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The Hidradenitis Suppurativa Foundation offers grants for HS research and clinical expertise, supporting early-stage to established investigators.

Grant Opportunities from the Hidradenitis Suppurativa Foundation: Supporting Innovation and Expertise in HS Research and Care

Kaitlyn Bader is the assistant managing editor of 

 and joined the MJH Life Sciences team in June 2022. She attended Otterbein University in Westerville, Ohio, and earned a Bachelor of Arts degree in literary studies with minors in creative writing and film studies. Prior to health care news, Kaitlyn worked in industrial marketing. She enjoys cooking, reading, and tending to her house plants.

Block emphasized the importance of breakout sessions geared toward varying levels of experience—beginner, intermediate, and advanced.  

Renata Block, MMS, PA-C, Highlights SDPA Fall Sessions

Maddi Hebebrand is an associate editor of 

and joined the MJH Life Sciences team in May 2024. She attended Baldwin Wallace University, studying Media Production and Film, and is now finishing her Masters in Digital Media through Ohio University. When she's not writing, Maddi loves to read, attend concerts and spend time with her family.

Delgocitinib is indicated for adults with CHE who either do not respond to or cannot use topical corticosteroids.

Delgocitinib Approved for Adults with Moderate to Severe CHE in Switzerland 

The conference aimed at providing physician assistants with the latest in dermatology advancements begins today in Las Vegas, Nevada.

Previewing the 2024 Fall SDPA Conference: What to Expect

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Jamie Restivo, MPAS, PA-C, shares some insights from the 5th Annual Keystone Dermatology Conference held from October 17 to 19 in Philadelphia, Pennsylvania. 

Clinical Pearls: PDPA’s 5th Annual Keystone Dermatology Conference

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

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?

With the launching of skin care lines growing, is the skin care market too saturated?

The skincare market has experienced significant growth, with numerous brands entering the industry, leading to increased competition. This saturation presents challenges for new entrants and existing brands to differentiate themselves and capture consumer attention. Despite the crowded market, opportunities still exist for brands that can offer unique value propositions, such as innovative formulations, sustainable practices, or targeting niche consumer segments. The key to success lies in understanding consumer needs, leveraging digital marketing strategies, and maintaining product quality to build brand loyalty and stand out in a competitive landscape.

POLL: Is the skin care market too saturated?

 kicks off today in Scottsdale, Arizona. Elevate-Derm West brings together Dermatology PAs and NPs for a 3 ½ day experience designed for dermatology APPs from across the nation.

The conference promises a blend of education, innovation, and networking. Showcasing sessions taught by leading experts, this year’s meeting hosts discussions titled, “AI in Dermatology,” “What's in Our Cosmetic Toolbox for the Medical Derm Provider?,” and “Corticosteroids: The Good, The Bad, The Ugly.”

will be on-site providing live coverage, including expert interviews, session recaps, late-breaking research rundowns, and more.

As attendees are planning their must-see sessions, 

 is asking readers what topics they are most looking forward to at Elevate-Derm West 2024.

If you're attending Elevate-Derm West and want to share your insights or experiences, email 

The 5th Annual Elevate-Derm West Conference in Scottsdale, Arizona, is a 3 ½ day event for Dermatology PAs and NPs, focusing on education, innovation, and networking. The conference features sessions on AI in dermatology, cosmetic tools for medical derm providers, and corticosteroids. Dermatology Times will provide live coverage, including expert interviews and session recaps. Attendees are encouraged to share their insights for potential feature opportunities. Subscriptions to Dermatology Times eNewsletters are available for those interested in continuous updates.

Share with us the topics you want to learn more about at Elevate-Derm West.

POLL: What Topics Are You Looking Forward to at Elevate-Derm West 2024?

Although both can be characterized by intense itch, atopic dermatitis and prurigo nodularis demonstrate key differences in appearance, cytokine pathways, and diagnostic criteria. When first examining patients, prurigo nodularis presents with nodular lesions compared with erythematous patches of atopic dermatitis.

 The importance of differentiating between the 2 conditions was recently discussed by Gil Yosipovitch, MD, in an interview with 

Yosipovitch, professor and Stiefel Endowed Chair of medical dermatology of the Dr. Phillip Frost department of dermatology at the Miller School of Medicine at the University of Miami and director of the Miami Itch Center, is an author and study investigator of countless publications and clinical studies on atopic dermatitis, prurigo nodularis, chronic itch, and more.

