Dissecting cellulitis of the scalp (DCS) is a chronic inflammatory disorder of the scalp that manifests as inflamed nodules and abscesses, with subsequent patchy, scarring hair loss. While its exact pathogenesis remains...Dissecting cellulitis of the scalp (DCS) is a chronic inflammatory disorder of the scalp that manifests as inflamed nodules and abscesses, with subsequent patchy, scarring hair loss. While its exact pathogenesis remains unclear, follicular occlusion, inflammation, and sinus tract formation are thought to be key contributors. We present two patients, a 26-year-old male and a 33-year-old male, with refractory DCS and concomitant hidradenitis suppurativa and acne conglobata who were successfully treated with a combination therapy regimen of bimekizumab, isotretinoin, and oral antibiotics.  .
Ezekwe U, Ugwueke G, Olagun-Samuel C
… +3 more, Akintilo L, Ugonabo N, Adotama P
J Drugs Dermatol
· 2026 Feb · PMID 41642153
Lichen planus pigmentosus (LPP) is a rare pigmentary disorder primarily affecting patients with skin of color. Currently, comprehensive evaluations for procedural interventions for LPP are limited in the literature. In t...Lichen planus pigmentosus (LPP) is a rare pigmentary disorder primarily affecting patients with skin of color. Currently, comprehensive evaluations for procedural interventions for LPP are limited in the literature. In this review, we assess current procedural options for LPP treatment, focusing on their efficacy, safety, and practical considerations. A comprehensive literature search using PubMed and Embase identified English studies published through December 2024 that examined cosmetic procedures for the treatment of LPP. Keywords included “lichen planus pigmentosus,” “laser,” “chemical peel,” “glycolic acid,” “salicylic acid,” “TCA,” “jessner,” “VI,” “cosmetic procedure,” “procedure”, and related terms. Articles without original data, sufficient results, or human participants were excluded. Data on study design, participant characteristics, procedural details, and clinical outcomes were extracted and reported in this descriptive review. A total of 16 studies were reviewed, which highlighted procedural approaches to managing LPP, including chemical peels (eg, phenol and glycolic acid), laser therapy (eg, Q-switched Nd:YAG, CO2 fractional, Picosecond Nd:YAG, erbium-doped fiber), and platelet-rich plasma therapy. Evidence was limited by small sample sizes, lack of randomized controlled trials, and reliance on case reports and series. Most studies included fewer than 20 participants, limiting the generalizability of findings. In conclusion, procedural interventions can serve as an alternative treatment option for LPP, especially for those unresponsive to standard treatments. Further research with larger cohorts and comparative trials are needed to further elucidate current findings. J Drugs Dermatol. 2026;25(2): doi:10.36849/JDD.9209.
BACKGROUND: Deucravacitinib, a first-in-class, oral, selective TYK2 inhibitor, has redefined systemic therapy options for moderate-to-severe plaque psoriasis. This review synthesizes published data from the POETYK phase...BACKGROUND: Deucravacitinib, a first-in-class, oral, selective TYK2 inhibitor, has redefined systemic therapy options for moderate-to-severe plaque psoriasis. This review synthesizes published data from the POETYK phase 3 and long-term extension (LTE) studies, together with current research and real-world clinical evidence, to provide clinicians a comprehensive perspective on the agent’s long-term efficacy, safety, and clinical utility. OBJECTIVE: To synthesize long-term efficacy and safety data for deucravacitinib and provide practical insights for real-world use. DISCUSSION: We reviewed published, long-term data for 1,519 patients on deucravacitinib over 5,000 person-years of exposure. Sustained clinical response was observed in the efficacy cohort (n=513), with PASI 75/90/100 responses maintained at 67%, 46%, and 22% at week 256 (mNRI). Nearly half of patients achieved minimal disease impact on daily life (DLQI 0/1). Patient-reported outcomes confirmed durable improvement in symptoms, itch, and quality of life. Deucravacitinib demonstrated a consistent safety profile with no new signals in the available long-term data. Rates of adverse and serious adverse events declined over time; acne, when present, was mild and transient. The agent’s selective TYK2 regulatory-domain inhibition distinguishes it mechanistically from broader JAK inhibitors, underpinning its favorable safety and tolerability. CONCLUSIONS: Long-term evidence affirms deucravacitinib’s durable disease control, stable safety, and patient-friendly convenience. With once-daily oral dosing, minimal laboratory monitoring, and efficacy across difficult-to-treat sites, deucravacitinib represents a practical and reliable long-term therapy with oral simplicity for patients with moderate-to-severe plaque psoriasis. J Drugs Dermatol. 2026;25:2(Suppl 1):s3-s10.
