Primary Care Dermatology Literature June 2026
Skin Research in Primary Care
Angioedema in Primary Care: Disease Course and Its Relation to ACE Inhibitor Use
Reineke Soegiharto, Sandra Aborah, Nicole Boekema-Bakker, Irene A M Groenewegen, André C Knulst, Juul M P A van den Reek, Heike Röckmann
Int J Dermatol. 2026 May 25. doi: 10.1111/ijd.70506. Online ahead of print.
No abstract available
Approach to urticaria in primary care
Isaac Kah Siang Ng, Valencia Shihuan Long, Lay Hoon Goh, Ellie Ci-En Choi
Singapore Med J. 2026 May 1;67(5):323-330. doi: 10.4103/singaporemedj.SMJ-2025-105.
No abstract available
Assessing the role of community pharmacists in early skin cancer detection: a real-world study. Morena Pappalardo, Marta Alcalde, Maria Estrada, Joan Francesc Mir, Jordi Casas, Cristina Rodriguez, Sònia Martinez, Josep Malvehy
Sci Rep. 2026 May 22. doi: 10.1038/s41598-026-54469-1. Online ahead of print.
Abstract: Identification of at-risk population is essential for skin cancer screening. Community pharmacists (CPs) play an important role in the healthcare system by participating in disease screening strategies in Spain. However, their role in skin cancer screening, in collaboration with general physicians and dermatologists, has not been addressed. To assess the role of CPs in identification of population with risk factors for early skin cancer detection. 184 CPs from 104 pharmacies (4.34% of the total number of pharmacies in the province of Barcelona), 49 primary care physicians (PCPs), and referral dermatologists across basic healthcare areas (BHAs) of the province of Barcelona. Volunteers attending community pharmacies were recruited by CPs. A skin cancer risk factor questionnaire was administered to each participant. Upper limbs were examined and pigmented lesions larger than 2 mm were noted. Participants were classified as at risk if at least one skin cancer risk factor was present. All participants were referred to PCPs for a Total Body Skin Examination (TBSE) and a skin cancer risk factor questionnaire re-administered, to the concordance with the pharmaceutical one. Finally, patients with suspected skin cancer or risk factors that required a dermatological evaluation were referred to dermatology specialists. 340 participants were prospectively recruited in the study, 240 were assessed by PCPs, and 74 of them were finally referred to dermatologists for diagnostic confirmation. Among referred patients, 15 malignant lesions were confirmed: one malignant melanoma, one squamous cell carcinoma, and 13 basal cell carcinomas. Additionally, seven actinic keratosis were confirmed. CPs can be involved in skin cancer screening programmes, in coordination with PCPs and dermatologists. They were able to identify skin cancer risk factors that enabled the diagnosis of a significant number of occult skin cancers.
Health care professionals' confidence in recognising different skin conditions presented in primary care: a cross-sectional survey. Chandhini Suresh, Hannah E Wainman, Hywel C Williams, Philippa Bowes, Ramyya Sivanathan, Julian Peace, Sonia Gran
Clin Exp Dermatol. 2026 May 22:llag214. doi: 10.1093/ced/llag214. Online ahead of print.
No abstract available
Skin Cancer: Diagnosis. Michelle Nelson, Remi K Hamel, Jennifer Nash
FP Essent. 2026 May:564:14-22.
Abstract: Family physicians play a critical role in early detection of skin cancers. Although visual inspection is the initial step, dermoscopy significantly improves diagnostic accuracy, particularly for melanoma and basal cell carcinoma. Advanced imaging technologies such as reflectance confocal microscopy, optical coherence tomography, and high-frequency ultrasonography may further enhance accuracy and reduce unnecessary procedures. However, these technologies are primarily used in academic or specialty dermatology settings. Biopsy is required for definitive diagnosis. For nonmelanoma skin cancers, no single biopsy technique has demonstrated superiority. A shave, punch, incisional, or excisional technique should be selected based on lesion characteristics, patient factors, and clinical judgment. For melanoma, excisional biopsy with margins of 1 to 3 mm and full-thickness removal is preferred. Saucerization (deep shave removal of the entire clinical lesion to the mid-dermis or deeper) may be acceptable if it allows accurate assessment of Breslow depth. Basal cell carcinoma subtypes include nodular, superficial, morpheaform (sclerosing), and infiltrative. Cutaneous squamous cell carcinoma is classified as in situ or invasive. The clinical subtypes of melanoma include superficial spreading, nodular, lentigo maligna melanoma, amelanotic, and acral lentiginous. If biopsy is not feasible because of lesion location or clinical suspicion persists despite benign histology, prompt dermatology referral is warranted.
