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Zoe Diana Draelos, MD, is a consulting professor of dermatology, Duke University School of Medicine, Durham, N.C. She is investigator, Dermatology Consulting Services, High Point, N.C., and a Dermatology Times Editorial Advisor and co-medical editor.

Articles

Keratin hair treatments straighten, smooth, and add shine—though formaldehyde risks raise safety concerns for dermatologists and salon professionals.

Keratin Hair Treatments and Formaldehyde Exposure

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.

Explore the top headlines of the week including insights on the latest clinical trials, therapeutic updates, and more.

Dermatology Times' Sunday Crossword: April 20, 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 HyBryte's treatment success in CTCL patients, the impact of the COVID-19 pandemic on BCC surgeries, the FDA approval of dupilumab for H1 antihistamine-refractory CSU, and more.

The Weekly Roundup: April 14-18

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In this expert Q&A, dermatologist Jeffrey Cizenski, MD, FAAD, offers perspectives on National Eczema Awareness Month and AbbVie's Under My Skin documentary.

Jeffrey Cizenski, MD, FAAD: Eczema Representation Through Under My Skin Documentary

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

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.

Polls 

POLL: Have Your Patients Asked About Cabtreo for Acne?

Last week, our Hyperhidrosis Awareness Month poll

 challenged your knowledge of the prevalence of excessive sweating. We asked: What percent of the global population is estimated to have hyperhidrosis? 

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

Even more so, not everyone who experiences excessive sweating has shared their symptoms and experiences with a health care professional.

 wants to hear from you. What percent of those with hyperhidrosis have discussed their excessive sweating with a health care professional?

 to share your hyperhidrosis insights or research.

Doolittle J, Walker P, Mills T, Thurston J. Hyperhidrosis: an update on prevalence and severity in the United States. 

. 2016;308(10):743-749. doi:10.1007/s00403-016-1697-9

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

POLL: What Percent of Those With Hyperhidrosis Have Discussed Their Sweating With a Health Care Professional?

Revolutionizing Atopic Dermatitis (RAD) Annual Meeting

 has unveiled its comprehensive agenda for the upcoming 7th annual conference, scheduled for June 6-7, 2025, in Nashville, Tennessee. This year's event promises an engaging lineup of sessions and esteemed speakers, continuing to advance knowledge and fostering innovation in the field of atopic dermatitis (AD).​

 to view the full agenda and learn more about registration and attendance.

The 2-day conference is structured to cover a wide array of topics pertinent to AD, featuring sessions led by numerous experts in dermatology. Below is an overview of the scheduled sessions:​

Pediatric AD: Patient, Provider, Caregiver Connection

Assessing the Evidence for OX40-OX40L Axis Inhibition for the Treatment of Atopic Dermatitis

The meeting will also feature late-breaking research presents and poster/abstract submissions.​

The RAD 2025 conference boasts a distinguished roster of speakers, each bringing a wealth of expertise and insight into various facets of AD:​

Bunick will explore the emerging role of OX40-OX40L axis inhibition in AD treatment, analyzing the latest evidence and its potential impact on patient care. His session will provide key insights into this novel therapeutic approach.

: Leading the session on the psychosocial burden of AD, Shahriari will explore the emotional and psychological challenges faced by patients, emphasizing the importance of holistic care approaches.​

: Chovatiya will delve into the role of Janus kinase inhibitors in AD treatment and discuss the strategic use of topicals and biologics, providing attendees with a comprehensive understanding of current therapeutic options.​

: Addressing complex cases involving AD and hair loss, Mayo will shed light on the intersection of these conditions and offer guidance on effective management strategies.​

: With sessions focusing on recent approvals in AD therapy and managing itch, Silverberg will provide updates on the latest treatment advancements and strategies for alleviating pruritus.

: Lio will lead discussions on the unique challenges of treating pediatric AD, emphasizing the importance of patient-provider-caregiver collaboration. His session will address both clinical strategies and the psychosocial aspects of managing AD in younger populations.

