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Allison Sit

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.

Mar 27
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Acne Treatment Advances: ODAC Video Interview

By Uncategorized

acne treatment advances

In a Next Steps in Derm video interview conducted in partnership with the ODAC Dermatology Conference, Hilary Baldwin, MD, FAAD, reviews the latest acne treatment advances, including emerging acne treatments and research breakthroughs. New studies highlight two innovative options: a triple combination topical therapy and the first new acne molecule introduced in 40 years, both designed to target the four key pillars of acne pathophysiology.

In the video, Dr. Baldwin also discusses the benefits of the oral antibiotic sarecycline, which can help patients achieve clearer skin while having a lower impact on the gut microbiome. In addition, she previews promising therapies in development, including a freshwater sponge–derived treatment, a fascin inhibitor, and a therapeutic acne vaccine.

Watch and gain insight into acne treatment advances that may change the future of acne care.

Mar 19
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Hedgehog Inhibitors for Advanced Basal Cell Carcinoma

By Surgical Dermatology

hedgehog inhibitors for advanced basal cell carcinoma

At the 2026 ODAC Conference, an expert panel led by Vishal A. Patel, MD, FACMS, and C. William Hanke, MD, MPH, FAAD, reviewed evolving strategies for hedgehog pathway inhibitors (HHIs) in advanced basal cell carcinoma (BCC), emphasizing practical clinical decision-making.

The discussion highlighted the two FDA-approved HHIs: vismodegib (approved in 2012 following the ERIVANCE trial) and sonidegib (approved in 2015 based on the BOLT trial). Reported objective response rates were 47% for vismodegib and 56.1% for sonidegib, with median durations of response of 9.5 months and 26 months, respectively. While cross-trial comparisons are limited, both agents demonstrated meaningful disease control and durable responses with continued therapy.

HHIs offer significant tumor shrinkage and may allow retreatment, but they are not typically curative. Common class-related adverse effects—including muscle cramps, dysgeusia, alopecia, and gastrointestinal symptoms—are usually low grade yet chronic, often affecting quality of life and adherence. Sonidegib’s longer half-life (28–30 days) compared with vismodegib (4–12 days) may influence toxicity duration and management decisions.

Clinically, HHIs are best used selectively:

  • As primary therapy for unresectable or inoperable BCC
  • As neoadjuvant therapy to reduce tumor burden before surgery or radiation
  • As bridge therapy to optimize cosmetic or functional outcomes

Even without complete tumor eradication, many patients achieve meaningful functional and cosmetic improvement. Ultimately, successful use of hedgehog inhibitors for advanced basal cell carcinoma depends on careful patient selection, proactive management of adverse effects, and thoughtful integration with surgery, radiation, and immunotherapy—expanding dermatologists’ options beyond surgical management alone.

This session summary was written by Dr. Erica Lin and published on Next Steps in Derm.

Mar 11
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Skin Side Effects of GLP-1s: JDD Buzz

By Medical Dermatology

GLP-1 skin side effects

GLP-1 receptor agonists are widely used for type 2 diabetes and weight loss. Their growing use has increased the likelihood that dermatologists will encounter related skin concerns.

A recent analysis of the FDA Adverse Event Reporting System examined reported skin side effects of GLP-1s. The study, which was published in the Journal of Drugs in Dermatology, identified a broad range of dermatologic events. The most frequently reported were pruritus, nonspecific rash, injection-site reactions, urticaria, and alopecia. Hair loss was a particularly notable finding, as it is not widely recognized as a potential effect. Reports of hypersensitivity reactions, including urticaria and rare severe reactions, also suggest a possible immune-mediated component, according to one of the study’s authors, who elaborated on the findings in a Next Steps in Derm interview.

Skin side effects of GLP-1s were reported more often among patients using GLP-1s for weight loss, possibly reflecting higher doses, rapid weight changes, or increased reporting. While some variation in reporting existed among individual agents, the data cannot determine true comparative risk.

Because FAERS is a passive reporting system, the findings show associations rather than causation and likely underestimate true incidence. Overall, GLP-1 therapies remain safe and effective, but dermatologic reactions may be underrecognized.

