Dr Jenny Murase presents a case of chronic hand eczema persisting despite well-controlled atopic dermatitis on dupilumab, highlighting the role of delgocitinib cream.

When the Hands Don’t Follow the Rest: Managing Chronic Hand Eczema Despite Systemic AD Control

Dr Jenny Murase presents a case of severe, dupilumab-refractory atopic dermatitis with idiopathic sudomotor failure successfully managed with lebrikizumab.

Lifelong Atopic Dermatitis with Idiopathic Sudomotor Failure: Response to Lebrikizumab After Dupilumab Failure

Dermatology has always woven together science and artistry, the molecular with the tangible. As topical innovation surges ahead, balance is being redefined. At this year’s 25th Annual Fall Clinical Dermatology Conference in Las Vegas, that shift will come into sharp focus.

The Changing Landscape of Topical Therapies: A Fall Clinical Preview 

Case author Graham Litchman, DO, MS, presents a case of a young adult patient with longstanding atopic dermatitis that remained uncontrolled despite multiple prior therapies, prompting consideration of dose escalation with a JAK inhibitor.

Jacked on JAKs: The Therapeutic Impact of Dose Escalation in a Case of Refractory Atopic Dermatitis

Case author Naiem T. Issa, MD, PhD, presents a case of a 10-year old white male with a 5-year history of atopic dermatitis, allergic rhinitis and exercise-induced asthma. 

Utility of Tapinarof Cream 1% in a Case of Severe and Recalcitrant Atopic Dermatitis In a Pediatric Patient

Charting the Course to Higher Targets With JAK Inhibition in Atopic Dermatitis

Identify strategies to counsel patients about higher treatment targets in moderate-to-severe atopic dermatitis (AD) management 

Discuss safety and efficacy data for approved and emerging Janus kinase (JAK) inhibitors in moderate-to-severe AD 

Apply safety data for JAK inhibitors to therapeutic selection for patients with moderate-to-severe AD 

FC25: Charting the Course to Higher Targets With JAK Inhibition in Atopic Dermatitis: An Online Activity

Illuminate the Role of IL-13 Inhibitors for the Management of Atopic Dermatitis

Differentiate biologic therapies for atopic dermatitis (AD) targeting interleukin (IL)-13 based on their clinical profile

Review emerging clinical data for IL-13 biologics in the treatment of moderate-to-severe AD 

Examine strategies to optimize the use of IL-13 biologics for the long-term management of moderate-to-severe AD 

FC25: Illuminate the Role of IL-13 Inhibitors for the Management of Atopic Dermatitis: An Online Activity

HowTo’ Treat the Toughest Spots: Tackling Head and Neck Atopic Dermatitis

Define the role of targeted biologics in the management of head and neck atopic dermatitis (AD) based on the latest real-world and long-term clinical evidence 

​​’HowTo’ Treat the Toughest Spots: Tackling Head and Neck Atopic Dermatitis: An Online Activity

Therapeutic Headscratchers: Updates in Treating Head and Neck Atopic Dermatitis 

Therapeutic Headscratchers: Updates in Treating Head and Neck Atopic Dermatitis: An Online Activity

Spotlight on IL-13: Long-Term Strategies in the Management of Moderate-to-Severe Atopic Dermatitis

Recognize the burden of itch in chronic, recurrent flares in moderate-to-severe atopic dermatitis (AD) despite topical corticosteroid use

Identify patients with moderate-to-severe AD eligible for biologic therapy according to the 2023 American Academy of Dermatology guidelines 

PANP25: Spotlight on IL-13: Long-Term Strategies in the Management of Moderate-to-Severe Atopic Dermatitis: An Online Activity

Controlling the Wolf in Sheep’s Clothing: Managing Pediatric Atopic Dermatitis with Biologic Therapies

Discuss the burden of moderate-to-severe atopic dermatitis (AD) and its associated comorbidities on pediatric patients’ quality of life

Identify the immune pathways implicated in the pathophysiology of moderate-to-severe AD

Apply recent clinical data for biologic therapies into the management of pediatric moderate-to-severe AD in order to prevent progression

PEDS25: Controlling the Wolf in Sheep’s Clothing: Managing Pediatric Atopic Dermatitis with Biologic Therapies: An Online Activity

Shining a Light on IL-13: Optimizing Moderate-to-Severe Atopic Dermatitis Treatment in Daily Practice

Differentiate biologic therapies targeting IL-13 based on their clinical profile

Review emerging clinical data for IL-13 biologics in the treatment of moderate-to-severe AD

Identify patients with moderate-to-severe AD eligible for biologic therapy according to the 2023 American Academy of Dermatology guidelines

Shining a Light on IL-13: Optimizing Moderate-to-Severe Atopic Dermatitis Treatment in Daily Practice: An Online Activity

Discuss strategies for effective clinical management of patients with atopic dermatitis (AD) inadequately controlled with biologic treatment 

Identify patients with moderate-to-severe AD for systemic therapy with Janus kinase (JAK) inhibitors 

Select the appropriate dose of JAK inhibitors to optimize treatment of AD

WCM25: Path to Relief: Advancing Care in Atopic Dermatitis With JAK Inhibitors: An Online Activity

Identify the burden of atopic dermatitis (AD) and plaque psoriasis on pediatric patients’ quality of life

Review the latest clinical evidence on approved and emerging non-steroidal topicals to manage AD and plaque psoriasis in pediatric patients

Outline practical and communication strategies for managing pediatric patients with AD and plaque psoriasis

PEDS24: Paving the Way for Non-Steroidal Topicals for Pediatric Patients With Atopic Dermatitis and Plaque Psoriasis: An Online Activity

Discuss optimization of treatment selection based on head-to-head data on systemic Janus kinase (JAK) inhibitors in moderate-to-severe atopic dermatitis 

Review long-term benefit-risk profile for systemic JAK inhibitors for the treatment of moderate-to-severe AD

Identify strategies to employ new efficacy targets in the treat-to-target framework for the management of moderate-to-severe atopic dermatitis 

Describe shared decision-making approaches for managing moderate-to-severe atopic dermatitis with systemic JAK inhibitors 

FC24: Is EASI 75 Good Enough or Can We Do Better? Elevating Efficacy and Long-Term Safety With JAK Inhibitors in Moderate-to-Severe Atopic Dermatitis: An Online Activity

Review emerging long-term data for nonsteroidal topical agents for the treatment of atopic dermatitis (AD) 

 Identify patients with AD who are eligible candidates for nonsteroidal topical agents

FC24: Gamechangers in Nonsteroidal Topical Management of Atopic Dermatitis: The Next Generation: An Online Activity

Discuss the role of interleukin (IL)-13 in the pathophysiology of the AD disease course

2024 Virtual Grand Rounds Session 16: November 20, 2024 - Lighting the Path for IL-13’s Role in Atopic Dermatitis

Describe the novel mechanisms of action of targeted atopic dermatitis (AD) therapies

Review the efficacy and safety from key clinical trials in emerging therapies for atopic dermatitis (AD)

2024 Virtual Grand Rounds Session 12: September 25, 2024 - New Targets in Atopic Dermatitis: What’s on Deck?

Describe how biologics target the disease pathway for AD

Review the clinical trial data for biologics to treat moderate-to-severe AD

Discuss the safety profile of biologics and how to manage adverse effects 

'HowTo' Closing the Healthcare Gaps in the Management of Moderate-to-Severe Atopic Dermatitis With Biologics: Microlearning CME Activity

