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Allison Sit

Jun 04
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Recognizing and Treating Cutaneous Lupus and Dermatomyositis

By ODAC Sessions

autoimmune connective tissue disorders

At the ODAC Dermatology Conference, Anthony Fernandez, MD, PhD, FAAD, shared his experience in autoimmune connective tissue disorders, highlighting the intersection between dermatology and rheumatology, and underscoring the importance of practical approaches in complex diseases.

Cutaneous Lupus

Dr. Fernandez began his session by addressing cutaneous lupus, stressing the need to recognize lesion patterns. “If you become familiar with the morphology of the skin lesions and the pattern of distribution, you should be able to recognize lupus and dermatomyositis.”

Regarding acute cutaneous lupus, he noted that, “All of these patients have systemic lupus erythematosus (SLE), so [they] are going to have a positive ANA and usually numerous positive anti-ENA antibodies.” However, he also cautioned, “Not every patient has a classic butterfly rash, so you need to look at the entire clinical picture.”

For subacute cutaneous lupus (SCLE), he emphasized photosensitivity. “Annular scaly lesions or psoriasiform lesions in a photo-distribution are a hallmark. About 25-40% of these patients may develop SCLE because of a medication they’re taking, so you need to perform a good medication history upon diagnosis.”

Chronic cutaneous lupus, particularly discoid lupus (DLE), carries unique implications. “A negative ANA does not rule out cutaneous lupus, especially with discoid lesions,” he stressed. “Patients with generalized discoid lupus, meaning they have lesions both above and below the neck, are at increased risk for progressing to SLE compared to patients with DLE lesions only above the neck.”

Dr. Fernandez advised antimalarials, hydroxychloroquine, and chloroquine as first-line systemic treatments for cutaneous lupus. “If a patient fails the first antimalarial, there is research supporting that switching to the alternative antimalarial may be effective in a significant percentage of cases.”

Dermatomyositis

Turning to dermatomyositis, Dr. Fernandez highlighted hallmark cutaneous features: heliotrope rash, Gottron’s papules, shawl sign, V-neck sign, and holster sign. He noted that any combination of these features may occur in patients with dermatomyositis, and cautioned about MDA5-positive disease. “These patients often present with skin lesions due to vasculopathy. There is a very strong risk of interstitial lung disease (ILD). Some may have a rapidly progressive ILD phenotype, which can be life-threatening despite aggressive treatment.”

For diagnosis, he recommended combining clinical and objective data. “You need to correlate what you see clinically with some objective data, mainly a lesional skin biopsy with histopathologic characteristics consistent with lupus or dermatomyositis.” He also advised autoantibody testing. “For dermatomyositis, myositis-specific autoantibodies correlate with clinical phenotype, so they have tremendous value in terms of how you test, monitor, and treat these patients.”

For treatment, Dr. Fernandez recommended typically starting with corticosteroids plus a steroid-sparing agent. “If patients fail traditional agents, IVIG is far and away the best medicine we currently have for treating the skin, myositis, or both.”

Looking ahead, he concluded with excitement about emerging therapies. “Oral JAK inhibitors, anti-interferon receptor monoclonal antibodies, and anti-interferon-beta monoclonal antibodies may be the first truly novel medicines that get approved for dermatomyositis in decades, depending upon results of ongoing phase 3 trials.” He conveyed to attendees, “Once you make a diagnosis, we currently have good medicines to offer, but the real excitement is what’s in the pipeline right now.”

This information was presented at the 2026 ODAC conference by Anthony Fernandez, MD, PhD, FAAD. The above highlights from this lecture were written and compiled by Samip Sheth, MD.

May 29
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Acral Dermoscopy: ODAC in the News

By Media Coverage, Uncategorized

acral dermoscopy

The challenge of diagnosing acral lesions—those found on the palms and soles—is a familiar one for even the most seasoned dermatologists. Because these areas follow a unique set of “rules” compared to the rest of the body, clinical confidence is paramount to avoiding unnecessary biopsies while catching early-stage melanomas.

