A Cohort Study

[Posted 27/Feb/2023]

AUDIENCE: Dermatology, Oncology

KEY FINDINGS: Microsatellites were associated with other adverse melanoma prognostic factors. A multivariate Cox regression analysis showed that they are an independent risk factor for worse OS, MSS, and disease-free survival. Patients with stage IIIB melanoma with microsatellites had worse OS and MSS, whereas patients with stage IIIC melanoma had worse OS but not MSS.

BACKGROUND: There is limited information on microsatellite survival outcomes in patients with melanoma. Purpose of this study is to evaluate survival outcomes in patients with microsatellites, assess their role within stage III stratification of the American Joint Committee on Cancer classification, and assess the results of sentinel lymph node biopsies in patients with microsatellites.

DETAILS: A retrospective bicenter cohort study from 1998 to 2019 included patients with a diagnosis of invasive cutaneous melanoma. Of a total of 5216 patients, 108 (2.1%) had microsatellites at initial staging. Survival analysis showed that microsatellites were an independent risk factor with decreased overall survival (OS), melanoma-specific survival (MSS), and disease-free survival, with hazard ratios of 1.57, 1.76, and 1.76, respectively. Stratified analysis in patients with stage III melanoma showed a 5-year OS of 35% (95% CI, 17.3%-73.4%) and a MSS of 45% (95% CI, 23.1-87.5) for patients with stage IIIB melanoma with microsatellites.

Copyright © Elsevier Ltd. All rights reserved.

Source: Riquelme-Mc Loughlin, C., Sandoval-Clavijo, A., Blnco de Tord, M., et al. (2023). Prognostic Role Of Microsatellites In Melanoma and Implications In The American Joint Committee On Cancer Classification System: A Cohort Study. Journal of the American Academy of Dermatology. 2023; 88(2): 338-347. Published: February, 2023. DOI: 10.1016/j.jaad.2022.10.027.

A Retrospective Repeated Cross-Sectional Study

[Posted 3/Oct/2025]

AUDIENCE: Family Medicine, Infectious Disease

KEY FINDINGS: Medicare beneficiaries aged 65 years and older with HIV in the USA were more likely to receive opioid prescriptions and have OUD indicators than matched beneficiaries without HIV. Findings could help guide clinical opioid prescription guidelines and public health surveillance among this vulnerable ageing population.

BACKGROUND: There is longstanding concern that people with HIV receive prescription opioids at higher rates and have a disproportionate burden of opioid use disorder (OUD) compared with their counterparts without HIV. We aimed to evaluate trends of opioid prescriptions and indicators of OUD in an understudied but growing population of older adults with HIV.

DETAILS: For this retrospective repeated cross-sectional study, authors constructed annual cohorts through a nationally representative sample of fee-for-service Medicare beneficiaries aged 65 years and older in the USA with Part D coverage (ie, prescription drug) enrolled between Jan 1, 2008, and Dec 31, 2021. Beneficiaries were eligible for inclusion in each cross-sectional cohort if they had reached the age of 65 years by Jan 1 of the calendar year and had 1 year of continuous Medicare enrolment in Part A (inpatient hospital care), B (outpatient care), and D. Beneficiaries with HIV were matched in a 1:3 ratio to beneficiaries without HIV on age, sex, race or ethnicity, US state, and dual eligibility status (Medicare and Medicaid). The main outcomes were receipt of at least one opioid prescription and any indicator of OUD (ie, formal diagnosis, medication for OUD, or opioid-related or emergency department visits) during each calendar year. Generalised estimating equations were used to estimate odds ratios (ORs) of each outcome, comparing matched beneficiaries with or without HIV. Due to data availability, our analysis of indicators of OUD was restricted to 2008-16. Across all years, 163,429 beneficiaries with HIV and 490,287 beneficiaries without HIV were included (475,516 [72.7%] were male, 178,200 [27.3%] were female; 305,776 [46.8%] were non-Hispanic White, 238,172 [36.4%] were Black [or African American], 84,128 [12.9%] were Hispanic, 8964 [1.4%] were Asian or Pacific Islander, and 16,676 [2.6%] were other races or ethnicities). During 2008-21, 57,373 (35.1%) of 163,429 people with HIV and 138,547 (28.3%) of 490,287 people without HIV received at least one opioid prescription. During 2008-16, 2408 (3.1%) of 76,637 people with HIV and 2831 (1.2%) of 229,911 people without HIV had any indicator of OUD. Across all analysed years, beneficiaries with HIV had significantly increased odds of receiving at least one opioid prescription (OR 1.38, 95% CI 1.36-1.39) and having indicators of OUD (2.61, 2.47-2.76) compared with their matched counterparts without HIV.

Copyright © The Author(s). Elsevier Ltd. All rights reserved.

Source: Shiau, S., Drago, F., Kinkade, C. W., et al. (2024). Prescription Opioid Use and Opioid Use Disorder Among Older Adults With HIV in the USA From 2008 to 2021: A Retrospective Repeated Cross-Sectional Study. The Lancet Primary Care. 2025; 1(3): 100017. Published: September, 2025. DOI: 10.1016/j.lanprc.2025.100017.