Hello, I'm Dr. Jim Dorasso, and I'm happy to bring to you how to close the healthcare gaps in the management of moderate to severe atopic dermatitis with biologics, supported by an educational grant from Lilly. So this is how to for dermatologists. And who better than to have with me Dr. Peter Leo from Chicago, well known for his knowledge in atopic dermatitis and other areas, and Dr. To April Armstrong, who comes to us as chief of the division of dermatology at UCLA. The good news is this program is accredited for the CME credit. You get zero point 25 AMA category one credits. So be sure that you claim them. The learning objectives are here. And basically, this is going to be a conversation to show dermatologists how to. So at this point, I'd like to open the discussion to Dr. Leo or Dr. Armstrong, whoever wants to go first. How do you decide when to start a systemic or a biologic agent for a patient with atopic dermatitis? I'll jump right in first and I'll say, I think this is an exciting area that is rapidly changing because even just as recently as six years ago, we didn't have biologics. So there's still a relatively new addition to our armamentarium. And for me, what I'm finding is that little by little, my threshold is going down where I might start it. So this is a moving target. But ultimately, we want to try, of course, to do our topical therapies, make sure they're maximizing that we want to make sure that we really have the correct diagnosis, because some of the referrals, I'm sure we all get, it's like, wait a minute, is this really atopic dermatitis? Should we do patch testing? Should we do a biopsy to make sure the reason this is failing is because we've got the wrong disease? And then, of course, we want to ensure that it's having a big impact on quality of life. If those are met, if we know we've tried our best with topicals, we know it is atopic derm and it's having a big impact. I think that is a very reasonable time to say, listen, the next step is going to be systemic. And generally speaking, our first line, systemic therapy, is going to be a biologic. Yeah, question about that, April, I'll ask you, is Peter said about starting with topical therapies, but a lot of times we see patients that come in that have really extensive disease, severe disease, they've been around the block a few times, and we're going to want to start systemic therapy right away along with topicals. Do you agree with that? Absolutely. I think when we first assess patients disease severity, and Peter couldn't have said it better in terms of looking at the history of patients and assessing for disease burden, I think disease severity definitely is one of those things that reigns supreme in this decision making process. I just want to offer also a practical tip of what payers are looking for. And this is really important because sometimes they have these automated systems where they scan your note and then looking for the keywords there. So very important. Moderate to severe atopic dermatitis, if you put any numbers there. So they're looking for BSA 10% or greater. If you put an easy score, they're looking for easy score, 16 or greater. And if you put IGA score, they're looking for IGA score three or greater. And the reason is because these are typically the parameters in which the patients were evaluated in the clinical trials. And knowing what they're looking for, I think can be very important in terms of getting our medications approved for our patients. And I find that it's important to capture anything they previously used and how it interferes with their life, interferes with sleep, missing work, et cetera. Now, I've been in practice for 37 years. So for 30 years, I did not have any of these right. So I've been practicing in, I don't want to say the stone age, but these agents are new. It's a lot to learn for a lot of people, even new people coming out, a lot of new information. So how do you decide whether these are the same when you're looking at different agents or whether there are differences between them, how do you distinguish that? Peter, let's go back to you. I think it is a challenge because even for the nerdy ones of us who are focused on these, the ones that we have right now, and we, of course, have two approved in the United States, with a third really close to being approved. It's already approved in Europe, but hopefully we'll have it here soon. So we have dupliumab, trailokinumab and waiting in the wings, lebrechizumab. Now, it's important, and I'm going to turn it over to April to tell us how they're different, but it's important to know that they're targeting roughly the same pathway. They're really focused on IL 13, and dupliumab, of course, also gives us aisle four. But generally speaking, this is kind of the same mechanism, and this is not something totally different. We have other different mechanisms like the jack inhibitors, and we have things like anti IL 30 ones coming, but these guys are all kind of tightly focused. And then maybe, April, you could tell us, because you do it beautifully, about how molecularly they're slightly different and what that might mean. Let's take a look at the MoA of these biologics. Dupilamab is a receptor binder. So you see dupilamab here, monoclonal antibody binding to Il four receptor alpha, thereby inhibiting the signaling of Il four as well as IL 13. When we look at trailoquinumab, trailoquinumab here binds to IL 13 as a ligand binder, and it binds to IL 13 at a site such that IL 13 cannot interact directly with its native receptor. When we look at lebrechizumab, it's different from trilokinumab in that lebrchizumab, while binding to IL 13 ligand directly, it binds to a site where IL 13 can still interact with its native receptor. However, inhibits IL 13 signaling by preventing the dimerization between the two subunits of the receptor. Here. Another difference between lebricizumab and trailokinumab is that when we look at trailokinumab, trilocinumab bound IL 13 cannot interact with its decoy receptor, whereas leprechizumab bound IL 13 can still interact with its decoy receptor. Now, the significance of that is still unknown, but something that we're continuously hoping to study. Yeah, I think it's important because Peter was talking about how they're very similar in their mechanism, but I think we have to make sure people understand there are a lot of differences between these different agents, and you can't think of them as entirely being interchangeable. They have differences in their dosing. They have differences in their pharmacokinetics. They have differences in where they bind and their binding affinities. You may have an adverse event from one where you don't necessarily have that same adverse event from the other. You may have differences in how patients respond. So it's still nice to have these choices. It's not like they're all, I'll use PETA's favorite food, pizzas that all taste the same. There are differences between them. They're slices of pizza, but they're a little different from one another. So I'll ask the final question. When patients come in and you want to start one of these systemic biologic agents and even some of the other agents that we have, systemic agents and they ask, am I going to be on this forever? It's a long term disease, right? So how do you address that with the patients? Peter, I'll go back to you. The key question my patients ask me, and I'm really happy to say that for at least some, and I never want to over promise and under deliver. So I under promise it when I say it. But I say for at least some patients, if they do well for a period of time, and usually I say on the order of months or even maybe a year or two, where they're stable and comfortable and clear, I truly believe that patients can come off of these medicines and sometimes be in a relative state of remission. And we've seen this both in kind of the natural history of the disease, where I've had patients who've had to stop it for varying reasons. Maybe they're going to try to conceive or they're going to go out of the country, and then I followed up with them and they've actually done okay. And of course, we know that for trailocinumab, it actually even has a decreased dosing regimen for when they're doing well, and increased interval at monthly instead of every two weeks. So we can already see that we can at least taper in some of these situations or potentially even take a break for some patients. And I think that's pretty exciting. April, you have anything to add on that? Yes. I think when we look at our various biologics, and if we look at some of our long term data from some of these biologics, you look at sometimes I have this withdrawal arm where the patients are actually taken off of the medication. And what is seen is that actually there is a good maintenance of response, actually, especially in patients who have been responders in the first place. So that do tell us that, in fact, there are some patients, perhaps you can get these even greater than the approved increase in terms of the interval in which you can get them to be off the drug and still maintain that response. I have to say it's a very individualized decision. I typically want to see my patients to first of all achieve clear, because if they don't achieve clear, they have some type of subclinical inflammation that tells me that maybe we're not able to stretch out, for example, the dosing interval. So if they have been clear on the dosing that they are approved to be on for a while, then I think it's not unreasonable to consider possibly longer dosing intervals for our patients. What I use as my measuring stick is not always to wait for the examiner's dermatitis to appear, but when their itching starts to come back because it's the itch that rashes, remember. Now I understand why they told me that back in the 1980s when I was a resident. But one of the things I think is important, when patients ask, am I going to be on this forever? They don't know how much better they can be. They've been living with the disease or the parents, been living with the kid and dealing with it once they get started and their life is now different and they're so much better than what they were. They're not itching all the time. Their threshold for wanting to stop it changes. They're willing to go longer in many cases because they never felt that good. I tell them, we can stop it anytime you want to. Just give me a chance to help you manage it. Don't disappear for six months and go back to square one because that makes it a lot harder. So I really appreciate the discussion today. It's great talking to you. I always learn from both of you. And I think it's important for our listeners to recognize that we have great therapies here. We have two agents that are approved, another one coming. There's similarities, but there are differences between them. So learn those differences so you can use them optimally and make sure you're talking to the patient about what their problems are and what they need, because ultimately that's what's going to lead to success or failure. So thank all of you for joining us today, and I hope you learned how to utilize these agents. Bye.

Discuss the burden of disease in patients with moderate-to-severe AD

Discuss the safety profile of biologics and how to manage adverse effects

Closing the Healthcare Gaps in the Management of Moderate-to-Severe Atopic Dermatitis (AD) With Biologics

Appreciate the widespread prevalence and current epidemiology of syphilis 

Integrate new FDA approved treatment for scabies, as needed 

To review the current systemic therapies from the American academy of dermatology’s newly published guidelines of care for atopic dermatitis

To review assessments of severity for choosing systemic therapies or phototherapy

2023 Virtual Grand Rounds Session 15: November 29, 2023 - Atopic Dermatitis Guideline Update and What You Need to Know Now about STDs

Describe the risk-benefit profile on the long-term use of topical steroids

Review the key data on topical non-steroidal treatments for the management of psoriasis

Review new developments in treatment options for rosacea

Discuss how antibiotics can be incorporated into rosacea therapy while minimizing the potential for resistance.

2023 Virtual Grand Rounds Session 12: September 20, 2023 - What's New in Topical Therapy of Psoriasis and What's New in Rosacea

Identify challenges associated with the use of topical corticosteroids in patients with AD and psoriasis 

Review nonsteroid topical agents for the treatment of AD and psoriasis 

Discuss clinical considerations for PAs and NPs who prescribe topical therapies to patients with AD and psoriasis 

What is New in Non-Steroidal Topical Options for Atopic Dermatitis and Psoriasis:  Clinical Insights for Dermatology PAs and NPs: Seminar-in-Depth Online CME Activity