: As an expert on chronic hand eczema, Yu will highlight the challenges associated with this condition in the context of AD, providing best practices for diagnosis and treatment.

 is proud to have been a long-standing partner of RAD, providing in-depth 

coverage of its 2024, 2023, and 2022 in-person and virtual events

’ parent company—in November 2024, RAD is now part of our family of educational resources.

As RAD enters its next chapter under the 

 looks forward to continuing the tradition of delivering exclusive coverage of the meeting’s groundbreaking sessions and expert discussions. Leading up to this year's event, we will be previewing key sessions with insights from featured speakers, and our team will be on-site in Music City to bring real-time coverage, expert pearls, and updates on the most important innovations in AD.

Stay tuned for updates as more speakers and late-breaking research presentations are announced. For registration details and additional information, visit the official 

Use code DT40 for 40% off your RAD 2025 registration.

MJH Life Sciences acquires Revolutionizing Atopic Dermatitis (RAD) Annual Meeting; expands leadership in dermatology education. News release. Accessed April 2, 2025. 

https://www.globenewswire.com/news-release/2024/11/18/2982960/0/en/MJH-Life-Sciences-acquires-Revolutionizing-Atopic-Dermatitis-RAD-Annual-Meeting-expands-leadership-in-dermatology-education.html

The 7th annual Revolutionizing Atopic Dermatitis (RAD) meeting, set for June 6-7, 2025, in Nashville, will feature a diverse agenda focusing on advancements in atopic dermatitis (AD). Esteemed speakers will cover topics such as JAK inhibitors, psychosocial impacts, pediatric AD, and chronic hand eczema. The conference will also present late-breaking research and poster submissions. Dermatology Times, now part of MJH Life Sciences, will provide comprehensive coverage of the event, highlighting key sessions and innovations in AD treatment and management.

Get a glimpse of the cutting-edge atopic dermatitis research, breakthroughs, and insights to be presented at the 7th RAD Annual Meeting, June 6-7, 2025.

Exploring the 2025 Revolutionizing Atopic Dermatitis (RAD) Annual Meeting Agenda

In the second round of breakout sessions at the 

 in Las Vegas, Nevada, Omar Noor, MD, FAAD; Douglas DiRuggiero, DMSc, MHS, PA-C; and Lakshi Aldredge, MSN, ANP-BC, DCNP, FAANP, focused on common challenges and innovations in treating plaque psoriasis and atopic dermatitis (AD). To foster collaboration and discussion around the cases, the meeting attendees were divided into 3 groups, with each Horizons chair moderating a session. 

 of a woman aged 27 years who had eczematous lesions covering more than 20% of her body surface area. N

 of a woman aged 25 years who presented with erythematous and scaly patches on her face, neck, and upper trunk.

Aldredge led the third breakout group, which tackled issues in AD in pediatrics and topical treatment options. She shared the case of a female patient aged 12 years with moderate AD that had been worsening over the past several months. The patient presented with 8% BSA; areas impacted included the hands, arms, and trunk. The patient reported persistent itching, redness, and discomfort, particularly on her hands. Like the previous patients, she reported sleeping difficulties stemming from the itch.

The history revealed the patient had onset of symptoms when she was 10, Aldredge reported. There is a familial history of asthma (her father) as well as a history of hay fever (her mother). Past treatments included a short history of oral antihistamines during severe itching episodes. She also received crisaborole 2%.

The patient is using daily emollient and moisturizer as well as a topical corticosteroid (mometasone 0.1%). The patient’s parents report they have been reluctant to try topical therapies on the hands. Moreover, they are concerned about the long-term use of corticosteroids, especially the thinning of skin. Both the patient and the parents are looking for fast-acting, effective treatment, Aldredge told attendees.

Aldredge reviewed the treatment landscape of topical therapies for AD, including prescription moisturizers, topical corticosteroids, topical calcineurin inhibitors, topical PDE4 inhibitors, topical JAK inhibitors, and topical antimicrobials. In doing so, she noted the GRADE (Grading of Recommendations Assessment, Development and Evaluation), strength of recommendation, and the severity level for which the agents might be appropriate as put forth by the 2023 American Academy of Allergy, Asthma and Immunology/American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters GRADE- and Institute of Medicine-based recommendations.

