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Personalized Medicine in Dermatology: Current Status and Challenges
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Personalized Medicine in Dermatology: Current Status and Challenges

A Special Issue of Journal of Personalized Medicine (ISSN 2075-4426) belonging to the section "Personalized Therapy in Clinical Medicine".

Deadline for manuscript submissions: 31 October 2026 | Viewed by 3665

Editors

Dr. Lidia Sacchelli

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Guest Editor
1. Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, 40138 Bologna, Italy
2. Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy
Interests: acne; psoriasis; biotechnological therapies; quality of life and ethical communication
Special Issues, Collections and Topics in MDPI journals
Dr. Michelangelo La Placa

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Guest Editor
Dermatology Division, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40126 Bologna, Italy
Interests: dermatology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Personalized medicine is transforming dermatology by moving from generalized treatments to tailored approaches based on individual clinical, genetic, and lifestyle profiles. This is especially important in chronic inflammatory conditions such as psoriasis, acne, and hidradenitis suppurativa, where patient variability is considerable.

This Special Issue aims to explore the current landscape and future of personalized medicine in dermatology. We seek to highlight how precision strategies can improve therapeutic outcomes, reduce side effects, and enhance patient quality of life.

Advancements in biotechnology, pharmacogenomics, and digital health are driving more accurate diagnoses, treatment monitoring, and customized care, paving the way for truly patient-centered dermatology.

We welcome original research, reviews, and clinical perspectives on personalized dermatology. Relevant topics include biomarkers, treatment algorithms, targeted therapies, digital tools, patient-reported outcomes, and real-world applications of precision medicine.

You may choose our Joint Special Issue in JCM.

Dr. Lidia Sacchelli
Dr. Michelangelo La Placa
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • psoriasis
  • quality of life
  • acne
  • hidradenitis suppurativa
  • biotechnological therapies
  • personalized medicine
  • autoimmune skin diseases

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Published Papers (4 papers)

