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Background: Alopecia areata (AA) is a hair loss disorder that can seriously impact quality of life. Janus kinase (JAK) inhibitors, including deuruxolitinib, have previously demonstrated significant hair regrowth in AA., Objective: The Phase 3 THRIVE-AA1 randomized, double-blinded, placebo-controlled trial (NCT04518995) evaluated the safety and efficacy of the oral JAK1/JAK2 inhibitor deuruxolitinib in adult patients with AA., Methods: Patients aged 18-65 years with ≥50% hair loss were randomized to deuruxolitinib 8 mg twice daily, deuruxolitinib 12 mg twice daily, or placebo for 24 weeks. The primary end point was the percentage of patients achieving a Severity of Alopecia Tool score ≤20. A key secondary end point was the percentage of satisfaction of hair patient-reported outcome responders., Results: Significantly higher proportions of patients taking deuruxolitinib met the primary end point (8 mg 29.6%; 12 mg 41.5% versus placebo 0.8%). Both deuruxolitinib doses achieved significant improvements in all secondary end points versus placebo, including satisfaction of hair patient-reported outcome (8 mg 42.1%; 12 mg 53.0% versus placebo 4.7%). Most treatment-emergent adverse events were mild or moderate, consistent with other oral JAK inhibitors., Limitations: Further studies are required to understand longer-term safety, efficacy, and impact of treatment cessation., Conclusion: Both doses of deuruxolitinib were effective for hair regrowth. Patient satisfaction aligned with hair growth., Competing Interests: Conflicts of interest Dr King has served on advisory boards and/or is a consultant and/or is a clinical trial investigator for AbbVie, AltruBio Inc, Almirall, AnaptysBio, Arena Pharmaceuticals, Bioniz Therapeutics, Bristol Myers Squibb, CoNCERT Pharmaceuticals (subsequently acquired by Sun Pharmaceutical Industries Limited), Equillium, Horizon Therapeutics, Eli Lilly, Incyte Corp., Janssen Pharmaceuticals, LEO Pharma, Otsuka/Visterra Inc, Pfizer, Regeneron, Sanofi Genzyme, Sun Pharmaceutical Industries Limited, TWi Biotechnology Inc, and Viela Bio Inc; also served on speaker bureaus for AbbVie, Incyte, Eli Lilly, Pfizer, Regeneron, and Sanofi Genzyme and is a scientific advisor for BiologicsMD. Dr Senna has been a speaker for Eli Lilly and Pfizer and a principal investigator and/or received research funding from Follica, Eli Lilly, CoNCERT Pharmaceuticals (subsequently acquired by Sun Pharmaceutical Industries Limited), Santiste Medical, and LEO Pharma; has also served on scientific advisory boards and/or been a consultant for Eli Lilly, Follica, L'Oreal, Kintor, and Pfizer, and is on the board of directors/medical advisory board for the National Alopecia Areata Foundation, Scarring Alopecia Foundation, and the American Hair Research Society. Dr Mesinkovska has been an advisor for CoNCERT Pharmaceuticals (subsequently acquired by Sun Pharmaceutical Industries Limited), Eli Lilly, and Pfizer, a principal investigator for AbbVie, Arcutis Biotherapeutics, Bristol Myers Squibb, CoNCERT Pharmaceuticals (subsequently acquired by Sun Pharmaceutical Industries Limited), Eli Lilly, and Pfizer and a speaker for Eli Lilly. Dr Lynde has been a speaker and/or consultant for AbbVie, Amgen, Aralez, Arcutis, Bausch Health, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Cipher, Dermavant, Devonian, Eli Lilly, Fresenius Kabi, Galderma, GSK, Incyte, Innovaderm, Intega Skin, Janssen, Kyowa Kirin, La Roche Posay, LEO