Primary Care Dermatology Literature May 2025
Skin Research in Primary Care
Eleni Domzaridou, Matthew J Carr, David M Williams, Anthony J Avery, Tjeerd van Staa, D Aled Rees, Darren M Ashcroft
Pharmacoepidemiol Drug Saf. 2025 May;34(5):e70153. doi: 10.1002/pds.70153.
Abstract conclusion: A fifth of patients receiving CS accounted for over 80% of oral and inhaled CS prescribing in primary care. Identifying these patients is crucial for targeting future interventions to promote patient safety and cost-effective CS use.
Ahmed Abdulaziz Alsaati, Reem Abdullah Albejais, Rahaf Faisal Aldawish, Kawthar Hassan Alali, Samia Talal Abdullah Khalil, Sajjad Ibrahim Alhajji, Nouf Talal A Mleeh, Logain Alghanemi
Cureus. 2025 Mar 27;17(3):e81276. doi: 10.7759/cureus.81276. eCollection 2025 Mar.
Abstract: Background Primary care physicians (PCPs) should have adequate skills to manage common skin conditions, such as eczema, psoriasis, and vitiligo, and reduce the rate of referrals to dermatologists. Objective The aim of this study was to assess PCPs' knowledge in diagnosing and managing common dermatological conditions. Methods This cross-sectional survey study involved PCPs in Saudi Arabia. The questionnaire consisted of three sections: demographic information, case scenarios, and questions assessing the ability to manage skin conditions. Knowledge scores were calculated by assigning one point for each correct answer. Participants rated their perceived ability on a Likert scale, ranging from 1 (totally disagree) to 5 (totally agree). Results Diagnostic accuracy was generally high, with between 61.5% and 89.8% of respondents correctly identifying the presented cases. However, only about 50% had effective knowledge of tinea corporis, seborrheic keratosis, acute urticaria, and tinea capitis. Higher knowledge levels correlated with older age (p<0.001), being a consultant or specialist (p<0.001), and working in primary healthcare (p<0.001). While 63.2% felt confident in managing common skin conditions, this confidence correlated weakly with overall knowledge (rho = 0.261, p = 0.002). Additionally, over 90% of PCPs agreed to refer difficult cases. Conclusions The knowledge of PCPs in the management of common skin conditions showed several serious deficiencies, leading to unnecessary referrals to dermatologists. There is a need for specific dermatology training programs for PCPs. Dermatology courses in medical school curricula should focus on preparing students to manage common skin conditions.
Final Patel, Samantha Epstein, Sonal D Shah, Leah Lalor
Pediatr Dermatol. 2025 Apr 27. doi: 10.1111/pde.15960. Online ahead of print.
Abstract: Many pediatric dermatologists train pediatric residents to diagnose and manage common skin conditions. Our study assesses the educational burden and workload pediatric dermatologists face in training pediatric residents (N = 65). Although most pediatric dermatologists (68.2%) agree that their efforts are valued by their department and consider the teaching important (93%), only 12.7% feel they are fairly compensated for this, and 27% attribute teaching pediatric residents to burnout. Our study highlights the need for systemic changes to support teaching efforts through compensation, protected time, or alternative educational models.
Type 1 Diabetes/Hidradenitis Suppurativa Comorbidity-A Population-Based Study
Shany Sherman, Ron Slama, Danielle Bar, Yochai Schonmann, Arnon D Cohen, Yossef H Taieb, Daniel Mimouni, Alon Peretz, Hadar Duskin-Bitan
J Clin Med. 2025 Apr 11;14(8):2625. doi: 10.3390/jcm14082625.
Abstract Background: Type 1 diabetes (T1D) and hidradenitis suppurativa (HS) share several metabolic and inflammatory dysfunctions. Prior studies of the potential link between the diseases either lacked validated T1D diagnoses or established only an indirect association. This study sought to determine the odds of HS developing in patients with a validated diagnosis of T1D and to characterize the clinical features of HS/T1D comorbidity.
Conclusions: T1D is associated with higher odds of the subsequent development of HS. Awareness of HS/T1D comorbidity is recommended owing to the elevated burden of metabolic and autoimmune conditions.
