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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.

Articles

Recent literature shows that children from racial minority groups with lower-income families have higher disease prevalence but reduced access to care.

Pediatric AD Disparities in the United States: An Updated Review

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.

This review of the latest dermatologic studies includes insights into disparities in pediatric atopic dermatitis, nurse-led models for skin cancer detection, and more.


Journal Digest: April 9

Catch up on dermatology news, highlights, and insights from the past 24 hours.

Daily Derm Times: April 8, 2025

The Kesty Redness Scale offers a validated, easy-to-use tool to reliably assess facial redness in clinical dermatology.

Kesty Redness Scale Enhances Analysis of Facial Erythema, Study Reports

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Paul Wynn is a medical writer based in Brooklyn, New York.

New York - Two years ago Neil Sadick, M.D., started a newsletter to inform his patients about new procedures and research studies at his practice in New York City. One issue included stories about laser liposuction, the new botulinum toxin B molecule called Myobloc, and IPL photorejuvenation.

Extra ... Extra  ...

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

A novel systematic review and meta-analysis has analyzed procedural treatments for periorbital hyperpigmentation, or dark eye circles.

 Through this analysis, it was found that lasers and combination therapies are the most effective and satisfactory treatments for dark eye circles. Intense periorbital hyperpigmentation can be emphasized based on skin laxity, vascular congestion, and the anatomical structure of the face.

All literature published up to February 2023 in major databases like PubMed, Scopus, and Web of Science was searched. Investigators used key words like “infraorbital dark circles,” “infraorbital hyperpigmentation,” “periorbital dark circles,” “periorbital hyperpigmentation,” “dark eye circles,” and “under-eye dark circles.”

After an initial search of 278 records, 33 studies featuring 1320 patients were included in the final count. Twelve were one-arm studies, 17 were two-arm studies, and 4 were three-arm studies. Most of the trials were conducted in Iran, Egypt, India, the United States, and China.

Clinicians recorded procedure parameters, scoring methodology, clinical improvement, pre-and post-treatment pigment scores, patient satisfaction levels, and adverse events. The therapies were divided into the following categories;

Lasers and light therapies like fractional CO

Combination therapies (microneedling + chemical peels or fillers + lasers)

The most effective methods were lasers and combination treatments, with 82% and 75% of patients experiencing excellent or good improvement, respectively. This is defined as improvement of > 50%. The CO

 laser was the most commonly used laser.

Chemical peels (63%), carboxytherapy (54%), and PRP (44%) were less effective. Additionally, only 25% of chemical peel users had “excellent” results but there was a higher rate of 37% for “good” improvement. There was only one study each that focused on fillers and autologous fat injections, so the analysis is limited. However, in those trials, 94% and 74% of participants saw a marked improvement, respectively.

In terms of patient satisfaction, combination therapies had the highest rates, with 49% of participants reporting an excellent rate of > 75%. Laser treatments were predominant in the good satisfaction rate category, with more than half of patients being satisfied with their therapies. Chemical peels (24%) and PRP treatments (17%) had limited patient satisfaction.

All therapies had some mild and transient adverse effects. The lasers were associated with short durations of burning, erythema, discomfort, swelling, pain, and edema. However, these were reduced when CO

 laser was combined with PRP. Additionally, Q-switched and picosecond Nd:YAG lasers had higher rates of post-inflammatory hyperpigmentation compared to carboxytherapy and the picosecond 755-nm laser. But combined laser treatments also had reduced healing times.

This review does have some limitations including the lack of uniform measurements and high heterogeneity across all the studies.

“Efforts to reduce this variability through subgroup analysis and stratification by specific treatment settings and geographic location were unsuccessful, indicating the presence of complex, possibly unmeasured variables affecting treatment outcomes,” the authors wrote. “This suggests that caution is needed when interpreting these results due to the potential masking of true treatment effects.”

