Primary Care Dermatology Literature Jan 2026
Skin Research in Primary Care
Julian Matthewman, Anna Schultze, Krishnan Bhaskaran, Amanda Roberts, Spiros Denaxas, Kathryn E Mansfield, Sinéad M Langan
Nat Commun. 2025 Dec 20. doi: 10.1038/s41467-025-67247-w. Online ahead of print.
Abstract: Atopic eczema may be associated with multiple health conditions. Here, we systematically explore risks across the full health spectrum based on the International Classification of Diseases, assessing associations between eczema and 2058 ICD-10 codes, 1593 phecodes, and 201 Global Burden of Disease codes. In English primary care electronic health records (1997 - 2023) we identify cohorts of people with eczema (up to 3 million) and matched (by age, sex, general practice) comparators without eczema (up to 14 million). In up to 25 years of follow-up, we capture outcomes recorded during hospital admissions. People with eczema show higher rates of several outcomes across multiple organ systems. Among those followed up from eczema diagnosis in childhood, atopic/allergic conditions and infections account for most excess diagnoses. Consistent across cohorts and analyses, large relative risk increases are seen for inflammatory bowel conditions (e.g., K50 Crohn disease, crude hazard ratio 1.70 [1.63-1.77]) and eye diseases (e.g., H16 Keratitis, crude hazard ratio 1.71 [1.57-1.86]). We provide a dashboard to explore and browse the full range of results.
L Ferrándiz, J A Heras-Hitos, P Casas Rodríguez, A Valcarce-Leonisio, O San Martín, R Ruiz-Villaverde
Actas Dermosifiliogr. 2025 Dec 18:104585. doi: 10.1016/j.ad.2025.104585.
Abstract: Actinic keratosis is a skin disease with the potential to progress to cutaneous squamous cell carcinoma, making its treatment essential. However, the last update of the Spanish adaptation of the European clinical guidelines dates back to 2014. This document includes the recommendations agreed upon by 75 primary care and dermatology experts on the optimal management of patients with actinic keratosis. In general, early and detailed diagnosis of actinic keratosis using dermoscopy and referral to dermatology is recommended, especially in high-risk patients. Regarding treatment, experts recommend the use of treatments adapted to the degree and extent of the injuries, highlighting the use of molecules such as 5-fluorouracil for isolated and field of cancerization injuries, as well as tirbanibulin for grade 1 and 2 isolated and field of cancerization injuries. These consensual recommendations seek to serve as a clinical guide on the routine management of patients with actinic keratosis.
Antibiotic use and guideline concordance in primary care acne management: A cross-sectional study
Shipra Lather, Waseemah Begam Abdul Azeez, Joelle Lam, Justin Wee-Min Chong, Pey Gein Wong, Howard Bauchner, Sky Wei Chee Koh
Ann Acad Med Singap. 2025 Oct 15;54(11):752-754. doi: 10.47102/annals-acadmedsg.2025130.
No abstract available
Elizabeth V Seiverling, Asghar Shah, Martin A Weinstock, Jane M Grant-Kels, Nathan P Falk, Daniel M Siegel
J Clin Aesthet Dermatol. 2025 Oct;18(10):59-65.
Abstract:
Background: Skin cancer is the most common cancer faced by adults in
the United States. Melanoma, while a less common subtype of skin cancer
compared to basal cell and squamous cell carcinomas, is associated with greater
rates of metastases, mortality, and morbidity, and its rate of incidence is
projected to increase. Primary care physicians (PCPs) can play an important
role in skin cancer detection and in the decision to refer a patient to a
dermatologist. Technologies such as the elastic scattering spectroscopy (ESS)
device (DermaSensor, Inc.), a handheld, noninvasive assistive tool, may help in
the evaluation of a skin growth and improve appropriate referral decision
making.
Conclusion: The ESS device improved PCP accuracy in managing lesions suggestive of melanoma and increased their sensitivity for all skin cancers and melanoma. Participating internal medicine and family medicine physicians reported increased confidence in their assessments with the device. The ESS device can improve PCP decision making when managing lesions suggestive of melanoma.
Susannah Baron, Rukshana Ali, Maria Akinde, Alpa Kanji, Amy Dobson, Carsten Flohr, Carrie Cheung, Ingrid Muller
Br J Dermatol. 2025 Dec 19;193(Supplement_3):ljaf465.002. doi: 10.1093/bjd/ljaf465.002.
