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Competing Interests: Conflicts of interest Dr Shi is on the board of directors for the Hidradenitis Suppurativa Foundation; is a stock shareholder of Learn Health; and has served as an advisory board member, investigator, speaker, and/or received research funding from Sanofi Genzyme, Regeneron, AbbVie, Eli Lilly, Novartis, SUN Pharma, LEO Pharma, Pfizer, Incyte, Boehringer Ingelheim, Aristea Therapeutics, Menlo Therapeutics, Dermira, Burt’s Bees, Galderma, Kiniksa, UCB, Target-PharmaSolutions, Altus Lab/cQuell, MYOR, Polyfins Technology, GpSkin, Skin Actives Scientific, and the National Eczema Association. Dr Hsiao is on the board of directors for the Hidradenitis Suppurativa Foundation and is a consultant for Novartis and speaker for AbbVie. Drs Rick and Morgan and Author De have no conflicts of interest to declare.

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: Chronic hand eczema (CHE) is a burdensome disease, and new well-documented, safe and efficacious treatments are warranted. In a recent CHE phase IIa trial, the pan-Janus kinase (JAK) inhibitor delgocitinib in an ointment formulation was found to be efficacious and well tolerated., Objectives: This trial assessed the dose response, efficacy and safety of delgocitinib cream in CHE., Methods: In this double-blind, phase IIb dose-ranging trial, adults with CHE and a recent history of inadequate response or contraindication to topical corticosteroids were randomized to delgocitinib cream 1, 3, 8, 20 mg g -1 or vehicle treatment twice daily for 16 weeks. The primary endpoint was the Investigator's Global Assessment for CHE (IGA-CHE) treatment success [0 (clear) or 1 (almost clear) with a ≥ two-point improvement from baseline to week 16]. Secondary endpoints were the time to IGA-CHE treatment success and changes in Hand Eczema Severity Index (HECSI); other endpoints were itch and pain numerical rating scale (NRS) scores, and Patient's Global Assessment (PaGA) at week 16., Results: Patients (n = 258) were randomized 1 : 1 : 1 : 1 : 1 to delgocitinib cream 1, 3, 8, 20 mg g -1 or vehicle. A significant dose-response relationship was established for IGA-CHE (P < 0.025). IGA-CHE treatment success at week 16 was achieved in 21.2% (1 mg g -1 ), 7.8% (3 mg g -1 ), 36.5% (8 mg g -1 ), 37.7% (20 mg g -1 ) and 8.0% (vehicle) of patients. Delgocitinib 8 and 20 mg g -1 showed a treatment effect against vehicle (P < 0.001). Similarly, there were improvements in HECSI, itch and pain NRS scores, and PaGA. Delgocitinib cream was well tolerated with the majority of adverse events being mild or moderate and considered unrelated to treatment. The most frequently reported adverse events were nasopharyngitis (17.3-29.4% in delgocitinib groups vs. 40% in vehicle group), eczema (5.8-11.3% in delgocitinib groups vs. 16.0% in vehicle group) and headache (3.8-11.5% in delgocitinib groups vs. 4.0% in vehicle group)., Conclusions: In this trial, delgocitinib cream showed a dose-response relationship in terms of efficacy and was well tolerated., (© 2022 The Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.)

Competing Interests: V.Y.S. is on the board of directors for the Hidradenitis Suppurativa Foundation (HSF), is a stock shareholder of Learn Health, and has served as an advisory board member, investigator, speaker, and/or received research funding from Sanofi Genzyme, Regeneron, AbbVie, Eli Lilly, Novartis, SUN Pharma, LEO Pharma, Pfizer, Incyte, Boehringer Ingelheim, Aristea Therapeutics, Menlo Therapeutics, Dermira, Burt's Bees, Galderma, Kiniksa, UCB, Target-PharmaSolutions, Altus Lab/cQuell, MYOR, Polyfins Technology, GpSkin, and Skin Actives Scientific. J.L.H. is on the board of directors for the Hidradenitis Suppurativa Foundation, has served as a consultant for Boehringer Ingelheim, Novartis, and UCB, and has served as a consultant and speaker for AbbVie. The remaining authors have no funding or conflicts of interest to declare

