FC 2025 Conference Highlights

Take a peek at the atmosphere and buzz in the conference rooms, exhibit hall, and receptions from Fall Clinical 2025 in Las Vegas!

Shawn G. Kwatra, MD, presented a compelling session on the evaluation and management of chronic itch, underscoring its profound impact on patient quality of life. Chronic pruritus, he noted, impairs quality of life to a degree comparable to that of stroke and more than conditions such as heart failure with an implantable defibrillator or patients on hemodialysis. Despite being one of the most common symptoms in dermatology, pruritus often remains diagnostically elusive and therapeutically challenging. Through a series of illustrative cases, Dr Kwatra emphasized that chronic itch can be the first sign of systemic disease and requires careful evaluation beyond the skin. Dr Kwatra discussed emerging insights into the genetic and immunologic underpinnings of chronic itch, including a potential polygenic risk association in prurigo nodularis. He reviewed targeted treatments such as dupilumab, which has shown efficacy for chronic itch of various etiologies, and low-dose naltrexone, which modulates μ-opioid signaling and inflammatory mediators to relieve refractory scalp pruritus and symptoms in conditions such as epidermolysis bullosa. Additionally, he provided a practical framework for laboratory and clinical evaluation, including eosinophil counts and screening for systemic causes when the origin of itch is unclear. Concluding with complex cases of widespread pruritic dermatoses, Dr Kwatra illustrated how integrating immune profiling and genomic analysis can identify dominant cytokine pathways (IL-13, IL-17) and guide rational biologic therapy selection.

Alexandra Golant, MD, Mona Shahriari, MD, and G. Michael Lewitt, MD, presented a session focused on the evolving role of interleukin-13 (IL-13) inhibition in atopic dermatitis, sharing new insights, case experiences, and strategies for optimizing treatment in clinical practice.Dr Golant opened by underscoring the central role of IL-13 in atopic dermatitis pathophysiology. Elevated across age groups and skin tones in patients with atopic dermatitis, IL-13 drives barrier disruption, decreases filaggrin expression, and fuels pruritus and lichenification. She reviewed case examples, including an adolescent with long-standing disease who achieved rapid and sustained improvement on lebrikizumab. Dr Golant emphasized how patient-defined goals such as comfort at school, confidence in social settings, and reduced topical burden align with the responses seen in trials. Early and aggressive targeting of IL-13 was presented as a way to meet both clinical and quality-of-life outcomes.Dr Shahriari expanded on the comparative efficacy of IL-13 biologics, highlighting pivotal data from SOLO, ADvocate, ECZTRA, and long-term extension studies. Both lebrikizumab and tralokinumab demonstrated durable control, with maintenance of EASI90 and pruritus relief extending beyond 2 years. She also addressed switching strategies, noting that patients discontinuing dupilumab for adverse events often achieved better outcomes on lebrikizumab compared with those stopping for inadequate response. Dr Shahriari presented cases of patients with dupilumab-associated ocular surface disease whose symptoms resolved when transitioned to tralokinumab or Janus kinase inhibitors, underscoring the importance of individualized sequencing.Dr Lewitt concluded with a practical perspective on integrating IL-13 inhibitors into daily practice. He illustrated this with a young adult patient who prioritized clearance of hand and facial dermatitis with minimal treatment burden. After 16 weeks of lebrikizumab, both skin clearance and pruritus improved markedly, restoring confidence and function. Dr Lewitt highlighted safety profiles across the IL-13 inhibitor class, emphasizing that adverse events are generally manageable and that selective inhibition may be particularly appealing when patients prefer targeted therapy without systemic immunosuppression. Looking forward, the faculty noted that biologics with extended half-lives, bispecific antibodies, and oral agents may further expand long-term disease control options.