A Prospective Interventional Study

[Posted 29/Sep/2025]

AUDIENCE: General Surgery, Internal Medicine, Hematology

KEY FINDINGS: Curettage remains optimal for thick, hyperkeratotic SKs, enabling histopathological confirmation. The 532 nm laser, preferred subjectively for convenience, may suit small, non-hyperkeratotic lesions but warrants further validation. Propane-butane cryotherapy offers a cost-effective alternative. The discordance between patient preferences (prioritizing convenience) and clinical efficacy underscores the need for personalized treatment strategies balancing outcomes, tolerability, and cosmetic expectations.

BACKGROUND: Seborrheic keratosis (SK) is the most prevalent benign skin tumor associated with aging, posing esthetic concerns and potential discomfort. The rising demand for cosmetic interventions prompts the exploration of effective removal methods. This study compares three treatment modalities: curettage, 532 nm laser, and propane-butane cryotherapy.

DETAILS: A prospective interventional clinical study was conducted with 30 subjects, treating 123 SK using curettage, 532 nm laser, and propane-butane cryotherapy. Randomized allocation and evaluations at 0, 4, 8, and 12 weeks were employed. Objective measures included clearance rates (assessed by a dermatologist) and blinded cosmetic ratings by 125 observers. Subjective outcomes encompassed patient-reported pain (VAS), side effects, satisfaction, and preferences. Curettage achieved the highest clearance rate (87.5% vs. laser: 55%, cryotherapy: 50%; p < 0.01). However, patients perceived complete healing most frequently with laser (90% vs. curettage: 87%, cryotherapy: 53%). Despite lower efficacy, 67% favored laser for future treatments, valuing minimal bleeding and no dressings. Observers rated curettage's cosmetic outcomes superior (50% vs. laser: 22.5%). Laser caused the fewest side effects (mean 0.93/lesion) but highest pain (VAS: 4.62 vs. cryotherapy: 3.85). Cryotherapy showed efficacy comparable to laser (50% vs. 55%) but more adverse events.

Copyright © Wiley Periodicals LLC. All rights reserved

Source: Timmermann, V., Krengel, S., Mrowka, P,, et al. (2024). Practical Approaches for Seborrheic Keratosis Treatment: Curettage Versus 532-nm Lithium Borate Laser Versus Cryotherapy: A Prospective Interventional Study. Lasers in Surgery and Medicine. 2025; 57(7): 581-589. Published: September, 2025. DOI: 10.1002/lsm.70042.

Results From the BE BRIGHT Open-Label Extension Trial

[Posted 10/Sep/2025]

AUDIENCE: Dermatology, Family Medicine

KEY FINDINGS: Almost two-thirds of bimekizumab-treated patients achieved and maintained complete skin clearance through 4 years, making bimekizumab an effective, rapid, and durable long-term treatment option.

BACKGROUND: Patients with moderate to severe psoriasis experience significant burden on quality of life. Long-term management with latest-generation biologics can facilitate sustained complete skin clearance and improved patient well-being. Aim of this study is to report 4-year end-of-study bimekizumab efficacy and safety in patients with moderate to severe psoriasis.

DETAILS: Data were pooled from 3 phase 3 trials (BE VIVID, BE READY, and BE SURE) and their open-label extension (OLE; BE BRIGHT). Efficacy is reported for patients who received bimekizumab continuously from baseline into the OLE. Safety is reported for patients who received >=1 bimekizumab dose. Seven hundred seventy-one patients received bimekizumab from baseline into the OLE. A high proportion achieved complete skin clearance (100% improvement from baseline in Psoriasis Area and Severity Index) at Week 52 (76.2%) and maintained this to Week 196 (64.7%). The rate of treatment-emergent adverse events over 4 years was 169.8/100 patient-years (N = 1495) and did not increase with longer exposure. The most common treatment-emergent adverse events were nasopharyngitis, oral candidiasis, and upper respiratory tract infection, consistent with bimekizumab's known safety profile.

Copyright © Elsevier Ltd. All rights reserved.

Source: Blauvelt, A., Langley, R. G., Lebwohl, M., et al. (2024). Bimekizumab Durability of Efficacy Through 196 Weeks and Safety Through 4 Years in Patients With Moderate to Severe Plaque Psoriasis: Results From the BE BRIGHT Open-Label Extension Trial. Journal of the American Academy of Dermatology. 2025; 93: 644-653. Published: September, 2025. DOI: 10.1016/j.jaad.2025.04.038.

[Posted 28/Aug/2025]

AUDIENCE: Neurology, Pediatric, Neurosurgery

KEY FINDINGS: Infants up to 6 weeks of age with genetically diagnosed SMA who were treated with risdiplam before the development of clinical signs or symptoms appeared to have better functional and survival outcomes at 12 and 24 months than untreated infants in natural history studies. Larger, controlled studies with longer follow-up are needed to further understand the relative efficacy and safety of presymptomatic treatment of SMA with risdiplam.

BACKGROUND: Risdiplam, an oral pre–messenger RNA splicing modifier, is an efficacious treatment for persons with symptomatic spinal muscular atrophy (SMA). The safety and efficacy of risdiplam in presymptomatic disease are unclear.

