Primary Care Dermatology Literature November 2025
Skin Research in Primary Care
Alberto Pilotto, Wanda Morganti, Emanuele Seminerio, Eleonora Lacorte, Carlo Custodero, Nicola Veronese, Peter Fielding, Carolina Massone, Paola Piscopo, Elisa Fabrizi, Patrizia Lorenzini, Alberto Magni, Gaetano Piccinocchi, Carlo Ignazzi, Lorenza Busco, Mario Barbagallo, Cesare Massone, Pierangelo Lora Aprile, Nicola Vanacore
BMC Prim Care. 2025 Oct 27;26(1):323. doi: 10.1186/s12875-025-02951-6.
Abstract:
Background: In Europe around 40% of people aged ≥ 65 years are affected by multiple non-communicable chronic diseases (NCDs). The Comprehensive Geriatric Assessment (CGA) showed its usefulness in early identifying healthcare needs of older people with NCDs to develop a care plan to meet these needs. PrimaCare_P3 study aims at assessing healthcare needs of older people referring to their general practitioners (GPs) to plan a personalised prevention programme (PPP) based on the results of the CGA-based short version of the Multidimensional Prognostic Index (BRIEF-MPI).
Conclusions: These data suggest that the CGA-based BRIEF-MPI assessment could effectively identify older adults' healthcare needs to be addressed with a PPP in general practice setting.
Sydnae A Taylor, Mandeep Ubhi, Shaista Tayabali, Rakesh Narendra Modi, Arvind Kaul, Abigail Taiwo, Kaira Naidu, Martha A Piper, Muna Abdullah, Wendy Diment, Elaine Dunbar, James Cantwell, David D'cruz, Melanie Sloan
Ethn Health. 2025 Oct 27:1-22. doi: 10.1080/13557858.2025.2575343. Online ahead of print.
Abstract:
Background: In the United Kingdom (UK), individuals of minoritized ethnic groups report poorer healthcare experiences and face disparities in health outcomes and access to healthcare services relative to their White counterparts. While it has been demonstrated that sociodemographic characteristics play important roles in the risk of developing rheumatic diseases, disease progression, and treatment journeys, there is limited understanding of the experiences of minoritized ethnic groups in the UK. This study aimed to investigate how the social and structural processes associated with ethnicity affect the medical experiences of people with systemic autoimmune rheumatic diseases in the UK.
Conclusions: Our study demonstrated that the socio-structural processes related to ethnicity, namely racism, social deprivation, stereotyping and institutional bias, impact the medical experiences of SARDs patients in multitudinous ways. Some patients reported systemic and interpersonal racism, racialized stereotyping, and mistrust in care, while others listed factors that they considered were protective against discrimination, such as education and location. Socio-cultural factors, including language barriers and variations in clinician understandings of patient experiences, further impact doctor-patient interactions.
Awadh Alamri, Rose A Alraddadi, Dhaii Alzahrani, Amal H Abualola, Hadeel A Maaddawi, Renad F Alharthy, Alanoud Y Alkhashan, Maria Y Ashqan, Esraa A Shaheen, Bashaer Almahdi, Hatoon M Althobaiti
Front Med (Lausanne). 2025 Oct 10:12:1641322. doi: 10.3389/fmed.2025.1641322.
Abstract:
Background: Acanthosis nigricans (AN) is a skin disorder marked by darkening and thickening of the skin, often linked to metabolic abnormalities. This systematic review of randomized controlled trials (RCTs) assesses the comparative effectiveness and tolerability of different topical treatment options of AN, aiming to determine the most suitable therapeutic strategies.
Conclusion: Both urea and tretinoin are effective treatments for AN, choice of therapy should be individualized tretinoin for predominant hyperpigmentation, urea for erythema or lower irritation tolerance, salicylic acid as a tolerable alternative, and TCA peel when stronger procedural options are suitable glycolic peel showed more modest effects.
Sean P Gavan, Katherine Payne, William G Dixon, Sabine N van der Veer, Alexander C T Tam, Nick Bansback
NPJ Digit Med. 2025 Oct 24;8(1):625. doi: 10.1038/s41746-025-01898-3.
