A Spatially Coordinated Keratinocyte-Fibroblast Circuit Recruits MMP9+ Myeloid Cells to Drive IFN-I-Driven Inflammation in Photosensitive Autoimmunity.

Photosensitivity is central to cutaneous lupus erythematosus (CLE) and dermatomyositis (DM), but the mechanisms linking UVB exposure to tissue-specific autoimmunity are poorly defined. Using single-cell RNA sequencing, spatial transcriptomics, UVB provocation, and in vitro modeling, we identify MMP9⁺ CD14⁺ myeloid cells as critical mediators of photosensitivity. These cells expand significantly in lesional skin, produce IFN-b, and colocalize with cytotoxic CD4⁺ T cells at the dermal-epidermal junction.

Safety Profile of Upadacitinib: Descriptive Analysis in Over 27,000 Patient-Years Across Rheumatoid Arthritis, Psoriatic Arthritis, Axial Spondyloarthritis, Atopic Dermatitis, and Inflammatory Bowel Disease.

Introduction: We report the long-term safety of upadacitinib (oral, selective, and reversible Janus kinase inhibitor) in rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), non-radiographic axial spondyloarthritis (nr-axSpA), atopic dermatitis (AD), Crohn's disease (CD), and ulcerative colitis (UC).

Methods: Data were analyzed from 16 studies (data cutoff August 15, 2024). Each treatment group was pooled across studies within each indication.

Juvenile localized scleroderma: a large retrospective cohort study from a tertiary care center.

Background: Juvenile localized scleroderma is a rare pediatric inflammatory disease that primarily affects the skin and subcutaneous tissue but also has the potential to impact deeper tissues and can be associated with extracutaneous manifestations, leading to substantial impairment and disability. Management approaches vary, but in recent years, expert groups have attempted to streamline the approach to care with consensus treatment plans.

Methods: This retrospective cohort study included pediatric juvenile localized scleroderma patients with ≥ 3 years of follow-up identified within a 21-year period (1999-2020) at a single tertiary care pediatric hospital in the USA.

Eosinophilic Fasciitis and Morphea Share Gene Signatures of Inflammatory Cell Death, Self-DNA Recognition, and Enhanced Jak/Signal Transducer and Activator of Transcription Signaling.

The pathogenesis of eosinophilic fasciitis (EF) and morphea is poorly understood. We analyzed skin biopsies from patients with EF and morphea compared with those from adult healthy skin using gene expression profiling, Ingenuity Pathway Analysis, and immunostaining. EF gene expression showed significant overlap with morphea.

Spatial Transcriptomics Identifies Immune-Stromal Niches Associated with Cancer in Adult Dermatomyositis.

Adult-onset dermatomyositis (DM) is an autoimmune inflammatory myopathy with distinct cutaneous manifestations and a strong malignancy association. Through comparative analysis with cutaneous lupus erythematosus (CLE), our integrated spatial and single-cell transcriptomics analysis revealed unique immune and stromal niches associated with DM subtypes. Unexpectedly, we found an association between cancer-associated DM skin lesions and the presence of dispersed immune infiltrates enriched with macrophages, CD8+ T cells, plasma cells, and B cells with preserved vascular architecture.

Monoclonal antibody targeting IFNβ for the treatment of NXP2-positive ulcerative juvenile dermatomyositis.

This report outlines the case of a 9-year-old girl with severe anti-nuclear matrix protein 2 antibody-positive juvenile dermatomyositis presenting with disease refractory to multiple traditional therapies. Treatment with an experimental monoclonal antibody inhibiting interferon beta (IFNβ) resulted in the rapid resolution of her muscle weakness and cutaneous and gastrointestinal ulcers. This case highlights the potential benefit of inhibiting IFNβ in the management of recalcitrant juvenile dermatomyositis.

Efficacy, safety, and target engagement of dazukibart, an IFNβ specific monoclonal antibody, in adults with dermatomyositis: a multicentre, double-blind, randomised, placebo-controlled, phase 2 trial.

