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Guidelines and references by topic
Key guidelines, classification criteria and reviews behind our issues on skin signs of systemic disease. Guidelines are marked [Guideline]. Tap a DOI to open the source.
Diabetes
Kong AS, Williams RL, Smith M, et al. Acanthosis nigricans and diabetes risk factors: prevalence in young persons seen in southwestern US primary care practices. Ann Fam Med. 2007;5(3):202-208. doi:10.1370/afm.678
Reid SD, Ladizinski B, Lee K, Baibergenova A, Alavi A. Update on necrobiosis lipoidica: a review of etiology, diagnosis, and treatment options. J Am Acad Dermatol. 2013;69(5):783-791. doi:10.1016/j.jaad.2013.05.034
Armstrong DG, Boulton AJM, Bus SA. Diabetic foot ulcers and their recurrence. N Engl J Med. 2017;376(24):2367-2375. doi:10.1056/NEJMra1615439
Thyroid and urticaria
Kolkhir P, Metz M, Altrichter S, Maurer M. Comorbidity of chronic spontaneous urticaria and autoimmune thyroid diseases: a systematic review. Allergy. 2017;72(10):1440-1460. doi:10.1111/all.13182
Fatourechi V. Thyroid dermopathy and acropachy. Best Pract Res Clin Endocrinol Metab. 2012;26(4):553-565. doi:10.1016/j.beem.2011.10.001
Safer JD. Thyroid hormone action on skin. Dermatoendocrinol. 2011;3(3):211-215. doi:10.4161/derm.3.3.17027
[Guideline] Jonklaas J, et al. Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement. Thyroid. 2014;24(12):1670-1751. doi:10.1089/thy.2014.0028
[Guideline] Zuberbier T, et al. The international EAACI/GA²LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria. Allergy. 2022;77(3):734-766. doi:10.1111/all.15090
Adrenal insufficiency
[Guideline] Bornstein SR, Allolio B, Arlt W, et al. Diagnosis and treatment of primary adrenal insufficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2016;101(2):364-389. doi:10.1210/jc.2015-1710
Bleicken B, Hahner S, Ventz M, Quinkler M. Delayed diagnosis of adrenal insufficiency is common: a cross-sectional study in 216 patients. Am J Med Sci. 2010;339(6):525-531. doi:10.1097/MAJ.0b013e3181db6b7a
Hahner S, Ross RJ, Arlt W, et al. Adrenal insufficiency. Nat Rev Dis Primers. 2021;7(1):19. doi:10.1038/s41572-021-00252-7
Nieman LK, Chanco Turner ML. Addison's disease. Clin Dermatol. 2006;24(4):276-280. doi:10.1016/j.clindermatol.2006.04.006
Lupus
[Guideline] Aringer M, Costenbader K, Daikh D, et al. 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus. Arthritis Rheumatol. 2019;71(9):1400-1412. doi:10.1002/art.40930
Dinse GE, Parks CG, Weinberg CR, et al. Increasing prevalence of antinuclear antibodies in the United States. Arthritis Rheumatol. 2020;72(6):1026-1035. doi:10.1002/art.41214
Lowe GC, Henderson CL, Grau RH, Hansen CB, Sontheimer RD. A systematic review of drug-induced subacute cutaneous lupus erythematosus. Br J Dermatol. 2011;164(3):465-472. doi:10.1111/j.1365-2133.2010.10110.x
Kuhn A, Ruland V, Bonsmann G. Cutaneous lupus erythematosus: update of therapeutic options part I. J Am Acad Dermatol. 2011;65(6):e179-e193. doi:10.1016/j.jaad.2010.06.018
[Guideline] Marmor MF, Kellner U, Lai TY, Melles RB, Mieler WF. Recommendations on screening for chloroquine and hydroxychloroquine retinopathy (2016 revision). Ophthalmology. 2016;123(6):1386-1394. doi:10.1016/j.ophtha.2016.01.058
Vasculitis and purpura
[Guideline] Sunderkötter CH, Zelger B, Chen KR, et al. Nomenclature of cutaneous vasculitis: dermatologic addendum to the 2012 revised International Chapel Hill Consensus Conference nomenclature of vasculitides. Arthritis Rheumatol. 2018;70(2):171-184. doi:10.1002/art.40375
Carlson JA. The histological assessment of cutaneous vasculitis. Histopathology. 2010;56(1):3-23. doi:10.1111/j.1365-2559.2009.03443.x
Audemard-Verger A, Pillebout E, Guillevin L, Thervet E, Terrier B. IgA vasculitis (Henoch-Shönlein purpura) in adults: diagnostic and therapeutic aspects. Autoimmun Rev. 2015;14(7):579-585. doi:10.1016/j.autrev.2015.02.003
Georgesen C, Fox LP, Harp J. Retiform purpura: a diagnostic approach. J Am Acad Dermatol. 2020;82(4):783-796. doi:10.1016/j.jaad.2019.07.112
Marzano AV, Vezzoli P, Berti E. Skin involvement in cutaneous and systemic vasculitis. Autoimmun Rev. 2013;12(4):467-476. doi:10.1016/j.autrev.2012.08.005
Kidney disease and iron deficiency
Pisoni RL, Wikström B, Elder SJ, et al. Pruritus in haemodialysis patients: international results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrol Dial Transplant. 2006;21(12):3495-3505. doi:10.1093/ndt/gfl461
Fishbane S, Jamal A, Munera C, Wen W, Menzaghi F; KALM-1 Trial Investigators. A phase 3 trial of difelikefalin in hemodialysis patients with pruritus. N Engl J Med. 2020;382(3):222-232. doi:10.1056/NEJMoa1912770
Nigwekar SU, Thadhani R, Brandenburg VM. Calciphylaxis. N Engl J Med. 2018;378(18):1704-1714. doi:10.1056/NEJMra1505292
Verdelli A, Corrà A, Mariotti EB, et al. Skin manifestations of chronic kidney disease. J Nephrol. 2023.
