9). Brepocitinib 30 mg was superior to placebo across all nine key secondary end points, including skin disease activity, systemic glucocorticoid tapering, and functional disability, with improvements observed as early as week 4. Serious infections were more frequent in the brepocitinib 30-mg group than in the placebo group (10% vs. 1%). No deaths occurred during the trial. CONCLUSIONS: In adults with dermatomyositis that was resistant to previous therapy, the use of brepocitinib at a dose of 30 mg (but not at a dose of 15 mg) resulted in significant benefits with respect to a composite myositis index, skin disease severity, glucocorticoid tapering, and functional disability. (Funded by Priovant Therapeutics; ClinicalTrials.gov number, NCT05437263.).
15 May 2026
Read appraisal →The Journal of dermatological treatment
Beyond efficacy: pulse duration is crucial for adverse events in pulsed dye laser therapy for rosacea
BACKGROUND: Pulsed dye laser (PDL) is widely used for erythematotelangiectatic rosacea (ETR); however, the influence of pulse duration remains unclear. OBJECTIVE: To compare the efficacy and tolerability of 6 and 10 ms PDL pulse durations for ETR. METHODS: In this single-center, prospective, randomized controlled study, 80 patients with ETR received single PDL treatment using either a 6 or 10 ms pulse duration (9-11 J/cm2, 7 mm spot size). Erythema was assessed by blinded dermatologists using the Clinical Erythema Assessment (CEA) and telangiectasia scores, and Rosacea Area and Severity Index (RASI). ImageJ analysis measured the Relative Intensity of Redness (RIR) and Percentage of Erythema Area (PEA). Adverse events were recorded on days 3 and 7, and patient global assessment (PGA) and symptom improvement were evaluated at week 4. RESULTS: Both groups showed significant improvements in CEA, RASI, RIR, and PEA (p < 0.001), with no significant between group differences. However, edema (p < 0.05) and purpura (p < 0.001) were more frequent with the 6 ms setting. No significant differences were observed between the groups on the PGA, erythema improvement scale, or symptom improvement scale. CONCLUSION: Both pulse durations effectively reduced erythema, but 10 ms demonstrated more favorable tolerability.
13 May 2026
Read appraisal →Lancet (London, England)
Enpatoran, a Toll-like receptor 7/8 inhibitor, in moderate-to-severe systemic lupus erythematosus: findings from Cohort B of a multicentre, international, double-blind, placebo-controlled dose-finding phase 2 trial
BACKGROUND: Toll-like receptors (TLR) 7 and 8 (TLR7/8) are activators of innate and adaptive immunity contributing to lupus pathogenesis. In Cohort B of WILLOW, a phase 2, randomised, placebo-controlled, double-blind, basket, dose-finding study, enpatoran, an oral small molecule inhibitor of TLR7/8, was evaluated in participants with active systemic lupus erythematosus (SLE). METHODS: Participants were eligible if they were aged 18-75 years with moderate-to-severe SLE, with or without cutaneous manifestations, had a disease duration of at least 6 months, and were receiving a stable dose of medication before the screening period. Participants were recruited from 132 centres in 22 countries. In Part 1, participants were randomly allocated in a 1:2 ratio to receive either placebo or 100 mg enpatoran, both twice-daily. Following the enrolment of 60 participants, Part 2 was activated and additional participants were randomly allocated in a 1:1:1:1 ratio to 25 mg, 50 mg, or 100 mg of enpatoran or placebo, all twice-daily, for 24 weeks. Random allocation was stratified by region, biomarker status, and hybrid Safety of Estrogens in Lupus Erythematosus National Assessment-SLE Disease Activity Index score. The primary objective was to evaluate the dose-response relationship of enpatoran, using British Isles Lupus Assessment Group-based Composite Lupus Assessment (BICLA) response rate at week 24, based on multiple comparison procedure-modelling analysis. Study visits were scheduled from week 0 to week 24, followed by a 2-week safety follow-up period for participants who chose not to enter the long-term extension. From weeks 2 to 12, glucocorticoid doses were tapered to a prednisone-equivalent dose of no more than 5 mg/day, as clinically tolerated. Adverse events were monitored continuously throughout the study; safety parameters (including physical examination, vital signs, and routine chemistry and haematology) were assessed at all study visits. The trial was registered at ClinicalTrials.gov (NCT05162586) and a long-term extension study is ongoing. FINDINGS: Between May 4, 2022, and Feb 6, 2024, participants were screened for eligibility for WILLOW cohorts A and B; 715 participants were screened and 354 were randomly allocated and included in the Cohort B safety population (95 to placebo, 71 to 25 mg enpatoran, 74 to 50 mg enpatoran, and 114 to 100 mg enpatoran). One patient allocated to the placebo group was found to be ineligible and was excluded from the full analysis set for the efficacy analyses. 335 (95%) of 353 participants were female, 18 (5%) were male, and median age was 41 years (IQR 33-51). At week 24, the study did not meet its primary objective of identifying a statistically significant dose-response relationship for enpatoran in BICLA response rate (p=0·14). BICLA response rates at week 24 were higher with all doses of enpatoran (25 mg: 41 [58%] of 71; odds ratio [OR] vs placebo 2·2 [95% CI 1·1-4·0], 50 mg: 36 [49%] of 74; OR 1·5 [95% CI 0·8-2·8], and 100 mg: 56 [49%] of 114; OR 1·6 [95% CI 0·9-2·8]) versus placebo (37 [39%] of 94). The most common treatment-emergent adverse event was diarrhoea, in four (6%) of 71, two (3%) of 74, and two (2%) of 114 participants in the 25 mg, 50 mg, and 100 mg enpatoran groups, respectively, and seven (7%) of 95 participants in the placebo group. Serious adverse events were reported in one (1%) of 71, three (4%) of 74, five (4%) of 114, and three (3%) of 95 participants treated with 25 mg, 50 mg, and 100 mg enpatoran and placebo, respectively. INTERPRETATION: In this study of participants with moderate-to-severe SLE, enpatoran improved BICLA response rates versus placebo; however, the primary objective of a statistically significant dose-dependent effect on disease activity based on BICLA response was not met. Enpatoran was well tolerated across all dose groups. FUNDING: Merck Healthcare (Darmstadt, Germany).
13 May 2026
Read appraisal →Journal of clinical oncology : official journal of the American Society of Clinical Oncology
Phase I Study of Mosperafenib, a Novel Paradox Breaker B-Raf Proto-Oncogene Serine/Threonine Kinase (BRAF) Inhibitor, in Patients With BRAF V600-Mutant Solid Tumors
PURPOSE: BRAF V600 mutations are tumor-agnostic oncogenic drivers whose targeted inhibition is challenged by therapeutic resistance. Mosperafenib is a novel paradox breaker and brain-penetrant BRAF inhibitor (BRAFi), tested in this study for safety, maximum tolerated dose (MTD), pharmacokinetics (PK), and preliminary clinical activity. PATIENTS AND METHODS: This phase Ia/b study was conducted in patients with advanced solid tumors harboring a BRAF V600 mutation (ISRCTN13713551). The modified continuous reassessment method guided dose escalation of mosperafenib, which was given orally up to 3,600 mg once daily in 28-day cycles. The primary objective was to estimate the MTD and/or recommended phase II dose(s). RESULTS: Eighty patients (60% BRAFi-exposed)-63 with colorectal cancer (CRC), 13 with melanoma, and 4 with other solid tumors-received ≥1 dose of mosperafenib as a single agent for a median of 3.7 months (range, 0.2-28.6). Two dose-limiting grade 3 toxicities of rash and rash maculopapular were reported. MTD was not reached. Grade 3 to 4 treatment-related adverse events (TRAEs) occurred in 13 patients (16.3%); no grade 5 TRAEs events were reported. Two patients (2.5%) discontinued study treatment due to TRAEs. There were no reports of palmar-plantar erythrodysesthesia or keratoacanthoma. Linear and time-independent PK was demonstrated across the tested dose range, achieving exposure levels with sustained PK-derived pERK inhibition ≥90%. An exposure-response relationship was observed. Overall response rate was 24.2%, including two complete responses and 14 partial responses. Median progression-free survival was 6.4 months in patients with CRC (200 mg once daily-1200 mg three times a day) and 3.5 months in patients with melanoma (200 mg once daily-800 mg twice a day). CONCLUSION: Mosperafenib demonstrated a favorable safety profile, sustained target inhibition, and early signs of clinically meaningful single-agent activity in BRAFi-naïve and BRAFi-exposed patients.
13 May 2026
Read appraisal →Biomedical physics & engineering express
Vitiligo state assessment based on progressive transfer learning and multimodal domain adaptation
Vitiligo is a common skin depigmentation disorder; assessing its state is crucial for the treatment outcome. Collecting multimodal data for vitiligo assessment is complex and costly in clinical practices, and the limited data size restricts the performance of deep learning models. Transfer learning can alleviate the shortage of training data in medical image recognition, however, its applications in vitiligo state assessment are constrained by feature differences between natural and medical images and insufficient generalization to different modalities. To address these challenges, this paper introduces a vitiligo state assessment method based on progressive transfer learning and multimodal domain adaptation. The scheme uses a large set of unlabeled medical images as a bridge to reduce the discrepancies between natural and medical images through multi-step fine-tuning. An adaptive parameter unfreezing strategy is then applied for the accurately labeled target data to improve the adaptability and accuracy of the model. In addition, an integrated multimodal domain adaptation approach based on CycleGAN and hue, saturation, value color space transformation is proposed to reduce the impact of modality differences on transfer learning. Experimental results demonstrate that compared to the conventional transfer learning method, the proposed method improves the accuracy by 2.4% and 3.6% on the clinical and Wood's lamp modality datasets, respectively. This accurate vitiligo state assessment method can be applied to a wide range of multimodal dermatological diseases where labeled data is limited.
13 May 2026
Read appraisal →Journal of ethnopharmacology
Senecio scandens Buch. - Ham.: A comprehensive review of botany, phytochemistry, biological activity, toxicity, quality control, application, and practical domain.
ETHNOPHARMACOLOGICAL RELEVANCE: Senecio scandens Buch.-Ham., a medicinal herb from the Asteraceae family, contains flavonoids, terpenoids, and alkaloids as its primary bioactive compounds. It is commonly used in the treatment of ocular diseases and dermatological conditions. However, with its expanding applications across various fields, growing attention has been directed toward the potential safety concerns associated with its use. AIM OF THE REVIEW: This article systematically reviews existing literature on S. scandens, examining its botany, phytochemistry, biological activity, toxicity, applications, and development utilization, to provide a theoretical basis for in-depth exploration of its pharmacological mechanisms and resource development. MATERIALS AND METHODS: This study conducted a systematic review of literature on S. scandens published from 1972 to 2025, based on databases including PubMed and Web of Science. Plants names are provided in accordance with "The Plant List" (https://wfoplantlist.org/). RESULT: Over 200 chemical constituents, primarily flavonoids, terpenoids, and alkaloids, have been isolated and identified from S. scandens, endowing it with diverse biological activities such as anti-inflammatory, antibacterial, antioxidant, and anti-tumor effects. To address potential hepatorenal toxicity from its pyrrolizidine alkaloids, relevant safety guidelines have been gradually established alongside various clinical dosage forms. It is also widely used in fields including medicine, animal husbandry, agriculture, and cosmetics. CONCLUSION: By systematically reviewing the botany, phytochemistry, biological activity, toxicity, application, and development and utilization of S. scandens, this paper identifies key utilization obstacles, proposes future research directions, and provides a theoretical framework for its further development.
