2026-05-14T12:05:46Z https://skindeep.skinonline.org/oai.php

10.1553/skindeep.2025.153393 2025-04-10 skinonline

The footprint of AI-generated text in dermatology publications Wolber,Anna Kittler,Harald Artificial intelligence dermatology large language models SKINdeep 1: e153393 Background: Large language models (LLMs) may help to diversify authorship in scientific journals by supporting non-English speaking researchers in writing, revising, and editing scientific papers. Objectives: To quantify the frequency of AI-generated text in the dermatology literature and to relate these results to the geographic diversity of authorship. Methods: We extracted abstracts of 4573 articles published in 21 dermatology journals in March 2024 from 2017 to 2024. We identified AI-generated content using an AI-detector and adjusted the raw rates to account for false positives. Additionally, we computed diversity indices to quantify temporal trends in the geographic distribution of the affiliations of first authors. Results: We found that the raw rate of AI-generated abstracts remained relatively stable from 2018 to 2023 but exhibited a significant increase in March 2024. In March 2024, the raw rate of AI-generated abstracts was 33.8% (95% CI: 30.0% to 37.8%) and significantly higher than in any preceding year. After adjusting for false positives, the proportion of AI-generated abstracts remained relatively stable below 5% from 2018 to 2023 but jumped to 17.9% (95% CI: 14.9%–21.3%) in 2024. There was a positive correlation between the rate of AI-generated abstracts and the journal’s impact factor for articles published before 2024, with a correlation coefficient of 0.42 (95% CI: -0.01 to +0.72, P-value = 0.06). Regarding the geographic distribution of the affiliations of first authors, both the Shannon and Simpson diversity indices showed a decrease in 2024 compared to the baseline year of 2017. Conclusions: Our data suggest that the year 2024 indicates a turning point in the use of AI-generated text in the dermatology literature, with the occurrence of AI-generated text increasing significantly compared to previous years. However, the increasing adoption of AI tools alone is not sufficient to enhance the diversity of scientific output in specialized fields such as dermatology. Why was the study undertaken? This study was performed to quantify the frequency of AI-generated text in the dermatology literature and to relate these results to the geographic diversity of authorship. What does this study add? This study shows that the prevalence of AI-generated texts in dermatological literature has increased significantly in 2024 but that this increase has not been accompanied by a greater geographic diversity of scientific contributions in the field. What are the implications of this study for the understanding of skin physiology and pathology and/or disease management? The influence of scientific literature on funding priorities and drug development is profound and a lack of diversity impacts disease understanding and clinical care. Despite a historical peak in its usage, LLMs did not improve the visibility of countries traditionally underrepresented in the dermatology literature. info:eu-repo/semantics/altIdentifier/eissn/3061-0281 info:eu-repo/semantics/altIdentifier/pissn/3061-029X info:eu-repo/semantics/openAccess CC BY-NC 4.0 Austrian Academy of Sciences Press 2025 Original Article text/html info:doi:10.1553/skindeep.2025.153393 https://doi.org/10.1553/skindeep.2025.153393 https://skindeep.skinonline.org/article/153393/ https://skindeep.skinonline.org/article/153393/download/pdf/ en

10.1553/skindeep.2025.142637 2025-04-10 skinonline

Live but not heat-killed Staphylococcus epidermidis elicit an anti-inflammatory phenotype in human embryonic Langerhans cells Pan,Yi Hochgerner,Mathias Bordag,Natalie Absenger-Novak,Markus Strobl,Herbert Bieber,Thomas Wolf,Peter Langerhans cell atopic dermatitis skin microbiome immunology Staphylococcus aureus Staphylococcus epidermidis SKINdeep 1: e142637 Background: In atopic dermatitis (AD), the skin is colonized by high levels of Staphylococcus aureus (SA), while levels of the commensal Staphylococcus epidermidis (SE) are reduced. Levels of SA correlate with the severity of the disease, while transplantation of SE into the skin can ameliorate AD. Objectives: It is hypothesized that the underlying mechanism is supported by Langerhans cells (LCs) which sense a shift in the microbiome and then either continue to perpetuate the disease (with SA) or to act as anti-inflammatory agents, ameliorating the inflammation (with SE). However, many different experimental protocols generating very different results have made the literature on this topic complex and hard to understand. Methods: In this study, we specifically tested human, embryonic stem cell-derived LCs and measured their reactions to SA and SE. We directly compared co-cultures exposed to living SA and SE and to heat-killed bacteria. We analyzed the gene expression of the LCs with qPCR and flow cytometry, the secreted cytokines via ELISA, and their downstream effect on T cells. Results: Our data show that exposure to living SA causes LCs to mature; in turn, this activates a T-cell response of cytokine secretions resembling the inflammatory phenotype observed in AD patients. Meanwhile, SE-primed LCs do not activate T cells, but instead act as anti-inflammatory agents by secreting high levels of IL-10. Importantly, this difference can only be observed in living bacteria. LCs react to heat-killed SE as pro-inflammatory agents, as they do to SA (albeit slightly weaker). Conclusions: Using living bacteria is absolutely crucial when performing experiments to reflect the in vivo situation. Our results expand on the work of others and contribute to the ongoing investigation of interactions of the skin and its microbiome. Why was the study undertaken? Numerous studies have observed that SE not only correlates with less severe AD, but can ameliorate the disease. This study was undertaken to further investigate the immunological mechanisms related to this effect. What does this study add? Our data shows that SE modifies T-cell reactions via LCs. Importantly, only living SE has this anti-inflammatory effect; heat-killed SE instead has a pro-inflammatory effect similar to that of S. aureus. What are the implications of this study for the understanding of skin physiology and pathology and/or disease management? The skin microbiome plays a key role in AD, but at the heart of AD pathophysiology are T cells. We present further evidence that the missing link between the microbiome and the T cells is in fact the LCs. List of abbreviations: AD: Atopic dermatitis; APC: Antigen-presenting cell; DC: Dendritic cell; LC: Langerhans cell; mo-LC: Monocyte-derived Langerhans cell; LN: Lymph nodes; PBMCs: Peripheral blood mononuclear cells; SA: Staphylococcus aureus; SE: Staphylococcus epidermidis. info:eu-repo/semantics/altIdentifier/eissn/3061-0281 info:eu-repo/semantics/altIdentifier/pissn/3061-029X info:eu-repo/semantics/openAccess CC BY-NC 4.0 Austrian Academy of Sciences Press 2025 Original Article text/html info:doi:10.1553/skindeep.2025.142637 https://doi.org/10.1553/skindeep.2025.142637 https://skindeep.skinonline.org/article/142637/ https://skindeep.skinonline.org/article/142637/download/pdf/ en