All right, so next we have Dr. Linda Steingle and Dr. Jim del Rossell coming onto the stage, and we're going to have a discussion on topical management of inflammatory skin disease and specifically focusing on atopic dermatitis as well as psoriasis. So I'll have them go ahead, take it away. Okay. Thanks so much, April. And we have a lot to talk about. It's a braid new world for the treatment of atopic dermatitis and psoriasis, and we have some really wonderful new topical agents, and it's been a long time. We really need some topical agents. If we think about what we prescribe, the vast majority are actually topical therapy. So we're going to talk about what's new in non steroidal topical options for atopic dermatitis and psoriasis, clinical insights for dermatology, pas, and nps. This is where we come from, and this is a CME accredited symposium. So our objectives for this short presentation are to identify the challenges associated with topical corticosteroids for atopic derm and psoriasis, review our non steroidal options, and discuss clinical considerations for pas and nps who prescribe topical therapies, which we all do. So when we're thinking about topical therapy for either atopic dermatitis or psoriasis, we know that topical steroids really seem to be the mainstay of therapy. But I consider topical, especially potent topical steroids to be a short term solution to a long term problem. They can get the disease under control fairly quickly, but you can't use them long term. They're just not going to be ok. We have a number of local as well as systemic potential side effects. So what do we have, Jim, in terms of new options? So we have a couple of different options, but I think one of the other things about topical corticosteroids is patients are typically told about the concerns. So a lot of times they don't even use them. And so there's inconsistency with their use, even though we know they're very effective. So we have three agents. We have topical ruxalitinib, which is FDA approved for mild to moderate atopic dermatitis patients twelve years of age and older. We have topical topiniroff, that's an arrow hydrocarbon modulating agent agonist, 18 years of age and older, for plaque psoriasis and reflumalast. Twelve years of age and older, which is a pd four inhibitor. Tembrinoroff and reflumalast are also under evaluation for atopic dermatitis. So we'll get into this. So where do we start? Let's start with plaque psoriasis. And here's an example of a patient that had psoriasis for many years, was going into a study with Tapinirov, and was washed out of some of the standard therapies, had moderate severity, which is a physician global assessment of three, and significant itching. Remember that psoriasis does have in many patients a fair amount of itching and was very bothersome to him. He had it in other areas. But here we're showing you on the lower extremities, and now you're seeing at week four, and this was with once daily use, the itching went down from an eight out of ten to one out of ten. So a marked reduction in itching. And the Pazi score went down from a nine to four, which is a very good reduction when you're looking at that particular scenario. But is this considered a successful result to the patient or to the clinician? So in your own mind, would you be thinking this is something that after four weeks with a non steroidal treatment, that's the only thing that they used, that this would be something that you would be happy with and that the patient would be happy with knowing that you have to go further. So in the clinical trial, when you look at this particular patient, they got to mild, so they would be considered an endpoint failure in the study. If you were looking at the study and the same at week twelve, they continued to improve, but they were still rated as mild global assessment of two. So that's considered an endpoint failure in the study. But we can determine for ourselves if we think this is a pretty darn good result. So I'm going to turn it over to linder to go over some of the pivotal information in the trial. But I think what's important to look at is you could keep going with this therapy. You don't have to be concerned about stopping, you don't have to be concerned about where they're using it, you don't have to be concerned about the severity at baseline and can keep pushing it till hopefully they get to completely clear, because you don't have that baggage of side effects with the topical steroids. And as you mentioned, Jim, this kind of simplifies the treatment regimen. We all have patients who come in with a bag of medications. They don't even know what they're using. Half of them are the same, half are expired. They have no idea. Now we can simplify it down one topical, they can use it wherever they want. They can use on the face, the skin folds, wherever they need to. And in clinical trials, up to 40% of patients got to clear, or almost clear with that two grade improvements, using this cream once a day for twelve weeks. Now, when we think about our non steroidal options, they can work, but often they're stinging and burning. And if you think about topical vitamin A, vitamin D, even the atopic drugs, they all sting and burn. But when we look at using to pin her off in the sensitive areas, it was overall very well tolerated. So you can use it on those very sensitive areas and generally not have to talk that patient down from the stinging and burning. When we look at the side effect profile, we saw that folliculitis and contact dermatitis were the most common adverse events, but generally these were mild or moderate, and they tended to really go away without even any treatment. We do have a long term study, and Jim mentioned this earlier today. Patients got to completely clear, and then we took their drug away. But guess how many people got to clear? Almost clear, almost 60%. And that's patients who had up to 20% body surface area who weren't using any steroids concomitantly, and actually almost 41% got completely clear of all of their psoriasis using a non steroidal option. And we did see patients had a durable remission. In fact, when they stopped their medication, they had a durable disease free period that went for about four months. That meant you could go on holiday for a few weeks and maybe leave your medication at home. Half of them went more than four months, half of them went less than four months. But if you look at the charts, almost everyone went at least one month without their disease coming back. But that was pushing them to be completely clear, which hadn't been done before in previous trials. So here's another case I'm looking at. So this is thinking about this being in the same patient, okay. Involvement on the elbows, involvement on the anterior tibial area, the Shin area, and the axilla. Remember, in clinical trials, we almost expect that all the lesions that are involved in different areas are going to march to the same rate of clearance, but that's not going to be the case in the real world. Thick elbows may take longer than an intitrogenous area or a thinner plaque on a location, but if you look at how this patient is progressing along, these are actually not the same patient. But you could think about it in terms of that. This could all be on the same patient, and they're going to progress at a different rate. So those smiley faces tell you where they actually got to endpoint success in the study, that they got at least a two grade improvement. And to clear. Almost clear. But look at how the visible progress happens. And I think that's really what we have to look at. The clinical trials help us. But looking at a chart or a graph or a line graph or a bar graph, it doesn't show you what's actually happening. It just gives you average results to get a drug approved by the FDA. So here are two areas, the knee and the back of the hand, that were actually not endpoint success, but you can see a significant difference. And all these patients were being treated with topical refumalast. Okay, so these were patients that were being treated with the 0.3% once a day in the clinical trial, and you can see a pretty successful result. So Linda is going to go through the data from that particular study group. And, Jim, you really reinforced the fact that when we're looking at endpoints in a clinical trial, it's a very high bar. Doesn't mean that that last patient won't be your best friend and want to give you a Christmas gift, even though they didn't reach the actual endpoint. I prefer Hanukkah, because you get, like, seven gifts or eight. Right, eight. So let's look at the clinical data for reflumolast. And as you mentioned, this is another topical non steroidal option, PdE four, using this also once a day. It's a cream formulation, no steroids, nothing else. And we saw a nice separation from vehicle as early as week two. And by the end of eight weeks now, we see up to 42% of patients getting to clear. Almost clear again with that two grade improvement. What was different about these studies is we actually separately looked at the intertrignous areas and evaluated them separately, and we saw up to about 70% of patients got to clear or almost clear, and most of them got to completely clear of their inverse psoriasis. That is tough to treat. You can't put a potent steroid on a skin fold because you're risking potentially strier. You can use a non steroidal, but it might sting and burn. What we found with reflumolas was this was well tolerated. The local tolerability was very, very good. The main side effects, as you can see, little bit of headache, diarrhea, hypertension, low. But we do see a very small amount of systemic absorption. This drug is a potent drug, but we use oral PD four, s, and we know that they're safe. We did do a long term study, and the long term studies are really done to look to see if there's any extra safety signal. Bottom line was this drug was well tolerated. No new safety signals, even when patients had access to this drug over the course of an entire year. We also have a foam formulation, and I think this is really exciting. It's not psoriasis or atopic derm, but for sebderm. And we did also study it for scalp psoriasis and body psoriasis. This drug works in the foam formulation just as well and has a very similar side effect profile. So I think one of the things that's important, when you look at the safety of rufumalast and you look at the reported cases of diarrhea, they were very uncommon, and none of them led to discontinuation. They were very, very mild. And if you look at that formulation, the ingredient that actually solubilizes it is the same one that was used with axone and similar type of thing. You don't want systemic absorption, so it actually partitions the drug superficially. So you get very, very low systemic levels. So it's not likely that if you use it appropriately, that a patient's going to get diarrhea that's actually related to the drug. So what about atopic dermatitis so far? Here's a case, and my nurse practitioner, who's been working with me since 1997, Lisa's over there on the corner. She's probably going to crawl under the table. But this is a 15 year old patient. Eczema since childhood. Multiple food allergies. Established patient with contact dermis with atopic dermatitis that had a flare on the distal extremities. This patient had some splits between the creases of the fingers. Significant discomfort with that. He had a girlfriend. He didn't feel comfortable holding her hands. He was concerned she's going to get infected. Went to an urgent care and got some cephalaxin and some eupyn. Had been using hydrocortisone. They had previously used topical corticosteroids when he was younger. They didn't particularly like using topical steroids, but they weren't totally adamant against it. And so this is after the patient was put on topical ruxalitinib. So they got the topical ruxalitinib and was applying that twice a day. The big difference here was the itching turned off very, very quickly. He had difficulty sleeping during the day or during the evening, so it made a big difference in terms of the itching. But look at two weeks, how much visible difference there is in the eruption, some continuation of the lichenification, but that is expected to continue to improve. So this was, I think, very impressive. This is what we had gleaned from the clinical studies and was a case that we actually saw in clinical practice. And thank you, Lisa, for sharing that with us. So what did we see in the clinical trials? And as Jim mentioned, it's really nice. And with all three of these drugs, the actual practice really does mirror what we saw in the clinical trials. So this is a topical jack inhibitor. Two studies mirror images of each other. We see separation as early as week two. Over 50% of patients using this drug twice a day. No steroids got to clear or almost clear. And this is after just eight weeks. And as you mentioned, it turns off the itch really dramatically. And we see that very steep line within the first few days of people really noticing a significant decrease in their itch. And that continues to improve over the know. Linda, I almost didn't know from seeing the studies, but I was thinking, is this really going to be true? And we've actually been seeing it in several different patients. How quick it turns off the itching in many patients really made me feel much better about it. Yeah. And in terms of the side effect profile, again, we are not seeing local tolerability problems, even though this is a non steroidal, basically, the drug was well tolerated. Now, this is a topical jack inhibitor, and we spoke several times already about where the box warning comes. I want you to know, ruxalidinib is FDA approved in the oral formulation. And guess what? The oral does not have a box warning. Okay? So that just shows what's going on with the FDA. You have to treat these box warnings seriously. You should not use this drug in more than 20% body surface area, but keep it all in perspective. And so when you actually look at this, and we went over this previously in the program, if you're looking at the application of the drug and how it actually gets very limited systemic exposure orally, you get systemic exposure topically. It's primarily within the skin. And if you look at the maximum use studies, you can see here that it takes getting up to about 38% to 40% body surface area before you might even see getting to a level that can trigger some of the potential problems that you can have with thromboembolism. So there's a real safety net put in there if you're utilizing it on 20% body surface area or less. And when we actually look at invitiligo, it's 10% body surface area or less, because you're going to be using that over a more prolonged period of time. This is a case I showed earlier today. This was a patient that was working at a radiology tech. She had more of a lichenified, not as inflamed, but atopic dermatitis. That was very pardic. She couldn't sleep. She had actually not done well with topical corticosteroids. Some of them she was using intermittently because she was concerned about side effects. And she did extremely well with a rapid reduction in itching. Right. She went from an eight out of ten to a two out of ten very, very quickly and had a very, very good clinical response. And if you look at the data, there's a couple of very nice publications. Andy Blauvelt just did a very nice one, looking at the actual reduction in itching. Two point improvement and four point improvement, both very, very early and clinically relevant. And there is data on utilizing this long term. No new safety signals. When it flares back up, you go back to it. When the patient's completely clear, you stop it. And so what about continuing on with some of the other agents? So we mentioned that the arrowhydrocarbon receptor agonist to Pinarov is being evaluated for atopic dermatitis, and so is reflumolast, which is a PD four inhibitor. So let's look first at reflumalast. It's a zero point 15% cream. Once a day, four weeks of patients using this. And you can see here there's significant difference between the active in the vehicle and easy 75 and in IgA. Right. And here's a patient that was shared with me by a nurse practitioner from Texas. He used it on his child. Right. And it used the higher strength that's available. And you can see here an atopic dermatitis flared. You see all the previous treatments the patient had, and two weeks later was completely cleared with excellent tolerability. So this is encouraging that we have this coming along to pin her off the adoring data. Eight weeks, you can see here, very impressive results versus the vehicle. The same type of adverse effects, very low and very limited, very well tolerated. And here's a patient. This was sent to me by Matt Bruno from Texas, 39 years old, long history of atopic dermatitis, very pritic. She doesn't like medication. She's used corticosteroids and other non steroidals in the past. Uses a lot of homeopathic things, but they're not working. So she was treated with topical topinoroff. Here you see her at baseline, and then two weeks later, she was substantially improved and continued it on to four weeks later. So you can see her at two weeks, and then at four weeks, she was essentially completely clear. And in the axilla, she had the same type of situation with an excellent response. So I think, Linda, that gives them some idea of where we're at, and we'll let you summarize the end. So again, topical corticosteroids have been the cornerstone, but we need long term options. We see that these new topicals are a short term solution as well as a long term solution. And we have some really great molecules in the pipeline. So it's an exciting time. We have the cadence of like, newscasters. Absolutely. We should be on tv. Thank you very much.

Overview the role of biologics for the management of moderate-to-severe atopic dermatitis 

Identify patients who would benefit from biologics for the management of moderate-to-severe atopic dermatitis 

Discuss how PAs and NPs can work in a multidisciplinary team to manage patients with moderate-to-severe AD on biologics

The PA and NPs Role in Managing Atopic Dermatitis With Biologics in Clinical Practice: Online CME Activity

Identify challenges associated with the use of topical corticosteroids in patients with atopic dermatitis (AD) and psoriasis

Review nonsteroid topical agents for the treatment of AD and psoriasis

Discuss clinical considerations for prescribing topical therapies to patients with AD and psoriasis


2023 Virtual Grand Rounds Session 9: June 14, 2023 - Topical Non-Steroidal Management of Atopic Dermatitis and Psoriasis: Clinical Insights for Dermatology Providers

Describe the clinical trial data on JAK inhibitors for the management of atopic dermatitis (AD) 

Identify patients who would benefit from the management of AD with JAK inhibitors 

Construct a treatment plan to manage patients with AD on JAK inhibitors 

Managing Atopic Dermatitis from Head-to-Toe with JAK Inhibitors: Online CME Activity

Apply the latest evidence-based guidelines and data to management of patients with a range of dermatologic conditions

Evaluate findings from recent clinical trials to identify appropriate adjustments to current treatment and management strategies

Recognize the benefits of newly studied treatments

2023 Virtual Grand Rounds Session 5: March 29, 2023 - Highlights from the AAD

Underline the multidimensional burden of moderate-to-severe atopic dermatitis in children and adolescents

Recall the multidimensional benefits of systemic biologics for the management of moderate-to-severe atopic dermatitis in children and adolescents

Discuss seamless integration of biologics into daily clinical practice through enhanced multidisciplinary care

Strategies to Alleviate the Multidimensional Burden of Moderate-to-Severe Atopic Dermatitis in Children and Adolescents: Online CME Activity

Overview the key data on systemic biologics for the management of moderate-to-severe atopic dermatitis in children and adolescents

Identify children and adolescents who would benefit from biologics for the management of moderate-to-severe atopic dermatitis 

Describe strategies to integrate biologics into daily clinical practice to effectively manage moderate-to-severe AD

Moderate-to-Severe Atopic Dermatitis in Children and Adolescents: Stop the Itch that Rashes: Online CME Activity

Recall the key symptoms for atopic dermatitis

Review the clinical trial data on JAK inhibitors for the management of moderate-to-severe AD

Discuss practical trips to manage side effects associated with JAK inhibitors

Illustrate individualized treatment plans based on patient- and disease-related considerations

The Patient and Physician Journey of Atopic Dermatitis From Diagnosis Through Treatment: Online CME Activity

Describe how biologics targeted the disease pathway for atopic dermatitis

Review the clinical trial data for new and emerging agents to treat moderate-to-severe AD

Discuss strategies to involve patients and their families in the shared-decision making process

Atopic Dermatitis: Inspecting the Evidence & Learning from Expert Experience: Online CME Activity

Review data on JAK inhibitors to treat AD 

Describe how to individualize care with JAK inhibitors in patients with atopic dermatitis 

Discuss strategies to prevent and manage adverse events associated with JAK inhibitors 

Atopic Dermatitis Management - Getting the Inside Track on JAKs: Online CME Activity

