eightY-Eighth issue
June 25, 2025
Prevalence of comorbidities among pediatric patients with hidradenitis suppurativa: A meta-analysis
JAMA Dermatology
JAMA Dermatology
HS is already not fun… but here comes its plus-ones!
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease often beginning in adolescence. While much is known about comorbidities in adult HS, the burden of associated conditions in pediatric patients remains unclear. This systematic review and meta-analysis of 19 studies involving 17,267 pediatric patients with HS and 8.2 million controls, aiming to determine the prevalence of medical and psychiatric comorbidities in pediatric HS.
What did they find?
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease often beginning in adolescence. While much is known about comorbidities in adult HS, the burden of associated conditions in pediatric patients remains unclear. This systematic review and meta-analysis of 19 studies involving 17,267 pediatric patients with HS and 8.2 million controls, aiming to determine the prevalence of medical and psychiatric comorbidities in pediatric HS.
What did they find?
- Acne vulgaris was the most common comorbidity (pooled prevalence 43%) followed by obesity (37%).
- Anxiety and depression were also frequently reported (18% and 8%, respectively).
- There was moderate-certainty evidence supporting associations with obesity and depression, and low-certainty evidence for diabetes.
- Trisomy 21 was seen in 4% of pediatric HS cases, suggesting a potential genetic associations.
Patients with psoriasis and suppurative hidradenitis (PSO-SH) share genetic risk factors and are at risk of increased morbidity
Journal of the American Academy of Dermatology
Journal of the American Academy of Dermatology
When inflammation runs in the family… meet PSO-SH, the duo you didn’t know were related.
Hidradenitis suppurativa (HS) and psoriasis (PSO) are chronic inflammatory skin diseases traditionally considered distinct. While PSO is well studied, with known genetic risk factors and targeted therapies, HS remains less understood and more difficult to treat. Emerging evidence suggests a possible genetic connection between the two. This study examined patients with both HS and PSO (HS-PSO) using the All of Us database, and whole genome sequencing, to investigate potential clinical and genetic overlap.
What did they find?
Main Takeaway: Patients with concurrent PSO and HS (PSO-HS) may represent a distinct clinical and genetic subgroup, characterized by shared non-HLA genetic risk factors and a high burden of comorbidities. These findings highlight the need for tailored screening and treatment strategies for this population.
Hidradenitis suppurativa (HS) and psoriasis (PSO) are chronic inflammatory skin diseases traditionally considered distinct. While PSO is well studied, with known genetic risk factors and targeted therapies, HS remains less understood and more difficult to treat. Emerging evidence suggests a possible genetic connection between the two. This study examined patients with both HS and PSO (HS-PSO) using the All of Us database, and whole genome sequencing, to investigate potential clinical and genetic overlap.
What did they find?
- The study included 35 PSO-HS patients, 1,036 HS-only patients, and 1,835 PSO-only patients, along with cross-sectional clinical data from 52 additional patients with PSO-HS.
- PSO-HS patients (n=35) were predominantly female (70%) and had a high comorbidity burden (89%).
- Obesity was present in 100% of PSO-HS patients, significantly higher than in PSO-only patients (58.5%; OR: 2.69, 95% CI: 1.30–5.80; P<0.05).
- Crohn’s disease was more frequent in PSO-HS (17.1%) compared to PSO-only (3.5%; OR: 4.66, 95% CI: 1.49–12.12) and HS-only (2.0%; OR: 11.98, 95% CI: 3.50–36.55); all P<0.05.
- PSO-HS patients had worse general physical health (OR: 3.09, 95% CI: 1.56–6.12), social health (OR: 2.38, 95% CI: 1.26–4.47), and social satisfaction (OR: 2.31, 95% CI: 1.25–4.28) than PSO-only patients, even after adjusting for obesity and Crohn’s; all P<0.05.
- Among 24 genotyped patients, PSO-HS had the highest polygenic risk score (PRS: 108.22), primarily driven by non-HLA alleles, compared to PSO-only (101.18), HS-only (99.84), and controls (98.58), suggesting a shared genetic susceptibility.
Main Takeaway: Patients with concurrent PSO and HS (PSO-HS) may represent a distinct clinical and genetic subgroup, characterized by shared non-HLA genetic risk factors and a high burden of comorbidities. These findings highlight the need for tailored screening and treatment strategies for this population.