Real-World Use of Topical Treatments for Atopic Eczema in Children and Young People: Systematic Review. Phuong Hua, Sarah Newman, Farhad Shokraneh, Alyson L Huntley, Matthew J Ridd
Clin Exp Allergy. 2026 May 20. doi: 10.1111/cea.70346. Online ahead of print.No abstract available
Predicting Laryngeal Involvement in Pemphigus Vulgaris Using a Clinical Risk Score
Dean Ariel, Nir Tsur, Daniel Mimouni, Tamir Lotan, Gal Trieman, Meital Oren-Shabtai
JAMA Dermatol. 2026 May 1;162(5):497-502. doi: 10.1001/jamadermatol.2026.0391.
Abstract Importance: Deep laryngeal involvement occurs in 10% to 40% of patients with pemphigus vulgaris and can cause life-threatening airway complications. However, fiber-optic laryngoscopy-the standard detection method-is invasive and causes patient discomfort. Evidence-based criteria for determining which patients require laryngoscopic examination are lacking.
Conclusions and relevance: In this study, the clinical prediction model using routinely assessed parameters achieved good discrimination and high negative predictive value. If externally validated, this tool may help identify low-risk patients who can safely defer laryngoscopy while prioritizing higher-risk patients for evaluation.
Building the foundations for an international patient-centred outcomes set for psoriasis: A scoping study. Emma Vyvey, Rani Soenen, Hazel Oon, Sicily Mburu, Maren Awici-Rasmussen, Azura Mohd Affandi, Wayne Gulliver, Siew Eng Choon, Tiago Torres, Allison FitzGerald, Alvaro Gonzalez-Cantero, Anna López-Ferrer, Chih-Hung Lee, Fernando Valenzuela, Julia-Tatjana Maul, Luis Puig, Masanori Okuse, Mohamed El-Komy, Peter Foley, Ron Vender, Wolf-Henning Boehncke, Josef Pohunek, Ya Hsin Wang, Angela Londoño-García, Gail Todd, Margarita Velasquez-Lopera, Mark Lebwohl, Edmund Lau, Marcus Schmitt-Egenolf, Niels Hilhorst, Spencer Connell, Elfie Deprez, Nanja van Geel, Christopher Griffiths, Peter Van de Kerkhof, Jo Lambert
J Eur Acad Dermatol Venereol. 2026 Jun;40(6):1005-1018. doi: 10.1111/jdv.70313.
Abstract Background: Value-based healthcare emphasizes outcomes that matter to patients, and patient-centred outcomes sets are vital to its success. For psoriasis, initial work proposed a patient-centred outcomes set in Belgium, but it requires further validation to ensure international applicability.
Conclusions: This scoping study convened an international Working Group of patient representatives and dermatologists to establish the fundamentals for a patient-centred outcomes set. The subsequent Delphi process will finalize consensus, advancing value-based psoriasis management worldwide.
Perceived Readiness and Barriers to Self-Management in Pediatric Atopic Dermatitis Patients and Parents. Allison R Loiselle, Jessica K Johnson, Wendy Smith Begolka
Pediatr Dermatol. 2026 May-Jun;43(3):609-614. doi: 10.1111/pde.70117. Epub 2025 Nov 18.
Abstract Background: Adolescents and young adults (AYA) with atopic dermatitis (AD) must transition from caregiver-led to self-managed care and eventually to adult healthcare providers. While transition readiness is well studied in other chronic conditions, it remains underexplored in AD. This study assesses transition readiness and perceived barriers to self-management among AYA with AD and parents of AYA.
Conclusions: AYA report greater transition readiness than parents perceive. Structured transition planning involving both groups may improve alignment and confidence in AD self-management.
A systematic review of the barriers to diagnosis of vulval lichen sclerosus in primary care
Louise Clarke, Rheanne Leatherland, Rosalind C Simpson
Clin Exp Dermatol. 2026 May 26;51(6):929-938. doi: 10.1093/ced/llaf481.
Abstract Background: Vulval lichen sclerosus (VLS) is a chronic, inflammatory genital skin condition causing itch, pain, anatomical changes and increased risk of vulval cancer. Diagnostic delay and misdiagnosis are common. Once diagnosed, VLS can be effectively treated using very strong topical corticosteroids. Most women with symptoms of VLS first present to primary care in the UK.
Conclusions: This review highlights obstacles for women in achieving a diagnosis of VLS. Education and knowledge gaps were reported by clinicians and patients. Clinicians lack knowledge of vulval skin disease and patients lack knowledge of vulval anatomy. Targeted, comprehensive education for clinicians could expedite diagnosis. Dismissive clinician attitudes compound patient feelings of anxiety and embarrassment, reinforcing taboos and stigma. Acknowledgement of embarrassment and stigma validates feelings, improving patient interactions. Future research priorities should include the development of a diagnostic tool and implementation of a complex intervention to expedite diagnosis.