Atopic Dermatitis

WEDNESDAY, Jan. 14, 2026 (HealthDay News) -- For patients with <a href="/conditions/atopic-dermatitis" target="_blank" rel="noopener noreferrer">atopic dermatitis</a> (AD), the <a href="/conditions/tyk2-inhibitors" target="_blank" rel="noopener noreferrer">tyrosine kinase inhibitor</a> ICP-332 has a favorable safety profile and is efficacious, according to a study published online Jan. 14 in JAMA Dermatology.Jinhua Xu, Ph.D., from Huashan Hospital in Shanghai, and colleagues randomly assigned 75 patients aged 18 to 75 years with a diagnosis of AD for one year or longer and a history of contraindication or inadequate response to topical therapy to receive ICP-332 at 80 mg or 120 mg or placebo orally once daily for four weeks in a 1:1:1 ratio.The researchers found that among the 74 patients included in the safety set, 68, 76, and 75 percent in the placebo group and the 80- and 120-mg ICP-332 groups, respectively, experienced treatment-emergent adverse events, with all events mild or moderate. Decreased blood fibrinogen was the most common adverse event (4, 44, and 21 percent, respectively). At week 4, percentage reductions in the <a href="/conditions/eczema" target="_blank" rel="noopener noreferrer">Eczema</a> Area and Severity Index (EASI) were −78.2, −72.5, and −16.7 percent in the 80-mg ICP-332 group, 120-mg ICP-332 group, and placebo group, respectively. A significantly higher 75 percent or greater improvement in EASI response rate was seen with both ICP-332 doses versus placebo (56.0 percent difference versus placebo), and a greater percentage of Validated Investigator Global Assessment for Atopic Dermatitis score of 0 or 1 and improvement of 2 or more points at week 4 was seen in the 80-mg ICP-332 group versus placebo (32.0 percent difference versus placebo)."ICP-332 monotherapy was efficacious and demonstrated a favorable benefit-risk profile compared with placebo in adults with moderate-to-severe AD," the authors write.Several authors disclosed ties to InnoCare Pharma Tech Co., which is developing ICP-332 and funded the study. One author also has a related patent pending.<a target="_blank" rel="noopener noreferrer" href="https://jamanetwork.com/journals/jamadermatology/fullarticle/2843770">Abstract/Full Text</a>

Higher percentage reductions in Eczema Area and Severity Index seen with 80 mg ICP-332, 120 mg ICP-332 versus placebo

ICP-332 Has Favorable Safety Profile, Is Efficacious for Atopic Dermatitis

WEDNESDAY, Jan. 7, 2026 (HealthDay News) -- Children conceived via assisted reproductive technology (ART) have a higher risk for developing <a href="/conditions/atopic-dermatitis" target="_blank" rel="noopener noreferrer">atopic disease</a>, according to a study published online Dec. 30 in JAMA Network Open.Yao-Chi Hsieh, M.D., from Kuang Tien General Hospital in Taichung, Taiwan, and colleagues assessed whether conception via ART is associated with an increased risk for atopic disease. The analysis included 69,785 children (13,957 in the ART group and 55,828 in the naturally conceived control group) born in Taiwan between 2004 and 2014.The mean follow-up durations for the ART and control groups, respectively, were 7.99 and 8.41 years for asthma, 5.79 and 6.34 years for allergic rhinitis, and 7.34 and 7.62 years for <a href="/conditions/atopic-dermatitis" target="_blank" rel="noopener noreferrer">atopic dermatitis</a>.The researchers found that after adjusting for potential confounders, the ART group showed a higher likelihood of developing asthma (adjusted hazard ratio [aHR], 1.13), allergic rhinitis (aHR, 1.15), or atopic dermatitis (aHR, 1.08) compared with the control group. In a subgroup analysis, children conceived with fresh embryos had a heightened risk for developing allergic rhinitis versus those conceived with frozen embryos (aHR, 1.12)."These findings underscore the importance of long-term follow-up for offspring conceived via ART and further investigation into the underlying biological mechanisms by which ART may contribute to atopic disease development," the authors write.<a target="_blank" rel="noopener noreferrer" href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2843233">Abstract/Full Text</a>

Findings show significant risk for asthma, allergic rhinitis, or atopic dermatitis

Assisted Reproductive Technology Linked to Atopic Disease Risk in Offspring

MONDAY, Dec. 22, 2025 (HealthDay News) -- Nemolizumab rapidly relieves itch and sleep disturbance among patients with moderate-to-severe <a href="/conditions/atopic-dermatitis" target="_blank" rel="noopener noreferrer">atopic dermatitis</a> (AD) and <a href="/conditions/prurigo-nodularis" target="_blank" rel="noopener noreferrer">prurigo nodularis</a> (PN), according to a study published online Dec. 16 in the Journal of the European Academy of Dermatology &amp; Venereology.Sonja Ständer, M.D., from University Hospital Münster in Germany, and colleagues conducted a post-hoc analysis of four pivotal randomized controlled clinical trials of nemolizumab in AD (ARCADIA 1 and 2 [1,728 participants]) and PN (OLYMPIA 1 and 2 [560 participants]) to assess the improvement of itch during the first 14 days of therapy.The researchers found that in AD, nemolizumab rapidly reduced itch, with a difference versus placebo apparent by day 2 in peak pruritus numerical rating scale responders (pooled data, 10.7 versus 2.9 percent); the difference increased steadily through day 14. In PN, nemolizumab also reduced itch rapidly, with a difference seen by day 2 (pooled data: 17.2 versus 3.7 percent). Nemolizumab-treated patients also had early improvement in sleep (day 2). In pooled analyses, 9.9 versus 4.6 percent of nemolizumab- versus placebo-treated patients with AD and 13.4 versus 4.3 percent with PN were sleep disturbance numerical rating scale responders."These new data reinforce our understanding of nemolizumab's rapid onset of action in relieving itch and, in turn, improving sleep in patients living with atopic dermatitis and prurigo nodularis, as well as its role in targeting the IL-31 pathway," coauthor Christophe Piketty, M.D., Ph.D., from Galderma Research and Development in Switzerland, said in a statement.Several authors disclosed ties to biopharmaceutical companies, including Galderma, which manufactures nemolizumab and funded the study.<a target="_blank" rel="noopener noreferrer" href="https://onlinelibrary.wiley.com/doi/10.1111/jdv.70250">Abstract/Full Text</a>

Data from four randomized clinical trials confirm benefits by day 2 in atopic dermatitis, prurigo nodularis

Nemolizumab Rapidly Relieves Itch, Sleep Disturbance in Atopic Dermatitis

MONDAY, Dec. 22, 2025 (HealthDay News) -- Iron deficiency without anemia is a common feature of moderate-to-severe <a href="/conditions/atopic-dermatitis" target="_blank" rel="noopener noreferrer">atopic dermatitis</a> (AD), according to a study published online Nov. 27 in Nutrients.Małgorzata Ponikowska, from Wroclaw Medical University in Poland, and colleagues characterized iron status in patients with AD and examined its relationship with disease severity and quality of life. The analysis included 86 adult patients with moderate-to-severe AD.The researchers found that abnormalities in circulating iron biomarkers, indicative of iron deficiency, were prevalent in patients with AD: 45 percent of patients had low transferrin saturation (Tsat; &lt;20 percent), 37 percent low ferritin, and 26 percent reduced serum iron, despite largely normal hemoglobin. Patients with pro-inflammatory activation (as measured by elevated high-sensitivity C-reactive protein &gt;5 mg/L) had a pattern characterized by lower iron and Tsat and higher soluble transferrin receptor levels. Lower serum iron remained associated with worse Dermatology Life Quality Index scores in a multivariable analysis, while higher transferrin was associated with greater disease severity, measured by the Eczema Area and Severity Index and SCORing Atopic Dermatitis."In conclusion, our study identifies dysregulated iron homeostasis -- indicative of iron deficiency -- as a prevalent systemic feature of atopic dermatitis. These disturbances are linked to disease severity and impaired quality of life, suggesting that altered iron metabolism may represent a potentially modifiable systemic correlate of the AD phenotypes," the authors write. "Future studies should explore whether targeted correction of iron deficiency can improve patient outcomes."<a target="_blank" rel="noopener noreferrer" href="https://www.mdpi.com/2072-6643/17/23/3743">Abstract/Full Text</a>

Furthermore, iron deficiency is associated with higher clinical burden

Iron Deficiency Without Anemia Common With Moderate-to-Severe Atopic Dermatitis

FRIDAY, Dec. 5, 2025 (HealthDay News) -- For adults with <a href="/conditions/atopic-dermatitis" target="_blank" rel="noopener noreferrer">atopic dermatitis</a>, <a href="/videos/wch-2024-conference-highlights/WCH24-whats-new-in-the-medicine-chest" target="_blank" rel="noopener noreferrer">rocatinlimab</a> treatment yields significant improvements across clinical end points, according to a study published online Nov. 25 in The Lancet.Emma Guttman-Yassky, M.D., from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues performed two global phase 3 studies to assess the efficacy and safety of rocatinlimab for the treatment of moderate-to-severe atopic dermatitis in adults (ROCKET-IGNITE [IGNITE] and ROCKET-HORIZON [HORIZON]). In IGNITE, patients were randomly assigned to receive subcutaneous 300-mg rocatinlimab, 150-mg rocatinlimab, or placebo (328, 217, and 222, respectively), while in HORIZON, patients were randomly assigned to receive subcutaneous 300-mg rocatinlimab or placebo (543 and 183, respectively).The researchers found that both trials met their coprimary end points at week 24 (Eczema Area and Severity Index [EASI]-75 response [≥75 percent improvement in EASI score from baseline] and validated Investigator's Global Assessment for Atopic Dermatitis [vIGA-AD] score of 0 or 1). In IGNITE and HORIZON, rocatinlimab treatment resulted in significant improvements in EASI-75 response versus placebo at week 24 (42 versus 36 versus 13 percent in IGNITE; 33 versus 14 percent in HORIZON). For vIGA-AD score of 0 or 1 response at week 24, significant improvements were seen with rocatinlimab versus placebo in IGNITE (24 versus 19 versus 9 percent) and HORIZON (19 versus 7 percent). In both IGNITE and HORIZON, the incidences of treatment-emergent adverse events were generally similar across the groups."By targeting memory T cells through <a href="/podcasts/the-spot-check-podcast/Season-1-episode-7" target="_blank" rel="noopener noreferrer">OX40</a>, rocatinlimab not only clears the skin and relieves itch, but continues to improve patients' lives over time with a strong safety profile," Guttman-Yassky said in a statement.Several authors disclosed ties to biopharmaceutical companies, including Amgen and Kyowa Kirin, which funded the study.<a target="_blank" rel="noopener noreferrer" href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)01865-3/">Abstract/Full Text</a><a target="_blank" rel="noopener noreferrer" href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02152-X/abstract">Editorial</a>

Significant improvements seen in coprimary end points of EASI-75 response and vIGA-AD score of 0 or 1 versus placebo