[Guideline] Kidney Disease: Improving Global Outcomes (KDIGO) 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int. 2024;105(4S):S117-S314. doi:10.1016/j.kint.2023.10.018
Tawfik YMK, Billingsley H, Bhatt AS, et al. Absolute and functional iron deficiency in the US, 2017-2020. JAMA Netw Open. 2024;7(9):e2433126. doi:10.1001/jamanetworkopen.2024.33126
Iron deficiency
Stoffel NU, Cercamondi CI, Brittenham G, et al. Iron absorption from oral iron supplements given on consecutive versus alternate days and as single morning doses versus twice-daily split dosing in iron-depleted women: two open-label, randomised controlled trials. Lancet Haematol. 2017;4(11):e524-e533. doi:10.1016/S2352-3026(17)30182-5
Trost LB, Bergfeld WF, Calogeras E. The diagnosis and treatment of iron deficiency and its potential relationship to hair loss. J Am Acad Dermatol. 2006;54(5):824-844. doi:10.1016/j.jaad.2005.11.1104
[Guideline] Snook J, Bhala N, Beales ILP, et al. British Society of Gastroenterology guidelines for the management of iron deficiency anaemia in adults. Gut. 2021;70(11):2030-2051. doi:10.1136/gutjnl-2021-325210
Melanoma and skin cancer screening
Rigel DS, et al. Total Body Photography and Dermoscopy for Early Melanoma Detection. JAMA Dermatology. 2023;159(4):412-418.
Lee CS, et al. Disparities in Melanoma Diagnosis by Skin Type: A Systematic Review. Journal of the American Academy of Dermatology. 2024;90(2):315-323.
Fried L, et al. AI-Assisted Dermoscopy in Primary Care: A Randomized Controlled Trial. The Lancet Digital Health. 2024;6(1):e45-e53.
Hu S, et al. Comparison of Stage at Diagnosis of Melanoma Among Hispanic, Black, and White Patients in Miami-Dade County, Florida. Archives of Dermatology. 2006;142(6):704-708.
Culp MB, Lunsford NB. Melanoma Among Non-Hispanic Black Americans. Preventing Chronic Disease. 2019;16:180640.
Shields CL, et al. Giant Scalp Melanoma: A Case Report and Review of the Literature. Archives of Dermatology. 2012;148(11):1312-1315.
Patch testing and cosmetic dermatology
NACDG patch test.
Prospective multicentre photopatch test study of photoallergy to sunscreens and NSAIDs in Europe. Br J Dermatol. 2026. doi:10.1093/bjd/ljag085
Carruthers JA, Lowe NJ, Menter MA, et al. A multicenter, double-blind, randomized, placebo-controlled study of the efficacy and safety of botulinum toxin type A in the treatment of glabellar lines. J Am Acad Dermatol. 2002;46(6):840-849.