The key takeaway for clinicians is to consider GLP-1 therapy as a potential contributing factor when evaluating new or unexplained skin findings and to counsel patients accordingly as use of these medications continues to expand.

Mar 03
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New PDT Devices: ODAC Video Interview

By Video Pearls

new PDT devices

Photodynamic therapy (PDT) has a long history as a treatment option in dermatology, yet the modality may be on the cusp of a renaissance. Emerging technologies are entering the market. In this Next Steps in Derm video interview, Dr. Neal Bhatia outlines how these innovations enhance the patient experience, including reducing claustrophobia and treatment time. In addition, he shares how the devices increase PDT effectiveness, especially when treating the extremities.

If you’re not already offering PDT, you may want to reconsider once you watch this interview. Dr. Bhatia says these new devices make incorporating PDT easier. Watch as he shares his expertise on the best ways to schedule PDT as well as how long to let ALA sit on the skin for maximum benefit.

Feb 23
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Dermatologic Effects of Vaping: From the ODAC Poster Hall

By Medical Dermatology

dermatologic effects of vaping

Electronic cigarette use is increasing in the U.S., rising from 4.5% in 2019 to 6.5% in 2023. Although often perceived as safer than traditional smoking, vaping exposes users to carcinogens, volatile compounds, and heavy metals, and its long-term health effects are not fully known. A scoping review presented as a poster at ODAC examines the dermatologic and oral health impacts of vaping.

In an interview with Next Steps in Derm, poster author Julianna Gregory, BSN, shares that the most common findings involved the face and oral cavity. Patients developed persistent oral ulcerations that often improved only after stopping vaping. Facial effects included irritant and allergic contact dermatitis of the lips, perioral skin, cheeks, and eyelids, sometimes linked to metal allergens such as nickel from device components. Vaping was also reported to exacerbate inflammatory and autoimmune skin diseases, including discoid lupus.

Beyond the face, vaping was associated with urticaria and diffuse inflammatory eruptions on the trunk and extremities, suggesting systemic immune activation. Hand dermatitis was also reported due to repeated contact with devices and e-liquid residue. A case of post-surgical free flap compromise highlighted potential vasoconstrictive effects of vaping and raised concerns about impaired wound healing, similar to traditional smoking.

Importantly, dermatologic reactions were reported even with nicotine-free products, indicating that other constituents—such as flavorings, propylene glycol, glycerin, thermal byproducts, and device-derived materials—can act as irritants, allergens, or immune triggers.

Clinicians should routinely ask about vaping as part of the dermatologic history, consider it in unexplained or treatment-resistant conditions (especially involving the face, hands, or oral mucosa), and counsel patients on cessation, including in perioperative settings. The findings also highlight the need for better documentation of vaping behaviors and greater awareness of its potential cutaneous risks.

Feb 17
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AD and Regional Eczemas: ODAC in the News

By ODAC Sessions

AD and regional eczemas

At the ODAC Dermatology Conference, Peter Lio, MD, FAAD, shared an updated, patient-centered overview of atopic dermatitis (AD) and regional eczemas, integrating emerging science with real-world clinical strategies.

As noted in an article by The Dermatology Digest, Dr. Lio emphasized AD and regional eczemas are self-perpetuating disorders involving the skin barrier, immune system, microbiome, and sensory nerves. He outlined the epithelial barrier hypothesis and the concept of epicutaneous sensitization. Early, proactive intervention was framed as essential to preventing chronic inflammation, infections, and subsequent disease.

On therapy, Dr. Lio reviewed the expanding role of non-steroidal topical agents, noting their usefulness in sensitive areas and for patients who want a non-steroidal option. He also reinforced the value of adjunctive strategies such as wet wrap therapy. For systemic treatment, he discussed biologics and oral JAK inhibitors, highlighting evidence that dupilumab can uniquely improve the skin microbiome in moderate-to-severe AD. Shared decision-making was a central theme, with Dr. Lio presenting his ESTAR framework to help align treatment choices with patient priorities, and sharing the importance of written action plans.

Finally, Dr. Lio addressed topical steroid withdrawal as a legitimate and evolving diagnosis. He noted that formal diagnostic criteria are forthcoming, signaling progress toward clearer guidance for clinicians.