Rocatinlimab Yields Significant Improvements in Atopic Dermatitis

FRIDAY, Nov. 14, 2025 (HealthDay News) -- For people with <a href="/conditions/atopic-dermatitis" target="_blank" rel="noopener noreferrer">eczema</a>, symptoms do not differ with weekly versus daily bathing, according to a study published online Nov. 9 in the British Journal of Dermatology.Lucy Bradshaw, from the University of Nottingham in the United Kingdom, and colleagues compared the impact of weekly versus daily bathing in people with eczema in a pragmatic superior randomized controlled trial. A total of 438 people with self-reported eczema aged 1 year or older were randomly allocated to the weekly bathing group (bath or shower once or twice a week) or the daily bathing group (at least six times per week) for four weeks (218 and 220 participants, respectively). The primary outcome was participant-reported eczema symptoms collected weekly using the Patient-Orientated Eczema Measure (POEM; range, 0 to 28).The primary analysis including 195 and 193 participants allocated to daily bathing and weekly bathing, respectively, who completed at least one follow-up questionnaire. The researchers found that at baseline, one, two, three, and four weeks, the mean POEM scores were 14.5, 11.7, 12.2, 11.7, and 11.6, respectively, in the daily bathing group, and 14.9, 12.1, 11.3, 10.5, and 10.6, respectively, in the weekly bathing group. Over four weeks, the adjusted difference in mean POEM score for weekly versus daily bathing was −0.4 (95 percent confidence interval, −1.3 to 0.4; P = 0.30). There were no reports of serious unintended effects or harms."The findings of our study are great news for people living with eczema. It means they can choose a frequency of bathing that suits them," Bradshaw said in a statement.One author disclosed ties to AbbVie.<a target="_blank" rel="noopener noreferrer" href="https://academic.oup.com/bjd/advance-article/doi/10.1093/bjd/ljaf417/8315016">Abstract/Full Text</a>

No significant difference seen in mean POEM score for weekly versus daily bathing over four weeks

Eczema Symptoms Do Not Differ With Daily, Weekly Bathing

THURSDAY, Nov. 6, 2025 (HealthDay News) -- For women undergoing implant-based reconstruction and for patients undergoing bone grafting procedures, <a href="/conditions/atopic-dermatitis" target="_blank" rel="noopener noreferrer">atopic diseases</a> are associated with an increased risk for implant complications and revision surgeries, according to two studies presented at the annual meeting of the American College of Allergy, Asthma &amp; Immunology, held from Nov. 6 to 10 in Orlando, Florida.Philong Nguyen, from the University of Texas Medical Branch in Galveston,,and colleagues examined the association between atopic skin conditions and implant-related complications among female breast cancer patients who underwent implant-based reconstruction from 2002 to 2022. The analyses included 10,205 patients with and 10,205 without atopic skin conditions after propensity score-matching. The researchers found that compared with patients without atopic or allergic skin conditions, those with atopic conditions had significantly elevated risks for implant complications, capsular contracture at two and three years, and revision surgeries at all time points (risk ratios, 1.2, 1.2, and 1.1, respectively).Joshua Wang, from the University of Texas Medical Branch, and colleagues conducted a retrospective cohort study to examine the impact of atopic diseases on bone grafting complications. After propensity score matching, the cohort included 19,334 patients with and 19,334 without atopic disease. The researchers found that patients with atopic diseases had higher risks for infection or wound complications, osteomyelitis, and hardware removal at 90 days (hazard ratios, 1.19, 1.29, and 1.22, respectively). The atopic cohort remained at elevated risk for infection or wound complications, osteomyelitis, hardware removal, mechanical loosening, and revision surgery at two years (hazard ratios, 1.20, 1.20, 1.21, 1.35, and 1.16, respectively)."These results suggest that allergic conditions can affect the body's ability to heal after surgery -- not just in the skin, but in the bones as well," Wang said in a statement.<a target="_blank" rel="noopener noreferrer" href="https://acaai.org/news/people-with-allergies-or-eczema-may-face-higher-risk-of-surgical-complications/">Press Release</a><a target="_blank" rel="noopener noreferrer" href="https://25eventannual.com/acaai25/">More Information</a>

Patients with atopic diseases also have increased risks for complications, revision surgery after bone grafting

ACAAI: Breast Implant Complications, Revision Surgery More Likely in Patients With Eczema

<div class="raw-html-embed"><iframe src="https://player.mux.com/IoyBSrMLy00008bQVxLHkQrCeXx8pXmwo00PiCnhXbop024" style="width: 100%; border: none; aspect-ratio: 16/9;" allow="accelerometer; gyroscope; autoplay; encrypted-media; picture-in-picture;" allowfullscreen=""></iframe></div>Watch as James Q. Del Rosso, DO, shares insights on tralokinumab’s role in achieving disease control after dupilumab and JAK inhibitor failureIn this video, James Del Rosso, DO, reviews a Fall Clinical 2025 poster presentation that highlights a real-world case demonstrating successful disease control with tralokinumab in a patient whose severe atopic dermatitis (AD) was refractory to multiple prior systemic therapies.Clinical case overviewThe case involved a 29-year-old male with long-standing AD, a history of recurrent skin infections, asthma, allergies, and a recent episode of pneumonia.&nbsp;The patient initiated dupilumab but experienced an inconsistent response and ocular adverse effects (conjunctivitis and blepharitis). Two Janus kinase (JAK) inhibitors were later trialed (upadacitinib for 4 months, abrocitinib for 3 months) and achieved only partial efficacy complicated by acneiform eruptions.Response to tralokinumabThe patient transitioned to tralokinumab while presenting with Investigator’s Global Assessment (IGA) 4 disease severity. After one year of treatment, he achieved complete clearance (IGA 0), with marked improvement in itch and quality of life.Dr Del Rosso notes that while treatment trajectories in AD vary widely, this case demonstrates the value of mechanistic diversity within available biologics. For this patient, tralokinumab provided both clinical efficacy and relief from the adverse events that limited previous therapies.Supporting evidence in the literatureAdditional reports reinforce these findings. A 2023 publication in the Journal of Dermatological Treatment described a patient with dupilumab-associated facial and neck erythema and subsequent lichenification while on upadacitinib. Transitioning to tralokinumab led to rapid improvement in erythema and overall AD control.Likewise, a 2025 case series in the Journal of Clinical and Aesthetic Dermatology presented 15 adult cases of arthropathies and arthralgias arising during dupilumab therapy (duration 1–48 months). Upon switching to tralokinumab, all patients maintained disease control without recurrence or persistence of joint symptoms.Takeaway for cliniciansDr Del Rosso notes that these cases highlight the progressive diversification of therapeutic mechanisms in AD. For patients with suboptimal response or adverse effects on prior biologics or JAK inhibitors, switching to another targeted agent, in this case, tralokinumab, may achieve durable control without compromising tolerability.

A real-world case highlights the therapeutic potential of tralokinumab in patients with difficult-to-treat AD

NEWS ALERT: Tralokinumab Achieves Complete Clearance After Multiple Treatment Failures in Atopic Dermatitis

WEDNESDAY, Oct. 15, 2025 (HealthDay News) -- The prevalence of <a href="/conditions/atopic-dermatitis" target="_blank" rel="noopener noreferrer">atopic dermatitis</a> (AD) increased among <a href="/conditions/pediatric-dermatology" target="_blank" rel="noopener noreferrer">children</a> and adults from 2021 to 2024, according to a study published online Oct. 6 in the Journal of the American Academy of Dermatology.Kaitlyn R. Chan, from King's College London in the United Kingdom, and colleagues examined the prevalence of AD in the United States using data from the 2021 and 2024 National Health Interview Surveys.The analysis included 78,732 participants. The researchers found that the prevalence of AD was 7.3 and 10.7 percent in adults and children in 2021, and 7.6 and 12.7 percent, respectively, in 2024. The increase in prevalence was significant in children but not adults. In all cohorts, except for the 2021 children, AD was more prevalent in females than males. For both sexes, prevalence increased from 2021 to 2024. AD was most prevalent among children aged 6 to 11 years when stratified by age and decreased with age; in every cohort, there was an increase from 2021 to 2024. In 2024, prevalence was significantly higher in Native Hawaiian and Other Pacific Islander adults than White adults. Participants who self-identified as Asian had the lowest prevalence of AD."Approximately 19,841,686 adults and 9,184,746 children in the [United States] had AD in 2024, up from 18,502,032 adults and 7,757,726 children in 2021, reflecting a nationwide increase that warrants further research into AD pathophysiology, epidemiology, diagnostic criteria, and treatment pathways," the authors write.One author disclosed ties to the biopharmaceutical industry.<a target="_blank" rel="noopener noreferrer" href="https://www.jaad.org/article/S0190-9622(25)02973-1/fulltext">Abstract/Full Text</a>

AD prevalence increased for both sexes; was most prevalent among children aged 6 to 11 years and declined with age

2021 to 2024 Saw Increase in Prevalence of Atopic Dermatitis

MONDAY, Sept. 29, 2025 (HealthDay News) -- The U.S. Food and Drug Administration has approved Opzelura cream 1.5 percent (ruxolitinib) for children ages 2 to 11 years with atopic dermatitis (AD).The approval is the first topical Janus kinase (JAK) inhibitor for the short-term, noncontinuous chronic treatment of mild-to-moderate AD in nonimmunocompromised children (age 2 years and older) whose disease is not well controlled with topical prescription therapies or when topical therapies are not recommended.The approval is based on results from the phase 3 TRuE-AD3 trial, which evaluated the safety and efficacy of Opzelura cream in children ages 2 to &lt;12 years with AD. The primary end point was met, with significantly more patients treated with Opzelura achieving Investigator's Global Assessment-treatment success versus patients treated with vehicle control cream. The trial also met the secondary end point of more Opzelura-treated patients demonstrating ≥75 percent improvement in the Eczema Area and Severity Index at week 8 versus control. No new safety signals were observed, with the most common adverse reaction being upper respiratory tract infection."Navigating a complex condition like atopic dermatitis can be very challenging for children," Peter Lio, M.D., from the Northwestern University Feinberg School of Medicine in Chicago, said in a statement. "With this approval, we now have a new, nonsteroidal topical option that expands how we care for kids with this chronic disease."Approval of Opzelura was granted to Incyte.<a target="_blank" rel="noopener noreferrer" href="https://nam11.safelinks.protection.outlook.com/?url=https%3A%2F%2Finvestor.incyte.com%2Fnews-releases%2Fnews-release-details%2Fincyte-announces-additional-fda-approval-opzelurar-ruxolitinib&amp;data=05%7C02%7Clsolomon3%40gsu.edu%7C8194b68812094704b3a008ddf7f3cb6c%7C515ad73d8d5e4169895c9789dc742a70%7C0%7C0%7C638939348677509931%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&amp;sdata=9zslzZjvzwd8MZUuM1LbSpbUbZO3X%2BZWwUbA2N1%2Fk3M%3D&amp;reserved=0">More Information</a>

It is the first topical JAK inhibitor approved in the U.S. for pediatric atopic dermatitis

