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Competing Interests: Conflicts of interest Dr Garg has served as an advisor for AbbVie, Aclaris Therapeutics, Anaptys Bio, Aristea Therapeutics, Boehringer Ingelheim, Bristol Myers Squibb, Incyte, Insmed, Janssen, Novartis, Pfizer, Sonoma Biotherapeutics, UCB, Union Therapeutics, Ventyx Biosciences, and Viela Biosciences, and receives honoraria. He receives research grants from AbbVie, UCB, National Psoriasis Foundation, and CHORD COUSIN Collaboration (C3). He is a cocopyright holder of the HS-IGA and HiSQOL instruments. Dr Noe has served as an advisor for Boehringer Ingelheim and Janssen and received honoraria. She has received research grants from Boehringer Ingelheim and Bristol Myers Squibb. She is senior editor for the Journal of Psoriasis and Psoriatic Arthritis. Dr Anadkat has served as a consultant and/or advisor for ImClone, Bristol Myers Squibb, AstraZeneca, Therakos, Aspire Bariatrics, Biogen, Amgen, Veloce, Adgero, Eli Lilly, AbbVie, UCB Biopharma, Innovaderm, Boehringer Ingelheim, OnQuality, Novocure, Springworks, BioLinq, and Protagonist. He has served as a principal investigator for Novartis, Boehringer Ingelheim, Lutris, OnQuality, UCB Biopharma, InflamRx, Eli Lilly, InCyte, AbbVie, Moonlake, AnaptysBio, Hana Biosciences, Xoma, Veloce, Biogen, Xbiotech, ChemoCentryx, Moberg, Regeneron, and Phoenecis. Dr Armstrong has served as an investigator, scientific advisor, and/or speaker to AbbVie, Almirall, Arcutis, ASLAN, Beiersdorf, BI, BMS, EPI, Incyte, LEO, UCB, Janssen, Lilly, Mindera, Nimbus, Novartis, Ortho Dermatologics, Sun, Dermavant, Dermira, Sanofi, Regeneron, and Pfizer. Dr Bhutani is currently a principal investigator for studies being sponsored by AbbVie, Castle, CorEvitas, Dermavant, and Pfizer. She has additional research funding from Novartis and Regeneron. She has served as an advisor for AbbVie, Arcutis, Boehringer Ingelheim, Bristol Myers Squibb, Janssen, LEO, Lilly, Pfizer, Novartis, Sun, and UCB. Dr Farberg has served as an advisor for Apogee, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Castle Biosciences, Feldan, Incyte, Galderma, Janssen, L’Oréal, Novartis, Ortho Dermatologics, Pfizer, Regeneron, Sanofi, Sun Pharmaceuticals, and UCB. Dr Han has served as an investigator, consultant/advisor, or speaker for AbbVie, Amgen, Apogee, Arcutis, Bausch Health, Boehringer Ingelheim, Bond Avillion, Bristol Myers Squibb, Castle Biosciences, Celgene Corporation, Dermavant, DermTech, Eli Lilly and Company, EPI Health, Incyte, Janssen Pharmaceuticals, LEO Pharma, L’Oréal, MC2 Therapeutics, Novartis, Ortho Dermatologics, PellePharm, Pfizer, Regeneron, Sanofi Genzyme, SUN Pharmaceuticals, and UCB. Dr Hawkes has served as an advisor/consultant for AbbVie, Arcutis, Boehringer Ingelheim, BMS, Janssen, LearnSkin, LEO, Lilly, Novartis, Pfizer, Regeneron-Sanofi Genzyme, and UCB. Paid speaker for Boehringer Ingelheim, BMS, Regeneron, Sanofi Genzyme, and UCB. He also currently serves as a councilor for the International Psoriasis Council and sits on the medical board and scientific advisory committee of the National Psoriasis Foundation. Dr Lebwohl has served as an advisor to Aditum Bio, Almirall, AltruBio Inc, AnaptysBio, Arcutis, Inc, Aristea Therapeutics, Avotres Therapeutics, Brickell Biotech, Boehringer Ingelheim, Bristol Myers Squibb, Cara Therapeutics, Castle