A study published in Dermatitis assessed data from three phase 3 studies to evaluate aggregate response benefit of dupilumab versus upadacitinib in patients with moderate-to-severe atopic dermatitis. In the Heads Up study, upadacitinib 30 mg demonstrated significantly superior skin clearance benefits over dupilumab at week four. In the Measure Up 1/2 studies, both upadacitinib 30-mg and 15-mg doses showed substantial improvements in skin clearance compared with placebo at week 16. Upadacitinib also outperformed dupilumab in terms of itch reduction across different categories. The aggregate response benefit in skin clearance and itch reduction favored upadacitinib 30 mg over dupilumab and upadacitinib 15 or 30 mg over placebo, the authors concluded.
Abrocitinib efficacy after switching from dupilumab. Read more.
DermWorld Insights and Inquiries: Early-onset hypertension associated with extensive capillary malformations — A new worry to raise dermatologists’ blood pressure
Just as President Reagan implored General Secretary Gorbachev to “tear down this wall,” so has the molecular revolution torn down the wall of uncertainty regarding the etiology of capillary malformations (CMs, AKA port wine stains [PWS] or nevus flammeus). CMs are associated with physical and functional effects, and often lead to decreased emotional and social overall health-related quality of life. Dermatologists are intimately familiar with complications that may accompany syndromic PWS, such as glaucoma and seizures in SWS, limb overgrowth in DCMO and KTS, and asymmetric lipomatous lesions in CLOVES. A newly reported association demanding attention is early-onset hypertension (defined as hypertension before the age of 55 years) associated with extensive cutaneous CMs harboring postzygotic variations in GNAQ and GNA11. Keep reading!
AAD releases updated acne guidelines
As part of its commitment to promote dermatologic research and ensure the highest-quality patient care, the Academy published updated guidelines of care for the management of acne vulgaris on Jan. 30. The new guidelines make 18 evidence-based recommendations for topical therapies, systemic therapies, and good clinical practices. Read the guidelines in JAAD now.
Multiple biologic failure in psoriasis
An article published in JAAD describes the characteristics associated with development of multiple biologic failure (MBF) versus good clinical response to the first biologic. Of 1,039 patients analyzed, 47% had a good response while 6.3% experienced MBF. Female sex, shorter psoriasis duration, earlier year of biologic initiation, prior nonbiologic systemic therapy use, history of hyperlipidemia, and Medicaid insurance were significantly associated with MBF, although there was a lower level of support for the latter two variables. The first-to-second biologic sequence most observed with MBF was TNF-a inhibitor to IL-17 inhibitor use. These characteristics may identify patients needing more frequent follow-up.
Clinical factors indicating the presence and invasiveness of nail unit melanoma in patients with longitudinal melanonychia
A retrospective study published in Dermatologic Surgery found that high band color intensity, variegation, nail plate splitting, Hutchinson sign, and band change were significantly correlated with malignancy. Nail plate splitting demonstrated a positive correlation with melanoma invasion, whereas blurred lateral borders showed a negative correlation. Nail plate splitting also correlated with melanoma invasion depth, with these patients having a Breslow depth that was 0.734 millimeters greater than those without nail plate splitting. According to the authors, these clinical signs should raise suspicion of malignancy in cases of longitudinal melanonychia, warranting prompt biopsy consideration.
Dermatologist nail experts discuss the diagnosis and management of onychomycosis as well as increasing resistance to anti-fungal therapies. Read more in DermWorld.
Webinar: Academy update on Medicare payment reform
Want to know what the Academy is doing about Medicare physician payment reform? Join Academy leaders on Feb. 20 at 7 p.m. CT to learn more and to find out what AADA members can do to fight for fair payments. Register now.
Correction: Mohs vs. conventional excision: Reducing rates of BCC, SCC
In last week’s DermWorld Weekly, the lead article originally used the term “Mohs” rather than “Micrographic surgery.” The JEADV study evaluated multiple micrographic surgery techniques. DermWorld Weekly regrets the error. View the corrected article.
Advertisement
The American Academy of Dermatology is a non-profit professional organization and does not endorse companies or products. Advertising helps support our mission.