KOH 5% solution versus diclofenac 3% for the treatment of actinic keratosis - Results from a three-armed RCT. U Reinhold, N Leitz, R Dominicus, E L Szabó, T Dirschka, G Popp, T C Fischer, N Adamini, R Ostendorf, M Asefi, H Durani, T Hölting, U Amann, F Kreuziger, T Assmann, H Brüning, L Freitag, K Hoffmann, R Gedschold
J Eur Acad Dermatol Venereol. 2026 Jun;40(6):1050-1058. doi: 10.1111/jdv.70069.
Abstract Background: Actinic Keratosis (AK) has the potential to progress into malignant cancer, thus necessitating timely and effective treatment. Despite several existing therapies, there is still a need for effective, well-tolerated therapeutic options, especially in the early treatment of patients with few isolated lesions in primary care.
Conclusions: KOH 5% solution proved superior to placebo and, when compared to diclofenac 3% gel, demonstrated significantly higher efficacy at EOT, as well as faster onset of action with comparable long-term efficacy and tolerability. KOH 5% solution is a valuable addition to the available treatment options for lesion-directed therapy in patients with mild-to-moderate AK.
Katherine Memory, Stephanie MacNeill, Kim Thomas, Miriam Santer, Matthew Ridd
Skin Health Dis. 2026 Mar 17;6(3):339-342. doi: 10.1093/skinhd/vzaf112. eCollection 2026 Jun.
Abstract: This study sought to describe use of topical treatments during eczema maintenance and flare-ups, using data from the Best Emollients for Eczema (BEE) trial. Findings showed that flare-ups were common, emollient use was generally high and that whilst topical corticosteroid use increased marginally during flare-ups, their overall use remained low. Our work is a reminder that parents may under-treat their child's eczema flare-ups with topical corticosteroids, and that clinicians should always ask and advise about flare-up management, addressing any barriers to treatment use.
A Primary Care Intervention to Improve Melanoma Detection and Management
Alexandra Verdieck, Elizabeth Berry, Heather Holderness, Adeeb Haroon, Maria N Danna, Jeremy Erroba, Sancy Leachman, Talia Hodes, Emile Latour, Elizabeth Stoos, Deborah Cohen, Sue Flocke
J Am Board Fam Med. 2026 Jan;39(1):159447. doi: 10.3122/jabfm.2025.250110R2.
Abstract Background: The incidence of cutaneous melanoma is increasing while access to dermatology care remains limited. Primary care clinicians are poised to identify and triage melanomas. However, barriers exist, including clinician knowledge and confidence. We tested the feasibility of an educational intervention to improve melanoma identification and management in primary care.
Conclusions: Melanoma education increased the specificity of primary care clinicians' e-consults without increasing in-person dermatology referrals or unnecessary biopsies. While this intervention has promise for improving skin cancer care in primary care, efforts are needed to increase clinician engagement in this education.
Mehdi Boostani, Paolo Gisondi, Francesco Bellinato, Tara Kiss, Christos C Zouboulis, Drew Kuraitis, Noah Goldfarb, Nóra Nádudvari, Banu Farabi, Balazs Hodosi, Péter Holló, Norbert M Wikonkal, Kende Lőrincz, András Banvölgyi, Gyorgy Paragh, Norbert Kiss
Front Med (Lausanne). 2026 May 13:13:1791488. doi: 10.3389/fmed.2026.1791488.
Abstract Introduction: Psoriasis is common, but diagnosis and early severity assessment can be delayed because of variable presentation and overlap with mimicking dermatoses. Multimodal large language models (LLMs) may assist image-based triage.
Conclusion: Under standardized conditions, general-purpose multimodal LLMs, especially ChatGPT-5 and ChatGPT-4o, showed strong performance for psoriasis recognition and reasonable support for PGA scoring and treatment suggestions, supporting potential use by primary care physicians when dermatology specialist access is limited.
In our own words: Patient-identified priorities for eczema care conversations
Jessica K Johnson, Julian Rizza, Charlene Miciano, Wendy Smith Begolka
J Am Acad Dermatol. 2026 May;94(5S):S2-S5. doi: 10.1016/j.jaad.2026.02.069.
Abstract: Atopic dermatitis affects more than appearance of the skin and presents a wide range of challenges that can impact a person's physical, mental, and social well-being. Although clinical care often prioritizes visible aspects of disease and treatment response, lived experiences reveal a broader definition of eczema burden, which can lead to misalignment regarding care approaches and treatment effectiveness, leading to care dissatisfaction. Opportunity exists to address patient-health care provider discordance and anchor care conversations in what matters most to people affected by eczema to foster optimal outcomes. This work was co-developed with 2 individuals affected by eczema (an adult patient and a caregiver) and is grounded in a patient-centered process using targeted conversations on the burden of atopic dermatitis and patient-driven priorities for health care conversations. Although the perspectives shared are limited to the unique journeys of these contributors and are not intended to represent the full spectrum of atopic dermatitis experiences, they parallel qualitative sentiments shared with the National Eczema Association by many patients and caregivers. We discuss a strong desire from the eczema community for more personalized eczema care that better acknowledges and addresses the comprehensive impact of the disease.
