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Article History

Received: 20 June 2025

Accepted: 19 December 2025

First Online: 19 January 2026

Declarations

:

: Jonathan I. Silverberg has received grants and/or personal fees from AbbVie, AFYX Therapeutics, Arena Pharmaceuticals, Asana BioSciences, Bluefin Biomedicine, Boehringer Ingelheim, Celgene, Dermavant, Dermira, Eli Lilly and Company, Galderma, GlaxoSmithKline, Incyte Corporation, Kiniksa, LEO Pharma, Luna Pharma, Menlo Therapeutics, Novartis, Pfizer, Rapt Therapeutics, Regeneron, and Sanofi. Lindsay Ackerman has received honoraria as an advisory board member, consultant, and/or speaker and served as an investigator for AbbVie, Amgen, Apollo Therapeutics, argenx, AstraZeneca, Biofrontera, Bristol Myers Squibb, Castle Biosciences, ChemoCentryx, CorEvitas, Corrona, DermTech, Eli Lilly and Company, Exact Sciences, GlaxoSmithKline, Helsinn Healthcare, IgGenix, Incyte Corporation, Janssen, Kymera Therapeutics, Kyowa Kirin, LEO Pharma, Lilly ICOS, Mindera, Novartis, Regeneron, Replimune, Sanofi, Sun Pharma, Takeda, Timber Pharmaceuticals, Trevi Therapeutics, and UCB Pharma. Jerry Bagel has received research funds payable to the Psoriasis Treatment Center of New Jersey from AbbVie, Amgen, Arcutis, Boehringer Ingelheim, Brickell Biotech, Bristol Myers Squibb, Celgene Corporation, Corrona, Dermavant, Dermira, Eli Lilly and Company, Janssen, Kadmon Corporation, LEO Pharma, Menlo Therapeutics, Mindera, Novartis, Pfizer, Regeneron, Sanofi, Sun Pharma, TARGET PharmaSolutions, Taro Pharmaceutical Industries, UCB Pharma, and Valeant Pharmaceuticals and has received consultant fees or speaker fees from AbbVie, Amgen, Arcutis, Bristol Myers Squibb, Dermavant, Eli Lilly and Company, Incyte Corporation, Janssen, Mindera, Novartis, and UCB Pharma. Linda Stein Gold is an investigator, consultant, and/or speaker for AbbVie, Amgen, Arcutis, Bristol Myers Squibb, Dermavant, Eli Lilly and Company, Galderma, Incyte Corporation, Janssen, Novartis, Ortho Dermatologics, Pfizer, Regeneron, Sanofi, and UCB Pharma. Andrew Blauvelt has received consulting fees, speaker honoraria, and/or served as a clinical study investigator for AbbVie, Abcentra, ACELYRIN, Aclaris Therapeutics, Affibody, Aligos Therapeutics, Allakos Therapeutics, Almirall, Alumis, Amgen, AnaptysBio, Apogee Therapeutics, Arcutis, Arena Pharmaceuticals, ASLAN Pharmaceuticals, Athenex, Bluefin Biomedicine, Boehringer Ingelheim, Bristol Myers Squibb, Cara Therapeutics, Concert Pharmaceuticals, CTI BioPharma, Dermavant, EcoR1 Capital, Eli Lilly and Company, Escient Pharmaceuticals, Evelo Biosciences, Evommune, Forte Biosciences, Galderma, HighlightII Pharma, Incyte Corporation, Innovent Bio, Janssen, Landos Biopharma, LEO Pharma, Lipidio Pharma, Microbion Biosciences, Merck, Monte Rosa Therapeutics, Nektar, Novartis, Overtone Therapeutics, Paragon Therapeutics, Pfizer, Q32 Bio, Rani Therapeutics, RAPT Therapeutics, Regeneron, Sanofi, Sanofi Genzyme, Spherix Global Insights, Sun Pharma, Takeda, TLL Pharmaceutical, TrialSpark, UCB Pharma, UNION Therapeutics, Ventyx Biosciences, Vibliome Therapeutics, and Xencor. David Rosmarin has received honoraria as a consultant, received research support, conducted trials, and/or served as a speaker for AbbVie, Abcuro, AltruBio, Amgen, Arena Pharmaceuticals, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Concert Pharmaceuticals, CSL Behring, Dermavant, Dermira, Eli Lilly and Company, Galderma, Incyte Corporation, Janssen, Kyowa Kirin, Merck, Nektar, Novartis, Pfizer, RAPT Therapeutics, Recludix Pharma, Regeneron, Revolo Biotherapeutics, Sanofi, SUN Pharma, UCB Pharma, Viela Bio, and Zura Bio and is an editorial board member of Dermatology and Therapy . David Rosmarin was not involved in the selection of peer reviewers for the manuscript nor any of the subsequent editorial decisions. Raj Chovatiya has served as an advisory board member, consultant, and/or investigator for AbbVie, Apogee, Arcutis, Arena Pharmaceuticals, argenx, ASLAN Pharmaceuticals, Beiersdorf, Boehringer Ingelheim, Bristol Myers Squibb, Cara Therapeutics, Dermavant, Eli Lilly and Company, EPI Health, Incyte Corporation, LEO Pharma, L’Oréal, National Eczema Association, Pfizer, Regeneron, Sanofi, and UCB Pharma; has served as a speaker for AbbVie, Arcutis, Dermavant, Eli Lilly and Company, EPI Health, Incyte Corporation, LEO