10.1553/skindeep.2025.148220 2025-04-10 skinonline

Clinicopathological spectrum of lichen planus Cerroni,Lorenzo Schadelbauer,Eva Kogler,Angelika Fried,Isabella Acquired inflammatory linear dermatoses clinicopathological variants Histopathological features Lichen planus Lichen planopilaris Lichenoid dermatitis SKINdeep 1: e148220 The term „lichenoid“ was first established as a clinical definition for diseases characterized by flat, dull red papules with smooth surface. Over time, a second definition of lichenoid became commonly used as well, the histopathological one, which refers to a dense, bandlike inflammatory infiltrate obscuring the dermo-epidermal junction. Today, the term lichenoid is used interchangeably in its clinical and histopathological meanings to define the so-called lichenoid dermatoses. Lichenoid dermatoses represent a group of unrelated inflammatory conditions that share some clinical and/or histopathological features; some of these are clinically but not histopathologically lichenoid, while others are histopathologically but not clinically lichenoid. Lichen planus (LP) represents the prototype of a cutaneous inflammatory disease that presents with both clinical and histopathological lichenoid features. Besides the skin, the disease commonly affects the oral mucosa and the nails. Involvement of the hairs (lichen planopilaris) can result in a form of scarring alopecia. Several clinical and/or histopathological variants of LP have been described over the years, including such disparate forms as linear, atrophic, hypertrophic, and ulcerative LP among others. In some cases, association with other diseases (e.g., LP pemphigoides, LP/lupus erythematosus overlap syndrome) is well described. It is important to understand that the variants of LP are not specific entities; for example, an atrophic LP is commonly pigmented, often located at sites of inverse LP, and may present with an annular configuration. In this article we briefly review the protean clinicopathological spectrum of LP. info:eu-repo/semantics/altIdentifier/eissn/3061-0281 info:eu-repo/semantics/altIdentifier/pissn/3061-029X info:eu-repo/semantics/openAccess CC BY-NC 4.0 Austrian Academy of Sciences Press 2025 Review Article text/html info:doi:10.1553/skindeep.2025.148220 https://doi.org/10.1553/skindeep.2025.148220 https://skindeep.skinonline.org/article/148220/ https://skindeep.skinonline.org/article/148220/download/pdf/ en

10.1553/skindeep.2025.145006 2025-04-10 skinonline

Eosinophils in skin disease: bystanders or pathogenic players? Stingl,Georg Cerroni,Lorenzo Wolf,Peter Eosinophilic dermatoses itch cytokines Th2 pathway SKINdeep 1: e145006 Eosinophils, i.e. eosinophilic granulocytes, play a crucial role in the physiologic host defense against parasites but are also promoters of allergic tissue inflammation of the Th2 type. They are central players in the so-called eosinophilic dermatoses, such as Wells syndrome, hypereosinophilic syndrome, eosinophilic granulomatosis with polyangiitis, eosinophilic fasciitis, and eosinophilic folliculitis among others. Eosinophils originate from the bone marrow, enter the skin under the influence of chemokines and other chemotactic factors, and are linked to a Th2 type cytokine milieu of IL-3, IL-4, IL-5, IL-13 and IL-31. We herewith describe the cardinal features as well as pathophysiological aspects of eosinophilic dermatoses. Moreover, we outline novel targeted treatments, including antibodies against key cytokines governing eosinophil differentiation, migration and function. info:eu-repo/semantics/altIdentifier/eissn/3061-0281 info:eu-repo/semantics/altIdentifier/pissn/3061-029X info:eu-repo/semantics/openAccess CC BY-NC 4.0 Austrian Academy of Sciences Press 2025 Review Article text/html info:doi:10.1553/skindeep.2025.145006 https://doi.org/10.1553/skindeep.2025.145006 https://skindeep.skinonline.org/article/145006/ https://skindeep.skinonline.org/article/145006/download/pdf/ en