Future research with more objective assessment methods can help validate these existing results. Furthermore, larger sample sizes, longer follow-ups, and split-face designs can better represent the populations impacted by periorbital hyperpigmentation. 

This literature is the first of its kind to comprehensively review procedural treatments.

 With these findings, the researchers emphasize the significance of personalized treatment approaches that will fulfill patient and clinician needs and expectations.

1. Pour Mohammad A, Zeinali R, Jafary P, Mortaja M, Jafarzadeh A, Goodarzi A. The first systematic review and meta‐analysis of pharmacological and nonpharmacological procedural treatments of Dark Eye Circles (periorbital hyperpigmentations): One of the most common cosmetic concerns. 

2.Maghfour J, Olayinka J, Hamzavi IH, Mohammad TF. A Focused review on the pathophysiology of post-inflammatory hyperpigmentation.

 2022;35(3):320-327. doi:10.1111/pcmr.13038

2. Sawant O, Khan T. Management of periorbital hyperpigmentation: An overview of nature-based agents and alternative approaches. 

A comprehensive review and meta-analysis evaluated procedural treatments for periorbital hyperpigmentation, identifying lasers and combination therapies as the most effective. The study analyzed 33 studies with 1,320 patients, categorizing treatments into lasers, chemical peels, PRP, carboxytherapy, fillers, microneedling, and combinations. Lasers and combination therapies showed the highest improvement rates, while chemical peels and PRP were less effective. Patient satisfaction was highest with combination therapies. The review highlighted limitations such as study heterogeneity and called for future research with more objective assessments and larger sample sizes to validate findings.

A comprehensive evaluation of therapies found that lasers were most effective with high rates of patient satisfaction.

Analyzing Current Procedures for Periorbital Hyperpigmentation

A protocol for dermatology service learning for medical students: supporting laser tattoo removal for adults impacted by the justice-system

A recent study explored a novel dermatology-based service-learning program designed to integrate medical students into a laser tattoo removal clinic serving individuals impacted by the criminal justice system. The program aimed to provide early clinical exposure, enhance communication skills with diverse patient populations, and foster mentorship between students while allowing participation in dermatologic care. Evaluation of the program’s first 2 cohorts indicated strong student satisfaction, with participants citing motivations rooted in social justice and interest in dermatology. Findings suggest that the initiative successfully supports students’ professional development and preparedness to serve underserved communities, though improvements in onboarding processes were noted.

Case Reports in Dermatological Medicine: 

Petechiae and a persistent violaceous nodule: A presentation of blastic plasmacytoid dendritic cell neoplasm to dermatology

A recent case study discussed a rare presentation of blastic plasmacytoid dendritic cell neoplasm (BPDCN) in a 76-year-old male, characterized by erythematous macules, petechiae, purpura, and a violaceous nodule. BPDCN, a highly aggressive hematologic malignancy, often manifests with cutaneous symptoms, but its diagnosis can be challenging due to its rarity and variable presentation. The case highlights the importance of early suspicion and tissue biopsy, which led to a definitive diagnosis through immunohistochemical staining. The study emphasizes the need for dermatologists to consider BPDCN in elderly patients with hemorrhagic lesions, as early detection is critical for improving patient outcomes.

The addition of low-dose lidocaine and triamcinolone reduces the adverse effects of 2-deoxycholate injection without affecting the long-term results

A recent study investigated the combination of low-dose triamcinolone acetonide (TAC) and lidocaine with deoxycholic acid (DCA) injections to reduce adverse effects while maintaining treatment efficacy. In a randomized trial with 15 participants, the intervention group (DCA with TAC and lidocaine) experienced significantly less pain and swelling compared to the control group (DCA with lidocaine). Both groups showed similar effectiveness in reducing submental fat, but the intervention group had a greater volumetric loss. The study concluded that the addition of TAC and lidocaine enhances patient comfort and treatment results without increasing steroid-related adverse effects.