Comorbidities of atopic dermatitis in adults and children
Shanthi Narla, Jonathan I Silverberg
J Am Acad Dermatol. 2026 May;94(5S):S10-S13. doi: 10.1016/j.jaad.2025.10.043.
Abstract: Atopic dermatitis is increasingly recognized by dermatologists as a systemic disease with significant comorbidities beyond the skin. This narrative review highlights the broad range of medical and psychiatric conditions associated with atopic dermatitis in children and adults, including depression, cardiovascular and endocrine conditions, autoimmune disorders, and serious infections. The burden of these comorbidities increases with disease severity and has important implications for treatment selection, including the potential benefit of therapies with multisystem efficacy. Dermatologists are uniquely positioned to identify early signs of comorbid conditions and initiate appropriate referrals. Proactive screening and interdisciplinary collaboration-especially with mental health, primary care, allergy/immunology, rheumatology, endocrinology, and cardiology-are essential for comprehensive care and tailoring treatment strategies to individual patient needs.
Pharmacy-based triage to preselect high-risk individuals for skin cancer screening: A pilot study
An Buckinx, Laurence Feldmeyer, Philippa Golling, Carlo Mainetti, Cristina Mangas, Anja Wysocki, Véronique Del Marmol, Regina von Burg, Eva von Wartburg, Stephen P Jenkinson, Daniel Hohl, Olivier Gaide
J Eur Acad Dermatol Venereol. 2026 May 28. doi: 10.1111/jdv.70531. Online ahead of print.
No abstract available
Celeste Boesjes, Marjolein de Bruin-Weller, Nicolaas P A Zuithoff, Said El Bouhaddani, Inge Haeck, Marijke Kamsteeg, Marie-Louise Schuttelaar, Luca Le Treust, Nick Denholm, Ahmet Akkoc, Simon F Thomsen, Ida Vittrup, Thomas Birkner, Luise Heinrich, Jochen Schmitt, Stephan Weidinger, Thomas Werfel
Acta Derm Venereol. 2026 May 27:106:0231. doi: 10.2340/actadv.v106.adv-2025-0231.
Abstract: Clinical trials have demonstrated the effectiveness of baricitinib, an oral selective Janus kinase 1/2 inhibitor, for patients with moderate-severe atopic dermatitis, but data from real-world practice are limited. This non-interventional cohort study evaluated clinician- and patient-reported disease severity over 16 weeks using 3 national atopic dermatitis registries: BioDay (Netherlands), SCRATCH (Denmark) and TREATgermany (Germany). Absolute scores for Eczema Area and Severity Index (EASI) and itch Numerical Rating Scale (Itch-NRS) were assessed at baseline and follow-up (Week 13/16) for each registry and for the overall pooled cohort. Descriptive analyses, generalized linear mixed modelling and meta-analysis approaches were applied to complete-case and multiply-imputed datasets. In total, 264 patients (89 BioDay, 117 SCRATCH, 58 TREATgermany) were included. Results showed improvements in EASI, with 58%, 68% and 62% achieving EASI≤7 at Week 13/16 in BioDay, SCRATCH and TREATgermany, respectively. In the pooled cohort, the proportion was 62% (95% CI: 50-73%). The pooled mean EASI change was -7.8 [14.4,-1.1]. Effectiveness was generally observed in both biologic-naïve and -experienced patients. Notable heterogeneity was observed, particularly for Itch-NRS, with the proportion achieving NRS≤4 ranging from 20% (BioDay) to 71% (TREATgermany). These real-world findings support the effectiveness of baricitinib while also highlighting variability in patient outcomes.
Arav Kannen, Carolyn Marlow, Suzanne Edwards, Arabella Wallett
Australas J Dermatol. 2026 Jun;67(4):e239-e247. doi: 10.1111/ajd.70081. Epub 2026 Mar 6.
Abstract Background: Vulval Lichen Sclerosus (VLS) is a chronic inflammatory condition requiring lifelong management to prevent severe complications including malignancy. A shared care model between general practitioners (GPs) and public non-GP specialists (dermatologist or gynaecologist) for patients with stable LS would alleviate the demand on public vulval services. This study aims to assess GPs' level of comfort in performing vulval examinations for patients with VLS which would underpin the feasibility of shared care. It also explores GPs' level of confidence in vulval health, preferences for future vulval training and perspectives on rapid access pathways which would enable a successful shared care approach.