12 May 2026
Read appraisal →Journal of ethnopharmacology
Advances in the pharmacology and mechanism of anti-skin aging in Tonifying Traditional Chinese Medicines
ETHNOPHARMACOLOGICAL RELEVANCE: According to the Traditional Chinese Medicine (TCM) tenet that "internal imbalances manifest externally," skin aging reflects deficiencies in qi, blood, and organ systems-particularly the liver and kidneys. Tonifying Traditional Chinese Medicines (TTCM) address these root causes, nourishing the skin and delaying aging through internal regulation, as documented in classical texts including the Shennong Ben Cao Jing and the Compendium of Materia Medica. AIM OF THE STUDY: This article systematically reviews the anti-skin-aging mechanisms of TTCM by integrating traditional applications with modern pharmacological evidence. It explores their multi-component, multi-target, and multi-pathway actions, evaluates current experimental models, and investigates the emerging role of artificial intelligence (AI) in advancing TTCM research. MATERIALS AND METHODS: We systematically searched PubMed, China National Knowledge Infrastructure (CNKI), Web of Science and Scopus for articles published from January 2015 to August 2025 with keywords such as "skin aging", "anti-aging" and the Latin names of TTCM (e.g. Panax ginseng, Astragalus membranaceus). Cellular, animal and clinical studies were analyzed for active constituents, molecular targets, ageing biomarkers and related signalling pathways. RESULTS: TTCM demonstrates anti-skin-aging effects through systemic regulation of organ function and qi-blood-yin-yang balance. At the molecular level, TTCM attenuates senescence through antioxidative, anti-inflammatory, extracellular matrix (ECM) stabilizing mechanisms, mediated by modulation of multiple pathways, such as Mitogen-Activated Protein Kinase (MAPK), Tumor Protein p53 (p53) and Nuclear factor erythroid 2-related factor 2 (Nrf2), exemplifying a "holistic regulation-targeted intervention" therapeutic paradigm. CONCLUSIONS: TTCM exerts anti-skin-aging effects through multi-component, multi-target and multi-pathway synergism. We strongly recommend the further integration of TTCM with modern medicine and in-depth mechanistic studies to promote translational applications.
12 May 2026
Read appraisal →European journal of pediatrics
Diagnostic accuracy of artificial intelligence versus 263 pediatric clinicians for childhood exanthems
Pediatric exanthematous diseases pose diagnostic challenges because clinical presentations overlap. To determine whether current artificial intelligence (AI) models achieve diagnostic accuracy within or above the performance distribution of pediatric residents and specialists for common rash-associated diseases. Participants and AI models were evaluated against definitive diagnoses confirmed by clinical features, laboratory findings, and consensus of two pediatric infectious disease specialists. A volunteer sample of 263 pediatric clinicians: 107 residents (years 1 through 4) and 156 specialists. Each clinician completed a blinded multiple-choice questionnaire with a clinical photograph and accompanying clinical data per case. The same cases were presented to three AI models: ChatGPT, Gemini, and Copilot. Among 263 clinicians (107 residents, 156 specialists), specialists scored higher than residents (median, 46 [IQR, 42-50] vs 41 [IQR, 36-46]; P < .001; r = 0.32). ChatGPT correctly diagnosed 53 of 61 cases (86.9%), Gemini 50 (82.0%), and Copilot 44 (72.1%). Both ChatGPT and Gemini exceeded the upper bound of the specialist population median 95% CI (47.17). All three AI models scored above the resident 95% CI upper bound (42.76). Disease-level accuracy ranged from 0% (insect bites, all models) to 100% (9 conditions, all models). Fourth-year residents scored higher than first- and second-year residents (P = .001; ε2 = 0.13).Conclusions: AI models given clinical data alongside images matched or exceeded specialist-level performance for pediatric exanthems. Accuracy varied by disease; failures clustered in conditions that require contextual reasoning. Physician oversight remains necessary where AI accuracy is lowest. What is Known • Childhood exanthematous diseases pose significant diagnostic challenges due to their overlapping clinical presentations. • Artificial intelligence models are becoming increasingly proficient in accurately diagnosing these conditions. What is New • In this diagnostic accuracy study of 61 cases evaluated by 263 clinicians and 3 artificial intelligence models, ChatGPT (86.9%) and Gemini (82.0%) exceeded the 95% CI upper bound of the specialist population median. Disease-level accuracy ranged from 0 to 100% across models • Artificial intelligence models given clinical data alongside images can match or exceed specialist-level accuracy for common pediatric exanthems, but failures in context-dependent diagnoses require physician oversight.
12 May 2026
Read appraisal →Journal of Crohn's & colitis
Safety of advanced therapies during pregnancy in women with immune-mediated inflammatory diseases: a systematic review and meta-analysis
BACKGROUND AND AIMS: We aimed to assess the safety of advanced therapies, excluding tumor necrosis factor inhibitors (anti-TNFs), for the treatment of immune-mediated inflammatory diseases (IMIDs), on pregnancy and neonatal outcomes. METHODS AND ANALYSIS: We performed a systematic review and meta-analysis. Study selection and data extraction were conducted independently by two reviewers. Primary outcomes included live births, major congenital malformations (MCMs), miscarriages, and stillbirths. Risk of bias was assessed using ROBINS-I, and the certainty of evidence was evaluated using GRADE. Meta-analyses of prevalence and odds ratios (ORs) comparing advanced therapies with anti-TNFs were conducted using fixed and random effect models. RESULTS: Of 14 661 manuscripts screened, 49 studies met the inclusion criteria: eight cohorts, nine case series, and 32 case reports. Most cohort studies were at a critical risk of bias. The majority of the available data related to ustekinumab (1324 exposed offspring) and vedolizumab (585 exposed offspring) whereas data on other biologics and JAK inhibitors were very limited. Pregnancies exposed to biologics had a pooled prevalence of 82.43% for live births, 0.55% for MCMs, 8.16% for miscarriage, and 0.00% for stillbirths. No significant differences in adverse pregnancy or neonatal outcomes were observed compared with women exposed to anti-TNFs. Overall, the level of evidence was very low, due largely to reliance on small observational studies and case reports. CONCLUSION: Current evidence does not suggest an increased risk of adverse pregnancy or neonatal outcomes with advanced therapies for IMIDs. However, larger, high-quality studies are needed, and these findings should be interpreted as hypothesis-generating.
12 May 2026
Read appraisal →International health
Atopic dermatitis in Ethiopia: a systematic review and meta-analysis
Despite being a leading contributor to the global burden of skin disease there is no information on the national prevalence of atopic dermatitis in Ethiopia. Therefore, the purpose of this systematic review and meta-analysis was to estimate the pooled national prevalence of atopic dermatitis in Ethiopia. A computerized systematic search using multiple databases was performed in search of relevant English articles from the inception of the databases to 30 July 2023. It was done in accordance with the Preferred Reporting Items for Systematic review and Meta-Analysis (i.e. PRISMA) standard. R and R Studio software were used for statistical analysis. A random-effects model was used for calculating the pooled estimate of the prevalence of atopic dermatitis. Forest plots and tables were used to represent the data. We found 10 full-text observational studies with 25 920 participants suitable for the review after checking for inclusion and exclusion criteria. The overall pooled prevalence of atopic dermatitis in Ethiopia was 12.75% (95% CI 8.32 to 17.17%). The subgroup analysis found that the atopic dermatitis pooled prevalence was 7% (95% CI 3 to 10%), 17% (95% CI 4 to 30%) and 20% (95% CI 15 to 24%) in the Oromia region, Amhara region and Addis Ababa city administration, respectively. This study demonstrates that atopic dermatitis is highly prevalent in Ethiopia, affecting approximately one in eight individuals, with significant geographical variations. To effectively address this condition, it is crucial to implement awareness campaigns, prioritize specialized training for healthcare professionals, allocate resources to high-prevalence areas, establish a national registry for monitoring, develop community support programs and encourage further research, as there are currently few studies on the condition.
11 May 2026
Read appraisal →Journal of burn care & research : official publication of the American Burn Association
FGF2 in Burn Wound Healing: From Molecular Function to Clinical Application-A Systematic Review
Burn injuries trigger complex inflammatory and metabolic cascades that impair wound healing and increase morbidity. Fibroblast growth factor 2 (FGF2), a potent mediator of cellular proliferation, angiogenesis, and extracellular matrix remodeling, has emerged as a promising therapeutic agent in burn care. This systematic review evaluated the biological mechanisms, delivery strategies, and clinical outcomes associated with FGF2 in burn wound healing to clarify its therapeutic value and translational potential. Following PRISMA 2020 standards, a structured literature search was conducted across PubMed, EMBASE, Web of Science, Cochrane, and Google Scholar to identify studies investigating FGF2 in thermal injuries. Eligible records included clinical trials, in vivo models, and in vitro experiments. Methodological quality and risk of bias were assessed using the Newcastle-Ottawa Scale, the SYRCLE tool, and the Oxford Levels of Evidence. Thirty-three studies (1992-2025) met inclusion criteria, encompassing randomized controlled trials, animal models, and mechanistic analyses. Fibroblast growth factor 2 accelerated repair by stimulating fibroblast proliferation, keratinocyte migration, angiogenesis, and matrix organization. Topical FGF2 formulations shortened healing time and improved scar quality in partial-thickness burns. Innovative carriers, including hydrogels, liposomes, and gene-activated matrices, enhanced bioavailability and sustained local effects. In diabetic and complex burn models, FGF2 mitigated inflammation, preserved barrier integrity, and promoted re-epithelialization. Efficacy depended on dosage and wound characteristics. Studies reported favorable safety profiles with minimal and mild adverse events. Fibroblast growth factor 2 demonstrates regenerative and immunomodulatory potential in burn management. Broader adoption requires harmonized regulatory evaluation, optimized delivery systems, and multicenter validation to define its role in precision-guided burn care.
11 May 2026
Read appraisal →The Journal of dermatological treatment
Comparative efficacy and safety of oral azithromycin versus doxycycline in moderate-to-severe Acne vulgaris: a systematic review and meta-analysis
BACKGROUND: Acne vulgaris is a chronic inflammatory disease and is one of the leading causes of dermatological morbidities among young adults. Doxycycline is widely recommended as first-line therapy for moderate to severe acne; however, its use is limited. OBJECTIVE: To systematically compare the efficacy and safety of oral azithromycin pulse therapy versus doxycycline in patients with moderate to severe acne vulgaris. METHODS: This systematic review and meta-analysis followed PRISMA guidelines. A comprehensive literature search on different databases was performed. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Mean differences (MDs) and risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using random-effects models based on heterogeneity. RESULTS: A total of 23 comparative studies comprising 2,769 patients were included. Pooled analysis demonstrated a statistically significant improvement in global acne severity favoring azithromycin (GAGS reduction: MD 1.81; 95% CI 1.28-2.34; I2 = 0%). Azithromycin achieved a significantly greater reduction in non-inflammatory lesion counts (MD -7.56; 95% CI -14.33 to -0.79). No significant differences were observed in inflammatory lesion reduction (MD 1.08; 95% CI -0.03 to 2.18). CONCLUSION: Oral azithromycin pulse therapy appears to have similar efficacy, better tolerability, and fewer side effects as compared to doxycycline.
