OBJECTIVE AND SIGNIFICANCE: This study evaluates the efficacy and safety of a combined treatment approach using CO laser therapy and oral Thalidomide for the management of skin lesions in patients with classic Kaposi's s...OBJECTIVE AND SIGNIFICANCE: This study evaluates the efficacy and safety of a combined treatment approach using CO laser therapy and oral Thalidomide for the management of skin lesions in patients with classic Kaposi's sarcoma (CKS). METHODS: We conducted a prospective observational study at the First Affiliated Hospital of Guangxi Medical University, spanning from April 2021 to April 2023. The study focused on assessing the therapeutic outcomes in terms of macroscopic and microscopic changes in skin lesions before and after the treatment. RESULTS: This study enrolled 10 patients with an average age of 62.8 years, who predominantly exhibited skin lesions on their lower limbs, with some involvement of the upper limbs. Throughout the 6-24 months follow-up period, patients were administered oral thalidomide at a dosage of 100 mg per day and underwent three CO laser sessions on average. Post-treatment, complete resolution of Kaposi's sarcoma (KS) was observed in 9 out of 10 patients, with histopathology and dermoscopy showing no residual KS-related manifestations. Adverse reactions occurred in three patients (30%), including red marks, skin scars, and itching. CONCLUSION: The combination of CO laser therapy with oral thalidomide offers a straightforward, efficacious, and safe treatment for cutaneous lesions in classic CKS patients.
BACKGROUND: Dupilumab has revolutionized treatment of moderate-to-severe atopic dermatitis (AD). However, its use has been associated with ophthalmologic adverse events referred to as dupilumab-associated ocular surface...BACKGROUND: Dupilumab has revolutionized treatment of moderate-to-severe atopic dermatitis (AD). However, its use has been associated with ophthalmologic adverse events referred to as dupilumab-associated ocular surface disease (DAOSD), reported in up to 30% of patients. Although several risk factors have been proposed, the role of Demodex folliculorum remains poorly defined. OBJECTIVES: To evaluate the association between eyelid Demodex infestation and DAOSD development during the first 16 weeks of dupilumab therapy. METHODS: This prospective study enrolled 30 adults with moderate-to-severe AD initiating dupilumab. All patients underwent ophthalmologic evaluation, Ocular Surface Disease Index (OSDI) scoring, Schirmer testing, conjunctival cultures, and Demodex detection. Follow-up was performed at 16 weeks. Patients were stratified by DAOSD status. RESULTS: DAOSD developed in 33% ( = 10), presenting as blepharoconjunctivitis. Baseline Demodex infestation was significantly more frequent in the DAOSD group (70.0% vs. 5.0%; = .0004; OR = 44.3). Baseline Eczema Area and Severity Index (EASI) scores, IgE levels, and Schirmer results did not differ. Post-treatment OSDI scores were higher in DAOSD patients (median 37.5 vs. 4.6; = .0001). Bacterial cultures were not associated with DAOSD. CONCLUSIONS: Eyelid Demodex infestation is strongly associated with DAOSD development. Pretreatment screening may identify high-risk individuals. As most cases occur within 16 weeks, this study focused on the early treatment phase.
AIM: To evaluate outcomes of adding skin-flap transfer to negative-pressure wound therapy (NPWT) for complex pressure ulcers. METHODS AND MATERIAL: Twenty-nine patients (Aug 2018-Sep 2022) were divided into control (debr...AIM: To evaluate outcomes of adding skin-flap transfer to negative-pressure wound therapy (NPWT) for complex pressure ulcers. METHODS AND MATERIAL: Twenty-nine patients (Aug 2018-Sep 2022) were divided into control (debridement + NPWT, = 14) and observation (same plus flap transfer, = 15). One-year follow-up compared healing rates, healing time, postoperative stay, total stay, cost, Zarit caregiver burden, SF-36 quality of life, complications and recurrence. RESULTS: Healing rates, healing time, postoperative stay, complications and recurrence did not differ ( > 0.05). Observation group had shorter total stay, lower costs, reduced caregiver burden and better SF-36 scores ( < 0.05). CONCLUSIONS: Skin-flap transfer combined with NPWT safely treats complex pressure ulcers, improving quality of life, reducing caregiver load and overall costs without increasing complications or recurrence.