Pharma, L'Oreal, Medexus, MedX, Merck, Novartis, P&G, Pediapharm, Pfizer, Regeneron, Roche, Sanofi Genzyme, Sandoz, Sentrex, Sun Pharmaceutical Industries Limited, TEVA, Tribute, UCB, Viatris, and Volo Health; and has also been a principal investigator for AbbVie, Acelyrin, Akros, Altius, Amgen, Aralez, Arcutis, Avillion, Bausch Health, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Celltrion, Cipher, CoNCERT Pharmaceuticals (subsequently acquired by Sun Pharmaceutical Industries Limited), Dermavant, Devonian, Eli Lilly, Evelo, Galderma, GSK, Incyte, Innovaderm, Intega Skin, Janssen, Kyowa Kirin, La Roche Posay, LEO Pharma, L'Oreal, Medexus, MedX, Merck, MoonLake, Novartis, P&G, Pediapharm, Pfizer, Regeneron, Roche, Sanofi Genzyme, Sandoz, Sentrex, Sun Pharmaceutical Industries Limited, TEVA, Tribute, UCB, Valeant, Viatris, and Volo Health. Dr Zirwas has been an investigator and/or speaker and/or consultant for AbbVie, Acrotech, Aldeyra, Advanced Derm Solutions, All Free Clear/Sun, Amgen, Anaptys Bio, Apogee, Arcutis, Bausch and Lomb, Biocon, Bristol Myers Squibb, Cara, Castle Biosciences, CoNCERT Pharmaceuticals (subsequently acquired by Sun Pharmaceutical Industries Limited), Connect Biopharma, Dermavant, Edessa Biotech, EPI Health, Evelo, Galderma, Genentech/Novartis, Incyte, Janssen, L'Oreal, LEO Pharma, Level-Ex, Eli Lilly, LUUM, Nimbus, Oculus, Peloton, Pfizer, Regeneron/Sanofi, Trevi, Trifecta, and UCB; has also been an advisor for Vial and is part owner of AsepticMD. Dr Maari has served on advisory boards and/or is a consultant and/or is a clinical trial investigator for AbbVie, Almirall, AnaptysBio, Arena Pharmaceuticals, Bristol Myers Squibb, CoNCERT Pharmaceuticals (subsequently acquired by Sun Pharmaceutical Industries Limited), Horizon Therapeutics, Eli Lilly, Incyte Corp., Janssen Pharmaceuticals, LEO Pharma, Pfizer, Regeneron, Sanofi Genzyme, Sun Pharmaceutical Industries Limited, Valeant, Dermavant, Novartis, Amgen, and UCB. Dr Prajapati has been an advisor, consultant, and/or speaker for AbbVie, Actelion, Amgen, Aralez, Arcutis, Aspen, Bausch Health, BioScript Solutions, Boehringer Ingelheim, Bristol Myers Squibb, Canadian Psoriasis Network, Celgene, Cipher, CoNCERT Pharmaceuticals (subsequently acquired by Sun Pharmaceutical Industries Limited), CorEvitas, Eczema Society of Canada, Eli Lilly, Galderma, GlaxoSmithKline, Homeocan, Incyte, Janssen, LEO Pharma, Medexus, Novartis, Pediapharm, Pfizer, Sanofi Genzyme, Sun Pharmaceutical Industries Limited, Tribute, UCB, and Valeant; investigator for AbbVie, AnaptysBio, Arcutis, Arena, Bausch Health, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, CoNCERT Pharmaceuticals (subsequently acquired by Sun Pharmaceutical Industries Limited), CorEvitas, Dermavant, Dermira, Eli Lilly, Galderma, Incyte, Janssen, LEO Pharma, Nimbus Lakshmi, Novartis, Pfizer, RAPT Therapeutics, Regeneron, Reistone, Sanofi Genzyme, Takeda, and UCB; received grants from AbbVie, Bausch Health, Janssen, LEO Pharma, Novartis, and Sanofi Genzyme. Dr Sapra has been a principal investigator, consultant, or speaker for AbbVie, Amgen, Arcutis, Avillion, Bausch Health, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, CoNCERT Pharmaceuticals (subsequently acquired by Sun Pharmaceutical Industries Limited), Dermavant, Eli Lilly, Galderma, GSK, Incyte, Innovaderm, Janssen, LEO Pharma, Merz, Novartis, Pfizer, Pulse Biosciences, Regeneron, Roche, Sanofi, UCB, and Valeant. Dr Brzewski has been a principal investigator and/or consultant for AbbVie, Acelyrin, Alvotech