FDA Approves Opzelura for Atopic Dermatitis in Children

WEDNESDAY, Sept. 10, 2025 (HealthDay News) -- For patients with atopic dermatitis (AD), the cumulative recurrence rate after discontinuing dupilumab is 23.4 percent, according to a study published online Aug. 12 in Frontiers in Medicine.Maohua Chen, from the University of Electronic Science and Technology of China in Chengdu, and colleagues examined the recurrence rate, time to recurrence, and factors influencing recurrence in patients with moderate-to-severe AD after discontinuing dupilumab.The median follow-up time was 49 weeks, and the statistical analysis included 141 AD patients. The researchers found that of these patients, 33 relapsed (relapse rate, 23.4 percent), with a median time to relapse of 29 weeks. Allergic conjunctivitis, duration of treatment &lt;16 weeks, body mass index ≥28 kg/m2, male sex, and positive familial predisposition to allergy were predictors with a significant effect on recurrence (hazard ratios, 7.912, 5.871, 5.653, 5.634, and 3.438, respectively)."In conclusion, this study confirms the disease characteristic of AD recurrence and emphasizes the necessity of individualized treatment, postdiscontinuation monitoring, and long-term standardized management of AD patients with different risk factors for recurrence to minimize recurrence and optimize the overall health of the patients," the authors write.<a target="_blank" rel="noopener noreferrer" href="https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1585368/full">Abstract/Full Text</a>

Predictors with significant effect on recurrence include allergic conjunctivitis, duration of treatment &lt;16 weeks, male sex

Eczema Recurrence Rate of 23.4 Percent Reported After Discontinuing Dupilumab

WEDNESDAY, Sept. 17, 2025 (HealthDay News) -- Patients with <a href="/conditions/atopic-dermatitis" target="_blank" rel="noopener noreferrer">atopic eczema</a> (AE) have an increased risk for suicidal ideation (SI), according to a study presented at the European Academy of Dermatology and Venereology Congress 2025, held from Sept. 17 to 20 in Paris.Julien Seneschal, M.D., Ph.D., from the CHU St. André in France, and colleagues surveyed 15,223 adults with AE and 7,968 controls without eczema across 27 countries to examine the prevalence of SI and its associated risk factors in the Scars of Life study. AE patients were classified by age of onset (adult-onset [EOA], 7,383; adolescent-onset [ETA], 4,965; and childhood-onset [ECA], 2,875).The researchers found that SI was reported by 13.2 percent of AE patients compared with 8.5 percent of controls. No significant difference was seen in the prevalence of SI across AE subgroups, but all had elevated odds of SI versus controls (odds ratios, 1.56, 1.71, and 1.72 for EOA, ETA, and ECA, respectively). Key predictors were revealed on comparison of 2,010 SI cases with 13,213 non-SI cases, including younger age (odds ratio, 1.6 for younger than 30 years) and obesity (odds ratio, 1.29). Clinical risk factors included moderate-to-severe AE, pruritus, skin pain, and high symptom intensity (visual analog scale ≥7; odds ratios, 2.01, 1.3, 1.7, and 1.43, respectively). The SI group had higher stigmatization scores (26.01 ± 18.57 versus 17.12 ± 17.46)."The results highlight that the effects of atopic eczema are more than skin deep, with suicidal thoughts representing a serious and frequent concern that is often overlooked by health care professionals," coauthor Delphine Kerob, from La Roche Posay, said in statement. “We hope this study will help health care professionals better recognize and address these challenges, supporting patients’ overall well-being more effectively.”Several authors disclosed ties to La Roche Posay. La Roche Posay Laboratoire Dermatologique conducted the Scars of Life study.<a target="_blank" rel="noopener noreferrer" href="https://eadv.org/congress/">More Information</a>

Key predictors of suicidal ideation included younger age and obesity, as well as pruritus, skin pain, symptom intensity

Suicidal Ideation Risk Elevated for Patients With Atopic Eczema

WEDNESDAY, Aug. 13, 2025 (HealthDay News) -- For patients with skin of color and <a href="/conditions/atopic-dermatitis" target="_blank" rel="noopener noreferrer">atopic dermatitis</a> (AD), <a href="/resources/toolkit/drugs/ebglyss" target="_blank" rel="noopener noreferrer">lebrikizumab</a> is efficacious and safe, according to a study published online July 15 in the American Journal of Clinical Dermatology.Andrew Alexis, M.D., M.P.H., from Weill Cornell Medicine at Cornell University in New York City, and colleagues conducted an open-label trial involving 90 adults and adolescents with moderate-to-severe AD, Fitzpatrick skin phototype IV to VI, and self-reported race other than White. Participants received lebrikizumab 250 mg subcutaneously every two weeks for 16 weeks. Responders, defined as patients with at least 75 percent improvement in the Eczema Area and Severity Index (EASI 75) and/or Investigator's Global Assessment (IGA) score of 0/1 with at least a 2-point improvement from baseline, received lebrikizumab every four weeks from weeks 16 to 24, while those with inadequate response continued receiving lebrikizumab every two weeks.The researchers found that EASI 75, EASI 90, and IGA 0/1 were achieved by 69.2, 44.9, and 44.9 percent of patients, respectively, at week 16; 58.1 percent of patients reported a ≥4-point improvement for the Pruritus Numeric Rating Scale. At week 24, 78.4, 47.3, and 54.1 percent of patients, respectively, achieved EASI 75, EASI 90, and IGA 0/1 in the pooled treatment arms. Overall, 62.9, 88.2, and 95.5 percent of patients with Fitzpatrick skin phototype IV, V, and VI, respectively, achieved EASI 75 at week 24. Reduced hyperpigmentation was seen at week 24 for 64.4 percent of patients with baseline PDCA-Derm-assessed hyperpigmented areas."Lebrikizumab treatment was associated with improvements in postinflammatory hyperpigmentation and quality of life, with over half of patients reporting being mostly or completely satisfied with their treatment," the authors write.Several authors disclosed ties to pharmaceutical companies, including Eli Lilly, which manufactures lebrikizumab and funded the study.<a target="_blank" rel="noopener noreferrer" href="https://link.springer.com/article/10.1007/s40257-025-00970-8">Abstract/Full Text</a>

64.4 percent of patients with postinflammatory hyperpigmented lesions at baseline experienced reduced hyperpigmentation at week 24

Lebrikizumab Efficacious, Safe for Patients With Skin of Color, Eczema

Update (September 2025): Anzupgo is now commercially available and can be prescribed in the United States. Following FDA approval in July 2025, the therapy has officially entered the market and is accessible to clinicians for eligible patients. &nbsp;&nbsp;<div class="raw-html-embed"><iframe src="https://player.mux.com/b9nulaDMvMw1Byc2Kvsn1ADezcP6h3b02tSgX2MEuYIM?metadata-video-title=Anzupgo+Launch+Alert&amp;video-title=Anzupgo+Launch+Alert" style="width: 100%; border: none; aspect-ratio: 427/240;" allow="accelerometer; gyroscope; autoplay; encrypted-media; picture-in-picture;" allowfullscreen=""></iframe></div>Watch as James Q. Del Rosso, DO, reviews clinical trial data, mechanism of action, safety, and more. &nbsp;The US Food and Drug Administration has approved Anzupgo (delgocitinib) cream (20 mg/g) for the treatment of moderate-to-severe chronic hand eczema (CHE) in adults who are not adequately controlled with topical corticosteroids or for whom such treatment is not advisable. This represents the first FDA-approved therapy specifically indicated for CHE.Mechanism of actionAnzupgo is a topical pan-Janus kinase (JAK) inhibitor, targeting JAK1, JAK2, JAK3, and tyrosine kinase 2. It modulates multiple cytokine signaling pathways involved in the pathophysiology of CHE via inhibition of the JAK-STAT pathway, with topical administration limiting systemic exposure.Clinical trial insightsFDA approval was supported by results from two identical randomized, double-blind, vehicle-controlled trials (DELTA 1 and DELTA 2) involving 960 adults with moderate-to-severe CHE.<ul><li>Primary endpoint: Investigator’s Global Assessment for Chronic Hand Eczema Treatment Success (IGA-CHE TS) at Week 16:<ul><li>DELTA 1: 20% with Anzupgo vs 10% with vehicle (p=0.006)</li><li>DELTA 2: 29% with Anzupgo vs 7% with vehicle (p&lt;0.0001)</li></ul></li><li>Key secondary endpoint (≥4-point reduction in severity of itch and pain as measured by the Hand Eczema Symptom Diary):<ul><li>Itch: 47% of Anzupgo-treated patients in both DELTA 1 and DELTA 2 achieved this reduction at Week 16, vs 23% and 20% with cream vehicle (p&lt;0.0001).</li><li>Pain: 49% of Anzupgo-treated patients in both trials achieved this reduction at Week 16, vs 28% and 23% with cream vehicle (p&lt;0.0001).</li></ul></li></ul>Safety profileThe safety profile of Anzupgo was comparable to that of vehicle. Adverse events occurring in ≤ 1% of patients included application site pain, paresthesia, erythema, pruritus, and bacterial skin infections.Patients completing 16 weeks of treatment in the DELTA 1 and DELTA 2 trials were eligible to enter DELTA 3, a 36-week open-label extension assessing long-term safety.Product availabilityAnzupgo has been launched in multiple international markets and is expected to be made available in the US soon.&nbsp;

The topical pan-JAK inhibitor is the first FDA-approved therapy specifically indicated for chronic hand eczema

LAUNCH ALERT: FDA Approves Anzupgo (Delgocitinib) Cream for Moderate-to-Severe Chronic Hand Eczema in Adults 

THURSDAY, July 24, 2025 (HealthDay News) — The U.S. Food and Drug Administration (FDA) has signed off on the first-ever cream specifically approved for treating chronic hand eczema (CHE).CHE is a common condition marked by redness, itching and cracking on the hands and wrists.Anzupgo (delgocitinib cream) is approved for adults with moderate-to-severe CHE who can’t use topical steroids or who don’t respond well to them."The approval of Anzupgo reinforces our commitment to investing in difficult-to-treat skin conditions to deliver new treatments to patients where the need is greatest," <a target="_blank" rel="noopener noreferrer" href="https://www.leo-pharma.com/who-we-are/our-governance/our-leadership">Christophe Bourdon</a>, CEO of LEO Pharma, maker of Anzupgo, said in a news release.Unlike atopic dermatitis, which is the most common form of <a href="/conditions/atopic-dermatitis" target="_blank" rel="noopener noreferrer">eczema</a>, CHE is rare and debilitating. It affects about 10% of the U.S. population and lasts for more than three months or recurs at least twice a year, according to the National Eczema Association.Anzupgo works by blocking the effects of <a href="/conditions/jak-inhibitors" target="_blank" rel="noopener noreferrer">JAK enzymes</a>, which trigger the inflammation that can kickstart a hand eczema flare.Genetics and exposure to irritants and allergens are contributing causes of this form of eczema. People who are most at risk work in industries such as cleaning, hairdressing and health care, where they are more likely to come into contact with and react to chemicals.Studies show that the condition can take a dramatic toll on a person’s quality of life and mental well-being.A Detroit dermatologist welcomed the FDA’s action.“In my career as a dermatologist, I have witnessed firsthand the significant burden that the itch and pain of CHE places on patients, and the challenges they face living with it,” <a target="_blank" rel="noopener noreferrer" href="https://www.henryford.com/physician-directory/s/stein-gold-linda">Dr. Linda Stein Gold</a>, director of clinical research at Henry Ford Health in Detroit, said in a <a target="_blank" rel="noopener noreferrer" href="https://www.leo-pharma.com/media-center/news/2025-fda-approval">LEO Pharma US news release</a>. "I believe this new treatment option will be welcomed by dermatologists who are looking for effective and safe ways to address these symptoms.”Studies leading up to the FDA approval found that people with hand eczema who used the cream were more likely to improve than their counterparts treated with a placebo cream. The cream does not carry the same boxed warning that other topical and oral JAK inhibitors must.“We’re thrilled that the FDA recognizes the impact that moderate-to-severe chronic hand eczema has on patients,” Kristin Belleson, CEO and president of the National Eczema Association, said in a news release.“People living with a debilitating skin disease on their hands find it extremely difficult; it can impact their ability to work, touch, and connect with important people in their lives," she added. "The approval … provides hope and promise for the eczema community and those seeking lasting relief from disruptive symptoms.”The cream was already approved in the European Union, United Kingdom, Switzerland and United Arab Emirates.More informationThe National Eczema Association has more on <a target="_blank" rel="noopener noreferrer" href="https://nationaleczema.org/types-of-eczema/hand-eczema/">chronic hand eczema</a>.SOURCE: LEO Pharma US, news release, July 23, 2025