Abstract: This study aimed to identify and appraise published cost-effectiveness analyses of mobile device-based active remote monitoring technologies for long-term conditions. A systematic literature review (PROSPERO: CRD42023406364) identified studies from Medline and Embase (2008 until November 2024). Interventions required frequent patient-reported responses to questions about their condition on a mobile device (smartphone or tablet). Seven cost-effectiveness analyses were identified for six long-term conditions: rheumatoid arthritis; schizophrenia; older adults with complex conditions; cancer; multiple sclerosis; inflammatory bowel disease. Interventions facilitated early intervention to prevent condition worsening (n = 4); self-management (n = 2); and patient-initiated care (n = 1). Intervention costs were estimated by top-down costing (n = 2); bottom-up micro-costing (n = 3) and assumptions (n = 2). Mobile device-based active remote monitoring was cost-effective in six of the seven studies with a high degree of decision uncertainty. The results will help decision-makers, intervention developers and analysts to guide resource allocation, product development and study designs for future mobile device-based monitoring interventions, respectively.
David E Goldsbury, Damien McCarthy, Caroline G Watts, Chi So, Olivia Wawryk, Chris Kearney, Gillian Reyes-Marcelino, Kirstie McLoughlin, Jon Emery, Anne E Cust
Public Health Res Pract. 2025 Mar 28;35(1):PU24003. doi: 10.17061/phrp34122406.
Abstract:
Objectives: To describe patterns of skin checks for potential skin
cancers in general practice and subsequent skin-related healthcare, and the
associated costs.
Conclusions: Skin checks for potential skin cancers occur frequently in Australian general practice and accumulate substantial health system costs, with one in five skin checks resulting in subsequent treatment. This study adds to scarce real-world skin check and cost data in Australia.
Manasi Parikh, Gloria Fang, Faith Poon, Manuella Kyeremeh, Daniel Cruz, Karen Ki, Sooyee Huang, Siya Lin, Collin Hong, Hannah O Chan
Front Med (Lausanne). 2025 Oct 6:12:1661554. doi: 10.3389/fmed.2025.1661554.
No abstract available
Differences in prescription for impetigo and cellulitis across years in three European countries
Thomas Bettuzzi, Christophe Strady, Sylvain Diamantis, Matta Matta
J Antimicrob Chemother. 2025 Nov 3:dkaf400. doi: 10.1093/jac/dkaf400. Online ahead of print.
Abstract:
Background: Cellulitis and impetigo account for many outpatients' visits and antibiotic prescriptions. They are mainly caused respectively by Streptococcus spp. and Staphylococcus aureus. French guidelines recommend amoxicillin as a first-line antibiotic for cellulitis and pristinamycin for severe impetigo, whereas the UK guidelines recommend flucloxacillin for both infections and no Belgian guidelines are published.
Conclusion: Prescribing patterns are very heterogeneous across European countries and publication of guidelines did not affect prescribing habits.
Ning Ding, Yinhao Li, Zheng Zhao, Xiangfu Meng, Mingqiang Sun, Xueqing Ren, Ying Wang
Front Med (Lausanne). 2025 Oct 17:12:1667794. doi: 10.3389/fmed.2025.1667794. eCollection 2025.
Abstract:
Conclusion: This machine learning-based diagnostic tool showed strong performance and interpretability in differentiating eczema from psoriasis using routine laboratory data. The user-friendly web interface enables rapid, non-invasive decision support in outpatient clinical settings.
Ryo Saito, Kiyoshi Furutani, Shoji Mihara, Tsunemi Numata, Yoshikazu Kameyoshi, Toshihiko Tanaka, Hajime Shindo, Naomasa Niimi, Kazumasa Iwamoto, Takaaki Hiragun, Makiko Hiragun, Shunsuke Takahagi, Akio Tanaka, Michihiro Hide
J Dermatol. 2025 Oct 31. doi: 10.1111/1346-8138.70027. Online ahead of print.
Abstract: Disease duration of urticaria is variable from days to decades. However, the mechanism of persistence for urticaria is largely unknown. To investigate factors which relate to the prognosis of urticaria, we conducted a cross-sectional analysis on disease durations of 1061 patients with urticaria who visited nine primary dermatology clinics from 1st October to 11th November 2020. Among them, 216 (20.4%) had acute urticaria, while 383 (36.1%) and 125 (11.8%) had suffered from urticaria for 3 years or more and for 10 years or more, respectively. There was no significant difference between males and females in disease duration. In patients under 20 years old, 75 (38.9%) had acute urticaria. By contrast, more than 20% of patients older than 50 years had urticaria for 10 years or more. Disease duration for 3 years or more of patients with dermographism and those with cholinergic urticaria was 42% and 45.3%, respectively. Although a majority of urticaria likely remit, more than one-third of patients at primary dermatology clinics suffer from urticaria for 3 years or longer. The disease duration was longer in older patients, those with dermographism and/or cholinergic urticaria.