Journal of the European Academy of Dermatology and Venereology: 

Completed suicide in patients with skin disease: A systematic review and meta-analysis

A recent meta-analysis explored the risk of completed suicide in adult patients with various skin diseases. The study reviewed 37 original studies, including over 3.8 million patients, to assess the relationship between skin diseases and suicide. The findings showed no significant association between psoriasis, dermatitis, and completed suicide. However, melanoma was associated with a higher risk of suicide, with a standardized mortality rate (SMR) of 2.89, and non-melanoma skin cancer in females also showed an increased risk (SMR: 1.30). Additionally, hidradenitis suppurativa (HS) was strongly linked to an elevated suicide risk (odds ratio: 2.86). The study suggests that dermatologists should consider suicidality, particularly in patients with melanoma and HS, while further research is needed for other skin diseases.

Neutrophil extracellular traps are widely distributed across lesional and perilesional hidradenitis suppurativa skin, and elevated serum NET markers associate with moderate to severe HS disease

A recent study explored the role of neutrophil extracellular traps (NETs) in HS. The study found increased levels of CitH3, a key NET component, in both lesional and perilesional skin of patients with HS. Elevated serum levels of NET markers, including CitH3, nucleosomes, and calprotectin, were also observed in HS patients compared to healthy individuals. Additionally, higher NET marker levels correlated with more severe disease activity.

Ojeda VD, Nguyen HA, Nandamuri S, et al. A protocol for dermatology service learning for medical students: supporting laser tattoo removal for adults impacted by the justice-system. 

Anzelc M, Druskovich C, Cusick A, Franklin M. Petechiae and a persistent violaceous nodule: A presentation of blastic plasmacytoid dendritic cell neoplasm to dermatology. 

Ge S, Weiss RA, Schilling L, Noell CM. The addition of low-dose lidocaine and triamcinolone reduces the adverse effects of 2-deoxycholate injection without affecting the long-term results. 

Hrvatin Stancic B, Henning MAS, Eriksen N, Dornonville de la Cour JE, Saunte DML, Jemec GBE. Completed suicide in patients with skin disease: A systematic review and meta-analysis. 

van Dalen SCM, Stein JWJ, Bruurmijn T, et al. Neutrophil extracellular traps are widely distributed across lesional and perilesional hidradenitis suppurativa skin, and elevated serum NET markers associate with moderate to severe HS disease. 

What new studies have you been involved with or authored? Share with us by emailing 

A novel dermatology service-learning program integrates medical students into a laser tattoo removal clinic for justice-impacted individuals, enhancing clinical exposure and communication skills. A case study highlights the rare presentation of blastic plasmacytoid dendritic cell neoplasm, emphasizing early detection. A study on deoxycholic acid injections shows that adding triamcinolone and lidocaine reduces adverse effects without compromising efficacy. A meta-analysis links melanoma and hidradenitis suppurativa to increased suicide risk. Research on hidradenitis suppurativa reveals elevated neutrophil extracellular traps correlating with disease severity.

This review of the latest dermatologic studies includes insights into supporting laser tattoo removal for adults impacted by the justice-system, a case of blastic plasmacytoid dendritic cell neoplasm, and more.


Journal Digest: March 19

2025 American Academy of Allergy, Asthma, and Immunology/World Allergy Organization Joint Congress

, Jonathan Bernstein, MD, FAAAAI, presented multiple abstracts on the efficacy of rilzabrutinib in chronic spontaneous urticaria (CSU).

In addition, Bernstein authored an abstract outlining findings from the LIBERTY-CSU CUPID Study A and Study C phase 3 trials evaluating dupilumab (Dupixent; Regeneron and Sanofi) in patients with CSU who remain symptomatic despite H1-antihistamine treatment.

, Bernstein, a physician practicing in Cincinnati, Ohio, explored the studies and their key insights, their clinical impact on dermatologists and allergists, and the implications for the future of CSU treatment.