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Research

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15 pages, 1043 KB  
Article
Early Ocular-Surface Changes During Dupilumab Treatment According to Hyaluronic Acid Use: A Prospective Cohort Study
by Giuseppe Demichele, Giulia Ciccarese, Aurora De Marco, Giovanni Petruzzella, Chiara Barlusconi, Cristiana Mileti, Giovanni Alessio, Maria Gabriella La Tegola, Rosa Anna Favale, Francesca Ambrogio, Alexandre Raphael Meduri, William Andrew Rosato, Rossana Spadavecchia, Paolo Romita, Domenico Bonamonte and Caterina Foti
J. Pers. Med. 2026, 16(9), 476; https://doi.org/10.3390/jpm16090476 - 16 Sep 2026
Viewed by 14
Abstract
Background: Ocular-surface abnormalities are common in patients with moderate-to-severe atopic dermatitis and may predispose to dupilumab-associated ocular surface disease (DAOSD). We investigated early ocular-surface changes during dupilumab treatment and whether baseline-guided hyaluronic acid (HA) eye-drop use was associated with more favorable ocular [...] Read more.
Background: Ocular-surface abnormalities are common in patients with moderate-to-severe atopic dermatitis and may predispose to dupilumab-associated ocular surface disease (DAOSD). We investigated early ocular-surface changes during dupilumab treatment and whether baseline-guided hyaluronic acid (HA) eye-drop use was associated with more favorable ocular outcomes. Methods: In this prospective single-center cohort study, patients with moderate-to-severe atopic dermatitis underwent ophthalmologic assessment before dupilumab initiation and after 4 months. HA 0.15% eye drops were prescribed to patients with at least one basal or reflex Schirmer value ≤15 mm and ocular symptoms. Ocular outcomes included tear break-up time (TBUT), basal and reflex Schirmer tests, meibography, and the Ocular Surface Disease Index (OSDI). Follow-up values were compared between HA users and non-users using baseline-adjusted models with false-discovery-rate correction. Results: Thirty-nine patients were included; 18 received HA eye drops and 21 did not. Twenty-seven patients (69.2%) had at least one baseline Schirmer value ≤15 mm. At 4 months, reflex Schirmer values were higher in HA users than in non-users after baseline adjustment (adjusted mean difference, 5.60 mm; 95% CI, 1.64–9.57; p = 0.007; q = 0.035). In the low-Schirmer subgroup, HA use was associated with higher reflex Schirmer (8.50 mm; 95% CI, 4.84–12.17; q < 0.001) and basal Schirmer values (5.07 mm; 95% CI, 1.41–8.73; q = 0.022). Among untreated patients with low baseline Schirmer values, reflex tear production decreased in eight of nine patients, despite OSDI scores remaining within the conventional normal range. Conclusions: HA supplementation at dupilumab initiation was associated with more favorable changes in tear production, particularly among patients with reduced baseline Schirmer measurements. Objective deterioration in tear production despite persistently low OSDI scores highlights the limitations of symptom-based assessment alone. These findings support baseline ophthalmologic evaluation and combined objective and symptom monitoring during dupilumab treatment. Larger controlled studies are needed to determine whether early, targeted HA eye-drop use can prevent clinically relevant dupilumab-associated ocular surface disease. Full article
(This article belongs to the Special Issue Personalized Medicine in Dermatology: Current Status and Challenges)
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12 pages, 805 KB  
Article
Systemic Immune–Inflammation Index (SII) as a Predictive Biomarker of Therapeutic Response in Psoriasis: A Retrospective Comparative Analysis of Anti-TNF, Anti-IL-17, and Anti-IL-23 Agents
by Emanuele Trovato, Francesca La Marca, Benedetta Simonini, Martina Dragotto, Enrico Calandra, Francesca Lussana, Alessandra Cartocci and Pietro Rubegni
J. Pers. Med. 2026, 16(6), 323; https://doi.org/10.3390/jpm16060323 - 16 Jun 2026
Viewed by 903
Abstract
Background/Objectives: The Systemic Immune–Inflammation Index (SII), derived from routine blood counts, has emerged as a potential marker of systemic inflammation in psoriasis. However, its longitudinal behavior across different systemic and biologic therapies remains poorly characterized. This study aimed to evaluate changes in SII [...] Read more.
Background/Objectives: The Systemic Immune–Inflammation Index (SII), derived from routine blood counts, has emerged as a potential marker of systemic inflammation in psoriasis. However, its longitudinal behavior across different systemic and biologic therapies remains poorly characterized. This study aimed to evaluate changes in SII over time, assess its relationship with Psoriasis Area and Severity Index (PASI) scores, and compare SII trajectories among different treatment classes. Methods: A retrospective single-center study included 210 adults with psoriasis treated for 12 months with cyclosporine, anti-TNF-α, anti-IL-17, or anti-IL-23 agents. SII and PASI were recorded at baseline, 16, 36, and 52 weeks. Correlations between SII and PASI were assessed using Spearman’s analysis. Longitudinal changes were evaluated using the Friedman test, and treatment-group differences were assessed using Kruskal–Wallis analysis. An adjusted multivariable linear regression model including age, sex, body mass index, psoriatic arthritis, baseline PASI, and treatment group was performed to identify factors associated with Δ%SII. Results: SII correlated with PASI at baseline (ρ = 0.406, p < 0.001) and at 52 weeks (ρ = 0.186, p = 0.007), whereas no significant associations were observed at intermediate timepoints. Longitudinal analyses demonstrated significant differences in SII trajectories among treatment groups (p < 0.001). SII increased over time in the cyclosporine and anti-TNF-α groups, while anti-IL-17 and anti-IL-23 therapies were associated with marked and sustained reductions. In the adjusted model, anti-IL-17 (β = −90.7, 95% CI −119.6 to −61.8, p < 0.001) and anti-IL-23 therapies (β = −97.9, 95% CI −126.2 to −69.6, p < 0.001) remained independently associated with greater reductions in SII compared with cyclosporine, whereas anti-TNF therapy showed no significant difference. Conclusions: SII is a dynamic marker of systemic inflammatory changes in psoriasis and exhibits distinct longitudinal patterns according to treatment class. The pronounced reductions observed with IL-17 and IL-23 inhibitors support the potential value of SII as an adjunctive measure of systemic inflammation. However, prospective studies are required to clarify its clinical utility and determine its role in routine patient management. Full article
(This article belongs to the Special Issue Personalized Medicine in Dermatology: Current Status and Challenges)
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11 pages, 229 KB  
Article
Effectiveness of Bimekizumab in Multi-Failure Psoriatic Patients: A Retrospective, Real-World Multicenter Study
by Francesca Satolli, Giulia Rech, Silvia Gerosa, Laura Bigi, Andrea Conti, Vito Di Lernia, Claudia Lasagni, Rosita Longo, Michela Tabanelli and Federico Bardazzi
J. Pers. Med. 2026, 16(1), 27; https://doi.org/10.3390/jpm16010027 - 5 Jan 2026
Cited by 1 | Viewed by 1484
Abstract
Background/Objectives: Patients with moderate-to-severe psoriasis who experience inadequate response or loss of efficacy to multiple biologic agents (“multi-failure patients”) represent a particularly challenging subgroup in clinical practice. Evidence regarding the efficacy of bimekizumab in this setting is still limited. This multicentre, real-life study [...] Read more.
Background/Objectives: Patients with moderate-to-severe psoriasis who experience inadequate response or loss of efficacy to multiple biologic agents (“multi-failure patients”) represent a particularly challenging subgroup in clinical practice. Evidence regarding the efficacy of bimekizumab in this setting is still limited. This multicentre, real-life study aimed to evaluate the effectiveness, safety, and treatment persistence of bimekizumab in patients with moderate-to-severe psoriasis who had failed at least two previous biologic therapies. Methods: This multicentre, retrospective, real-life study across Italian referral centers retrospectively collected clinical data from 33 adult patients with plaque psoriasis treated with bimekizumab across Italian referral centers. Efficacy was assessed through changes in Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) scores at weeks 4 and 16. Logistic regression was performed to identify predictors of treatment response, and Kaplan–Meier analysis evaluated drug survival up to 12 months. Results: The mean baseline PASI was 14.5 ± 7.1, decreasing to 1.5 ± 4.0 at week 16 (p < 0.001). PASI90 and PASI100 responses were achieved by 57.6% and 42.4% of patients at this timepoint, respectively, while mean DLQI improved by 84.2%. In this small cohort, no significant differences in efficacy were observed according to the number or class of prior biologic failures. Genital psoriasis was associated with a lower likelihood of achieving PASI100. Adverse events were generally mild to moderate in severity and manageable in routine clinical practice. No discontinuations occurred due to lack of efficacy; all withdrawals were related to mild adverse events or personal reasons. Twelve-month drug survival reached 85.4% (95% CI 63.8–100). Conclusions: Bimekizumab demonstrated rapid, marked, and sustained clinical improvements with a favorable safety profile in multi-failure psoriasis patients. These findings support its role as an effective and well-tolerated therapeutic option for individuals with highly refractory disease in real-life practice. Full article
(This article belongs to the Special Issue Personalized Medicine in Dermatology: Current Status and Challenges)

