British Association of Dermatologists

Lay Summary Alopecia areata (AA) is a long-term condition that can occur in both children and adults. AA can appear as patches of baldness on the scalp. Sometimes, nail growth is also affected. Hair on other parts of the body may also fall out, such as the beard, eyebrows and eyelashes. Alopecia totalis is the name for total loss of scalp hair. Alopecia universalis is complete loss of scalp, facial and body hair. This is the second version of the guideline. The British Association of Dermatologists gathered a group of experts in managing people of all ages with AA. The group consisted of eight consultant dermatologists, one dermatology specialist registrar, one general practitioner, one psychologist, two people with AA and a team with expertise in preparing guidelines. This group of experts reviewed relevant studies published until 11 July 2025. Using the evidence, the group produced recommendations using rigorous standards for guideline development. The guideline development group produced 56 recommendations for management of people with AA. They also made 9 recommendations for future research and suggested 11 audit points for hospitals. Based on the guideline, a patient information leaflet is also available on the British Association of Dermatologists’ website (https://www.skinhealthinfo.org.uk/condition/alopecia-areata).

This study assesses incidence, and overall and net survival in patients with lentigo maligna (LM) in England. Data show excellent 5-year net survival for all ages (> 100%), but overall survival in those aged 80+ years is only 60.4%, reflecting the impact of comorbidities and limited life expectancy. These findings highlight the need for LM management guidelines to incorporate frailty assessment and support shared decision making in older adults, including consideration of nonsurgical approaches.

The incidence data for England from 2013 to 2022 indicates that there were 171 cases every year on average, which gives a crude incidence rate of 0.31 per 100 000 person-years and a nonsignificant annual increase of 1.42%, before the COVID-19 pandemic, 2013–2019. Dermatofibrosarcoma protuberans (DFSP) has a high 5-year net survival rate of 99.2% and an overall survival rate of 96.5%, which indicates a generally favourable DFSP prognosis once resected.

Abstract Stevens–Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) is a rare, life-threatening mucocutaneous adverse reaction. Limited clinical trials have been undertaken, and clinicians are reliant on case reports and series to guide clinical care. However, these case report and series have never been summarized. Our objective was to scrutinize the clinical characteristics (patient metrics, aetiology, management and complications) reported in case reports and series of SJS/TEN. The OVID MEDLINE and Embase databases were searched from inception to 2023 (updated in 2024). Case reports and series of patients with SJS/TEN of all ages were included. Articles had to be published in English, with keyword data that could be extracted from the abstract or title. Screening and data extraction were conducted by paired researchers independently. Clinical characteristics were categorized thematically; patients could be in more than one category. Patient and clinical characteristics were described using percentages. From 1847 articles identified, 1591 were included, of which 1166 (73%) abstracts were available; 204 (13%) were case series. In total, 1684 patients were included; 56% (484 of 869) were female; age 0–18 years was the commonest age group (18%, 143 of 814); and 1% (17 of 1684) were pregnant. The most common medical histories reported were HIV (17%, 61 of 364), neurological conditions (16%, 59 of 364) and mental health conditions (8%, 30 of 364). The most frequent cancer histories were haematological (28%, 54 of 196), lung (21%, 42 of 196), gastrointestinal/colorectal, and neurological (both 12%, 24 of 196). Erythema multiforme major (24%, 16 of 67) was the most common differential diagnosis. Overall, 137 causative drug classes were reported; the three most common were anticonvulsants (20%, 247 of 1262), nonsteroidal anti-inflammatories (7%, 83 of 1262) and immune checkpoint inhibitors (6%, 71 of 1262). The most common causative individual drugs were lamotrigine (n = 76), carbamazepine (n = 71), phenytoin (n = 45), co-trimoxazole (n = 36) and pembrolizumab (n = 28). The most prevalent causative infections were mycoplasma (31%, 33 of 108), COVID-19 (19%, 21 of 108) and herpes simplex virus (6%, 6 of 108). Investigations undertaken included human leucocyte antigen testing (15%, 34 of 232), lymphocyte transformation test (11%, 26 of 232) and drug patch testing (7%, 17 of 232). The most common treatments were steroid (any route; 53%, 382 of 718), intravenous immunoglobulins (26%, 184 of 718), antibiotics (14%, 98 of 718) and ciclosporin (10%, 70 of 718). The most frequent complications were ocular (other than conjunctivitis, symblepharon, corneal ulcer; 25%, 100 of 405), gastrointestinal (other than dysphagia, liver failure, vanishing bile duct syndrome; 14%, 55 of 405) and skin (13%, 54 of 405). Overall, 7% (111 of 1684) died. This is the first scoping review summarizing all case reports and series of SJS/TEN. We have highlighted reported medication and infection triggers, which may help healthcare professionals to identify a cause and be aware of those at risk. Regarding treatments, steroids are the mainstay, alongside intravenous immunoglobulin and ciclosporin. The range of complications emphasizes the need for a multidisciplinary management approach both in the short- and longer-term care of patients.

This global study on atopic dermatitis reveals an overall prevalence of 9.6% among adults aged 16 years and older, with the highest rates in Asia, followed by Latin America and Europe. Findings highlight significant variations in prevalence by age, sex and ethnicity, challenging common beliefs and establishing new benchmarks for understanding the global distribution and impact of atopic dermatitis.

摘要： 【摘要】 难治性慢性自发性荨麻疹（CSU）对H1抗组胺药标准或加倍剂量、或联合使用均抵抗，临床常见，诊疗难度大。现有荨麻疹指南或共识无法满足难治性CSU的高质量规范化管理，有必要制订针对难治性CSU的诊疗指南。中华医学会皮肤性病学分会和中国医师协会皮肤科医师分会组建指南工作组，联合全国29位荨麻疹研究领域专家，全面梳理评估国内外现有循证证据，结合我国国情，经过多轮论证，形成了本指南，旨在为难治性CSU的诊断和治疗提供参考，指导临床实践。

The British Association of Dermatologists and British Geriatrics Society recommend routine screening for frailty for all patients aged ≥ 65 years being considered for management of skin cancer using a validated tool such as the Rockwood Clinical Frailty Scale.