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Maddi Hebebrand is an associate editor of 

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Explore the top headlines of the week including insights on clinical trials, CBD products, and more.

Dermatology Times' Sunday Crossword: March 30, 2025

Marie Bosslett is the assistant editor of 

 and joined the MJH Life Sciences team in October 2024. She attended Loyola University Maryland in Baltimore and earned a Bachelor of Arts in Communication with minors in marketing and writing. When she’s not writing, Marie enjoys going to concerts, reading on the beach, and spending time with friends and family.

In case you missed it, this week we had news about CBD products in dermatology, Journey Medical's launch of Emrosi for rosacea, the psychological impact of melanoma, and more.

The Weekly Roundup: March 24-28

This week, we feature top articles from our sister publications on clinical trials, FDA updates, and more.

The Rx Recap: March 23-29

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A. Nair is a freelance writer based in India.

Final Thoughts: The Importance of Comparative Studies in AD

Panelists offer concluding insights and emphasize the critical role of comparative studies in advancing atopic dermatitis treatment strategies.

clinical

Video Series

Lisa M. Arkin, MD, associate professor and director of pediatric dermatology at the University of Wisconsin, Madison, emphasized the importance of collaboration between pediatric dermatologists and laser surgeons in treating vascular anomalies at the 

2025 American Academy of Dermatology Annual Meeting

she said that bringing together specialists with different perspectives is essential for developing more precise, effective treatments for young patients.

Optimizing Laser Therapy for Vascular Anomalies: Why Early, Multidisciplinary Care Matters

Arkin highlighted that vascular anomalies require a multidisciplinary approach, as no single treatment modality works for all cases. Although laser therapy generally works well for port wine birthmarks, she told 

that other vascular anomalies often require a combination of treatments, including systemic therapies like propranolol for infantile hemangiomas. She stressed the importance of building a network of colleagues across specialties to ensure the best patient outcomes.

“The first step is really to build your village,” she told 

. “You want a village of other folks who can help with systemic therapy or procedural interventions, propranolol for infantile hemangiomas. And then you want to get a community of laser surgeons who can help you if you're new to treating with laser, because there are a lot of pitfalls that can happen in these.”

One of the key points Arkin discussed was the importance of early intervention.

 that there is strong evidence supporting the benefits of treating port wine birthmarks early, as laser therapy is most effective when the skin is thinner and has less melanin, allowing better light penetration. She encouraged dermatologists to refer patients as soon as possible to maximize treatment success.

For infantile hemangiomas, Arkin advised that laser treatment should not be overlooked once the lesions are stabilized on systemic therapy. However, she cautioned that clinicians must be vigilant for warning signs such as early ischemia, which can indicate ulceration risk. Thoughtful and strategic treatment planning is essential to avoid complications, Arkin added.

When treating complex vascular anomalies, Arkin explained that selecting the appropriate laser wavelength is critical. Factors such as lesion depth, dominant chromophore, and energy levels must be carefully balanced to achieve optimal results, she told 

. She stressed that laser therapy should be integrated into a broader treatment strategy rather than viewed as a standalone solution.

Ultimately, Arkin underscored that pediatric dermatologists and laser surgeons working together can significantly improve patient outcomes. “I think pediatric dermatologists and laser surgeons working together will improve outcomes for our patients,” she told 

. “And in some ways, we want to see the world from different perspectives. So being able to negotiate and navigate and listen to other perspectives, it's going to bring the field forward… Collaboration is key.”

1. Arkin LM. Critical Gaps and Controversies in Laser Treatment of Port Wine Birthmarks and other Vascular Anomalies. Presented at the 2025 AAD Annual Meeting; March 7-11; Orlando, Florida.

2.Geronemus RG, Duerr HA. Early Intervention for Port-Wine Stains. 

https://www.dermatologytimes.com/view/early-intervention-for-port-wine-stains

Lisa M. Arkin, MD, shared how early laser treatment and multidisciplinary approaches improves outcomes for vascular anomalies. 