Review

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15 pages, 857 KB  
Review
Repigmentation Competence in Vitiligo: Integrating Immune, Regulatory, Regenerative, and Microenvironmental Axes
by Maria Efenesia Baffa, Roberto Maglie, Stefano Colabrese, Carlo Pipitò, Vincenzina Rubino, Sasha Visinoni, Lucrezia Cerchiai, Marzia Caproni and Emiliano Antiga
J. Pers. Med. 2026, 16(8), 418; https://doi.org/10.3390/jpm16080418 - 6 Aug 2026
Viewed by 454
Abstract
Vitiligo is an autoimmune depigmenting disorder characterized by marked heterogeneity in therapeutic response, both between patients and among lesions within the same individual. While current therapies primarily target interferon-γ (IFN-γ)-driven inflammation, clinical outcomes remain variable and frequently incomplete, suggesting that additional lesion-specific biological [...] Read more.
Vitiligo is an autoimmune depigmenting disorder characterized by marked heterogeneity in therapeutic response, both between patients and among lesions within the same individual. While current therapies primarily target interferon-γ (IFN-γ)-driven inflammation, clinical outcomes remain variable and frequently incomplete, suggesting that additional lesion-specific biological factors contribute to repigmentation potential. In this narrative review, we propose the concept of repigmentation competence to describe the capacity of an individual lesion to achieve clinically meaningful repigmentation under therapy. We hypothesize that this competence emerges from the interaction of four interconnected biological axes: (i) cytokine network and immune memory, (ii) local immune regulation, (iii) regenerative capacity, and (iv) microenvironmental permissiveness. A targeted search of PubMed/MEDLINE and ClinicalTrials.gov up to March 2026 was conducted to identify translational studies, mechanistic models, and clinical trials relevant to these pathways. Evidence was synthesized thematically with emphasis on cytokine-mediated mechanisms and their interaction with regenerative and tissue-context processes. The IFN-γ/CXCL9/CXCL10 axis and tissue-resident memory T cells (TRM) represent the most clinically validated drivers of disease persistence, as demonstrated by the therapeutic efficacy of JAK inhibitors, although immune suppression alone often fails to achieve complete or durable repigmentation. In contrast, regulatory pathways involving PD-1/PD-L1 signaling, regulatory T cells (Tregs), IL-10, TGF-β, and IL-2–based strategies remain biologically compelling but only partially translated into effective therapies. Regenerative capacity has also emerged as an important determinant of treatment response, with growing evidence supporting the role of melanocyte stem cell niches, follicular regeneration, and Wnt/β-catenin signaling. Accordingly, regenerative approaches such as non-cultured epidermal cell suspension (NCES) are increasingly being integrated into combination therapeutic strategies. The lesional microenvironment remains the least therapeutically developed axis despite growing experimental evidence supporting its importance in melanocyte survival and migration. Collectively, these observations suggest that the variable efficacy of current therapies may reflect different combinations of lesion-specific biological constraints. The emerging benefit of combination strategies may therefore derive not simply from additive effects, but from the simultaneous engagement of multiple axes involved in repigmentation competence. Our review supports a shift from a predominantly drug-centered model toward a lesion-oriented framework integrating immune, regenerative, regulatory, and microenvironmental determinants of response. Full article
(This article belongs to the Special Issue Personalized Medicine in Dermatology: Current Status and Challenges)
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