10.1553/skindeep.2025.150261 2025-04-10 skinonline

The deep imaging phenotype for melanoma risk stratification Kahler,Sam Rutjes,Chantal Janda,Monika Soyer,H. Peter Primiero,Clare Melanoma AI Artificial Intelligence total body photography risk prediction skin cancer SKINdeep 1: e150261 Targeted surveillance for individuals at high-risk for melanoma is increasingly recognized as a feasible and effective alternative to population-wide melanoma screening. However, current risk stratification models to identify these high-risk individuals are often reliant on subjective or self-reported metrics, which are vulnerable to bias and poor reproducibility. The deep imaging phenotype describes the concept of leveraging parallel advances in total body photography (TBP) and artificial intelligence (AI) to improve risk stratification using personalized severity and spatial distribution of cutaneous risk factors. This narrative review explores the progress towards the deep imaging phenotype in dermatology, with a focus on its clinical applications, challenges, and future directions. It explores (i) the limitations of existing melanoma risk prediction, (ii) advancements in TBP and AI-driven analysis of the cutaneous phenotype; (iii) integration of phenotype with clinical and genomic information; (iv) frameworks for clinical, logistic, and ethical implementation of phenotypic measures into clinical practice. Progress towards the deep imaging phenotype has included algorithms that report nevus characteristics (count, size, and distribution), severity and distribution of photodamage, facultative and innate skin tones, freckling, and other parameters for objective and personalized risk stratification. Phenotypic measures correlate with melanoma risk and may be integrated with traditional clinical and genomic risk factors to enhance current risk assessment. Clinicians and consumers report acceptance of this approach, although, most evidence to date focuses on individual phenotypic features rather than the collective synergy of all measures. Supporting information technology infrastructure, legal frameworks, and clinical guidelines are underdeveloped and should be prioritized before clinical implementation. Objective risk stratification using personalized cutaneous risk factors may empower the effective allocation of resources, reduce over-surveillance in low-risk populations, and offer timely interventions to individuals at high risk. info:eu-repo/semantics/altIdentifier/eissn/3061-0281 info:eu-repo/semantics/altIdentifier/pissn/3061-029X info:eu-repo/semantics/openAccess CC BY-NC 4.0 Austrian Academy of Sciences Press 2025 Review Article text/html info:doi:10.1553/skindeep.2025.150261 https://doi.org/10.1553/skindeep.2025.150261 https://skindeep.skinonline.org/article/150261/ https://skindeep.skinonline.org/article/150261/download/pdf/ en

10.1553/skindeep.2025.151578 2025-07-04 skinonline

Frequent cutaneous manifestations of rare monogenic dental diseases: a review of OMIM data and cases from own clinical practice Nagy,Nikoletta Szell,Marta rare diseases monogenic diseases Mendelian dental cutaneous manifestation SKINdeep 1: e151578 In the last two decades, the elucidation of the genetic background of monogenic dental diseases has been significantly enhanced. In the Online Mendelian Inheritance in Man (OMIM) database there are 144 isolated or syndromic ones. Out of this 55 rare monogenic dental diseases (38%) are accompanied by cutaneous manifestations. In this study, we review the group of rare monogenic diseases with dental and cutaneous manifestations and observed the most frequent skin findings (hypohidrosis, hyperkeratosis, dry skin and skin fragility), nail symptoms (dysplastic nails and hypoplastic nails) and hair abnormalities (sparse hair, alopecia and hypertrichosis) and highlighted the genes associated with these frequent clinical features. We also summarized the frequent dental anomalies (missing teeth, abnormal shape of teeth, enamel abnormalities and delayed eruption or uneruption of teeth). Among the additional non-dental and non-cutaneous manifestations ophthalmological, skeletal and otorhinolaryngological abnormalities are the most frequently developing ones. Regarding the genetic background, there are 42 disease-causing genes associated with the 55 entities. Here, we also highlighted the WNT10A, CTSC and EDA1 associated diseases in order to demonstrate how different variants of these genes can lead to the development of different phenotypes. Reviewing rare monogenic dental-cutaneous diseases, the association of the identified special clinical features may raise the attention of the specialist in everyday clinical parctice and help in the identification of the underlying genetic background. info:eu-repo/semantics/altIdentifier/eissn/3061-0281 info:eu-repo/semantics/altIdentifier/pissn/3061-029X info:eu-repo/semantics/openAccess CC BY-NC 4.0 Austrian Academy of Sciences Press 2025 Original Article text/html info:doi:10.1553/skindeep.2025.151578 https://doi.org/10.1553/skindeep.2025.151578 https://skindeep.skinonline.org/article/151578/ https://skindeep.skinonline.org/article/151578/download/pdf/ en