Rigosertib shows efficacy in RDEB-associated advanced SCC patients
British Journal of Dermatology
British Journal of Dermatology
It might seem RIGged, but RIGosertib is rigorously wrecking RDEB-SCC!
Recessive dystrophic epidermolysis bullosa (RDEB) is a rare genetic skin disorder characterized by chronic wounds and increased risk of aggressive cutaneous squamous cell carcinoma (SCC), the leading cause of early mortality in this population. In this open-label, investigator-initiated Phase 2 trial, five patients with advanced or metastatic RDEB-SCC were treated with rigosertib, a PLK1 inhibitor, administered either orally or intravenously. Patients were monitored over 12 months for tumor response, safety, quality of life, and pharmacokinetics.
What did they find?
Main Takeaway: Rigosertib demonstrated anti-tumor activity in patients with advanced RDEB-SCC, showing promising efficacy and manageable toxicity in a population with no approved treatment options.
Recessive dystrophic epidermolysis bullosa (RDEB) is a rare genetic skin disorder characterized by chronic wounds and increased risk of aggressive cutaneous squamous cell carcinoma (SCC), the leading cause of early mortality in this population. In this open-label, investigator-initiated Phase 2 trial, five patients with advanced or metastatic RDEB-SCC were treated with rigosertib, a PLK1 inhibitor, administered either orally or intravenously. Patients were monitored over 12 months for tumor response, safety, quality of life, and pharmacokinetics.
What did they find?
- Four out of five patients (80%) had a clinical response, with two (40%) reaching complete remission and two (40%) showing partial response.
- Plasma drug levels were higher than previous patient populations, likely due to low body mass in RDEB.
- Reported adverse events included cystitis, hematuria, and abdominal pain, leading to dose reductions in 2 patients.
- Quality of life scores remained stable or improved in 3 of 5 patients.
Main Takeaway: Rigosertib demonstrated anti-tumor activity in patients with advanced RDEB-SCC, showing promising efficacy and manageable toxicity in a population with no approved treatment options.
The plot thickens...
Malignant transformation of cutaneous lichen planus (LP) to squamous cell carcinoma (SCC) is rare, but when observed, it is most often associated with the hypertrophic subtype (HLP). Prior studies in oral LP suggest that p16, a tumor suppressor protein, plays a role in the progression of oral LP to SCC. Researchers retrospectively compared immunohistologic expression of p16 in HLP (n=34), well-differentiated SCC (n=33), and healthy controls (n=33) using immunohistochemical analysis.
What did they find?
Main Takeaway: Overexpression of cytoplasmic p16 in hypertrophic lichen planus may reflect cell cycle dysregulation and support its potential role in neoplastic transformation to SCC.
Malignant transformation of cutaneous lichen planus (LP) to squamous cell carcinoma (SCC) is rare, but when observed, it is most often associated with the hypertrophic subtype (HLP). Prior studies in oral LP suggest that p16, a tumor suppressor protein, plays a role in the progression of oral LP to SCC. Researchers retrospectively compared immunohistologic expression of p16 in HLP (n=34), well-differentiated SCC (n=33), and healthy controls (n=33) using immunohistochemical analysis.
What did they find?
- 100% of HLP and SCC samples showed positive p16 staining compared to 51.5% of healthy controls.
- The percentage of keratinocytes expressing p16 was significantly higher in HLP and SCC compared to controls (P<0.001).
- No significant difference in p16 expression levels was observed between HLP and SCC.
- Cytoplasmic p16 expression was significantly higher in HLP than in SCC (P<0.001).
Main Takeaway: Overexpression of cytoplasmic p16 in hypertrophic lichen planus may reflect cell cycle dysregulation and support its potential role in neoplastic transformation to SCC.
Exploring the potential of omega-3 fatty acids in acne patients: A prospective intervention study
Journal of Cosmetic Dermatology
Journal of Cosmetic Dermatology
Rerouting acne management!
Growing evidence supports the role of nutrition in managing acne vulgaris. Omega-3 fatty acids, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) are essential nutrients known to reduce inflammatory cytokines and insulin-like growth factor 1 (IGF-1) signaling. Insufficient omega-3 levels may be an under-recognized contributor to acne development or severity. This 16-week, single-center study of 60 patients investigated whether correcting omega-3 deficiency could lead to clinical improvement in acne severity.