Optimizing Laser Therapy for Vascular Anomalies: Why Early Multidisciplinary Care Matters

Christopher B. Zachary, MBBS, MRCP, FRCP, professor and chair emeritus of dermatology at the University of California, Irvine, discussed a novel treatment approach for basal cell carcinoma—apoptosis or programmed cell death—at the 2025 American Academy of Dermatology (AAD) Annual Meeting in Orlando, Florida.

Zachary, who has been working with a team at Henry Ford and UCI, explained that researchers have identified an optimal temperature range, around 53° to 55° for approximately 60 seconds

 to induce apoptosis in cancerous skin cells without significant damage to surrounding tissue.

“All you get is just a little bit of elevation, a little bit of erythema-like appearance, which persists for about a week, gradually improving,” he told 

. “Then, at about two weeks, you get an influx of new blood vessels, which appear clinically, and then at six months or so, there's very little in the way of scarring. And indeed, 9 out of 10 skin cancers, even with this rather crude system we have, will be histologically clear because we excised these at the end of 3 months after the last treatment and can demonstrate that these tumors have disappeared—9 out of 10.”

Apoptosis-Based Skin Cancer Treatment Shows Promise

A significant advantage of apoptosis-based therapy is its non-invasive nature, he said, adding it will be an especially attractive option for older patients who may be less surgically inclined. Additionally, Zachary suggested that this treatment could become widely accessible: “Any qualified dermatologist will be able to do this technique,” he said, contrasting it with Mohs surgery, which requires specialized training.

However, barriers to adoption remain. Zachary noted that the process needs to gain FDA approval, and reimbursement concerns could delay widespread implementation. Unlike Mohs surgery, which is well-compensated, there is currently no dedicated CPT code for apoptosis-based treatments.

Zachary also voiced concerns about the overuse of Mohs surgery in the US,

 arguing that many superficial basal cell carcinomas and squamous cell carcinomas in situ could be treated through non-Mohs techniques. “As a society, as a group of dermatologists, we should realize that Mohs is overdone,” he told 

, acknowledging that his views might be controversial among Mohs surgeons. “I’m not against Mohs surgery. I’m very much pro-Mohs,” he clarified. “There are large cancers that are infiltrated, recurrent, or in critical anatomic areas—send those cases for Mohs, absolutely…What I’m against is doing fatuous, tiny areas that were probably removed with the shave biopsy and don’t need any Mohs. That’s overdoing it.”

Looking ahead, Zachary predicts a decade-long development process before apoptosis-based treatments reach widespread clinical use, similar to the trajectory of cryolipolysis for fat reduction. “We’ll see what happens in the future,” he told 

. “Why don’t you come back to me next year?”

Read more from the AAD Annual Meeting from 

1. Zachary CB. Advances in Devices to Treat Nonmelanoma Skin Cancer. Presented at the 2025 AAD Annual Meeting; March 7-11; Orlando, Florida.

2. Buchanan L, Brewer J. When to Call a Time Out on Mohs Surgery. 

May 7, 2023. Accessed March 15, 2025. https://www.dermatologytimes.com/view/when-to-call-a-time-out-on-mohs-surgery

Christopher B. Zachary, MBBS, MRCP, FRCP, shares insights in apoptosis-based skin care treatment.

“PRX is a topical collagen biostimulator that has been out in Europe for a while. It's now come to the United States in the past year. It has a 33% TCA. It has hydrogen peroxide and about a 5% kojic acid. And together, the TCA, because of the hydrogen peroxide, penetrates, but not as much, and so you don't wind up with the hyperpigmentation you might see in a 33% TCA in somebody with my skin tone otherwise,” said Jeanine Downie, MD, FAAD, in an interview with Dermatology Times at the 2025 American Academy of Dermatology (AAD) Annual Meeting in Orlando, Florida.

