Practical Algorithm on Topical Treatment of Flaring Atopic Dermatitis (AD) With or Without Secondary Infection

Schachner LA, Hebert AA, Sidbury R, et al. J Drugs Dermatol. 2025;24(6):621-630. doi:10.36849/JDD.8967

Abstract

Acute exacerbations or flares are a key characteristic of atopic dermatitis (AD), often associated with sleep deprivation, as well as experiences of stigmatization, social withdrawal, anxiety, and depression. Local skin colonization with Staphylococcus aureus (SA) is a key contributor to AD, particularly to AD flares. Treating SA-driven active AD, especially in cases where skin that is secondarily infected complicates management, calls for a carefully balanced approach that serves to calm AD activity and clear local infection and SA related colonization.

The methodological approach included a systematic literature review to inform an expert panel before a face-to-face meeting to develop a practice-based algorithm for managing AD flares with or without secondary infection. A panel of nine experts in dermatology, including both Board-certified dermatologists and pediatric dermatologists, engaged in a discussion followed by an online review to refine the algorithm and to provide clear guidance on the topical treatment of flaring AD with or without AD skin that is secondarily infected.

Sputum quality affects assessment of airway microbiology in childhood asthma

Taylor, S.L., Brooks, C.R., Elms, L. et al. Respir Res 26, 209 (2025). https://doi.org/10.1186/s12931-025-03266-x

Abstract

Background

The analysis of sputum is the principal basis for characterising lower airway microbiology in those with chronic respiratory conditions. For such analysis to be informative, samples that poorly reflect the lower airways must be identified and removed. Our cross-sectional study explored the relationship between the quality of sputum samples and their microbiological content. We further investigated the impact of excluding low quality samples on observed microbiota-disease relationships in childhood asthma.

Methods

Induced sputum was collected from children with or without asthma. Sputum quality was assessed according to squamous cell%, cell viability%, detection of sputum plugs, and salivary α-amylase levels.

Understanding the atopic dermatitis-psoriasis phenotypic switch through a mechanistic epidemiology approach

Kerry Yang, Alexandra Mircescu, Deborah Okusanya, Samiha Mohsen, Danlin Zeng, Sonia Czyz, Isabelle Vallerand, Giovanni Damiani, Christopher G. Bunick, Fatemeh Jafarian. medRxiv 2025.05.25.25328309; doi: https://doi.org/10.1101/2025.05.25.25328309

Abstract

Atopic Dermatitis (AD) and psoriasis (PsO) are two frequent dermatologic conditions that may co-occur in a cluster of patients, yet current understanding of how these two conditions relate to one-another remains poorly understood. One way to better understand their relationship is through a process called phenotypic switching, where AD and PsO can turn into one another. We utilized a pharmacovigilance-based epidemiological approach to better understand this phenomenon. By generating adverse event-related disproportionality signals for various therapies and therapeutic classes used in AD and PsO, several potential mechanisms for the AD-PsO phenotypic switch were uncovered.

Effectiveness and Safety of Respiratory Syncytial Virus Vaccine for US Adults Aged 60 Years or Older

Anderer S.  JAMA. Published online May 30, 2025. doi:10.1001/jama.2025.7762

Key Points

Question  What is the effectiveness of vaccines against respiratory syncytial virus (RSV) among older adults and at-risk subgroups, and are there major adverse events associated with vaccination?

Findings  In this case-control study of 787 822 patients tested for RSV, vaccine effectiveness was approximately 75% among adults aged 60 years or older against RSV-associated acute respiratory infection, urgent care or emergency visits, or hospitalization; effectiveness was less but still substantial among immunocompromised patients. An estimated excess of 11.2 cases of Guillain-Barré syndrome followed administration per 1 000 000 doses of RSV vaccine.

Meaning  These findings suggest that RSV vaccination of older patients is effective even for most immunocompromised patients, but diagnoses of Guillain-Barré syndrome are increased after vaccination.

Abstract

Importance  Respiratory syncytial virus (RSV) is associated with hospitalization and death among older adults.