Abstract: Eczema, an itchy skin condition, affects up to 20% of children. Habitual scratching/chronic itch-scratch cycle promotes inflammation, infection, affects sleep and causes psycho-social distress. Habit reversal has been used to reduce scratching and improve eczema but randomised controlled trial (RCT) evidence is limited, particularly in children, and no RCTs have utilised virtual interventions. The Kids in Control (KIC) MDT team was awarded a UKDCTN themed research grant to develop and assess the acceptability, usability, and feasability of a virtual behavioural intervention for children aged 8-12 with itchy eczema. Existing educational and intervention materials were refined to a virtual 3 part programme designed to increase eczema understanding, scratching awareness and change scratching behaviour. Using the person based approach to intervention development a bespoke KIC website was built and parents/children were invited to participate in qualitative think-aloud interviews (nationally via Eczema Outreach Support and National Eczema Society) designed to ensure the intervention was acceptable, meaningful, and optimally engaging. A balanced group of 8 children/parents participated in individual, transcribed think aloud interviews and then a table of changes and thematic analysis was completed. Key themes explored were engaging material, willingness to try it, self efficacy, relatability, eczema impact, parent facilitation and understanding the material. Key changes were made and the modified KIC was explored in a transcribed virtual focus group of 4 children/parents. Analysis of key themes enabled further changes resulting in a 3 part optimally engaging virtual behaviour intervention programme ready for further evaluation in a trial setting.
Liam Neal, Tom Yates, Sharmin Shabnam, Matthew McCarthy, Paddy C Dempsey, Melanie Davies, Kamlesh Khunti, Francesco Zaccardi
Diabetes Res Clin Pract. 2025 Dec 15:231:113058. doi: 10.1016/j.diabres.2025.113058.
Abstract:
Aims: Diabetic foot ulceration (DFU) is a serious complication of diabetes. Frailty is common in individuals with type 2 diabetes and has been associated with a higher mortality risk. We investigated the risk of DFU and mortality in relation to frailty in individuals with type 2 diabetes.
Conclusions: Information on age and frailty at type 2 diabetes diagnosis is necessary to enhance risk stratification and guide personalised diagnostic and therapeutic strategies for DFU.
Topical steroid withdrawal: a serious, under-recognised skin condition
Fatima N Hamed, Rhiannon A Bates, Claire Daley, Hadi Abushaira
BMJ Case Rep. 2025 Dec 16;18(12):e264476. doi: 10.1136/bcr-2024-264476.
Abstract: Topical steroid withdrawal (TSW) is a serious and often under-recognised dermatological condition. It is an adverse reaction to prolonged use of topical corticosteroids (TCS), which may occur following tapering or sudden cessation of treatment. TCS are widely used in the therapeutic management of various dermatological conditions, demonstrating notable efficacy in treating conditions such as atopic eczema and psoriasis. However, it is now recognised that prolonged use of TCS can lead to the development of TSW. TSW is characterised by the skin's dependence on exogenous steroids, with symptoms emerging when the skin becomes less responsive to treatment; when TCS are tapered or after they are discontinued. Common symptoms of TSW include burning, itching, erythema and skin thinning, which can extend beyond the original areas of steroid application.As public awareness of TSW continues to grow, the condition has also emerged as a pressing focus in dermatological research. Despite these advancements, the underlying pathophysiology of TSW remains intricate and only partially understood. Diagnosis poses a significant challenge due to the highly variable clinical presentations, emphasising the critical need for timely recognition. Early and accurate recognition not only prevent potential mismanagement but also ensure that patients receive the comprehensive support necessary to navigate this often-debilitating condition.This report presents and dissects a clinical case of TSW and includes a detailed account from a TSW patient over a period of 22 months. The report aims to highlight the complexities involved in diagnosing and managing the condition, emphasise the necessity for heightened awareness among clinicians and encourage the development of tailored interventions in clinical practice to address the unique challenges posed by TSW.
Jiayue Zheng, Karla Robles-Velasco, Sonia Sharma, Isabel Canzi Almada de Souza Lima, Veronica Ferris Pasquini, Rodrigo G Ducati, Hermenio Lima
Sci Rep. 2025 Dec 25. doi: 10.1038/s41598-025-32163-y. Online ahead of print.
No abstract available
Factors influencing quality of life in patients with psoriasis: A large cross-sectional study
Jieyi Wang, Zhaoping Lin, Xiaoting Wu, Xuqin Hong, Guo Tian, Hui Li, Dongying Luo, Guiyuan Zhang, Cong Huang, Kaoyuan Zhang, Chaofeng Chen, Mengxing Cui, Weiwei Tian, Weilong Zhong, Bo Yu, Yanfen Zou, Bo Liang, Changbing Shen, Jing Gao
Chin Med J (Engl). 2025 Dec 24. doi: 10.1097/CM9.0000000000003841.