BACKGROUND: The integration of artificial intelligence (AI), particularly large language models (LLMs), into healthcare has rapidly expanded. In dermatology, machine learning is increasingly employed for diagnosis, progn...BACKGROUND: The integration of artificial intelligence (AI), particularly large language models (LLMs), into healthcare has rapidly expanded. In dermatology, machine learning is increasingly employed for diagnosis, prognosis, and treatment planning. However, the reliability of AI-generated recommendations, especially in chronic conditions such as psoriasis, remains insufficiently explored. OBJECTIVE: This study aims to evaluate the alignment of two prominent LLMs—ChatGPT and DeepSeek—with the clinical guidelines for psoriasis treatment issued by the American Academy of Dermatology (AAD). METHODS: Thirty-one guideline-based questions were formulated using the 2021 AAD-NPF guidelines. Each question was presented to ChatGPT-4 and DeepSeek. Responses were evaluated by two board-certified dermatologists blinded to the model source and rated as either concordant or discordant with the guidelines. Discrepancies were resolved by a third reviewer. Concordance rates were calculated according to the strength of recommendations, and inter-model agreement was assessed using Cohen’s kappa coefficient. RESULTS: Both ChatGPT and DeepSeek demonstrated an overall concordance rate of 87.1%. While both models fully aligned with strong recommendations, ChatGPT showed higher concordance with moderate recommendations (87.5% vs 81.3%), whereas DeepSeek outperformed ChatGPT in scenarios involving limited recommendations (66.7% vs 33.3%). Inter-model agreement was moderate (κ = 0.43). CONCLUSION: Although ChatGPT and DeepSeek show promise in aligning with evidence-based dermatologic care, inconsistencies, particularly in cases with limited evidence, highlight the necessity of clinical oversight. AI may serve as a valuable adjunct in psoriasis management; however, its safe integration into practice requires careful validation and context-sensitive application.  .
BACKGROUND: Energy-based devices (EBDs) are increasingly used to manage acne and its sequelae. While literature supports the use of appropriate skin care for acne, few studies address how to effectively integrate skincar...BACKGROUND: Energy-based devices (EBDs) are increasingly used to manage acne and its sequelae. While literature supports the use of appropriate skin care for acne, few studies address how to effectively integrate skincare with EBDs. METHODS: Six dermatologists from North America, participated in a live meeting to develop an acne treatment algorithm integrating skincare and EBDs. Six additional advisors contributed through a pre-meeting survey (along with 94 other physicians). The eleven dermatologists (authors) from Asia, Europe, Australia, and North America participated in algorithm development and manuscript review. RESULTS: The proposed algorithm describes how to integrate skin care with the use of EBDs in clinical practice. CONCLUSIONS: This algorithm provides an approach for managing acne and best practices for integrating skin care with EBDs when treating acne and acne sequelae.  .
Acne vulgaris is an inflammatory skin condition affecting adolescents and adults of both sexes. Clascoterone cream 1% is indicated for the topical treatment of acne vulgaris in patients ≥12 years of age based on the r...Acne vulgaris is an inflammatory skin condition affecting adolescents and adults of both sexes. Clascoterone cream 1% is indicated for the topical treatment of acne vulgaris in patients ≥12 years of age based on the results of two Phase 3 trials (NCT02608450 and NCT02608476). This post hoc analysis evaluated the efficacy and safety of clascoterone cream 1% in patient subgroups defined by age (adolescent vs adult) and sex (male vs female). Patients ≥12 years of age with mild-to-moderate acne applied clascoterone cream 1% or vehicle twice daily for 12 weeks. Efficacy was assessed from Investigator’s Global Assessment (IGA) treatment success and inflammatory, noninflammatory, and total lesion counts, and safety from frequency and severity of adverse events. Treatment with clascoterone cream 1% vs vehicle resulted in significantly greater IGA treatment success rates for all subgroups: at week 12, 47/287 (16.4%) vs 12/306 (3.9%) adolescent, 77/330 (23.3%) vs 29/309 (9.4%) adult, 32/226 (14.2%) vs 13/252 (5.2%) male, and 92/391 (23.5%) vs 28/363 (7.7%) female patients achieved IGA treatment success. Patients treated with clascoterone cream 1% vs vehicle in all subgroups also experienced significantly greater lesion count reductions. From baseline to week 12, clascoterone cream 1% treatment resulted in significantly larger reductions in lesion counts in adult vs adolescent patients; there were no statistically significant differences between male and female patients. Adverse events were similar across subgroups. These results further support the efficacy and tolerability of clascoterone cream 1% across the spectrum of patients ≥12 years of age with acne vulgaris.  .
BACKGROUND: Granuloma annulare (GA) is a benign inflammatory dermatosis characterized by dermal granuloma formation. While its etiology is unclear, GA has been linked to systemic comorbidities. Localized GA typically res...BACKGROUND: Granuloma annulare (GA) is a benign inflammatory dermatosis characterized by dermal granuloma formation. While its etiology is unclear, GA has been linked to systemic comorbidities. Localized GA typically responds to corticosteroids, but generalized GA often follows a more refractory course. Pentoxifylline has emerged as a potential steroid-sparing agent, though data are limited. METHODS: A retrospective chart review was conducted on 102 patients diagnosed with GA at a single academic dermatology clinic in rural Appalachia. Demographic data, disease subtype, treatment history, and comorbidities were recorded. Comorbidity prevalence was compared with state and national averages. Statistical analysis assessed associations between disease extent, treatment response, and comorbidity burden. RESULTS: The cohort was 79% female with a mean age of 46 years; 19% of cases were pediatric. Generalized GA accounted for 46% of cases and showed elevated rates of type 2 diabetes (36%), hypothyroidism (26%), and autoimmune disease (15%). Patients with ≥3 comorbidities were more likely to have prolonged disease (>2 years). Generalized GA required more treatment attempts (P<0.001) and had higher failure rates than localized disease. Pentoxifylline achieved a 64% response rate in generalized GA, outperforming hydroxychloroquine and topical corticosteroids. CONCLUSIONS: Generalized GA is more treatment-resistant and associated with a greater comorbidity burden. Pentoxifylline demonstrated favorable efficacy and may serve as a first-line systemic agent in refractory cases. Further multi-center studies are needed to validate these findings and guide evidence-based management of GA.  .