Biosciences, Celltrion, Corevitas, Dermavant Sciences, Dr Reddy, EPI, Evommune, Inc, Facilitatation of International Dermatology Education, Forte Biosciences, Foundation for Research and Education in Dermatology, Galderma, Helsinn, Incyte, LEO Pharma, Meiji Seika Pharma, Mindera, Pfizer, Seanergy, Strata, Trevi, and Verrica. He receives research funds from AbbVie, Amgen, Arcutis, Avotres, Boehringer Ingelheim, Cara Therapeutics, Dermavant Sciences, Eli Lilly, Incyte, Janssen Research & Development, LLC, Ortho Dermatologics, Regeneron, and UCB, Inc. Dr Rekhtman has served as an advisor to Castle Biosciences. Dr Song has served as a consultant/speaker for AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Janssen, Lilly, Novartis, Pfizer, Sanofi & Regeneron, LEO, UCB, Incyte, SUN, Dermavant, Arcutis, Alphyn, and Apogee. He is an investigator for Arcutis, SUN, Bristol Myers Squibb, Amgen, CorEvitas, DermBiont, Apogee, and TARGET-Derm. Dr Duffin has served as an advisor/consultant for AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, CorEvitas, Janssen, LEO, Lilly, Novartis, Pfizer, UCB, and WCG/Trifecta and receives honoraria. She is an investigator for Amgen, AbbVie, Castle Biosciences, UCB, Boehringer Ingelheim, CorEvitas, Janssen, Lilly, Pfizer, UCB, Novartis, and receives research grant funding. Author Strunk has no conflicts of interest to declare.

Competing Interests: Conflicts of interest Tina Bhutani is a principal investigator for trials sponsored by Abbvie, Castle, CorEvitas, Dermavant, Galderma, Mindera, and Pfizer. She has received research grant funding from Novartis and Regeneron. She has been an advisor for Abbvie, Arcutis, Boehringer-Ingelheim, Bristol Myers Squibb, Janssen, Leo, Lilly, Novartis, Pfizer, Sun, and UCB. Wilson Liao has received research grant funding from Abbvie, Amgen, Janssen, Leo, Novartis, Pfizer, Regeneron, and TRex Bio. Lianne S. Gensler has received grant funding from Novartis, Pfizer and UCB and has been an advisor for AbbVie, Eli Lilly, Fresenius Kabi, Gilead, Janssen, MoonLake, Novartis, Pfizer and UCB. The remaining authors have nothing to disclose.

Background: Psoriasis patients with poor therapeutic response to multiple biologic agents are not well-characterized., Objective: To describe the characteristics associated with development of multiple biologic failure (MBF) versus good clinical response (GR) to the first biologic., Methods: This prospective cohort analysis evaluated patients in the multicenter CorEvitas Psoriasis Registry who initiated their first biologic between 2015 and 2020 and were followed for ≥24 months. Multivariable logistic regression identified sociodemographic, clinical, and patient-reported outcomes that differed between MBF (discontinued ≥2 biologics of different classes, each used for ≥90 days, due to inadequate efficacy) and GR (continued use of first biologic for ≥2 years) patients., Results: One thousand thirty-nine patients were analyzed (490 GR [47.2%], 65 MBF [6.3%]). Female sex, shorter psoriasis duration, earlier year of biologic initiation, prior nonbiologic systemic therapy use, history of hyperlipidemia, and Medicaid insurance were significantly associated with MBF, though the latter 2 variables exhibited wider confidence intervals, indicating a lower level of support. The first-to-second biologic sequence most observed with MBF