Abstract:
Background: Psoriasis is a systemic disease that brings enormous mental pressure and economic burden to patients and has a significant impact on patients' quality of life (QoL). This study aimed to explore factors affecting the dermatology life quality index (DLQI) in patients with psoriasis.
Conclusion: Physicians should focus on significant factors, such as sex, age, marital status, education, work status, sub-types, disease course, PASI score, without joint pain, and without nail holes, to improve the QoL of patients with psoriasis.
Emek Kocatürk, Pascale Salameh, Riccardo Asero, Mojca Bizjak, Ana Gimenez-Arnau, Clive Grattan, David Pesqué, Nidia Planella-Fontanillas, Leonie Shirin Herzog, Thomas Buttgereit, Hanna Bonnekoh , Daria Fomina, Elena Kovalkova, Marina Lebedkina, Alicja Kasperska-Zajac, Magdalena Zając, Mateusz Zamłyński, Kanokvalai Kulthanan, Papapit Tuchinda, Maryam Khoshkhui, Zohreh Hassanpour, Jonny Peter, Aurelie Du-Thanh, Raisa Meshkova, Mohamed Abuzakouk, Michael Makris, Laurence Bouillet, Alexis Bocquet, Stamatios Gregoriou, Simon Francis Thomsen, Joachim Dissemond, Petra Staubach, Andrea Bauer, Inna Danilycheva, Martijn van Doorn, Claudio Parisi, Martin Metz, Joachim W Fluhr, Torsten Zuberbier, Karsten Weller, Pavel Kolkhir
J Eur Acad Dermatol Venereol. 2026 Jan;40(1):67-78. doi: 10.1111/jdv.70027. Epub 2025 Sep 18.
Abstract:
Background: Chronic spontaneous urticaria (CSU), a disease predominantly affecting females, has limited information available on its differences between females and males of varying ages.
Conclusions: Compared with males, female CSU patients experience more burdensome disease, which gets worse in midlife.
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 Dec 23;51(1):27-34. doi: 10.1093/ced/llaf362.
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: Using ARM we found that the most frequently prescribed drug combinations associated with increased BP risk were used to treat cardiovascular diseases and hypertension. Patients should be vigilant for skin changes following these drugs rather than avoid them.
Association of autoimmune diseases with chronic rhinosinusitis in general practices in Germany
D U Seidel, S Bode, K Kostev
Rhinology. 2026 Jan 5. doi: 10.4193/Rhin25.241. Online ahead of print.
Abstract:
Several population-based studies have reported increased prevalence of autoimmune diseases (AID) in patients with chronic rhinosinusitis (CRS). Large-scale datasets from Taiwan demonstrated associations between CRS and conditions such as rheumatoid arthritis, ankylosing spondylitis, polymyositis, psoriasis, Sjögren's syndrome, and systemic lupus erythematosus (SLE) (1,2). However, sex-specific patterns have not been investigated. We examined associations between CRS and 20 pre-existing AID using a nationally representative primary care database, with a focus on sex-specific differences. Data were drawn from the IQVIA Disease Analyzer (>1,300 general practices in Germany, including diagnoses and prescriptions). Adults with an initial diagnosis of CRS (ICD-10: J32) between 2010-2024 were matched 1:1 to controls without CRS or nasal polyps (J33), based on age, sex, observation time, and CRS-related comorbidities (3) (Figure S1, online supplement). Conditional logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals, stratified by sex. We also performed subgroup analyses by age, asthma, allergy, and nicotine dependence.
Tips for teaching skin procedures to family medicine residents
Farhad Motamedi, Christine Rivet, Eric Wooltorton
MedEdPublish (2016). 2025 Dec 12:15:23. doi: 10.12688/mep.20422.2. eCollection 2025.
Abstract:
Background: As the incidence of skin cancer is growing and access to specialty care is becoming more limited in most settings, family physicians must take on an increasing role in detecting and managing skin cancer. Unfortunately, most family physicians are not adequately trained to perform the skin biopsies or excisions needed to do this.
Conclusions: Family medicine training programs have a responsibility to ensure that their learners gain adequate expertise to diagnose skin cancers. This includes the ability to perform skin biopsies. These tips will help educators and institutions training family medicine residents design more effective ways to teach skin procedures.
Alexander Shayesteh, Maja Af Klinteberg, Sophie Vrang, Gunnthorunn Sigurdardottir, MariHelen Sandström Falk, Mikael Alsterholm
JMIR Form Res. 2025 Dec 31:9:e85183. doi: 10.2196/85183.
