Journal Digest: April 8

Credit: Dermatology Times

Journal of the American Academy of Dermatology: The Application of Circulating Tumor DNA in Advanced Cutaneous Squamous Cell Carcinoma: Potential Opportunities and Challenges

Sun et al’s research letter on the application of circulating tumor DNA (ctDNA) in advanced cutaneous squamous cell carcinoma (cSCC) demonstrated the potential benefits and challenges of utilizing ctDNA as a predictive biomarker in personalized treatment approaches. The study author’s response emphasized the importance of identifying reliable biomarkers to enhance personalized treatment strategies for advanced cSCC cases. Sun et al applauded previous research which introduced a personalized ctDNA assay with a focus on single-nucleotide variants in tumor tissue, showing a sensitivity of 63.6% in detecting ctDNA in plasma from advanced cSCC patients. According to Sun et al, although their findings offer positive insights into the role of ctDNA in cSCC management, more research is needed to validate its clinical utility, address limitations such as sample size and lack of long-term follow-up, and to explore the potential synergies of ctDNA with other biomarkers for improved predictive capabilities in advanced cSCC.¹

European Journal of Allergy and Clinical Immunology: Targeting IL-13 With Tralokinumab Normalizes Type 2 Inflammation in Atopic Dermatitis Both Early and at 2 years

Guttman-Yassky et al evaluated the impact of tralokinumab, a monoclonal antibody targeting IL-13, on skin and serum biomarkers in patients with moderate to severe atopic dermatitis (AD). Their research investigated how IL-13 neutralization affects key molecular pathways associated with AD pathophysiology over short and long-term treatment periods. Findings from the study demonstrated that tralokinumab treatment led to significant reductions in serum levels of type 2 biomarkers (CCL17/TARC, periostin, IgE, and IL-22) by week 4, with further decreases seen at week 16. Clinical improvements, such as reductions in eczema severity and pruritus, were also more pronounced in tralokinumab-treated patients compared to placebo. Tralokinumab normalized epidermal pathology, reducing epidermal hyperplasia and expression of inflammatory markers in lesional skin towards non-lesional levels. The study results highlight the role of IL-13 in AD pathogenesis and suggest that targeted IL-13 inhibition with tralokinumab can modulate key molecular pathways associated with AD, potentially representing a disease-modifying approach for long-term management of moderate to severe AD, according to Guttman-Yassky et al.²

Pediatric Dermatology: Lymphoplasmocytic Plaque in Children: A Report of an Atypical Location

Teixeira et al described a case report of a 10-year-old Caucasian male with a history of asthma and allergic rhinitis who presented with an enlarging plaque on the right upper limb. Initially diagnosed as hypertrophic lichen planus, treatment with clobetasol ointment initially improved the condition but worsened after discontinuation. A histopathological examination revealed a dense inflammatory infiltrate predominantly composed of plasma cells, supporting the diagnosis of lymphoplasmocytic plaque in children (LPC). LPC is a rare chronic dermatosis primarily affecting children and adolescents, typically presenting as solitary plaques or papules, often on the lower legs but also reported on the upper limbs, according to the authors. Differential diagnosis includes primary lymphoproliferative disorders and pseudolymphomas. Treatment options include topical and intralesional steroids. Surgical excision is curative but was declined in this case. Teixeira et al stressed the importance of recognizing LPC and tailoring treatment accordingly, as well as noted the need for further research on this underrecognized skin disorder.³

Archives of Dermatologic Research: Skin Color Reporting in Squamous Cell Carcinoma-related Randomized Controlled Trials in Top Dermatology Journals: A Systematic Review

Salmen et al’s systematic review investigated the extent of skin of color reporting in randomized controlled trials (RCTs) focusing on squamous cell carcinoma (SCC) in top dermatology journals. Among the 39 studies that were analyzed, 59% included data on skin of color, with a predominant representation of white patients. Subgroup analysis did not reveal significant differences based on study location, year of publication, or funding source. The study emphasized the crucial role of considering skin of color in SCC research due to its implications for cancer detection and recurrence. Salmen et al also noted a lack of consistent reporting of skin of color in high-quality RCTs, suggesting a need for improved awareness and standardization in demographic data collection within dermatology studies to address the diverse needs of patients with SCC.⁴

References

1. Sun H, Shen W, Zhong H-J. The application of circulating tumor DNA in advanced cutaneous squamous cell carcinoma: potential opportunities and challenges, J Am Acad Dermatol (2024), doi: https://doi.org/10.1016/j.jaad.2024.03.043.
2. Guttman-Yassky E, Kabashima K, Staumont-Salle D, et al. Targeting IL-13 with tralokinumab normalizes type 2 inflammation in atopic dermatitis both early and at 2 years. Allergy. Published online April 2, 2024. doi:10.1111/all.16108
3. Teixeira J, Pereira S, Xará JR, Cardoso JC, Ramos L. Lymphoplasmocytic plaque in children: A report of an atypical location. Pediatr Dermatol. Published online March 31, 2024. doi:10.1111/pde.15555
4. Salmen NL, Menage K, Baumann AN, Curtis DP, Brodell RT. Skin color reporting in squamous cell carcinoma-related randomized controlled trials in top dermatology journals: a systematic review. Arch Dermatol Res. 2024;316(4):115. Published 2024 Mar 30. doi:10.1007/s00403-024-02843-2