10.1553/skindeep.2025.150947 2025-07-04 skinonline

Advances in antioxidant therapies for epidermolysis bullosa management Muñoz,Antonella Catalán,Evelyng Cossio,Maria-Laura Palisson,Francis Fuentes,Ignacia Epidermolysis bullosa chronic wounds antioxidants oxidative stress wound healing SKINdeep 1: e150947 Epidermolysis Bullosa (EB) is a rare genetic disorder characterized by skin and mucous membrane fragility. Oxidative stress is recognized as a major factor contributing to persistent and recurrent lesions. It can induce genomic damage, protein oxidation, lipid peroxidation, pathological angiogenesis and hypoxia. Despite the severity of the condition, therapeutic options remain limited. Here we explore the potential role of antioxidant compounds in EB patients, incorporating these compounds as a novel cornerstone in EB management. info:eu-repo/semantics/altIdentifier/eissn/3061-0281 info:eu-repo/semantics/altIdentifier/pissn/3061-029X info:eu-repo/semantics/openAccess CC BY-NC 4.0 Austrian Academy of Sciences Press 2025 Review Article text/html info:doi:10.1553/skindeep.2025.150947 https://doi.org/10.1553/skindeep.2025.150947 https://skindeep.skinonline.org/article/150947/ https://skindeep.skinonline.org/article/150947/download/pdf/ en

10.1553/skindeep.2025.148530 2025-07-22 skinonline

A special case of annular elastolytic giant cell granuloma: case report and mini-review Teschl,Eva Fink-Puches,Regina Hofmann-Wellenhof,Rainer Cerroni,Lorenzo Erythema elastolytic giant cell granuloma elastolysis elastophagocytosis SKINdeep 1: e148530 Annular elastolytic giant cell granuloma (AEGCG) is a rare and variable clinical picture in dermatology.As not all forms present with the annular variant, the term elastolytic giant cell granuloma (EGCG) was introduced. However, the histopathological features are constant and are characterised by elastolysis and elastophagocytosis in all clinical variants.In this clinical letter, we present a 92-year-old male patient with non-palpable, figured erythema on the back.Taking into account the clinical, dermoscopic and histological findings of our patient, we were able to make the diagnosis of EGCG.Timely recognition of the rare elastolytic giant cell granuloma is crucial, as it may be associated with both systemic diseases and malignancies. Due to the different clinical manifestations, knowledge of the significance of histopathology is also essential for diagnosis.Prompt detection of EGCG and a directly associated search for causes can identify any pre-existing malignancies, minimise their secondary effects and thus improve the prognosis. info:eu-repo/semantics/altIdentifier/eissn/3061-0281 info:eu-repo/semantics/altIdentifier/pissn/3061-029X info:eu-repo/semantics/openAccess CC BY-NC 4.0 Austrian Academy of Sciences Press 2025 Letter to the editor text/html info:doi:10.1553/skindeep.2025.148530 https://doi.org/10.1553/skindeep.2025.148530 https://skindeep.skinonline.org/article/148530/ https://skindeep.skinonline.org/article/148530/download/pdf/ en

10.1553/skindeep.2025.153393 2025-09-03 skinonline

Photoallergic drug eruption secondary to oral terbinafine prescribed for management of tinea incognita Stark,Madeleine Lara Rivero,Alexis Murrell,Dedee photoallergy drug reaction tinea incognito SKINdeep 1: e162876 This case presents a 68-year-old woman who developed a photoallergic drug reaction secondary to oral terbinafine. Oral and topical terbinafine were prescribed to treat a widespread intensely pruritic tinea incognito infection. This case highlights a rare adverse effect to a medication commonly prescribed by both dermatologists and physicians in general. info:eu-repo/semantics/altIdentifier/eissn/3061-0281 info:eu-repo/semantics/altIdentifier/pissn/3061-029X info:eu-repo/semantics/openAccess CC BY-NC 4.0 Austrian Academy of Sciences Press 2025 Letter to the editor text/html info:doi:10.1553/skindeep.2025.153393 https://doi.org/10.1553/skindeep.2025.153393 https://skindeep.skinonline.org/article/162876/ https://skindeep.skinonline.org/article/162876/download/pdf/ en