OBJECTIVE: Effective systemic treatments for psoriasis may reduce the need for topical therapies. The objective of this study was to evaluate changes in topical prescriptions after apremilast initiation. MATERIALS AND ME...OBJECTIVE: Effective systemic treatments for psoriasis may reduce the need for topical therapies. The objective of this study was to evaluate changes in topical prescriptions after apremilast initiation. MATERIALS AND METHODS: This retrospective cohort study was performed in the Japanese JMDC health insurance claims database. Adults with psoriasis initiating apremilast between 01/03/2018 and 31/07/2021 and prescribed topical therapies in the previous six months were eligible. Topical therapy prescription was compared between the six months preceding and the six months following apremilast initiation. Data from 319 patients were analyzed. RESULTS: The cumulative amount (grams) of topical therapies prescribed decreased significantly following apremilast initiation from 195.8 ± 236.1 to 162.2 ± 230.9 for steroids ( < 0.001) and from 84.6 ± 89.6 to 77.1 ± 104.6 for vitamin D analogues ( = 0.018). No significant change was observed for fixed-dose combinations (from 133.2 ± 140.0 to 143.4 ± 136.8; = 0.487) or total topical therapy (from 309.9 ± 272.3 to 301.0 ± 293.0; = 0.131). For steroids, the reduction was only significant for 'very strong' potency steroids (-33.6 g; = 0.001). Eighteen patients (6%) discontinued all topical therapy following apremilast initiation and 69 (22%) were prescribed fewer concomitant topical therapies. CONCLUSION: In conclusion, initiation of systemic apremilast treatment is associated with reduced prescription of topical therapies. Treatment with apremilast may decrease the burden of long-term exposure to topical therapies.
BACKGROUND: Psoriasis is frequently associated with non-communicable disease (NCD) comorbidities, prompting interest in how these concurrent conditions may influence psoriasis treatment outcomes. OBJECTIVES: To assess NC...BACKGROUND: Psoriasis is frequently associated with non-communicable disease (NCD) comorbidities, prompting interest in how these concurrent conditions may influence psoriasis treatment outcomes. OBJECTIVES: To assess NCD prevalence and their influence on psoriasis treatment outcomes. METHODS: From 2022 to 2024, we recruited psoriasis patients in Shanghai Skin Disease Hospital. Data on demographic features, NCD comorbidities and treatment outcomes at week 4 and week 8 were systematically collected through questionnaire, physical examination, and clinical severity assessment (psoriasis area and severity index [PASI], body surface area [BSA], physician's global assessment [PGA]). RESULTS: Among 1116 patients, 48.4% had at least one NCD comorbidity. NCD-free patients exhibited higher PASI response rates at both week 4 (46.5 39.1%) and week 8 (72.2 70.9%). Log binomial regression revealed that NCDs significantly reduced the likelihood of achieving PASI at week 4 (relative risk [RR] = 0.84, 95% confidence interval [CI]: 0.73-0.96), with a similar but non-significant trend at week 8 (RR = 0.98, 95% CI: 0.92-1.06). CONCLUSION: NCDs negatively impact early treatment outcomes in psoriasis patients. So we propose that dermatologists should integrate systematic NCD management into psoriasis treatment regimen.
Murase JE, Eyerich K, Chovatiya R
… +12 more, Hong HC, Bangert C, Strowd L, Deleuran M, Atwater AR, Rueda MJ, Elmaraghy H, Piruzeli MLB, Pau-Charles I, Yang FE, Zhong J, Staumont-Sallé D
PURPOSE OF THE STUDY: Head, neck (HN), and face involvement in atopic dermatitis (AD) poses a major psychological burden and can be challenging to effectively treat. New appearance of HN dermatitis has been reported with...PURPOSE OF THE STUDY: Head, neck (HN), and face involvement in atopic dermatitis (AD) poses a major psychological burden and can be challenging to effectively treat. New appearance of HN dermatitis has been reported with biologics used to treat AD. Lebrikizumab (LEBRI), a monoclonal targeting IL-13, is approved for AD treatment in the US, Europe and Asia. We evaluated HN dermatitis improvement using the HN Eczema Area and Severity Index (EASI) and a facial dermatitis questionnaire, along with safety evaluations focusing on HN and facial erythema. MATERIALS AND METHODS: Efficacy analyses were performed on placebo (PBO) controlled modified intention-to-treat (mITT) populations from the 16-week induction periods of ADvocate1 and ADvocate2 (pooled) and ADhere studies. Treatment-emergent adverse events (TEAEs) of HN and facial erythema were summarized from eight Phase 2 and 3 clinical trials. RESULTS: LEBRI resulted in significantly greater improvements than PBO in EASI HN subscore as early as Week 2 (ADvocate 1&2), with 68.1% improvement at Week 16. CONCLUSIONS: LEBRI improved EASI HN subscore and HN EASI clinical signs of erythema and facial dermatitis at Week 16. During the PBO-controlled period, an increased reporting of HN and facial erythema as TEAE was not observed in the LEBRI group and HN and facial TEAEs reporting did not increase with longer exposure.