11 May 2026
Read appraisal →Chinese medical journal
Artificial intelligence in atopic dermatitis: Current applications and future perspectives.
Atopic dermatitis (AD) is a prevalent and burdensome chronic skin disease, with profound effects on patient quality of life. Advancing its diagnosis and management remains a pressing clinical need. Artificial intelligence holds growing promise in addressing this challenge. This review outlines the current landscape of AD and explores the expanding role of AI in its care-from improving diagnostic accuracy and objective severity scoring to predicting therapeutic outcomes and personalizing treatment strategies. While these technologies are poised to transform dermatology practice, their successful integration will depend on overcoming technical and practical barriers through collaborative, interdisciplinary efforts. Further research and thoughtful implementation are essential to translate AI's potential into better, more precise patient care.
11 May 2026
Read appraisal →Transactions of the Royal Society of Tropical Medicine and Hygiene
Quality of life in Indian people affected by leprosy? A systematic review from the country with the highest burden of leprosy cases.
Quality of life (QoL) is important for people with leprosy since the disease can cause physical and psychological problems. These problems may result in stigma and social discrimination. India reported 107 851 new leprosy cases for the year 2023-24, accounting for 61.6% of new cases detected globally. This systematic review was conducted to assess the QoL among people affected by leprosy in India using existing literature. The Scopus, PubMed and Infolep databases were searched for articles for this systematic review and included only studies conducted in India. The critical appraisal tool of cross-sectional studies (AXIS) was used to assess the study quality and risk of bias. The search identified 253 articles. After screening titles and abstracts, 23 full-text articles were assessed for eligibility and 12 studies were included in the systematic review. The World Health Organization Quality of Life-Bref instrument was used to measure QoL. Of the 12 studies, the factors of disability (9 studies) and old age (8 studies) were highly associated with low levels of QoL. Five studies identified that low levels of QoL are associated with being female with the leprosy. Early identification and prevention of disabilities are important steps in improving the QoL. Increased investment is needed in leprosy programmatic activities and research to achieve the target of zero leprosy.
10 May 2026
Read appraisal →The Journal of dermatological treatment
A safety checklist before initiating second-generation immunomodulating drugs for inflammatory dermatoses: a systematic review
BACKGROUND/AIM: Second-generation immunomodulating drugs for inflammatory dermatoses have expanded over the past decades. Contraindications and special warnings must be considered before starting any treatment, but identifying all relevant safety information can be time-consuming. The objective is to provide an overview of contraindications, special warnings, and boxed warnings with the aim to establish a safety checklist, covering second-generation immunomodulatory therapies. METHODS: We identified contraindications, special warnings and boxed warnings provided by the European Medicines Agency and the US Food and Drug Administration, for second-generation immunomodulating drugs approved for inflammatory dermatoses. Both topical and systemic therapies were included. RESULTS: Most drug classes had warnings related to infections. Herpes zoster was listed for anti-CD20, IL-12/23i, INFi, JAKi and TYK2i, where hepatitis reactivation was reported for anti-CD20, TNFi, IL-17i, anti-BAFF, JAKi and TYK2i. Malignancy risk including skin cancer was mentioned for most classes, except IL-23i, IL-17i, IL-13i, IL-4/13i, IL-31i, IL-36i and PDE4i. Other serious warnings included neurological, cardiovascular, thrombotic, hepatic, renal, gastrointestinal, and psychiatric adverse events. CONCLUSION: This work provides a simple stepwise approach to managing contraindications and special warnings. Our safety checklist gives clinicians a rapid overview of contraindications, special warnings, and boxed warnings for the available drug classes approved for inflammatory dermatoses.
10 May 2026
Read appraisal →Journal of wound care
Incidence and risk factors of medical adhesive-related skin injury among ICU patients: a systematic review and meta-analysis
OBJECTIVE: To summarise the evidence regarding the incidence and risk factors of medical adhesive-related skin injury (MARSI) among patients in the intensive care unit (ICU). METHOD: A systematic review and meta-analysis was undertaken using articles available in nine databases: PubMed; the Cochrane Library; Web of Science; Embase; CINAHL; Chinese Biomedical Literature Database; China National Knowledge Infrastructure Database; Wanfang Database; and Weipu Database, from inception until 30 June 2024. Additional studies were identified by examining the references of relevant articles. The Stata 16.0 statistical platform (StataCorp LLC, US) was used for analysis. Study quality was assessed using the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality standards. RESULTS: Of 14,743 titles screened, 19 studies involving 5218 patients were included in the systematic review. The pooled incidence of MARSI was 21% (95% confidence interval (CI): 14%, 28%), and the incidence of MARSI among neonatal ICU, paediatric ICU and adult ICU was 15% (95% CI: 6%, 26%), 48% (95% CI: 35%, 60%) and 16% (95% CI: 11%, 22%), respectively. Significant risk factors in adult ICUs included oedema (odds ratio (OR): 8.144; 95%CI: 3.267, 20.304), Braden scale score (OR: 0.733; 95%CI: 0.641, 0.837), length of ICU stay (OR: 1.072; 95%CI: 1.026, 1.120), mechanical ventilation (OR: 3.698; 95%CI: 1.900, 7.199), sedative use (OR: 6.022; 95%CI: 2.859, 12.687), Nutritional Risk Screening 2002 score (OR: 4.241; 95%CI: 1.984, 9.065) and hypoalbuminaemia (OR: 4.321; 95%CI: 1.967, 9.488). CONCLUSION: This study found that MARSI is prevalent among ICU patients and is associated with multiple risk factors. Improved strategies for identifying and clinically managing MARSI in ICU patients are needed. Nevertheless, large-sample and multicentre studies are still warranted to validate the present study's findings.
10 May 2026
Read appraisal →Journal of wound care
Exudate management with a next-generation multilayered foam dressing in traumatic and surgical wounds: a prospective, multicentre study
OBJECTIVE: The aim of this study was to evaluate the efficacy, performance and safety of ConvaFoam (Convatec Ltd., UK), a next-generation multilayered foam dressing, in indicated surgical and traumatic wounds. METHOD: This prospective, multicentre, open-label study (ClinicalTrials.gov: NCT05632276) evaluated ConvaFoam dressings in surgical and traumatic wounds. Eligible patients were managed with ConvaFoam dressings in accordance with their instructions for use (maximum seven-day wear time) for ≤4 weeks. The primary endpoint was the proportion of patients and total dressings with excellent exudate management (defined as absence of strikethrough or periwound maceration). Secondary endpoints included: exudate management in dressings worn for seven days; healing rate; wear time; pain on application; usability; and safety. RESULTS: The study enrolled 52 patients (mean age: 48.2 years) with surgical (54%) or traumatic (46%) wounds. Median dressing wear time was five days (interquartile range: 1-7 days). Among patients who completed the study, 81% (38/47) were observed to have achieved excellent exudate management throughout all wound care visits (90% confidence interval (CI): 71, 90%). Excellent exudate management was also observed in 93% (209/224) of total dressings applied (90% CI: 90, 97%), including in 96% (47/49) of dressings worn for seven days. Only one patient in the study experienced periwound skin maceration at any study timepoint. Wound healing was observed in 93% of surgical wounds and 25% of traumatic wounds during the study period. Low levels of pain and high user satisfaction as per numeric pain scale and utility questionnaire, respectively, were reported. CONCLUSION: ConvaFoam dressings demonstrated excellent exudate management in >90% of dressing changes, and may promote an optimal environment for healing in surgical and traumatic wounds.
10 May 2026
Read appraisal →Journal of the European Academy of Dermatology and Venereology : JEADV
A deep learning-clinical nomogram hybrid for predicting sentinel lymph node metastasis in melanoma
BACKGROUND: Melanoma is a life-threatening skin malignancy, with sentinel lymph node metastasis (SLNM) serving as a critical prognostic factor. While machine and deep learning models using histopathology have focused on melanoma diagnosis, limited efforts have aimed to predict SLNM. OBJECTIVES: This study aimed to develop a collaborative machine and deep learning model that integrates histopathological patches and clinical data to predict SLNM in patients with invasive melanoma, thereby aiding decision-making regarding sentinel lymph node biopsy. METHODS: A total of 78 invasive cutaneous melanoma cases (43 SLNM-positive and 35 SLNM-negative) from the University of Yamanashi Hospital (2007-2022) were divided into training (n = 60) and test (n = 18) datasets. A clustering-constrained attention multiple-instance learning (CLAM) model was developed using haematoxylin and eosin-stained whole-slide images. Among the four CLAM variants, the model using a ResNet50trunc encoder trained on whole-tissue regions (CLAM-R50) demonstrated the best performance and was further integrated with a clinical nomogram. Hybrid modelling was performed using logistic regression, a support vector machine and gradient boosting. RESULTS: CLAM-R50 achieved an area under the receiver operating characteristic curve (AUROC) of 0.875, while the clinical nomogram achieved an AUROC of 0.826 on the test set. The gradient boosting hybrid model, termed the Melanoma Indicative Scorer for Sentinel Lymph node Evaluation (MISSLE), demonstrated the highest AUROC of 0.950 (95% bootstrapped confidence interval (CI): 0.933-1.00) on the test set. CLAM-R50 attention maps identified pale cytoplasm and plasma cell-like tumour cells as predictors of positive SLNM, whereas dense melanin deposition and lymphocyte-like tumour cells predicted negative SLNM. CONCLUSIONS: MISSLE integrates histopathological and clinical data to predict SLNM with high AUROC, surpassing the previous reports and offering a tool for clinical decision-making. Limitations include the single-centre design and predominantly Japanese cohort, limiting generalizability. The code and models are publicly available for external validation.
5 May 2026
Read appraisal →Analytical methods : advancing methods and applications
Beyond identification: inferring physical activity from fingerprint lipids using machine learning.
Fingerprints are a widely recognized form of forensic evidence, valued for their ability to link individuals with specific locations. Traditional fingerprint analysis relies on optical imaging to identify a match in a fingerprint database; however, where no match is found, the evidential value of a latent print is limited. Here, we present the first study to integrate matrix-assisted laser desorption/ionization mass spectrometry (MALDI-MS) with supervised machine learning to infer physical activity from fingerprint chemistry, expanding the utility of fingerprints beyond identification alone. Physical activity labels were derived from a validated questionnaire and converted into binary classes. Supervised machine learning algorithms were trained on the lipid features and evaluated against the survey-derived labels. The top-performing models were an ensemble algorithm based on multiple decision trees and a neural network, which classified physical activity with accuracies of 75 ± 8% and 73 ± 7%, respectively. These results demonstrate that fingerprint lipid chemistry encodes biologically meaningful information related to physical activity and establish a new approach for extracting lifestyle and behavioral indicators from trace evidence, with potential applications in forensic investigations and noninvasive fingerprint-based assessments in medicine.