was Tumor necrosis factor-α inhibitor to IL-17 inhibitor use., Limitations: Biologic adherence between visits was not evaluated., Conclusion: Approximately 6% of psoriasis patients met MBF criteria. The results identify characteristics associated with MBF that may distinguish patients warranting more frequent follow-up., Competing Interests: Conflicts of interest J.Q.J. has received research grant funding from the National Psoriasis Foundation and institutional funding from the University of California, San Francisco. A.C., C.R.T., and R.R.M. are employees of CorEvitas, LLC. E.B.W. has served as an investigator for Pfizer and Target RWE. S.R has served as an advisor for UCB, Novartis, Amgen, Fresenius Kabi, Abbvie, and Janssen. G.H. has received honoraria or research grants from AbbVie, Amgen, Arcutis, Athenex, Bausch Health, Boehringer Ingelheim, Bond Avillion, Bristol Myers Squibb, Celgene Corporation, Dermavant, DermTech, Eli Lilly and Company, EPI Health, Janssen Pharmaceuticals, LEO Pharma, MC2 Therapeutics, Novartis, Ortho Dermatologics, PellePharm, Pfizer, Regeneron Pharmaceuticals, Sanofi Genzyme, SUN Pharmaceutical Industries Ltd, and UCB. J.U.S. has received research grant funding from the National Psoriasis Foundation, Pfizer and Janssen and has served as a consultant for Janssen, Abbvie, Novartis, Sanofi, UCB and BMS. A.W.A. has served as a research investigator and/or scientific advisor to AbbVie, Almirall, Arcutis, ASLAN, Beiersdorf, BI, BMS, Dermavant, Dermira, EPI, Incyte, Janssen, Leo, Lilly, Modmed, Nimbus, Novartis, Ortho Dermatologics, Pfizer, Regeneron, Sanofi, Sun and UCB. T.B. has received research grant funding from Novartis and Regeneron and is a principal investigator for trials sponsored by Abbvie, Castle, CorEvitas, Dermavant, Galderma, Mindera, and Pfizer. T.B. has served as an advisor for Abbvie, Arcutis, Boehringer-Ingelheim, Bristol Myers Squibb, Janssen, Leo, Lilly, Novartis, Pfizer, Sun, and UCB. W.L. has received research grant funding from Abbvie, Amgen, Janssen, Leo, Novartis, Pfizer, Regeneron, and TRex Bio. The remaining authors have nothing to disclose., (Copyright © 2023 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Competing Interests: Conflicts of interest Dr Bhutani is a principal investigator for trials sponsored by AbbVie, Castle, CorEvitas, Dermavant, Galderma, Mindera, and Pfizer. She has served as an adviser for AbbVie, Arcutis, Boehringer Ingelheim, Bristol Myers Squibb, Janssen, Leo, Lilly, Novartis, Pfizer, Sun, and UCB. Authors Spencer, Jin, and Elhage as well as Drs Davis, Hakimi, and Liao have no conflicts of interest to declare.

Competing Interests: Conflicts of Interest Dr Wilson Liao has received research grant funding from Abbvie, Amgen, Janssen, Leo, Novartis, Pfizer, Regeneron, and TRex Bio. Dr Tina Bhutani has received research funding from Abbvie, Celgene, Galderma, Janssen, Pfizer, Regeneron, and Sun. She has served as an advisor for Abbvie, Boehringer-Ingelheim, Bristol Myers Squibb, Pfizer, Leo, Lilly, and Novartis. Drs Megan Mosca, Edward Hadeler, Julie Hong, and Marwa Hakimi have nothing to disclose.

Competing Interests: Conflicts of interest Dr Bhutani is currently an investigator for Celgene, Galderma, Janssen, and Regeneron and has been an advisor for AbbVie, Lilly, and Pfizer. Authors Nguyen and Shwe have no conflicts of interest to disclose.

