One Hundred and First issue
JANUARY 7TH, 2026
Health system experiences and care engagement in latine patients with hidradenitis suppurativa
JAMA Dermatology
JAMA Dermatology
HS care shouldn’t get lost in translation–especially when the pain speaks for itself
Latine patients with hidradenitis suppurativa (HS) in the US are reported to experience more severe disease and longer diagnostic delays compared with White patients. While barriers like insurance, access, and communication affect many HS patients, these challenges may disproportionately impact Latine patients due to additional factors like language discordance, cultural differences, and cost. This qualitative study interviewed 24 Latine adults with HS across academic and county hospital dermatology clinics in California (both English- and Spanish-preferring) to understand how health system factors shape care experiences and influence engagement with HS care plans.
What did they find?
Main Takeaway: For many Latine patients with HS, disparities extend beyond access to dermatology, but to whether care addresses the daily realities of the disease. This study identifies three actionable priorities: integrating wound care and pain management into HS care, reducing experiences that discourage care-seeking, and improving patient-centered communication, particularly with interpreters.
Latine patients with hidradenitis suppurativa (HS) in the US are reported to experience more severe disease and longer diagnostic delays compared with White patients. While barriers like insurance, access, and communication affect many HS patients, these challenges may disproportionately impact Latine patients due to additional factors like language discordance, cultural differences, and cost. This qualitative study interviewed 24 Latine adults with HS across academic and county hospital dermatology clinics in California (both English- and Spanish-preferring) to understand how health system factors shape care experiences and influence engagement with HS care plans.
What did they find?
- Among 24 Latine adults with HS (median age 37.5 years; 71% female; 46% Spanish-preferring; 79% Hurley stage 2–3), three major themes emerged:
- Theme 1: Gaps in wound care and pain management
- Limited guidance from dermatology teams led patients to rely on trial-and-error self-care, with substantial burden managing supplies, drainage, and pain outside the clinic.
- Theme 2: Perceived discrimination drives avoidance of care
- Patients reported feeling dismissed or judged based on race/ethnicity, language, income, gender, or appearance, eroding trust and contributing to delayed follow-up or disengagement from care.
- Theme 3: Interpreter-mediated communication limits patient-centered care
- Use of phone or video interpreters reduced emotional nuance and clarity around pain and lived experience, leading some patients to limit dermatology visits or shift care to Spanish-speaking primary care clinicians.
Main Takeaway: For many Latine patients with HS, disparities extend beyond access to dermatology, but to whether care addresses the daily realities of the disease. This study identifies three actionable priorities: integrating wound care and pain management into HS care, reducing experiences that discourage care-seeking, and improving patient-centered communication, particularly with interpreters.
ART changed the game, but skin disease in people living with HIV didn’t get the memo.
Dermatologic diseases are a hallmark of HIV-related morbidity, affecting up to 90% of people with HIV worldwide. While combination antiretroviral therapy (ART) has dramatically reduced classic AIDS-defining skin conditions, chronic dermatoses remain common in the modern ART era. As prior epidemiologic studies have been limited by older treatment regimens and less diverse populations, this study used a large, racially diverse longitudinal cohort in Washington, DC to characterize the prevalence, incidence trends, and risk factors for dermatologic disease among people with HIV from 2011-2023.
What did they find?
Main Takeaway: Despite major declines in dermatologic disease incidence with modern HIV care, skin conditions remain common among people with HIV and disproportionately affect certain groups.
Dermatologic diseases are a hallmark of HIV-related morbidity, affecting up to 90% of people with HIV worldwide. While combination antiretroviral therapy (ART) has dramatically reduced classic AIDS-defining skin conditions, chronic dermatoses remain common in the modern ART era. As prior epidemiologic studies have been limited by older treatment regimens and less diverse populations, this study used a large, racially diverse longitudinal cohort in Washington, DC to characterize the prevalence, incidence trends, and risk factors for dermatologic disease among people with HIV from 2011-2023.
What did they find?
- Among 11,738 people living with HIV included in the study, nearly half (49.4%) had at least one dermatologic diagnosis; infectious dermatoses were most common (41.5%), followed by inflammatory dermatoses (28.2%) and cutaneous malignancies (5.8%).
