What Did Dermatology Bring to the Table in 2024 That Impacts Patient Care in 2025 - Part 2

In Part 2 of “What Did Dermatology Bring to the Table in 2024 that Impact Patient Care in 2025” series, Seemal Desai, MD, Mark Lebwohl, MD, Dawn Merritt, DO, Joshua Zeichner, MD presented new data on several key dermatological conditions from vitiligo to acne.

Seemal Desai, MD presented exciting advancements in vitiligo treatment, starting with topical ruxolitinib, which showed significant efficacy, including 95% improvement in F-VASI by week 80, with 66% achieving 75% improvement and 33.9% reaching 90% by week 104. He highlighted promising oral therapies, such as upadacitinib and povorcitinib, for recalcitrant cases, along with phase 2b trial data on ritlecitinib for nonsegmental vitiligo. Dr. Desai also discussed innovative approaches like autologous skin cell suspension grafting for repigmentation and introduced thiamidol, a tyrosinase inhibitor that offers a targeted option for lightening hyperpigmented areas.

Dr Lebwohl presented updates on treatments for psoriasis, psoriatic arthritis, hidradenitis suppurativa (HS), atopic dermatitis (AD), and bullous pemphigoid (BP). In psoriasis, the FRONTIER 2 trial showed icotrokinra achieved PASI75 and PASI90 in 76.2% and 64.3% of patients by week 51, while TAK-279 (zasocitinib) reached PASI75 in 67.5% by week 12, and bimekizumab maintained PASI90 and PASI100 in 87.5% and 62.7% by week 16. For HS, the BE HEARD trials confirmed bimekizumab’s efficacy. In AD, lebrikizumab achieved EASI75 and EASI90 in 81.9% and 61.4% of patients by week 52, with upadacitinib outperforming dupilumab in EASI90 and EASI100 rates at 16 weeks. The JADE COMPARE trial found abrocitinib achieved higher EASI75 rates than dupilumab, while roflumilast maintained disease control in 57% of patients through week 56. Dupilumab showed significant efficacy in BP and CSU, reducing itch and hives regardless of baseline IgE levels. Lastly, a JAMA study examined short-term cardiovascular risks with JAK-STAT inhibitors.

Up next, Dr Merritt highlighted advances in the treatment of chronic spontaneous urticaria (CSU). Despite the historically low usage of omalizumab among dermatologists, there is renewed interest and promising developments in CSU therapies. Notable innovations include dupilumab, which has demonstrated significant improvement in itch and hive reduction during phase 3 trials, and remibrutinib, an oral medication showing remarkable efficacy in biologic-naïve patients. Additionally, barzolvolimab, a humanized monoclonal antibody targeting KIT, exhibits profound mast cell suppression and promising results from phase 2 trials. These emerging treatments, coupled with ongoing research and upcoming FDA submissions, signify a transformative period for managing CSU and enhancing patient outcomes.

Dr Zeichner explored the controversy surrounding benzene contamination in benzoyl peroxide (BPO) acne treatments. Testing revealed benzene levels above FDA safety thresholds in 34% of over-the-counter BPO products, raising concerns due to benzene’s carcinogenic potential. However, studies using data from NHANES and a retrospective cohort of over 50,000 individuals found no evidence linking BPO use to increased benzene blood levels or long-term cancer risk, including leukemia and lymphoma. He emphasized balancing risks and benefits, with practical tips like proper storage and application to minimize exposure. The findings reassure that BPO remains a safe and effective acne treatment when used appropriately.