Sheikh M Alif, Geza Benke, Hans Kromhout, Michael J Abramson, Manolis Kogevinas, Debbie Jarvis, Nicole Le Moual, Shyamali Dharmage, Vivi Schlünssen, Kjell Torén, Dan Norback, Theodore Lytras, Anne-Elie Carsin, Cecilie Svanes, Mario Olivieri, Sandra Dorado-Arenas, Isabel Urrutia, Silvia Pascual Erquicia, Sofie Acke, Hayat Bentouhami, Gunilla Wieslander, Nicola Murgia, Jesús Martínez-Moratalla, Bénédicte Leynaert, Katja Radon, Jessica Gerlich, Dennis Nowak, Simona Villani, Mathias Holm, Giuseppe Verlato, Angelo D'Errico, Per Bakke, Trude Duelien Skorge, Torgeir Storaas, Anna Dahlman-Höglund, Johan Hellgren, David Miedinger, Torben Sigsgaard, Paul D Blanc, Jan-Paul Zock
Thorax. 2025 Apr 29:thorax-2024-222307. doi: 10.1136/thorax-2024-222307.
Abstract conclusion: This strengthens the evidence that occupational exposures to sensitisers and chemical irritants contribute substantial risk and a substantive attributable fraction of adult-onset asthma. Control of implicated hazardous exposures and periodic screening of exposed workers should be considered.
Liborija Lugović-Mihić, Dora Bukal, Lorena Dolački, Lucija Zanze, Ema Barac, Renata Tomašević, Maja Vilibić
Pediatr Rep. 2025 Apr 21;17(2):50. doi: 10.3390/pediatric17020050.
Abstract conclusions: Adequate social competencies are essential for healthy mental development, as their impairments may be associated with psychological alterations or psychiatric disorders in childhood and adolescence that potentially persist into adulthood. These findings highlight the need for continuous psychological evaluation and the implementation of intervention programs from an early age. Psychological interventions, such as cognitive behavioral therapy, accompanied by psychopharmaceuticals, such as selective serotonin reuptake inhibitors (when indicated), seem to be the most beneficial treatment options in AD patients who have the most frequent psychiatric comorbidities: depression and anxiety.
Andrew Prestwich, Emma Gerrard, Kate Panniker
Psychol Health. 2025 Apr 24:1-20. doi: 10.1080/08870446.2025.2493885. Online ahead of print.
Abstract Objective: UK-based patients can consult with, and be treated by, pharmacists for various minor medical conditions. However, research needs to identify the psychological factors that influence patients' decisions to consult with a pharmacist over alternative treatment responses. The current study addressed this gap.
Conclusion: Strategies that increase pharmacists' perceived assertiveness and morality could enhance respect and trust of pharmacists. Such changes could facilitate the current drive in the UK to utilize pharmacies more to minimise GP service demand.
Patient Perspectives on Delayed Specialty Follow-Up After a Primary Care Visit
Leonor Fernández, Dru Ricci, Amie Pollack, Maelys J Amat, Meghan Drielak, Talya Salant, Gordon D Schiff, Umber Shafiq, Scot B Sternberg, James Benneyan, Mark Aronson, Erin Sullivan, Russell S Phillips
J Am Board Fam Med. 2025 Apr 23:jabfm.2024.240063R3. doi: 10.3122/jabfm.2024.240063R3. Online ahead of print.
Abstract conclusions: Failure to close diagnostic loops may be more likely when a patient is not given sufficient meaningful information, particularly if there is health system "friction" that reduces the patient's ability and ease to obtain a timely diagnostic referral appointment. Clinicians should use accessible language to communicate why a diagnostic referral is useful and important for the patient's health, and include a specific optimal time frame. The initial communication and the ease of the subsequent appointment booking both matter, and may compound or mitigate each other's effect. To reduce diagnostic referral failures and delays. clinicians should advocate for consistent appointment booking processes that systematically inform, equip, and empower patients with clear and meaningful referral information and timely appointments.
Biologic switching in psoriatic arthritis: Insights from real-world data and key risk factors
Amir Haddad, Nili Stein, Ilan Feldhamer, Arnon Dov Cohen, Walid Saliba, Devy Zisman
Semin Arthritis Rheum. 2025 Apr 17:73:152737. doi: 10.1016/j.semarthrit.2025.152737.
