Primary Care Dermatology Literature August 2025
Skin Research in Primary Care
Julien Anriot, Nadia Ikhlef, Gérard Duru, Sophie Darnis, Pauline Scouarnec, Younes Tamarat, Mona Amini-Adle, Luc Thomas
Dermatol Pract Concept. 2025 Jul 31;15(3). doi: 10.5826/dpc.1503a6122.
Abstract Background: Melanoma constitutes an increasing global health burden. In the light of a growing shortage of dermatologists in several countries, primary care has emerged as an optimal setting for skin cancer screening. Historically, skin cancer detection in France was typically managed by dermatologists, while general practitioners (GPs) were barely involved. In 2021, the Association of French GPs Practicing Dermoscopy was created to address this gap by promoting and legitimizing dermoscopy practice among primary care physicians.
Conclusions: Empowerment of primary care medicine through dermoscopy learning appears to be a promising way to overcome the relative shortage of diagnostic offer observed in several countries. Integrating skin cancer screening into a GP's practice may contribute to early melanoma detection and support ongoing efforts to lower melanoma mortality.
Rising scabies incidence and the growing burden on general practitioners
Saskia C van der Boor, Ines Figaroa, Annemarie A Uijen, Stijn Fh Raven, Cornelia Van Jaarsveld
BJGP Open. 2025 Aug 8:BJGPO.2025.0037. doi: 10.3399/BJGPO.2025.0037.
Abstract Background: Scabies cases are rising in several high-income European countries, but its true incidence remains unclear due to its non-notifiable status. General practitioners (GPs) play a key role in managing scabies, yet the impact on primary care is unknown.
Conclusion: Our findings highlight an exponential increase in scabies-related episodes, significantly increasing the burden on general practices. Regions experiencing rising scabies incidence rates should prioritize public health interventions to curb transmission, which require a coordinated clinical and public health response.
Gillian Santorelli, Lucy Pembrey, John Wright
Pediatr Allergy Immunol. 2025 Aug;36(8):e70166. doi: 10.1111/pai.70166.
Abstract Background: Discrepancies between parent reports and electronic health records (EHRs) challenge the accurate estimation of childhood allergic disease prevalence. This study aimed to: (1) compare parent reports of asthma, eczema, and allergic rhinitis with GP-recorded diagnoses; (2) identify factors associated with reporting differences; and (3) assess the predictive validity of parent reports for future diagnoses.
Conclusion: Neither parent reports nor EHRs alone capture the full picture of childhood allergic disease. Parent reports offer crucial insights into symptom burden and future risk, while EHRs provide objective diagnostic data. An integrating approach, combining both sources, is essential for comprehensive epidemiological research and a more complete understanding of disease burden.
Sahand Karimzadhagh, Shahriar Ghodous, Reza M Robati, Elahe Abbaspour, Mohamad Goldust, Nooshin Zaresharifi, Shirin Zaresharifi
Int J Dermatol. 2025 Jul 31. doi: 10.1111/ijd.17981. Online ahead of print.
Abstract conclusions: AI-assisted approaches significantly improved diagnostic accuracy among all clinicians, with generalists and nurse practitioners benefiting more than experienced dermatologists. Deep learning models in primary care, trained on smartphone images, achieved higher sensitivity (90%) and specificity (85%) than general practitioners. AI models significantly outperformed junior dermatologists and nonspecialists compared to senior dermatologists. Hence, integrating AI-assisted tools into clinical workflows, particularly in primary settings, can
Sarah Lee, Itohan Aigbekaen, Jennifer Huang
Acad Pediatr. 2025 Aug;25(6):102835. doi: 10.1016/j.acap.2025.102835. Epub 2025 Apr 15.
Abstract conclusion: This study highlights a geographic misalignment between pediatric dermatologists and primary care residency programs. Scalable strategies, including virtual learning modules and collaboration with nearby specialists, are needed to support integration of pediatric dermatology into training curricula and to help address geographic gaps in subspecialty educational exposure.
Vanessa Smith, Nathalie Berghen, Elvis Hysa, Amber Vanhaecke, Steven Wallaert, Emanuele Gotelli, Maurizio Cutolo
Clin Exp Rheumatol. 2025 Aug;43(8):1386-1390. doi: 10.55563/clinexprheumatol/1c8ikh.
Abstract conclusions: A simple HFUS discriminator between skin thickness of HC versus SSc, i.e., DT as measured at F2L, at a cut-off of 1.5 mm, is proposed for daily use in rheumatology clinics. Further validation should be executed through prospective multicentric cohorts.
Time for Your Skin (Diagnostic Ability) Check
J Lane Wilson, Jonathon Firnhaber
Prim Care. 2025 Sep;52(3):xv-xvi. doi: 10.1016/j.pop.2025.06.001. Epub 2025 Jun 23.