4 May 2026
Read appraisal →BMJ supportive & palliative care
Hand-foot syndrome prevention: pharmacological interventions-systematic review and network meta-analysis
INTRODUCTION: Hand-foot syndrome (HFS) is a dermatological side effect of chemotherapies such as capecitabine and pegylated liposomal doxorubicin. Over recent years, numerous randomised controlled trials (RCTs) have investigated various pharmacological strategies to prevent HFS. Although urea cream and celecoxib have shown promising results, the efficacy of topical diclofenac remains unclear. To provide a comprehensive comparison of pharmacological interventions for HFS prevention in cancer patients undergoing chemotherapy, we conducted a network meta-analysis (NMA). METHODS: We systematically searched PubMed, Cochrane and Scopus for relevant RCTs published up to November 2024. The primary outcome was the incidence of moderate to severe HFS (grade 2-3), while secondary outcomes included the occurrence of all-grade HFS (grade≥1) and chemotherapy modifications. Risk ratios (RR) with 95% CIs were estimated for all outcomes using NMA. RESULTS: Thirteen RCTs comprising 1983 patients, most of whom received capecitabine (n=1849) were included, evaluating five pharmacological interventions. Both topical diclofenac (RR 0.26, 95% CI 0.10 to 0.66) and celecoxib (RR 0.46, 95% CI 0.26 to 0.84) significantly reduced the risk of moderate to severe HFS compared with placebo. Notably, topical diclofenac was the only intervention that significantly reduced the incidence of all-grade HFS and the need for chemotherapy modifications. CONCLUSION: Our NMA demonstrates that topical diclofenac provides the most robust protective effect among available pharmacological interventions for HFS prevention and is also associated with fewer chemotherapy modifications. These findings support its consideration as a preferred preventative strategy for patients at risk of HFS during chemotherapy. PROSPERO REGISTRATION NUMBER: CRD42025643635.
3 May 2026
Read appraisal →PloS one
Clinical manifestations of bed bug bites: A systematic review of case reports
IMPORTANCE: Clinical characterization of bed bug (Cimex spp.) bite manifestations remains limited. OBJECTIVE: This systematic review synthesizes case reports to describe dermatological, systemic, and psychological outcomes of bed bug bites. EVIDENCE REVIEW: Following PRISMA guidelines, multiple databases, including Pubmed and Scopus, were searched using terms such as "bed bug," "Cimex lectularius," "Cimex hemipterus," "case report," and "case series." Extracted data included demographics, species, lesion type, anatomical distribution, and clinical manifestations. Quantitative and qualitative analyses were conducted. RESULTS: Eighty-four patients were included: 76 with C. lectularius (90.5%) and, 8 with C. hemipterus (9.5%). Sex distribution was balanced (47.6% females, 52.4% males), and mean ages were similar (females 37.5 ± 22.1, males 42.3 ± 21.27 years; p = 0.332). Extremities were commonly affected, arms were reported in 71.4% of cases, legs in 59.5% and trunk in 34.5%. Psychological symptoms were registered in a handful of case reports (Anxiety 9.5%, Stress 9.5%, Hopelessness 9.5%). Systemic symptoms, generally associated with anemia, were reported in cases related to severe infestations in neglected patients. Some differences in systemic and local signs and symptoms were detected depending on age group. CONCLUSIONS: Bed bug bites predominantly affect exposed extremities, although with variable dermatologic patterns that can be confused with other arthropod bites. Psychological manifestations were reported in a small subset of cases, while systemic complications were rare.
3 May 2026
Read appraisal →The Journal of dermatological treatment
Comparative efficacy and safety of platelet-rich plasma (PRP), injectable platelet-rich fibrin (i-PRF) and concentrated growth factors (CGF) for female pattern hair loss (FPHL): a prospective multicenter randomized clinical trial
BACKGROUND: Comparative studies among different autologous platelet concentrate types for FPHL remain lacking. METHODS: Patients with FPHL (Sinclair gradeII-III) were enrolled and randomized to receive 4 sessions of PRP, i-PRF or CGF treatment at 4-week intervals. The primary endpoint was the inter-group comparison of the non-vellus target area hair count (TAHC)-increase (%) at 24 weeks. Secondary endpoints included: within-group changes in TAHC from baseline; within-group changes in hair diameter (HD) from baseline and inter-group comparison of HD-increase (%) at 24 weeks; Growth factor concentrations were quantified to explore correlations with efficacy. RESULTS: Seventy-four patients completed the study. Post-treatment TAHC increased significantly from baseline in all groups (all p < 0.05). The TAHC-increase(%) was significantly greater in the CGF (27.11 ± 14.80%) and i-PRF (26.54 ± 11.46%) groups compared to the PRP group (14.53 ± 8.65%; p < 0.05), with no significant difference between CGF and i-PRF. Regarding HD increase, all three groups showed improvement, with no statistically significant differences observed among groups (p > 0.05). The i-PRF group showed the lowest adverse event rate. Vascular endothelial growth factor (VEGF) concentration demonstrated a significant positive correlation with the percentage increase in TAHC (r = 0.527, R2=0.278, p < 0.05). CONCLUSIONS: CGF and i-PRF demonstrated superior efficacy in increasing TAHC in FPHL patients. The i-PRF group had the lowest adverse event rate. VEGF levels may play a potential role in promoting hair growth.
2 May 2026
Read appraisal →The Journal of dermatological treatment
Modulation of mu-opioid pathway for the treatment of pruritus: a systematic review of 1,146 patients
BACKGROUND: Pruritus is a debilitating symptom and conventional therapies often provide incomplete relief. The μ-opioid receptor (MOR) pathway is a key regulator of itch, and μ-pathway-modulating agents are increasingly used off-label for refractory pruritus. AIM: This systematic review evaluates the efficacy, safety, and real-world use of μ-opioid pathway modulators for pruritus of dermatologic and systemic origin. METHODS: Following PRISMA guidelines (PROSPERO CRD420251207101), a comprehensive search of four databases identified 3,274 records, of which 69 studies met inclusion criteria, comprising 14 randomized controlled trials (RCTs; n = 795) and 55 non-randomized studies (n = 351). Owing to substantial clinical and methodological heterogeneity, findings were narratively synthesized. RESULTS: Five RCTs evaluated dermatologic conditions, including atopic dermatitis, prurigo nodularis, chronic urticaria, and lichen planopilaris, while nine RCTs assessed systemic pruritus, predominantly cholestatic and uremic pruritus. RCTs investigated oral or topical naltrexone, intravenous naloxone, nalmefene, and extended-release nalbuphine, with most demonstrating clinically meaningful reductions in pruritus intensity using validated itch scales. Non-randomized studies reported improvement across a wide range of dermatologic and systemic conditions, with adverse events generally mild and well tolerated. CONCLUSIONS: Overall, μ-opioid pathway modulators show promising efficacy with acceptable short-term safety across diverse pruritic conditions, although larger high-quality RCTs are required to define optimal dosing and support clinical translation.
2 May 2026
Read appraisal →JMIR dermatology
Public Interest in Janus Kinase (JAK) Inhibitors for Alopecia Areata: A Google Trend Analysis
Public interest in Janus kinase (JAK) inhibitors for alopecia areata increased following media coverage and the 2022 US Food and Drug Administration (FDA) approval of baricitinib, highlighting the need for patient education and physician guidance on appropriate indications and treatment selection for hair loss disorders.
28 Apr 2026
Read appraisal →Journal of ethnopharmacology
Salvia plebeia R.Br.: A comprehensive review of its ethnopharmacology, phytochemistry, pharmacological activities, quality control, and current applications.
ETHNOPHARMACOLOGICAL RELEVANCE: Salvia plebeia R.Br. (Lamiaceae), the dried aerial parts, has been traditionally used across China and East/South Asia to treat sore throat, bronchitis, nephritis edema, abscesses, mastitis, hemorrhoids, and bleeding disorders, consistent with traditional indications of heat-clearing, detoxifying, cooling blood, and promoting diuresis. AIM OF THE REVIEW: This study provides a systematic overview of the ethnopharmacology, phytochemistry, pharmacological activities, quality control, and current applications of S. plebeia, while highlighting current research gaps and future perspectives. MATERIALS AND METHODS: A comprehensive literature search was conducted using multiple scientific databases, including Web of Science, PubMed, Elsevier, ACS, CNKI, and Google Scholar, covering publications from database inception to October 2025. Relevant information on the ethnopharmacology, phytochemistry, pharmacological activities, quality control, and applications of S. plebeia was systematically collected, screened, and synthesized according to predefined inclusion/exclusion criteria. RESULTS: To date, 325 constituents have been identified, dominated by flavonoids, phenolic acids, terpenoids, volatile oils, sterols, lignans, and others. Extracts and purified compounds show tradition-relevant anti-inflammatory, antiviral, immunoregulatory, and antioxidant activities, while other reported effects (hepatoprotective, hypolipidemic, cardiovascular-protective, sedative/anticonvulsant, anticancer, and anti-photoaging) are presented as exploratory findings. Quality evaluation evolved from UV and HPLC to UPLC-MS fingerprinting using flavonoids and sesquiterpenes as markers. In practical applications, S. plebeia has been used in medicinal preparations for the management of pharyngitis, bronchitis, nephritis, dermatitis, and anorectal inflammation. In food sector, it has been developed into functional products, including health teas, chewable or effervescent tablets, composite beverages, and co-fermented vinegars. CONCLUSION: Although S. plebeia shows broad pharmacological potential, current investigations remain constrained by incomplete chemical space coverage, limited pharmacokinetic and toxicological characterization, and insufficient well-designed clinical evidence. Future research should focus on comprehensive constituent profiling, mechanism-oriented validation aligned with traditional indications, standardized quality markers/fingerprints, and rigorous PK-toxicology-clinical translation, to promote safe, effective, and evidence-based utilization of S. plebeia in medicine and functional food development.
27 Apr 2026
Read appraisal →ACS sensors
Multifunctional Wearable OLED-OPD System with Wavelength-Tunable Emission for Phototheranostics
The growing demand for noninvasive wearable healthcare technologies calls for compact platforms capable of integrating diagnostic sensing and therapeutic light delivery within a single device. Conventional systems typically rely on spatially separated light sources or rigid inorganic LEDs, leading to inefficient area usage and limited mechanical compatibility with soft biological tissues. Here, we present a multifunctional wearable optoelectronic platform based on wavelength-tunable organic light-emitting diodes (WTOLEDs) integrated with organic photodiodes (OPDs). The vertically stacked red and blue OLED structure enables polarity-dependent wavelength switching under AC driving, generating alternating emissions at 624 nm and 464 nm from a single compact device without lateral source separation. The surrounding geometry, in which the light-emitting region encircles the light-receiving element, provides an area-efficient optical interface that enhances optical coupling and signal sensitivity within a flexible form factor. Using this platform, we demonstrate dual-wavelength physiological monitoring via photoplethysmography (PPG) and therapeutic applications, including red-light photobiomodulation and blue-light-mediated bilirubin photodegradation. The device further exhibited stable thermal and mechanical performance under wearable operating conditions. These results establish a compact phototheranostic architecture enabling wavelength-selective sensing and therapy within a single wearable platform.
26 Apr 2026
Read appraisal →ACS sensors
All-in-One Wearable Hydrogel Patch for Multimodal Visualized and Quantitative Heatstroke Monitoring
Heat-related illnesses, particularly heatstroke, pose serious risks to outdoor workers, athletes, and individuals with impaired thermoregulation. Existing monitoring strategies are limited by invasive measurements, reliance on external power sources, and lack of real-time multimodal feedback. Here, this study presents an all-in-one wearable patch that integrates a dual-functional self-powered thermogalvanic hydrogel with a selective electrochemical interface for intuitive visual feedback, dynamic temperature tracking, and durable sweat analysis. The hydrogel enables real-time thermochromic visualization and active thermoelectric sensing of body temperature, while an integrated electrochemical module allows continuous and selective detection of Na+ and K+ ions in sweat. The multiplexed physical-chemical health-monitoring patch provides a multimodal dual-stage evaluation of body temperature and sweat ion level toward improving metabolic status control and alerting individual to heatstroke risk, holding promise for developing personalized healthcare and a scalable route to proactive heatstroke prevention.