- Incidence of all dermatologic disease declined significantly from 2011 to 2024, including infectious conditions (463 to 41 per 1,000), inflammatory conditions (306 to 62 per 1,000), and cutaneous malignancies (31 to 6 per 1,000); all P < 0.001.
- The most prevalent infections were dermatophytosis (19.9%), Herpes simplex virus (13.0%), and viral warts (12.3%), while less common infections included syphilis (6.0%), superficial mycoses (2.1%), community-acquired Staphylococcus aureus infections (1.3%), molluscum contagiosum (0.5%), Mpox (0.4%), and cutaneous mycobacterial infections (0.1%).
- The most common malignancy was HPV-associated squamous cell carcinoma (2.8%), with cisgender females having over sixfold higher odds of cutaneous malignancy than cisgender males (adjusted odds ratio: 6.57, 95% CI: 5.11-8.45).
- Across subcategories, higher dermatologic disease risk was associated with a lower nadir CD4 count, older age, public insurance, and prior opportunistic infections were strongly associated with higher dermatologic disease risk.
Main Takeaway: Despite major declines in dermatologic disease incidence with modern HIV care, skin conditions remain common among people with HIV and disproportionately affect certain groups.
When structure matters: Spatial proteomics links tertiary lymphoid architecture to immunotherapy response in Merkel cell carcinoma.
Immune checkpoint inhibitors (ICIs) have transformed outcomes in Merkel cell carcinoma (MCC), yet many patients still fail to respond to therapy. Tertiary lymphoid structures (TLS) have emerged as promising biomarkers of immunotherapy response in multiple cancers, but their role in MCC, and whether TLS organization matters, has remained unclear. In this spatial proteomics study, investigators analyzed the number, immune composition, and spatial architecture of TLS in MCC tumors treated with the anti–PD-L1 antibody avelumab.
What did they find?
Main Takeaway: In Merkel cell carcinoma, TLS architecture seems to matter as much as TLS presence. Spatial integration of B cells, T cells, and follicular dendritic cells strongly associates with immunotherapy response, highlighting spatial proteomics as a potentially powerful tool to refine TLS-based biomarkers and guide future immunotherapy strategies.
Immune checkpoint inhibitors (ICIs) have transformed outcomes in Merkel cell carcinoma (MCC), yet many patients still fail to respond to therapy. Tertiary lymphoid structures (TLS) have emerged as promising biomarkers of immunotherapy response in multiple cancers, but their role in MCC, and whether TLS organization matters, has remained unclear. In this spatial proteomics study, investigators analyzed the number, immune composition, and spatial architecture of TLS in MCC tumors treated with the anti–PD-L1 antibody avelumab.
What did they find?
- The number of TLS positively correlated with ICI response and survival.
- Responders to ICIs had significantly more intra-tumoral TLS than non-responders.
- TLS in responders showed dense T-cell infiltration into B-cell clusters, extending toward follicular dendritic cells.
- In non-responders, T cells remained peripheral to B-cell areas, suggesting impaired immune coordination.
- Spatial organization, rather than TLS size or cell counts alone, distinguished functional from non-functional TLS.
Main Takeaway: In Merkel cell carcinoma, TLS architecture seems to matter as much as TLS presence. Spatial integration of B cells, T cells, and follicular dendritic cells strongly associates with immunotherapy response, highlighting spatial proteomics as a potentially powerful tool to refine TLS-based biomarkers and guide future immunotherapy strategies.
RLEP really helps!
Histopathology is the diagnostic gold standard for leprosy, but is limited in atypical cases and for disease monitoring. Repetitive element (RLEP) is a highly specific M. leprae gene that can be quantified using qPCR as a marker of bacterial burden. Anti-phenolic glycolipid-I (anti-PGL-1) antibodies and IFN-y/IL-4 cytokines reflect humoral load and the skewed Th1-Th2 immune responses across the tuberculoid-lepromatous disease spectrum. In this prospective study, RLEP copy number in skin biopsies from 92 clinically diagnosed patients was correlated with serum immune markers, including paired pre- and post-treatment samples in 40 cases.
What did they find?
