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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.

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As 2024 comes to a close, Dermatology Times is taking a look back at the studies, therapies, and advances in prurigo nodularis this year.

Dermatology Times 2024 In Review: Prurigo Nodularis

and joined the MJH Life Sciences team in February 2023. She attended Kent State University and earned a Bachelor of Science degree in journalism with minors in public relations and creative writing. She enjoys making and listening to music, reading, and spending time with her cats, Astrid and Marceline.

Dermatology Times is looking back on the top stories in dermatology that involve strides in skin health equity: addressing disparities for skin of color, women, LGBTQ+ patients, and improving care access.

Making Strides for Skin Health Equity in 2024: Reviewing a Year of Progress

These promising results align with what was discovered in the single-ascending dose portion of the trial earlier this year.

VYNE Therapeutics Reports Positive Phase 1a MAD Data for BD2-Selective BET Inhibitor VYN202

As 2024 comes to a close, Dermatology Times is taking a look back at the studies, therapies, and advances in rosacea this year.

Dermatology Times 2024 In Review: Rosacea

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Learn what makes the Masterclasses in Dermatology conference a unique educational opportunity, and take a quick poll to tell us what you want to learn.

2024 Masterclasses in Dermatology Sneak Peek With Alice Gottlieb, MD, PhD

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

As 2024 comes to a close, the dermatology community is celebrating another year of transformative drug approvals, innovative clinical trials, educational conferences, and so much more. With such a busy year behind us, 

 is wondering – are you taking a much-deserved break ahead of the new year?

Take this week's poll below or email our team at 

 to share your thoughts. We would love to hear from you!

The dermatology field has experienced a year of significant advancements, including new drug approvals, groundbreaking clinical trials, and educational conferences. As the year concludes, professionals in the community are encouraged to reflect on these achievements and consider taking a well-earned break before the new year begins. Dermatology Times is reaching out to its audience to gather insights and feedback on how they plan to unwind and recharge, inviting them to participate in a poll or share their thoughts via email.

Click here to answer today's poll and read more about practice management around the holiday season.

POLL: Is Your Practice Closed for the Holidays?

Hyperhidrosis is not rare. According to the 

, approximately 385 million people worldwide live with hyperhidrosis.

In fact, they note that the amount of people living with chronic, excessive sweating is even higher than the amount of people living with other dermatologic conditions like psoriasis.

Just how common is hyperhidrosis in real-world comparisons?

The prevalence of hyperhidrosis is much higher in younger populations than in the general population, with 8.8% of individuals between the ages of 18 to 39 years old living with the condition. 

When comparing these statistics to everyday, common occurrences like hair color, the number of people with hyperhidrosis is greater than the 1% of individuals with natural red hair and 2% of individuals with natural blond hair. 

Despite how common hyperhidrosis is, it is estimated that 27% of those with the condition never receive a diagnosis.

 wants to hear from you. What percentage of the global population is estimated to have hyperhidrosis?

 to share your hyperhidrosis insights or research.

Albert. Fact check: Hyperhidrosis - International Hyperhidrosis Society: Official site. Home - International Hyperhidrosis Society. October 24, 1970. Accessed November 16, 2023. 

https://www.sweathelp.org/home/news-blog/542-fact-check-hyperhidrosis.html

Hyperhidrosis affects approximately 385 million people globally, surpassing the prevalence of other dermatologic conditions like psoriasis. It is notably more common in younger populations, with 8.8% of individuals aged 18 to 39 experiencing the condition. Comparatively, hyperhidrosis is more prevalent than natural red or blond hair, which affects 1% and 2% of the population, respectively. Despite its prevalence, 27% of those with hyperhidrosis remain undiagnosed. The article encourages engagement during Hyperhidrosis Awareness Month to share insights and research on the condition.

Click here to answer this week's poll for Hyperhidrosis Awareness Month.

Polls 

POLL: What Percent of the Global Population is Estimated to Have Hyperhidrosis?

Jason Hawkes, MD, MS: Looking Back on 2024, Ahead to 2025

 “When I look back at 2024, what are the big themes that I see that have been exciting? What I see happening in dermatology in the last year, which has been really great, is that we are developing clinical trial programs for many dermatologic conditions that we often ignored or under studied, under treated.These are conditions like alopecia areata, vitiligo, hidradenitis suppurativa, and what I've been really excited about is chronic spontaneous urticaria.These are conditions that we're aware of. We tried a lot of off label treatments, but now we're getting dedicated clinical trial programs. We're seeing the versatility of similar classes of medication that can be used for many things. I think the JAK inhibitors have been a good example of their utility as broad acting agents. They're narrower than the cyclosporine methotrexate, for example, but they're broader than our biologic agents, allowing them to work in multiple diseases. We're seeing these extended, expanded clinical trial programs for a lot of different conditions. I think it's nice to be able to talk to our patients about specific, dedicated trials to medications that studied this drug for that particular disease, as opposed to saying we don't know if this will work or we think it might work, it's off label. This was really, I think, expanding the layers of treatment that we have. We also saw the parceling out aspects of diseases like atopic dermatitis. We saw treatments dedicated and trials dedicated just for hand dermatitis or chronic hand eczema. We saw trials dedicated to genital psoriasis, scalp psoriasis, palmer plantar psoriasis. The fact that we're getting closer to some of these unique subsets is getting us closer to what I always envisioned as true personalized medicine. We can choose the therapy that we know works for a particular disease. We can look at clinical trial data or a particular variant. I love this aspect, because we can really tailor treatment choices now to our patients as they're sitting before us with these often ignored variants or subsets of disease.”

