The Newest in Dermatology: Acne, Atopic Dermatitis, Actinic Keratoses, Psoriasis, Skin Cancer, and More

A much-anticipated session with Drs Del Rosso, Lebwohl, and Zeichner reviewed the hottest new trends and therapeutics for multiple common dermatoses. Starting with acne, results from a clinical trial with the triple-combination gel with clindamycin, adapalene, and benzoyl peroxide were shown, touting a dramatic reduction in inflammatory and noninflammatory lesions by week 4.  For psoriasis, 3-year safety data has been published on bimekizumab, noting 18.5 events per 100 person years in the first year on the IL-17A and F inhibitor. Spesolimab has been shown to decrease flares in generalized pustular psoriasis with those who were started on high-dose spesolimab with a GPPGA score of 0 or 1 remaining flare-free for 48 weeks after week 4 of dosing. Deucravacitinib also has long-term efficacy data from clinical trials, with patients who achieved a PASI75 and PASI90 generally maintaining response for 3 years. 

The speakers moved on to discuss updates in atopic dermatitis including delgocitinib cream for chronic hand eczema, which tripled those obtaining IGA treatment success by week 8 when compared to placebo. For standard atopic dermatitis, response to abrocitinib may be predicted by week 4, and, for those who don’t achieve an EASI-50 reduction by this time point, dose-escalation to 200 mg should be considered. Tapinarof 1% cream has significant efficacy in children 2 years and up all the way to adults in atopic dermatitis. In a review of novel medications for a few other conditions, the efficacy of roflumilast foam for seborrheic dermatitis, which allowed 79% to obtain IGA success by week 8 compared to 48% using vehicle alone, was covered, along with the improvements of eyelash and eyebrow growth in patients with severe alopecia areata on baricitinib. Deuruxolitinib is another JAK inhibitor undergoing clinical trials for this condition. For chronic spontaneous urticaria, dupilumab improves itch and omalizumab improves sleep. 

Other advances in dermatology that were covered in this presentation centered around the improvements in gene expression tests. This may lead to advances in difficult-to-diagnose conditions like mycosis fungoides. The 2-GEP assay has a negative predictive value of 99.7%, indicating it can be used to rule out melanoma.