Bo Ri Kim

Long-term ketotifen use was associated with a significantly lower incidence of recorded diagnoses of benign cutaneous tumours among patients with neurofibromatosis type 1. No statistically significant association was observed for neural tumours. These findings suggest that ketotifen may be a potentially accessible adjunctive option in the management of benign cutaneous tumours in neurofibromatosis type 1.

Psoriasis is a chronic inflammatory skin disease influenced by environmental factors, including air pollution. However, large‐scale evidence from Asian populations, where particulate matter (PM) exposure is relatively high, remains limited. This study aimed to evaluate the association between long‐term PM exposure and psoriasis incidence, and short‐term exposure with exacerbation risk. We conducted a cohort study using the Korean National Health Insurance Service database, involving 8 396 764 individuals. Long‐term exposure was assessed based on annual average concentrations of fine PM (PM _2.5 ) and coarse PM (PM ₁₀ ), while short‐term exposure was measured using daily PM levels matched with control days. Long‐term exposure to PM _2.5 and PM ₁₀ was associated with a 19% and 27% higher risk of incident psoriasis (adjusted HR 1.19 and 1.27; 95% CI 1.16–1.22 and 1.25–1.30). Short‐term exposure was linked to an increased risk of psoriasis exacerbation (adjusted OR 1.03 for PM _2.5 , 95% CI 1.00–1.06; adjusted OR 1.01 for PM ₁₀ , 95% CI 1.00–1.03). Stronger associations were observed in younger individuals, urban residents, those with lower socioeconomic status, ever‐smokers, and patients with comorbid allergic diseases. These findings suggest that both long‐term and short‐term PM exposure contribute to psoriasis onset and exacerbation, underscoring air pollution as an important modifiable risk factor in psoriasis development and control.

Palmoplantar pustulosis (PPP) is a chronic relapsing inflammatory skin disorder predominantly affecting the palms and soles. Despite the continued use of oral systemic agents, real‐world data on their durability and treatment patterns in PPP remain limited. To investigate the treatment patterns, drug survival, and clinical factors associated with treatment persistence in patients with PPP receiving oral systemic therapies. We conducted a retrospective cohort study of patients diagnosed with PPP at a tertiary care referral center in Korea between January 2010 and August 2023. Patients were categorized according to the initial oral agent prescribed—cyclosporine, acitretin, or methotrexate. Treatment trajectories were assessed using predefined criteria, and 12‐month drug survival was evaluated. Clinical predictors of treatment non‐persistence were identified using Cox proportional hazards regression analysis. Among 374 patients, 192 received oral systemic therapy (cyclosporine, n = 110; acitretin, n = 72; methotrexate, n = 8). Cyclosporine was the most commonly prescribed first‐line agent. Median drug survival was the longest for cyclosporine, followed by methotrexate and acitretin ( p = 0.15). Nail involvement was associated with greater persistence (HR = 0.617; 95% CI: 0.444–0.857; p = 0.004), whereas baseline hypertension increased discontinuation risk (HR = 1.492; 95% CI: 1.015–2.195; p = 0.042). Discontinuation patterns differed by agent: cyclosporine was often stopped early due to adverse events but remained durable in patients who tolerated it; acitretin was associated with early and persistent adverse events, with well‐controlled disease emerging as a later reason for cessation; and methotrexate showed sustained use beyond 6 months, with most discontinuations attributed to well‐controlled disease. This study highlights the heterogeneous treatment trajectories and variable drug survival among oral agents for PPP. Nail involvement and hypertension may be key clinical predictors of persistence. These findings support individualized treatment approaches to improve long‐term management of PPP.

Objective: Given that the therapeutic evidence for doxycycline in rosacea has predominantly been derived from studies on papulopustular rosacea (PPR), this study aimed to evaluate the efficacy and safety of combined oral doxycycline, topical calcineurin inhibitor (TCI), and pulsed dye laser (PDL) therapy in erythematotelangiectatic rosacea (ETR) and to identify clinical predictors of treatment response. Materials and Methods: Medical photographs of patients with ETR treated with oral doxycycline, TCI, and two subsequent PDL sessions were retrospectively reviewed. Erythema on the right cheek was quantitatively measured using computer‐aided image analysis. Results: Of the 79 included patients, 47 had the ETR subtype and 32 had the mixed ETR/PPR subtype. Erythema significantly improved after oral doxycycline and TCI treatment ( p < 0.001) and further PDL treatment ( p < 0.001). Particularly, in patients with moderate‐to‐severe ETR, background erythema improved to a level comparable to that observed in patients with mild ETR after treatment ( p = 0.307). Post‐treatment erythema did not differ by age ( p = 0.963) or Fitzpatrick skin type ( p = 0.277); however, it was significantly lower among males ( p = 0.008) and in patients without prior steroid treatment ( p = 0.046). No serious adverse events, including photosensitivity, were observed. Conclusion: Combined oral doxycycline, TCI, and PDL therapy is effective and safe for ETR, especially in patients with higher severity. Prompt diagnosis and avoidance of steroid misuse may improve treatment responses.