26 Apr 2026
Read appraisal →Journal of plastic surgery and hand surgery
Characteristics and prognosis of skin cancer arising from burn scars: a systematic review
BACKGROUND: Burn scars are recognized risk factors for malignant skin transformation, most notably Marjolin's ulcer (MU). Despite extensive documentation in case reports and series, the epidemiological characteristics and prognosis of burn scar-related skin cancers have lacked large-scale systematic synthesis. METHODS: We conducted a systematic review in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, registered with PROSPERO (CRD42024545404), covering literature from PubMed, Scopus, and Web of Science up to 18 January 2024. Eligible studies included case reports, case series, and observational studies reporting any type of skin cancer in burn scars. Data were extracted on demographics, burn and tumor characteristics, treatment, latency, outcomes, and risk of bias using Joanna Briggs Institute tools. RESULTS: A total of 211 studies reporting 830 cases were included. The mean latency period from burn injury to cancer diagnosis was 21.7 years (SD = 19.6). Males constituted 53% of patients, with third-degree burns predominating (89.37%) and lower limbs being the most affected site (33.59%). Squamous cell carcinoma (SCC) was the most frequent malignancy (67.19%), followed by basal cell carcinoma (BCC, 3.83%) and other cancers (15.33%). Recurrence occurred in 13.2% of cases; mortality was 6.96%. SCC accounted for most deaths (63.8%), while melanoma and sarcoma exhibited high rates of recurrence and mortality. Lymph node metastasis and distant metastasis were found in 7.56 and 4.74% of cases, respectively. CONCLUSION: Skin cancers arising from burn scars, especially SCC, demonstrate aggressive clinical behavior with significant morbidity and mortality. Reduced latency periods and high metastatic potential highlight the importance of vigilant, long-term surveillance and radical initial treatment. This review provides a contemporary benchmark for epidemiological understanding and supports calls for international registries, molecular diagnostics, and standardized management protocols for burn scar malignancies.
25 Apr 2026
Read appraisal →PloS one
Identification and clinical implications of immune-related hub genes in psoriasis
BACKGROUND: Psoriasis, a chronic inflammatory skin disease affecting 2-3% of the global population, is driven by dysregulated immune responses. Despite advancements in biologic therapies, treatment challenges persist due to high recurrence rates. This study aimed to identify immune-related hub genes and elucidate their clinical implications in psoriasis pathogenesis and therapy. METHODS: Multiple microarray datasets from psoriasis patients (GSE30999, GSE106992, GSE14905, GSE78097, and GSE117468) were obtained to identify immune-key genes by differential gene analysis and Weighted Gene Co-expression Network Analysis (WGCNA). Subsequently, immune-related hub genes were identified using the Least Absolute Shrinkage and Selection Operator (LASSO) algorithm and Protein-Protein Interaction (PPI) networks, with further validation through Gene Set Enrichment Analysis (GSEA) and Receiver Operating Characteristic (ROC) curves to assess exploratory within-sample discrimination. Pearson correlation analysis evaluated the relationship between hub genes, skin lesion severity, and treatment outcomes. The study also conducted immune infiltration by using the Cell-type Identification by Estimating Relative Subsets Of RNA Transcripts (CIBERSORT) algorithm and identified potential therapeutic targets by the Drug-Gene Interaction Database (DGIdb). RESULTS: Thirty-one immune-related key genes were identified, and six hub genes (CLEC7A, CXCL1, IRF1, S100A12, S100A8, S100A9) were validated as central players in immune signaling pathways. These genes exhibited within-sample discrimination (AUC > 0.9) and correlated with disease severity and biological therapy efficacy. Immune infiltration analysis revealed increased activated memory CD4+ T cells and M1 macrophages in lesional skin, which was strongly associated with hub gene expression. Additionally, drug-gene interaction analysis identified potential therapeutic agents targeting these genes. CONCLUSION: This study identified six immune-related hub genes that were closely linked to the severity of psoriasis, the effectiveness of biological treatments, and infiltrated activated memory CD4+ T cells and M1 macrophages. Our findings elucidate a novel immune-related hub gene network in psoriasis and provide potential targets for the development and application of biologics.
23 Apr 2026
Read appraisal →PloS one
SCGAN-generated skin-tone-balanced extension of the HAM10000 dataset for fairer dermatological AI
This dataset presents a synthetic collection of skin lesion images generated using a tone-conditioned Generative Adversarial Network (GAN) to model skin tone variation in dermatological datasets, motivated by the limited representation of darker skin tones in commonly used benchmarks. The dataset includes 10,000 images, at a resolution of 128×128 pixels, equally divided between medium and dark skin tones, with lesion class labels assigned to follow the class distribution of the original HAM10000 dataset. To quantitatively characterize the generated data, we report Fréchet Inception Distance (FID) scores and a baseline classification experiment comparing models trained on HAM10000 alone versus HAM10000 augmented with the proposed synthetic images. This work provides a controlled synthetic extension intended to support fairness-aware experimentation, data augmentation, and downstream evaluation in dermatological machine learning.
20 Apr 2026
Read appraisal →Emerging microbes & infections
Optimizing machine learning-based diagnosis of neurosyphilis in HIV-negative patients: a multicenter, real-world comparison of international diagnostic criteria
Neurosyphilis continues to rise globally, yet diagnosis remains challenging, often requiring multidisciplinary expertise and multiple CSF assays that are difficult to access in resource-limited settings. We developed and compared machine-learning (ML) models tailored to six international diagnostic guidelines and built a free, web-based tool for guideline-adapted decision support. We assembled 1,648 suspected neurosyphilis cases from four centers, using Guangzhou as the training cohort and Beijing, Xiamen (China) and Seattle (USA) as external validation cohorts. Five algorithms (Random Forest, AdaBoost, SVC, NuSVC, XGBoost) were trained with randomized search and three-fold cross-validation; performance was assessed by AUC, PRAUC, calibration, decision-curve net benefit, Brier score, and SHAP for model explainability. Across models and guidelines, neurological symptoms, CSF protein, and CSF white blood cell count consistently ranked as the strongest predictors. All models achieved excellent discrimination (AUC and PRAUC >0.90) with good calibration, reliability, and positive clinical utility, though performance varied modestly by guideline. These findings indicate that the optimal ML approach depends on the diagnostic definition applied. Our freely available online tool operationalizes these models to provide clinicians worldwide with context-adapted support aligned to local criteria.
18 Apr 2026
Read appraisal →Science advances
Enhancing biomedical optical volumetric imaging via self-supervised orthogonal learning
Optical volumetric imaging grapples with inherent noise problems arising from photon budget constraints, light scattering, and space-bandwidth product bottlenecks, all of which degrade structural fidelity and become even more pronounced than in planar imaging. While deep learning presents potential for denoising, supervised methods are hindered by the impracticality of paired datasets, and existing self-supervised approaches fail to fully exploit the intrinsic volumetric structural redundancy inherent to optical imaging. Here, we present a self-supervised volumetric biomedical imaging denoiser (VALID) that leverages intrinsic three-dimensional spatial coherence for highly efficient volumetric denoising through a self-supervised orthogonal learning framework. VALID demonstrates robust denoising performance across diverse imaging modalities, including two- and three-photon microscopy, light-field microscopy, and optical coherence tomography, substantially enhancing structural fidelity in deep-tissue, multimodal, and dynamic imaging scenarios. By combining computational efficiency with zero-shot adaptability, VALID establishes a transformative approach to volumetric image enhancement with structure-aware precision.
16 Apr 2026
Read appraisal →Modern rheumatology
Epidemiological and clinical insights into Behçet's disease in Japan: a 2019 nationwide analysis
OBJECTIVES: To clarify contemporary epidemiological and clinical trends of Behçet's disease in Japan by analysing the 2019 National Database of Designated Intractable Diseases (MHLW), describing patient demographics, organ involvement, impact on daily life, and treatment patterns. METHODS: This study analysed the 2019 data from the National Database of Designated Intractable Diseases of Japan, provided by the Japanese Ministry of Health, Labour and Welfare. We focused on age distribution, symptom frequency, daily life impact, and treatment trends. RESULTS: In the 2019 database, 10 406 patients with BD were registered. The median age was 55 years, with a higher proportion of women affected (53.2%). Serious manifestations such as ocular, vascular, and central nervous system involvement were more frequent in males, whereas females showed more mucocutaneous and articular symptoms, representing mild forms of the disease. Pharmacological treatment was common (93.8%), with corticosteroids (44.3%), colchicine (50.9%), infliximab (17.0%), and adalimumab (9.6%) being frequently used. BD significantly affected daily life, with nearly one-third experiencing impaired mobility or depression. CONCLUSIONS: This nationwide analysis highlighted sex-based differences in clinical features and found that BD continues to substantially affect quality of life. The widespread use of biologics suggests a shift in therapeutic strategies.
16 Apr 2026
Read appraisal →Journal of investigational allergology & clinical immunology
Future Perspectives for Artificial Intelligence in Allergy: Advances in Diagnosis, Monitoring, and Personalized Care
Artificial intelligence (AI) is significantly transforming the specialty of allergy by offering novel tools for diagnosis, risk prediction, disease monitoring, and personalized care. This narrative review comprehensively explores key advances in the application of AI techniques-expert systems, machine learning, deep learning, and natural language processing-across various allergic diseases such as asthma, anaphylaxis, atopic dermatitis, food allergy, allergic rhinitis, eosinophilic esophagitis, and drug hypersensitivity reactions. Despite these advancements, several challenges persist, including model interpretability, external validation, and ethical and regulatory barriers. Nonetheless, AI holds strong potential to enhance diagnostic efficiency, therapeutic precision, and patient outcomes. This review presents an updated perspective on the state of the art of AI in allergy, highlighting both its achievements and ongoing challenges.
16 Apr 2026
Read appraisal →International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group
Effects of locally applied water-filtered infrared a irradiation adjunctive to iloprost and carbon dioxide hand baths in patients with systemic sclerosis and severe Raynaud's phenomenon - a randomized controlled trial
BACKGROUND: Almost all patients with systemic sclerosis (SSc) experience Raynaud's phenomenon (RP) with risk of digital ulcers (DU). In severe RP, intravenous iloprost is standard, yet additive hyperthermic therapy may enhance vasodilation and microcirculation. However, whether more intensive or alternative hyperthermic modalities offer benefits beyond commonly used CO2 hand baths remains unclear. METHODS: In this randomized, controlled trial, all patients received a baseline therapy of iloprost plus CO2 hand baths. The intervention group (IG) received additional water-filtered infrared-A (wIRA; 2 × 30 min/day, 8 days), while the control group (CG) received baseline therapy alone. The primary endpoint was the difference in RP-associated pain (VAS 0-100 mm) after treatment. Secondary outcomes included changes in RP duration, frequency, and intensity, Health Assessment Questionnaire (HAQ), serum interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF). RESULTS: Of 46 randomized patients, 38 (IG = 19, CG = 19) completed the study. Pain decreased from 70.4 ± 27.8 to 56.7 ± 21.4 mm with wIRA and from 73.9 ± 27.5 to 65.3 ± 26.8 mm in controls. Multivariable ANCOVA showed a mean difference of -14.7, 95% CI [-28.8;-0.7], p = 0.041 in favor of wIRA. RP duration improved more in the wIRA group (day 23: β = -3.8, 95% CI [-7.4;-0.2], p = 0.041), while RP frequency, intensity, HAQ, IL-6, and VEGF showed no significant differences (all p > 0.05). No adverse events occurred. CONCLUSIONS: Adjunctive wIRA during iloprost therapy was safe and yielded modest, short-term improvements in pain and RP duration. These exploratory effects warrant confirmation in larger controlled trials.
