Dermatology

Clobetasol lowers vulvar malignancy risk in lichen sclerosus; TCIs not linked to cancer

In this TriNetX cohort of 55,696 adults, vulvar lichen sclerosus carried an 11-fold higher vulvar malignancy risk than controls over 10 years. Lichen sclerosus also conferred an 8-fold increased risk of vulvar dysplasia compared with matched controls. Among 14,430 clobetasol-exposed patients, clobetasol use reduced vulvar malignancy risk at 2 years (RR 0.62; 95% CI 0.42–0.94) versus steroid-naïve controls. Topical calcineurin inhibitor exposure in 6,227 patients was not associated with increased dysplasia or malignancy at any time point. 1

Nationwide English data map broad multimorbidity burden in atopic eczema

Using English primary care and hospital records, investigators identified up to 3 million people with eczema and 14 million matched comparators. Over as long as 25 years of follow-up, eczema was associated with higher rates of many outcomes across multiple organ systems. In those diagnosed in childhood, excess diagnoses were mainly other atopic or allergic conditions and infections. Inflammatory bowel diseases showed large relative risk increases, including Crohn disease (crude HR 1.70; 95% CI 1.63–1.77). 2

Biologics show cancer outcomes comparable to conventional agents in psoriasis with active or recent malignancy

This surveillance cohort included 333 psoriasis patients with active cancer or malignancy within 5 years, treated with biologics or conventional systemic agents. Over a median 6-year follow-up, progression or recurrence rates per 100 patient-years were similar for biologics (10.7) and conventional therapies (10.5). One-year progression- or recurrence-free survival was 86% in both groups (p=0.89). Biologics did not increase cancer progression risk versus conventional agents (HR 1.02; 95% CI 0.59–1.77). 3

Delgocitinib cream yields rapid, sustained itch and pain relief in chronic hand eczema

This pooled DELTA 1 and 2 phase 3 analysis included 639 delgocitinib-treated and 321 vehicle-treated adults with moderate to severe chronic hand eczema. Delgocitinib twice daily produced a statistically significant itch reduction from day 1 versus vehicle and pain reduction from day 3. Among patients with baseline itch or pain ≥4, more delgocitinib-treated patients achieved ≥4-point reductions from week 2 onward than vehicle-treated patients. Reductions in itch and pain were maintained through week 16, and delgocitinib cream was well tolerated. 4