Background: Scalp conditions such as dandruff and pruritus are common even among otherwise healthy individuals and have been associated with impaired skin barrier function and abnormal epidermal differentiation. Moisturizers containing celastrol and Cichorium intybus root extract have previously demonstrated clinical benefits in patients with psoriasis, a condition characterized by similar pathogenic abnormalities. Objective: To evaluate changes in scalp condition following the use of a scalp moisturizer containing celastrol and C . intybus root extract and to assess the clinical utility of an artificial intelligence–based scalp assessment system (SPI‐AI) in detecting treatment‐related improvements. Methods: This prospective clinical trial enrolled 23 participants with scalp conditions, including erythema, dryness, scaling, and dandruff, who applied the moisturizer once daily for 4 weeks. The primary outcome was the change in scalp condition, assessed using SPI‐AI. Secondary outcomes included biophysical parameters (erythema index, stratum corneum hydration, and transepidermal water loss [TEWL]) and patient‐reported symptoms assessed using the visual analog scale (VAS). Results: At Week 4, the total SPI‐AI score showed significant improvement (23.7 ± 4.5 to 20.5 ± 4.3, p = 0.005), with the erythema (9.5 ± 3.5 to 7.6 ± 2.9, p = 0.003) and folliculitis (4.0 ± 1.6 to 2.7 ± 1.1, p = 0.008) components exhibiting the most pronounced changes. In parallel, patient‐reported symptoms improved significantly (5.9 ± 1.8 to 3.7 ± 1.7, p < 0.001). Among the secondary outcomes, erythema index decreased significantly at Week 2 (139.3 ± 37.3 to 131.4 ± 40.4, p = 0.020), whereas no significant changes were observed in stratum corneum hydration or TEWL. Treatment compliance was high without serious adverse events reported. Conclusions: A scalp moisturizer containing celastrol and C. intybus root extract significantly improved scalp condition and exhibited a favorable safety profile. SPI‐AI sensitively detected early changes in scalp condition in a clinical trial setting. Trial Registration: ClinicalTrials.gov Identifier: NCT07459023

Oh S, et al. Ann Dermatol. 2025 Nov;38:e8. https://doi.org/10.5021/ad.25.112

Kim BR, et al. Ann Dermatol. 2025 Oct;38:e4. https://doi.org/10.5021/ad.25.130

Several dermatological comorbidities, including juvenile xanthogranuloma, cutaneous mastocytosis, trichotillomania, xanthelasma palpebrarum, lipoma and malignant melanoma, have been frequently observed in patients with neurofibromatosis type 1 in different age groups. Dermatologists, who are crucial in diagnosing and managing this disorder throughout a patient’s life, should be aware of these comorbidities.

Bullous pemphigoid (BP) is an autoimmune blistering skin disorder with an increasing incidence, particularly among older adults. Given the role of medications in developing drug‐associated BP (DABP), exploring drugs that cause DABP is crucial for prescribing appropriate drugs to prevent BP development. This study aimed to identify drugs associated with DABP. In this nationwide retrospective cohort study, we compared 5066 patients newly diagnosed with BP with 10 132 matched controls. We first established a comprehensive drug list of all medications used in our country and conducted a case–control study to identify candidate drugs associated with DABP. To validate these associations, we performed a separate cohort study, enrolling patients with a confirmed diagnosis of BP and matched controls. In the screening stage, 88 drugs were associated with an increased risk of DABP, while 27 drugs were linked with a reduced risk. Validation confirmed that 78 drugs increased the risk of DABP, whereas 22 drugs lowered it. Among the candidate drugs, anti‐diabetic medications, including dipeptidyl peptidase‐4 (DPP4) inhibitors and sulfonylureas, neuropsychiatric drugs such as benserazide and carbidopa (used for Parkinson's disease) and donepezil and memantine (for Alzheimer's disease), increased the risk of DABP. Conversely, several anti‐inflammatory medications, including meloxicam and celecoxib and lipid‐lowering agents, such as rosuvastatin and atorvastatin, have been found to lower the risk of DABP. Lastly, diazepam, diltiazem, and Ginkgo biloba extracts exhibited protective effects against DABP development. This nationwide study, employing an unbiased analysis of all medications in our country, highlights a substantial number of medications linked to the development of DABP. Our study provides practical insights for drug selection to prevent the development of DABP in elderly patients.