Linda Stein Gold, MD, MS, Cheri Frey, MD, FAAD, Peter Lio, MD, FAAD, and Bruce Strober, MD, PhD, led an expert discussion highlighting cutting-edge advances in topical dermatologic therapy that are transforming treatment safety, efficacy, and patient outcomes across acne, rosacea, atopic dermatitis, and psoriasis.Dr Stein Gold opened with an evidence-based review addressing concerns regarding benzoyl peroxide (BPO) and potential benzene contamination. She summarized recent multicenter studies from 2024–2025 confirming that BPO use does not increase the risk of benzene-related malignancies, emphasizing that product stability depends on formulation chemistry and appropriate storage, specifically refrigeration, avoiding heat, and renewing products every few months. Dr Stein Gold also discussed the FDA approval of low-dose extended-release minocycline (DFD-29, 40 mg) for rosacea, presenting phase 3 data demonstrating strong efficacy, a favorable safety profile, and minimal microbiome disruption, supporting its role as a next-generation oral option for long-term rosacea management.Dr Frey followed with an overview of advances in cosmeceutical science, focusing on novel retinoid analogues, peptides, and regenerative skincare. She explained how new retinoid derivatives such as retinyl retinoate and hydroxypinacolone retinoate enhance collagen and hyaluronic acid production while reducing irritation compared to traditional formulations. Dr Frey also described the therapeutic potential of bioactive peptides, palmitoyl tetrapeptide-7, oligopeptide-68, acetyl hexapeptide-3, and copper tripeptide-1 (GHK-Cu), in promoting skin repair, modulating pigmentation, and attenuating inflammation, though she noted that delivery optimization remains a clinical challenge. She concluded with an introduction to exosome-based regenerative skincare, which can promote wound healing and dermal rejuvenation through the Wnt/β-catenin and VEGF pathways, while underscoring the importance of regulatory oversight and controlled clinical validation.Dr Lio then presented an update on the evolving therapeutic landscape for atopic dermatitis (AD), structuring his discussion around the practical goals of “Get Clear, Keep Clear, Keep It Up.” He reviewed new guideline-supported treatment algorithms incorporating topical corticosteroids, calcineurin inhibitors, and an expanding array of nonsteroidal options such as ruxolitinib, roflumilast, delgocitinib, and tapinarof. Comparative data demonstrated superior patient-reported outcomes with tacrolimus 0.03% versus crisaborole, while ruxolitinib and tapinarof provided durable disease control and favorable safety. Dr Lio emphasized the need for long-term maintenance strategies and barrier repair to sustain remission and improve quality of life.Dr Strober concluded with a discussion of topical innovation in psoriasis and seborrheic dermatitis. He reviewed pivotal trial data showing that roflumilast 0.3% and tapinarof 1% achieve high rates of clearance, durable remission, and excellent tolerability, even in intertriginous and facial regions. Dr Strober highlighted the DERMIS and PSOARING programs, noting the remittive effects of tapinarof and the consistent tolerability of roflumilast across age groups. He positioned both agents as first- and second-line nonsteroidal options that deliver biologic-level efficacy through topical mechanisms. Collectively, the speakers illustrated how formulation science, molecular innovation, and patient-centered design are converging to usher in a new era of precision-driven topical therapy in dermatology.

Marc Serota, MD, and Michelle Tarbox, MD, led an in-depth session on the evolving management of chronic spontaneous urticaria (CSU), emphasizing diagnostic precision, disease activity assessment, and the integration of novel biologic and small-molecule therapies into clinical practice.The duo began by outlining the classification of urticaria based on duration and cauases, differentiating between inducible and spontaneous forms, and underscoring that nearly 80% of chronic cases are spontaneous. They discussed current international guidelines recommending a stepwise approach: beginning with avoidance of triggers and second-generation H1 antihistamines, escalating doses up to fourfold if needed, and advancing to omalizumab or cyclosporine in refractory cases. The speakers emphasized disease monitoring using the Urticaria Activity Score (UAS7) and the Urticaria Control Test (UCT), where a UAS7 ≤6 or UCT ≥12 indicates well-controlled disease, reinforcing the shift toward objective, quantifiable disease assessment to step-up or step-down management. The session transitioned to therapeutic developments poised to transform CSU care. The team reviewed recent evidence supporting omalizumab, citing meta-analyses of 67 real-world studies confirming its strong efficacy and safety. Next, they presented emerging phase 3 data from the LIBERTY-CSU CUPID trials demonstrating significant reductions in itch severity and urticaria activity with dupilumab compared to placebo, achieving complete response rates in up to 30% of patients. They also highlighted the REMIX-1 and REMIX-2 studies evaluating the BTK inhibitor remibrutinib, which achieved meaningful UAS7 improvements by week 24 with comparable safety to placebo. The discussion concluded with an outlook on integrating these biologic and targeted therapies into personalized treatment algorithms, aiming to achieve faster disease control and improved quality of life for patients with CSU.