: What are the key differences in the appearance and/or lesions of prurigo nodularis vs atopic dermatitis?

: The key differences between prurigo nodularis and atopic dermatitis are that prurigo nodularis lesions are firm nodular lesions that are fibrotic, usually on extensor surfaces, and can leave scars. The classical atopic dermatitis does not have nodules, is eczematous, and is mainly in flexural areas. Rarely if ever, prurigo nodularis involves the face, while atopic dermatitis commonly does.

: What are the prominent cytokine pathways in prurigo nodularis and atopic dermatitis?

: Although in both conditions, type 2 cytokines play a major role including IL4, IL-13, and IL-31 in prurigo nodularis, the role of IL-31 in the dermis has a key role. Also, IL-22 seems to have a more robust role than in atopic dermatitis. In atopic dermatitis, thymic stromal lymphopoietin plays a more significant role as it's produced by keratinocytes. This emphasizes that in atopic dermatitis, the barrier disruption is a major key driver and the disease is more epidermal in origin, while in prurigo nodularis, it’s more of a dermal-epidermal process and the barrier damage is secondary.

 Regarding epidemiology, are there specific patient populations more likely to develop prurigo nodularis vs atopic dermatitis?

: Prurigo nodularis is more common in the elderly and rarely will be noticed in infants. Prurigo nodularis is 3.4 times more prevalent in Black patients. Of note in prurigo nodularis, there is a higher association of comorbidities including hypertension, diabetes, chronic kidney disease, end-stage depression, central sensitization pain disorders such as interstitial cystitis, irritable bowel syndrome, and fibromyalgia. Prurigo nodularis is also more common in HIV patients. In atopic dermatitis, there is a higher association with asthma, allergic rhinitis, eosinophilic gastritis, alopecia areata, and ADHD. Clearly, atopic dermatitis is more prevalent in the younger infant population.

: How does your treatment approach differ when managing prurigo nodularis compared to atopic dermatitis, particularly with the development of newer biologics? 

: As both conditions are predominantly associated with Type 2 inflammation, the biologics dupilumab, which targets the IL-4 receptor, and the recently approved nemolizumab targeting the IL-31 receptor are the mainstay of therapy. I believe that IL-4 and IL-13 have a more robust upstream role in atopic dermatitis than in prurigo nodularis, and I think that targeting the IL-31 receptor has a more rapid effect in prurigo nodularis than dupilumab. As prurigo nodularis could be associated with neural damage and neuropathy, using drugs targeting the neural system like GABAergic drugs and kappa opioids like butorphanol have a more effective role in prurigo nodularis than in atopic dermatitis.

Also, the use of topicals that target the neural system like the KAL cream (ketamine 10%, lidocaine 5%, and amitriptyline 5%) have a more effective role in prurigo nodularis lesions than in atopic dermatitis. As JAK/STAT inhibitors are not approved for prurigo nodularis, clearly, they are more utilized in atopic dermatitis. Although from my experience, using them off-label, they are very effective for prurigo nodularis patients. However, their safety profile is less than the targeted biologics, and therefore use in prurigo nodularis patients should be monitored more carefully. including blood tests and avoid using them when prurigo nodularis patients have too many comorbidities that can be associated with adverse effects of JAK/STATs such as thrombotic, cardiac, and metabolic disorders.

 What diagnostic tools or criteria do you prefer when differentiating between the 2 conditions? 

: Mainly good clinical assessments as the clinical presentations are quite straightforward. We recently found that 

, a neuropeptide highly associated with congestive heart failure, is a good biomarker for the severity of itch of different types including atopic dermatitis and prurigo nodularis. We think that in prurigo nodularis, it’s more robust and may be a better marker. Of note, specifically in atopic dermatitis patients with skin of color and especially younger ages, prurigo nodularis is more commonly noted and their atopic dermatitis phenotype is more like prurigo nodularis than the flexural eczema noted in White patients.

: How do the psychological and quality of life impact on patients compare in prurigo nodularis and atopic dermatitis, especially given the often severe itch in both?

: In both diseases, there are significant psychological components, with sleep impairment in more than 90% of patients that further augments anxiety and stress. It seems in prurigo nodularis patients that there is a higher prevalence of psychological comorbidities. Therefore, a holistic approach addressing the stress and anxiety component could be added as an adjunctive to the treatment regimen. Unfortunately, only a few dermatologists as well as psychiatrists and psychologists have an interest or expertise in addressing these issues that are of prime importance to patients’ well-being.