Main Takeaway: qPCR measurement of RLEP, combined with serum immune markers, clinical, and histopathologic features can aid in the classification, diagnosis, and disease monitoring of leprosy.
Histopathology is the diagnostic gold standard for leprosy, but is limited in atypical cases and for disease monitoring. Repetitive element (RLEP) is a highly specific M. leprae gene that can be quantified using qPCR as a marker of bacterial burden. Anti-phenolic glycolipid-I (anti-PGL-1) antibodies and IFN-y/IL-4 cytokines reflect humoral load and the skewed Th1-Th2 immune responses across the tuberculoid-lepromatous disease spectrum. In this prospective study, RLEP copy number in skin biopsies from 92 clinically diagnosed patients was correlated with serum immune markers, including paired pre- and post-treatment samples in 40 cases.
What did they find?
- RLEP copy number was significantly higher in the lepromatous spectrum than in the tuberculoid spectrum (P<0.001).
- Anti-pGL-1 (P=0.019) and IFN-y (P<0.001) levels were significantly higher in patients with leprosy compared to healthy controls.
- Post-treatment samples showed a significant decrease in RLEP copy number (P=0.002), anti-PGL-1 (P=0.009), IFN-y (P=0.001), and IL-4 (P<0.001) levels compared to pre-treatment samples.
Main Takeaway: qPCR measurement of RLEP, combined with serum immune markers, clinical, and histopathologic features can aid in the classification, diagnosis, and disease monitoring of leprosy.
Waking up in a pigment panic
Pigmentary disorders, including vitiligo, melasma, and post-inflammatory hyperpigmentation, affect millions worldwide but remain underrepresented in large-scale epidemiologic data. This population-based survey study analyzed global prevalence, quality of life (QOL) impact, and experiences of stigmatization associated with pigmentary disorders in 5 world regions.
What did they find?
Main Takeaway: Pigmentary disorders are common, underdiagnosed, and often carry psychosocial burdens across regions and skin types. Greater awareness, early recognition and culturally competent care are key to reduce stigma and improve outcomes.
Pigmentary disorders, including vitiligo, melasma, and post-inflammatory hyperpigmentation, affect millions worldwide but remain underrepresented in large-scale epidemiologic data. This population-based survey study analyzed global prevalence, quality of life (QOL) impact, and experiences of stigmatization associated with pigmentary disorders in 5 world regions.
What did they find?
- Of 39,769 adults surveyed, 50% of respondents had at least one pigmentary disorder: solar lentigo (27.5%), axillary hyperpigmentation (17.2%), PIH (14.8%), periorbital hyperpigmentation (14.7%), melasma (10.9%), or vitiligo (7.1%).
- Only 36% of respondents with a pigmentary disorder had a dermatologist-confirmed diagnosis
- Stigmatization scores were highest for vitiligo (23.1) and PIH (17.8); over half of respondents with PIH (55%) and melasma (49.4%) reported concealing their skin
- 43.8% reported a moderate or greater impact on quality of life (DLQI ≥ 6), highest in vitiligo (61.6%) and PIH (56.1%)
Main Takeaway: Pigmentary disorders are common, underdiagnosed, and often carry psychosocial burdens across regions and skin types. Greater awareness, early recognition and culturally competent care are key to reduce stigma and improve outcomes.
Nothing to see here, just platelets doing their job.
Endocrine-induced alopecia (EIA) and persistent chemotherapy-induced alopecia (pCIA) are distressing, often irreversible complications in breast cancer survivors with limited treatment options. This single-center, randomized, split-scalp pilot trial evaluated the safety and efficacy of platelet-rich plasma (PRP) injections administered monthly for 3 months, with outcomes assessed using blinded global assessment scores (GAS), trichoscopy, quality-of-life measures (Hairdex), and circulating tumor cell (CTC) analysis.
What did they find?
Main Takeaway: PRP appears to increase hair density and physician-assessed scalp coverage in treatment-resistant alopecia after cancer therapy. True efficacy remains uncertain due to split-scalp diffusion, highlighting the need for larger, whole-scalp controlled trials.
