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Grand RoundsWeekly Evidence Brief

Dermatology

Edition

30-Second Takeaway

  • Dermatoscopic ulceration, blue-white veil, and regression patterns carry prognostic information for melanoma metastasis and recurrence-free survival.
  • Most early-onset atopic dermatitis remits by adulthood, but early allergic multimorbidity flags a persistent phenotype.
  • Switching apremilast nonresponders to deucravacitinib provides meaningful PASI and quality-of-life improvements with oral therapy.

Week ending December 13, 2025

Dermatology Grand Rounds: Prognostic Dermoscopy, AD Trajectories, and Targeted Therapy Updates

Dermatoscopic Features Predict Melanoma Metastasis and Recurrence-Free Survival

NATURE COMMUNICATIONSDec 9, 2025

An international study had 30 dermatologists score 776 dermatoscopic images of stage IB+ melanomas for predefined structures, colors, and vessels. Extensive dermatoscopic ulceration and blue-white veil were associated with higher metastasis risk and reduced recurrence-free survival, particularly in early-stage disease. Extensive regression correlated with lower metastasis risk and improved recurrence-free survival. Dermatoscopy-only, histology-only, and combined models showed comparable prognostic accuracy for metastasis.

Childhood Atopic Dermatitis Often Remits, but Early Allergic Multimorbidity Predicts Persistence

JAMA NETWORK OPENDec 8, 2025

The German MAS birth cohort followed 1314 full-term newborns, slightly enriched for allergy risk, from birth to age 30 years. Cumulative AD incidence in the first five years was higher in children with allergic parents than those with nonallergic parents. Among 529 children with AD onset in the first five years, 87% were symptom-free at ages 20 and 30. Earlier onset within two years, female sex, early allergic sensitization, childhood asthma, and rhinitis were associated with a persistent AD phenotype.

Deucravacitinib Rescues Apremilast Nonresponders in Moderate-to-Severe Plaque Psoriasis

DERMATOLOGY AND THERAPYDec 6, 2025

This post hoc POETYK PSO-1/2 analysis examined patients who failed apremilast by week 24 despite moderate-to-severe plaque psoriasis. Nonresponders were switched to deucravacitinib 6 mg once daily and followed to week 52. PASI 75 response rates rose from 0% at week 24 to about 42%–46% at week 52 after switching. From weeks 24–52, PASI 90, sPGA 0/1, DLQI 0/1, and symptom scores all improved, with reduced PASI and BSA.

Bimekizumab Provides Superior and Durable Patient-Reported Outcomes Through 4 Years

DERMATOLOGY AND THERAPYDec 8, 2025

BE SURE, BE VIVID, and BE READY compared bimekizumab with adalimumab, ustekinumab, or placebo, with all patients entering the BE BRIGHT extension. During controlled periods, more bimekizumab-treated patients achieved P‑SIM=0 for itching, skin pain, and scaling versus adalimumab, ustekinumab, or placebo. Similar advantages were seen for DLQI=0 across items during comparator-controlled phases. In 771 patients receiving continuous bimekizumab into the extension, 65.5%–94.8% reported DLQI=0 across items at four years.

References

Numbered in order of appearance. Click any reference to view details.

Additional Reads

Optional additional studies from this edition.

Edition context

Clinical signal

  • Dermatoscopy may soon complement histopathology for bedside melanoma risk stratification, but these models require prospective validation before changing staging.
  • Longitudinal AD data refine counseling on remission and emphasize early asthma, rhinitis, and sensitization as red flags for chronic disease.
  • Newer oral, biologic, and investigational agents can rescue prior treatment failures while enabling individualized dosing intensity and intervals.