10.1553/skindeep.2025.166714 2025-09-17 skinonline

The sebaceous gland revisited: Friend and adversary Elias,Peter Wakefield,Joan Acne glycerol fatty acids hair sebaceous gland SKINdeep 1: e166714 Historically, sebaceous glands (SG) have been viewed as troublesome provocateurs of seborrheic dermatitis and acne. Yet, recent studies have illuminated a suite of positive attributes of SG (Points 1–6, below), including lubrication of hair follicles to avert scarring alopecia. Because of their abundant lipase activity, secreted SG lipids deliver both glycerol (endogenous humectant) and antimicrobial free fatty acids onto the skin surface (Points 2&3). Though human epidermis makes substantial vitamin D3 (VD3), in furred mammals, VD precursors must first be delivered onto the surface prior to photo- and thermal conversion into VD3 (Point 4). Likewise, epidermis deploys several antioxidant enzymes, but vitamin E is delivered to the skin surface via SG secretions (Point 5). Finally, SG secrete volatile odorants (Point 6) and possibly pheromones. info:eu-repo/semantics/altIdentifier/eissn/3061-0281 info:eu-repo/semantics/altIdentifier/pissn/3061-029X info:eu-repo/semantics/openAccess CC BY-NC 4.0 Austrian Academy of Sciences Press 2025 Review Article text/html info:doi:10.1553/skindeep.2025.166714 https://doi.org/10.1553/skindeep.2025.166714 https://skindeep.skinonline.org/article/166714/ https://skindeep.skinonline.org/article/166714/download/pdf/ en

10.1553/skindeep.2025.162540 2025-11-14 skinonline

Scoring systems for Mucous Membrane Pemphigoid – A review of the literature Heyworth,Annabelle Stark,Madeleine Murrell,Dedee Conjunctival Diseases (MeSH) Pemphigoid Benign Mucous Membrane (MeSH) Severity of Illness Index (MeSH) Skin Diseases Vesicobullous (MeSH) Validation Studies as Topic (MeSH) Non-Mesh Key Words Outcome measure Severity Score Validation SKINdeep 1: e162540 Mucous Membrane Pemphigoid (MMP) is a group of rare chronic autoimmune blistering diseases that predominantly affects one or more of the mucous membranes. Without treatment it can cause significant complications such as esophageal strictures, breathing difficulties, speech difficulties, laryngeal stenosis and blindness. Despite recent advances in targeted immunotherapy there have been no randomised controlled trials to date for MMP. Whilst this is partially a reflection of the rarity of the disease, it is also due to the lack of validated scoring systems. Validated scoring systems enable an investigator to effectively document response to treatment and communicate disease severity to peers. This article reviews and evaluates existing global and mucous membrane specific scoring systems for MMP. This article also proposes the creation of an Investigator’s Global Assessment for MMP as a future area of research. Why was the study undertaken? This scoping literature review was undertaken to provide an overview of the existing scoring systems for MMP. It critically analyses the strengths and weaknesses of the scoring systems and their validation studies, and points out any pathological associations with score results. What does this study add? This study introduces the concept of an IGA score for MMP, and discusses its utility and value. What are the implications of this study for the understanding of skin physiology and pathology and/or disease management? We hope this manuscript will aid in the creation of a validated IGA score, thus facilitating randomised controlled trials on MMP and FDA approval for MMP treatments. info:eu-repo/semantics/altIdentifier/eissn/3061-0281 info:eu-repo/semantics/altIdentifier/pissn/3061-029X info:eu-repo/semantics/openAccess CC BY-NC 4.0 Austrian Academy of Sciences Press 2025 Review Article text/html info:doi:10.1553/skindeep.2025.162540 https://doi.org/10.1553/skindeep.2025.162540 https://skindeep.skinonline.org/article/162540/ https://skindeep.skinonline.org/article/162540/download/pdf/ en

10.1553/skindeep.2025.169584 2025-12-02 skinonline

Treating severe junctional epidermolysis bullosa with artesunate Sinz,Sophie Koller,Ulrich Liemberger,Bernadette Hainzl,Stefan Klausegger,Alfred Hagen,Joerg von Müller,Norbert Mohr,Thomas Gerner,Christopher Temaj,Gazmend Laimer,MArtin Breitenbach-Koller,Hannelore Bauer,Johann artesunate LAMB3 severe junctional epidermolysis SKINdeep 1: e169584 Treating severe junctional epidermolysis bullosa with artesunate info:eu-repo/semantics/altIdentifier/eissn/3061-0281 info:eu-repo/semantics/altIdentifier/pissn/3061-029X info:eu-repo/semantics/openAccess CC BY-NC 4.0 Austrian Academy of Sciences Press 2025 Letter to the editor text/html info:doi:10.1553/skindeep.2025.169584 https://doi.org/10.1553/skindeep.2025.169584 https://skindeep.skinonline.org/article/169584/ https://skindeep.skinonline.org/article/169584/download/pdf/ en