Abstract conclusions: This study investigates health care utilization patterns related to TSW. The results indicate that the participants received insufficient support from health care providers for symptoms they attributed to TSW. The participants initiated and maintained health care provider contacts for symptoms attributed to AD to a greater extent than for TSW and sought information and support for TSW elsewhere. Targeted interventions to overcome this could be educational efforts for general practitioners and dermatologists about the current scientific knowledge of TSW as well as the TSW discourse on social media. In addition, health care providers need to engage and contribute to evidence-based content about TSW on relevant social media platforms to prevent the spread of misinformation about topical glucocorticoids.
Hidradenitis Suppurativa Education for General Practitioners: A Pilot Study
Anneliese Willems, Annika Smith, Erin McMeniman
Australas J Dermatol. 2025 Dec 30. doi: 10.1111/ajd.70037. Online ahead of print.
No abstract available
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. 2026 Jan;53(1):131-134. doi: 10.1111/1346-8138.70027. Epub 2025 Oct 31.
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.
Rita Branco Vargas, Tomás Costa, Teresa Leitão, Pedro Farinha, Miguel Peliteiro, Bruno Duarte, Cátia Santos
Cureus. 2025 Dec 18;17(12):e99541. doi: 10.7759/cureus.99541. eCollection 2025 Dec.
Abstract:
Atopic dermatitis (AD) is a chronic inflammatory skin disease with a significant impact on quality of life and healthcare systems. In Portugal, access to specialist care remains limited, particularly for patients requiring advanced therapies available only in hospital settings. This study aimed to implement and evaluate a structured referral protocol between primary and hospital dermatology services to improve AD management. Between April 2024 and February 2025, adult patients (≥18 years) coded with AD were identified at the USF Planície primary care center and assessed using a structured telephone questionnaire evaluating disease severity (Patient-Oriented Eczema Measure (POEM)), pruritus (Itch Numeric Rating Scale (INRS)), and sleep disturbance (Sleep Numeric Rating Scale (SNRS)). Of 213 identified patients, 119 (55.8%) were excluded - 94 (44.1%) could not be contacted; 19 (8.9%) denied the diagnosis; and 6 (2.8%) refused to participate - and 94 (44.1%) completed the assessment. Among these patients, 74 (78.7%) had mild or well-controlled disease, whereas 21 (22.3%) presented with moderate-to-severe AD. Patients with moderate-to-severe POEM showed a higher disease burden, with INRS ≥ 5 in 17 patients (85.0%), SNRS ≥ 5 in 5 patients (25.0%), and involvement of high-impact areas in 15 patients (75.0%), whereas in mild POEM, most patients had INRS < 5 (71, 95.9%), SNRS < 5 (74, 100%), and limited involvement of high-impact areas (16, 21.6%). This protocol demonstrated feasibility and clinical relevance, improving patient stratification and facilitating timely referral for specialist evaluation.
Nathaniel Baffoe-Mensah, Jules B Lipoff, Christine M Forke
J Med Educ Curric Dev. 2026 Jan 14:13:23821205251407778. doi: 10.1177/23821205251407778. eCollection 2026 Jan-Dec.
Abstract:
Background: Cutaneous Lyme disease presents differently in light versus dark skin, and delayed diagnosis can increase outcome severity. Insufficient exposure to manifestations of Lyme disease in dark skin during medical training may contribute to health inequities due to late or missed diagnoses. It remains unclear how Lyme disease, specifically, is represented in commonly used medical training materials. To inform curricula updates, we identified primary educational resources used for teaching dermatology at top-tier U.S. medical schools and assessed the representation of erythema migrans on light and dark skin in these materials.
Conclusions: Among commonly used medical student resources, few contain images of erythema migrans on dark skin; these were only found in web-based resources published since 2020. This differential representation has the potential to contribute to inequitable diagnosis and treatment across racial groups.
Kristina Nazzicone, Erin Dahlke, Linden Head, Thomas Herzinger, Lourdes Ramírez Hobak, Yuanshen Huang, Menelaos Konstantinidis, Glykeria Martou, Sonja Molin, Douglas R McKay, Yuka Asai
Int J Dermatol. 2026 Jan 18. doi: 10.1111/ijd.70300. Online ahead of print.
