This month’s news from across the specialty
What’s hot
December 1, 2025
In this monthly column, members of the DermWorld Editorial Advisory Workgroup identify exciting news from across the specialty.
New parents are participating in a new “nutty” trend where they give healthy infants their first taste of peanut butter in hospital parking lots and broadcast the experience on TikTok. Although driving to hospital parking lots to taste peanut butter is unnecessary and unfounded, it appears parents are getting the message that early exposure to peanuts and other allergenic foods may prevent food allergies.
Whether this message is getting to parents of infants with eczema, however, is unclear. A recent study by Gupta et al. revealed that only 10% of pediatricians caring for infants with severe eczema recommended introduction of peanuts at 4-6 months of life. After receiving an educational intervention combined with supportive tools, only 27% of pediatricians were able to follow recommended guidelines. Clearly, pediatricians need more support to promote early peanut introduction in infants with eczema.
Current consensus guidelines by American and Canadian allergists recommend introduction of peanuts at 4-6 months for infants with severe eczema (defined as eczema requiring frequent application of prescription-strength topical steroids). No screening with peanut-specific IgE, skin prick testing, or allergist consultation (or driving to hospital parking lots) is required prior to introduction of peanut (J Allergy Clin Immunol Pract. 2021(9): 22-43).
Dermatologists can help support pediatricians and prevent peanut allergies by recommending introduction of peanuts to the parents of all our infant patients (4-6 months) with eczema. </a>
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For many of my patients with pemphigus, starting rituximab (RTX) — a monoclonal antibody against CD20 on B-cells — is one of the hardest decisions. Originally used for lymphoma and later rheumatoid arthritis, RTX regimens remain under-optimized for pemphigus, prompting understandable apprehension.
I was therefore interested in a recent prospective open-label trial from China evaluating three RTX dosing regimens in adults with moderate-to-severe pemphigus vulgaris or foliaceus (doi: 10.1016/j.jaad.2025.05.1374). Patients were randomized to: (1) ultralow-dose RTX (ULRTX: 100 mg at weeks 0, 2, 26); (2) low-dose RTX (LRTX: 500 mg at weeks 0, 2); or (3) standard-dose RTX (SDRTX: 1000 mg at weeks 0, 2). All received glucocorticoids (0.5–1.0 mg/kg/day) tapered per S2k guidelines (doi: 10.1111/jdv.16752). Fifty-two patients completed the 52-week study: 26 ULRTX, 13 LRTX, 13 SDRTX.
Important similarities: All three regimens achieved high disease control, with complete remission rates of 92.3%, 100%, and 100% in ULRTX, LRTX, and SDRTX, respectively. Complete remission off therapy rates, glucocorticoid use, B-cell depletion, median time to anti-Dsg1/3 loss, relapse rates (15-25%), and adverse events (AE) were comparable. No deaths or treatment withdrawals due to serious AE occurred.
Differences emerged in time to remission off therapy, serious infections, and cost: ULRTX took longer to achieve remission off therapy (median 224 days vs. 172-183 days) and had earlier B-cell recovery (~6 months), necessitating a third RTX dose. Importantly, ULRTX had no serious infections, compared to 7.7% and 15.4% in LRTX and SDRTX, and was 32-53% more cost-effective.
While larger, long-term studies are needed, these findings may change my counseling: ultralow-dose RTX could offer similar efficacy with fewer infections and lower costs — encouraging hesitant patients to take that leap.
More What’s Hot!
Check out more What’s Hot columns from the DermWorld Editorial Advisory Workgroup.
