Faculty Bibliography

OBJECTIVES/UNASSIGNED:Urticaria pigmentosa (UP) is the most common form of cutaneous mastocytosis. UP presents with pruritic, red-brown macules and papules, and can be associated with systemic involvement. Currently, there is no cure for UP. Treatment options have been historically limited to antihistamines, which are effective for symptoms but not cosmesis of the lesions. While phototherapy is a recognized treatment for cutaneous mastocytosis, there is sparse evidence addressing the efficacy of narrowband UVB (NB-UVB) phototherapy for UP specifically. We describe three cases of long-standing UP successfully treated with NB-UVB. METHODS/UNASSIGNED:A retrospective chart review was performed to collect demographic characteristics, disease features, prior treatments, phototherapy parameters, adverse events, pruritus severity, and clinical response using investigator global assessment. RESULTS/UNASSIGNED:All three patients demonstrated clinical improvement with NB-UVB despite differences in disease duration, prior treatment history, and phototherapy adherence. Pruritus resolved during therapy for all patients, and two patients had documented improvement in lesion appearance. Treatment was well tolerated, with adverse events limited to mild, transient erythema in two patients and no severe or long-term complications documented. CONCLUSIONS/UNASSIGNED:These cases support NB-UVB as a durable and well-tolerated treatment option for selected adult patients with UP, particularly those with inadequate response to conventional therapies or need for adjunctive treatment.

BACKGROUND:Genital psoriasis remains underdiagnosed and undertreated despite its substantial impact on quality of life. The sensitive nature of genital involvement contributes to diagnostic delays, patient distress, and treatment challenges. The Genital Psoriasis Wellness Consortium, a multidisciplinary panel of US-based clinicians, previously developed consensus statements on physical diagnosis, patient conversations, quality of life impacts, and treatment. OBJECTIVE:We aimed to build on prior work by providing additional considerations to refine best practices across three areas: physical exam and diagnosis; pediatric and adolescent treatment; and adult and geriatric treatment. METHODS:The panel used the modified Delphi process and nominal group technique, informed by a systematic literature review, with consensus defined as ≥ 75% agreement on a 7-point Likert scale. RESULTS:The panel emphasized routine genital assessment within comprehensive skin exams and proactive empathetic communication to reduce stigma, with verbal consent and the offer of a chaperone as standard practice. In pediatric care, shared decision making among clinicians, caregivers, and patients fosters adherence. In adults and older patients, treatment decisions should consider comorbidities, polypharmacy, and individual goals; prioritizing therapies with established safety in intertriginous areas and minimizing long-term corticosteroid use. Simple regimens and attention to access barriers were identified as important to support adherence. CONCLUSIONS:These considerations aim to enhance diagnosis, optimize treatment, and improve outcomes through personalized empathetic care.