Brodalumab is a recombinant, fully human monoclonal antibody antagonist of the human interleukin-17 (IL-17) receptor A. It is indicated for the treatment of moderate-to-severe plaque psoriasis in adult patients who are c...Brodalumab is a recombinant, fully human monoclonal antibody antagonist of the human interleukin-17 (IL-17) receptor A. It is indicated for the treatment of moderate-to-severe plaque psoriasis in adult patients who are candidates for systemic therapy or phototherapy and have failed to respond or have lost response to other systemic therapies. Brodalumab blocks signaling mediated by IL-17 cytokines, disrupting the inflammatory feedback loop between immune cells and keratinocytes that drives psoriasis, which may explain its efficacy in clinical trials. To explore its postapproval effectiveness, this review synthesizes real-world evidence of brodalumab across 14 international studies. Studies showed rapid onset of action and sustained effectiveness through extended follow-up periods. Notably, brodalumab achieved high response rates in patients whose psoriasis had failed to respond to prior IL-17A inhibitors. Comparative analyses position brodalumab favorably against other biologics, demonstrating its superior response rates and faster onset of action. Furthermore, brodalumab was efficacious in difficult-to-treat psoriasis manifestations, including nail psoriasis, generalized pustular psoriasis, and psoriatic erythroderma. Limitations of this report include variations in study designs, follow-up durations, and baseline characteristics across reviewed studies. The evidence collectively establishes brodalumab as a valuable therapeutic option, particularly for patients with treatment-resistant psoriasis and challenging subtypes.  .
Periorbital hyperpigmentation is a common yet challenging cosmetic concern due to the thin, vascular, and pigment-prone nature of periocular skin, as well as its multifactorial etiology. Discoloration in this area can be...Periorbital hyperpigmentation is a common yet challenging cosmetic concern due to the thin, vascular, and pigment-prone nature of periocular skin, as well as its multifactorial etiology. Discoloration in this area can be driven by genetics, photoaging, dermal thinning, and pigmentary disorders, making treatment outcomes often unpredictable and temporary. The cysteamine–isobionic amide complex offers a novel, non-hydroquinone and non-retinoid approach, combining the multi-pathway pigment reduction of cysteamine with the barrier-supporting and pigment-evening properties of isobionic amide. This pilot study aimed to evaluate the safety, tolerability, and efficacy of the cysteamine-isobionic amide complex for periorbital hyperpigmentation using objective imaging and patient-reported outcomes. Seven participants self-administered treatment three to five times weekly for 10 weeks. Patient-reported outcomes demonstrated consistent improvements in pigmentation, radiance, and overall appearance, with 83.3% noting improvement in their primary concern and 100% indicating they would recommend the regimen. The treatment was well tolerated, with only one case of transient mild erythema. To our knowledge, this is one of the first studies to investigate the cysteamine–isobionic amide complex in the periorbital region, supporting its potential as a safe, at-home option for under-eye hyperpigmentation. Future controlled trials with larger and more diverse cohorts are warranted to confirm these preliminary findings and assess long-term efficacy.  .
BACKGROUND: Nearly 500,000 individuals seek care for burns every year in the United States. Almost one burn injury occurs every day among US service members during deployment. Severe burns can result in contractures, lim...BACKGROUND: Nearly 500,000 individuals seek care for burns every year in the United States. Almost one burn injury occurs every day among US service members during deployment. Severe burns can result in contractures, limiting the range of motion and affecting the ability to perform daily activities. OBJECTIVE: We aimed to characterize the use of lasers in the treatment of burn injuries and to describe burn injuries in the military population. METHODS: A systematic review was conducted of the literature using PubMed to find articles pertaining to burn injuries in the military population and the use of laser therapy for burn injuries. RESULTS: Forty articles were included. Types of laser used for the treatment of burn injuries included CO2 ablative fractional lasers, pulsed dye lasers, Erbium YAG lasers, and others. Laser therapy shows potential use for treating chronic contractures resulting from burn injuries. Significant improvements have been reported in reducing contractures and enhancing functionality, particularly among our service member population. CONCLUSION: Trauma dermatology is a growing field that includes the treatment of burn scars in both the military and civilian populations. Laser treatments show efficacy in treatment for burn-related contractures limiting mobility and for scarring.