Q: Your poster at the AAAAI meeting presented real-world treatment patterns among patients with CSU initiating advanced therapies. What key insights emerged from these findings, and how might they impact clinical practice?

In our retrospective analysis, we observed several noteworthy findings. First, add-on therapies were used in the majority of patients across all subgroups, including patients treated with omalizumab (55.9%), which was the most dispensed advanced therapy, systemic anti-inflammatory agents (51.9%), and systemic immunosuppressants (52.9%).

Additionally, the proportion of patients switching treatments was higher with systemic anti-inflammatories (44.3%) and systemic immunosuppressants (51%), compared to omalizumab (16%). However, more than a quarter of all omalizumab-treated patients (26.2%) were being prescribed higher than FDA-approved doses.

Ultimately, the findings suggest that, despite current treatment options, there is still a significant need for new advanced therapies that can more adequately control CSU symptoms.

Q: How does your research on CSU and advanced therapies address the evolving landscape of treatment options for patients who are unresponsive to conventional therapies?

Despite significant advancements, unmet needs remain for people suffering from CSU. The disease remains uncontrolled in up to 50% of patients, who continue to experience debilitating symptoms such as intensely itchy recurrent hives, swelling or both, which can significantly impact their day-to-day lives and quality of life.

Over time, we’ve learned multiple mechanisms can cause the inflammation underlying CSU, and consequently, patients have different needs or respond differently to treatments. Our goal with research is to better understand how patients are responding to existing advanced therapies, assess certain treatment patterns that can help us better address gaps in care, and further explore investigational medicines – targeting these different mechanisms – that could potentially fill these unmet needs.

Q: Could you elaborate on the significance of real-world data in the management of CSU, especially in the context of biologics and other advanced treatments?

As the treatment paradigm in CSU evolves, real-world data will be essential to understanding how different segments of patients respond to different therapeutic approaches, particularly new and emerging medicines. As mentioned above, real-world evidence will also help provide continued line of sight into unmet patient needs that we seek to address in clinical research.

Q: Rilzabrutinib, a novel oral BTK inhibitor, is being investigated in CSU. What are your thoughts on the potential role of rilzabrutinib in treating CSU patients?

Further research will be needed to fully understand the potential role of rilzabrutinib, but early data has suggested it could hold promise as a future treatment option for patients with moderate to severe CSU.

In an earlier readout from the RILECSU phase 2 study, rilzabrutinib significantly reduced itch, hives and urticaria in adult patients with moderate to severe CSU, demonstrating its potential to make a meaningful difference in CSU symptom control.

Additionally, the data presented at AAAAI, which showed treatment with oral rilzabrutinib was associated with significant and sustained improvements in angioedema outcomes in this same population, further support the earlier findings.

Q: With the increasing prevalence of CSU, what challenges do you face when selecting treatment strategies for diverse patient populations, and how do your findings aim to address these challenges?

Some of the biggest challenges that exist include access barriers to advanced therapies, as well as difficulties in diagnosing CSU in people with skin of color. It’s also worth noting that racially diverse patients can be underrepresented in clinical trials.

Given these challenges, real-world evidence is critical to understanding treatment patterns and outcomes for certain populations, which in turn, may help us make the case for more accessible advanced treatments.

Bernstein J, Lee CH, Ferrucci S, et al. Effects of rilzabrutinib on angioedema over 12 weeks: Results from the phase 2 RILECSU trial in participants with moderate-to-severe chronic spontaneous urticaria. Abstract presented at: 2025 AAAAI/WAO Joint Congress; February 28-March 3, 2025; San Diego, CA.

Talia J, Sarbjit S, Lee CH, et al. Rilzabrutinib improves chronic spontaneous urticaria in patients with and without allergic comorbidities: A subgroup analysis from the RILECSU study. Abstract presented at: 2025 AAAAI/WAO Joint Congress; February 28-March 3, 2025; San Diego, CA.