In taking a closer look at the options, Aldredge shared research from the 

 trials that indicatedruxolitinib (Opzelura; Incyte) may be a rapidly effective option. “When switched from vehicle to ruxolitinib, the proportion of patients with IGA 0/1 [Investigator’s Global Assessment score of 0 or 1] increased rapidly, and ​mean BSA decreased rapidly after 4 weeks,” she told attendees.

In addition, she noted the overall bioavailability of ruxolitinib cream is low (a fraction of that of the oral formulation)​, and the average steady-state trough plasma concentrations at the highest strength (1.5% twice daily) were less than 20% of ruxolitinib half-maximal inhibitory concentration for JAK2 inhibition in human whole blood assays.​ The data also found no correlations between concentrations at steady state and any hematological changes, except for a transient increase in platelets at week 2​.

These highlights bring up important issues that need to be considered in real-world patients, Aldredge noted. She le​d a thoughtful discussion of these issues with her breakout group.

Aldredge reviewed the long-term safety data for ruxolitinib reported in the TRuE AD1 and TRuE AD2 studies, which looked at 0.75% and 1.5% ruxolitinib cream compared with vehicle​. Researchers found low ruxolitinib plasma concentrations, she said. There were minimal application site reactions, and most reported AEs were considered unrelated to treatment. The most common AEs were upper respiratory tract infection and nasopharyngitis; there were minimal reports of notable serious infections, malignancies, MACE, and thrombotic events.

The patient and her parents considered the options presented and decided to initiate topical ruxolitinib 1.5%. The cream was applied twice daily to the affected areas. The patient was advised to continue with daily emollients and an oral antihistamine for breakthrough itching. After 8 weeks of treatment, there was a 50% reduction in EASI scores, indicative of significant improvement in eczema severity, Aldredge said. Similarly, the patient reported a marked reduction in pruritus as well as improved sleep. She had no applicationsite reactions and reported no AEs. Moreover, the parents reported treatment satisfaction as well as reduced anxiety concerning topical treatments.

​Aldredge’s group acknowledged the importance of addressing parents’ concerns when considering certain treatment options. Ultimately, leveraging research and data can help clinicians devise a thoughtful treatment plan to meet the patient’s needs and address parents’ concerns.

​Research continues to shed light on AD pathophysiology, and these new insights allow for increased treatment options for patients, according to the Horizons Chairs. The conversations within the breakout sessions pointed to an exciting time for research and new solutions. Based on the conversations, there is an increased dedication to finding the most appropriate, safe, and rapidly effective treatment for each patient by leveraging special issues like comorbidities, response, severity, and age.

AAAAI/ACAAI JTF Atopic Dermatitis Guideline Panel; Chu DK, Schneider L, Asiniwasis RN, et al. Atopic dermatitis (eczema) guidelines: 2023 American Academy of Allergy, Asthma and Immunology/American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters GRADE- and Institute of Medicine-based recommendations. 

. 2024;132(3):274-312. doi:10.1016/j.anai.2023.11.009

Papp K, Szepietowski JC, Kircik L, et al. Long-term safety and disease control with ruxolitinib cream in atopic dermatitis: results from two phase 3 studies. 

. 2023;88(5):1008-1016. doi:10.1016/j.jaad.2022.09.060

Gong X, Chen X, Kuligowski ME, et al. Pharmacokinetics of ruxolitinib in patients with atopic dermatitis treated with ruxolitinib cream: data from phase II and III studies. 

. 2021;22(4):555-566. doi:10.1007/s40257-021-00610-x

Experts at the Horizons in Advanced Practice meeting discussed challenges and innovations in treating plaque psoriasis and atopic dermatitis (AD). A case study of a 12-year-old with moderate AD highlighted the use of topical ruxolitinib, which showed significant improvement in eczema severity and pruritus. The treatment landscape for AD includes various topical therapies, with ruxolitinib cream demonstrating low systemic absorption and minimal adverse effects. The meeting emphasized the importance of addressing patient and parent concerns, leveraging research to tailor treatment plans, and the ongoing advancements in AD management.