Jacob C Williams, Joshua Southworth, Kira Rogers, Sizheng Steven Zhao
Rheumatol Adv Pract. 2025 Oct 13;9(4):rkaf121. doi: 10.1093/rap/rkaf121. eCollection 2025.
Abstract:
Objectives: Inflammatory arthritis (IA) is associated with a high comorbidity burden, yet few studies have compared comorbidities across IA subtypes. We aimed to compare 39 comorbidities across RA, PsA and axial spondyloarthritis (axSpA).
Conclusion: IA is linked to increased comorbidity prevalence, notably in cardiovascular, respiratory and gastrointestinal systems. The prevalence and odds of developing atherosclerotic cardiovascular disease were highest in those with RA. Individuals with axSpA have increased odds of developing epilepsy. These findings highlight the diverse comorbidity profiles across IA subtypes and support tailored management approaches.
Exploring the Disease Duration of Urticaria and Associated Determinants in Primary Care
R Soegiharto, B J Hengevelt, N Boekema-Bakker, I A M Groenewegen, A C Knulst, J M P A Van den Reek, H Röckmann
Clin Exp Allergy. 2025 Oct 30. doi: 10.1111/cea.70170. Online ahead of print.
No abstract available
Sara Mucherino, Annunziata Raimondo, Milana Krstin, Ignacio Aznar-Lou, Marianna Serino, Lara Perrella, Francesca Futura Bernardi, Ugo Trama, Enrica Menditto, Serena Lembo, Valentina Orlando
Pharmaceutics. 2025 Oct 1;17(10):1279. doi: 10.3390/pharmaceutics17101279.
Abstract:
Background: Medication adherence is one of the critical factors in optimizing treatment outcomes for chronic diseases such as atopic dermatitis (AD). Existing studies use aggregate data, but there is a need for assessment of medication adherence phases, such as the initiation and discontinuation of therapy. The aim of this study was to assess medication adherence across patients with moderate to severe AD, investigating the impact of drug treatment characteristics, particularly the route of administration, on adherence levels during treatment.
Conclusions: The observed differences in adherence patterns between topical tacrolimus and subcutaneous dupilumab suggest that distinct contextual and behavioral factors influence patient adherence during therapy.
Yoav Elizur, Mor Amital, Niv Ben-Shabat, Chen Patt, Galia Zacay, Simon Lassman, Dennis McGonagle, Abdulla Watad, Omer Gendelman, Howard Amital
Medicina (Kaunas). 2025 Oct 9;61(10):1809. doi: 10.3390/medicina61101809.
Abstract:
Background and Objectives: To examine the prevalence of fibromyalgia syndrome (FMS) in patients with psoriasis (PsO) and psoriatic arthritis (PsA) and its impact on treatment patterns and biologic therapy adherence.
Conclusions: In PsO patients, especially those with psoriatic arthritis, FMS is linked to greater treatment complexity and shorter biologic therapy survival, underscoring the need for tailored management strategies.
Johnatan Nissan, Michal Baum, Abdulla Watad, Yoav Elizur, Gilad Halpert, Arnon Dov Cohen, Howard Amital
Isr Med Assoc J. 2025 Oct;27(10):615-620.
Abstract:
Background: The association between new-onset atopic dermatitis (AD) and the coronavirus disease 2019 (COVID-19) pandemic was scarcely documented in the literature.
Conclusions: We observed a significant and nearly consistent annual increase in AD incidence from 2017 to 2022, across various sex and age groups. Further research is needed to explore the impact of the COVID-19 pandemic on rising trends in AD incidence.
Lucy Bradshaw, Laura M Howells, Ingrid Muller, Eleanor J Mitchell, Arabella Baker, Leila Thuma, Eleanor F Harrison, Liz Hartshorne, Yimin Jiang, Fiona Cowdell, Paul Leighton, Alan A Montgomery, Jane Ravenscroft, Matthew J Ridd, Miriam Santer, Reiko J Tanaka, Nicholas Hilken, Richard Swinden, Richard Dooley, Carron Layfield, Emma Campbell, Lydia Tutt, Sophia Collins, Natasha K Rogers, Kate Clement, Firoza Davies, Tracy Owen, Mars Eddis-Finbow, Devin Patel, Goldie Putrym, Aaron Foulds, Hywel C Williams, Amanda Roberts, Kim S Thomas
Br J Dermatol. 2025 Nov 10:ljaf417. doi: 10.1093/bjd/ljaf417. Online ahead of print.