Background: Abrocitinib efficacy by prior dupilumab response status in patients with moderate-to-severe atopic dermatitis has not previously been assessed in phase 3 studies., Objective: Examine efficacy and safety of abrocitinib among patients who received prior dupilumab., Methods: Patients with moderate-to-severe atopic dermatitis received abrocitinib 200 mg or 100 mg once daily in JADE EXTEND (phase 3 extension) after dupilumab in double-blind, placebo-controlled phase 3 JADE COMPARE., Results: Among prior dupilumab responders, ≥75% improvement in Eczema Area and Severity Index was achieved in 93.5% and 90.2% of patients who received 12 weeks of abrocitinib 200 mg and 100 mg, respectively; ≥4-point improvement in Peak Pruritus Numerical Rating Scale was achieved in 89.7% and 81.6%, respectively. Among prior dupilumab nonresponders, ≥75% improvement in Eczema Area and Severity Index was achieved with abrocitinib 200 mg and 100 mg in 80.0% and 67.7% and ≥4-point improvement in Peak Pruritus Numerical Rating Scale in 77.3% and 37.8%, respectively. Most common adverse events among abrocitinib-treated patients were nasopharyngitis, nausea, acne, and headache. Conjunctivitis occurred less frequently with abrocitinib in comparison to prior dupilumab., Limitations: Short-term, 12-week analysis; no placebo arm., Conclusion: Efficacy and safety profile of abrocitinib in JADE EXTEND supports the role of abrocitinib as a treatment for patients with moderate-to-severe atopic dermatitis, regardless of prior dupilumab response status., Competing Interests: Conflicts of interest Dr Shi is a stockholder of Learn Health and has served as an advisory board member or investigator and/or received research funding from Pfizer Inc, Sanofi-Genzyme, Regeneron, AbbVie, Eli Lilly, Novartis, SUN Pharma, LEO Pharma, Menlo Therapeutics, Dermira, Burt’s Bees, Galderma, Kiniksa Pharmaceuticals, UCB, Altus Lab, MYOR, Polyfin, GpSkin, and Skin Actives Scientific. Dr Bhutani is an investigator for Pfizer Inc, AbbVie, Galderma, Mindera, and Regeneron. She has served as a consultant and/or advisory board member for Pfizer Inc, AbbVie, Arcutis, Boehringer Ingelheim, Bristol Myers Squibb, Janssen, LEO Pharma, Eli Lilly, Novartis, Sun, and UCB. Dr Fonacier has been a consultant and advisory board member for Pfizer Inc, Regeneron, AbbVie, and Eli Lilly and has received research and educational grants (made to NYU Langone Hospital–Long Island) from Pfizer Inc, Regeneron, AstraZeneca, and Shire. Dr Deleuran has been a consultant, advisory board member, and/or speaker for Pfizer Inc, AbbVie, Eli Lilly, LEO Pharma, Regeneron, Incyte Biosciences International Sàrl, Sanofi-Genzyme, and Pierre Fabre. Dr Shumack has been an investigator, advisory board member, and/or speaker for Pfizer Inc, AbbVie, Eli Lilly, LEO Pharma, Sanofi, and Novartis. Drs Cameron and Yin are former employees of Pfizer Inc and may hold stock options. Drs Zhang, Chan, and Valdez are employees and shareholders of Pfizer Inc., (Copyright © 2022 American Academy of Dermatology, Inc. All rights reserved.)