INTRODUCTION: Sex-differences in biological treatment outcomes in adult patients with psoriasis are well known. Potential sex-differences in a real-world cohort of pediatric and young adult patients with psoriasis using...INTRODUCTION: Sex-differences in biological treatment outcomes in adult patients with psoriasis are well known. Potential sex-differences in a real-world cohort of pediatric and young adult patients with psoriasis using biologics were investigated in this study. METHODS: Data on pediatric (<18 years) and young adult (≥18 to ≤30 years) patients were obtained from the prospective, daily practice, ChildCAPTURE and BioCAPTURE registries. Drug survival and adverse event rates were compared between sexes. Confounder-corrected linear mixed models were used to compare Psoriasis Area and Severity Index (PASI) and (Children's) Dermatology Life Quality Index ((C)DLQI) scores between sexes. RESULTS: We included 117 pediatric (65 females) and 243 young adult (124 females) patients on biologics (753.4 observation years). Young adult males had a significantly higher PASI at biologic initiation compared to females, with the same trend for pediatric patients. A higher adverse event rate was observed in females compared to males in both pediatric and young adult patients. Drug survival, PASI and (C)DLQI course during the first treatment year, were comparable between pediatric and young adult females and males. CONCLUSION: Awareness on sex-differences (start PASI and adverse event rates) in pediatric and young adult patients with psoriasis is important for timely initiation and adjustment of appropriate treatment.
PURPOSE: This study aimed to identify factors influencing photodynamic therapy (PDT) efficacy in facial port-wine stains (PWS) and to develop a predictive model for treatment outcomes. METHODS: A retrospective analysis w...PURPOSE: This study aimed to identify factors influencing photodynamic therapy (PDT) efficacy in facial port-wine stains (PWS) and to develop a predictive model for treatment outcomes. METHODS: A retrospective analysis was conducted on 863 patients with facial PWS who had undergone hematoporphyrin monomethyl ether photodynamic therapy (HMME-PDT). Multivariate logistic regression analysis was employed to identify factors influencing efficacy and to construct a nomogram prediction model. RESULTS: A total of 265 patients (30.7%) obtained excellent results while 598 patients (69.3%) did not. The influencing factors identified included age, PWS location, type of PWS, prior treatment history, number of PDT sessions, and vascular and non-vascular features observed dermoscopy. Receiver operating characteristic curve analysis revealed that the area under the curve for the training and validation cohorts was 0.80 and 0.81, respectively. The calibration curve closely approximated the ideal diagonal line, and the Hosmer-Lemeshow test indicated a good fit for the model in both the training ( = 0.73) and validation cohorts ( = 0.52). Clinical decision curve analysis demonstrated a significantly improved net benefit in both cohorts. CONCLUSIONS: Our findings provide dermatologists with an accurate and effective tool for predicting PDT efficacy, facilitating the individualized management of facial PWS.
OBJECTIVE: Untreated vulvar lichen sclerosus (VLS) can lead to irreversible anatomical changes and increase malignancy risk. Some patients show poor response to standard treatments, resulting in refractory cases (RVLS)....OBJECTIVE: Untreated vulvar lichen sclerosus (VLS) can lead to irreversible anatomical changes and increase malignancy risk. Some patients show poor response to standard treatments, resulting in refractory cases (RVLS). METHODS: To explore risk factors associated with RVLS and integrate treatment strategies for improved clinical management, we conducted a retrospective analysis, which included patients with VLS who visited our outpatient clinic between March 2017 and March 2025. Additionally, an evidence synthesis of the currently reported treatment regimens for RVLS was conducted. RESULTS: A total of 457 patients were included, of whom 36 were diagnosed with RVLS (7.9%). A multivariable logistic regression model identified comorbid autoimmune thyroid diseases (OR 2.45; 95%CI 1.09-5.34), perianal region involvement (OR 3.20; 95%CI 1.19-8.09), and presence of erosion/fissures (OR 3.13; 95%CI 1.44-7.29) as independent predictors for RVLS. Furthermore, the treatment approaches for 281 patients with RVLS across 20 studies included Janus kinase inhibitors (JAK), adalimumab, methotrexate, cyclosporine, photodynamic therapy (PDT), and laser therapy, with assessments of efficacy, side effects, and recurrence. CONCLUSIONS: Our study identified three predictive factors for RVLS, which may help in treatment decisions and reduce ineffective therapy. And therapies such as JAK and PDT show promise as optimized options, although larger studies are needed.
