Dermatology

GLP‑1 RAs linked to more psoriasis but fewer autoimmune blistering diseases than DPP‑4 inhibitors

In a TriNetX target‑trial emulation of adults with type 2 diabetes (n=169,630 matched pairs), GLP‑1 RA initiation was associated with increased psoriasis risk (HR 1.19) versus DPP‑4 inhibitors. The same comparison showed lower risks of pemphigus (HR 0.32) and bullous pemphigoid (HR 0.61) with GLP‑1 RAs. Outcomes within 3 months were excluded to reduce protopathic bias, and results persisted across sensitivity and subgroup analyses. Applicability is to adults initiating GLP‑1 RAs or DPP‑4 inhibitors; residual confounding remains possible despite matching. 1

Consensus core outcome set for melasma clinical trials

A Delphi and consensus process produced a seven‑domain core outcome set for melasma trials, including pigmentation intensity, color of dark spots, area/distribution, and overall severity. Patient‑centered domains include treatment satisfaction and quality of life, plus persistent versus transient adverse events. Hormonal and intrinsic vascular factors were excluded for feasibility reasons, and Hispanic representation in the consensus was limited. Routine adoption will improve trial comparability and facilitate data pooling in melasma research. 2

Sensory symptoms and anxiety drive quality‑of‑life impairment in genital lichen sclerosus

In 217 adults with genital lichen sclerosus, 36.4% had symptoms‑related QoL impairment and 20.9% had psychosocial QoL impairment. Higher sensory symptom intensity, especially pruritus, and greater anxiety/depression were associated with worse QoL in multivariate models. Anxiety partially mediated the link between burning and psychosocial QoL and fully mediated the relapse‑psychosocial QoL relationship. Findings support integrated dermatologic and psychological assessment and treatment for patients with genital LS. 3