Benefits and harms of 42 chronic urticaria interventions
Authors of a study published in the Journal of Allergy and Clinical Immunology assessed the comparative benefits and harms of systemic treatments for chronic urticaria.
Standard-dose omalizumab (300 mg every four weeks) and remibrutinib were found to be among the most effective for improving multiple patient-important outcomes, although the safety profile of remibrutinib is less certain. While dupilumab improved urticaria activity, the researchers found its impact on quality of life is uncertain and no dupilumab trials addressed angioedema.
[FDA approves remibrutinib for chronic spontaneous urticaria. Read more.]
Cyclosporine appeared to be among the most effective treatments for improving urticaria activity but was among the most harmful for frequency of adverse events. Outcomes may be improved with azathioprine, dapsone, hydroxychloroquine, mycophenolate, sulfasalazine, and vitamin D. Benralizumab, quilizumab, and tezepelumab may not be more effective than placebo, though the evidence was uncertain.
Understanding and treating chronic itch. Read more.
DermWorld Insights and Inquiries: The aryl hydrocarbon receptor — Tapinarof is taking off
Tapinarof (Vtama) is FDA-approved for psoriasis and atopic dermatitis (AD). Three years ago, I wrote a commentary about tapinarof discussing its potential use in AD. In 2019, I was excited to learn about the aryl hydrocarbon receptor (AHR) and how tapinarof could help treat psoriasis in a far more elegant way than crude coal tar. AHR is a crucial regulator in the pathogenesis of autoimmune disorders. Understanding its pathophysiology has led to new therapeutic agents such as tapinarof, which is approved for psoriasis and atopic dermatitis, and used off label in lupus, vitiligo, ichthyotic diseases, and perioral dermatitis. The therapeutic potential of this agent seems limitless. Keep reading!
Switching biologics in patients with psoriasis
Authors of a study published in the Journal of Dermatological Treatment examined the efficacy of intraclass (transitioning between different biologics within the same class, such as varying TNF-α, IL-17, IL-23, or IL-12/23 inhibitors) versus interclass (shifting to a biologic from a distinct class, such as moving from an IL-23 inhibitor to an IL-17A inhibitor) switching of biologic agents in patients with psoriasis to see which switching strategy is more effective.
[Do new psoriasis biologics have better safety profiles than adalimumab? Read more.]
After 12 weeks, the proportion of patients achieving PASI75 was significantly higher in the intraclass switching group compared to the interclass switching group. In the long term, both switching strategies are effective and safe, the authors noted. This study also showed that adalimumab, ixekizumab, and risankizumab are the preferred agents for intraclass switching, whereas guselkumab serves as the primary agent for interclass transitions.
Dermoscopic changes in acquired melanocytic nevi during and after pregnancy
Authors of a Brief Report published in JAAD aimed to quantify dermoscopic changes in melanocytic nevi during pregnancy and postpartum, with a control group of nonpregnant biological sisters.
[Dermatologists discuss the safety of common dermatologic drugs in pregnant patients. Read more.]
Pregnant women had significantly higher rates of dermoscopic changes (26.3% vs. 4.8%), including enlargement (11.2% vs. 0.8%), altered dots/globules (5% vs. 2.3%), darker pigmentation (8.8% vs. 0.6%), and lighter pigmentation (2.7% vs. 0.2%). The changes persisted postpartum in 89.7% of cases. Dermoscopic alterations in melanocytic nevi during pregnancy are common and occur irrespective of anatomical location, parity, nevus count, and skin phototype, the authors concluded.
Dermoscopic predictors of melanoma in small-diameter melanocytic lesions. Read more.
Final 2026 Medicare Physician Fee Schedule: Dermatology impact tables available
The Academy estimates that the overall impact on dermatology payment will be an increase of about 1-2% for office-based settings. However, individual outcomes may vary based on specific practice mix, service volume, and location. AADA staff are continuing to analyze the final rule and its total impact on dermatologists.
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