Downie, a board-certified dermatologist at and founder of Image Dermatology in Montclair, New Jersey, presented “Pearls From the Masters of Dermatologic Surgery” at AAD on March 7.

In her session, Downie discussed critical updates on tattoo ink safety, new dermatologic technologies, biostimulators, and emerging trends in aesthetics and longevity science.

Jeanine Downie, MD, FAAD, discussed critical updates on tattoo ink safety, new dermatologic technologies, biostimulators, and more at AAD 2025.    

Tattoo Ink Risks, MultiFrax Laser, and the Impact of GLP-1 Medications on Skin Health 

Downie first highlighted the increasing prevalence of tattoos and the dermatologic complications associated with them. With nearly 38% of women and 27% of men in the US having tattoos, dermatologists frequently encounter tattoo-related reactions. She noted that 20% to 30% of tattoo inks are contaminated with microorganisms, while only 10% of ink contents are labeled. Many inks contain suspected carcinogens like polycyclic aromatic hydrocarbons (PAH) and components derived from car paint, printer toner, and carpet dye. These concerns underscore the need for dermatologists to be vigilant about tattoo reactions and patient education.

Next she introduced the MultiFrax, a handheld fractional laser combining 1550 nm and 1927 nm wavelengths for skin resurfacing and pigmentation treatment. This portable device offers versatility for treating fine lines, wrinkles, acne scars, and surgical scars across all skin types. She praised its convenience for multi-office practices and its efficacy in delivering simultaneous resurfacing and pigment correction.

PRX technology, a topical collagen biostimulator, has gained popularity in the US after success in Europe. Composed of 33% trichloroacetic acid (TCA), hydrogen peroxide, and kojic acid, it penetrates the skin without causing hyperpigmentation, making it suitable for all skin types and seasons. Unlike injectable biostimulators such as Sculptra or Radiesse, PRX provides a needle-free, painless option for skin rejuvenation on the face, neck, chest, and body.

Another emerging technology discussed was the use of salmon sperm polynucleotides for skin regeneration. While further research is needed, these compounds have shown promise in skin rejuvenation and even vascular occlusion management. Downie expressed enthusiasm for their potential dermatologic applications.

Downie also delved into the role of sirtuins (SIRT1 and SIRT3) in longevity, noting their higher levels in individuals who exercise regularly. She highlighted dietary sources such as berries, leafy greens, and red wine that can induce sirtuin activity, promoting cellular health and longevity.

With the widespread use of GLP-1 receptor agonists for weight loss, dermatologists are seeing increasing cases of facial volume loss, skin texture changes, and hair thinning. Downie discussed strategies to manage "Ozempic face" and help patients maintainskin health post-weight loss.

Beyond these clinical pearls, Downie emphasized the importance of the AAD meeting for professional growth, networking, and camaraderie. She finds the conference to be a source of inspiration and remains actively involved in the AAD diversity committee, contributing to the field in meaningful ways.

PRX, a topical collagen biostimulator, has recently gained traction in the US, offering a needle-free option for skin rejuvenation. Jeanine Downie, MD, FAAD, highlighted its benefits at the 2025 AAD Annual Meeting, alongside discussions on tattoo ink safety, MultiFrax laser technology, and emerging dermatologic trends. Concerns about tattoo ink contamination and the potential of salmon sperm polynucleotides for skin regeneration were addressed. Downie also explored sirtuins' role in longevity and the aesthetic challenges posed by GLP-1 medications, emphasizing the importance of professional growth and networking at the AAD meeting.

Jeanine Downie, MD, FAAD, discussed critical updates on tattoo ink safety, new dermatologic technologies, biostimulators, and more at AAD 2025.