McCann MR, Kosloski MP, Xu C, Davis JD, Kamal MA. Dupilumab: mechanism of action, clinical, and translational science. 

. 2024;17(8):e13899. doi:10.1111/cts.13899

Fölster-Holst R, Reimer R, Neumann C, et al. Comparison of Epidermal barrier integrity in adults with classic atopic dermatitis, atopic prurigo and non-atopic prurigo nodularis. 

. 2021;10(10):1008. Published 2021 Oct 7. doi:10.3390/biology10101008

Gil Yosipovitch, MD, reviews differences including lesion appearance, cytokine pathways, treatment options, and more. 

Recognizing Key Differences Between Atopic Dermatitis and Prurigo Nodularis

confirms findings of benzene presence and formation in benzoyl peroxide (BPO) drug and acne products—this time, with testing conducted at room temperature.

The latest round of benzene news follows the initial detection of high levels of benzene found in certain BPO-containing acne products 

. With the first detection of benzene, Valisure, LLC, an independent testing laboratory, 

 requesting a recall of products affected by the elevated levels of benzene to allow regulators to investigate.

The new study reports that "111 BPO drug products tested from major US retailers appear to be substantially contaminated with benzene when tested shortly after being acquired off the shelf."

Researchers acquired BPO products from major retail stores in several US states, conducting sampling in California, Connecticut, Florida, Illinois, New York, and Texas. Galderma Epsolay Benzoyl Peroxide Cream was used for incubation experiments at varying temperatures. Researchers utilized gas chromatography-mass spectrometry (GC-MS) to detect benzene levels, while selected ion flow tube-mass spectrometry tracked benzene release.

Results demonstrated that 34% of the products, equivalent to 38 products, contained benzene levels above the FDA's 2 parts per million (ppm) limit, with concentrations ranging from 

"The Bunick lab has been actively investigating acne vulgaris for over 5 years, with special emphasis on elucidating the biochemical and structural mechanisms of action of dermatologic antibiotics (e.g. tetracyclines, clindamycin) on the 

s ribosome. Our goal to understand the chemistry behind acne vulgaris and its therapies is consistent with understanding the stability of acne drugs, like benzoyl peroxide, and the decomposition pathways they undergo in human skin," said Christopher Bunick, MD, PhD, study author, associate professor of dermatology and translational biomedicine at Yale University School of Medicine in New Haven, Connecticut, and 

’ 2024 Winter Editor in Chief, in an exclusive statement to 

The source and age of the products did not significantly affect benzene levels. Additionally, heat and UV exposure, particularly sunlight, accelerated benzene formation, raising concerns about product degradation.

During UV testing, it was found that approximately 

 of benzene was generated in the chamber per hour of UVA/B exposure. 

"The results of the products sampled in this study suggest that formulation is likely the strongest contributor to benzene concentrations in BPO drug products that are commercially available, since the magnitude of benzene detected correlates most closely with specific brands or product types within certain brands," wrote the authors of the 

Additionally, the study authors used cold temperature incubation to test the Epsolay BPO product and confirmed their expectation that cold storage stabilizes BPO formulation, supporting the previous 

recommendations of the American Acne and Rosacea Society

When the Epsolay BPO product was incubated at 50°C, benzene formed linearly over time. Based on the data, approximately 

 of benzene formed per day of incubation and the concentration of benzene in the product reached 

 within approximately 5 hours of incubation at 50°C. After 2 weeks of incubation at 50°C, the product had 

To determine whether the altered environment of the BPO drug product that is dissolved in dimethyl sulfoxide would have a meaningful effect during the 20-minute 37°C GC-MS headspace equilibration period, an experiment was conducted where GC-MS headspace equilibration time was varied between 10 and 60 minutes. The results of 2 different test products (Clearasil Stubborn Acne Control 5 in 1 Spot Treatment Cream and Proactiv Renewing Cleanser) suggest that there is no substantive effect on benzene concentration from the 20-minute 37°C GC-MS headspace equilibration.

