Acne 

Actinic Keratosis 

Aesthetics

Alopecia

Biologic Treatments for Moderate to Severe Atopic Dermatitis 

Atopic Dermatitis 

Buy-and-Bill

COVID-19

Case-Based Roundtable

Chronic Hand Eczema

Drug Watch

Eczema

General Dermatology 

Hidradenitis Suppurativa

Melasma

NP and PA

Pediatric Dermatology

Pigmentary Disorders 

Practice Management 

Precision Medicine and Biologics

Prurigo Nodularis

Emerging Therapies Plaque Psoriasis

Treatments for Plaque Psoriasis 

Psoriasis 

Psoriatic Arthritis 

Rare Disease

Rosacea 

Skin Cancer (Nonmelanoma)

Skin Cancer

Vitiligo

Wound Care

News

Media

Around the Practice

Between The Lines

Case-Based Peer Perspective

Clinical Case Collective

DermView

Expert Perspectives

Fellows Face Off

Frontline Forum

Medical World News

Patient Perspectives

Podcasts

Readout360

Recognize and Refer

Conferences

Conference Coverage

Conference Listing

Events

Publication

Dermatology Times

CME/CE

Resources

DermIQ

Interactive Tools

Job Board

Partner Perspectives

Perspectives in Dermatology

Polls

Editorial Advisory Board

Partners

Subscribe

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.

Videos

Treatment decisions are increasingly guided by patient values, preferences, and quality-of-life considerations.

The Future of laBCC Treatment with Vishal Patel, MD, FAAD, FACMS

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.

Articles

Raj Chovatiya, MD, PhD, MSCI, explores case-based approaches to managing atopic dermatitis, focusing on treatment strategies, challenges, and clinical insights for improving patient outcomes.

Personalized Approaches to Atopic Dermatitis: Balancing Burden, Treatment, and Patient Preferences

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.

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

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

About

Advertise

Contact Us

Do Not Sell My Information

Terms and Conditions

Privacy Policy

Dermatology Times and Multimedia Medical, LLC

Facebook

Linkedin

Topics

Acne

Pigmentary Disorders

Practice Management

Psoriasis

Psoriatic Arthritis

Rosacea

1rem

Authors

Epidemiological studies have shown a significant association between indoor tanning and melanoma. This risk especially pertains to exposure in childhood and adolescence, as these are periods of greater biological vulnerability to ultraviolet (UV) radiation.

Teenagers and indoor tanning

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

Panelists discuss how IL-17 inhibitors differ in their targets within the IL-17 pathway. Secukinumab and ixekizumab block IL-17A, reducing inflammation in psoriasis and arthritis. Brodalumab inhibits IL-17RA, affecting multiple IL-17 cytokines, but carries suicide risk warnings. Bimekizumab targets IL-17A and IL-17F, potentially enhancing efficacy but with added risk of infections. These differences impact efficacy, safety, and patient selection in inflammatory diseases.

Mechanism of Action Differences Among IL-17 Inhibitors

Video content above is prompted by the following: 

How do the mechanisms of action of the approved IL-17 inhibitors differ from one another, and how might these differences translate in terms of efficacy and/or safety?

Secukinumab (IL-17A inhibitor)—approved 2015

Ixekizumab (IL-17A inhibitor)—approved 2016

Brodalumab (IL-17RA inhibitor)—approved 2017

Bimekizumab (IL-17A and IL-17F inhibitor)—approved 2023

Panelists discuss how IL-17 is a key pro-inflammatory cytokine in plaque psoriasis pathogenesis. It stimulates keratinocyte proliferation, promotes neutrophil recruitment, induces antimicrobial peptides, and up-regulates other inflammatory mediators, creating a self-perpetuating inflammatory cascade in lesional skin.

The Role of IL-17 in Psoriasis Pathogenesis

What is the role of IL-17 in the pathogenesis of plaque psoriasis, and how does it contribute to inflammation?

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.

Sharon A. Glick, M.D

Articles

Latest Updated Articles