February 25, 2026
IN THIS ISSUE / Feb. 25, 2026
Acne relapse after isotretinoin treatment
A Brief Report published in JAAD identified risk factors associated with acne relapse and isotretinoin retreatment after a course of high-dose isotretinoin. Patients who completed a minimum of one course of high-dose isotretinoin (total cumulative dose ≥ 220 mg/kg) were included and divided into three groups: patients without relapse, patients whose relapse required retreatment with isotretinoin, and patients whose relapse required other prescription acne medications.
[Take the Management of Acne Vulgaris: AAD Guidelines and Care Improvement Strategies course in the AAD Learning Center.]
Just over 23% relapsed requiring prescription acne medication, including 10% who received isotretinoin retreatment. Patients who were female, Black or African American, or had longer treatment duration had an increased risk of relapse. The risk of relapse decreased with a higher average daily dose by weight in the last two months of treatment. The authors concluded that dermatologists should consider a “strong finish” (∼2 mg/kg) daily dosing during the final two months of treatment.
10 mg vs. 20 mg isotretinoin for seborrheic dermatitis. Read more.
DermWorld What’s Hot: cSCC and adjuvant radiation therapy
When high-risk cSCC (HRCSCC) were stratified as “higher-risk” and “lower-risk” based on tumor characteristics defined in a prior study, higher-risk HRCSCC experienced double the reduction in locoregional recurrence and nodal metastasis after adjuvant radiation therapy (ART) as compared to lower-risk tumors. For lower-risk HRCSCC, which experience a much smaller risk reduction after ART, the risks and potential adverse effects of ART may outweigh potential benefit. Read more from Bridget E. McIlwee, DO, FACMS, FAAD.
Where to inject botulinum toxin for ‘bunny lines’
A commentary published in the Journal of Cosmetic Dermatology explored evidence challenging the long-standing assumption that for the treatment of ‘bunny lines,’ botulinum toxin (BoNT) should be injected directly into the crease itself. The authors noted recent data demonstrating that the region between the medial canthus and nasal dorsum — where bunny lines manifest — is not underlain by a discrete muscle but rather represents a non-muscular interval called the bunny triangle.
[Get insights from dermatologists on dealing with complications from cosmetic procedures. Read more.]
The wrinkle is not generated by a localized underlying muscle but by convergent traction from neighboring muscles, the authors wrote. “Injecting BoNT directly into the crease targets connective tissue and relies on passive diffusion, resulting in unpredictable efficacy and a higher likelihood of over- or under-treatment depending on the diffusion pattern.”
Comparison of botulinum toxin A formulations for treating glabellar strain. Read more.
Predictors of drug survival of biologics in HS
Authors of a Brief Report published in JAAD conducted a systematic review and meta-analysis to investigate the predictors of biologic drug survival in patients with hidradenitis suppurativa (HS). The most frequently investigated biologic was adalimumab, followed by infliximab.
[HS experts discuss the latest therapeutic, procedural updates to optimize disease management. Read more.]
Nine risk factors predicting one-year biologic discontinuation were analyzed. The authors found that previous or current smoking and female sex were associated with reduced biologic survival and that concomitant surgery and being biologic naïve were associated with increased biologic survival. Age, body mass index, duration of HS, and concomitant antibiotics were not meaningfully associated with biologic survival.
Read the JAAD HS supplement and take the course (11 CME credits).
Utilization of patch testing for contact dermatitis: Insights from DataDerm
A study published in JAAD used data from the Academy’s clinical data registry, DataDerm™ to evaluate trends of patch testing in patients with contact dermatitis (CD). Of 12,987,717 patients in DataDerm, 2.7% were diagnosed with CD, and 0.3% were patch tested. Of those diagnosed with allergic contact dermatitis (ACD), only 10% had patch testing. Patch tested patients were predominantly adult white females.
[Learn more about DataDerm.]
Children diagnosed with ACD were less likely to be patch tested compared to adults (8.5% vs. 10.3%). The authors suggested that this underrepresentation may be due to clinical hesitancy and access to the T.R.U.E. test, which is the only FDA-approved test for children.
Pediatric dermatologists share clues for distinguishing contact dermatitis from atopic dermatitis and discuss noteworthy allergens. Read more.