The objective was to investigate the reliability, validity, and meaningful change scores for the Physician's Global Assessment of Hands and/or Feet (hf-PGA), a measure of clinician-reported psoriasis severity on the hand...The objective was to investigate the reliability, validity, and meaningful change scores for the Physician's Global Assessment of Hands and/or Feet (hf-PGA), a measure of clinician-reported psoriasis severity on the hands/feet. Baseline, Week 8, and Week 16 data were analyzed from adult patients with moderate to severe plaque psoriasis ( = 99) in a Phase 2b multicenter, randomized, placebo-controlled, dose-ranging study (NCT05223868). The hf-PGA had high test-retest reliability between Weeks 8 and 16 in a clinically stable subgroup ( = 0.94, kappa = 0.85, percent agreement = 95.3%). Regarding validity, hf-PGA cross-sectional and change scores positively correlated with global measures of psoriasis severity (i.e. Investigator's Global Assessment, Psoriasis Area and Severity Index, and the Psoriasis Symptom and Sign Diary) and dermatological quality of life (i.e. Dermatology Life Quality Index) as hypothesized; relationships also aligned directionally (i.e. worse hf-PGA severity was associated with worse global severity and greater impact on quality of life). Anchor- and distribution-based analyses supported a hf-PGA change score of -2 as a clinically meaningful improvement. Thus, the hf-PGA demonstrated sufficient reliability, validity, and meaningful change thresholds; it is suitable for use in clinical studies and is fit-for-purpose for evaluating psoriasis severity on the hands/feet.
INTRODUCTION: Severe nodular acne causes significant psychological distress and reduces quality of life. Clascoterone 1% cream, a novel anti-androgen with a favorable safety profile, may enhance the efficacy of oral isot...INTRODUCTION: Severe nodular acne causes significant psychological distress and reduces quality of life. Clascoterone 1% cream, a novel anti-androgen with a favorable safety profile, may enhance the efficacy of oral isotretinoin, the gold-standard therapy for severe acne. This study compared isotretinoin monotherapy with isotretinoin plus topical clascoterone 1% cream. METHODS: Since June 2023, patients with severe/nodular acne at university-affiliated dermatology clinics were treated with isotretinoin, alone or combined with clascoterone 1% cream twice daily. In December 2024, records were retrospectively reviewed. The analysis included patients aged ≥12 years with severe/nodular acne who received isotretinoin (0.5-0.8 mg/kg/day) with or without clascoterone 1% cream for ≥24 weeks. Outcomes included facial lesion count, Investigator's Global Assessment (IGA), and facial xerosis at week 24. RESULTS: Eighty-two patients (44 monotherapy; 38 combination therapy) were included. Both groups showed significant reduction in facial lesion count (), but between-group differences were not significant. More patients in the combination group achieved IGA 0/1 (92.1% vs. 72.7%; ). Xerosis rates were lower in the combination group (84% vs. 91%) but not statistically significant. CONCLUSION: Clascoterone 1% cream may enhance isotretinoin efficacy without worsening adverse effects, offering a promising approach for severe/nodular acne. Further studies are needed to confirm long-term benefits.