Abstract conclusion: Cross class biologic switching is common in PsA management (48 %) and influenced by patient demographics and comorbidities. Switching patterns were consistent across time periods despite expanding therapeutic options.
Eli Magen, Eugene Merzon, Akim Geishin, Shai Ashkenazi, Iris Manor, Shlomo Vinker, Ilan Green, Avivit Golan-Cohen, Abraham Weizman, Ariel Israel
BMJ Ment Health. 2025 Apr 20;28(1):e301588. doi: 10.1136/bmjment-2025-301588.
Abstract conclusions: Various urticarial diseases are more prevalent in individuals with ADHD, possibly due to shared genetic factors, immune system dysfunction, or environmental triggers.
Clinical implications: This study suggests an association between ADHD and some urticaria subtypes. Physicians should be aware of this association and its public health implications.
M Salinas, E Flores, M Ahumada, M Leiva-Salinas, A Blasco, C Leiva-Salinas; PRIMLAB working group
Clin Biochem. 2025 Apr 17:137:110922. doi: 10.1016/j.clinbiochem.2025.110922.
Abstract conclusion: The laboratory, in collaboration with clinicians and utilizing CDSS, plays a central role in clinical decision-making by reporting SCORE2 risk prediction algorithms and treatment recommendations.
Herpes zoster vaccination: Primary care provider knowledge, attitudes, and practices
Nikita Stempniewicz, Eric Davenport, Jinyi Wang, Carolyn Sweeney
Hum Vaccin Immunother. 2025 Dec;21(1):2488093. doi: 10.1080/21645515.2025.2488093. Epub 2025 Apr 18.
Abstract: Primary care providers (PCPs) play a key role in vaccine recommendations and uptake, but limited information exists about PCP knowledge, attitudes, and practices regarding herpes zoster (HZ) vaccination. Clinical trials have shown that recombinant zoster vaccine (RZV) significantly reduces the risk of developing HZ. Hence, RZV is recommended by the US Advisory Committee on Immunization Practices (ACIP) for adults aged ≥50 years and immunocompromised adults aged ≥19 years. However, RZV uptake varies across age groups, and is lower for adults aged 50-59 compared to those aged ≥60 years. Using a cross-sectional web-based survey, this study described provider knowledge of HZ risk factors, ACIP recommendations, attitudes toward HZ vaccination, and HZ vaccination practices/barriers. Among 301 licensed PCPs in the US, knowledge of HZ risk factors was high, but only 29% were fully aware of the ACIP recommendations. PCPs indicated that HZ vaccination was important for patients aged 50-59, 60-69, and ≥70 years, with importance increasing with advancing age. During a typical week, an average of 44% (standard deviation = 32%) of PCPs reported initiating a conversation about HZ vaccination among adults aged 50-59 years. Key perceived barriers to recommending HZ vaccines to adults were contraindications and insufficient time to assess risk factors, while perceived HZ vaccine administration challenges included patients' out-of-pocket costs and lack of motivation. Results suggest that PCPs may benefit from updated information about ACIP recommendations, while both patients and providers may benefit from streamlining the vaccination process and educational efforts focused on addressing perceived barriers.
Sarah Lee, Itohan Aigbekaen, Jennifer Huang
Acad Pediatr. 2025 Apr 15:102835. doi: 10.1016/j.acap.2025.102835. Online ahead of print.
Abstract conclusions: 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.
Grammatical approach to describing skin lesions: framework and assessment
Adam Cardenas, Emilie A Foltz, Simi Cadmus, Dayna Diven
Dermatol Reports. 2025 Apr 15. doi: 10.4081/dr.2025.10097. Online ahead of print.
