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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.

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Catch up on coverage of FDA-approved drugs in the first half of 2024.

2024 Drug Approvals in Review: Part 1

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.

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

Dermatology Times 2024 In Review: Aesthetic/Cosmetic Dermatology

As 2023 comes to a close, Dermatology Times is taking a look back at the studies, therapies, and advances in psoriasis this year.

Dermatology Times 2024 in Review: Psoriasis

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

Dermatology Times 2024 In Review: Vitiligo

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Paul Wallace, MD, MPA, is the founder of Wallace Skin & Body Institute in Ladera Heights, California, and also served in the US Army for 22 years as a decorated specialist in military trauma and wound ballistics. 

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

At the 2023 Society of Dermatology Physician Assistants (SDPA) Annual Summer Dermatology Conference in Boston, Massachusetts, 

, a medical director for Novartis who has also been a practicing dermatology physician assistant (PA) for more than 20 years. At the meeting, Mast presented, "Disease State and Unmet Needs in Hidradenitis Suppurativa," where she discussed how to care for patients with hidradenitis suppurativa. 

 What do you hope attendees take away from your talk, "Disease State and Unmet Needs in Hidradenitis Suppurativa?"

. We know that they oftentimes end up in ERs and urgent cares, and so we're really trying to change that with HS awareness. Of course, we in dermatology do a great job of diagnosing these patients. But how can we get them to dermatology sooner and faster?

 What is the importance of awareness and recognition in HS?

 We hear often from patients that there is a long-standing history that they feel shame with this disease. It's very hard for them; it takes a lot of courage to see someone to begin with. And so I think just having empathy is the first thing that I've heard that everybody can do for these patients, is really showing that empathy for what they've been through and their journey, and that's really where we're trying to shine a light on HS, because we know that it's been hidden in the shadows, and we're trying to make these people comfortable to come and get help.

 Why is it such an exciting time in HS research and care?

 I think just the fact that there's a lot more research dollars going into this disease. I hope that one day this diseases is like psoriasis, that now we have a ton of different therapies for the disease. I think we're just at the tip of the iceberg for that. The fact that we're caring for these patients, that we're showing empathy and understanding them, I'm very excited about the future.

Understanding the disease, the pathophysiology better, and then also all the different treatments, because we know that this is a not a one treatment disease. Multimodal treatment is often needed, and surgical and medical management, and so being confident in both of those therapies, and partnering with the patient, will get them the best care.

Hidradenitis suppurativa (HS) patients face significant diagnostic delays, often seeking care in emergency settings. Increasing awareness and empathy are crucial to improving patient experiences and outcomes. The current landscape of HS research is promising, with increased funding and a focus on understanding the disease's pathophysiology. This progress is paving the way for diverse treatment options, similar to advancements seen in psoriasis care. A multimodal approach, combining surgical and medical management, is essential for effective HS treatment, emphasizing the importance of patient-provider partnerships.

Click here to answer this week's HS poll. 

Polls 

POLL: What is the Average Diagnosis Delay for Patients With HS?

New Systemic Treatment Options for Prurigo Nodularis

Video content above is prompted by the following:

There are two 2 systemic biologic treatments that have been recently approved for prurigo nodularis within the past few years. Can you describe these two 2 agents, including mechanisms of action, efficacy and safety, and what differentiates them from each other and from other PN treatment options?

A collection of clinical insights on prurigo nodularis, exploring awareness and educational efforts as well as trends in treatment.

Considerations for Setting Treatment Goals in Prurigo Nodularis

When treating patients with prurigo nodularis, what are some of the factors to consider when setting treatment goals?

How might the treatment approach differ based on the severity of the disease and other comorbidities?

TJ Chao, MPAS, PA-C, discusses how treatment goals for prurigo nodularis should be based on disease severity and comorbidities, with adjustments to the treatment approach to optimize patient outcomes.

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

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.

Paul Wallace, MD, MPA

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