Background: Dermatomyositis is a chronic autoimmune disease with distinctive cutaneous eruptions and muscle weakness, and the pathophysiology is characterised by type I interferon (IFN) dysregulation. This study aims to assess the efficacy, safety, and target engagement of dazukibart, a potent, selective, humanised IgG1 neutralising monoclonal antibody directed against IFNβ, in adults with moderate-to-severe dermatomyositis.

Methods: This multicentre, double-blind, randomised, placebo-controlled, phase 2 trial was conducted at 25 university-based hospitals and outpatient sites in Germany, Hungary, Poland, Spain, and the USA.

Comparison of 3D facial photographs and clinical documentation in patients with craniofacial morphea.

Diagnosis of craniofacial morphea (CM) relies upon clinical examination of progressive craniofacial changes. We assess the utility of 3D stereophotogrammetry in documenting asymmetry of the face compared to clinical notetaking. This retrospective study of 3D images and clinical documentation included 32 patients (mean age 15.

Innovation in Dermatomyositis.

Dermatomyositis (DM) is a rare autoimmune disease defined by the presence of characteristic cutaneous findings, an increased cancer risk, and variable extracutaneous pathology involving the muscles, lungs, gastrointestinal tract, heart, and/or joints. Although the pathogenesis of DM remains incompletely understood, the discovery of myositis-specific autoantibodies has been an important step forward in understanding disease heterogeneity in DM and stratifying risk for extracutaneous disease and malignancy. Moreover, the recent elucidation of key immunologic drivers of DM has laid the groundwork for the development of novel, targeted treatments in the DM therapeutic pipeline.

From traditional to targeted: the changing trajectory of therapies in dermatomyositis.

Purpose Of Review: New breakthroughs in our understanding of dermatomyositis (DM) have spawned the recent development of novel agents that specifically target key drivers in DM immunopathogenesis. This review aims to provide a comprehensive overview of new and forthcoming therapies for DM and to highlight their mechanisms of action, best evidence to date, and potential impact on disease management.

Recent Findings: Strategies that either counteract dysregulated interferon signaling [via the inhibition of interferon β, the type I interferon receptor subunit 1 (IFNAR1), or janus kinase (JAK)-signal transducer and activator of transcription (STAT) transduction] or induce durable autoreactive B cell depletion through chimeric antigen receptor (CAR) T-cell therapy appear to hold the most promise for sustained remission in DM.

Brepocitinib, a potent and selective TYK2/JAK1 inhibitor: scientific and clinical rationale for dermatomyositis.

Dermatomyositis (DM) is a rare and debilitating, systemic, autoimmune disease. While heterogenous in presentation and severity, DM is primarily characterised by a spectrum of skin and muscle disease, which may include proximal muscle weakness and recalcitrant cutaneous eruptions. DM may also be associated with joint pain and stiffness, inflammatory arthritis, dysphagia, fatigue, and calcinosis.

Interferon subverts an AHR-JUN axis to promote CXCL13 T cells in lupus.

Systemic lupus erythematosus (SLE) is prototypical autoimmune disease driven by pathological T cell-B cell interactions. Expansion of T follicular helper (T) and T peripheral helper (T) cells, two T cell populations that provide help to B cells, is a prominent feature of SLE. Human T and T cells characteristically produce high levels of the B cell chemoattractant CXCL13 (refs.

De novo autoimmune connective tissue disease and mortality in patients treated with anti-programmed death receptor-1 and anti-programmed death-ligand 1 therapy: a population-level cohort study.

Using a population-level cohort analysis, our study demonstrates that, although rare, autoimmune cutaneous connective tissue diseases (AiCTDs) in the setting of immune checkpoint inhibitors (ICIs) are not associated with a greater risk of mortality and overall approach a statistically significant decrease in mortality when compared with patients treated with ICIs who do not experience cutaneous immune-related adverse events. These findings are significant and highly relevant to dermatologists and oncologists caring for ICI recipients as it adds to the limited information on development of cutaneous AiCTD following ICI administration, for which enhanced understanding is critical to improving the care for this challenging patient population.