At the Horizons in Advanced Practice meeting, Lakshi Aldredge, MSN, ANP-BC, DCNP, FAANP, presented a case of a female patient aged 12 years with moderate AD that had been worsening over the past several months.

Reviewing Complex Cases: Topicals for Pediatric AD

 of a woman aged 27 years who had eczematous lesions covering more than 20% of her body surface area.

Because each patient brings a unique set of complications, history, and treatment goals, Noor shared a different example with his breakout group. Here, the attendees considered the case of a woman aged 25 years who presented with erythematous and scaly patches on her face, neck, and upper trunk. The patient also had moderate lichenification on antecubital and popliteal fossae. This patient similarly reported issues with quality of life. Specifically, she noted she has persistent pruritus that affects her sleep and activities of daily living.

A medical history revealed that she had AD since she was a child. She reported allergic reactions to dust mites and some foods (ie, peanuts and eggs). The patient noted that stress, like college exams, exacerbates her condition.

Initial treatment included a 600-mg subcutaneous loading dose of dupilumab followed by treatment once every 2 weeks, Noor told attendees. She continued daily emollient and was prescribed topical tacrolimus 0.1% ointment. At her 16-week follow-up appointment, there was a 30% reduction in EASI score, noting moderate AD severity improvement. She reported some reduction in pruritus but said it remained significant. At 6 months, the patient appeared to hit a treatment plateau. She remained at 30% improvement from baseline as measured by EASI scores. However, the persistent moderate pruritus continued to impact her quality of life. Frustrated, she was looking for quick and improved symptomology and better overall disease control.

Empathetic to her plight, Noor asked attendees questions to elicit a discussion around solutions for such a patient, including issues defining response/nonresponse and strategies around switching treatments.

Mechanism of Action, Efficacy, and Safety

To determine the next best treatment option to initiate, Noor reviewed the mechanisms of action of the available treatments. Dupilumab, he explained, binds at IL-4α, which blocks IL-4 and IL-13 signaling. Meanwhile, tralokinumab​ binds at IL-13. This prevents IL-13 from binding to IL-13Rα1 and IL-13Rα2 decoy receptor. As such, it blocks IL-13 signaling as well as endogenous IL-13 regulation. Finally, lebrikizumab​ binds IL-13, which prevents the formation of IL-13Rα1/IL-4Rα complex. In turn, this blocks downstream signaling.

With that in mind, Noor asked attendees which factors, including safety and efficacy, might determine whetherthe patient should be switched to another systemic therapy (eg, anti–IL-13) or if another class of therapeutics (eg, oral JAK inhibitor) should be considered. He asked in general whether there was evidence to suggest an optimal sequence for introducing and using biologics.

To provide perspective, Nood shared results from the 

. This was a 24-week, head-to-head phase 3b, multicenter, randomized, double-blinded, double-dummy, active-controlled clinical trial comparing the safety and efficacy of upadacitinib (Rinvoq; AbbVie)(n = 342) with dupilumab (n = 331) in adults with moderate to severe AD.​ (The trial excluded patients with a history of dupilumab or JAK inhibitor use.) “Improvements in EASI 75 and WorstItch Numeric Rating Scale were seen as early as 1 week after treatment initiation,” Noor said of upadacitinib. He also reviewed the safety data. The trial found higher rates of serious infection, eczema herpeticum, and herpes zoster for patients who received upadacitinib. For those who received dupilumab, rates of conjunctivitis and injection-site reactions were higher.​

Noor took a moment to review the boxed warnings for JAK inhibitors. There is an increased risk of serious infections that can lead to hospitalization or death. These can include active tuberculosis, invasive fungal infections (eg, candidiasis and pneumocystosis​), bacterial, viral (eg, herpes zoster), and other infections due to opportunistic pathogens​. In patients with rheumatologic arthritis, he said studies have indicated a higher rate of all-cause mortality with JAK inhibitors vs tumor necrosis factor blockers. He added that lymphoma and other malignancies, as well as thrombosis (ie, deep venous thrombosis, pulmonary embolism, and arterial thrombosis),​have been observed in patients with RA who are using JAK inhibitors. Finally, major cardiovascular events (eg, cardiovascular death, myocardial infarction, and stroke) have been associated with JAK inhibitors.