Feb 13
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Evaluating Skin Findings of Systemic Disease

By ODAC Sessions

skin findings of systemic disease

At the 2026 ODAC Dermatology Conference, attendees had the opportunity to learn about evaluating skin findings of systemic disease from Olayemi Sokumbi, MD, FAAD, professor of dermatology and laboratory medicine & pathology at Mayo Clinic. Dr. Sokumbi shared her expertise about evaluating skin findings that may occur in the context of systemic illness, emphasizing a structured derm-dermpath approach. Through two illustrative cases, she demonstrated how the skin serves as an early window to systemic disease and how clinicopathologic correlation (CPC) is integral to establishing the correct diagnosis.

Case 1:

Dr. Sokumbi described a gentleman in his 50s who presented with skin-colored papules on the ears accompanied by joint pains. The presence of concurrent systemic symptoms raised suspicion for an underlying systemic process, prompting a skin biopsy. Histopathology revealed foamy xanthomatous histiocytes, suggesting a non-Langerhans cell histiocytosis with inflammatory arthritis such as Erdheim-Chester disease (EDC). However, at least half of cases of EDC cases demonstrate a BRAF V600E mutation.1 Staining of this skin biopsy was negative for this mutation, prompting Dr. Sokumbi to return to the bedside and broaden the differential diagnosis. Subsequent physical examination revealed periungual papules and nodules, in a characteristic “coral beading” pattern, leading to the diagnosis of multicentric reticulohistiocytosis (MRH), a condition also associated with severe polyarthritis. The histopathologic pitfall requiring CPC was the presence of xanthomatized histiocytes, which are typical for EDC and underrecognized in MRH due to the rarity of this finding. Accurate diagnosis carries significant clinical implications, as MRH has a strong association with solid organ malignancy and requires therapeutic approaches distinct from those used in EDC.

Case 2:

Dr. Sokumbi presented the case of a young lady with diffuse cutaneous hyperpigmentation, which multiple providers had attributed to dermatoheliosis or photoaging. She highlighted, however, key photoprotected areas, such as the conchal bowls of the ears, also demonstrated blue-gray discoloration. The clinical differential diagnoses included lichen planus pigmentosus and argyria, yet the characteristic histopathologic features of these entities were not present on skin biopsy.

Instead, histologic examination revealed wavy deposits within the dermis that stained basophilic on Hematoxylin and Eosin and blue-black with Verhoeff Van Gieson (VVG) staining. Basophilic collagen fibers and altered deposits of elastic fibers have been reported as early-stage findings of ochronosis,3 in contrast to the classic late-stage yellow-brown banana-shaped collagen fibers. Based on these findings the patient was diagnosed with endogenous ochronosis/alkaptounuria, a genodermatosis characterized by impaired breakdown of tyrosine and phenylalanine.

In conclusion, Dr. Sokumbi emphasized how dermatologists are often uniquely positioned to diagnose systemic disease through careful evaluation of skin findings. Both cases underscored the importance of CPC. She encouraged repeating skin biopsies when the leading diagnosis remains unclear and collaborating with colleagues across specialties to ensure comprehensive management of systemic disease.

This session summary was written by Nagasai Adusumilli, MD, MBA, chief resident physician in dermatology at the George Washington University School of Medicine and Health Sciences.

References

  1. Haroche J, Cohen-Aubart F, Emile JF, et al. Reproducible and sustained efficacy of targeted therapy with vemurafenib in patients with BRAF(V600E)-mutated Erdheim-Chester disease. J Clin Oncol. 2015 Feb 10;33(5):411-8. PMID: 25422482.
  2. Camargo K, Pinkston O, Abril A, Sluzevich JC. Xanthomatous multicentric reticulohistiocytosis: an underrecognized variant. J Clin Rheumatol. 2018 Aug;24(5):285-287. PMID: 29239933.
  3. Chowdary S, Mahalingam M, Vashi NA. Reading between the layers: early histopathological findings in exogenous ochronosis. Am J Dermatopathol. 2014 Dec;36(12):989-91.PMID: 25415140.
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