Benjamin Ehst, MD, PhD, and Alexandra Golant, MD, presented an insightful session focused on the complex diagnosis and evolving treatment landscape of chronic hand eczema (CHE), a condition characterized by persistent inflammation, multifactorial triggers, and limited long-term therapeutic success.Dr Ehst began by emphasizing that CHE, defined as hand eczema lasting more than three months or recurring twice or more within a year, is rarely caused by a single factor. He described how atopic dermatitis, allergic contact dermatitis, and irritant exposures often overlap, complicating management. Through a case example of a 64-year-old manufacturing employee with recurrent fissuring and scaling, Dr Ehst demonstrated the importance of comprehensive history-taking and patch testing to identify occupational allergens. He highlighted that the pathophysiology of CHE involves cytokine-mediated inflammation via the JAK-STAT pathway, providing a rationale for the recent wave of targeted therapies. Dr Golant echoed the need to individualize care, noting that traditional approaches, such as topical corticosteroids, calcineurin inhibitors, and systemic immunosuppressants, often fail to maintain remission once treatment is stopped.The discussion then turned to emerging therapies offering renewed hope for this burdensome condition. Dr Golant reviewed pivotal phase 3 data from the DELTA 1 and 2 trials showing that delgocitinib cream, a topical pan-JAK inhibitor, achieved significant Investigator’s Global Assessment (IGA-CHE) responses by week 24, with nearly one-third of patients attaining clear or almost-clear skin in the long-term DELTA 3 extension. Dr Ehst highlighted similar promise from ruxolitinib cream, which produced rapid reductions in itch and eczema severity by day 7 in phase 2 studies. Additional data from the LIBERTY AD-HAFT trial demonstrated that dupilumab significantly improved hand and foot eczema outcomes, while interim tralokinumab results suggested parallel benefit without new safety concerns. Both speakers underscored the favorable tolerability profiles of these agents, marking a major shift from chronic steroid reliance toward precision-driven.

Lawrence F. Eichenfield, MD, started the session, delivering a highly informative lecture centered on practical pediatric dermatology pearls that enhance both diagnostic accuracy and patient care. Dr Eichenfield began by sharing a simple but effective clinical tip: using an otoscope to differentiate pilomatricomas from epidermal inclusion cysts or dermatofibromas. The illumination helps highlight the calcium deposits characteristic of pilomatricomas, allowing for a more confident bedside diagnosis without the need for advanced imaging.He continued with guidance on managing localized eyebrow alopecia, recommending a tiered tapering approach using clobetasol for seven days, followed by consideration of topical minoxidil or ruxolitinib as adjunctive therapies. Dr Eichenfield also provided practical strategies for improving pediatric procedures, including employing “iPhone hypnosis” for distraction and using a “spreadsheet method” to ensure efficiency and consistency during clinical interventions. To address parental hesitation toward treatment, he introduced the “unpack the backpack” method: an empathetic communication approach encouraging providers to explore and understand parental concerns before offering reassurance and education. The session concluded with an evidence-based review of pediatric hemangioma management, supported by clinical imagery that underscored treatment effectiveness and expected outcomes.Elizabeth (Lisa) A. Swanson, MD, then shared her top pearls—equal parts humor, empathy, and practical wisdom. She began with management strategies for atopic dermatitis (AD), emphasizing the growing array of new topical nonsteroidals such as tapinarof 1% cream (approved for ages 2+), roflumilast 0.15% cream (6+), and ruxolitinib 1.5% cream (2+). Dr Swanson highlighted how these agents offer steroid-sparing options that resonate with parents increasingly wary of topical corticosteroids due to misinformation circulating on social media.She also championed the value of compounded formulations for challenging pediatric cases. Two standouts included the Aron Regimen, a gentle yet highly effective combination of betamethasone valerate, mupirocin, and vanicream for severe facial AD in infants and toddlers, and a salicylic acid + 5-fluorouracil compound for recalcitrant warts, applied under occlusion for rapid clearance.Transitioning to communication pearls, Dr Swanson discussed the power of language in pediatric encounters. She reminded clinicians that words matter, urging them to avoid alarming or judgmental phrases (“shot,” “mutation,” “herpes”) and instead foster trust through reassurance (“I can help you,” “You came to the right place,” “I’m on your team”). She underscored that framing matters as much as pharmacology in building lasting therapeutic relationships.