No abstract available
Urticaria: Diagnosis and Management
Maya Bass, Lori Atkinson, Bennett S Shenker
Prim Care. 2025 Sep;52(3):651-659. doi: 10.1016/j.pop.2025.05.010. Epub 2025 Jul 5.
Abstract: Urticaria is a common dermatologic condition that affects about 20% of the population. It is caused by the release of histamines in response to a trigger. It is subdivided into acute urticaria and chronic urticaria (urticaria lasting more than 6 weeks). First-line treatment is second-generation H1-antihistamines and avoidance of known triggers. Long-term prevention also focuses on minimizing exposure to triggers including hot water, nonsteroidal anti-inflammatory drugs, tight clothing, and known allergens.
Ankitaben Han, Mitchell Bressack, J Lane Wilson
Prim Care. 2025 Sep;52(3):623-650. doi: 10.1016/j.pop.2025.05.009. Epub 2025 Jul 5.
Abstract: Disorders of pigmentation encompass a wide range of conditions categorized into hyperpigmentation, hypopigmentation, and depigmentation, each with distinct etiologies, clinical presentations, and implications. This article outlines the pathophysiology, clinical features, diagnostic approaches, and management strategies for these pigmentary disorders for primary care physicians. Recognizing systemic associations and rare presentations is also essential for primary care physicians to diagnose and guide treatment or dermatologic referral.
Acne, Perioral Dermatitis, Rosacea, and Hidradenitis Suppurativa
Maria A Schiaffino, Virginia Regula, Haley Coleman
Prim Care. 2025 Sep;52(3):593-621. doi: 10.1016/j.pop.2025.05.008.
Abstract: Acne and related dermatoses encompass a spectrum of conditions that present at different stages in life and are commonly seen in the primary care setting. The primary care clinician should be familiar with the presentation, diagnosis, differentiation and management of acne, perioral dermatitis, rosacea, and hidradenitis suppurativa. Factors such as patient age, genetics, hormones, infections, occupation, habits, cosmetics, and medications may impact the presentation of acne-like eruptions. Clinical presentation offers clues to the physician that help differentiate acneiform conditions like perioral dermatitis, rosacea, and hidradenitis suppurativa. These conditions do not respond to standard acne therapy and require different treatment strategies.
Psoriasis and Papulosquamous Disorders
Matthew F Helm, Karl T Clebak, Laura Critchfield, Leesha A Helm
Prim Care. 2025 Sep;52(3):567-591. doi: 10.1016/j.pop.2025.05.007. Epub 2025 Jun 23.
Abstract: Psoriasis is a chronic, inflammatory skin disease with a significant impact on quality of life. Psoriasis affects about 3% of the US population. Psoriasis is caused by an interaction between genetic and environmental triggers. Lifestyle modification and topical therapies such as emollients, topical corticosteroids, vitamin D analogues, and calcineurin inhibitors are used for limited disease. More severe psoriasis may require systemic therapy with available oral or biologic therapy.
Eric Sullivan, Jonathon Firnhaber
Prim Care. 2025 Sep;52(3):553-566. doi: 10.1016/j.pop.2025.05.006. Epub 2025 Jul 10.Abstract: Atopic dermatitis and contact dermatitis are among the most common dermatologic conditions encountered by the primary care clinician. Their presentation varies and can mimic infectious and other noninfectious conditions, making a thorough history essential, with particular emphasis on exposure to environmental and occupational irritants, as well as recognition of commonly affected sites. For all of these conditions, control of symptoms is often the goal of treatment, starting with general supportive care measures like frequent emollient use and often relying on topical steroidal and nonsteroidal agents as first-line therapies.
Nora E Lamartine, Ashten Duncan
Prim Care. 2025 Sep;52(3):537-552. doi: 10.1016/j.pop.2025.05.005. Epub 2025 Jul 4.
Abstract: Vesiculobullous diseases are heterogeneous mucocutaneous disease entities of varying etiologies, ranging from infections to autoimmune disorders to manifestations of underlying chronic health conditions. Since all etiologies are associated with vesicular or bullous lesions, diagnosing these conditions can be challenging. However, a thorough history and considering a patient's comorbidities can narrow the differential diagnosis and point to a particular etiology in many cases. A biopsy of active lesions with microscopic analysis can clarify the diagnosis in less obvious cases. This article explores the most common vesiculobullous diseases primary care clinicians should consider when evaluating and treating patients.
J Lane Wilson
Prim Care. 2025 Sep;52(3):513-535. doi: 10.1016/j.pop.2025.05.004. Epub 2025 Jul 4.Abstract: Benign skin tumors are common findings in primary care. The ability to recognize and diagnose them accurately is important to distinguish them from less common malignant lesions. Dermoscopy and biopsy can improve diagnostic accuracy and streamline dermatologic care.
