This Week in Dermatology — May 29, 2026

Welcome to This Week in Dermatology. This week we're covering 4 notable papers spanning the systemic burden of severe skin diseases and recent advances in therapeutics. Let's dive in.

First, we examine the significant systemic impact and mortality associated with severe dermatoses, with two papers this week offering crucial insights for bullous pemphigoid and severe cutaneous adverse reactions.

We begin in Sweden with a nationwide population-based cohort study published in *Acta dermato-venereologica* that quantifies the long-term mortality risk in patients with bullous pemphigoid [2].

The Study Investigators used national patient registries to identify over 5,700 patients with bullous pemphigoid and compared them to more than 17,000 matched controls from the general population.

Results They found that patients with bullous pemphigoid had a significantly higher risk of all-cause mortality, with a hazard ratio of 2.15, meaning their risk of death was more than doubled compared to controls. The one-year mortality rate was a striking 21.2%, and the ten-year rate reached 80.2%. When looking at causes of death, cardiovascular diseases were the largest single category, accounting for over 25% of deaths in the patient group. Interestingly, the authors also observed that patients treated with a combination of methotrexate, prednisolone, and potent topical corticosteroids had improved survival compared to other treatment groups.

Clinical Implications This large study confirms that bullous pemphigoid is a disease with very high mortality. It's a critical reminder to actively screen for and manage cardiovascular comorbidities in these patients. The finding of a potential survival benefit with combination therapy, while observational, is also noteworthy and warrants further investigation.

Moving from chronic mortality in bullous pemphigoid to acute morbidity in severe drug reactions, a study in *Clinical and experimental dermatology* investigated cardiac involvement in severe cutaneous adverse reactions, or SCARs [1].

The Study This was a single-center retrospective cohort study at a major Australian hospital, analyzing records of patients with Drug Reaction with Eosinophilia and Systemic Symptoms, known as DRESS, and Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis, SJS/TEN.

Results Cardiac involvement was identified in 15.2% of patients with DRESS and 6.3% of those with SJS/TEN. The most frequent cardiac symptom was dyspnea. Among patients who received cardiac investigations as part of their workup, new abnormalities on electrocardiograms were detected in up to 42% of cases. In a subgroup analysis of DRESS patients, cardiac involvement was associated with significantly higher rates of both renal involvement and ICU admission.

Clinical Implications These findings suggest that cardiac involvement in SCARs is an under-recognized but clinically important complication. This supports the case for routine cardiac assessment, including an ECG and cardiac biomarkers, in patients presenting with these severe reactions, particularly those with DRESS who show signs of other organ dysfunction.

Next, we turn to therapeutics, with a promising new topical for the rare disease epidermolysis bullosa and important data on biosimilar use in psoriasis.

In *Pediatric dermatology*, investigators report on the long-term efficacy and safety of Oleogel-S10, a topical gel derived from birch triterpenes, for children with epidermolysis bullosa [3].

The Study This was a prespecified subgroup analysis of 156 pediatric patients from the phase 3 EASE trial. The trial included a 90-day double-blind phase comparing Oleogel-S10 to a control gel, followed by a 24-month open-label phase where all patients could receive the active treatment.

Results The treatment significantly accelerated wound healing. Within 45 days, 44.6% of target wounds had achieved complete closure in the Oleogel-S10 group, compared to just 25.6% in the control group. This represents a 70% higher likelihood of healing. Over the 24-month open-label period, the mean total body wound burden was substantially reduced, decreasing from 12.5% body surface area at baseline to 5.3%. Furthermore, the treatment reduced the burden of care. At day 90, 38% of patients treated with Oleogel-S10 no longer required daily dressing changes, compared to only 9% of controls.

Clinical Implications This provides strong evidence for a new topical that can make a real difference for children with epidermolysis bullosa, not only by healing wounds faster but also by reducing the significant burden of daily care for patients and their families.

Finally, for the much more common condition of psoriasis, a study in *The British journal of dermatology* provides key data on biosimilar use [4].

The Study This was a randomized, double-blind trial specifically designed to support the interchangeability of the ustekinumab biosimilar, ABP 654, with the reference product. After an initial run-in period where all patients received the reference product, those who responded were randomized to either continue the reference product or to switch back and forth multiple times between the reference product and the biosimilar.

Results The study met its primary pharmacokinetic endpoints. The drug concentrations in the blood were equivalent between the group that kept switching and the group that continued on the reference product, with the 90% confidence intervals for the geometric mean ratios falling well within the prespecified similarity margin. Importantly, clinical efficacy as measured by PASI scores, safety, and the incidence of anti-drug antibodies were also similar between the two groups.

Clinical Implications This robust study design provides strong reassurance for clinicians. The data support the interchangeability of ABP 654 with reference ustekinumab, meaning switches can be made without compromising patient outcomes, which may facilitate access and reduce healthcare costs.

If you only have time for one paper this week, make it the nationwide study on bullous pemphigoid mortality by Albadri and colleagues in *Acta dermato-venereologica* [2]. The sheer scale of this study provides definitive, sobering data on the high mortality risk in BP, firmly establishing cardiovascular disease as the leading cause of death. It's a practice-changing reminder that our management of these patients must extend beyond the skin.

Here are the key takeaways from this week in Dermatology.

First: Bullous pemphigoid carries a more than two-fold increased risk of death, with over one in five patients dying within the first year. Cardiovascular disease is the main driver, so be vigilant about managing cardiovascular risk factors in your BP patients [2].

Second: In patients with severe drug reactions like DRESS and SJS/TEN, maintain a high index of suspicion for cardiac involvement. It’s more common than you might think, especially in DRESS, and warrants a low threshold for ordering an ECG and cardiac biomarkers [1].

Third: For pediatric patients with epidermolysis bullosa, Oleogel-S10 is an effective topical treatment that accelerates wound healing and reduces the burden of care [3].

Finally: You can be confident when switching between reference ustekinumab and its biosimilar, ABP 654. New data from a dedicated interchangeability trial shows no difference in drug levels, efficacy, or safety [4].

That's your roundup for This Week in Dermatology. The full transcript and references are available on the episode page in your AudioScholar library. This is an AI-curated summary — for clinical decisions, always consult primary sources and current guidelines. See you next week.