No abstract available
Melba Muñoz, Pascale Salameh, Magdalena Zajac, Daria Fomina , Elena Kovalkova, Elena Bobrikova, Gerelma Andrenova, Alicja Kasperksa-Zajac, Felix Aulenbacher, Leonie Shirin Herzog, Eva Maria Grekowitz, Thomas Buttgereit, Ana M Giménez-Arnau, Nidia Planella-Fontanillas, David Pesque, Maria Puertolas, Kanokvalai Kulthanan, Papapit Tuchinda, Mojca Bizjak, Mitja Košnik, Maryam Khoshkhui, Farahzad Jabbari Azad, Raisa Meshkova, Sergey Savchenko, Michael Makris, Niki Papapostolou, Jonny G Peter, Cascia Day, Cathryn McDougall, Mohamed Abuzakouk, Laurence Bouillet, Andrea Bauer, Claudio Alberto Salvador Parisi, Stamatios Gregoriou, Petra Staubach-Renz, Joachim Dissemond, Emek Kocatürk, Martijn B A van Doorn, Riccardo Asero, Clive Grattan, Simon Francis Thomsen, Aurélie Du-Thanh, Yana Hackler, Karsten Weller, Pavel Kolkhir
Clin Exp Allergy. 2026 Jan 14. doi: 10.1111/cea.70215. Online ahead of print.
Abstract:
Objective: The impact and contributing factors of DD in CU are unknown and were assessed in the present study.
Conclusions: Diagnosis of CU is delayed in one out of four patients. Greater awareness of the guideline-recommended CU classification, clinical presentation, and diagnostic work-up can facilitate CU diagnosis.
Julian Matthewman, Anna Schultze, Krishnan Bhaskaran, Amanda Roberts, Spiros Denaxas, Kathryn E Mansfield, Sinéad M Langan
Nat Commun. 2025 Dec 20;17(1):555. doi: 10.1038/s41467-025-67247-w.
Abstract: Atopic eczema may be associated with multiple health conditions. Here, we systematically explore risks across the full health spectrum based on the International Classification of Diseases, assessing associations between eczema and 2058 ICD-10 codes, 1593 phecodes, and 201 Global Burden of Disease codes. In English primary care electronic health records (1997 - 2023) we identify cohorts of people with eczema (up to 3 million) and matched (by age, sex, general practice) comparators without eczema (up to 14 million). In up to 25 years of follow-up, we capture outcomes recorded during hospital admissions. People with eczema show higher rates of several outcomes across multiple organ systems. Among those followed up from eczema diagnosis in childhood, atopic/allergic conditions and infections account for most excess diagnoses. Consistent across cohorts and analyses, large relative risk increases are seen for inflammatory bowel conditions (e.g., K50 Crohn disease, crude hazard ratio 1.70 [1.63-1.77]) and eye diseases (e.g., H16 Keratitis, crude hazard ratio 1.71 [1.57-1.86]). We provide a dashboard to explore and browse the full range of results.
Giselle Mosnaim, Sarbjit S Saini, Michael Holden, David M Lang, Stephanie L Mehlis, Ewa H Schafer, Jonathan A Bernstein
J Allergy Clin Immunol Glob. 2025 Dec 17;5(2):100626. doi: 10.1016/j.jacig.2025.100626. eCollection 2026 Mar.
Abstract:
Background: Chronic spontaneous urticaria (CSU) is a debilitating condition of the skin that leads to significant negative impacts on patient quality of life and psychological well-being. Given the complexities of the disease, care of patients with CSU is not always optimal, which presents the medical community with an opportunity to improve.
Conclusions: Greater understanding of patient factors, physician perspectives, and avenues to improve quality of care will assist physicians in providing better care, improving quality of life for patients with CSU. This study is an opportunity to provide patients with CSU with better understanding, support, and treatment.
Alexander R Gomez-Lara, Adam Zakaria, Maria Elena Sanchez-Anguiano, Erin H Amerson
JAAD Int. 2025 Nov 27:24:338-341. doi: 10.1016/j.jdin.2025.11.016. eCollection 2026 Feb.
No abstract available
The Cost-Effectiveness of Community Health Workers in Primary Health Care: A Systematic Review
Tijs Van Iseghem, Laura Vroonen, Emilie Op de Beeck, Annick Meertens, Caroline Masquillier, Edwin Wouters, Nick Verhaeghe
Value Health. 2026 Feb;29(2):324-344. doi: 10.1016/j.jval.2025.09.004. Epub 2025 Sep 20.Abstract:
Objectives: Global interest in community health worker (CHW) programs in primary health care (PHC) is rising because of their potential to advance universal health coverage and other global health goals. This systematic review examines the evidence on the cost-effectiveness of CHW interventions worldwide, with a focus on vulnerable populations in PHC settings.
Conclusions: This review found that CHWs can be cost-effective across multiple health domains, both in low-and middle-income countries and high-income countries. The lack of probabilistic sensitivity analysis, together with heterogeneity in contexts, interventions, and methods used to assess the cost-effectiveness of the CHW interventions makes it difficult to draw general conclusions about the value for money of CHWs in PHC.