Pharma, Pfizer, Regeneron, Sanofi, and UCB Pharma; and is an editorial board member of Dermatology and Therapy . Raj Chovatiya was not involved in the selection of peer reviewers for the manuscript nor any of the subsequent editorial decisions. Matthew Zirwas has served as a consultant, investigator, and/or speaker for AbbVie, Acrotech Biopharma, Advanced Derm Solutions, Aldeyra Therapeutics, all® free clear, Amgen, AnaptysBio, Apogee Therapeutics, Arcutis, Bausch + Lomb, Biocon, Bristol Myers Squibb, Cara Therapeutics, Castle Biosciences, Concert Pharmaceuticals, Dermavant, Edesa Biotech, Evelo Biosciences, Galderma, Genentech, Incyte Corporation, Janssen, L’Oréal, LEO Pharma, Level Ex, Eli Lilly and Company, LUUM, Meta, Nimbus Therapeutics, Novan, Novartis, Pfizer, Sanofi Regeneron, Trevi Therapeutics, UCB Pharma, Verrica Pharmaceuticals, and WCG Trifecta. Gil Yosipovitch has conducted clinical trials for or received research funds and/or honoraria for serving on the scientific advisory boards of AbbVie, Arcutis, Eli Lilly and Company, Escient Pharmaceuticals, Galderma, Kiniksa Pharmaceuticals, LEO Pharma, Novartis, Pfizer, Regeneron, and Sanofi. Jill Waibel has served as a consultant and/or investigator and/or on scientific advisory boards for Allergan, Amgen, argenx, BellaMia, Bristol Myers Squibb, Candela Healthcare, Cytrellis Biosystems, Eli Lilly and Company, Emblation, Galderma, Horizon, Janssen/Johnson & Johnson, Lumenis, Neuronetics, Pfizer, Procter & Gamble, RegenX, Sanofi, SkinCeuticals, Shanghi Biopharma, and Port Wine Birthmark and is a recipient of a VA Merit Grant for Amputated Veterans. Jenny E. Murase is on the speaker’s board for non-branded disease state management talks for UCB Pharma; has served on advisory boards for Eli Lilly and Company, LEO Pharma, Sanofi Genzyme, and UCB Pharma; and provided dermatologic consulting services for AbbVie and UpToDat. Ben Lockshin has received grants and/or research support from AbbVie, Dermira, Franklin Bioscience, Galderma, Incyte Corporation, Pfizer, Regeneron, and Sanofi. Jamie Weisman has been a speaker and/or investigator for and/or has received grants and/or honoraria from AbbVie, Amgen, Biogen, Boehringer Ingelheim, Celgene, Eli Lilly and Company, Janssen, LEO Pharma, Merck, Novartis, Pfizer, Regeneron, Stiefel, and Valeant Pharmaceuticals. Amber Reck Atwater was an employee of Eli Lilly and Company at the time of this study. She is currently affiliated with Distinctive Dermatology, Vienna VA, USA. Jennifer Proper, Maria Silk, Evangeline Pierce, Maria Lucia Buziqui Piruzeli, Sonia Montmayeur, Christopher Schuster, Maria Jose Rueda, and Sreekumar Pillai are employees and shareholders of Eli Lilly and Company. Jinglin Zhong is an employee of IQVIA. Eric Simpson reports personal fees from AbbVie, Advances in Cosmetic Medical Derm Hawaii, Amgen, AOBiome, Arcutis, Arena Pharmaceuticals, ASLAN Pharmaceuticals, Bristol Myers Squibb, CorEvitas, Dermira, Eli Lilly and Company, Evelo Biosciences, Excerpta Medica, FIDE, Forte Bio RX, Galderma, GlaxoSmithKline, Impetus Healthcare, Incyte Corporation, Innovaderm Reche, Janssen, Johnson & Johnson, Kyowa Kirin, LEO Pharma, MauiDerm, Medscape, Merck, MJH Holding, MLG Operating, Pfizer, Physicians World, PRImE, Recludix Pharma, Regeneron, Revolutionizing Atopic Dermatitis, Roivant, Sanofi Genzyme, Trevi Therapeutics, Valeant, Vindico Medical Education, and WebMD; and has received grants or serves as a principal investigator for AbbVie, Acrotech, Amgen, Arcutis, ASLAN Pharmaceuticals, Castle, CorEvitas, Dermira, Dermavant, Eli Lilly and Company, Incyte Corporation, Kymab, Kyowa Kirin, National Jewish Health, LEO Pharma, Pfizer, Regeneron, Sanofi, Target, and VeriSkin. These potential conflicts of interest have been reviewed and managed by Oregon Health & Science University.

: The study was undertaken in accordance with the ethical principles of the Declaration of Helsinki and approved by the institutional review board Advarra (6100 Merriweather Drive Suite 600, Columbia, MD 21044, IRB number Pro00066943) before the study was initiated. Written informed consent was obtained from all patients before enrollment in the study. For patients considered minors, written consent of a parent or legal guardian and assent of the minor were obtained. The authors affirm that human research participants provided written informed consent for publication of all images in this article.