Mark Lebwohl, MD, opened with updates on ritlecitinib, highlighting sustained scalp and brow regrowth in patients with alopecia areata over 24 to 48 weeks, and described a five-year follow-up case showing the need for ongoing intralesional triamcinolone for brow maintenance. Adelaide A. Hebert, MD, shared emerging evidence on topical ruxolitinib’s benefit in lichen planus and presented data on high-dose oral vitamin D rapidly attenuating inflammatory responses in sunburn and radiation dermatitis. David M. Pariser, MD, emphasized the practical role of medical scribes—whether in-person, virtual, or “on a stick”—in improving workflow, patient interaction, and the “Dermatologist Life Quality Index,” noting that the financial return often outweighs the cost. Neal D. Bhatia, MD, cautioned clinicians about the increasing ease with which patients file medical board complaints, urging vigilance in documentation, communication, and early legal consultation to mitigate risk.Later segments covered innovations in disease management and procedural dermatology. Dr Bhatia spotlighted SGX301 (topical hypericin photodynamic therapy) as an effective, non-mutagenic treatment for early-stage mycosis fungoides, achieving lesion responses up to 49% by week 24 with minimal local adverse effects. Dr Pariser discussed glycopyrronium cloth and sofpironium bromide gel as promising topical options for hyperhidrosis, while Dr Hebert highlighted updates in birth control pill use under the isotretinoin REMS program. Dr Lebwohl added that zoster and influenza vaccination may reduce dementia risk, underscoring the broader systemic value of preventive care. The panel concluded by encouraging clinicians to stay alert to emerging intralesional options—such as methotrexate, 5-FU, and cemiplimab—for keratinocyte carcinomas, reminding attendees that innovation continues across every corner of dermatology practice.

Andrew F. Alexis, MD, MPH, began by reviewing the multifactorial pathophysiology of melasma, which involves ultraviolet (UV) and visible light exposure, hormonal triggers, vascular changes, and inflammatory signaling. He highlighted recent evidence underscoring the central role of oxidative stress and the JAK–STAT pathway in melanogenesis. Topical therapies remain first-line, with hydroquinone continuing to serve as the gold standard despite limitations such as irritant dermatitis and risk of exogenous ochronosis. Dr Alexis discussed novel non-hydroquinone agents, including cysteamine, thiamidol (a potent human tyrosinase inhibitor), and multitarget cosmeceutical combinations like MB3 (2-MNG, niacinamide, cystoseira extract, and lipohydroxy acid), all of which have shown significant mMASI score reductions comparable to or exceeding hydroquinone-based regimens in clinical studies. Dr Alexis then focused on systemic and procedural advances. He reviewed data demonstrating that oral tranexamic acid (TXA), given at 250–325 mg twice daily for three months, can reduce mMASI scores by nearly 50%, with no thromboembolic events reported in large retrospective safety analyses. Adjunctive use of oral antioxidants such as Polypodium leucotomos and combination regimens integrating TXA with topical hydroquinone, retinoids, and kojic acid further improve pigment clearance. Procedural therapies, including glycolic acid peels, microneedling, and fractional 1927 nm thulium laser, enhance epidermal turnover and melanin removal, with best outcomes achieved when paired with maintenance topicals and strict photoprotection using mineral- and iron oxide–based sunscreens. Dr Alexis also highlighted that disorders like lichen planus pigmentosus and acquired dermal macular hyperpigmentation can mimic melasma and may respond to oral isotretinoin and low-energy fractional laser therapy. His concluding message stressed that successful pigment management hinges on personalized, multimodal regimens that address both melanocyte hyperactivity and skin barrier dysfunction.

