The development of new therapeutics for dermatologic conditions in recent years has been so prolific that Hensin Tsao, MD, PhD, used a “Maui Journal of Medicine” theme for his conference-opening presentation at the Maui Derm Hawaii 2025 meeting in Maui, Hawaii.
Dr. Tsao, Dr. Friedlander Recap Biggest Developments for Maui Derm
02/21/2025
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The development of new therapeutics for dermatologic conditions in recent years has been so prolific that Hensin Tsao, MD, PhD, adopted a “Maui Journal of Medicine” theme for his conference-opening presentation at the Maui Derm Hawaii 2025 meeting in Maui, Hawaii.
Following the traditional Hawaiian blessing and introduction from host program director George Martin, MD, Dr. Tsao and Sheila Fallon Friedlander, MD, presented “Dermatology in Review” to kick off the meeting.
“One of the biggest and most explosive areas of growth over the last 10 years has been the search for new drugs,” Dr. Tsao said.
Scalp Psoriasis
Dr. Tsao first touched on scalp psoriasis, noting that 40% to 90% of psoriasis patients have this difficult-to-treat type. He also highlighted research on tildrakizumab, an anti-IL-23 (p19) monoclonal antibody for psoriasis.1
“It’s effective and generally safe for scalp psoriasis,” he said, “which is good because, in general, scalp psoriasis has been difficult to treat.”
Dr. Tsao also spoke positively about the new oral IL-23 receptor peptide antagonist icotrokinra joining the family of oral peptide antagonists.2
“This is an exciting sort of new approach, getting away from injections,” he added.
Hidradenitis Suppurativa and CHE
Moving on to hidradenitis suppurativa (HS), Dr. Tsao highlighted bimekizumab, a dual IL-17A/F antibody shown to improve HS in a phase 2 study.3
Dr. Tsao referred to chronic hand eczema as “new frontier.”
“[It is] really quite challenging to treat, and here we’re looking into JAK inhibitors,” he said. “Topical steroid right now is the mainstay, but I think that’s moving away.”
In particular, he highlighted delgocitinib, a pan-JAK inhibitor formulated in a cream.4
“This is effective for moderate-to-severe chronic hand eczema,” Dr. Tsao said. “It is a cream, so we’re not expecting a large number of systemic side effects.”
Atopic Dermatitis and Skin Cancer
In atopic dermatitis, a new antibody targeting IL-13 worth noting is cendakimab, Dr. Tsao said, noting that there are only two FDA-approved IL-13 antibodies for treatment of atopic dermatitis (tralokinumab and lebrikizumab).
“Activation of this pathway is known to be a driver for atopic dermatitis,” he said.
Cendakimab has demonstrated significant benefits for moderate-to-severe atopic dermatitis,5 but Dr. Tsao cautioned that it is becoming important to differentiate which biologics perform better than others as more become available.
“The real question I raise with this one is: When does it become just another biologic inhibitor?” Dr. Tsao said.
Moving on to skin cancer, Dr. Tsao noted that advanced squamous cell carcinomas are a frequent cause of mortality in patients with kidney transplants. Cemiplimab for advanced squamous cell carcinoma had not been studied much, he pointed out, until recently.6
“This drug, in this sort of regimen […] can lead to some anti-SCC responses,” Dr. Tsao said. “Remember, most of these patients would have been dead with the advanced SCC. This was a pretty good advance in trying to tackle these patients.”
Public Response to Drugs
Dr. Tsao also discussed public response to drugs and accumulating strong data,7 the possibility of converting non-volar skin to pressure-responsive volar skin in ectopic dermatitis,8 detecting a “fingerprint in the blood” via liquid genome,9 and the promise of artificial intelligence (AI) for predictive purposes.10
“It’s the idea that they will get better and better and better,” Dr. Tsao said of AI. “We can use these to help educate your patients. And they’re good for event predictions. … [There is] a lot in your hands now that you can use to try to inform your patients of outcomes.
Pediatrics
Dr. Friedlander provided pediatric updates during her portion of the presentation. The most important article impacting the world of pediatric dermatology, she said, involved interfering with the natural course of chronic disease.
Two important articles she discussed involved reducing atopic march risk in atopic dermatitis patients prescribed dupilumab11 and evaluating dupilumab on the disease burden.12
She also stressed that while dupilumab has the most data, “if we were looking at JAK inhibitors, we might be seeing the same thing.”
“It appears to me that early intervention in atopic children may help,” she said.
Dr. Friedlander said the “big excitement drug” for both adolescents and adults is ritlecitinib, noting that it provides hope for patients with alopecia areata.13 She added, however, that clinicians need to reinforce to patients the importance of patience with this therapy.
“Data shows that up to a year, more and more patients respond, so I think it’s important not to give up early with ritlecitinib,” she said.
