Dermatology

CLL Nearly Doubles 10‑Year Absolute Skin Cancer Risk, Including Metastasis and Mortality

In this Danish matched cohort of 8352 patients with CLL, 10‑year absolute skin cancer risk reached 13.5% versus 6.9% in controls. Basal cell carcinoma and squamous cell carcinoma drove most events, with absolute risk differences of 3.2 and 3.3 percentage points, respectively. CLL patients also had higher risks of skin cancer metastasis and skin cancer–specific death than controls. These data support at least semiannual full‑body exams, aggressive field therapy, and strong photoprotection counseling in CLL. Coordination with hematology is critical to time dermatologic interventions around evolving CLL therapies and immunosuppression intensity. 1

Cutaneous Toxicities of Modern Transplant Immunosuppression: Agent-Specific Pearls for SOTRs

This JAAD review summarizes cutaneous adverse effects of induction agents, calcineurin inhibitors, antimetabolites, mTOR inhibitors, corticosteroids, and co‑stimulation blockers in SOTRs. Early effects include hypersensitivity eruptions, alopecia, and aphthous ulcers, while chronic use leads to photosensitivity, impaired wound healing, and skin cancer. Azathioprine and cyclosporine are highlighted as increasing cutaneous squamous cell carcinoma risk, whereas mTOR inhibitors may confer relative protection. The SUNTRAC risk calculator is proposed to triage SOTRs to appropriate dermatologic surveillance intensity. Dermatologists are urged to co‑manage immunosuppression with transplant teams to reduce cutaneous morbidity without compromising graft survival. 2

Two Years of Dupilumab in Infants and Young Children with AD: Sustained Control, Familiar Safety

This open-label extension followed 180 children aged 6 months to 5 years with moderate-to-severe AD on dupilumab for up to 2 years. Dosing shifted from weekly weight-based regimens to weight-tiered injections every 4 weeks, with unrestricted topical therapy but no chronic systemic agents. By week 104, 92.1% achieved EASI‑75 from parent study baseline and mean affected BSA fell by 49%. Nearly 88% experienced at least one treatment-emergent adverse event, mostly mild or moderate; serious drug-related events were rare and resolved. The safety profile mirrored prior pediatric dupilumab studies, supporting continuous long-term use when clinically indicated. 3

Ritlecitinib Maintains Robust Alopecia Areata Responses Through 3 Years

In 191 patients aged ≥12 years with ≥50% scalp hair loss, daily ritlecitinib 50 mg produced durable 3‑year responses. At 3 years, 65.1% (observed) and 47.1% (LOCF) achieved SALT ≤20, with about one third reaching SALT 0 in observed data. Most patients who reached SALT ≤20 at 1 year maintained that response at 3 years, indicating durability once regrowth is established. Female sex, White race, shorter disease duration, and less extensive baseline loss predicted better outcomes. No new safety signals emerged over 3 years, supporting long-term ritlecitinib as a chronic therapy option in severe alopecia areata. 4