Endocrine-induced alopecia (EIA) and persistent chemotherapy-induced alopecia (pCIA) are distressing, often irreversible complications in breast cancer survivors with limited treatment options. This single-center, randomized, split-scalp pilot trial evaluated the safety and efficacy of platelet-rich plasma (PRP) injections administered monthly for 3 months, with outcomes assessed using blinded global assessment scores (GAS), trichoscopy, quality-of-life measures (Hairdex), and circulating tumor cell (CTC) analysis.
What did they find?
- Hair coverage improved from baseline (GAS +1.2 at 12 weeks, +1.5 at 24 weeks; P < 0.001), with no difference between PRP and control sides.
- Significant increase in hair density from baseline (+21 vs +16 hairs/cm²; P < 0.05), again without inter-side differences.
- Quality of life did not significantly improve (Hairdex 41.1 → 39.4; P > 0.05), highlighting persistent psychosocial burden despite objective hair growth.
- No tumor recurrence or metastasis over 24–30 months, despite CTCs detected in 2 patients.
Main Takeaway: PRP appears to increase hair density and physician-assessed scalp coverage in treatment-resistant alopecia after cancer therapy. True efficacy remains uncertain due to split-scalp diffusion, highlighting the need for larger, whole-scalp controlled trials.
Comparing ready-to-use and powder abobotulinumtoxinA for glabellar lines
Journal of Cosmetic Dermatology
Journal of Cosmetic Dermatology
Efficacy. Durability. Safety. Pain intensity not included.
Injection of Botulinum toxin type A is the most commonly performed nonsurgical aesthetic procedure worldwide, with well-established efficacy for glabellar lines. Traditional abobotulinumtoxinA requires reconstitution, introducing potential variability in preparation, dosing accuracy, and workflow efficiency. A ready-to-use liquid formulation (RTUaboBoNT-A) was developed to streamline clinical practice and reduce preparation errors. However, comparative randomized data remain limited. This triple-blinded randomized controlled trial evaluated whether RTUaboBoNT-A offers comparable efficacy, durability, safety, and patient satisfaction compared with reconstituted abobotulinumtoxinA for moderate-to-severe glabellar wrinkles.
What did they find?
Main Takeaway: Ready-to-use abobotulinumtoxinA and reconstituted abobotulinumtoxinA demonstrated equivalent efficacy, durability, and safety for the treatment of moderate-to-severe glabellar lines. While the ready-to-use formulation offers practical workflow advantages by eliminating reconstitution, it was associated with higher injection-related pain, an important consideration.
Injection of Botulinum toxin type A is the most commonly performed nonsurgical aesthetic procedure worldwide, with well-established efficacy for glabellar lines. Traditional abobotulinumtoxinA requires reconstitution, introducing potential variability in preparation, dosing accuracy, and workflow efficiency. A ready-to-use liquid formulation (RTUaboBoNT-A) was developed to streamline clinical practice and reduce preparation errors. However, comparative randomized data remain limited. This triple-blinded randomized controlled trial evaluated whether RTUaboBoNT-A offers comparable efficacy, durability, safety, and patient satisfaction compared with reconstituted abobotulinumtoxinA for moderate-to-severe glabellar wrinkles.
What did they find?
- Efficacy: Both formulations produced significant reductions in electromyographic activity of the corrugator supercilii and procerus muscles across follow-up, with no significant differences between groups at any time point (P=0.11 and P=0.93, respectively).
- Wrinkle severity: Glabellar line severity improved significantly in both groups at rest and during contraction, with comparable improvements between RTU and powder formulations across all follow-ups (P=0.737 and P=0.39, respectively).
- Patient satisfaction: FACE-Q scores improved significantly from baseline through 3 months in both groups, with no inter-group differences in satisfaction outcomes.
- Pain: RTUaboBoNT-A was associated with significantly higher injection-related pain compared with the reconstituted formulation (P=0.01).
- Safety: No adverse events were reported in either group, supporting a favorable safety profile for both formulations.
Main Takeaway: Ready-to-use abobotulinumtoxinA and reconstituted abobotulinumtoxinA demonstrated equivalent efficacy, durability, and safety for the treatment of moderate-to-severe glabellar lines. While the ready-to-use formulation offers practical workflow advantages by eliminating reconstitution, it was associated with higher injection-related pain, an important consideration.
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Copyright © 2025 - All Rights Reserved.