10.1553/skindeep.2025.172072 2025-12-10 skinonline

Effects of environmental humidity on epidermal physiology Denda,Mitsuhiro Dry keratinocyte stratum corneum cytokine calcium ATP cortisol SKINdeep 1: e172072 Previous studies have suggested that changes in season and environmental humidity influence skin health. In particular, hairless human skin is directly affected by environmental conditions. For example, a dry environment influences the water-impermeable barrier function of the epidermis. A drastic decrease in environmental humidity induces barrier dysfunction. A dry environment also induces several inflammatory factors, including those from the peripheral immune system, and affects the skin’s endocrine system. However, the mechanisms underlying these effects require further investigation through experimental scientific studies. This paper summarizes current findings and offers a new perspective on the effects of environmental humidity on skin health. info:eu-repo/semantics/altIdentifier/eissn/3061-0281 info:eu-repo/semantics/altIdentifier/pissn/3061-029X info:eu-repo/semantics/openAccess CC BY-NC 4.0 Austrian Academy of Sciences Press 2025 Review Article text/html info:doi:10.1553/skindeep.2025.172072 https://doi.org/10.1553/skindeep.2025.172072 https://skindeep.skinonline.org/article/172072/ https://skindeep.skinonline.org/article/172072/download/pdf/ en

10.1553/skindeep.2025.173725 2025-12-22 skinonline

Microbiome and response to immunotherapy in malignant melanoma Woltsche,Johannes Mutz-Rabl,Christiane Schratter,Hanna Hofmann-Wellenhof,Rainer Stadlbauer,Vanessa Wolf,Peter Melanoma microbioma immune checkpoint inhibition SKINdeep 1: e173725 Immune checkpoint inhibitors (ICIs) have improved survival in advanced melanoma; however, a considerable number of patients does not respond, and side effects are common. Studies suggest that the gut microbiome may influence ICI outcomes, with certain bacteria and microbial functions being linked to a positive response in some patient groups. However, findings are inconsistent across studies, and no universal microbial biomarkers have been identified. Longitudinal and multi-omic analyses indicate that microbial dynamics may matter, and that other body sites, such as the skin and the intratumoral environment, could also be relevant. More systematic research and testing of multiple hypotheses is needed before microbiome-based strategies may be reliably applied in clinical practice. Here, we summarize evidence connecting the human microbiome to ICI response in melanoma. info:eu-repo/semantics/altIdentifier/eissn/3061-0281 info:eu-repo/semantics/altIdentifier/pissn/3061-029X info:eu-repo/semantics/openAccess CC BY-NC 4.0 Austrian Academy of Sciences Press 2025 Perspectives text/html info:doi:10.1553/skindeep.2025.173725 https://doi.org/10.1553/skindeep.2025.173725 https://skindeep.skinonline.org/article/173725/ https://skindeep.skinonline.org/article/173725/download/pdf/ en

10.1553/skindeep.2026.176139 2026-01-20 skinonline

Cutaneous sarcoidosis in the precision medicine era Gabriel,Anna Stary,Georg Cutaneous sarcoidosis pathomechanisms diagnosis treatment SKINdeep 2: e176139 Sarcoidosis is an inflammatory disorder of unknown origin that belongs to the group of granulomatous diseases. It is characterized by the development of typical non-caseating granulomas in affected organs, which may progress to fibrosis and organ dysfunction. The lungs are most frequently involved, followed by the lymph nodes and skin. Cutaneous sarcoidosis presents with highly variable clinical forms and disease courses. Skin involvement may precede systemic manifestation, occur simultaneously, or develop later in the disease. The treatment of cutaneous sarcoidosis often poses a challenge for physicians, as therapeutic responses vary widely depending on patient heterogeneity and lesion morphology. Currently, systemic or topical glucocorticoids remain the gold standard of therapy, yet their efficacy is inconsistent and long-term use is limited by side effect. In contrast to other chronic inflammatory conditions, targeted therapies for sarcoidosis are still scarce. However, recent advances in sarcoidosis research are paving the way for novel treatment options, including mTOR inhibition or targeting of the JAK/STAT pathway. A deeper understanding of disease mechanisms is expected to facilitate the development of more specific and effective therapies for cutaneous sarcoidosis in the future. info:eu-repo/semantics/altIdentifier/eissn/3061-0281 info:eu-repo/semantics/altIdentifier/pissn/3061-029X info:eu-repo/semantics/openAccess CC BY-NC 4.0 Austrian Academy of Sciences Press 2026 Review Article text/html info:doi:10.1553/skindeep.2026.176139 https://doi.org/10.1553/skindeep.2026.176139 https://skindeep.skinonline.org/article/176139/ https://skindeep.skinonline.org/article/176139/download/pdf/ en