Background: Moisturizers traditionally function to replenish both the intercellular lipid lamella and natural moisturizing factors, and form a hydrolipid film on the skin surface to decrease transepidermal water loss and improve hydration. As we continue to identify epidermal lipid imbalance in patients with atopic dermatitis, we turn to the use of bioactive ingredients in moisturizers for improving barrier repair and function., Methods: This review aims to explore the modern use of moisturizers in targeting various components of the skin barrier, dampening immune response, and restoring microbial balance. We conducted a balanced and comprehensive narrative review of the literature. Studies were identified by searching electronic databases (MEDLINE and PubMed), focusing on studies and trials regarding moisturizers that include endocannabinoids, bioactive lipids, anti-inflammatory agents, antioxidants, and microbiome modulators. Only articles published in English language were included., Results: The aforementioned ingredients exert additional biological effects to improve skin function by upregulating lipid synthesis, decreasing neurosensory transmission of itch signals, reversing oxidative stress, decreasing inflammatory cell activity and cytokine release, and modulating skin microbiota. The shift from traditional moisturizers to those with bioactive ingredients, anti-inflammatory agents, and microbiome modulating effects opens a realm of possible therapeutic options for patients with barrier-defective cutaneous conditions., Conclusion: Focusing on the disrupted skin barrier as a target for both prevention and treatment and incorporating a combined strategy that utilizes the aforementioned agents to tackle barrier dysfunction from different angles remains a promising area for clinical impact in dermatology., (© 2021 Wiley Periodicals LLC.)

Although hand eczema (HE) and chronic hand eczema (CHE) are common conditions with significant disease burden, they traditionally have had limited treatment options beyond topical and short-term systemic corticosteroids. We reviewed published and preliminary evidence on the current and emerging topical and systemic therapeutic agents for HE and CHE. The etiologies of various HE subtypes are discussed, and remaining knowledge and practice gaps are highlighted to encourage further investigations. A comprehensive search of ClinicalTrials.gov and PubMed was completed for clinical trials that utilized known and emerging treatment options for HE and CHE. Several agents that target IL-4 and IL-13 signaling, keratinocyte proliferation, inflammatory cytokine production, bacterial protein synthesis, and inflammatory mediator (TNF-α, JAK1, JAK2, and JAK3) proliferation are shown to be involved in the pathogenesis of CHE. Systemic agents include dupilumab, alitretinoin, acitretin, cyclosporine, azathioprine, and probiotics. Topical agents include delgocitinib, retapamulin, halometasone/triclosan, calcipotriol/betamethasone, tacrolimus, and pimecrolimus. These modalities have demonstrated varying degrees of clinical efficacy, evaluated by subjective assessments and scoring indexes. Targeted therapies are emerging for HE, but options are still limited, partially due to our narrow understanding of this heterogeneous condition. Additional and targeted therapeutic options are needed to match the rising prevalence and burden of HE. KEYPOINTS: Hand eczema (HE) is a heterogenous dermatosis with limited therapeutic options due to a lack of international guidelines regarding classification of HE subtypes and treatment. This review discusses current and emerging topical and systemic agents and their efficacies in the treatment of different types of hand eczema., (© 2019 Wiley Periodicals, Inc.)

Atopic dermatitis (AD) is a common inflammatory skin disease that chronically affects children and adults worldwide. Environmental exposures, heritable factors, immune dysregulation, and skin barrier malfunction all contribute to the multifactorial nature of AD. It is known that maternal and paternal influences are important predictors for the risk of AD in offspring. This review examines and compares the evidence and mechanisms behind specific maternal and paternal factors that may contribute to the pathogenesis of AD.

Atopic dermatitis (AD) is a highly prevalent chronic inflammatory skin disease. Current knowledge about the etiology of AD suggests that it is multifactorial and involves the interaction of several factors, including environmental triggers, genetics, immunologic factors, and skin barrier dysfunction. The prenatal environment has a significant influence on fetal development, including the maturation of skin barrier function. This review summarizes maternal factors that have been reported to influence the development of AD in offspring, including maternal genetics, nutrition, breastfeeding, environment, and behaviors., (© 2017 Wiley Periodicals, Inc.)

Atopic dermatitis (AD) is a chronic inflammatory skin disease that can significantly decrease quality of life. AD is commonly associated with comorbidities including ocular surface disease (OSD). Conjunctivitis is the most common OSD associated with AD and can increase in incidence with use of monoclonal antibody biologics that target the type 2 inflammatory pathway. The objective of this review is to raise awareness of comorbid OSD in AD patients that dermatologists may encounter, with a focus on conjunctivitis, and equip dermatologists to address mild ocular concerns. We provide background on the subtypes and pathogenesis of comorbid OSD in AD patients and describe OSD associated with type 2 inflammation-inhibiting AD biologics. We also discuss screening and diagnosis, recommended treatment options for dermatologists, and when to refer to an eye care specialist. This multispecialty approach aims to support the overall health of AD patients and provide optimal patient care. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) affects up to 20% of children worldwide. We identified the top 50 cited AD articles in the last seven decades and examined their characteristics. The majority were discussing the pathogenesis of AD and have paved the way for discovering targeted immunomodulatory treatments. A lack of geographic diversity was noted, thus encouraging more countries to be involved in AD research can further progress the future of AD management. [ABSTRACT FROM AUTHOR]