DETAILS: Authors conducted an open-label study of daily oral risdiplam (with the dose adjusted to 0.2 mg per kilogram of body weight) in infants 1 day (birth) to 42 days of age with genetically diagnosed SMA but without strongly suggestive clinical signs or symptoms. The primary outcome, assessed in infants with two SMN2 copies and a baseline ulnar compound muscle action potential (CMAP) amplitude of at least 1.5 mV, was the ability to sit without support at month 12. Natural history studies have shown that the majority of infants with two SMN2 copies who are untreated would have a severe SMA phenotype (type 1), would never sit independently, would receive permanent ventilation and feeding support, or would die by 13 months of age. Secondary outcomes that were assessed over a period of 24 months included survival, ventilatory support, motor milestones, the development of clinically manifested SMA, feeding, and growth. A total of 26 infants with two, three, or four or more copies of SMN2 were enrolled. After 12 months of treatment, 21 infants (81%) could sit unsupported for 30 seconds, 14 (54%) could stand alone, and 11 (42%) could walk alone. A total of 4 of 5 infants (80%; 95% confidence interval, 28 to 100) with two SMN2 copies and a baseline ulnar CMAP amplitude of at least 1.5 mV were able to sit without support for at least 5 seconds. Three infants were withdrawn from the study by a parent or caregiver after the month 12 visit. Of 23 infants who completed 24 months of treatment, all were alive without the use of permanent ventilation or feeding support. Over a period of 24 months, nine treatment-related adverse events were reported in 7 infants; none of these events were serious.

Copyright © Massachusetts Medical Society. All rights reserved.

Source: Finkel, R. S., Servais, L., Vlodavets, D., et al. (2024). Risdiplam in Presymptomatic Spinal Muscular Atrophy. N Engl J Med. 2025; 393(7): 671-682. Published: August 13, 2025. DOI: 10.1056/NEJMoa2410120.

A Histological Study in a Porcine Model.

[Posted 26/Aug/2025]

AUDIENCE: General Surgery, Dermatology, Family Medicine

KEY FINDINGS: MRF predominantly promotes the synthesis of Collagen I and Collagen III, increasing the Collagen I/III ratio, and regulates the expression of MMP-1, MMP-3, MMP-9, TGF-ß, and EGF. These factors collectively drive fibroblast activation, migration, and ECM remodeling. These changes are indicative of the potential for MRF to support skin regeneration and rejuvenation. Preliminary findings suggest that ADSCs may contribute to these regenerative processes.

BACKGROUND: Microneedle radiofrequency (MRF) is a promising skin rejuvenation treatment. However, the mechanisms underlying its effects on extracellular matrix (ECM) remodeling remain unclear. This study aimed to investigate the immediate histological effects of MRF under varying settings, its short-term impact on collagen and elastin synthesis, and the roles of fibroblasts and adipose-derived stem cells (ADSCs).

DETAILS: Porcine abdominal skin was treated with an MRF device containing 49 insulated microneedles using varying energy parameters (8-12 W; 100-300 ms). Immediate histological responses to treatment were evaluated through hematoxylin and eosin (H&E) staining. Short-term changes in collagen and elastin synthesis at Days 7 and 28 posttreatment were assessed via picrosirius red and Victoria blue staining. Additionally, expression and distribution of ECM remodeling-related proteins (MMPs, TGF-ß, EGF, Ki67) and ADSCs were analyzed by multiplex immunohistochemistry (mIHC) and western blot analysis. H&E staining revealed thermal coagulation zones in the dermis immediately after MRF treatment, with zone size increasing with higher power and longer pulse durations (p < 0.05). By Day 28, Collagen I and III densities and organization significantly improved, with the Collagen I/III ratio rising to 7.05 ± 1.21 in the treatment area (p < 0.01) and 3.90 ± 0.37 in the surrounding dermis (p < 0.001). Elastic fibers also showed increased density. mIHC staining demonstrated significant upregulation of MMP-1, MMP-3, and MMP-13 expression in treated and surrounding dermal regions by Day 7 (p < 0.01); however, by Day 28, MMP-1, MMP-9, and MMP-13 expression significantly decreased (p < 0.05), whereas MMP-3 remained elevated. Furthermore, expression levels of TGF-ß, EGF, and Ki67 significantly increased by Day 28 (p < 0.05). mIHC analysis of the fibroblast marker FSP-1 coexpression, along with Western blot analysis of Collagen I, Collagen III, MMP-1, MMP-3, TGF-ß, and EGF, revealed similar trends. Notably, significant expression of ADSC markers was detected at Day 7 posttreatment (p < 0.01).

Copyright © John Wiley & Sons, Inc or related companies. All rights reserved.

Source: Yidan, X., Yi, Z., Hao, W., et al. (2025). Microneedle Radiofrequency Induces Extracellular Matrix Remodeling Through Fibroblast Activation: A Histological Study in a Porcine Model. Lasers Surg. Med.. 2025; 57(6): 528-543. Published: August, 2025. DOI: 10.1002/lsm.70033.