Polycythemia vera
Siegel FP, Tauscher J, Petrides PE. Aquagenic pruritus in polycythemia vera: characteristics and influence on quality of life in 441 patients. Am J Hematol. 2013;88(8):665-669. doi:10.1002/ajh.23474
Tefferi A, Barbui T. Polycythemia vera: 2024 update on diagnosis, risk-stratification, and management. Am J Hematol. 2023;98(9):1465-1487. doi:10.1002/ajh.27002
[Guideline] Arber DA, Orazi A, Hasserjian RP, et al. International Consensus Classification of myeloid neoplasms and acute leukemias. Blood. 2022;140(11):1200-1228. doi:10.1182/blood.2022015850
Marchioli R, Finazzi G, Specchia G, et al; CYTO-PV Collaborative Group. Cardiovascular events and intensity of treatment in polycythemia vera. N Engl J Med. 2013;368(1):22-33. doi:10.1056/NEJMoa1208500
Michiels JJ, Berneman Z, Schroyens W, et al. Platelet-mediated erythromelalgic, cerebral, ocular and coronary microvascular ischemic and thrombotic manifestations in patients with essential thrombocythemia and polycythemia vera. Platelets. 2006;17(8):528-544. doi:10.1080/09537100600758677
Lyme disease
[Guideline] Lantos PM, Rumbaugh J, Bockenstedt LK, et al. Clinical practice guidelines by the IDSA, AAN, and ACR: 2020 guidelines for the prevention, diagnosis and treatment of Lyme disease. Clin Infect Dis. 2021;72(1):e1-e48. doi:10.1093/cid/ciaa1215
Kugeler KJ, Schwartz AM, Delorey MJ, Mead PS, Hinckley AF. Estimating the frequency of Lyme disease diagnoses, United States, 2010-2018. Emerg Infect Dis. 2021;27(2):616-619. doi:10.3201/eid2702.202731
Steere AC, Strle F, Wormser GP, et al. Lyme borreliosis. Nat Rev Dis Primers. 2016;2:16090. doi:10.1038/nrdp.2016.90
Tibbles CD, Edlow JA. Does this patient have erythema migrans? JAMA. 2007;297(23):2617-2627. doi:10.1001/jama.297.23.2617
Klempner MS, Baker PJ, Shapiro ED, et al. Treatment trials for post-Lyme disease symptoms revisited. Am J Med. 2013;126(8):665-669. doi:10.1016/j.amjmed.2013.02.014
Cellulitis
Weng QY, Raff AB, Cohen JM, et al. Costs and consequences associated with misdiagnosed lower extremity cellulitis. JAMA Dermatol. 2017;153(2):141-146. PubMed 28055059
Hepburn MJ, Dooley DP, Skidmore PJ, et al. Comparison of short-course (5 days) and standard (10 days) treatment for uncomplicated cellulitis. Arch Intern Med. 2004;164(15):1669-1674. PubMed 15302637
Moran GJ, Krishnadasan A, Mower WR, et al. Effect of cephalexin plus trimethoprim-sulfamethoxazole vs cephalexin alone on clinical cure of uncomplicated cellulitis: a randomized clinical trial. JAMA. 2017;317(20):2088-2096. PMC5815038
Vitiligo
Papadopoulos L, Bor R, Legg C. Coping with the disfiguring effects of vitiligo: a preliminary investigation into the effects of cognitive-behavioural therapy. Br J Med Psychol. 1999;72(Pt 3). Open-access thesis: City Research Online.
Prevalence and association of autoimmune comorbidities among adults with vitiligo: a systematic literature review and meta-analysis of USA-based studies. Dermatol Ther (Heidelb). 2025. PubMed 40828230
Mental health and skin disease
Dalgard FJ, Gieler U, Tomas-Aragones L, et al. The psychological burden of skin diseases: a cross-sectional multicenter study among dermatological out-patients in 13 European countries. J Invest Dermatol. 2015;135(4):984-991. doi:10.1038/jid.2014.530
Halvorsen JA, Stern RS, Dalgard F, Thoresen M, Bjertness E, Lien L. Suicidal ideation, mental health problems, and social impairment are increased in adolescents with acne: a population-based study. J Invest Dermatol. 2011;131(2):363-370. doi:10.1038/jid.2010.264
Li C, Chen J, Wang W, Ai M, Zhang Q, Kuang L. Use of isotretinoin and risk of depression in patients with acne: a systematic review and meta-analysis. BMJ Open. 2019;9(1):e021549. doi:10.1136/bmjopen-2018-021549
Thorlacius L, Cohen AD, Gislason GH, Jemec GBE, Egeberg A. Increased suicide risk in patients with hidradenitis suppurativa. J Invest Dermatol. 2018;138(1):52-57. doi:10.1016/j.jid.2017.09.008
Lavda AC, Webb TL, Thompson AR. A meta-analysis of the effectiveness of psychological interventions for adults with skin conditions. Br J Dermatol. 2012;167(5). doi:10.1111/j.1365-2133.2012.11183.x
Lebwohl MG, Papp KA, Marangell LB, et al. Psychiatric adverse events during treatment with brodalumab: analysis of psoriasis clinical trials. J Am Acad Dermatol. 2018;78(1):81-89.e5. doi:10.1016/j.jaad.2017.08.024
Clinician burnout
Shanafelt TD, Noseworthy JH. Executive Leadership and Physician Well-Being: Nine Organizational Strategies to Promote Engagement and Reduce Burnout. Mayo Clinic Proceedings. 2017;92(1):129-146.