Conclusion: Most GPs in this study were comfortable in undertaking vulval examinations for patients with VLS and expressed an inclination to participate in shared care. Further efforts are required to provide GPs with additional training and rapid access pathways for specialist input to facilitate a safe and effective shared care model.
Daniel Lindsay, Shaun Stangl, Kiana Ronagh, Jessica Cameron, Richard Johns, Jim Muir, Louisa G Collins
Australas J Dermatol. 2026 Jun;67(4):214-227. doi: 10.1111/ajd.70063. Epub 2026 Feb 11.
Abstract Background/objectives: The rising incidence of skin cancer places a significant burden on Australia's health workforce. To support workforce planning, we estimated the supply of dermatologists and general practitioners (GP) working in skin cancer medicine, service demand and need across Queensland in 2023.
Conclusions: Access to dermatology services is limited for Queensland residents living outside the southeast region, with few providers available within reasonable proximity. GPs are managing a growing skin cancer workload in Queensland. This could be eased by increased use of telemedicine, upskilling other health professionals in skin cancer medicine and improving care efficiency.
The Management of Acne in General Practice using Isotretinoin: A Scoping Review Protocol
Shane Collins, Tony Foley, Diarmuid Quinlan, Emma Wallace, Laura Sahm, Aisling Farrell
HRB Open Res. 2026 Feb 26:9:21. doi: 10.12688/hrbopenres.14215.1.
Abstract: Introduction: Acne Vulgaris (Acne) is a common, chronic, cutaneous disorder associated with scarring, hyperpigmentation, and adverse psychological effects. The high prevalence of acne places a significant burden on healthcare systems worldwide due to the cost of treatment. The high usage of antibiotics in the treatment of this condition also has a significant impact on the prevalence of antimicrobial resistance. Isotretinoin is considered to be the most effective treatment for the management of severe acne; however, issues remain with inequitable access to this drug. General Practitioners (GPs) are ideally placed to identify and manage patients with moderate-to-severe acne; however, in many countries the prescription of isotretinoin is limited to secondary care. To the authors' knowledge, no review has been conducted to identify, map and analyse literature pertaining to GPs' use of isotretinoin for the management of acne.
Conclusions: The objective of this scoping review is to comprehensively identify, map, and analyse literature pertaining to the management of acne using isotretinoin in general practice.
Knowledge among primary care physicians on urticaria treatment: Impact of educational interventions
Jorge Sánchez, Ana Caraballo, Jaime Ocampo, Elizabeth García
J Allergy Clin Immunol Glob. 2026 May 7;5(4):100729. doi: 10.1016/j.jacig.2026.100729.
Abstract Objective: We evaluated changes over time in primary care physicians' (PCPs) knowledge regarding diagnosis and management of urticaria. Additionally, we explored the characterization of access barriers reported by urticaria specialists.
Conclusion: Educational initiatives appear to positively influence PCPs' knowledge and management of urticaria; however, persistent gaps highlight the need for ongoing, targeted educational strategies and system-level improvements to reduce barriers in medical care.
Piergiacomo Calzavara-Pinton, Enrico Iemoli, Pallavi Saraswat, Nadine Chapman-Rothe, Ornella Bonavita, Tara Raftery, Vinodh Nallasamy, Mahrukh Zahid, Viviane Sprecher, Abigail Herbst, Bridget Gaglio, Fabio Speranza, Patrick Daniele, Riccardo Asero
World Allergy Organ J. 2026 May 29;19(7):101404. doi: 10.1016/j.waojou.2026.101404.
Abstract Introduction: Patients with chronic spontaneous urticaria (CSU) often experience diagnostic delays and uncontrolled disease, highlighting the need to improve CSU care. The BRIDGE study, a hybrid type 1 effectiveness-implementation study, evaluated the effectiveness and feasibility of an urticaria care package (UCP) to increase patient-reported outcome (PRO) use in clinical practice and improve CSU care among general practitioners (GPs). Two surveys were conducted, 1 before and 1 after UCP implementation. This report focuses on pre-implementation data regarding the management and knowledge of CSU among GPs in Italy.
Conclusion: Pre-implementation data revealed substantial knowledge gaps in CSU management among GPs in Lombardy, supporting the need for additional training to improve CSU management.
The association between COVID-19 vaccines and bullous pemphigoid risk: A UK population-based study
Mikolaj Swiderski, Yana Vinogradova, Matthew J Ridd, Zenas Z N Yiu, Antonia Lloyd-Lavery, Vibhore Prasad, Bruno Gran, Sonia Gran
J Eur Acad Dermatol Venereol. 2026 Jun 5. doi: 10.1111/jdv.70521. Online ahead of print.