Swiss, Amgen, BenevolentAI, Bioeq GmbH, Biogen, Celltrion, CoNCERT Pharmaceuticals (subsequently acquired by Sun Pharmaceutical Industries Limited), Eli Lilly, Horizon Therapeutics, Janssen, LEO Pharma, Pfizer, Regeneron, and Samsung Bioepis. Dr Osman has been an advisor for AbbVie, Affibody, Allergan, Amgen, AnaptysBio, Arcutis, Aurigene, Botanix, Castle Biosciences, Chemocentryx, CoNCERT Pharmaceuticals (subsequently acquired by Sun Pharmaceutical Industries Limited), Dermavant, DS Biopharma, Eli Lilly, Foamix Pharmaceuticals, Galderma, Janssen, Incyte, LEO Pharma, Reistone, Sun Pharmaceutical Industries Limited, and Valeant. Dr Hanna has been an advisory board member, principal investigator, investigator, speaker, and/or consultant for AbbVie, Akros, Allergan, Altius Healthcare, Amgen, Aralez, Arcutis, Bausch Health, Biopharma, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Coherus, CoNCERT Pharmaceuticals (subsequently acquired by Sun Pharmaceutical Industries Limited), Cutanea, Dermira, Galapagos, Galderma, Glenmark, Incyte, Janssen, LEO Pharma, Lilly, Lumenis, Merz, Novartis, Pediapharma, Pfizer, Prollenium, Regeneron, Revanesse, Reistone, Sandoz, Sanofi, Sun Pharma, and UCB. Dr Wiseman has been a principal investigator, consultant, advisor, or speaker for Acelyrin, AbbVie (previously Abbott), Akros, Amgen, Arcutis, Asana BioSciences, AstraZeneca, Bausch Health, Bristol Myers Squibb, CoNCERT Pharmaceuticals (subsequently acquired by Sun Pharmaceutical Industries Limited), Celgene, Dermavant, Dermira, Dice, Eli Lilly, Evelo, Galderma, Glenmark, Incyte, Janssen, LEO Pharma A/S, L'Oreal, Merck Frosst Canada, Moonlake, Novartis, Pfizer, Principia, PRCL Research, Regeneron, Sanofi, Takeda, Timber. Drs Hamilton and Cassella are employees of Sun Pharmaceutical Industries, Inc., (Copyright © 2024 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Real-world knowledge of the burden of hidradenitis suppurativa (HS) on patients remains limited., Objectives: To measure the impact of adalimumab on moderate-to-severe HS patients' health-related quality of life (HRQoL) and work productivity., Methods: In 23 Canadian centres, 138 adults with moderate-to-severe HS requiring a change in ongoing therapy were treated with adalimumab for up to 52 weeks as per the physician's practice. Patient-reported outcome measures (PROMs) were obtained at baseline, weeks 24 and 52 to measure overall HRQoL, HS severity, levels of anxiety and depression, impact and symptoms of HS, work productivity and activity impairment. A post-hoc analysis further explored the PROMs by abscess and inflammatory nodule (AN) count at baseline (≤5, low; 6-10, medium; ≥11, high)., Results: From baseline to weeks 24 and 52, all PRO overall scores improved significantly ( P ≤ .0023). The number of patients reporting "good disease control" and "complete disease control" increased from 9.7% to 66.4% over 52 weeks. The score in Health Utility Index Mark 3 (HUI3) pain attribute meaningfully decreased over 52 weeks (mean difference ≥.05). The HS symptoms skin "tenderness" and "itchiness" improved the most. Work productivity loss and activity impairment improved by approximately 20% over 52 weeks. Disease burden improved more in 24 week responders with low and medium AN counts at baseline than in those with high AN count or in 24 week nonresponders., Conclusion: At week 24 and maintained at week 52 in a real-world setting, adalimumab meaningfully improved HRQoL, work productivity, and activity impairment in moderate-to-severe HS patients.