Key Takeaways<ul><li>The U.S. Food and Drug Administration has given its nod to a new treatment for chronic hand eczema</li><li>Anzupgo is now the only topical therapy specifically approved for chronic hand eczema</li><li>This form of eczema affects about 10% of the U.S. population</li></ul>

FDA Approves First Cream for Treating Chronic Hand Eczema

FRIDAY, July 25, 2025 (HealthDay News) -- In an update to the guidelines for managing <a href="/conditions/atopic-dermatitis" target="_blank" rel="noopener noreferrer">atopic dermatitis</a> in adults, four new treatment recommendations are presented. The focused update was published online July 16 in the Journal of the American Academy of Dermatology.Dawn M.R. Davis, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues updated previous guidelines issued by the American Academy of Dermatology on the management of atopic dermatitis in adults by providing evidence-based recommendations on use of topical and systemic therapies.The authors developed four recommendations for atopic dermatitis management in adults, all strong, with a high certainty of evidence. <a href="/resources/toolkit/drugs/vtama" target="_blank" rel="noopener noreferrer">Tapinarof</a> cream is recommended for adults with moderate-to-severe atopic dermatitis. <a href="/conditions/pd4-inhibitors" target="_blank" rel="noopener noreferrer">Roflumilast</a> 0.15 percent cream is recommended for adults with mild-to-moderate atopic dermatitis. <a href="/resources/toolkit/drugs/ebglyss" target="_blank" rel="noopener noreferrer">Lebrikizumab</a> is recommended for moderate-to-severe atopic dermatitis, as is <a href="/conditions/il-inhibitors" target="_blank" rel="noopener noreferrer">nemolizumab</a> with concomitant topical therapy."Additional, long-term efficacy and safety data and data on patient-reported outcomes in real-world settings are needed to provide additional insights into the efficacy, effectiveness, and safety of these therapies for the management of atopic dermatitis," the authors write. "Comparative studies of these medications and available standard AD therapies would provide an understanding of the role of these therapies in the armamentarium of AD treatments."Several authors disclosed ties to the biopharmaceutical industry.<a target="_blank" rel="noopener noreferrer" href="https://www.jaad.org/article/S0190-9622(25)02125-5/fulltext">Abstract/Full Text</a>

Strong recommendations presented for tapinarof cream, roflumilast cream, lebrikizumab, nemolizumab with concomitant topical therapy

Novel Treatments Recommended for Management of Atopic Dermatitis in Adults

WEDNESDAY, July 23, 2025 (HealthDay News) -- Daily emollient application beginning before age 9 weeks is associated with a reduced cumulative incidence of <a href="/conditions/atopic-dermatitis" target="_blank" rel="noopener noreferrer">atopic dermatitis</a> by 24 months in a population not selected for risk, according to a study published online July 23 in JAMA Dermatology.Eric L. Simpson, M.D., from Oregon Health &amp; Science University in Portland, and colleagues examined whether emollient intervention in <a href="/conditions/pediatric-dermatology" target="_blank" rel="noopener noreferrer">infants</a> not selected for risk reduces atopic dermatitis incidence in a randomized pragmatic clinical trial involving 1,247 infant-parent dyads. The dyads were randomly assigned to a daily full-body emollient application daily moisturizer group starting by age 9 weeks or a control group that refrained from emollient use.The researchers found that the cumulative incidence of atopic dermatitis was 36.1 and 43.0 percent in the emollient and control groups, respectively, at 24 months, with a relative risk of 0.84. A larger magnitude of effect was seen in the population not at high risk for atopic dermatitis (relative risk, 0.75). The presence of a dog in the house did not significantly modify the protective effect (relative risk, 0.68). No between-group differences were seen in cutaneous adverse events."Given the current and frequent use of moisturizers by the U.S. population, this intervention may represent a practical and safe approach to reducing the burden of atopic dermatitis in U.S. communities," the authors write.Several authors disclosed ties to the biopharmaceutical and dermatology industries.<a target="_blank" rel="noopener noreferrer" href="https://jamanetwork.com/journals/jamadermatology/article-abstract/2836819">Abstract/Full Text</a><a target="_blank" rel="noopener noreferrer" href="https://jamanetwork.com/journals/jamadermatology/article-abstract/2836822">Editorial</a>

Daily emollient applications starting before age 9 weeks linked to reduction in cumulative incidence of atopic dermatitis at age 24 months

Daily Emollient Application May Reduce Risk for Atopic Dermatitis in Infants

WEDNESDAY, July 16, 2025 (HealthDay News) -- For patients with <a href="/conditions/atopic-dermatitis" target="_blank" rel="noopener noreferrer">atopic dermatitis</a> (AD), the self-reported number of flares is predictive of future disease severity and frequency of future flares, according to a study published online July 16 in JAMA Dermatology.Mia-Louise Nielsen, Ph.D., of the Copenhagen University Hospital-Bispebjerg in Denmark, and colleagues validated the predictability of flares and disease severity in patients with AD and quantified the importance of predictors using the Danish Skin Cohort. In addition, boosted random forests were used to explore predictors of annual flares and disease severity. The study included 878 patients with AD, with 26, 405, 169, and 278 reporting zero, one to five, six to 10, and more than 10 yearly flares, respectively, in 2022.The researchers observed a significant association between the number of annual flares reported in 2022 and most patient-reported severity measures reported in 2023. The number of annual flares reported in 2022 was significantly associated with the Patient-Oriented Eczema Measure and Dermatology Life Quality Index when adjusting for the Patient-Oriented Scoring of Atopic Dermatitis score at baseline. Flare severity, duration, and number were found to be among the most important predictors of AD severity when using predictive machine learning models, while disease severity was among the strongest predictors of the number of annual flares."The current findings suggest that flares might serve as an early indicator of disease progression or inadequate disease control, highlighting that flares could be relevant in clinical decision-making to support optimal treatment strategies," the authors write.Several authors disclosed ties to the biopharmaceutical industry.<a target="_blank" rel="noopener noreferrer" href="https://jamanetwork.com/journals/jamadermatology/fullarticle/2836498">Abstract/Full Text</a>

Flare severity, duration, and number were among most important predictors of AD severity

Number of Atopic Dermatitis Flares Linked to Lower QoL, More Severe Disease

TUESDAY, July 15, 2025 (HealthDay News) -- A high dietary inflammatory index (DII), which quantifies the inflammatory potential of diet, is associated with increased prevalence of <a href="/conditions/atopic-dermatitis" target="_blank" rel="noopener noreferrer">atopic dermatitis</a> (AD), according to a study published online June 19 in Frontiers of Immunology.Kaiyue Tan, from The First Clinical College of Shandong University of Traditional Chinese Medicine in Jinan, China, and colleagues examined the association between DII quartiles and AD risk using large-scale population-based cross-sectional data from the Korean National Health and Nutrition Examination Survey 2017 to 2023.The researchers observed a significant association for higher DII scores with AD prevalence. Compared with those in the lowest quartile, participants in the highest DII quartile had a significantly increased risk for AD (adjusted odds ratio, 1.73), and there was a significant sex interaction noted, with stronger associations seen in the female group. A possible linear association was observed between DII and AD risk in a restricted cubic spline analysis."This study demonstrated for the first time in an Asian population that high DII is positively associated with AD risk, and the effect was more pronounced in women and those ≤54 years of age," the authors write. "Future validation of associations through repeated dietary measurements, inclusion of omitted anti-inflammatory components, and prospective designs is warranted."<a target="_blank" rel="noopener noreferrer" href="https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2025.1606145/full">Abstract/Full Text</a>

Significant sex interaction observed, with stronger associations in the female group

High Dietary Inflammatory Index Tied to Increased Prevalence of Eczema

TUESDAY, July 15, 2025 (HealthDay News) -- <a href="/conditions/atopic-dermatitis" target="_blank" rel="noopener noreferrer">Atopic dermatitis</a> (AD) was associated with an increased risk for chronic kidney disease (CKD) in an Asian population, according to a study published online July 10 in the Journal of Dermatology.Hsi-Chih Chen, from the Tri-Service General Hospital at the National Defense Medical Center in Taipei, Taiwan, and colleagues conducted a nationwide, longitudinal study to examine the correlation between AD and the risk for CKD using data from Taiwan's National Health Insurance Research Database. A total of 15,179 individuals with AD were identified and compared to 60,716 age- and sex-matched individuals without AD.The researchers found that after adjustment for potential confounders, patients with AD had an elevated risk for CKD compared with the non-AD comparison cohort (adjusted odds ratio, 1.30). In both men and women and in all age groups, the association between AD and an increased risk for CKD was evident. There was a trend toward increasing odds ratios seen with increasing frequency of clinical visits for AD."Our findings remained robust in subgroup analyses, which demonstrate that a positive association exists between AD and CKD risk in both genders and in all age groups," the authors write. "The clinical implications of the present study merit further investigation."<a target="_blank" rel="noopener noreferrer" href="https://onlinelibrary.wiley.com/doi/10.1111/1346-8138.17841">Abstract/Full Text</a>

Association between AD and increased risk for chronic kidney disease seen for men and women and in all age groups

Atopic Dermatitis May Be Linked to Increased Risk for CKD

WEDNESDAY, July 2, 2025 (HealthDay News) -- Increased levels of environmental pollutants are associated with an increased burden of <a href="/conditions/atopic-dermatitis" target="_blank" rel="noopener noreferrer">atopic dermatitis</a>, according to a systematic review and meta-analysis published online June 25 in JAMA Dermatology.Megan Park, from the University of Toronto, and colleagues summarized and assessed the certainty of evidence on associations between environmental factors and atopic dermatitis outcomes in adults aged 18 years and older. A total of 42 studies were included in the review.The researchers found that atopic dermatitis outpatient clinic visits increased for every 10-μg/m3 increase in particulate matter 10 μm in diameter or less, particulate matter 2.5 μm in diameter or less, sulfur dioxide, and nitrogen dioxide (risk ratios, 1.008, 1.013, 1.029, and 1.014, respectively). Increased atopic dermatitis-related visits were seen in association with extreme environmental temperatures (hot and cold). There was a possible association for higher precipitation, including rain, with increased atopic dermatitis severity; probable associations were seen for higher levels of humidity with increased atopic dermatitis severity. An uncertain association was seen for increased duration of sunlight exposure on atopic dermatitis severity. Probable associations were seen for secondhand smoking exposure and traffic and industrial plant exposure with an increased prevalence of atopic dermatitis."These findings have direct public health implications, adding to the impetus to decrease pollution and mitigate climate change worldwide," the authors write.<a target="_blank" rel="noopener noreferrer" href="https://jamanetwork.com/journals/jamadermatology/article-abstract/2835460">Abstract/Full Text</a>