15 Apr 2026
Read appraisal →Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Mepitel Film versus StrataXRT for the prevention of radiation dermatitis in post-mastectomy radiotherapy: a systematic review and meta-analysis of randomized controlled trials
BACKGROUND: Radiation dermatitis (RD) affects up to 90% of patients receiving post-mastectomy radiotherapy, with moist desquamation causing significant morbidity. Barrier films and dressings such as Mepitel Film and StrataXRT have been shown to be effective compared to moisturizers, but their relative effectiveness remains debated. This systematic review and meta-analysis compares these interventions for preventing RD. METHODS: Following PRISMA guidelines, we systematically searched MEDLINE, Embase, and Cochrane Library through March 14, 2026. An additional grey literature search was performed in clinicaltrials.gov and Google Scholar. Eligible studies were RCTs directly comparing StrataXRT and Mepitel Film in breast cancer patients receiving adjuvant radiation therapy. Two reviewers independently screened studies, extracted data, and assessed risk of bias using RoB 2.0 and certainty of evidence with the GRADE appraoch. Meta-analysis used random-effects models to pool risk ratios (RR) for moist desquamation, and incidence of grade 2 and 3 RD, with I2 statistics quantifying heterogeneity. RESULTS: From 33 screened records, two intra-patient, non-inferiority RCTs (n = 120) met inclusion criteria. Both studies randomized medial/lateral chest wall halves to each intervention in post-mastectomy patients. Pooled analysis revealed no significant difference in moist desquamation incidence between StrataXRT (21.7%) and Mepitel Film (20.0%) (RR 1.03; 95% CI 0.52-2.04; P = 0.93), with low heterogeneity (I2 = 35%). Secondary outcomes showed Mepitel Film significantly reduced grade 2 or 3 RD (RR 1.34, 95% CI 1.10-1.64, P = 0.004). However, Mepitel Film trended toward higher incidence of itchiness (10.8% vs. 5.0%, P = 0.11). Patient preference data were conflicting, with one trial favoring StrataXRT for ease of use and the other showing no clear preference. CONCLUSION: While StrataXRT and Mepitel Film demonstrated similar efficacy for preventing moist desquamation, Mepitel Film offered superior protection against grade 2 to 3 RD. However, this conclusion should be interpreted with caution given the underlying methodological limitations of the included studies, including small and potentially underpowered sample sizes, and variations in radiation fractionation schedules and RT techniques.
15 Apr 2026
Read appraisal →Journal of controlled release : official journal of the Controlled Release Society
Redox-active microneedles for disease management.
Reactive oxygen and nitrogen species are essential to several biological functions, from maintaining cellular homeostasis to driving disease progression and aging. As such, the precise modulation of cellular redox states has emerged as a promising medical strategy. In parallel, microneedle technology has rapidly advanced over the past two decades, offering minimally invasive, targeted, and painless delivery of therapeutics. This review presents a comprehensive analysis of the emerging field of redox-active microneedles (RAMs), a novel class of wearable medical devices with broad potential for treating infected wounds, cancer, psoriasis, diabetes, arthritis, hair loss, skin aging, and potentially many other conditions. By integrating redox biology with advanced microneedle-based drug delivery systems, RAMs are poised to transform personalized and precision medicine, an evolution supported by a growing number of patents, clinical trials, and rapid advancements in catalytic, photodynamic, and nanomedicine research.
11 Apr 2026
Read appraisal →Acta dermato-venereologica
Predicting Melanoma Impact on the Swedish Healthcare System from the Adult Population Using Machine Learning on Registry Data
Melanoma incidence has increased in Western countries over the past 50 years, leading to significant healthcare costs. In Sweden, comprehensive healthcare registries enable large-scale prediction studies using machine learning. Several machine learning models were evaluated to predict melanoma diagnoses using Swedish registry data, assessing the added value of diagnostic and medication data beyond demographics. The study included all adults in Sweden with continuous residency for 9.5 years (n = 6,036,186). The outcome was a melanoma diagnosis, including melanoma in situ, recorded within 5 years after the index date (31 December 2014). Predictors included age, sex, income, education, marital status, region of birth, diagnoses, and dispensed drugs. Models tested were logistic regression, gradient boosting, random forests, and a neural network. A total of 38,582 individuals (0.64%) developed melanoma. The gradient boosting model using all predictors performed best, with an area under the receiving operating characteristics curve (AUC) of 0.735 (95% confidence interval [CI], 0.725-0.746). When diagnosis and medication data were excluded, AUC dropped to 0.681 (95% CI: 0.670-0.691). The findings highlight that including healthcare codes improves predictive performance, and demonstrate the utility of Swedish registries for computational phenotyping. This approach may support early detection of melanoma and targeted follow-up.
10 Apr 2026
Read appraisal →JCI insight
Cutaneous adipose tissue carries a strong inflammatory signature in patients with psoriasis.
This study provides a comprehensive evaluation of the cutaneous adipose tissue (CAT) transcriptome in patients with psoriasis and investigates the effects of IL-17 blockade on CAT inflammation through a randomized placebo-controlled trial using secukinumab (ObePso-S study, ClinicalTrials.gov NCT03055494). RNA sequencing analysis of CAT biopsies from 82 patients with psoriasis revealed 2132 differentially expressed transcripts compared with healthy controls. Notably, significant gene dysregulation was observed in both lesional skin (LS)-CAT and non-lesional (NL)-CAT, including activation of IL-17-driven pathways, antimicrobial peptide-related, and neutrophil degranulation signatures. Stratification by obesity demonstrated that obese psoriatic CAT exhibited a more than 2-fold higher number of differentially expressed genes than non-obese counterparts, suggesting a synergistic interaction between psoriasis and obesity in driving CAT inflammation. Treatment with secukinumab markedly improved inflammatory signatures in psoriatic CAT, with greater improvements observed in obese patients. These findings reveal a pronounced and partially IL-17-dependent inflammatory phenotype in psoriatic CAT, challenge the conventional concept of psoriasis as a solely superficial skin disease, and highlight CAT as an important contributor to systemic inflammation in psoriasis.
10 Apr 2026
Read appraisal →ACS applied materials & interfaces
Physically Cross-Linked Biopolymer-Based Strong and Stretchable Organohydrogel with Self-Healing and Biocompatibility for Environmentally Tolerant Strain Sensors
The development of wearable strain sensors increasingly focuses on multifunctional materials that integrate mechanical robustness, self-repairing capacity, temperature-resilient conductivity, and biocompatibility. Herein, we developed a physically cross-linked biopolymer-based organohydrogel by incorporating gelatin (Gel) and β-cyclodextrin-grafted chitosan (CDCS), designated as Gel/CDCS, reinforced through hydrogen bonding, ionic interactions, and host-guest complexation. The optimized Gel/CDCS1 organohydrogel with 1% of CDCS exhibited outstanding stretchability, with a tensile strain at break of 410.9% and a tensile strength of 92.2 kPa, while maintaining 85% of its mechanical properties after self-healing at 40 °C. The introduction of kosmotropic salts (Na3Cit and NaCl) and a glycerol-water binary solvent system conferred remarkable environmental adaptability, allowing stable performance from -20 to 37 °C. Notably, it achieved a high ionic conductivity of 0.946 S m-1 at room temperature, alongside 0.606 S m-1 at -20 °C and 0.330 S m-1 at 37 °C, ensuring operation under extreme conditions. The strain sensor displayed high sensitivity with a gauge factor (GF) increasing from 1.06 to 1.34 over a broad strain range and maintained a stable electrical response over 600 consecutive stretching cycles. Additionally, it enabled reliable detection of diverse human motions, including facial expressions, joint bending, and breathing, demonstrating excellent conformability and signal stability during on-body monitoring. Additionally, Gel/CDCS1 exhibited excellent biodegradability, degrading by over 80% in soil within 4 days, and showed high biocompatibility with fibroblast viability of around 80%. These attributes establish Gel/CDCS1 as a promising eco-friendly candidate for next-generation flexible electronics, wearable strain sensors, and biomedical applications.
10 Apr 2026
Read appraisal →ACS applied materials & interfaces
Bioinspired Janus Electronic Textiles with Moisture and Thermal Management
Wearable electronics have attracted great attention in recent decades. However, excessive sweat accumulation on skin often has a significant effect on the signal stability, comfort, and safety of electronic skin in practical applications. Herein, a skin-comfortable Janus electronic textile (e-textile) that integrates unidirectional liquid transport and passive radiative cooling properties is developed. This e-textile is fabricated through laser ablation and single-side plasma treatment of carbon nanotubes (CNTs) doped with polydimethylsiloxane (PDMS). The resulting e-textile features a conical pore structure and asymmetric wettability, enabling unidirectional sweat transport from the skin surface to a superhydrophilic silk layer, thereby maintaining a dry and comfortable skin microenvironment. The Janus e-textile achieves a solar reflectivity of 69.2% and a mid-infrared emissivity of 98.3%, reducing the temperature by approximately 5.0 °C compared with a cotton fabric under solar intensity, demonstrating a superior radiative cooling performance. Moreover, the Janus e-textile exhibits stable resistance changes under cyclic stretching and bending, accurately detecting subtle movements across various body parts while reliably acquiring electromyography (EMG) signals. This work positions the Janus e-textile as a pioneering solution for next-generation wearable technologies, integrating thermal and moisture management with advanced resistive strain sensing and EMG capabilities for applications in sports, rehabilitation, and health monitoring.
10 Apr 2026
Read appraisal →ACS applied materials & interfaces
Evolving Beyond Nature: AI-Driven Rapid Advancements of Bio-Inspired Electronic Skin
Electronic skin (e-skin) is a rapidly developing technology at the intersection of humans and machines with tremendous applications in robotics, healthcare, sports performance, and other fields of wearable electronics. With the recent popularization of artificial intelligence (AI), data-driven approaches to materials design and geometric functional optimization have accelerated e-skin development, enabling optimized microstructures, novel functionalities, and improved usability. Recent progress in bioinspired materials design and functionality enhancements for e-skin is paving the way for future-facing machine learning-powered tools to further accelerate their development. In this review, we discuss the traditional properties of e-skins, their sensing mechanisms, and suitable applications. Then, we investigate and categorize bioinspired structures from material, structural, and functional perspectives. Next, we outline the fundamentals of AI for data-driven optimization and how it can be utilized toward bioinspired e-skin design. This blended e-skin design framework culminates in novel applications, from customizable layouts for personalized therapeutics to dynamic environment recognition for enhanced robotics. Finally, we will explore the challenges of e-skin human-machine interfaces, including their hardware limitations, sensitivity, and longevity issues, and offer insights into future-proof research.