Abstract:
Background: Questions about washing are a high priority for people with eczema (syn. atopic dermatitis, atopic eczema) but are rarely the focus of randomised controlled trials (RCTs).
Objectives: To assess the impact of weekly bathing compared to daily bathing in people with eczema in the first of a series of eczema citizen science online trials in the United Kingdom.
Conclusions: The trial found no evidence of a difference in eczema symptoms between bathing or showering weekly compared to daily. These results are helpful for people with eczema, giving them the freedom to choose what suits them best.
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. 2025 Nov 5:llaf481. doi: 10.1093/ced/llaf481. Online ahead of print.
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 potent 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 in both clinicians and women on their own normal 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 include the development of a diagnostic tool and implementation of a complex intervention to expedite diagnosis.
Tinea Vanderwerff, Laurie Newton
J Pediatr Health Care. 2025 Nov 7:S0891-5245(25)00276-7. doi: 10.1016/j.pedhc.2025.09.012. Online ahead of print.
Abstract:
Guttate psoriasis is a dermatological condition that can present suddenly and progress rapidly, often prompting patients to seek medical evaluation. Although a well-recognized condition in dermatology, guttate psoriasis may be unfamiliar to pediatric primary care healthcare providers (HCPs). This case report emphasizes the importance of recognizing guttate psoriasis as a potential sequela of Group A Streptococcus (GAS) infection, particularly in children and adolescents. Additionally, it emphasizes the importance of thorough history-taking and a physical assessment to support accurate diagnoses, improve patient outcomes, minimize unnecessary referrals to dermatology, and ultimately reduce healthcare costs for patients and their families.
Fumi Matsuki, Sumire Suzuki, Takashi Hirose, Tatsuhiko Suzuki, Takahito Yoshida, Yoshihiro Onishi, Ryohei Yamamoto
Gen Fam Med. 2025 Aug 10;26(6):547-554. doi: 10.1002/jgf2.70055. eCollection 2025 Nov.
Abstract:
Background: Atopic dermatitis is a chronic inflammatory skin condition treated with topical corticosteroids as first-line therapy. The Finger-Tip Unit (FTU) serves as an objective indicator for determining appropriate amounts of topical corticosteroids. However, the amount of topical corticosteroids prescribed and the amount actually applied by patients based on the FTU method in clinical practice and its efficiency remain unclear.
Conclusions: In patients with atopic dermatitis, about one-third or more had insufficient corticosteroid prescriptions and applications based on FTUs. All healthcare providers, including primary care physicians, dermatologists, and pharmacists, may ensure prescription amounts and provide guidance on application doses that align with FTU methods.
Treating Venous Leg Ulcers in Primary Care: The Cluster-Randomized Ulcus Cruris Care Trial
Thomas Fleischhauer, Nina Sander, Manuel Feisst, Sinclair Awounvo, Lisa Weller, Regina Poss-Doering, Gunter Laux, Attila Altiner, Uwe Müller-Bühl, Joachim Szecsenyi, Jonas D Senft
Dtsch Arztebl Int. 2025 Dec 12:(Forthcoming):arztebl.m2025.0207. doi: 10.3238/arztebl.m2025.0207. Online ahead of print.
Abstract:
Background: Venous leg ulcers (VLUs) markedly restrict patients' everyday activities and impair their quality of life. Compression is the most important treatment measure but is often not consistently implemented in practice. The aim of the Ulcus Cruris Care (UCC) project was to develop a primary care approach for the systematic support of evidence-based, patient-centered treatment.
Conclusion: This multicenter RCT suggests a potential benefit of the UCC intervention but does not confirm its efficacy. The UCC approach can specifically target deficits in outpatient care for chronic wounds at the primary care level.
Systemic Janus kinase inhibitors in inflammatory dermatoses: A primer for general practitioners
Laxmi Iyengar, John C Su
Aust J Gen Pract. 2025 Nov;54(11):793-797. doi: 10.31128/AJGP-12-24-7487.
Abstract:
Background: General practitioners (GPs) are increasingly encountering patients treated with novel disease-modifying systemic treatments for chronic inflammatory conditions. The Janus kinase (JAK) signalling pathway has been strongly implicated as a key mediator in a broad cohort of chronic inflammatory conditions including rheumatoid arthritis, inflammatory bowel disease and, more recently, selective small molecule JAK signalling inhibitors have been used to treat inflammatory dermatoses such as atopic dermatitis and have led to promising outcomes.