“The idea of a treatment-free period is such that with the studies that we looked at with tapinarof and atopic dermatitis, we found that if you get patients with atopic dermatitis to completely clear skin, there was a durable treatment-free period of time, which was 80 consecutive days. So that means, on average, people could go 80 days without using any medication until their disease came back as mild or worse,” said Linda Stein Gold, MD, FAAD, in an interview with 

American Academy of Dermatology (AAD) Annual Meeting

Stein Gold, a board-certified dermatologist and director of dermatology clinical research at Henry Ford Health System in Detroit, Michigan, discussed 

 on the efficacy of tapinarof (Vtama) cream, 1% (Organon) in maintaining low disease activity in adults and children aged 2 years and older with atopic dermatitis (AD) following treatment-free intervals. The data comes from a new analysis of the phase 3 ADORING 3 study.

As a study investigator, Stein Gold reviewed how treatment for AD often involves multiple considerations, including achieving disease control, maintaining remission, addressing flare-ups, and treating sensitive areas. Given the multifaceted nature of AD management, compliance can be difficult even with a well-structured plan.

Linda Stein Gold, MD, FAAD, discusses the late-breaking tapinarof cream data presented at AAD 2025. 

Insights From the ADORING 3 Study and Tapinarof’s Treatment-Free Periods in AD 

The ADORING 3 trial, a 48-week open-label, long-term extension study, assessed patients who achieved complete disease clearance (Validated Investigator Global Assessment for Atopic Dermatitis [vIGA-AD] = 0) after treatment with tapinarof. These patients discontinued treatment and were monitored for maintenance of disease control. Patients whose disease returned to mild or greater severity (vIGA-AD ≥ 2) were eligible for retreatment.

The primary objectives of the study included evaluating the duration of disease control in treatment-free intervals and assessing itch severity using the Eczema Area and Severity Index (EASI) and Peak Pruritus Numerical Rating Scale (PP-NRS).

Overall, following discontinuation of tapinarof cream, patients maintained low disease activity for a mean of 79.8 consecutive days. At the end of the treatment-free interval, researchers reported 84% of participants had a vIGA-AD score of 2 (mild disease), with a mean EASI score of 3.4 and a mean weekly PP-NRS score of 2.9, suggesting sustained symptom relief.

A key finding from the recent analysis suggests the potential for a treatment-free period in patients who achieve completely clear skin. According to Stein Gold, clinical trials demonstrated that once patients reached clear skin status, they experienced an average of 80 consecutive days without requiring additional treatment before their disease returned to at least a mild state. This durable treatment-free period represents a significant advancement, as it may reduce the burden of continuous medication use and improve adherence.

According to Stein Gold, the implications of these findings are particularly relevant for both dermatologists and patients. Traditionally, many AD therapies require ongoing use to maintain disease control, often leading to concerns about long-term safety, treatment fatigue, and adherence. The ability to extend the duration between treatments while maintaining disease control offers a promising shift in AD management. Tapinarof’s potential to provide prolonged remission periods could enhance patient satisfaction, minimize treatment complexity, and improve overall quality of life.

Stein Gold emphasized the importance of tailoring AD treatment to improve both clinical outcomes and patient adherence. As more data emerge on tapinarof’s efficacy and durability, its role in the long-term management of AD may continue to expand, offering the ability to reduce treatment burden while maintaining disease control.

New analysis of Organon’s VTAMA (tapinarof) cream, 1% phase 3 data shows atopic dermatitis disease activity remained low after treatment-free interval in adults and children 2 years of age and older. News release. Organon. March 8, 2025. Accessed March 8, 2025.

Tapinarof cream 1% once daily: Maintenance of low disease activity including pruritus through end of the treatment-free interval in a long-term extension trial in patients down to 2 years of age with atopic dermatitis. Poster presented at the 2025 American Academy of Dermatology Annual Meeting. March 7-11, 2025. Orlando, FL.

Tapinarof cream, 1% (Vtama), has shown promise in maintaining low disease activity in atopic dermatitis (AD) patients during treatment-free intervals. The ADORING 3 study revealed that patients who achieved clear skin could remain treatment-free for an average of 80 days before symptoms returned to a mild state. This finding suggests a potential shift in AD management, reducing the need for continuous medication and improving adherence. The study highlights the importance of personalized treatment plans to enhance clinical outcomes and patient satisfaction.