OBJECTIVE: Androgenic alopecia (AGA) is a genetic, non-scarring hair loss disorder influenced by peripheral androgens, affecting patients' appearance, and quality of life. This study compared the effects of 5% minoxidil,...OBJECTIVE: Androgenic alopecia (AGA) is a genetic, non-scarring hair loss disorder influenced by peripheral androgens, affecting patients' appearance, and quality of life. This study compared the effects of 5% minoxidil, platelet-rich plasma (PRP), and their combination on hair count, telogen/anagen ratio, and vellus hair in AGA patients. MATERIAL AND METHODS: This retrospective study included AGA patients treated at the dermatology department. Dermoscopic images taken before and 6 months after treatment with the Molemax device were analyzed using Tricoscan software. Demographic data, disease characteristics, and previous treatments were recorded. Staging followed the Ludwig and Hamilton-Norwood classifications. Patients were categorized into three groups: Group I (5% minoxidil), Group II (PRP), and Group III (combined therapy). RESULTS: The study included 45 patients (53.3% female; mean age 27.8 ± 8.6 years). Groups II and III showed significant improvement in hair count, density, terminal hair count, and anagen ratio ( < 0.05). Vellus hair count and density significantly decreased in Group III ( < 0.05). Patient-reported improvement did not differ significantly among groups ( > 0.05). CONCLUSION: PRP improves hair growth parameters in AGA and is more effective when combined with minoxidil, especially in reducing vellus hair. These results support PRP's role in AGA treatment.
PURPOSE: This study describes the use of upadacitinib, a JAK1 inhibitor, in combination with oral minoxidil for treatment of alopecia universalis (AU) with comorbid Crohn's disease (CD) and atopic dermatitis (AD). AU is...PURPOSE: This study describes the use of upadacitinib, a JAK1 inhibitor, in combination with oral minoxidil for treatment of alopecia universalis (AU) with comorbid Crohn's disease (CD) and atopic dermatitis (AD). AU is the most extensive form of alopecia areata (AA), a chronic autoimmune condition that often requires systemic therapy for hair regrowth. While JAK inhibitors (JAKis) have demonstrated efficacy in each condition, data on upadacitinib's use in patients with coexisting disease are limited. MATERIALS AND METHODS: We report the case of a 20-year-old male with CD who developed AU one year after initiating adalimumab. Following inadequate CD control and progression of hair loss, he was diagnosed with coexisting AU and AD. An IBD-directed regimen of upadacitinib (45 mg/day induction, 30 mg/day maintenance) was initiated with oral minoxidil, increased from 2.5 to 10 mg/day. RESULTS: By 7 weeks, he experienced resolution of gastrointestinal symptoms and early hair regrowth; by 11 weeks, he achieved complete regrowth of scalp, eyebrow, eyelash, and beard hair. Colonoscopy confirmed histologic remission. CONCLUSIONS: This case highlights the potential of JAK is to address potentially overlapping immune-mediated disorders and suggests that upadacitinib, in combination with oral minoxidil, may promote rapid AU remission. These findings may inform future treatment approaches for complex autoimmune presentations.
PURPOSE: Onychomycosis, in contrast to other routine superficial dermatophyte infections, is difficult to treat and poor outcomes are not unusual. Few guidelines for onychomycosis management have been published, and thes...PURPOSE: Onychomycosis, in contrast to other routine superficial dermatophyte infections, is difficult to treat and poor outcomes are not unusual. Few guidelines for onychomycosis management have been published, and these vary considerably from region to region. To meet global antifungal stewardship (AFS) goals, there must be global management guidelines for clinicians to follow in their onychomycosis practice. We aimed to survey current practices for onychomycosis management across a variety of global regions and compare practices to published treatment guidelines, as well as to what degree the management practices may facilitate AFS practices. MATERIALS AND METHODS: An informal literature review was performed to identify regional onychomycosis guidelines. An online survey of our colleagues was distributed to assess current onychomycosis management practices and challenges for comparison with associated regional guidelines. Guidelines and practices were reviewed for adherence to the general AFS principles. RESULTS: Our review of current practices shows that, despite guidelines, identification of the infecting species is often not obtained, and treatment provision does not strictly follow existing guidelines. Lack of laboratory access prevents diagnosis and antifungal susceptibility testing that can help provide targeted treatments and resistance surveillance. Better diagnostic methods are needed as a component to improve management decisions, and provide the reliable monitoring required for effective AFS. Broader clinical testing is needed to address knowledge gaps in onychomycosis therapy. Meeting these challenges must be a priority as antifungal resistance is quickly becoming a worldwide problem. CONCLUSIONS: As a reservoir for resistant strains, onychomycosis represents a significant future medical/economic burden. Future onychomycosis guidelines must address the challenge of resource limitations experienced by clinicians, as well as the challenge of balancing the need for AFS principles with the specific needs of onychomycosis therapy.
