Marta Lopez-Pando

Post-inflammatory hyperpigmentation and post-inflammatory erythema are common sequelae of acne, particularly affecting individuals with skin of color. Up to 85% of patients with Fitzpatrick phototypes IV–VI develop post-inflammatory hyperpigmentation following inflammatory acne lesions. Acne-induced hyperpigmentation (AIH) results from increased melanin production and deposition triggered by inflammatory mediators, while acne-induced macular erythema reflects vascular alterations. Both AIH and acne-induced macular erythema can persist for months or even years, significantly contributing to the psychosocial burden of acne and negatively impacting patients’ quality of life — sometimes to a greater extent than active acne itself. Female individuals, darker skin color, severe acne, facial sites, excessive sunlight exposure, and traumatized lesions are important risk factors for AIH. Diagnosis relies on visual inspection, acne history, and skin phototype assessment. Treatment options include topical agents such as azelaic acid, retinoids, antioxidants, and hydroquinone, as well as systemic therapies such as isotretinoin, oral antibiotics, and oral tranexamic acid. Chemical peeling and energy-based devices, including lasers and microneedling, offer additional therapeutic avenues. Photoprotection is crucial in managing AIH, particularly in skin of color patients. Despite the high prevalence of AIH, there is a lack of validated patient-reported outcome measures specific to AIH/acne-induced macular erythema, highlighting the need for further research and standardized assessment tools. This article provides a practical approach, highlighting therapeutic strategies and recommendations for AIH across all skin types.

Background/Objectives: The incidence of both non-melanoma and melanoma skin cancers has increased significantly in recent years. Understanding their epidemiology is essential for implementing effective community prevention strategies and optimizing healthcare resource planning. This study aimed to (1) quantify the number of skin tumors diagnosed at the Central University Hospital of Asturias (HUCA) from 2014 to 2023; (2) describe temporal trends in the incidence of basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma; and (3) analyze the clinical and histopathological features of melanoma and estimate age-standardized incidence rates. Methods: A retrospective study was conducted using data from the Pathology Registry of HUCA. Diagnosed cases were collected in an Excel database and analyzed with SPSS v.27. Quantitative variables were expressed as mean ± standard deviation; categorical variables as counts and percentages. Incidence rates and 95% confidence intervals were calculated using EPIDAT 4.2, based on the European standard population. Municipal population data were obtained from the SADEI website. Results: A total of 7477 BCC, 2689 SCC, and 585 melanoma cases were identified. Over the study period, BCC cases increased by 50%, SCC by 80%, and melanoma by 159%. Among melanoma cases, 89% were diagnosed by dermatologists, 60% were women, 33.1% were melanoma in situ, and 73.3% were superficial spreading melanomas. Age-standardized melanoma incidence rose from 8.85/100,000 in 2014 to 18.50 in 2023. Conclusions: Skin cancer incidence, especially melanoma, has risen markedly in Asturias, with more in situ cases suggesting improved early detection. The 2020 decline reflects COVID-19′s impact on access to care, underscoring the need for sustained prevention and screening efforts.

In routine clinical settings, identifying the factors that influence the persistence of biologic therapies is crucial for tailoring psoriasis management to individual patient profiles. This study aimed to evaluate the real-world drug survival of tildrakizumab in patients diagnosed with plaque psoriasis at the Dermatology Department of HUCA and to explore the clinical predictors of treatment discontinuation. We conducted a retrospective, hospital-based analysis involving 100 patients treated with tildrakizumab (Ilumetri^®) between 1 January 2021 and 30 April 2024. Kaplan–Meier estimates were used to construct survival curves, and multivariate analyses were performed using Cox proportional hazards regression models. Both crude and adjusted hazard ratios (HRs) were calculated to assess potential differences across patient subgroups. The multivariate analysis identified statistically significant associations between reduced drug survival and the presence of psoriatic arthritis (p = 0.02), previous biologic exposure (p = 0.02), and arterial hypertension (p = 0.012). Other comorbidities did not demonstrate significant effects. The most common reasons for treatment discontinuation were primary inefficacy and suboptimal response in patients with arthritis. Overall, tildrakizumab demonstrated robust survival outcomes in this patient population, though diminished persistence was observed in those with prior biologic use, comorbid arthritis, and hypertension.