Linda Stein Gold, MD, FAAD, discusses the late-breaking tapinarof cream data presented at AAD 2025.

 Insights From the ADORING 3 Study and Tapinarof’s Treatment-Free Periods in AD

“This is the first study ever conducted for a topical agent for the treatment of prurigo nodularis. So really opening up avenues for the development and treatment. We're very excited about this for our patients,” said Shawn Kwatra, MD, FAAD, in an interview at the 

2025 American Academy of Dermatology (AAD) Annual Meeting

Kwatra, a board-certified dermatologist, professor and chair of dermatology at the University of Maryland School of Medicine, chief of service dermatology at the University of Maryland Medical Center, and a 

 Editorial Advisory Board member, presented late-breaking data at AAD from the TRuE-PN1 and TRuE-PN2 studies on ruxolitinib cream 1.5% (Opzelura; Incyte) for the treatment of patients with prurigo nodularis.

Shawn Kwatra, MD, FAAD, reviews his late-breaking data presentation at AAD on the first original studies of a topical cream for prurigo nodularis. 

Late-Breaking Data: Phase 3 Updates on Ruxolitinib Cream for Prurigo Nodularis 

The pivotal phase 3 TRuE-PN clinical trial program –TRuE-PN1 and TRuE-PN2 studies – evaluated twice-daily ruxolitinib cream in patients aged 18 years and older.

In TRuE-PN1, results at week 12 showed that over 44% of patients achieved a ≥4-point reduction in itch (Worst-Itch Numeric Rating Scale), compared to approximately 20% in the placebo group. Additionally, all secondary end points demonstrated statistical significance, including improvements in skin lesions, quality-of-life scores, and pruritus relief as early as day 4. Significantly more patients who applied ruxolitinib cream vs vehicle control achieved an Investigator's Global Assessment for Stage of Chronic Prurigo Treatment Success at week 12 (15.8% vs 3.9%).

The TRuE-PN2 study yielded similar findings, with approximately 40% of patients achieving a 4-point itch reduction, despite a slightly higher placebo response. According to the announcement, although the primary end point was in favor of ruxolitinib cream vs vehicle, it did not reach statistical significance due to high placebo response. The overall safety profile of ruxolitinib in the TRuE-PN clinical trial program was consistent with previous data and no new safety signals were found.

According to Kwatra, these phase 3 trials mark the first-ever study of a topical therapy for prurigo nodularis. Given the significant early and sustained improvements observed, ruxolitinib cream represents a promising non-systemic option for patients with prurigo nodularis, addressing both pruritus and lesion resolution.

Kwatra S. Efficacy and safety of ruxolitinib cream in patients with prurigo nodularis: results from a phase 3, randomized, vehicle-controlled study (TRuE-PN1). Poster presented at: 2025 American Academy of Dermatology Annual Meeting. March 8, 2024; Orlando, FL.

Incyte announces results of phase 3 clinical trials evaluating ruxolitinib cream 1.5% (Opzelura) in patients with prurigo nodularis (PN) at 2025 American Academy of Dermatology Annual Meeting. News release. Incyte. March 8, 2025. Accessed March 8, 2025. 

https://investor.incyte.com/news-releases/news-release-details/incyte-announces-results-phase-3-clinical-trials-evaluating

Ruxolitinib cream 1.5% has shown promise as a topical treatment for prurigo nodularis, according to phase 3 TRuE-PN1 and TRuE-PN2 studies. These trials, presented at the 2025 AAD Annual Meeting, demonstrated significant improvements in itch reduction and skin lesions, with over 44% of patients in TRuE-PN1 achieving a ≥4-point reduction in itch. Although TRuE-PN2 showed a high placebo response, the overall safety profile was consistent with previous data. Ruxolitinib cream offers a promising non-systemic option for managing prurigo nodularis symptoms.

A. Nair

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