One in 23 patients on systemic therapy for skin disease converts to latent TB — screen by drug class and by where they live

The edition in brief

A meta-analysis of 31 studies and 15,005 dermatology patients on systemic therapy found a pooled latent TB conversion rate of 4.3% in those who screened negative at baseline, highest with TNF inhibitors, then IL-17 inhibitors and ustekinumab, and an active TB rate of 1.0%, higher in high-burden regions. For Indian practice this argues for repeat interval testing, not only a baseline test, and for preferring lower-risk classes where TB exposure is likely. A JAAD clinical review of JAK inhibitors in adults aged 65 and over supports upadacitinib 15 mg and abrocitinib 100 mg for atopic dermatitis and deucravacitinib for psoriasis in carefully selected patients, with cardiovascular and cancer risk assessed first; age-specific data remain sparse. A Dutch registry of 309 children on dupilumab showed sustained control at three years (mean EASI 3.4) and 80.1% drug survival, with ocular surface disease in 36.6%. The FDA has listed a Class II recall of one lot of Lupin clobetasol propionate 0.05% cream in the US for failed content uniformity; it is a quality issue, not a new safety signal for clobetasol.