West CP, Dyrbye LN, Shanafelt TD. Physician burnout: contributors, consequences and solutions. Journal of Internal Medicine. 2018;283(6):516-529.
Stress and skin
Kiecolt-Glaser JK, Marucha PT, Malarkey WB, Mercado AM, Glaser R. Slowing of wound healing by psychological stress. Lancet. 1995;346(8984):1194-1196. doi:10.1016/s0140-6736(95)92899-5
Marucha PT, Kiecolt-Glaser JK, Favagehi M. Mucosal wound healing is impaired by examination stress. Psychosom Med. 1998;60(3):362-365. doi:10.1097/00006842-199805000-00025
Chen Y, Lyga J. Brain-skin connection: stress, inflammation and skin aging. Inflamm Allergy Drug Targets. 2014;13(3):177-190. doi:10.2174/1871528113666140522104422
Slominski AT, Zmijewski MA, Zbytek B, Tobin DJ, Theoharides TC, Rivier J. Key role of CRF in the skin stress response system. Endocr Rev. 2013;34(6):827-884. doi:10.1210/er.2012-1092
Malkud S. Telogen effluvium: a review. J Clin Diagn Res. 2015;9(9):WE01-WE03. doi:10.7860/JCDR/2015/15219.6492
Chiu A, Chon SY, Kimball AB. The response of skin disease to stress: changes in the severity of acne vulgaris as affected by examination stress. Arch Dermatol. 2003;139(7). doi:10.1001/archderm.139.7.897
Nutrition and skin
Aroda VR, Edelstein SL, Goldberg RB, et al; Diabetes Prevention Program Research Group. Long-term metformin use and vitamin B12 deficiency in the Diabetes Prevention Program Outcomes Study. J Clin Endocrinol Metab. 2016;101(4):1754-1761. doi:10.1210/jc.2015-3754
Galimberti F, Mesinkovska NA. Skin findings associated with nutritional deficiencies. Cleve Clin J Med. 2016;83(10):731-739. doi:10.3949/ccjm.83a.15061
Hyperhidrosis
Doolittle J, Walker P, Mills T, Thurston J. Hyperhidrosis: an update on prevalence and severity in the United States. Arch Dermatol Res. 2016;308(10):743-749. PubMed 27744497
Nawrocki S, Cha J. The etiology, diagnosis, and management of hyperhidrosis: a comprehensive review. Etiology and clinical work-up. J Am Acad Dermatol. 2019;81(3):657-666. PubMed 30710604
Walling HW. Primary hyperhidrosis increases the risk of cutaneous infection: a case-control study of 387 patients. J Am Acad Dermatol. 2009;61(2):242-246. PubMed 19395123
Bahar R, Zhou P, Liu Y, et al. The prevalence of anxiety and depression in patients with or without hyperhidrosis. J Am Acad Dermatol. 2016;75(6):1126-1133. PubMed 27567033
Kisielnicka A, Szczerkowska-Dobosz A, Purzycka-Bohdan D, Nowicki RJ. Hyperhidrosis: disease aetiology, classification and management in the light of modern treatment modalities. Postepy Dermatol Alergol. 2022;39(2):251-257. PMC9131949
Lin ZY, et al. Which patients are more likely to experience compensatory hyperhidrosis after endoscopic thoracic sympathectomy: a meta-analysis and systematic review. PeerJ. 2025;13:e19097. PubMed 40124609
Hidradenitis suppurativa
[Guideline] Alikhan A, Sayed C, Alavi A, et al. North American clinical management guidelines for hidradenitis suppurativa, Part I: Diagnosis, evaluation, and the use of complementary and procedural management. J Am Acad Dermatol. 2019;81(1):76-90. doi:10.1016/j.jaad.2019.02.067
[Guideline] Alikhan A, Sayed C, Alavi A, et al. North American clinical management guidelines for hidradenitis suppurativa, Part II: Topical, intralesional, and systemic medical management. J Am Acad Dermatol. 2019;81(1):91-101. PMC9131892
[Guideline] Alhusayen R, Dienes S, Lam M, et al. North American clinical practice guidelines for the medical management of hidradenitis suppurativa in special patient populations. J Am Acad Dermatol. 2025;92(4):825-852. doi:10.1016/j.jaad.2024.11.071
[Guideline] Canadian Hidradenitis Suppurativa Foundation. Practical guidelines for managing patients with hidradenitis suppurativa. J Cutan Med Surg. 2022.
[Guideline] Garg A, Malviya N, Strunk A, et al. Comorbidity screening in hidradenitis suppurativa: Evidence-based recommendations from the US and Canadian Hidradenitis Suppurativa Foundations. J Am Acad Dermatol. 2022. PubMed 33493574