10.1553/skindeep.2026.173515 2026-01-26 skinonline

Far-UVC in human skin: safety evidence and therapeutic potential in dysbiosis-driven dermatoses Zarfl,Maximillian Wolf,Peter Far-UVC Skin safety Microbiome modulation Dysbiosis Atopic dermatitis Cutaneous T-cell lymphoma Polymorphic light eruption SKINdeep 2: e173515 Far-UVC exhibits potent antimicrobial activity while limiting penetration into viable epidermis. Unlike conventional 254 nm UV-C, far-UVC induces DNA photodamage only in superficial keratinocytes, with no evidence of basal cell involvement or photocarcinogenesis in preclinical and pilot human studies. These features have established far-UVC as a promising tool for infection control in occupied environments. Beyond disinfection, far-UVC may also represent a novel therapeutic modality in dermatology. Several dermatoses, including atopic dermatitis, cutaneous T-cell lymphoma, and polymorphic light eruption, are characterized by cutaneous dysbiosis that drive inflammation. Far-UVC’s selective action on surface-associated pathogens could modulate microbial imbalance while sparing deeper commensals and host tissue. Early data suggest potential for ecological rebalancing and immune modulation. Translational studies are now needed to test whether controlled far-UVC exposures can reshape microbial communities and improve disease outcomes in dysbiosis-driven dermatoses. info:eu-repo/semantics/altIdentifier/eissn/3061-0281 info:eu-repo/semantics/altIdentifier/pissn/3061-029X info:eu-repo/semantics/openAccess CC BY-NC 4.0 Austrian Academy of Sciences Press 2026 Perspectives text/html info:doi:10.1553/skindeep.2026.173515 https://doi.org/10.1553/skindeep.2026.173515 https://skindeep.skinonline.org/article/173515/ https://skindeep.skinonline.org/article/173515/download/pdf/ en

10.1553/skindeep.2026.172466 2026-01-28 skinonline

Advances in understanding and management of chronic wounds: translational medicine approaches Cabral,Gabriela Wolff-Winiski,Barbara Chronic wound advanced wound care translational medicine biomarker personalized medicine SKINdeep 2: e172466 Chronic wounds represent a global health challenge, affecting millions of patients and resulting in substantial morbidity, mortality, and economic burden. Great advances are being made in understanding the basic molecular and cellular mechanisms that maintain wounds in a chronic state. Despite these developments, no new pharmacological treatments have been approved for over two decades. This lack of progress reflects limitations in preclinical models, stringent regulatory requirements, and patient heterogeneity. The diverse patient population is characterized by multiple comorbidities and wounds of multifactorial origin, which complicates diagnosis and hinders the development of effective therapies. Focusing on human studies and translational models, this review provides an overview of the biology of chronic wounds, current treatment options, and recent developments. Emerging translational strategies are shifting the paradigm from passive management with traditional wound dressings to personalized, multimodal interventions, as well as advances in biomarker identification, including omics- and cell-based functional biomarkers. Combined with artificial intelligence, these innovations hold the potential to initiate a new era of precision medicine for chronic wound care. info:eu-repo/semantics/altIdentifier/eissn/3061-0281 info:eu-repo/semantics/altIdentifier/pissn/3061-029X info:eu-repo/semantics/openAccess CC BY-NC 4.0 Austrian Academy of Sciences Press 2026 Review Article text/html info:doi:10.1553/skindeep.2026.172466 https://doi.org/10.1553/skindeep.2026.172466 https://skindeep.skinonline.org/article/172466/ https://skindeep.skinonline.org/article/172466/download/pdf/ en

10.1553/skindeep.2026.183007 2026-02-23 skinonline

Diagnosis of a case of scabies infestation with line-field confocal optical coherence tomography Muller,Nicholas Tan,Samuel Nufer,Kaitlin Darch,Katherine van Rooji,Nicholas Khosrotehrani,Kiarash Soyer,H. Peter Manahan,Melissa Wu,Jason General dermatology diagnosis confocal microscopy scabies line-field optical coherence tomography SKINdeep 2: e183007 We present a case of scabies diagnosed with LC-OCT with a video of the live scan across the volume of the scabietic burrow. info:eu-repo/semantics/altIdentifier/eissn/3061-0281 info:eu-repo/semantics/altIdentifier/pissn/3061-029X info:eu-repo/semantics/openAccess CC BY-NC 4.0 Austrian Academy of Sciences Press 2026 Letter to the editor text/html info:doi:10.1553/skindeep.2026.183007 https://doi.org/10.1553/skindeep.2026.183007 https://skindeep.skinonline.org/article/183007/ https://skindeep.skinonline.org/article/183007/download/pdf/ en