“ARM Yourself with Knowledge": Emmy Graber, MD, MBA, Shares Insights on Acne, Rosacea, and More

 "So one of the most exciting things to me about dermatology in 2024 was just seeing how much is new in dermatology. I went to a lot of meetings this year, including running my own virtual meeting, the "ARM Yourself with Knowledge" meeting. And it's just phenomenal to look back at 10 years ago and see what we have now and what everyone is talking about. And there's so many new pharmaceuticals and therapeutic modalities for many different diseases. And I think, in general, hearing about all of my colleagues speak about these different things in 2024 has been especially exciting for me."

“Don’t Touch This”: Contact Dermatitis Insights and Updates from Matthew Zirwas, MD

"The most exciting aspect of dermatology in the past year for me is an easy one, and it has nothing to do with anything else I've talked about today. It is the rise of the drug, oral roflumilast. If you are not using oral roflumilast on essentially a daily basis in your practice, you are behind the times. So oral roflumilast is an oral PDE-4 inhibitor. It costs $10 a month through some of the mail order pharmacies. So mechanistically, it is identical to Otezla. However, it is substantially more effective. One of the really good randomized, double-blind trials we have comparing it to methotrexate, showed that 50% of people got to passing 90 and about 70% of people got to passing 75. And this is with a drug that is non-immunosuppressive and requires no labs. It does cause GI upset in about 10% of patients. It does cause depression in about 1%, just like apremilast. But it's 10 bucks a month without insurance. So, it's a phenomenally good drug to use. Am I using it primarily in psoriasis and eczema? No, because I've got even better drugs for both of those. But where it's amazing? Number one, in psoriasis and eczema patients, when, for whatever reason, you can't get access to an FDA-approved therapy. But then the places where it's super good; lichen planus, lichen planopilaris, oral lichen planus, generalized granuloma annulare, even localized GA, cutaneous connective tissue diseases, pyoderma gangrenosum, and hidradenitis suppurativa. So, all of these inflammatory dermatoses, we now have a new agent that is super easy to use, is really cheap, and is broad spectrum, and it's especially good for a lot of things we haven't had good treatments for up till now."

Experts in the field shared insights with Dermatology Times on what they found most innovative, educational, and helpful in the past year.

2024 Expert Insights: More Options than Ever

Prurigo nodularis (PN) is a chronic skin disorder characterized by multiple firm nodular lesions, often symmetrically distributed on areas of the skin that are accessible to scratching.

 A history of scratching, picking, or rubbing has been identified as one of the core symptoms of PN and can have a notable impact on patient quality of life.

PN can be mistaken for various disorders, including Kyrle disease, bullous pemphigoid, neurotic excoriations, hypertrophic lichen planus, and atopic dermatitis with lichen simplex chronicus.

 When assessing skin biopsy results, histopathologic features such as pseudoepitheliomatous hyperplasia, hypergranulosis in the epidermis, focal parakeratosis, and thick compact orthohyperkeratosis can be characteristic of PN.

The pathophysiology of PN is not fully understood but current evidence suggests that its underlying mechanism stems from the intersection of neural dysregulation and immunological dysfunction.

 Translational studies over the past 15 years have revealed new insights into the pathogenesis of the disease, leading to the identification of specific immunological pathways that play an important role in the disease.

 Specifically, Th2-associated cytokines such as IL-31 and IL-4 have been identified as therapeutics targets, leading to the FDA approval of the IL-4 and IL-13 inhibitor dupilumab (Dupixent) in 2022 and the IL-31 inhibitor nemolizumab (Nemluvio) in 2024, both indicated for the treatment of adult patients with PN.

As more therapeutic options become available for PN, a high need remains for increased awareness of the disease and its impact, which could yield earlier and/or more accurate and diagnosis and treatment. To that end, inquiries into the impact of PN have increasingly articulated its economic, comorbidity, and quality of life burden.

According to findings published in 2023, patients with PN have been found to have higher rates of comorbidities, including not only atopic dermatitis but also chronic hepatitis C, chronic kidney disease, congestive heart failure, chronic obstructive pulmonary disease, depression, and type 2 diabetes.

