Journal Digest: September 30, 2026

JAMA Dermatology | Efficacy and Safety of Ruxolitinib Cream in Patients With Cutaneous Lichen Planus: A Randomized Clinical Trial

A phase 2 randomized, double-blind, vehicle-controlled trial evaluated ruxolitinib 1.5% cream in 64 adults with predominantly cutaneous lichen planus. At week 16, Investigator’s Global Assessment treatment success—defined as clear or almost clear skin with at least a 2-grade improvement—was achieved by 50.0% of patients receiving ruxolitinib compared with 21.9% receiving vehicle (P = .01). Among patients eligible for itch assessment, a 4-point or greater improvement in itch was achieved by 48.4% versus 16.1%, respectively (P = .004). Improvements continued during the 16-week open-label extension, and no serious treatment-emergent adverse events or treatment discontinuations due to adverse events were observed with ruxolitinib.

For dermatology clinicians, the findings suggest topical ruxolitinib may offer a nonsteroidal treatment option for cutaneous lichen planus, a condition for which no disease-specific therapies are currently approved and treatment frequently relies on topical corticosteroids. Larger and longer-term studies will be needed to establish its role in routine management.¹

Journal of the European Academy of Dermatology and Venereology | Early Systemic Intervention for Vitiligo: A Prospective Bicentric Interventional Study

A prospective study of 51 patients examined whether initiating systemic treatment early in the course of nonsegmental vitiligo could improve repigmentation. Patients were grouped according to disease duration and activity and received narrowband UV-B phototherapy plus twice-weekly oral corticosteroid mini-pulses for 6 months. At month 6, 75% improvement in Vitiligo Extent Score was achieved by 46% of patients diagnosed within the previous 6 months, compared with 16% of patients with long-standing disease and recent lesions and none of those with long-standing disease without active lesions (P = .01). Mature epidermal melanocytes also persisted more frequently in recently diagnosed patients.

For clinicians, the findings suggest there may be an early therapeutic window in vitiligo during which intervention can produce greater repigmentation, including in areas traditionally considered difficult to treat. The relatively small cohort and use of a uniform combination regimen should be considered when interpreting the findings.²

Journal of Dermatological Treatment | Treatment Response to Systemic Therapies in Pediatric-Onset Versus Adult-Onset Psoriasis: A Longitudinal Real-World Study

A longitudinal real-world study of 1873 patients compared treatment responses among individuals with pediatric-onset versus adult-onset psoriasis receiving IL-17 inhibitors, IL-23 or IL-12/23 inhibitors, methotrexate, or phototherapy. Among 576 patients treated with IL-17 inhibitors, those with pediatric-onset disease had higher PASI 90 response rates over 1 to 6 months, ranging from 26.1% to 62.2%, compared with 14.6% to 51.2% among those with adult-onset disease. Adult-onset psoriasis was associated with lower odds of achieving PASI 90 after adjustment for potential confounders (adjusted OR, 0.62; 95% CI, 0.42-0.89; P = .011). No significant differences based on age of disease onset were identified with the other evaluated treatment classes.

For dermatology clinicians, the results raise the possibility that age of psoriasis onset may be relevant when considering response to IL-17 inhibition. However, because differences were not observed across the other systemic treatment groups, additional comparative-effectiveness studies are needed before disease onset can be used to guide treatment selection.³

Dermatology and Therapy | 48-Week Real-World Atopic Dermatitis Study on Minimal Disease Activity, Associated Factors, and Agreement Between Clinician- and Patient-Reported Outcomes

A prospective real-world study followed 96 adolescents and adults with moderate-to-severe atopic dermatitis for up to 48 weeks after initiating advanced therapy with a biologic or Janus kinase inhibitor. Minimal disease activity (MDA), defined using both clinician- and patient-reported outcomes, was achieved by 42.7% of evaluable patients at week 16, 52.6% at week 24, and 46.0% at week 48. Rates did not significantly differ between biologic and JAK inhibitor treatment groups. Lower baseline disease severity and fewer previous systemic treatments were among the factors associated with MDA at earlier time points.

Agreement was generally higher among clinician-reported measures than between clinician- and patient-reported outcomes. Of the combinations evaluated, EASI ≤3 plus Dermatology Life Quality Index 0/1 demonstrated the most consistent performance as a potential practical definition of MDA. For clinicians, the results reinforce the importance of incorporating both objective disease measures and the patient's experience when evaluating whether AD is adequately controlled.⁴

JAMA Dermatology | Best Practices for Managing Pseudofolliculitis Barbae: An Expert Consensus Delphi Study

A 3-round Delphi study involving US dermatologists with expertise in pseudofolliculitis barbae (PFB) developed expert consensus recommendations addressing diagnosis, behavioral modification, medical therapy, procedural treatment, and occupational considerations. Forty statements reached the predefined threshold of at least 75% agreement. Experts supported modification of hair-removal practices as first-line management, along with targeted topical and systemic therapies and procedural approaches such as laser hair removal. Consensus was not reached on a standardized PFB grading scale, oral isotretinoin for refractory disease, superficial chemical peels, or multiblade razor use.

For dermatology clinicians, the consensus provides a practical framework for a condition that lacks standardized management recommendations. The emphasis on modifying shaving practices before escalating treatment may be particularly relevant when counseling patients with recurrent disease, while areas without consensus highlight priorities for additional clinical research.⁵

References

1. Mangold AR, Lockshin B, Lai Z, et al. Efficacy and safety of ruxolitinib cream in patients with cutaneous lichen planus: a randomized clinical trial. JAMA Dermatol. Published online September 23, 2026. doi:10.1001/jamadermatol.2026.3646. JAMA Network
2. Bertold C, Seneschal J, Fontas E, et al. Early systemic intervention for vitiligo: a prospective bicentric interventional study. J Eur Acad Dermatol Venereol. Published online September 25, 2026. doi:10.1111/jdv.70748. Wiley Online Library
3. Li S, Jiang Y, Muheyati D, et al. Treatment response to systemic therapies in pediatric-onset versus adult-onset psoriasis: a longitudinal real-world study. J Dermatolog Treat. Published online September 23, 2026. doi:10.1080/09546634.2026.2734961. ArxivLens
4. Rodriguez-Sanna AI, García-Moronta C, Castro-Martin J, et al. 48-week real-world atopic dermatitis study on minimal disease activity, associated factors, and agreement between clinician- and patient-reported outcomes. Dermatol Ther (Heidelb). Published online September 25, 2026. doi:10.1007/s13555-026-01924-6. Springer Nature
5. Alomary SA, Baker NJ, Ugwueke G, et al. Best practices for managing pseudofolliculitis barbae: an expert consensus Delphi study. JAMA Dermatol. Published online September 23, 2026. doi:10.1001/jamadermatol.2026.3579.