10.1553/skindeep.2026.182644 2026-02-24 skinonline

Diagnostics and treatment of cutaneous and mucocutaneous Leishmania infections: expert recommendations Handisurya,Alessandra Winkler,Stefan Kniha,Edwin Thalhammer,Florian Harpain,Lucie Salzer,Helmut Krause,Robert Weiss,Günter Walochnik,Julia Leishmaniasis cutaneous leishmaniasis mucocutaneous leishmaniasis diagnostics treatment guidelines SKINdeep 2: e182644 Cutaneous and mucosal/mucocutaneous Leishmania infections may present with very different clinical signs depending on the involved species, the site of infection and the immune status of the host. Leishmania species are intracellular protozoan pathogens transmitted by phlebotomine sand flies, of which over 20 species infecting humans have been described. Leishmania infections are rather common, with an estimated number of one million new cases per year worldwide. The countries with the highest incidence of cutaneous leishmaniasis cases are Afghanistan, Algeria, Brazil, Colombia, Iraq, Libya, Pakistan, Peru, Syria, and Tunisia, while most mucocutaneous cases occur in Bolivia, Brazil, Ethiopia, and Peru. The disease is also endemic in all Southern European countries, with approximately 700 autochthonous human cases reported each year and many more asymptomatic infections. Central Europe is considered non-endemic for the disease; however, epidemiological patterns are affected by travel habits, migration, globalization, and climate change. This review focuses on the diagnostic procedures and treatment options for cutaneous and mucocutaneous Leishmania infections. info:eu-repo/semantics/altIdentifier/eissn/3061-0281 info:eu-repo/semantics/altIdentifier/pissn/3061-029X info:eu-repo/semantics/openAccess CC BY-NC 4.0 Austrian Academy of Sciences Press 2026 Review Article text/html info:doi:10.1553/skindeep.2026.182644 https://doi.org/10.1553/skindeep.2026.182644 https://skindeep.skinonline.org/article/182644/ https://skindeep.skinonline.org/article/182644/download/pdf/ en

10.1553/skindeep.2026.176050 2026-04-03 skinonline

Herpes virus-based therapeutics in dermato-oncology – Past, present and future perspectives Krecu,Maximilian Fiebiger,Paul Wally,Verena Koelblinger,Peter Oncolytic herpes simplex virus (oHSV) T-VEC RP1 oncolytic virotherapy cancer immunotherapy melanoma non-melanoma skin cancer SKINdeep 2: e176050 Mode of action of oHSVs (T-VEC / RP1): oHSVs are injected into tumor cells, where viral DNA replicates and replaces tumor DNA. The HSV US11 gene enhances viral replication, while GM-CSF expression is intended to trigger an additional systemic anti-tumor immune response through the recruitment and activation of macrophages, dendritic cells, and other leukocytes, thereby enhancing the spread of immune-mediated oncolysis beyond the injected lesion. In RP1, GALV-GP-R− expression shall promote systemic anti-tumor activity. Viral replication leads to oncolysis and the release of tumor-derived antigens (TDAs), which are taken up by dendritic cells to activate CD4+ and CD8+ T cells. This process triggers both local inflammation and a pronounced anti-tumor immune response, ultimately inducing further tumor cell death through apoptosis. GM-CSF = granulocyte-macrophage colony-stimulating factor; Created in https://BioRender.com. Abstract The growing incidence of skin cancers, including malignant melanoma and non-melanoma skin cancers, presents an ongoing challenge in dermato-oncology. In recent years, herpes virus-based therapeutics, particularly oncolytic herpes simplex virus (oHSV), have gained attention as promising treatment strategies. Engineered to selectively infect and destroy cancer cells while preserving healthy tissue, oHSV induces direct oncolysis and in some patients also promotes systemic anti-tumor immune responses. These mechanisms make oHSV-based approaches especially appealing in cutaneous malignancies, where local and immune-mediated systemic tumor control is critical. Various oHSV variants have been developed to enhance tumor specificity, immune activation, and clinical efficacy. In this review, we highlight the role of herpes virus-based therapies in dermato-oncology, focusing on their mechanisms of action, clinical development, and therapeutic potential in skin cancer treatment. info:eu-repo/semantics/altIdentifier/eissn/3061-0281 info:eu-repo/semantics/altIdentifier/pissn/3061-029X info:eu-repo/semantics/openAccess CC BY-NC 4.0 Austrian Academy of Sciences Press 2026 Review Article text/html info:doi:10.1553/skindeep.2026.176050 https://doi.org/10.1553/skindeep.2026.176050 https://skindeep.skinonline.org/article/176050/ https://skindeep.skinonline.org/article/176050/download/pdf/ en

10.1553/skindeep.2026.176837 2026-04-14 skinonline

Endovenous thermal ablation for truncal varicose veins: Indications, techniques, and long-term outcomes Deinsberger,Julia Kienzl,Philip Weber,Benedikt Endovenous thermal ablation chronic venous insufficiency radiofrequency ablation endovenous laser ablation SKINdeep 2: e176837 Endovenous thermal ablation techniques have transformed the management of chronic venous insufficiency, providing minimally invasive alternatives to traditional surgical approaches. By delivering controlled heat energy to incompetent veins, these procedures achieve durable closure, restore efficient venous circulation, and relieve symptoms such as pain, swelling, and varicosities. The two principal modalities are radiofrequency ablation and endovenous laser therapy. This article provides an up-to-date overview of current indications, techniques, outcomes, and guideline recommendations for these procedures. info:eu-repo/semantics/altIdentifier/eissn/3061-0281 info:eu-repo/semantics/altIdentifier/pissn/3061-029X info:eu-repo/semantics/openAccess CC BY-NC 4.0 Austrian Academy of Sciences Press 2026 Review Article text/html info:doi:10.1553/skindeep.2026.176837 https://doi.org/10.1553/skindeep.2026.176837 https://skindeep.skinonline.org/article/176837/ https://skindeep.skinonline.org/article/176837/download/pdf/ en