Background: Psoriasis is an inflammatory, IL-17-driven skin disease in which autoantigen-induced CD8 + T cells have been identified as pathogenic drivers., Objective: Our study focused on comprehensively characterizing the phenotypic variation of CD8 + T cells in psoriatic lesions., Methods: We used single-cell RNA sequencing to compare CD8 + T-cell transcriptomic heterogeneity between psoriatic and healthy skin., Results: We identified 11 transcriptionally diverse CD8 + T-cell subsets in psoriatic and healthy skin. Among several inflammatory subsets enriched in psoriatic skin, we observed 2 Tc17 cell subsets that were metabolically divergent, were developmentally related, and expressed CXCL13, which we found to be a biomarker of psoriasis severity and which achieved comparable or greater accuracy than IL17A in a support vector machine classifier of psoriasis and healthy transcriptomes. Despite high coinhibitory receptor expression in the Tc17 cell clusters, a comparison of these cells with melanoma-infiltrating CD8 + T cells revealed upregulated cytokine, cytolytic, and metabolic transcriptional activity in the psoriatic cells that differed from an exhaustion program., Conclusion: Using high-resolution single-cell profiling in tissue, we have uncovered the diverse landscape of CD8 + T cells in psoriatic and healthy skin, including 2 nonexhausted Tc17 cell subsets associated with disease severity., (Copyright © 2020 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)

Background: Vismodegib is a first-in-class agent targeting the hedgehog signaling pathway for treatment of patients with locally advanced basal cell carcinoma (BCC) and metastatic BCC. There have been concerns about the development of squamous cell carcinoma (SCC) in patients treated with this drug., Objective: We sought to determine whether treatment with vismodegib is associated with an increase in the risk of cutaneous SCC., Methods: In this retrospective cohort study, patients treated with vismodegib as part of phase I and II clinical studies were compared with participants from the University of California, San Francisco, Nonmelanoma Skin Cancer Cohort who received standard therapy for primary BCC. In total, 1675 patients were included in the analysis, and the development of SCC after vismodegib exposure was assessed., Results: The use of vismodegib was not associated with an increased risk of subsequent development of SCC (adjusted hazard ratio, 0.57; 95% confidence interval, 0.28-1.16). Covariates including age, sex, history of previous nonmelanoma skin cancer, and number of visits per year were significantly associated with the development of SCC., Limitations: A limitation of the study was that a historic control cohort was used as a comparator., Conclusions: Vismodegib was not associated with an increased risk of subsequent SCC when compared with standard surgical treatment of BCC., (Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Psoriasis significantly impacts patients' quality of life., Objectives: The purpose of this study was to prospectively assess the quality-of-life impact of treatment for moderate to severe plaque psoriasis by using a validated quality-of-life psychometric instrument that has been widely used in nondermatologic settings., Methods: In all, 32 patients with moderate to severe plaque psoriasis received 24 weeks of adalimumab treatment. Patients completed the Psychological General Well-Being (PGWB) Index, which evaluates 6 domains including anxiety and depression. The primary end point was the change in total PGWB score at weeks 12 and 24 of adalimumab treatment compared with baseline., Results: Statistically significant improvement in the total PGWB score was documented by week 4. By week 24, all 6 PGWB domains showed statistically significant improvement from the pretreatment baseline., Limitations: One limitation of this study is that the comparison between our psoriasis data and PGWB data from other major medical conditions was not conducted in a head-to-head manner. Another limitation is that we did not have a controlled (placebo) arm., Conclusion: Based on PGWB scores, patients with untreated psoriasis have as much impairment in psychological well-being as patients with other major medical diseases including breast cancer, coronary artery disease, congestive heart failure, and diabetes and that potent intervention improves psychological well-being to where it is comparable with that of patients with asymptomatic hypertension. A prompt intervention with an effective dermatologic treatment is not only critical, but capable of restoring the physical and psychological well-being of patients with psoriasis., (Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.)

Background: Systemic treatment options for generalized atopic dermatitis (AD) are limited. To our knowledge, there have been no prospective trials examining the use of oral tacrolimus, a calcineurin inhibitor, in AD., Objectives: We assessed the safety and efficacy of sequential therapy with oral tacrolimus and topical tacrolimus in the treatment of generalized AD using the Eczema Area and Severity Index and the Physician Global Assessment scores as the primary end points., Methods: Twelve patients with AD covering at least 50% body surface area were enrolled. Patients in both phases of the study received sequential therapy with oral and topical tacrolimus over a 14-week treatment period. Eczema Area and Severity Index, Physician Global Assessment, and pruritus scores were calculated at each study visit., Results: Patients recorded a 67% improvement in the Eczema Area and Severity Index score, a 45% improvement in the Physician Global Assessment score, and a 69% reduction in the pruritus score., Limitations: This investigator-initiated, open-label, single-center, proof-of-concept study lacks a large sample size and placebo control group., Conclusion: Sequential therapy with oral tacrolimus and topical tacrolimus may be an effective treatment for AD. A large, randomized control study is warranted., (Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.)