No abstract available
Henna Odisho, Malin Karlberg-Traav, Agneta Anderzen-Carlsson, Georgina Gethin, Dimitri Beeckman
Int Wound J. 2026 Jun;23(6):e70970. doi: 10.1111/iwj.70970.
Abstract: This study aimed to explore how persons living with a hard-to-heal wound and their family members experience care. The inclusion criteria for patients were wounds that had persisted for more than 6 weeks or hard-to-heal wounds that had recently healed. The study included 16 participants (13 patients and 3 family members) from primary healthcare services in Örebro County, Sweden. The interview data were transcribed and analysed using reflexive thematic analysis. One overarching theme was generated: Navigating an uncertain path towards healing, along with three subthemes: (1) Striving to be an active agent, (2) Being part of collaboration efforts and (3) Being a bystander in the search for the right treatment. Together, these themes illustrate how patients and family members engaged in an uncertain care process as they sought to understand the condition and manage care in everyday life. These everyday efforts reflected forms of invisible agency, as participants did not always recognise them as meaningful contributions to wound care. The findings highlight the importance of person-centred approaches that recognise and value patients' and family members' everyday contributions to wound care and support self-management through partnerships among patients, family members and HCPs.
The Management of Acne in General Practice using Isotretinoin: A Scoping Review Protocol
Shane Collins, Tony Foley, Diarmuid Quinlan, Emma Wallace, Laura Sahm, Aisling Farrell
HRB Open Res. 2026 Feb 26:9:21. doi: 10.12688/hrbopenres.14215.1.
Abstract Introduction: Acne Vulgaris (Acne) is a common, chronic, cutaneous disorder associated with scarring, hyperpigmentation, and adverse psychological effects. The high prevalence of acne places a significant burden on healthcare systems worldwide due to the cost of treatment. The high usage of antibiotics in the treatment of this condition also has a significant impact on the prevalence of antimicrobial resistance. Isotretinoin is considered to be the most effective treatment for the management of severe acne; however, issues remain with inequitable access to this drug. General Practitioners (GPs) are ideally placed to identify and manage patients with moderate-to-severe acne; however, in many countries the prescription of isotretinoin is limited to secondary care. To the authors' knowledge, no review has been conducted to identify, map and analyse literature pertaining to GPs' use of isotretinoin for the management of acne.
Conclusions: The objective of this scoping review is to comprehensively identify, map, and analyse literature pertaining to the management of acne using isotretinoin in general practice.
Knowledge among primary care physicians on urticaria treatment: Impact of educational interventions
Jorge Sánchez, Ana Caraballo, Jaime Ocampo, Elizabeth García
J Allergy Clin Immunol Glob. 2026 May 7;5(4):100729. doi: 10.1016/j.jacig.2026.100729.
Abstract Background: Primary care physicians (general practitioners, family physicians, emergency physicians, among others) are often the first point of medical contact for patients with urticaria. Appropriate initial management enables early disease control and reduces the overall burden on patients and health care systems.
Conclusion: Educational initiatives appear to positively influence PCPs' knowledge and management of urticaria; however, persistent gaps highlight the need for ongoing, targeted educational strategies and system-level improvements to reduce barriers in medical care.
Piergiacomo Calzavara-Pinton, Enrico Iemoli, Pallavi Saraswat, Nadine Chapman-Rothe, Ornella Bonavita, Tara Raftery, Vinodh Nallasamy, Mahrukh Zahid, Viviane Sprecher, Abigail Herbst, Bridget Gaglio, Fabio Speranza, Patrick Daniele, Riccardo Asero
World Allergy Organ J. 2026 May 29;19(7):101404. doi: 10.1016/j.waojou.2026.101404.
Abstract Introduction: Patients with chronic spontaneous urticaria (CSU) often experience diagnostic delays and uncontrolled disease, highlighting the need to improve CSU care. The BRIDGE study, a hybrid type 1 effectiveness-implementation study, evaluated the effectiveness and feasibility of an urticaria care package (UCP) to increase patient-reported outcome (PRO) use in clinical practice and improve CSU care among general practitioners (GPs). Two surveys were conducted, 1 before and 1 after UCP implementation. This report focuses on pre-implementation data regarding the management and knowledge of CSU among GPs in Italy.
Conclusion: Pre-implementation data revealed substantial knowledge gaps in CSU management among GPs in Lombardy, supporting the need for additional training to improve CSU management.
The association between COVID-19 vaccines and bullous pemphigoid risk: A UK population-based study
Mikolaj Swiderski, Yana Vinogradova, Matthew J Ridd, Zenas Z N Yiu, Antonia Lloyd-Lavery, Vibhore Prasad, Bruno Gran, Sonia Gran
4J Eur Acad Dermatol Venereol. 2026 Jun 5. doi: 10.1111/jdv.70521.