The Dermatology Digest highlights an ODAC session on the topic presented by Jennifer Stein, MD, PhD, FAAD, professor and associate vice chair at the NYU Grossman School of Medicine. The article outlines Dr. Stein’s actionable, everyday strategies, including:

  • The Golden Rule: “Furrows are Fine, Ridges are Risky”
  • Acquired Acral Three-Step Algorithm
  • The BRAAFF Algorithm

In the article, Dr. Stein also shares some considerations in patients with darker skin types:

  • Most algorithms may not perfectly translate to patients with darker skin tones.
  • In Fitzpatrick Skin Types V and VI, clinicians may encounter physiologic volar melanocytic macules that display parallel ridge patterns but are entirely benign. While these findings are common in skin of color, Dr. Stein cautioned that the “index of suspicion” must remain high to ensure acral melanoma isn’t overlooked.

Evaluating the nail unit presents its own set of hurdles, as the pigment often originates in the difficult-to-biopsy nail matrix. Dr. Stein breaks down the evaluation into two categories:

  • Non-melanocytic: Before suspecting a tumor, rule out fungal infections (look for a “reverse triangle” pattern) and subungual hemorrhages (look for red-to-black spots with filamentous edges).
  • Melanocytic: Benign ethnic melanonychia often presents with gray, homogeneous lines. However, the “Ugly Duckling” concept is your best friend here. Look for outliers: bands that are wider at the base, involve multiple colors, or cause nail plate destruction.

Dermoscopy is an invaluable tool, but it works best when paired with clinical intuition. By mastering the distinction between furrows and ridges and remaining mindful of how these patterns shift across different skin types, clinicians can provide more accurate, confident care for their patients.

Read the original article posted to The Dermatology Digest.

May 21
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Psoriasis and Psoriatic Arthritis in Patients With Skin of Color

By Video Pearls

psoriasis and psoriatic arthritis in patients with skin of color

In a video interview at our sister conference, Skin of Color Update, Mona Shahriari, MD, FAAD, encouraged dermatology clinicians to broaden the psoriasis color palette. She says recognizing the skin tone differences in the presentation of psoriasis can improve diagnosis and care. Dr. Shahriari is associate clinical professor of dermatology at Yale University School of Medicine.

Watch as she shares:

  • The role of biopsy when diagnosing psoriasis in skin of color
  • Challenges in diagnosing psoriatic arthritis in patients with darker skin tones
  • Latest research in treating scalp psoriasis
  • Pigmentary sequelae and the quality of life impact

If you’re committed to providing quality psoriasis care for all of your patients, this is a must-view video.

May 13
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Topical Nonsteroidal Therapies for Atopic Dermatitis

By Patient Care

topical nonsteroidal therapies

A new consensus in the Journal of Drugs in Dermatology recommends advanced nonsteroidal topicals — topical JAK inhibitors, aryl hydrocarbon receptor agonists, and PDE‑4 inhibitors — as frontline therapy for AD over traditional topical corticosteroids.

In an interview with Next Steps in Derm, author Christopher Bunick, MD, PhD, shares the panel’s evidence‑based process, graded recommendations, and practical implications for clinic.

Why this matters:

  • These agents offer improved efficacy and safety vs. steroids, especially on thin or sensitive skin (face, folds, genitalia).
  • They better control itch, inflammation, and barrier dysfunction — translating to real gains in sleep and quality of life.
  • Their safety profile supports longer‑term use and easier patient adherence.
  • The consensus provides actionable guidance on where nonsteroidal topicals fit alongside biologics and small molecules.

This interview is a must‑read to update your treatment algorithms and patient counseling.