OBJECTIVE: To investigate the efficacy and safety of 308-nm excimer laser therapy with or without fire needle therapy in patients with stable acral vitiligo. METHODS: A retrospective study was conducted to review patient...OBJECTIVE: To investigate the efficacy and safety of 308-nm excimer laser therapy with or without fire needle therapy in patients with stable acral vitiligo. METHODS: A retrospective study was conducted to review patients with stable acral vitiligo treated between January 2020 and October 2024. In addition to topical halometasone cream, patients received either 308-nm excimer laser therapy alone (laser group) or a combination of 308-nm excimer laser and fire needle therapies (combination group) for three months. Vitiligo Area Scoring Index (VASI), physician global assessment (PGA), pain during treatment, and side effects were compared between the groups. RESULTS: A total of 62 patients (32 in the laser group and 30 in the combination group.) were included. The mean age was 34.2 ± 9.8 years, with 39 (62.9%) males. Baseline characteristics were comparable between the two groups. Patients in both groups experienced a reduction in VASI scores (0.06 ± 0.74 and 0.16 ± 0.14 in the laser and combination groups, respectively). Compared with the laser group, the combination group showed significant improvement in lesion appearance, but reported mild pain ( < 0.001). Both groups experienced mild skin reactions, which resolved quickly after treatment. CONCLUSIONS: Combination therapy with 308-nm excimer laser and fire needle is a safe and effective approach for stable acral vitiligo.
Provide insights into the incidence, pre-sentation and management of follicular events and contact dermatitis in patients with plaque psoriasis or atopic dermatitis (AD) treated with tapinarof cream 1%. Key clinical tri...Provide insights into the incidence, pre-sentation and management of follicular events and contact dermatitis in patients with plaque psoriasis or atopic dermatitis (AD) treated with tapinarof cream 1%. Key clinical trial publications for tapinarof were reviewed and augmented with the authors' opinions based on real-world clinical experience. In the PSOARING and ADORING trials, discontinuation rates due to follicular events and contact dermatitis were low and most patients did not require dose modifications or treatment interruptions. In our experience, which includes the use of tapinarof in combination with other agents, tapinarof is generally well tolerated and if events of folliculitis or contact dermatitis occur, patients can be advised to temporarily discontinue application on affected sites until the event resolves, continuing application to other affected areas and body regions. Education on the correct application of tapinarof is important in the management of psoriasis and AD. Tapinarof is a novel topical treatment option for adults with plaque psoriasis and patients with AD, with no restrictions regarding application sites and duration of use. Follicular events and contact dermatitis associated with tapinarof treatment are generally mild and self-limiting and rarely interfere with therapy. NCT05014568, NCT05032859, NCT05142774, NCT03956355, NCT03983980, NCT04053387.
BACKGROUND: Pemphigus vulgaris (PV) is a chronic autoimmune blistering disease with high morbidity and mortality, treated mainly with long-term immunosuppressants. Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS...BACKGROUND: Pemphigus vulgaris (PV) is a chronic autoimmune blistering disease with high morbidity and mortality, treated mainly with long-term immunosuppressants. Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN) is an acute, life-threatening drug reaction with severe skin and mucosal involvement. No approved therapies currently exist for SJS/TEN. AIM: To demonstrate that the soluble form of Fas ligand (sFasL) is a relevant therapeutic target in both PV and SJS/TEN, and to provide evidence that PC111, a fully human monoclonal antibody against sFasL, is effective in both conditions. EVIDENCE REVIEW: In PV, autoantibodies (PVIgG) target desmogleins, leading to blistering via signaling cascades. sFasL, released upon PVIgG binding, contributes to this process by promoting desmoglein degradation and acantholysis. In SJS/TEN, elevated sFasL induces keratinocyte apoptosis, contributing to epidermal detachment. FINDINGS: PC111 blocks acantholysis and blister formation in PV through a local, rapid mechanism, downstream of the immune system, thus differentiating from the currently used immunosuppressive treatments. In SJS/TEN, PC111 prevents keratinocyte apoptosis induced by patient serum and improves ocular symptoms in a mouse model. Its fast action suggests potential for early intervention to halt disease progression. CONCLUSIONS: PC111 may act as a disease-modifying agent, promoting long-term remission in PV and preventing progression in early-stage SJS/TEN.