Eligible uninsured patients or patients outside of the health system can also be added to electronic medical records with a designation of "trial-status only" or with a note of "no billing to insurance." Challenges and solutions for improving clinical trial enrollment for patients with low socioeconomic status Lack of Insurance and Accessibility The US Census Bureau reports health insurance coverage based on income. [Extracted from the article]

Importance: While dupilumab has emerged as an effective treatment for moderate-to-severe atopic dermatitis (AD) since its approval in 2017, interleukin-4 and 13 blockade has also demonstrated efficacy in off-label chronic dermatologic conditions. Objective: To identify chronic dermatologic conditions in which dupilumab has demonstrated efficacy. Findings: Thirty-three reports of dupilumab use in non-AD dermatologic conditions were identified through systematic literature review. Effective use of dupilumab has been reported in case reports and case series in the treatment of chronic pruritus, prurigo nodularis, eczematous eruption of aging, allergic contact dermatitis, chronic hand eczema, alopecia areata, urticaria, eosinophilic annular erythema, bullous pemphigoid and papuloerythroderma of Ofuji. Clinical trials are underway evaluating the efficacy of dupilumab in allergic contact dermatitis, chronic hand eczema, alopecia areata, chronic spontaneous urticaria and cholinergic urticaria. Conclusions and relevance: Overlap in immune signaling pathways between AD and chronic pruritus, eczematous eruption of aging, allergic contact dermatitis, chronic hand eczema, alopecia areata, urticaria, eosinophilic annular erythema, bullous pemphigoid and papuloerythroderma of Ofuji make these conditions candidates for dupilumab therapy when standard treatments have failed or are contraindicated. While promising as a therapeutic option, off-label prescribing of dupilumab requires consideration of challenges in insurance authorization and out-of-pocket cost to the patient. [ABSTRACT FROM AUTHOR]

Objective: The pathophysiology of atopic dermatitis (AD) involves a complex interplay between immune system dysfunction, genetics, and environmental factors. It is well known that nutritional status is essential to a proper functioning immune system, leading to a highly debated question regarding the role of dietary factors in the pathogenesis of AD. Food allergies and elimination diets have been broadly studied in atopy; however, less consideration has been given to how vitamins, minerals, and other micronutrients influence the risk for AD and severity of symptoms. This systematic review discusses evidence on how various micronutrients, including vitamins (C, E, and D) and trace minerals (zinc, selenium, iron, copper, magnesium, and strontium) are associated with AD, and how supplementation influence disease severity. Design: A systematic search was conducted to identify the role that oral micronutrients have on AD. The authors reviewed 49 studies herein. Results: While there are weak associations between vitamins C or E and AD, there is sufficient evidence to suggest that vitamin D supplementation provides benefit in AD patients. Deficiency of selenium and zinc may exacerbate AD. Current reports are not sufficient to confidently discern the role of other vitamins and trace minerals on AD. Conclusions: Though oral micronutrients may play a role in AD, the current literature is limited, and there is a need for more comprehensive randomized controlled trials (RCTs) to truly decipher the role between oral micronutrients and AD. [ABSTRACT FROM AUTHOR]

Abstract: Circadian rhythm is a biological clock that controls a wide range of physiological functions throughout the body, including various skin functions. A 24‐h diurnal cycle, governed by an endogenous clock in the brain, largely controls cutaneous diurnal rhythm, which external factors, including temperature, humidity, diet, and stress, also modulate locally. Circadian rhythm influences cutaneous blood flow and properties of skin barrier function, such as transepidermal water loss and capacitance, and has important implications in atopic dermatitis (AD). This review explores how aberrations in circadian rhythm may play a role in the pathogenesis of AD and proposes implementation of chronotherapy to improve treatment outcomes in patients with AD. [ABSTRACT FROM AUTHOR]

Using PAS in conjunction with assessment of treatment adherence may help evaluate the true efficacy of PN therapies. Does the extent of dermal fibrosis in PN impact the efficacy of topical and systemic therapies and contribute to treatment-resistant PN? Evaluating treatment adherence and minimizing barriers to adherence may be the most effective PN treatment strategy at this time. [Extracted from the article]

Skin is an important interface between the host and its environment. Inflammatory dermatoses often have disrupted skin barrier function, rendering patients more susceptible to allergenic triggers leading to an exaggerated immune response. The skin surface lipid film, an important component of the skin barrier, comprises a mixture of keratinocyte and sebaceous gland-derived lipids. Recent evidence demonstrated that defective keratinocyte lipid synthesis predisposes for the development of atopic dermatitis. However, the important role of sebaceous gland-derived lipids in skin inflammatory diseases may be underrecognized. This overview focuses on the importance of the contribution of sebaceous glands to barrier function. Sebaceous gland alteration may play a role in the pathogenesis of common skin diseases including acne vulgaris, atopic dermatitis, psoriasis, rosacea, and seborrheic dermatitis. [ABSTRACT FROM AUTHOR]