Objective: This narrative review will discuss the role of JAK/signal transducers and activators of transcription (STAT) signalling in atopic dermatitis and other inflammatory skin conditions.
Discussion: A better understanding of the risks and benefits of JAK inhibitors, along with the recommended monitoring guidelines, will result in improved patient outcomes.
Alexandre Ladet, Sandra Lawton, Michael J Boffa
Dermatol Pract Concept. 2025 Oct 1;15(4):e20255208. doi: 10.5826/dpc.1504a5208.
Abstract:
Conclusion: This review demonstrates the value of training PCPs in dermoscopic diagnostic algorithms through short courses to improve triage of suspicious lesions. However, it is still necessary to define a territorial organization, a precise working framework and limits for PCPs who take on this role.
Raymond Matthews, April W Armstrong, Matthias Augustin, Christopher Baker, José Manuel Carrascosa, Brian Kirby, Richard Langley, Sandy McBride, Adam Reich, Ricardo Romiti, Francesca Sampogna, Richard B Warren
Dermatol Ther (Heidelb). 2025 Nov 22. doi: 10.1007/s13555-025-01573-1.
Abstract:
Introduction: Delays remain in patients receiving effective treatment strategies that have potential to clear their skin of psoriasis, improve their quality of life (QoL) and change the psoriatic disease course, which, if uncontrolled, can irreversibly alter an individual's life course (i.e. cumulative life course impairment [CLCI]). This study explored current international awareness and consideration of the potential impact of psoriasis over the life course within clinical assessments and decisions about its management.
Conclusions: Misalignment exists in the experience of people living with psoriasis versus its assessment in clinical practice. Support is needed for assessment and monitoring of elements that may contribute to CLCI in clinical practice worldwide, to guide early psoriasis treatment decision-making to mitigate the risk for CLCI. Infographic available for this article. INFOGRAPHIC.
Paula Andrea Ramos Chaparro, Erwin Hernando Hernández Rincón, Nicolas Melo Sierra, Gabriela Alejandra Osorio Betancourt, Diana Marcela Díaz Quijano, Samuel David Barbosa Ardila, Mariam Rolón Cadena, Alejandro Rueda Rodríguez
Medwave. 2025 Nov 20;25(10):e3120. doi: 10.5867/medwave.2025.10.3120.
Abstract:
Introduction: Artificial intelligence (AI) is increasingly present in dermatology, demonstrating accuracy levels comparable to, or even superior to, those of dermatologists in diagnosing skin lesions from clinical and dermoscopic images. This review provides an overview of AI's role in the automated classification and monitoring of skin lesions.
Conclusions: This narrative review highlights the crucial role of AI in dermatology, emphasizing its potential to enhance diagnostic accuracy for skin lesions.
An Online Questionnaire Improves Outcomes for Children With Atopic Eczema
Danielle Paea, Kate L Francis, David Orchard
Australas J Dermatol. 2025 Nov;66(7):e420-e432. doi: 10.1111/ajd.14574. Epub 2025 Aug 13.
Abstract:
Background: Atopic dermatitis (AD) is a condition where management can be complicated as it involves significant education about a variety of triggers and treatment options. Access to specialist care for eczema is often limited in many situations, leading parents of children with AD to seek online support for guidance on effective management strategies.
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.
Lian van der Gang, Keneshka Atash, Nicolaas Zuithoff, Inge Haeck, Celeste Boesjes , Octavian Bacoş-Cosma, Laura Loman, Marijke Kamsteeg, Simone Stadhouders-Keet, Albert Oosting, Anneke van Lynden-van Nes, Klaziena Politiek, Antoni Gostynksi, Lisette Berntsen-Zandbergen, Wianda Christoffers, Annebeth Flinterman, Wouter R Touwslager, Berit Velstra, Shiarra Stewart, Francine van Erp, Marlies de Graaf, Marie-Louise Schuttelaar, Marjolein S de Bruin-Weller
J Eur Acad Dermatol Venereol. 2025 Dec;39(12):2056-2068. doi: 10.1111/jdv.20674.
Abstract:
Background: Limited data exist on the comparative risk of infections during biologic and Janus kinase inhibitor (JAKi) treatment for atopic dermatitis (AD) in daily practice.
Conclusions: This cohort study demonstrated an increased risk of infection during JAKi treatment compared to dupilumab for moderate-to-severe AD. These findings enhance understanding of the differential infection risk with targeted therapies in AD, aiding tailored treatment choices that consider patient-specific risks such as prior skin infections.