Dr. Friedlander also noted that several studies have shown that vaccinations are safe for patients on dupilumab.14
“You want to [make sure to] talk to families about it,” she added.
Dr. Friedlander wrapped her presentation talking about AI. The human element is still necessary, she said, but AI can be a useful tool. She noted that ChatGPT performs just as well as pediatric dermatologists on case-based questions, though not quite as well on board exam type questions.
“We are still winning, but by just a hair,” she said. “Do not take everything that ChatGPT tells you at face value. Double check. But it’s a great way to start differential diagnosis.” n
— by Jason Mazda
1. Gebauer K, et al. Efficacy and safety of tildrakizumab for the treatment of moderate-to-severe plaque psoriasis of the scalp: A multicenter, randomized, double-blind, placebo-controlled, Phase 3b study. J Am Acad Dermatol. 2024;91(1):91-99.
2. Bissonnette R, et al. An Oral Interleukin-23-Receptor Antagonist Peptide for Plaque Psoriasis. N Engl J Med. 2024;390(6):510-521. doi: 10.1056/NEJMoa2308713.
3. Kimball AB, et al. Efficacy and safety of bimekizumab in patients with moderate-to-severe hidradenitis suppurativa (BE HEARD I and BE HEARD II): two 48-week, randomised, double-blind, placebo-controlled, multicentre phase 3 trials. Lancet. 2024;403(10443):2504-2519. doi: 10.1016/S0140-6736(24)00101-6. Epub 2024 May 22.
4. Bissonnette R, et al. Efficacy and safety of delgocitinib cream in adults with moderate to severe chronic hand eczema (DELTA 1 and DELTA 2): results from multicentre, randomised, controlled, double-blind, phase 3 trials. Lancet. 2024;404(10451):461-473. doi: 10.1016/S0140-6736(24)01027-4. Epub 2024 Jul 18.
5. Blauvelt A, et al. Cendakimab in Patients With Moderate to Severe Atopic Dermatitis: A Randomized Clinical Trial. JAMA Dermatol. 2024;160(8):856–864. doi:10.1001/jamadermatol.2024.2131.
6. Hanna GJ, et al. Cemiplimab for Kidney Transplant Recipients With Advanced Cutaneous Squamous Cell Carcinoma. J Clin Oncol. 2024;42(9):1021-1030. doi: 10.1200/JCO.23.01498. Epub 2024 Jan 22.
7. Lee EY, et al. Oral Antibiotics and Risk of Serious Cutaneous Adverse Drug Reactions. JAMA. 2024;332(9):730-737. doi: 10.1001/jama.2024.11437.
8. Lee SS, et al. The use of ectopic volar fibroblasts to modify skin identity. Science. 2024 Sep 6;385(6713):eadi1650. doi: 10.1126/science.adi1650. Epub 2024 Sep 6.
9. Akaike T, et al. Circulating Tumor DNA Assay Detects Merkel Cell Carcinoma Recurrence, Disease Progression, and Minimal Residual Disease: Surveillance and Prognostic Implications. J Clin Oncol. 2024;42(26):3151-3161. doi: 10.1200/JCO.23.02054. Epub 2024 Jul 25.
10. Varey AHR, et al. Predicting Recurrence-Free and Overall Survival for Patients With Stage II Melanoma: The MIA Calculator. J Clin Oncol. 2024;42(10):1169-1180. doi: 10.1200/JCO.23.01020. Epub 2024 Feb 5.
11. Lin TL, et al. Reduced atopic march risk in pediatric atopic dermatitis patients prescribed dupilumab versus conventional immunomodulatory therapy: A population-based cohort study. J Am Acad Dermatol. 2024;91(3):466-473. doi: 10.1016/j.jaad.2024.05.029. Epub 2024 Jun 14.
12. Tsai SY, et al. Evaluation of dupilumab on the disease burden in children and adolescents with atopic dermatitis: A population-based cohort study. Allergy. 2024;79(10):2748-2758. doi: 10.1111/all.16265. Epub 2024 Aug 21.
13. King B, et al. Efficacy and safety of ritlecitinib in adults and adolescents with alopecia areata: a randomised, double-blind, multicentre, phase 2b-3 trial. Lancet. 2023 May 6;401(10387):1518-1529. doi: 10.1016/S0140-6736(23)00222-2. Epub 2023 Apr 14.
14. Lieberman JA, et al. A systematic review and expert Delphi Consensus recommendation on the use of vaccines in patients receiving dupilumab: A position paper of the American College of Allergy, Asthma and Immunology. Ann Allergy Asthma Immunol. 2024;133(3):286-294. doi: 10.1016/j.anai.2024.05.014. Epub 2024 Jun 5.
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