Noor further explored the risk of cardiovascular events and all-cause mortality in patients with skin diseases taking JAK inhibitors by looking at data from a recent meta-analysis of 35 randomized clinical trials with a total of 20,651 patients.JAK inhibitors included in the analysis were tofacitinib (Xeljanz; Pfizer), abrocitinib (Cibinqo; Pfizer), ​baricitinib (Olumiant; Eli Lilly and Incyte), upadacitinib, ritlecitinib (Litfulo; Pfizer), and delgocitinib (Anzupgo; LEO Pharma). In looking at major adverse cardiovascular events and all-cause mortality, the study failed to find a significant difference between JAK inhibitors and placebo/active comparator​ (OR, 0.83; 95% CI, 0.44-1.57; 30 trials)​. Similarly, they found no statistical difference between JAK inhibitors and placebo/active comparator​ for venous thromboembolism (OR, 0.52; 95% CI: 0.26-1.04; 30 trials)​. Finally, Noor reported that the study found oral and topical JAK inhibitors showed similar association without significant heterogeneity in endpoints.​ Thus, Noor added it is important to shed additional light and perspective on the boxed warnings when discussing treatment options with patients.

Returning to the case, Noor reported the clinician and patient decided the best course was to switch to upadacitinib. Dupilumab was discontinued, and upadacitinib was initiated at 15 mg orally once daily. Emollient and topical tacrolimus were continued as needed.

​Noor led the group in a discussion on related important topics. For instance, what is the appropriate washout period when switching from dupilumab to upadacitinib?​ If the response to upadacitinib is not adequate, what next steps can be taken? What are approaches to the concept of cycling through multiple biologics?​

Practical issues also need to be addressed, Noor told attendees. He led the conversation on navigating insurance and patient concerns over costs when prescribing biologics. As part of this, he discussed patient assistant programs, buy-and-bill practices, and the importance of biologics coordinators in navigating challenges to ensure patients receive the most appropriate treatments.

Haddad EB, Cyr SL, Arima K, McDonald RA, Levit NA, Nestle FO. Current and emerging strategies to inhibit type 2 inflammation in atopic dermatitis. 

. 2022;12(7):1501-1533. doi:10.1007/s13555-022-00737-7

Blauvelt A, Teixeira HD, Simpson EL, et al. Efficacy and safety of upadacitinib vs dupilumab in adults with moderate-to-severe atopic dermatitis: a randomized clinical trial. 

. 2021;157(9):1047-1055. doi:10.1001/jamadermatol.2021.3023

Ingrassia JP, Maqsood MH, Gelfand JM, et al. Cardiovascular and venous thromboembolic risk with JAK inhibitors in immune-mediated inflammatory skin diseases: a systematic review and meta-analysis. 

. 2024;160(1):28-36. doi:10.1001/jamadermatol.2023.4090

The Horizons in Advanced Practice meeting in Las Vegas focused on challenges and innovations in treating plaque psoriasis and atopic dermatitis (AD). Discussions centered on patient cases, treatment responses, and the use of biologics and JAK inhibitors. A case study highlighted a 25-year-old woman with moderate AD, whose treatment with dupilumab plateaued, prompting consideration of alternative therapies. The meeting reviewed the mechanisms, efficacy, and safety of various treatments, including a comparison of upadacitinib and dupilumab. The importance of understanding boxed warnings and navigating practical issues like insurance and patient assistance programs was emphasized.

At the Horizons in Advanced Practice meeting, Omar Noor, MD, FAAD, presented a case of a woman aged 25 years who presented with erythematous and scaly patches on her face, neck, and upper trunk.

Jeffrey Cizenski, MD, FAAD

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