What did they find?
Growing evidence supports the role of nutrition in managing acne vulgaris. Omega-3 fatty acids, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) are essential nutrients known to reduce inflammatory cytokines and insulin-like growth factor 1 (IGF-1) signaling. Insufficient omega-3 levels may be an under-recognized contributor to acne development or severity. This 16-week, single-center study of 60 patients investigated whether correcting omega-3 deficiency could lead to clinical improvement in acne severity.
What did they find?
- 98.3% of participants (mean age: 26) had a baseline HS-omega-3 Index < 8%, with a cohort mean of 4.9%, indicating widespread deficiency.
- Supplementation with algae-derived EPA/DHA (800 mg DHA / 400 mg EPA daily) and Mediterranean diet counseling raised the mean index to 8.3% by week 16 (P < 0.001).
- Both inflammatory and non-inflammatory lesions decreased significantly, with >79% reporting improvement by day 40 (P < 0.001).
- Patient’s reported quality of life improved, with Dermatology Life Quality Index (DLQI) scores dropping from 4.9 to 2.4 (P < 0.001), with the biggest boost in papulopustular acne.
Intralesional insulin is superior to intralesional botulinum toxin-A in the treatment of keloids
Dermatologic Surgery
Dermatologic Surgery
From glucose to glow-up, insulin fights the granulation game
Keloids are raised, fibrous scars that extend beyond the original wound margins and result from abnormal wound healing. They are notoriously difficult to treat, with few consistently effective therapies. This randomized controlled trial from Egypt evaluated the efficacy of intralesional insulin, botulinum toxin A (BTX-A), and corticosteroids in 63 patients over a 4-month period using the validated Patient and Observer Scar Assessment Scale (POSAS).
What did they find?
Main Takeaway: Intralesional insulin appears to be a safe, affordable, and effective treatment for keloids, demonstrating comparable efficacy to corticosteroids and superior results to BTX-A, with a more favorable side effect profile.
Keloids are raised, fibrous scars that extend beyond the original wound margins and result from abnormal wound healing. They are notoriously difficult to treat, with few consistently effective therapies. This randomized controlled trial from Egypt evaluated the efficacy of intralesional insulin, botulinum toxin A (BTX-A), and corticosteroids in 63 patients over a 4-month period using the validated Patient and Observer Scar Assessment Scale (POSAS).
What did they find?
- Insulin reduced keloid volume by 66.6%, outperforming BTX-A (25.3%) and trailing steroids (75%).
- Compared to BTX-A, insulin showed significant improvement in pigmentation, thickness, vascularity, and surface relief (P < 0.05).
- Mild, reversible hypoglycemia occurred in 8 of 21 insulin-treated patients, while skin atrophy was seen in 13 of 21 steroid-treated patients.
- Both insulin and steroids were statistically superior to BTX-A in improving POSAS total scores, with no significant difference between insulin and steroids.
Main Takeaway: Intralesional insulin appears to be a safe, affordable, and effective treatment for keloids, demonstrating comparable efficacy to corticosteroids and superior results to BTX-A, with a more favorable side effect profile.
Treatment of acne-induced macular hyperpigmentation in Fitzpatrick skin types V-VI
Journal of Drugs in Dermatology (SOC)
Journal of Drugs in Dermatology (SOC)
When the acne clears but the dark spots stick around …
Acne-induced macular hyperpigmentation (AMH) is a common concern among patients with Fitzpatrick Skin Types (FST) V–VI, yet treatment data specific to these skin types is limited. This article reviewed available studies evaluating AMH therapies specifically in patients with highly melanated skin.
What did they find?
Acne-induced macular hyperpigmentation (AMH) is a common concern among patients with Fitzpatrick Skin Types (FST) V–VI, yet treatment data specific to these skin types is limited. This article reviewed available studies evaluating AMH therapies specifically in patients with highly melanated skin.
What did they find?
- Tazarotene, azelaic acid, and niacinamide-based regimens significantly reduced lesion size, pigmentation, or count in FST V–VI patients.
- Salicylic acid peels improved AMH in 80% of patients, and thiamidol led to reduced melanin index scores (P<0.001).
- Combination acne treatments like clindamycin/benzoyl peroxide improved AMH in 75% of participants.
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