Casale T, Saini S, Bernstein J, et al. Dupilumab improves itch and urticaria activity in patients with chronic spontaneous urticaria: Pooled results from two phase 3 trials (LIBERTY-CSU CUPID Study A and Study C). Abstract presented at: 2025 AAAAI/WAO Joint Congress; February 28-March 3, 2025; San Diego, CA.

Recent studies presented at the 2025 AAAAI/WAO Joint Congress highlight the ongoing challenges and advancements in treating chronic spontaneous urticaria (CSU). Despite existing therapies, many patients remain symptomatic, underscoring the need for new treatments. Real-world data reveal significant use of add-on therapies and frequent treatment switching, particularly with systemic agents. Rilzabrutinib, a novel BTK inhibitor, shows promise in reducing CSU symptoms. The research emphasizes the importance of understanding diverse patient responses and addressing unmet needs, especially in underrepresented populations, to improve CSU management.

At AAAAI/WAO 2025, Bernstein explored new findings on rilzabrutinib and dupilumab in CSU, highlighting treatment gaps and future therapies.

Q&A: Jonathan Bernstein, MD, FAAAAI, Discusses Advances in Chronic Spontaneous Urticaria Treatments and AAAAI Data

“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.

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

Among available biologic therapies, risankizumab, an interleukin-23 (IL-23) inhibitor, has been approved for treating moderate to severe plaque psoriasis. While clinical trials have demonstrated the short-term efficacy of risankizumab, long-term real-world data remain crucial to understanding its sustained effectiveness and impact on treatment goals. A recent study, presented as a poster at the

 2025 American Academy of Dermatology (AAD) Annual Meeting

, examines the achievement of National Psoriasis Foundation (NPF) treatment goals and the durability of clinical response in patients who received risankizumab continuously for 36 months. The data were sourced from the CorEvitas Psoriasis Registry, a prospective observational registry across the United States and Canada.

This analysis included adult patients diagnosed with moderate to severe plaque psoriasis, as defined by an Investigator’s Global Assessment (IGA) score of ≥3. To be eligible, patients must have initiated risankizumab treatment at baseline and maintained persistent use for 36 months (±3 months). The study evaluated treatment success based on the NPF’s predefined treatment goals:

 Defined as achieving either body surface area (BSA) involvement ≤3% or a ≥75% improvement in BSA from baseline.

Evaluated through the Dermatology Life Quality Index (DLQI), with success defined as a DLQI score of 0/1, indicating minimal impact on daily life.

In addition, the study assessed the durability of response in patients who achieved a 90% reduction in the Psoriasis Area and Severity Index (PASI90) at 12 months, measuring whether they maintained this response through 36 months.

The study cohort consisted of 179 patients, with 40.8% being women. The mean patient age was 48.8 years (SD ±15.4), and the average duration of psoriasis was 17 years (SD ±13.9). Baseline disease severity was characterized by a mean BSA involvement of 14.7% (SD ±14.6).

According to the poster presented at AAD, following 36 months of continuous risankizumab treatment:

96.2% of patients (152/158) with baseline BSA >3% achieved the NPF-defined acceptable response.

84.2% of patients (133/158) achieved the NPF-defined target response.

68.8% of patients (110/160) with a baseline DLQI >1 reached a score of 0/1, indicating minimal or no impact on quality of life.

Risankizumab, an IL-23 inhibitor, has shown promising long-term efficacy in treating moderate to severe plaque psoriasis. A study presented at the 2025 AAD Annual Meeting evaluated its effectiveness over 36 months using data from the CorEvitas Psoriasis Registry. The study found that a significant majority of patients achieved the National Psoriasis Foundation's treatment goals, including acceptable and target responses, and maintained a high level of skin clearance. Additionally, many patients reported improved quality of life, underscoring risankizumab's potential as a durable treatment option.

Findings suggest that most patients on risankizumab met or exceeded the National Psoriasis Foundation’s treatment goals.

Paul Wynn

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