No abstract available
Henna Odisho, Malin Karlberg-Traav, Agneta Anderzen-Carlsson, Georgina Gethin, Dimitri Beeckman
Int Wound J. 2026 Jun;23(6):e70970. doi: 10.1111/iwj.70970.
Abstract: This study aimed to explore how persons living with a hard-to-heal wound and their family members experience care. The inclusion criteria for patients were wounds that had persisted for more than 6 weeks or hard-to-heal wounds that had recently healed. The study included 16 participants (13 patients and 3 family members) from primary healthcare services in Örebro County, Sweden. The interview data were transcribed and analysed using reflexive thematic analysis. One overarching theme was generated: Navigating an uncertain path towards healing, along with three subthemes: (1) Striving to be an active agent, (2) Being part of collaboration efforts and (3) Being a bystander in the search for the right treatment. Together, these themes illustrate how patients and family members engaged in an uncertain care process as they sought to understand the condition and manage care in everyday life. These everyday efforts reflected forms of invisible agency, as participants did not always recognise them as meaningful contributions to wound care. The findings highlight the importance of person-centred approaches that recognise and value patients' and family members' everyday contributions to wound care and support self-management through partnerships among patients, family members and HCPs.
Dorsa Manavi, Alice Tunks, Wendy Diment, Alessandra Bortoluzzi, James A Bourgeois, Lucy Calderwood, Xiaofeng Yan, Melanie Sloan
Rheumatol Int. 2026 Jun 4;46(6):128. doi: 10.1007/s00296-026-06143-y.
Abstract: Fibromyalgia is frequently diagnosed alongside systemic autoimmune rheumatic diseases (SARDs), yet impacts remain poorly understood. This study aimed to examine patients' and clinicians' perspectives of the psychosocial, clinical, and relational impact of fibromyalgia as a co-diagnosis in SARDs. We employed explanatory mixed-methods study integrating survey data from 1269 adults with SARDs, and interviews with patients (n = 19) and clinicians (n = 21). Outcomes included wellbeing (WEMWBS, 14-70), trust, confidence in receiving medical help, adaptation, satisfaction with care (all 1-5), and self-rated health (0-100). Independent t-tests compared outcomes by fibromyalgia status and by patients' diagnostic acceptance. Qualitative open-text responses and interviews were analysed thematically. Among participants (95.1% female n = 1207; lupus 31.0% n = 393 and rheumatoid arthritis 31.3% n = 397), fibromyalgia was reported by 25.9% (n = 329) of whom 52.8% (n = 174) questioned diagnostic accuracy. Compared with those without fibromyalgia, affected participants reported significantly lower wellbeing (mean difference(SD) = -4.206(0.608)), trust in GPs (mean difference(SD) = -0.239(0.092)) and rheumatologists (mean difference(SD) = -0.515(0.097)), confidence in receiving help (mean difference(SD) = -0.459(0.073)), and satisfaction with care (mean difference(SD) = -0.563(0.073)), alongside poorer adaptation (mean difference(SD) = -0.223(0.066)) and life satisfaction (mean difference(SD) = -0.519(0.071)), but higher self-rated health (mean difference(SD) = 11.107(1.411); all p < 0.05). Diagnostic acceptance showed minimal quantitative differences across outcomes. Thematic analysis highlighted that diagnostic uncertainty was driven by overlapping symptoms and limited biomarkers. Variations in clinician practices affected patients' trust and acceptance. Furthermore, misdiagnosis and dismissal led to stigma, delayed recognition of conditions, and considerable patient distress. In SARDs, fibromyalgia diagnosis is associated with poorer wellbeing and reduced trust in healthcare providers, irrespective of diagnostic acceptance, and often reflects diagnostic uncertainty. Mechanism-based explanations may help improve communication and provide greater clinical utility than categorical diagnostic labelling.
Thomas Werfel, Annice Heratizadeh, Matthias Augustin, Christine Bangert, et al.
Allergol Select. 2026 Jun 15:10:120-144. doi: 10.5414/ALX02638E. eCollection 2026.
Abstract: This guideline is a partial update of the S3 guideline on atopic dermatitis (AWMF register no. 013-027) published in 2023. The chapters on systemic therapy with biologics and Janus kinase inhibitors as well as the chapter on pregnancy, breastfeeding and family planning in the context of systemic therapies for atopic dermatitis have been updated. This was prompted by new approvals (lebrikizumab, nemolizumab), approval extensions (abrocitinib from 12 years of age, baricitinib from 2 years of age) and new evidence on the use of biologics before and during pregnancy. In addition, a new chapter on treatment goals, treatment expectations and criteria for treatment adjustment ("treat-to-target") in systemic therapies has been added to the guideline. This article only presents the updated and newly added chapters. The complete guideline is available on the AWMF website.