Natasha Atanaskova-Mesinkovska, MD, PhD, presented an engaging overview of both established and emerging treatments for hair loss. She began with a classic focus on minoxidil, highlighting dosing differences across men, women, and children. In addition to its well-known vasodilatory mechanism, Dr Mesinkovska emphasized that minoxidil also has anti-androgenic and anti-inflammatory properties, giving it therapeutic potential across several forms of hair loss. She addressed common concerns about blood pressure effects and rare complications such as pericardial effusion, presenting data and practical strategies to help clinicians manage these issues confidently.She then discussed JAK inhibitors, reviewing their efficacy, mechanisms, and safety in conditions such as alopecia areata, frontal fibrosing alopecia, lichen planopilaris, and central centrifugal cicatricial alopecia. Dr Mesinkovska recommended a treatment trial of six to nine months before assessing hair regrowth outcomes.Next, she addressed the connection between allergy and hair loss, encouraging clinicians to consider atopy in all patients with hair loss. She reviewed possibilities of allergic contact dermatitis and the role of patch testing in patients with unexplained alopecia. Her research suggests that environmental allergens, such as dust mites, may influence immune responses in alopecia areata and contribute to earlier onset and greater severity, particularly among patients of Chinese ancestry. Reflecting this allergic-immune link, she noted reports of hair regrowth with dupilumab in pediatric alopecia areata and with tralokinumab in adults who have both atopic dermatitis and alopecia areata.Finally, Dr Mesinkovska highlighted several innovative therapies, including PP405, a topical small molecule in development, and exosome-based approaches. Exosomes are extracellular vesicles that carry bioactive molecules and act as natural biological messengers. They show promise for regenerative, anti-inflammatory, and hair-restorative applications in future dermatologic care.

Brett King, MD, PhD, and E. James Song, MD, delivered a comprehensive and practical session on inflammatory skin diseases, focusing on the evolving role of JAK inhibitors (JAKis) across multiple dermatologic conditions.Dr King began by outlining strategies for differentiating types of alopecia and optimizing therapy for alopecia areata (AA). He emphasized that patients may respond differently to various JAK inhibitors and that lack of efficacy with one agent does not preclude success with another. For AA, he recommended combining baricitinib with oral minoxidil and advised switching to a different JAKi if there is no regrowth after six to nine months at maximal dosing. He also reviewed data supporting the use of abrocitinib and tofacitinib for generalized granuloma annulare, drawing from open-label clinical trial results. In atopic dermatitis (AD), Dr King highlighted similar therapeutic nuances, noting that patients unresponsive to one JAKi may respond to another.Dr Song expanded on this discussion, focusing on managing partial responses to JAKis and strategies such as adding corticosteroids or dupilumab. He reinforced that nonresponse to one JAKi does not predict universal failure across the class. For AA, Dr Song discussed considering dupilumab as an alternative in patients with a strong atopic history or elevated IgE (≥200 IU/mL). Shifting to AD, he reviewed the latest insights on nemolizumab, approved for pruritus associated with AD, including emerging reports of dermatitis-type adverse events and recommendations for clinical use. He also discussed predictors of dupilumab responders and concluded with a look at tofacitinib’s potential role in unstable vitiligo, underscoring the expanding therapeutic landscape of JAK inhibitors across inflammatory dermatology.

To learn more and register, click below! Learn more!