Uveitis in Adults: A Review

Maghsoudlou P, Epps SJ, Guly CM, Dick AD.  JAMA. Published online May 28, 2025. doi:10.1001/jama.2025.4358

Clinical Features of Uveitis

Abstract

Importance  Uveitis is characterized by inflammation of the uvea—the middle portion of the eye composed of the iris, ciliary body, and choroid—causing eye redness, pain, photophobia, floaters, and blurred vision. Untreated uveitis may cause cataracts, glaucoma, macular edema, retinal detachment, optic nerve damage, and vision loss.

Observations  Uveitis predominantly affects individuals aged 20 to 50 years. Anterior uveitis affects the iris and ciliary body (41%-60% of cases); intermediate uveitis affects the pars plana (attachment point of vitreous humor) and peripheral retina (9%-15%); posterior uveitis involves the choroid and/or retina (17%-23%); and panuveitis involves all uveal layers (7%-32%).

Cannabinoid WIN55,212-2 restores bronchial epithelium by regulating oxidative stress and STAT6 phosphorylation

Pérez-Diego M, Angelina A, Pat Y, Maldonado A, Sevilla-Ortega C, Martín-Cruz L, Yazici D, Rückert B, Sokolowska M, Martín-Fontecha M, Akdis M, Akdis CA, Palomares O. J Allergy Clin Immunol. 2025 May 16:S0091-6749(25)00551-2. doi: 10.1016/j.jaci.2025.05.002.

Abstract

Background

Viral infections and type 2 immune responses perpetuate airway epithelial barrier dysfunction and inflammation, leading to the development and progression of asthma. The synthetic cannabinoid WIN55,212-2 displays anti-inflammatory properties by acting on different immune system cells.

Objectives

To investigate the capacity of WIN55,212-2 to restore bronchial epithelial barrier function in asthma in the context of viral infections or type 2-driven inflammation.

Is fibromyalgia an autoimmune disorder?

 Clauw D, Sarzi-Puttini P, Pellegrino G, Shoenfeld Y.  Autoimmun Rev. 2024 Jan;23(1):103424. doi: 10.1016/j.autrev.2023.103424. 

Highlights

• •
  Certain aspects of FM are still controversial, including pathophysiology, which remain a subject of debate
• •
  FM shares many clinical features, sometimes designing overlapping diseases, with other conditions, including, chronic fatigue syndrome (CFS), sick building syndrome (SBS), post-COVID syndrome, and many others
• •
  Anti-GPCR (anti- G protein-coupled receptor antibodies), autoantibodies directed against the autonomic nervous system receptors, have been detected in the serum of patients with FM, and their titers correlated with clinical symptoms
• •
  Fibromyalgia belongs to nociplastic pain which means that the central nervous system is the driving force behind this pain mechanism, and the key phenotypic features include widespread pain, fatigue, and sleep, memory, and mood disturbances

External exposome and incident asthma across the life course in 14 European cohorts: a prospective analysis within the EXPANSE project

Yu, ZhebinMetspalu, Andres et al. The Lancet Regional Health – Europe, Volume 0, Issue 0, 101314

Summary

Background

The joint impact of exposure to multiple urban environmental factors on asthma remains unclear.

Methods

We analysed data from 14 European cohorts to assess the impact of the urban exposome on asthma incidence across the life course. We linked three external exposome domains (air pollution, built environment, ambient temperature) to the participants’ home addresses at baseline. We performed k-means clustering within each domain and assessed associations of clusters with asthma adjusting for potentially relevant covariates in cohort-specific analyses, with subsequent separate meta-analyses for birth and adult cohorts. An environmental risk score using a coefficient-weighted sum approach was used to assess the impact of combining the three domains.

Findings

 Associations between the environmental risk score
(combining three external exposome domains)
and asthma incidence

A total of 7428 incident asthma cases were identified among 349,037 participants (from birth up to age 70+). Overall, we observed higher risks of asthma for clusters characterized by high particulate matter and nitrogen dioxide exposure in adults (ORmeta = 1.13, 95%CI:1.01–1.25), and clusters characterized by high built-up area and low levels of greenness in both children and adults (ORmeta = 1.36, 95%CI: 1.14–1.64 for birth cohorts and ORmeta = 1.15, 95%CI: 1.03–1.28 for adult cohorts, respectively).