May 05
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A Dermatology & Dermatopathology Approach to Systemic Disease

By ODAC Sessions

clinicopathologic correlation

At ODAC, Olayemi Sokumbi, MD, FAAD, delivered a masterclass in clinicopathologic correlation — a timely reminder that careful clinicopathologic thinking changes diagnoses, management, and outcomes. Through two cases, Dr. Sokumbi outlined how clinicopathologic correlation is a clinical imperative:

  • Case 1: Flesh‑colored papules initially called “skin tags” were reclassified as multicentric reticulohistiocytosis after integrating distribution, clinical course (periungual/hand involvement, inflammatory arthritis), and histology — a diagnosis with major implications for arthritis management and malignancy screening.
  • Case 2: Subtle, diffuse skin discoloration with otherwise non‑diagnostic biopsies was clarified by elastic tissue stain to be ochronosis due to alkaptonuria, prompting genetic and systemic workup.

These cases illustrate how dermatologists and dermatopathologists can be the first to uncover multisystem disease and steer timely, life‑altering care.

Practical reminders: Don’t be afraid to re‑biopsy, use targeted IHC and special stains, and maintain close dermatopathology collaboration. Persistence and multidisciplinary care are often the key.

Apr 27
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Skin Rejuvenation With Microtoxin: From the ODAC Poster Hall

By Aesthetic Dermatology

microtoxin

Microtoxin is shifting how we approach skin rejuvenation — not by paralyzing muscle, but by improving the skin itself. At ODAC, a retrospective chart review presented by Carolyn Duong, BS (Kansas City University), found that superficially placed, highly diluted botulinum toxin produced meaningful gains in texture, pore size, sebum control, reduced erythema, and refinement of shallow scars — all while preserving natural facial movement.

How does it differ from traditional neuromodulators? Microtoxin is delivered as many small intradermal injections across the face to influence sebaceous/eccrine glands, arrector pili, fibroblast signaling, and neurovascular pathways rather than targeting skeletal muscle. The result is diffuse skin quality improvement rather than focal muscle weakening.

Clinical takeaway: Microtoxin is a valuable complementary tool for diffuse skin concerns (texture, oiliness, mild erythema, superficial scars) but is not a replacement for fillers, lasers, or surgery for deep wrinkles, volume loss, or advanced laxity. Technique standardization and careful patient selection are essential.

Apr 20
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Advances in UV Filters, Blue Light Defense, & Beyond

By ODAC Sessions

sun protection

At ODAC, Misty Eleryan, MD, MS, FACMS, delivered a timely roadmap for Sun Protection 2.0 — reframing photoprotection beyond UV and into visible/infrared damage, formulation science, and personalized strategies.

Key takeaways:

  • Photodamage spans UVA/UVB, visible light, and infrared — explaining why some patients still photoage despite diligent sunscreen use.
  • White cast from mineral sunscreens undermines adherence; improving texture and cosmetic elegance is a public-health priority.
  • Innovation is underway: nanotechnology for photostability and reduced absorption, antioxidants (vitamins C/E) to neutralize reactive oxygen species, sunscreen “boosters,” and potential biotech discovery of novel UV filters.
  • Regulatory reality: no new US filters since 1999. The 2025 SAFE Sunscreen Standards Act may finally accelerate safe, globally informed approvals.
  • Emerging tools: wearable UV sensors, topical cannabidiol research, and oral photoprotective supplements like polypodium.

Practical message: Sunscreen remains the foundation, but photoprotection must be multifaceted, involving product choice, behavior, nutrition, and emerging tech. Dermatologists should lead these conversations to improve adherence and outcomes.

Read the full session summary written by Milaan Shah, MD, to explore formulation advances, policy shifts, and actionable counseling tips you can use with patients today.

Apr 14
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Reddit Eczema vs. AAD Guidelines: JDD Buzz

By Medical Dermatology

Reddit eczema

When patients tell you they “Googled it” or turned to Reddit, it’s tempting to sigh. However, these forums are where many patients first learn about their skin condition. A new JDD study compared top posts from r/eczema with the latest AAD atopic dermatitis guidelines and the results are both sobering and useful for clinicians.

Highlights:

  • Posts with more misinformation tended to diverge from guideline recommendations, yet many attracted high engagement.
  • Higher upvote percentages correlated with greater guideline alignment — community signals can help surface evidence-consistent advice.
  • Readability did not predict accuracy: clear writing isn’t always correct.