Importance: A clear dosing regimen for methotrexate in psoriasis is lacking, and this might lead to a suboptimal treatment. Because methotrexate is affordable and globally available, a uniform dosing regimen could potentially optimize the treatment of patients with psoriasis worldwide., Objective: To reach international consensus among psoriasis experts on a uniform dosing regimen for treatment with methotrexate in adult and pediatric patients with psoriasis and identify potential future research topics., Design, Setting, and Participants: Between September 2020 and March 2021, a survey study with a modified eDelphi procedure that was developed and distributed by the Amsterdam University Medical Center and completed by 180 participants worldwide (55 [30.6%] resided in non-Western countries) was conducted in 3 rounds. The proposals on which no consensus was reached were discussed in a conference meeting (June 2021). Participants voted on 21 proposals with a 9-point scale (1-3 disagree, 4-6 neither agree nor disagree, 7-9 agree) and were recruited through the Skin Inflammation and Psoriasis International Network and European Academy of Dermatology and Venereology in June 2020. Apart from being a dermatologist/dermatology resident, there were no specific criteria for participation in the survey. The participants worked mainly at a university hospital (97 [53.9%]) and were experienced in treating patients with psoriasis with methotrexate (163 [91.6%] had more than 10 years of experience)., Main Outcomes and Measures: In a survey with eDelphi procedure, we tried to reach consensus on 21 proposals. Consensus was defined as less than 15% voting disagree (1-3). For the consensus meeting, consensus was defined as less than 30% voting disagree., Results: Of 251 participants, 180 (71.7%) completed all 3 survey rounds, and 58 participants (23.1%) joined the conference meeting. Consensus was achieved on 11 proposals in round 1, 3 proposals in round 2, and 2 proposals in round 3. In the consensus meeting, consensus was achieved on 4 proposals. More research is needed, especially for the proposals on folic acid and the dosing of methotrexate for treating subpopulations such as children and vulnerable patients., Conclusions and Relevance: In this eDelphi consensus study, consensus was reached on 20 of 21 proposals involving methotrexate dosing in patients with psoriasis. This consensus may potentially be used to harmonize the treatment with methotrexate in patients with psoriasis.

Vandetanib is an oral tyrosine kinase inhibitor with cutaneous adverse effects that include the development of acne. We present a patient who underwent vandetanib therapy for stage IV medullary thyroid cancer in conjunction with the use of doxycycline for acne that developed. After vandetanib use, blue-grey pigmentation developed in the acne on his face, chest, back, and arms, which darkened after the use of doxycycline. We review the literature to report that this blue-grey hyperpigmentation was likely vandetanib-induced but may have been the result of both drugs being used in combination., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article., (© The Author(s) 2022.)

The Iroquoian and Algonquian-speaking Peoples of North America discovered numerous natural treatments to dermatological conditions long prior to European settlement. Anthropological evidence suggests that treatments for atopic dermatitis, dermatophyte infections, and syphilitic lesions were derived from Sassafras albidum , genus Salix trees, and S assafras officinale . Literature suggests these medicinal properties are attributed to the naturally abundant safrole, salicylic acid, and ascorbic acid in these flora. Numerous instances of these natural medicinal discoveries later being implemented into European literature reaffirms the impact of Indigenous medicine on contemporary dermatology.