Skin Cancer in the Rural South: Strengthening Dermatologic Training for Frontline Primary Care
Sarah E Burstein, Howard I Maibach
Cureus. 2026 Jun 17;18(6):e111042. doi: 10.7759/cureus.111042. eCollection 2026 Jun.
Abstract: Skin cancer remains a major public health challenge in the rural Southeastern United States (US), where elevated disease burden coincides with limited access to dermatologic care. Rural populations face increased risk due to occupational exposure to ultraviolet light, poverty, lower rates of routine skin screening, and transportation barriers, yet many nonmetropolitan counties have no practicing dermatologists. Consequently, primary care physicians (PCPs) often serve as the first, and sometimes only, clinicians evaluating suspicious skin lesions. Despite this responsibility, dermatology remains underrepresented in undergraduate medical education and primary care training. Because dermatologic diagnosis relies heavily on pattern recognition, morphologic assessment, and familiarity with presentations across diverse skin tones, insufficient training may contribute to delayed recognition of premalignant and malignant lesions, particularly among medically underserved populations. This editorial argues that strengthening dermatologic education within general medical training is a pragmatic and immediately actionable strategy to address workforce maldistribution and reduce rural skin cancer disparities. This is not a proposal for PCPs to replace dermatologists, but rather a call to equip frontline clinicians with the foundational skills needed to recognize, triage, and appropriately manage high-risk dermatologic presentations.
Lidia Gazzola, Matteo Augello, Silvia Cavinato, Antonio Briozzo, Federico D'Amico, Nicola Schiano Moriello, Francesco Vladimiro Segala, Luisa Frallonardo, Francesco Di Gennaro, Annalisa Saracino, Danilo Tacconi, Michele Gilio, Maria Frontuto, Giustino Parruti, Annamaria Cattelan, Giulia Marchetti
JAC Antimicrob Resist. 2026 Jun 17;8(3):dlag119. doi: 10.1093/jacamr/dlag119.
Abstract Conclusions: This multicentre survey highlights substantial variability in ABSSSI management across Italian expert centres, with key gaps in care pathways, specialist availability, and data collection. Addressing these issues may improve standardization and efficiency of care.
My Söderholm, Anna Moberg, Magnus Falk
Melanoma Res. 2026 May 29. doi: 10.1097/CMR.0000000000001110. Online ahead of print.
Abstract: Primary care physicians typically perform the initial assessment of skin lesions. Artificial intelligence tools, using techniques such as convolutional neural networks, are under development and have shown promise for evaluating dermoscopic images for the detection of skin cancer. These tools could possibly support physicians. This study investigated possible factors that might affect the specificity of an artificial intelligence tool, associated with the patient, lesion, or dermoscopic characteristics, which clinicians could potentially avoid, or for which the tool could be optimized. A total of 228 dermoscopic images from a prospective clinical trial in primary care were retrospectively examined by a resident general practitioner using conventional dermoscopy algorithms to describe the lesion characteristics. All lesions falsely classified as melanomas suspected by the artificial intelligence tool in the trial were compared with the true negative lesions with regard to lesion and patient characteristics. Elevated lesions were more often correctly classified as benign compared with macular lesions [odds ratio (OR) = 16, 95% confidence interval (CI) = 2.0-120, P = 0.008]. The tool was more likely to falsely suspect melanoma if the ruler in the dermoscopic image was located over the lesion (OR = 2.0, 95% CI = 1.1-3.4, P = 0.017). This indicates that elevated lesions can be reliably assessed when using this type of tool, while the presence of a ruler might need attention in the optimization of artificial intelligence tools for melanoma assessment.
Tigest Ajeme, Oumer Ali, Agumasie Semahegn, Asrat Mengiste, Eiman Siddig Ahmed, Mersha Kinfe, Selamawit Kebede, Stephen Bremner, Vasso Anagnostopoulou, Malcolm Brewster, Gail Davey, Abebaw Fekadu, Maya Semrau
BMC Prim Care. 2026 Jun 16;27(1):240. doi: 10.1186/s12875-026-03425-z.
Abstract Conclusion: This study introduced a context-driven, integrated, and holistic wound care package aimed at managing chronic wounds alongside their associated mental health and psychosocial challenges. The package encompasses interventions that address the physical, psychological, and social impacts of chronic wounds in individuals affected by neglected tropical diseases of the skin and related conditions. It employs multilevel implementation strategies targeting individuals, communities, and the health system to reduce morbidity, disability, and the economic and psychosocial burdens linked to chronic wounds. This standardized, scalable, and sustainable care model provides a promising approach for Ethiopia and other low- and middle-income countries.