Abstract: Teaching the foundation of dermatology for non-dermatologists has proven difficult, especially in a compact undergraduate medical education system. This has consequently led to insufficient preparation of non-dermatologists, including primary care residents, to identify, describe, and manage skin conditions. We present a grammatical approach for learning and describing skin lesions that will provide an early, expandable framework built from easily digestible components. From results in our own institution, we hope this tool will empower trainees of all expertise and specialties to apply their knowledge at the bedside and aid in communication and collaboration with dermatology consultants when needed. Twenty-one first-year medical students at the University of Texas at Austin Dell Medical School voluntarily completed our learning module with a pre- and post-survey, which recorded their confidence in verbally describing common skin lesions and formulating differential diagnoses. 85.7% of respondents said the learning tool helped them better organize a description of skin findings. There was a statistically significant increase in confidence after the learning tool for describing skin lesions (p<0.05) and formulating a differential diagnosis (p<0.05). These results suggest the grammatical approach improves the confidence of trainees by both describing skin lesions and formulating differential diagnoses based on the lesion's description.
Paweł Pietkiewicz, Natalia Salwowska, Verche Todorovska, Marian Voloshynovych, Paweł Falkowski, Piotr Giedziun, Cristian Navarrete-Dechent , Adarsha Adhikari, Nora Pollozhani, Enzo Errichetti
Dermatol Pract Concept. 2025 Apr 1. doi: 10.5826/dpc.1502a5466. Online ahead of print.
Abstract Objective: The study objective was to explore fluorescence patterns in relation to demographic and geographic factors, disease subtype, lesion morphology, Psoriasis Area and Severity Index (PASI) score, seasonal variations, and bathing practices.
Conclusion: The study confirms that red fluorescence in psoriatic lesions under UVFD is suppressed by sun exposure and correlates with disease severity.
Lorenzo Blandi, Paola Bertuccio, Carlo Signorelli, Helmut Brand, Timo Clemens, Cristina Renzi, Anna Odone
J Prev Alzheimers Dis. 2025 Apr 12:100167. doi: 10.1016/j.tjpad.2025.100167.
Abstract conclusions: Our population-based study found an increased risk of developing dementia among severe Zoster cases. Those results support the importance of improving Zoster prevention and extending the vaccination recommendations to younger age groups.
Muhammad Asaduzzaman, Md Zamiur Rahaman, Sadia Afrin, Rifat Ara, Seemab Mehmood, Elena Boriani, K M Saif-Ur-Rahman
Public Health. 2025 May:242:311-318. doi: 10.1016/j.puhe.2025.03.020. Epub 2025 Apr 1.
Abstract conclusions: Our systematic review identifies gender as a factor in antibiotic prescribing that remains insufficiently explored. Further research and policy discussions are needed to examine global prescribing patterns through a gender lens.
Mandy Wan, Ashley P Jones, Daniel Maskrey, Monica Arenas-Hernandez, Anna Rosala-Hallas, Paula E Beattie, Susannah Baron, Fiona Browne, Sara J Brown, Joanna E Gach, Danielle Greenblatt, Ross Hearn, Eva Hilger, Ben Esdaile, Michael J Cork, Emma Howard, Marie-Louise Lovgren, Suzannah August, Farhiya Ashoor, Paula R Williamson, Tess McPherson, Donal O'Kane, Jane Ravenscroft, Lindsay Shaw, Manish D Sinha, Catherine Spowart, Bjorn R Thomas, Tracey H Sach, Alan D Irvine, Carsten Flohr
Clin Exp Dermatol. 2025 Apr 1:llaf147. doi: 10.1093/ced/llaf147. Online ahead of print.
Abstract: This is a secondary analysis of a multicentre randomised controlled trial of ciclosporin and methotrexate in children and young people (CYP) with severe atopic dermatitis (AD). Longitudinal trough ciclosporin and erythrocyte methotrexate polyglutamates (MTX-PG) concentrations were measured to evaluate their associations with treatment response and adverse events. Both ciclosporin (4 mg/kg/day) and methotrexate (0.4 mg/kg/week) led to a significant reduction in disease severity scores over the 36-week treatment period. Higher trough ciclosporin concentrations were associated with lower disease severity scores and may serve as a useful tool for therapeutic drug monitoring of ciclosporin in CYP with AD. However, in contrast to a previously published study, steady-state erythrocyte-MTX-PG concentrations showed no significant association with treatment response. Drug concentrations were comparable between patients with and without drug-related adverse events.