10 Apr 2026
Read appraisal →JMIR dermatology
Community-Based Teledermatology for Urgent Suspected Skin Cancer: Health Economic Cost-Comparison and Discrete Event Simulation Study
BACKGROUND: The increasing incidence and financial burden of skin cancer place immense pressure on the UK's National Health Service (NHS). Systemic challenges, including dermatologist shortages and long waiting lists, complicate timely assessment of skin lesions for patients under the urgent suspected cancer pathway. While teledermatology offers an innovative solution compared to traditional face-to-face appointments, standard teledermatology models still face limitations in addressing health care access barriers. Community-based decentralized models may reduce such barriers, but the cost and operational impact of such specific models remain largely underresearched. OBJECTIVE: This study evaluated the differences in financial cost to the NHS and patient waiting times at the Northern Care Alliance NHS Foundation Trust by comparing a community-based teledermatology model using Pathpoint eDerma against the Trust's standard-of-care for patients in the urgent suspected skin cancer pathway. METHODS: This study used an ambidirectional design involving 2 distinct analyses. The cost comparison analysis (CCA) compared costs incurred under the teledermatology model (intervention arm, n=563) against the Trust's standard care, represented by a synthetic comparator arm (n=4011). The discrete event simulation (DES) modeled the operational impact on patient waiting times over a 1-year period. Data for the intervention arm were collected prospectively from December 2022 to May 2023 for CCA and up to November 2023 for DES, while comparator data were collected retrospectively from September 2021 to December 2022. Publicly available resource costs were incorporated to ensure the robustness of the analyses. RESULTS: The community-based teledermatology model was associated with significant improvements in both cost to the NHS and patient waiting times. The CCA revealed a mean cost saving of £45 (£1=US $1.24) per referral (95% CI £22-£60; P<.001). This cost saving was associated with a 26% reduction in the proportion of patients requiring a full diagnostic biopsy, falling from 48% (1925/4011) in standard care to 22% (124/563) in the teledermatology model as well as time savings in face-to-face clinics and administration. Furthermore, the DES demonstrated that, on average, the teledermatology pathways decreased the time to reach a clinical diagnosis by 9.90 (95% CI 9.64-10.16) days; to communicate a diagnosis to patients by 54.18 (95% CI 50.76-57.61) days; and to reach a histopathological diagnosis by 62.8 (95% CI 59.76-65.83) days compared to standard care. CONCLUSIONS: The implementation of the community-based teledermatology model appears to be a highly effective, cost-efficient strategy associated with shortened patient journeys. The intervention showed a faster initial triage phase, but the study identified the histopathology process as the next major systemic constraint that could deter further pathway efficiency. Achieving timely diagnosis for all patients, including those requiring diagnostic biopsies, will necessitate continued strategic investment in innovative technologies to accelerate this downstream process.
7 Apr 2026
Read appraisal →Journal of ethnopharmacology
Unveiling the genus Taraxacum: From folk medicine to chemodiversity-driven pharmacological and toxicological outcomes-A systematic review
ETHNOPHARMACOLOGICAL RELEVANCE: The genus Taraxacum (dandelion), belonging to the Asteraceae family, encompasses over 2800 species predominantly found in temperate to subtropical regions of the Northern Hemisphere. Dandelion has a long history as a functional food and traditional medicine in numerous countries, including China, Turkey, Spain, Italy, etc. Traditional application records indicate that dandelion might be used extensively to treat kidney stones, constipation, eczema, ulcers, inflammation, etc. However, the therapeutic application of different Taraxacum species varies significantly across regions, which may be influenced by local cultural and medical traditions. AIM OF THE REVIEW: This review provides a comprehensive summary of recent advancements in traditional applications, phytochemistry (highlighting 184 newly identified compounds), pharmacology, and toxicology, offering novel insights into both genus-wide characteristics of Taraxacum (covering 55 species) and species-specific differences. MATERIALS AND METHODS: A comprehensive search for relevant data was conducted using keywords such as "Taraxacum", "dandelion", "Taraxaci Herba", "pu gong ying", and others across multiple scientific databases, including Google Scholar, Web of Science, PubMed, ScienceDirect, Baidu Scholar, CNKI, online ethnobotanical databases, ethnobotanical monographs, The Plant List, Dictionary of Chinese Ethnic Medicine and considered data from 1972 to 2025. World Flora Online (http://www.worldfloraonline.org/) was utilized for confirming the correct species names of Taraxacum genus. The gathered information on the ethnobotanical usages, phytochemistry, pharmacology, and toxicology is comprehensively summarized in this paper. RESULTS: The literature review indicates that dandelion, a medicinal and edible plant, has been extensively utilized in traditional Chinese medicine since the 7th century. In Europe, its edible and medicinal properties began to be acknowledged and applied during the Middle Ages. In ethnomedical practice, dandelion has been used as diuretic, laxative, anti-inflammatory remedy, digestive aid, etc. Building on the 197 compounds reported from T. officinale, this review highlights over 180 newly identified compounds from 19 Taraxacum species, expanding the genus-wide catalog to more than 380 constituents. Recent toxicological and safety evaluations corroborate that T. officinale F.H.Wigg., T. mongolicum Hand.-Mazz., and T. lacistrum Sahlin possess a favorable safety profile. CONCLUSIONS: The genus Taraxacum is a promising medicinal and edible plant, exhibiting a range of biological activities, including anti-cancer, anti-inflammatory, and antioxidant effects. These properties align with its ethnobotanical usages, confirming its traditional use as diuretic, laxative, anti-inflammation, and digestive aid. However, research on its effects on neurodegenerative and cardiovascular diseases remains limited. Future studies should focus on in vivo experiments to explore the material basis and mechanisms underlying the therapeutic effects of dandelion species. Furthermore, current phytochemical and pharmacological research has overlooked several Taraxacum species with well-documented traditional uses. Investigating these understudied species is essential to fully elucidate the potential therapeutic value of the genus Taraxacum.
6 Apr 2026
Read appraisal →Chinese medical journal
Efficacy and safety of topical finasteride spray solution in the treatment of Chinese men with androgenetic alopecia: A phase III, multicenter, randomized, double-blind, placebo-controlled study
BACKGROUND: Topical finasteride is a novel treatment for men with androgenetic alopecia (AGA). This study aimed to evaluate the efficacy and safety of topical finasteride spray solution in Chinese men with AGA. METHODS: This randomized, double-blind, placebo-controlled, phase III trial enrolled 270 individuals with AGA from 16 sites across China between December 2021 and March 2023. The participants were randomized at a ratio of 2:1 to receive either topical finasteride or placebo treatment once daily for 24 weeks. The primary endpoint was the change from baseline in target area (0.903 cm 2 area) hair count at week 24. The secondary endpoints were change from baseline in target area hair count at week 12, target area terminal hair count at weeks 12 and 24, target area terminal hair width at week 24, and target area hair width at week 24; an improvement of vertex hair growth assessed by the investigator at week 24; and the patient-assessed scores on the Male Hair Growth Questionnaire at week 24. RESULTS: A total of 270 individuals were enrolled and randomized, and 251 completed the study (165 in topical finasteride group, 86 in placebo group). Compared with the placebo group, in the topical finasteride group, the change from baseline in target area hair count was significantly higher at week 24 ( P <0.05), although it was only numerically higher at week 12 ( P = 0.0688). Significant differences favoring topical finasteride over placebo were observed for change from baseline in target area terminal hair count at weeks 12 ( P <0.05) and 24 ( P <0.01). The improvement of vertex hair growth assessed by the investigator was significantly greater in the topical finasteride group vs. the placebo group at week 24 ( P <0.01). Topical finasteride was generally safe and well-tolerated. CONCLUSIONS: In Chinese men with AGA, topical finasteride spray solution increased hair growth and showed good safety and tolerability profile during a 24-week treatment period. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT05135468.
5 Apr 2026
Read appraisal →PloS one
Safety and efficacy of Vectored thermal pulsation, Intense pulsed light, and Eyelid Warm compress therapies (VIEW) for meibomian gland dysfunction: Study design and baseline characteristics of a randomized controlled trial
BACKGROUND: Meibomian gland dysfunction (MGD) is one of the most prevalent chronic eye diseases, characterized by meibomian gland obstruction and abnormal meibum secretion both in quantity and quality. OBJECTIVE: To assess the efficacy and safety of vectored thermal pulsation (VTP), intense pulsed light plus meibomian gland expression (IPL + MGX), and eyelid warm compress (EW). METHODS: This is a 3-arm, assessor-masked, randomized controlled trial. 360 symptomatic mild to moderate MGD subjects would be recruited and randomized into 3 intervention groups. Subjects from Group-A, Group-B, and Group-C would be treated with one-session VTP (at baseline), four-session IPL + MGX (at baseline, month-1, month-2, and month-3 visits), and twice-daily EW for 15 months, respectively. All subjects would be prescribed topical artificial tears (Hypromellose, 0.3% w/v) to be used as frequently as needed from wash-out (1 month before baseline) to endpoint (month-15 visit). Subjects would be assessed 9 times throughout a total of 16-month study period. Five self-administered questionnaires would be collected each time in random order. Masked observers would conduct examinations using slit-lamp biomicroscopy, LipiView® II, and Keratograph 5M machines. The eye with worse MGD would be selected and analyzed as the study eye. Tear film break-up time (TFBUT) at month-6 and month-15 visits are the primary outcomes. RESULTS: 374 subjects were enrolled and randomized into three groups, and 372 subjects (aged 54.4 ± 14.7 years) were finally analyzed. The mean of TFBUT time at baseline was 3.1 ± 1.7 seconds. CONCLUSION: This is the first head-to-head comparison of three physical treatments for mild to moderate MGD on their therapeutic efficacy, safety, longevity and compliance in a randomized controlled trial setting.
5 Apr 2026
Read appraisal →Journal of wound care
Micrografts-a novel ally in hard-to-heal wounds: a systematic review.
OBJECTIVE: Wound healing is complex, and hard-to-heal (chronic) wounds pose significant treatment challenges, especially in adults. Micrografts (MGs) are emerging as a promising treatment for wounds refractory to conventional approaches. MG involves transplanting a stem cell suspension to the wound to promote healing. Scientific studies on MG are increasing; however, a systematic review is needed for a comprehensive understanding of its efficacy. METHOD: A systematic review conducted on 30 March 2024 used PubMed, Scopus and Web of Science databases to evaluate skin and dermal MGs in wound healing. PRISMA guidelines were followed and predefined inclusion and exclusion criteria were applied. All authors reviewed the studies and discussed results to ensure consistency in study screening, selection and data extraction. RESULTS: A total of 1251 papers were examined, with 23 eligible for full-text review. After exclusions based on language, reviews, MG size and tissue focus, 15 articles were included in the final review: seven case reports; five case series; two prospective series (one with 70 patients, the other with 30 patients) and a case-control study. CONCLUSION: The results of the reviewed studies suggest that MGs may promote wound healing, with reported reductions in healing time and improvements in clinical symptoms in hard-to-heal wounds. However, standardisation of treatment protocols and application methods is required. The role of MGs in the treatment of acute wounds remains to be clarified.