Probable associations seen for secondhand smoking exposure and traffic and industrial plant exposure with increased prevalence of atopic dermatitis

Increased Levels of Environmental Pollutants Linked to Atopic Dermatitis

MONDAY, June 9, 2025 (HealthDay News) -- Early-life dog exposure may modify the genetic effect of the single nucleotide variant rs10214237 on <a href="/conditions/atopic-dermatitis" target="_blank" rel="noopener noreferrer">atopic eczema</a> (AE) via <a href="/podcasts/derms-and-conditions/season3-podcast-episode-49" target="_blank" rel="noopener noreferrer">IL7R</a>, according to a study published online June 4 in Allergy.Marie Standl, Ph.D., from the Helmholtz Zentrum München–German Research Center for Environmental Health in Neuherberg, Germany, and colleagues examined gene-environment interactions to examine the pathophysiology of AE. Interaction was tested between the 24 most significant AE-associated loci identified from genome-wide association studies and 18 early-life environmental factors using data from 16 European studies. A further 10 studies and in vitro modeling were used to independently assess findings.The researchers found that the discovery analysis (25,339 individuals) showed suggestive evidence for interaction between seven environmental factors and at least one established single nucleotide variant (SNV) for AE, with a total of 14 interactions. In the replication analysis, with 254,532 individuals, there was a nominally significant interaction for dog exposure with the SNV rs10214237 (on chromosome 5p13.2 near IL7R), with odds ratiointeraction = 0.91; the risk effect of the T allele was only seen for those not exposed to dogs. For siblings in the discovery analysis, a similar interaction with rs10214237 was observed (odds ratiointeraction = 0.84), but a replication analysis was underpowered. Lower IL-7R expression was seen in human keratinocytes in association with the rs10214237 homozygous risk genotype, and a differential response was seen according to the rs10214237 genotype for dog exposure modeled in vitro."More work is needed, but our findings mean we have a chance to intervene in the risk of allergic disease, to protect future generations," coauthor Sara J. Brown, M.D., Ph.D., from the University of Edinburgh, said in a statement.Several authors disclosed ties to the pharmaceutical industry.<a target="_blank" rel="noopener noreferrer" href="https://onlinelibrary.wiley.com/doi/10.1111/all.16605">Abstract/Full Text</a>

Findings support observational epidemiology showing protective effect of dog exposure early in life

Early Dog Exposure May Modify Genetic Effect on Atopic Eczema Risk

MONDAY, May 19, 2025 (HealthDay News) -- In a clinical report published online May 19 in Pediatrics, the American Academy of Pediatrics presents updated guidance for the treatment of children with atopic dermatitis (AD).Noting that many pediatricians may not feel comfortable treating AD or other dermatologic conditions, Jennifer J. Schoch, M.D., from the University of Florida in Gainesville, and colleagues reviewed pediatric AD and provided an up-to-date approach to skin-directed management incorporating recent advances.The authors note that successful AD treatment involves the triad of maintenance skin care, topical anti-inflammatory medications, and avoidance of triggers. General recommendations for treatment include frequent bathing (daily or every other day) with lukewarm water and gentle cleanser. Products with added fragrance, dyes, or essential oils should be avoided, as they are potential irritants and/or contact allergens. Topical anti-inflammatories, including corticosteroids and calcineurin inhibitors, should be applied once to twice daily to active eczema patches; unless specifically instructed, topical medications should not be mixed with topical emollients, as this dilutes the potency of the medication. Dupilumab and Janus kinase inhibitors are emerging treatments for AD. In patients with AD, moisturizers should be applied liberally to the entire body skin surface at least daily, especially after a bath or shower. Flare can be reduced with reduction of triggers and proactive treatment with topical anti-inflammatories. Patients with severe, recalcitrant, and/or complicated AD should be referred to subspecialists."Ongoing collaboration between pediatric primary care providers and AD specialists can optimize care for patients with complex AD," the authors write.One author disclosed ties to Janssen Biotech and Exactech.<a target="_blank" rel="noopener noreferrer" href="https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2025-071812/201952/Atopic-Dermatitis-Update-on-Skin-Directed">Abstract/Full Text</a>

Topical anti-inflammatories should be applied once to twice daily to active eczema patches

AAP Updates Guidelines for Pediatric Atopic Dermatitis Management

FRIDAY, May 23, 2025 (HealthDay News) -- An artificial intelligence (AI) Three-Item Severity (TIS) score can identify eczema-affected areas and severity scores from user-uploaded images, according to a research letter published online May 19 in Allergy.Utako Okata-Karigane, M.D., from the Keio University School of Medicine in Japan, and colleagues developed an AI-based model to assess eczema severity from user-uploaded photos. Three algorithms were trained and integrated: body part detection, skin lesion detection, and severity assessment. The TIS score, a localized severity assessment ranging from 0 to 9, evaluating erythema, edema/papulation, and excoriation, was adopted because the model analyzes representative images rather than full-body images.A total of 9,656 images with itch scores were included to establish and validate AI-TIS. The researchers found that the trained AI model correctly detected 98 and 100 percent of body parts and eczema areas, respectively; across 220 test images, the model correlated well with TIS scores determined by board-certified dermatologists and/or allergists (R = 0.73). Across 8,556 images, AI-TIS showed a lower correlation with itch intensity on a 0-to-5 numeric rating scale (R = 0.11). In 15 patients, correlations of AI-TIS with TIS, SCORing Atopic Dermatitis (SCORAD), and objective-SCORAD were R = 0.16, 0.4, and 0.53, respectively."This study lays the groundwork for future advancements in AI-driven dermatological assessments, enhancing both patient care and clinical research," the authors write.Several authors disclosed ties to the biopharmaceutical industry.<a target="_blank" rel="noopener noreferrer" href="https://onlinelibrary.wiley.com/doi/10.1111/all.16586">Abstract/Full Text</a>

AI-TIS score correlated well with TIS scores determined by board-certified dermatologists and/or allergists

AI Three-Item Severity Score Can ID Eczema From Patient-Uploaded Images

WEDNESDAY, May 7, 2025 (HealthDay News) -- The global burden of atopic dermatitis (AD) in older adults is considerable and is expected to continue increasing to 2050, according to a study published online April 1 in Frontiers in Public Health.Yi Ou, from the First Affiliated Hospital of Chongqing Medical University in China, and colleagues examined the global burden of AD in older adults from 1990 to 2021 and projected change to 2050. Estimates of prevalence, incidence, and disability-adjusted life-years (DALYs) attributable to AD among individuals aged 60 years and older were extracted from the Global Burden of Diseases Study 2021.The researchers found that the global prevalence of AD in older adults increased from 1990 to 2021 to 11,009,630 cases, even as age-standardized rates decreased, with population growth the main driver. Incidence rates were higher among women and those aged 75 to 79 years. There were positive correlations observed for incidence, prevalence, and DALY rates with sociodemographic index (SDI) levels, while a significant decline was seen in SDI-related inequalities. Increasing incidence, prevalence, and DALY numbers for AD in older adults were anticipated up to 2050, while a decrease was expected in age-standardized DALY rates."Globally, AD represented an underestimated public health concern primarily affecting individuals aged 60 and older, with variations observed across genders, age groups, regions, and nations," the authors write. "Consequently, targeted strategies for the effective prevention and management of AD in the older adult are needed to address the impending challenge."<a target="_blank" rel="noopener noreferrer" href="https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1569119/full">Abstract/Full Text</a>

Global prevalence of older adult AD increased from 1990 to 2021 and is expected to continue increasing to 2050

Global Burden of Atopic Dermatitis in Older Adults Is Considerable

WEDNESDAY, April 30, 2025 (HealthDay News) -- For adolescents and adults with moderate-to-severe atopic dermatitis (AD), once-daily ivarmacitinib is efficacious, according to a study published online April 30 in JAMA Dermatology.Yan Zhao, Ph.D., from the Peking University People's Hospital in Beijing, and colleagues examined the efficacy and adverse events associated with ivarmacitinib among adolescents and adults with moderate-to-severe AD in a multicenter, double-blind, placebo-controlled phase 3 randomized clinical trial. Patients aged 12 to 75 years were randomly assigned to receive once-daily 4- or 8-mg ivarmacitinib or placebo for 16 weeks (113, 112, and 111 patients, respectively).The researchers found that at week 16, significantly more patients in the 4-mg and 8-mg ivarmacitinib groups achieved an Investigator Global Assessment score of 0 (clear) or 1 (almost clear) with at least a 2-grade improvement compared with those in the placebo group (36.3 and 42.0 percent, respectively, versus 9.0 percent). The ivarmacitinib groups also had significantly higher rates of Eczema Area and Severity Index score improvement of 75 percent (54.0 and 66.1 percent versus 21.6 percent in the 4-mg and 8-mg ivarmacitinib groups, respectively, versus placebo). Overall, 69.0, 66.1, and 64.9 percent of patients reported treatment-emergent adverse events in the 4-mg and 8-mg ivarmacitinib and placebo groups, respectively. Serious treatment-emergent adverse events occurred in 2.7, 1.8, and 2.7 percent, respectively."Ivarmacitinib represents a promising new treatment option for patients whose AD is not adequately controlled by topical therapies," the authors write.Several authors disclosed ties to biopharmaceutical companies, including Jiangsu Hengrui, which manufactures ivarmacitinib and funded the study.<a target="_blank" rel="noopener noreferrer" href="https://jamanetwork.com/journals/jamadermatology/fullarticle/2833318">Abstract/Full Text</a>

More patients achieved IGA score of 0 or 1 with at least a 2-grade improvement with once-daily 4-mg or 8-mg ivarmacitinib versus placebo

Ivarmacitinib Efficacious for Moderate-to-Severe Atopic Dermatitis

WEDNESDAY, April 23, 2025 (HealthDay News) -- Children with early-onset atopic dermatitis (AD) have an elevated risk for pediatric uveitis, according to a study published online April 3 in JAMA Ophthalmology.Yung-Yu Chu, M.D., from Chi Mei Medical Center in Tainan City, Taiwan, and colleagues assessed whether the risk for pediatric uveitis is increased in children with early-onset AD versus a matched control population. The analysis included 114,889 patients with early-onset AD and 114,889 propensity score-matched controls without AD.The researchers found that the AD cohort had a higher risk for developing pediatric uveitis versus controls (0.08 versus 0.05 percent; hazard ratio, 1.92). Similar results were seen among patients without dupilumab use (0.08 versus 0.05 percent; hazard ratio, 1.77) and those without autoimmune conditions (0.07 versus 0.05 percent; hazard ratio, 1.52). Patients with severe AD had a higher risk for developing pediatric uveitis versus those with nonsevere AD (0.40 versus 0.08 percent; hazard ratio, 3.64)."This cohort study of children with early-onset AD found an elevated risk of pediatric uveitis compared with matched controls, independent of autoimmune conditions or dupilumab use," the authors write. "These findings support the potential need to consider ophthalmologic monitoring in children with early-onset AD to try to detect and subsequently manage uveitis if it develops."<a target="_blank" rel="noopener noreferrer" href="https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2832128">Abstract/Full Text</a>

Findings independent of autoimmune conditions or dupilumab use

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