Jonathon Firnhaber
Prim Care. 2025 Sep;52(3):499-512. doi: 10.1016/j.pop.2025.05.003. Epub 2025 Jun 27.
Abstract: Keratinocyte carcinoma, traditionally termed nonmelanoma skin cancer, comprises basal cell and cutaneous squamous cell carcinoma and is the most common human malignancy. Basal cell carcinoma most commonly appears as a pearly pink, dome-shaped papule with prominent telangiectatic surface vessels. Squamous cell carcinoma most commonly appears as a firm, smooth, or hyperkeratotic papule or plaque, often with central ulceration. Cutaneous melanoma remains the most serious skin cancer worldwide, with progressively increasing incidence year by year. Clinicians should have a high index of suspicion that pigmented or otherwise unusual-appearing lesions may represent melanoma.
Karl T Clebak, Christopher R Davis, Kara Romanowski, Michael T Partin
Prim Care. 2025 Sep;52(3):471-485. doi: 10.1016/j.pop.2025.05.001. Epub 2025 Jul 4.
Abstract:
Skin infections are prevalent in primary care, spanning from superficial conditions like impetigo to severe, life-threatening cases such as necrotizing fasciitis. This article provides an in-depth review of the clinical presentation, diagnosis, and management of common bacterial, fungal, and viral skin infections, with practical insights tailored for primary care physicians. Emphasis is placed on evidence-based approaches, distinguishing features between similar infections, and treatment options ranging from topical antibiotics to advanced surgical interventions. This comprehensive guide ensures primary care providers are equipped to recognize and manage skin infections effectively, enhancing patient outcomes through timely and appropriate care.
Pediatric Infectious Skin Conditions
John N Boll Jr, Adwoa Boahene, Courtney Goettel
Prim Care. 2025 Sep;52(3):437-469. doi: 10.1016/j.pop.2025.04.004. Epub 2025 Jul 4.
Abstract: Pediatric infectious skin conditions are frequently managed in primary care offices. Familiarity with these conditions and an understanding of a patient's individual characteristics, including vaccine status, ethnicity, and risk of drug-resistant pathogens, is crucial for proper diagnosis and management. Proper diagnosis considers these factors but is also aided by dermoscopy, which is a noninvasive tool for improving diagnostic accuracy both by confirming the diagnosis but also ruling out other diagnoses. Through a proper diagnosis, appropriate treatment can be administered for these skin conditions. In addition, appropriate preventative strategies, including vaccination, can be encouraged to patients and their families.
Maria Lovén, Laura Huilaja, Markus Paananen, Paulus Torkki
J Eur Acad Dermatol Venereol 2025 Sep;39(9):1666-1674. doi: 10.1111/jdv.20451. Epub 2024 Dec 2.
Abstract:
Background: The management of patients with skin changes can be challenging in primary healthcare; general practitioners (GPs) often lack the expertise to make accurate assessments and treatment decisions. The standard care pathway for skin changes can result in extended treatment times and costs.
Conclusions: The integration of dermatological expertise into primary care settings is cost-effective and can streamline the management of patients with skin conditions without worsening their QoL.
Bidirectional association between vitiligo and melasma: A large-scale population-based study
Shany Sherman, Hadar Duskin-Bitan, Tamir Agiv, Danielle Bar, Lilach Marom-Haham, Assi Levi, Daniel Mimouni, Li-Chi Chen, John E Harris, Jen Barak Levitt, Yochai Schonmann, Arnon D Cohen, Doron Netzer
Indian J Dermatol Venereol Leprol. 2025 Jul 4:1-7. doi: 10.25259/IJDVL_1828_2024.
Abstract:
Background: The dual diagnosis of vitiligo and melasma and their association has hardly been studied.
Conclusion: A bidirectional association between vitiligo and melasma was observed. Treatment strategies for individuals with a dual diagnosis warrant further investigation.
Raiza Brito Cipriano, Wilson Falco Neto, Fabiano N Barcellos Filho, Alexandre Dias Porto Chiavegatto Filho
An Bras Dermatol. 2025 Aug 13;100(5):501169. doi: 10.1016/j.abd.2025.501169.
Abstract:
Background: Accurate diagnoses in dermatology can be challenging for general practitioners. In this context, the support of artificial intelligence tools can be beneficial in the Brazilian primary care setting.
Conclusion: The developed technology obtained good predictive performance and clinical coherence. There is a need for adaptation for implementation, using national data. The results indicate the potential for similar models to be improved and adapted to clinical practice for the benefit of the Unified Heath System.
An Online Questionnaire Improves Outcomes for Children With Atopic Eczema
Danielle Paea, Kate L Francis, David Orchard
Australas J Dermatol. 2025 Aug 13. doi: 10.1111/ajd.14574. Online ahead of print.