4 Apr 2026
Read appraisal →Biofabrication
High-fidelity 'top-down' DLP bioprinting of multi-material soft tissue constructs enabled by computer vision-based layer control
Bioprinting continues to redefine the frontiers of regenerative medicine by enabling the fabrication of complex, three-dimensional (3D) tissue constructs that emulate native biological and mechanical functions. However, despite significant progress, critical challenges remain, particularly in achieving precise multi-material integration, high-resolution patterning, and structural fidelity necessary for functional tissue engineering. A major limitation in 'top-down' vat photopolymerization bioprinting, especially digital light processing (DLP)-based approaches, lies in the precise control of layer thickness, a parameter that directly affects mechanical integrity, biological activity, and spatial resolution. This study presents a novel, automated platform designed to overcome one of the most persistent bottlenecks in multi-material top-down DLP bioprinting: the real-time, accurate measurement of the dynamic gap between the cured layer and the bioink surface. Through a comparative assessment of classical computer vision and deep learning (convolutional neural network-based) techniques, we demonstrate a system capable of achieving sub-0.1 mm precision (0.092 mm) with strong correlation to mechanical measurements (R= 0.994). This vision-based system adapts to a wide range of bioinks with varying viscosities, opacities, and photopolymerization kinetics, eliminating the need for manual recalibration during material switching. As a demonstration of its capabilities, we successfully printed a multimaterial vascular-like tissue structure with high spatial fidelity across heterogeneous biomaterials. Further, we bioprinted a multimaterial skin tissue model, featuring compartmentalized dermal/bone analogs, to enablein vitrofunctional evaluation. These case studies highlight the platform's potential to advance biofabrication workflows by improving reproducibility, material adaptability, and structural precision, paving the way toward clinically scalable tissue manufacturing systems.
4 Apr 2026
Read appraisal →The Journal of investigative dermatology
A Metabolism-Driven Prognostic Model and PSMD14-SP1-GYS1 Axis Reveal Therapeutic Vulnerabilities in Melanoma
Melanoma is a highly aggressive cutaneous malignancy characterized by a strong propensity for metastasis and therapy resistance, with its progression being closely linked to metabolic reprogramming. This study integrated multiomics data (The Cancer Genome Atlas, Gene Expression Omnibus, European Nucleotide Archive) and advanced machine learning to develop prognostic and immunotherapy prediction models for melanoma, focusing on 114 metabolism-related pathways. Cox regression identified 70 genes linked to survival, with functional enrichment revealing key metabolic pathway alterations. A metabolism-related prognostic model (MRPM) was constructed using 101 combinations of machine learning algorithms, demonstrating superior predictive accuracy across 4 cohorts. High-risk patients showed worse survival and immunotherapy response in melanoma and other cancers. Tumor microenvironment analysis revealed MRPM's negative correlation with immune infiltration and positive association with tumor purity. Single-cell sequencing highlighted MRPM gene enrichment in melanocytes. Mechanistically, GYS1 (the key gene in MRPM) emerged as a pivotal prognostic gene that promotes melanoma proliferation and metastasis. Regulatory studies uncovered SP1's transcriptional control of GYS1- and PSMD14-mediated stabilization of SP1 through K48-linked ubiquitination removal. In vivo validation confirmed that PSMD14 knockdown suppressed tumor growth through SP1-GYS1 axis disruption. This work establishes MRPM as a robust predictive tool and elucidates the PSMD14-SP1-GYS1 regulatory network as a potential therapeutic target in melanoma metabolism.
4 Apr 2026
Read appraisal →Regional anesthesia and pain medicine
Deciphering risk factors for severe postherpetic neuralgia in patients with herpes zoster: an interpretable machine learning approach
INTRODUCTION: Postherpetic neuralgia (PHN) is a common complication of herpes zoster (HZ). This study aimed to use a large real-world electronic medical records database to determine the optimal machine learning model for predicting the progression to severe PHN and to identify the associated risk factors. METHODS: We analyzed the electronic medical records of 23,326 patients diagnosed with HZ from January 2010 to June 2020. PHN was defined as pain persisting for ≥90 days post-HZ, based on diagnostic and prescription codes. Five machine learning algorithms were compared with select the optimal predictive model and a subsequent risk factor analysis was conducted. RESULTS: Of the 23,326 patients reviewed, 8,878 met the eligibility criteria for the HZ cohort. Among these, 801 patients (9.0%) progressed to severe PHN. Among the various machine learning approaches, XGBoost-an approach that combines multiple decision trees to improve predictive accuracy-performed the best in predicting outcomes (F1 score, 0.351; accuracy, 0.900; area under the receiver operating characteristic curve, 0.787). Using this model, we revealed eight major risk factors: older age, female sex, history of shingles and cancer, use of immunosuppressants and antidepressants, intensive initial pain, and the neutrophil-to-lymphocyte ratio. When patients were categorized into low-risk and high-risk groups based on the predictive model, PHN was seven times more likely to occur in the high-risk group (p<0.001). CONCLUSIONS: Leveraging machine learning analysis, this study identifies an optimal model for predicting severe PHN and highlights key associated risk factors. This model will enable the establishment of more proactive treatments for high-risk patients, potentially mitigating the progression to severe PHN.
4 Apr 2026
Read appraisal →Int J Surg
Artificial Intelligence in melanoma research: a bibliometric analysis
BACKGROUND: As one of the most lethal skin cancers, melanoma has encountered many obstacles in diagnosis and therapy. Artificial intelligence (AI) can help improve early diagnosis, prognosis, and treatment of melanoma. However, there is a lack of detailed and accurate bibliometric analysis of the field. METHODS: All publications were extracted from Web of Science Core Collection based on AI and melanoma terms. Bibliometric analysis was conducted on 1476 articles/reviews by using VOSviewer, CiteSpace, and bibliometrix for co-authorship, citation, keyword, and journal analysis. RESULTS: There was a sudden increase in publications each year after 2017 and reached 260 in 2024. The United States (337 publications) and China (292 publications) ranked top in publication productivity. Germany was the top institution and author country. IEEE Access (57 publications) and Diagnostics (54 publications) were core journals. The two most prominent research hotspots were AI-assisted diagnosis and AI-integrated immunotherapy according to the keyword analysis. CONCLUSION: AI in melanoma research has exploded since 2017. It is recommended that future research focus on various datasets, explainable AI, and cross-disciplinary cooperation to promote the transformation of achievements into clinical practice.
1 Feb 2026
Read appraisal →Cancer Cell
Precision treatment with artificial intelligence assisted subtyping enhances therapeutic efficacy in HR+/HER2- breast cancer: The LINUXtrial.
We report the results of LINUX (NCT05594095), a multicenter, randomized, controlled phase II platform trial aiming to identify effective precision treatments for hormone receptor-positive/human epidermal growth factor receptor 2-negative metastatic breast cancer after resistance to cyclin-dependent kinase 4/6 inhibitor. A total of 105 patients were categorized into four similarity network fusion (SNF) subtypes by artificial intelligence-assisted classification and randomly assigned to receive subtyping-based precision therapy (N = 70) or treatment of physician's choice (N = 35). Results demonstrate superior primary endpoint of objective response rates in the subtyping-based groups compared to controls: 10% versus 0% for SNF1, 65% versus 30% for SNF2, 40% versus 30% for SNF3, and 70% versus 20% for SNF4. Grade 3-4 treatment-related adverse events occurred in 37% of both groups. These findings highlight the clinical benefits of subtyping-based precision therapies, particularly for SNF2 and SNF4 subtypes, warranting further validation in phase III trials.
1 Feb 2026
Read appraisal →Clin Dermatol
Chancroid.
Chancroid, caused by Haemophilus ducreyi, is a sexually transmitted genital ulcerative condition associated with inguinal bubo formation. The relative prevalence of chancroid has dramatically declined based on surveillance findings in those few endemic settings where the appropriate diagnostic tools exist; however, laboratory-based diagnostics are lacking to assist clinical management and support etiological surveillance in most parts of the world. Recent yaws surveys within the Western Pacific region indicate that H ducreyi has re-emerged as a frequent cause of chronic skin ulceration. Although there have been no antimicrobial susceptibility studies for three decades, it is assumed that a cure remains possible with extended-spectrum cephalosporins, macrolides, or fluoroquinolones. HIV-1-infected patients require careful followups due to reports of treatment failure with single-dose regimens. Buboes may need additional treatment with either aspiration or excision and drainage.
1 Jan 2026
Read appraisal →Clin Dermatol
Gonorrhea.
Neisseria gonorrhoeae, a Gram-negative intracellular pathogen, causes gonorrhea. Although usually sexually transmissible, it can be acquired by direct inoculation. Untreated gonococcal infections have deleterious impacts, including adverse pregnancy outcomes, ectopic pregnancy, infertility, and even blindness. Extended-spectrum cephalosporins remain the mainstay of therapy, and gonococcal culture is essential to determine susceptibility to these agents. Antimicrobial resistance is a global public health concern, and a few new agents are in the pipeline. Gonorrhea control programs rely on health education, access to diagnostic testing (where possible), effective therapy, and partner notification. Introducing inexpensive, sensitive, and specific point-of-care tests will aid antimicrobial stewardship efforts in countries using the syndromic management approach. Targeted vaccination of higher-risk populations with cross-protective outer membrane vesicle-based meningococcal B vaccines might reduce N. gonorrhoeae transmission in the future. Doxycycline postexposure prophylaxis may further reduce gonococcal incidence in the short term; however, its long-term impact on the human resistome/microbiome remains unknown.
1 Jan 2026
Read appraisal →Ann Med
Advancements in artificial intelligence for atopic dermatitis: diagnosis, treatment, and patient management
Atopic dermatitis (AD) is a common and complex skin disease that significantly affects the quality of life of patients. The latest advances in artificial intelligence (AI) technology have introduced new methods for diagnosing, treating, and managing AD. AI has various innovative applications in the diagnosis and treatment of atopic dermatitis, with particular emphasis on its significant benefits in medical diagnosis, treatment monitoring, and patient care. AI algorithms, especially those that use deep learning techniques, demonstrate strong performance in recognizing skin images and effectively distinguishing different types of skin lesions, including common AD manifestations. In addition, artificial intelligence has also shown promise in creating personalized treatment plans, simplifying drug development processes, and managing clinical trials. Despite challenges in data privacy and model transparency, the potential of artificial intelligence in advancing AD care is enormous, bringing the future to precision medicine and improving patient outcomes. This manuscript provides a comprehensive review of the application of AI in the process of AD disease for the first time, aiming to play a key role in the advancement of AI in skin health care and further enhance the clinical diagnosis and treatment of AD.
1 Dec 2025
Read appraisal →Ann Allergy Asthma Immunol
Current updates in the epidemiology and comorbidities of atopic dermatitis
Atopic dermatitis (AD) is a chronic, inflammatory skin disorder that affects individuals across the lifespan, with significant implications for both public health and individual well-being. This paper provides an overview of the epidemiology of AD, focusing on its prevalence, incidence, and risk factors across different populations and regions. We evaluate the growing global burden of AD, highlighting trends in both high-income and low- to middle-income countries, and the impact of socioeconomic, environmental, and genetic factors on disease manifestation. The review also explores the variations in disease severity, age of onset, and comorbidities such as asthma and allergic rhinitis. This paper emphasizes the need for more robust epidemiologic studies to further elucidate the complex interactions between genetic predisposition and environmental exposures in the development and progression of AD and explores the potential role of technology (eg, artificial intelligence) in helping to collect robust epidemiologic data. Understanding the epidemiology of AD is crucial for identifying high-risk groups, informing preventive strategies, and optimizing management approaches.
1 Nov 2025
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