In the initial March 2024 report, Valisure tested 66 BPO products including creams, lotions, gels, and washes that are available over the counter from main retailers or in prescription form. Valisure's testing found high levels of benzene when BPO products were incubated at 37°C (98.6°F: standard body temperature), 50°C (122°F: accepted pharmaceutical stability testing temperature), and 70°C (158°F: transportation or passenger vehicle temperature).

Among the 66 products, Valisure found that some products contained up to 12 times the "allowed" amount of 2 parts per million of benzene. Overall, Valisure found that Proactiv's 2.5% BPO cream contained 

 of benzene; Target's Up & Up 2.5% BPO cream had 

; Estee Lauder's Clinique 2.5% BPO cream had 

; Reckitt Benckiser Group's Clearasil 10% BPO cream had 

, as some of the products with the highest parts per million.

A research letter published on March 14, 2024, in 

 further examined the testing methods used in March 2024 to detect benzene found in BPO-containing acne products.

Although the FDA conditionally “allows” 

 in drug products, there is truly no safe level of benzene. According to Kucera et al, the FDA specifies that no drug products should contain benzene due to its toxicity, but that 

 is acceptable only for products that absolutely require benzene for manufacturing. Although the stability studies focused on the development of benzene over time, the “Day 0” values represented the baseline concentration of benzene in the products before incubation or any exposure to elevated temperatures. Of the 71 stability-tested products in both studies, 24 products had starting benzene concentrations over 2 ppm and 11 products were over 10 ppm.

"The discovery of benzene formation in benzoyl peroxide acne treatments presents a potentially serious public health risk," said David Light, in a 

"Our research demonstrates that these products, widely used by consumers of all ages, can potentially contain or generate concerningly high levels of benzene, particularly under common environmental conditions. This issue highlights the critical importance of rigorous independent testing of drug products to help protect consumers from harmful contaminants," Light said.

The potential health risks associated with benzene formation in BPO products emphasize the urgent need for further precautions and understanding. As Bunick explained to 

, those with concerns should start by reviewing the primary research before implementing practical steps to reduce exposure.

"For colleagues with questions or concerns, I encourage them first to read carefully the primary research articles," Bunick told

. "Then, the single most immediate step they could take to mitigate concerns about using benzoyl peroxide products or patient fears is to encourage refrigeration of the medicine at all times, replace the medicine every ~ 12 weeks, and avoid storage in or near heat and sunlight."

Edney A. Second study finds cancer risk in Proactiv, Clearasil and other acne creams. Bloomberg. October 7, 2024. Accessed October 7, 2024. 

https://www.bloomberg.com/news/articles/2024-10-07/proactive-clearasil-contain-cancer-risk-second-study-finds?srnd=undefined&leadSource=uverify%20wall

Kucera K, Zenzola N, Hudspeth A, et al. Evaluation of benzene presence and formation in benzoyl peroxide drug products. 

https://www.jidonline.org/article/S0022-202X(24)02155-9/fulltext

Valisure citizen petition on benzene in benzoyl peroxide drug products. Valisure. March 5, 2024. Accessed October 7, 2024. 

https://assets-global.website-files.com/6215052733f8bb8fea016220/65e8560962ed23f744902a7b_Valisure%20Citizen%20Petition%20on%20Benzene%20in%20Benzoyl%20Peroxide%20Drug%20Products.pdf

Testing methods: Kucera K, Zenzola N, Hudspeth A, et al. Benzoyl peroxide drug products form benzene. 

. 2024;132(3):37702. doi:10.1289/EHP13984

Top dermatology journal publishes new Valisure research on benzene presence and formation in benzoyl peroxide drug products. Valisure. October 7, 2024. Accessed October 7, 2024. 

https://www.valisure.com/valisure-newsroom/new-valisure-scientific-paper-on-benzene-in-benzoyl-peroxide-products

Recent research highlights benzene contamination in benzoyl peroxide (BPO) acne products, with 34% of tested items exceeding FDA limits. Benzene formation is influenced by product formulation, heat, and UV exposure. Cold storage stabilizes BPO, reducing benzene levels. Testing methods confirmed no significant effect on benzene concentration from varying GC-MS headspace equilibration times. Valisure's earlier findings showed some products with benzene levels far exceeding the FDA's conditional limit. Recommendations include refrigerating BPO products, replacing them every 12 weeks, and avoiding heat and sunlight exposure.

New peer-reviewed research published in the Journal of Investigative Dermatology examined 111 products at room temperature.

Jamie Restivo, MPAS, PA-C

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