 Findings from a recent retrospective analysis presented at the 2024 Fall Clinical Dermatology Conference showed that patients were more likely to have been newly diagnosed with a comorbidity vs matched controls. Among comorbidities identified in patients with PN were other dermatologic conditions (such as atopic dermatitis), as well as attention-deficit/hyperactivity disorder, autism, autoimmune disease, metabolic disease, and sleep disorders.

 Patients with PN were also found to have significantly higher costs, likely exacerbated by the increased prevalence of comorbidities. These results echo previously published data showing that patients with PN are also more likely than the general population to have longer hospital stays and increased cost of care.

One key observation from the investigators of the recently presented data at Fall Clinical Dermatology Conference is that many patients with PN are receiving treatment for the mental health symptoms of PN, while many could benefit from treatments that address autoimmune and inflammatory aspects of the disease. They also highlighted the need for more effective measures to address these burdens in this patient population.

Given the increased knowledge regarding the pathogenesis of PN as well as the associated economic, comorbidity, and quality-of-life burden on patients, the need for greater awareness of the disease in the clinical community and among patients is clearer. As we learn more about the mechanisms of disease, patients must be educated about their disease, the importance of appropriate treatment, and the availability of systemic agents that may offer benefits.

One organization that is raising awareness about PN is the Prurigo Nodularis League, which was founded in 2014 and serves as a mutual platform for clinicians and patients to raise global awareness and provide news relating to PN. League members are regularly informed about the results of current studies and news about diagnostics and treatment. Visit 

The next article in this series on prurigo nodularis will explore the data for available and emerging systemic agents.

Elmariah S, Kim B, Berger T, et al. Practical approaches for the diagnosis and management of prurigo nodularis: United States expert panel consensus. 

. 2021;84(3): 747-760. doi:10.1016/j.jaad.2020.07.025

Müller S, Zeidler C, Ständer S. Chronic prurigo including prurigo nodularis: new insights and treatments. 

. 2024;25(1):15-33. doi:10.1007/s40257-023-00818-z

Labib A, Ju T, Vander Does A, Yosipovitch G. Immunotargets and therapy for prurigo nodularis. 

Joel MZ, Hydol-Smith J, Kambala A, Cornman H, Kwatra SG. Prevalence and comorbidity burden of prurigo nodularis in United States adults enrolled in All of Us research program. 

. 2023;89(5): 1056-1058. doi:10.1016/j.jaad.2023.06.045

Elmariah SB, Princic N, Richards M, et al. Economic and comorbidity burden of prurigo nodularis and drivers of higher healthcare costs in the US: a retrospective analysis of claims data of patients diagnosed between 2017 and 2022. Poster presented at: 44th Annual Fall Clinical Dermatology Conference; October 24-27, 2024; Las Vegas, NV

Whang KA, Kang S, Kwatra SG. Inpatient burden of prurigo nodularis in the United States. 

. 2019;6(3): 88. doi:10.3390/medicines6030088

Increased awareness for prurigo nodularis may help to usher in a new era of timelier and more targeted treatment.

The Burden of Prurigo Nodularis

Cabtreo (Ortho Dermatologics; formerly known as IDP-126) was approved by the US Food and Drug Administration

 (FDA) in October 2023 for the treatment of patients aged 12 years and older with acne vulgaris. Cabtreo is the first FDA-approved fixed-dose triple-combination gel (clindamycin 1.2%/adapalene 0.15%/benzoyl peroxide 3.1%) for patients with acne. Cabtreo is expected to be available in Q1 of 2024.

, more than half (52.5%) of patients treated with Cabtreo achieved treatment success as measured by a 2-point or greater reduction from baseline in Evaluator’s Global Severity Score and clear or almost clear skin. In the first of the phase 3 trials, the proportion of patients treated with Cabtreo achieving clear or almost clear skin (49.6%) was significantly greater than patients being treated with a vehicle gel (24.9%). The second phase 3 trial demonstrated consistent significant rates of treatment success among Cabtreo- treated patients (50.5%) versus patients in the vehicle gel group (20.5%).

What are your thoughts about Cabtreo as the newest acne topical? Email us at 

Cabtreo, a fixed-dose triple-combination gel, received FDA approval in October 2023 for treating acne vulgaris in patients aged 12 and older. It combines clindamycin, adapalene, and benzoyl peroxide, marking the first such approved formulation. Clinical trials demonstrated its efficacy, with over half of the patients achieving significant improvement in acne severity. Phase 3 trials showed Cabtreo's superiority over a vehicle gel, with nearly 50% of patients achieving clear or almost clear skin. Cabtreo is anticipated to be available in the first quarter of 2024.

Click here to answer this week's acne poll.

Alice Gottlieb, MD, PhD

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