Abstract conclusion: The online eczema triggers questionnaire provides positive outcomes in managing a child's AD in the primary care setting, giving access to care and advice whilst waiting for a specialist appointment. The severity of AD upon presentation was found to be less pronounced in individuals who completed the questionnaire, resulting in a reduced need for follow-up appointments. It offers an opportunity to enhance health and well-being outcomes for children and their families whilst also reducing the long-term demand for specialist AD care.
Mikolaj Swiderski, Grazziela Figueredo, Yana Vinogradova, Roger D Knaggs, Karen E Harman, Rowan H Harwood, Vibhore Prasad, Monica S M Persson, Carron Layfield, Sonia Gran
Clin Exp Dermatol. 2025 Aug 6:llaf362. doi: 10.1093/ced/llaf362. Online ahead of print.
Abstract:
Background: Bullous pemphigoid (BP) is a serious autoimmune skin disease affecting older people. Given the highly prevalent polypharmacy in older people, identifying drug combinations associated with high BP risk is needed.
Conclusions: ARM found that most frequently prescribed drug combinations associated with increased BP risk treated cardiovascular diseases and hypertension. Patients should be vigilant for skin changes following these drugs rather than avoid them.
Claire Doyle, Anne-Marie Tobin, Tony Foley
Skin Health Dis. 2025 Jun 25;5(4):273-280. doi: 10.1093/skinhd/vzaf043. eCollection 2025 Aug.
Abstract:
Background: Despite a high frequency of presentations of skin disease in primary care, research has demonstrated a paucity of dermatology teaching in the medical school curriculum and a variable level of postgraduate dermatology teaching in general practice training. While it is clear that general practitioner (GP) trainees feel they would benefit from additional dermatology teaching, there is a gap in the literature regarding the factors that influence their learning.
Conclusion: This study broadens our understanding of factors that influence the dermatology learning of GP trainees. Findings generated from this study may be utilized to improve the clinical learning environment and inform the dermatology curriculum of GP trainees.
Diagnosis and management of vulval lesions
Claire Haigh, Helen Yiling Sun, Gayle Fischer
Curr Opin Obstet Gynecol 2025 Jul 25. doi: 10.1097/GCO.0000000000001054.
Abstract:
Purpose of review: The vulva is part of the skin. A wide spectrum of dermatological diseases affects the vulva, including infections, dermatoses, manifestations of hormonal and systemic conditions, and neoplasia. Vulval diseases are typically associated with significant delay in diagnosis due to limited healthcare practitioner knowledge amongst primary care physicians and specialists alike. This review article provides an update on the diagnosis and management of common vulval lesions.
Summary: Vulval complaints are common. It is important to not only be able to differentiate between benign findings and potentially premalignant or malignant lesions but also recognise and manage common causes of vulval lesions such as dermatitis, psoriasis, lichen sclerosus, infectious causes of disease, and nonsexually acquired genital ulceration.
Florence Vroman, Lisa P van der Rijst, Octavian I Bacoş-Cosma, Nicolaas P A Zuithoff, Marijke Kamsteeg, Paula P M van Lumig, Laura Loman, Marie-Louise L A Schuttelaar, Marjolein S de Bruin-Weller, Marlies de Graaf
J Dermatolog Treat. 2025 Dec;36(1):2539282. doi: 10.1080/09546634.2025.2539282. Epub 2025 Jul 30.
Abstract:
Purpose: Upadacitinib is approved for treating moderate-to-severe atopic dermatitis (AD) aged ≥12 years. We evaluated upadacitinib's effectiveness and safety in AD adolescents in daily practice.
Conclusions: Our findings indicate that upadacitinib is effective and relatively safe for adolescents with moderate-to-severe AD; however, 33.3% discontinued treatment.
Anneliese Willems, Alvin H Chong, Amanda Tapley, Sandra Grace, Parker Magin
Fam Pract. 2025 Jun 4;42(4):cmaf053. doi: 10.1093/fampra/cmaf053.
Abstract conclusions: While Australian GPs report high confidence in diagnosing and managing common dermatological conditions, confidence declines for rarer, more complex presentations. Notably, GPs feel more confident in managing skin cancers than diagnosing them, indicating a need for enhanced training in diagnostic skills, particularly dermoscopy. These findings have implications for education delivery.
Dorothea Dehnen, Kristina Flägel, Dorothea Wild, Jost Steinhäuser
GMS J Med Educ. 2025 Jun 16;42(3):Doc38. doi: 10.3205/zma001762. eCollection 2025.
Abstract conclusion: The results provide initial evidence that discrepancies may exist between the level of desired competency by the end of undergraduate medical education, as specified by the NKLM, and the level of proficiency actually achieved in terms of practical clinical skills. More teaching and feedback methods may need to be established to impart these skills during undergraduate medical education and to integrate these skills into complex clinical contexts.