Journal Digest: August 5, 2026

Journal of Pediatric Dermatology | The Association Between Isotretinoin Use and Suicidality in Adolescents: A Narrative Review

This narrative review examined whether isotretinoin is associated with suicidality in adolescents with acne, addressing ongoing concerns about psychiatric adverse effects. Researchers reviewed 24 full-text studies identified through searches of PubMed, MEDLINE, Embase, PsycINFO, and the Cochrane Library covering publications from 1982 through September 2024. Although case reports have described suicidal ideation, attempts, and completed suicide during isotretinoin therapy, these events were rare. Observational, cohort, and case-time-control studies did not consistently demonstrate increased suicidality among isotretinoin users. In comparisons with adolescents prescribed antibiotics, isotretinoin was not associated with increased suicidality during treatment, although suicidal behavior was more prevalent during the year after treatment. Reported suicidal ideation appeared more likely to emerge early during or after therapy. The findings support individualized psychiatric screening and ongoing monitoring rather than routinely avoiding isotretinoin because of suicide concerns, while recognizing that adolescents with acne may already have elevated baseline mental health risk.¹

International Journal of Telemedicine and Applications | Patient-Centered Teledermatology: Bridging Pharmacies and Dermatologists

In France, a pilot study evaluated a pharmacy-based teledermatology model designed to improve access to specialist care, where dermatologist wait times average about 3 months. Forty urban and rural pharmacies submitted 731 cases through a secure platform after training in clinical photography and tele-expertise; 714 consultations were completed. Dermatologists provided diagnoses and management recommendations, with response times improving from an initial mean of 5.4 days to 1–2 days by the end of the study. Cases included suspected melanoma, 27 carcinomas, actinic keratoses, eczema, atopic dermatitis, rosacea, vitiligo, and shingles. Pharmacists reported 72% satisfaction, 94% supported scaling the service with adaptations, and patients were reported to have an 88% satisfaction rate. The findings highlight how trained pharmacists can support early triage and referral of suspicious lesions while extending specialist expertise to underserved patients. However, successful implementation requires coordinated primary care communication, reimbursement, and streamlined treatment pathways.²

Journal of the European Academy of Dermatology and Venereology | Successful Co-Administration of Secukinumab and Dupilumab in a Patient With Psoriasis and Paradoxical Atopic Dermatitis

In this case report, a 47-year-old man with severe plaque psoriasis developed severe, pruritic atopic dermatitis (AD) 12 weeks after starting secukinumab, despite achieving complete psoriasis clearance. After secukinumab discontinuation, his AD improved with dupilumab, but psoriasis rapidly recurred. Secukinumab was therefore restarted alongside dupilumab to target the distinct IL-17 and IL-4/IL-13 inflammatory pathways. Over 3 years of concurrent treatment, both conditions remained well controlled without serious infections, clinically significant laboratory abnormalities, or other reported adverse events. Eosinophil counts and IgE levels also decreased with AD improvement. After approximately 6 months, the dupilumab interval was extended from every 2 weeks to every 4 weeks while maintaining disease control. This case highlights a potential strategy for managing paradoxical AD when discontinuing an effective psoriasis biologic is undesirable. However, dual biologic therapy remains supported primarily by case-level evidence and requires individualized risk-benefit assessment, monitoring, and consideration of cost and access.³

Journal of Cosmetic Dermatology | The Need for Objective Quantitative Pigment Assessment in Comparative Laser Trials for Melasma

A recent randomized split-face trial found that both 1064-nm picosecond and Q-switched Nd:YAG lasers improved melasma, with no significant difference in efficacy and less procedural pain reported with picosecond treatment. However, this commentary highlights an important limitation: outcomes were assessed primarily with hemi-mMASI and GAIS, which rely on clinical observation and may miss subtle changes in pigmentation. Because melasma can involve heterogeneous epidermal, dermal, and mixed pigment, objective tools such as reflectance spectrophotometry, colorimetry, Mexameter measurements, standardized dermoscopy, or reflectance confocal microscopy could provide more sensitive quantification of treatment response. This may be particularly important when comparing modalities with similar clinical outcomes or when sample sizes limit statistical power. Quantitative imaging could also detect early pigment recurrence before it becomes clinically apparent, improving assessment of durability. According to the authors, incorporating objective pigment measurements into future laser studies could strengthen evidence-based treatment selection and longitudinal monitoring.⁴

Dermatologic Therapy | High Frequency of Fibromyalgia in Rosacea: Sleep Quality and Depression as Major Drivers of Disease Burden in a Controlled Cross-Sectional Study

This controlled cross-sectional study found a striking association between rosacea and fibromyalgia syndrome (FMS), with 68.5% of 54 patients with rosacea meeting 2010 American College of Rheumatology criteria compared with 9.8% of 51 matched controls. Patients with rosacea also reported greater functional impairment, anxiety, and depression. Among those with rosacea, depression and poor sleep quality were the strongest independent predictors of FMS severity, together explaining 48% of the variance in Fibromyalgia Impact Questionnaire scores. Fatigue was the only independent predictor of FMS presence, with an odds ratio of 7.17; fatigue and sleep quality also showed strong ability to distinguish patients with and without FMS. The study additionally found that subjective dryness was more common in erythematotelangiectatic rosacea than papulopustular disease. The findings highlight the importance of looking beyond cutaneous findings and asking about widespread pain, fatigue, sleep quality, and mood symptoms, particularly in patients with persistent or disproportionate disease burden.⁵

References

1. Rydberg AM, Miller KA, McKean AJ. The Association Between Isotretinoin Use and Suicidality in Adolescents: A Narrative Review. Pediatr Dermatol. Published online July 21, 2026. doi:10.1111/pde.70296

2. Perez-Cullell N, Buresi V, Homehr N, Brutin JL, Fraysse J. Patient-Centered Teledermatology: Bridging Pharmacies and Dermatologists. Int J Telemed Appl. 2026;2026:9409013. Published 2026 Jul 29. doi:10.1155/ijta/9409013

3. Park SY, Park M, Gwang HE, et al. Successful Co-Administration of Secukinumab and Dupilumab in a Patient With Psoriasis and Paradoxical Atopic Dermatitis. JEADV Clinical Practice, 0 (2026): 1–3. doi:10.1002/jvc2.70326

4. Anand T, Anand N. The Need for Objective Quantitative Pigment Assessment in Comparative Laser Trials for Melasma. Journal of Cosmetic Dermatology 25, no. 8 (2026): e71112, doi:10.1111/jocd.71112

5. Kaya K, Digis M, Karaca GA, Gural Y, Demir B. High Frequency of Fibromyalgia in Rosacea: Sleep Quality and Depression as Major Drivers of Disease Burden in a Controlled Cross-Sectional Study. Dermatologic Therapy, 2026, 5211362, 9 pages, 2026. doi:10.1155/dth/5211362