Importantly, r/eczema also offers peer support, exposure to emerging therapies, and practical tips that can empower patients. For clinicians, that’s an opportunity: Learn the narratives patients encounter, proactively address misconceptions, and tailor education to individual needs.

Rather than dismissing patient-sourced knowledge, use it to strengthen communication, build trust, and improve shared decision-making. Read a Next Steps in Derm commentary with one of the study’s authors to explore the study’s methods, findings, and practical strategies for bridging clinic care with online patient communities.

Apr 08
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Rethinking Prurigo Nodularis: ODAC Session Summary

By ODAC Sessions

prurigo nodularis

At ODAC 2026, Adam Friedman, MD, FAAD, shared a prurigo nodularis (PN) case that might feel familiar: multiple nodules, relentless itch, one question — why? His message: PN is not merely scratching or a bystander to other dermatoses. It’s a distinct neuroimmune disorder with systemic implications, and overlap does not mean sameness.

PN is sustained by a maladaptive neuroimmune loop: IL‑31 drives itch via sensory neurons, periostin amplifies neural signaling and keratinocyte inflammation, and chronic scratching remodels skin and nerves. Clinically this maps to two meaningful subtypes — inflammatory‑predominant and neuropathic‑predominant — which helps explain variable responses to therapy.

Management goals are simple: reduce itch, interrupt the itch‑scratch cycle, and heal lesions. Tools span topical agents (emerging data for ruxolitinib), neural modulators (gabapentin, pregabalin, mirtazapine), adjuncts like PEA, targeted biologics (nemolizumab), and evolving JAK inhibitors. Expectation setting is key: control, not cure, and “stay on to stay clear” for many patients.

PN often coexists with systemic disease and lifestyle factors that compound burden and reduce quality of life. As mechanism‑driven therapies expand, identifying phenotype and personalizing combinations will improve outcomes.

Read the full session summary, written by Tammy Gonzalez, MD, PhD, to dive into Dr. Friedman’s practical framework and therapeutic insights.

Apr 02
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Behind the Bottle Part Deux: JDD Podcast LIVE

By Medical Dermatology

sensitive skin

If you were at ODAC 2026, you already felt the electricity in the room — and now the JDD Podcast is capturing that energy. For its milestone 100th episode, the JDD Podcast returns with Part 2 of “Behind the Bottle,” hosted by Adam Friedman, MD, FAAD, and recorded live in front of ODAC attendees. Building on the first installment with Peter A. Lio, MD, FAAD, this episode pulls back the curtain again on how clinicians can thoughtfully navigate the ever-expanding OTC universe.

Why this episode matters:

  • Two timely, frequently misunderstood conditions take center stage: sensitive skin syndrome and dermatoporosis. Both are becoming increasingly common in clinical practice and yet are often misunderstood.
  • The conversation is practical and evidence-driven. Dr. Friedman and Dr. Lio dissect the underlying biology, clinical presentation, and real-world management challenges clinicians face when recommending products or designing care plans.
  • It’s the JDD Podcast you know — a smart mix of preclinical and clinical data, pragmatic pearls you can use on Monday morning, and Dr. Friedman’s signature wit.

What you’ll take away

  • Clear frameworks for recognizing and diagnosing sensitive skin syndrome — a state of cutaneous hyperreactivity marked by stinging, burning, and barrier dysfunction — so you can separate subjective complaints from objective disease and tailor recommendations accordingly.
  • Practical approaches to managing dermatoporosis (yes, the “osteoporosis of the skin”) — from identifying at-risk patients to minimizing fragility, tearing, and impaired wound healing in an aging population.

This episode is essential listening for dermatologists, dermatology trainees, advanced practice providers, and any clinician who wants to make smarter, more confident product recommendations and care decisions — especially those treating older adults or patients with reactive skin.

The episode is available now on the JDD Podcast feed and wherever you get your podcasts. Listen, subscribe, and share with colleagues who could use a clearer roadmap for sensitive skin and dermatoporosis.

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