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Medical Dermatology

Jul 07
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Prurigo Nodularis: How to Treat

By Medical Dermatology

prurigo nodularis

With two FDA-approved therapies now available, it’s hard to believe that prurigo nodularis (PN) was only recently considered a unique dermatologic condition. In this Next Steps in Derm video interview, in partnership with the ODAC Dermatology Conference, ODAC Conference Co-Chair Adam Friedman, MD, FAAD, shares both the history and current state of PN treatment. Watch and learn if using dupilumab or nemolizumab is a slam dunk or if combination therapy may be needed for full clearance. Learn if there’s still a role for topical therapies in the age of systemics. Plus find out what’s coming down the PN pipeline.

Further Reading

If you want to read more about prurigo nodularis, check out the following articles published in the Journal of Drugs in Dermatology:

New Horizons in Our Understanding of Prurigo Nodularis and Its Management

ABSTRACT

Prurigo nodularis (PN) was first accurately described more than a century ago by Hyde and Montgomery as chronic itchy nodules commonly noted in symmetric distribution on extensor sites of limbs, upper back, and abdomen.1 For decades PN patients were among the most challenging to treat as they suffer from intractable itch that affects their sleep dominates their daily life activities and causes many psychological comorbidities such as mood disorders including anxiety, stress, and depression. In the last decade, significant advances in our understanding of the pathophysiology of PN have been achieved suggesting this condition involves mainly type 2 immune dysregulation and abnormal neural sensitization, which led to the development of new targeted treatments.

Management of Prurigo Nodularis

ABSTRACT

Background: Prurigo nodularis (PN) is a chronic disease characterized by intense pruritus and nodular lesions associated with reduced quality of life. Until recently, no US Food and Drug Administration (FDA)-approved therapies have been available for the management of PN. Treatment regimens have been highly variable and clinical management guidelines are lacking overall; formal treatment guidelines do not exist within the US. In 2022, dupilumab became the first FDA-approved medication for PN. Multiple novel agents that target the neuroimmune underpinnings of the disease are currently in development and show promise for this challenging disorder.

Objective: To review current treatments and emerging therapies for effective management of patients with PN.

Methods: We reviewed publications on PN management identified from PubMed, Embase, Web of Science, and the Cochrane Library. We also included publicly available data on clinical trials for PN therapies reported on the US National Library of Medicine ClinicalTrials.gov, the International Conference on Harmonisation-Good Clinical Practice (ICH-GCP) Database, and the European Clinical Trials (EudraCT) Database.

Results: The recommended management of PN begins with an assessment of disease severity, including disease burden and pruritus intensity, and evaluation of comorbid medical disorders. Treatment goals include resolution of itch, improvement in nodules or cutaneous lesions, and improvement in quality of life. Therapies should be selected based on a patient’s clinical presentation and comorbidities. Treatment should simultaneously address the neural and immunologic components of PN. Combination therapy, particularly with conventional agents, may be beneficial.

Limitations: Data on most conventional PN treatments are limited to anecdotal reports, small clinical trials, or expert consensus recommendations. No head-to-head comparative trials have evaluated the relative efficacy of conventional and/or emerging agents, or combination therapy.

Conclusion: An effective treatment approach for patients with PN should reduce pruritus, allow nodular lesions to heal, and improve individual quality of life. The treatment landscape for PN is rapidly evolving with one FDA-approved agent and several new promising therapies on the horizon.

Did you enjoy this video interview? Find more here.

Jun 16
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Atopic Dermatitis and Mental Health: Patient Buzz

By Medical Dermatology

atopic dermatitis and mental health

Dermatologists are experts at treating what is visible. But as highlighted in a recent article by Everyday Health, there is an “invisible burden” of atopic dermatitis (AD) that cannot be seen on the skin’s surface: the profound toll it takes on a patient’s mental health.

Because AD is a psychophysiological disorder, psychological stress actually triggers inflammation that worsens flares, creating a frustrating, vicious cycle. Chronic itch and sleep disturbances quickly compound this distress, frequently leading to anxiety, depression, and irritability.

Yet a major gap remains in patient care. Patients often hesitate to bring up their mental health during an office visit, and many dermatologists feel unequipped or too pressed for time to broach the topic.

To bridge this gap, read this Next Steps in Derm interview with Mohammad Jafferany, MD, DFAPA, MCPS, a professor of psychodermatology, psychiatry, and behavioral sciences. He shares practical, clinical insights that every dermatologist can implement today. From understanding the bidirectional connection to normalizing the mental health.

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 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 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.

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.

Dec 02
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Incorporating Acneceuticals: JDD Podcast

By Medical Dermatology

acneceuticals

Acneceuticals are a new category of acne products on the market. These are over-the-counter actives that can be used on their own or as adjunctive therapies to keep acne-prone skin clear.

In this JDD Podcast, host and ODAC Conference Co-Chair Adam Friedman, MD, FAAD, is joined by acne researcher Hilary Baldwin, MD, FAAD, to share highlights from her latest Journal of Drugs in Dermatology supplement on the real-world use of acneceuticals. Listen as they share an algorithm that guides product picks and delve into skincare science for acne. Hear clinical pearls and find out why, when treating acne, you may want to give a second glance at the skin care aisle.

In addition to her credibility as a researcher, Dr. Baldwin is also known for her engaging lectures chock-full of practical guidance. Register for ODAC and attend Dr. Baldwin’s medical dermatology sessions:

  • The 2025 Acne Treatment Landscape: Prescription, OTC, and Adjunctive Therapies
  • Integrating Cosmeceuticals With Prescription Therapies for Barrier Repair
  • Treating Keloids With Confidence: Evidence-Based Approaches for Dermatologists

Episodes of the JDD Podcast are available on iTunes, Spotify, Stitcher and TuneIn.

 

Nov 05
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Improve Quality of Life in Patients With Hyperhidrosis

By Medical Dermatology

hyperhidrosis

Hyperhidrosis affects nearly 400 million people worldwide, yet it’s often misunderstood and underdiagnosed. In fact, 27% of adults never receive a diagnosis, according to the International Hyperhidrosis Society. The condition greatly impacts a person’s quality of life: People with excessive sweating face nearly three times the risk of anxiety and depression.

November is Hyperhidrosis Awareness Month. Let’s bring excessive sweating out of hiding and help people find understanding and treatment.

Join us for the ODAC Pre-Conference Virtual Symposium on Tuesday, November 11, where dermatologist Dr. Angela Lamb will share strategies and new tools to improve quality of life in patients with excessive sweating. You’ll also experience case-based sessions on chronic itch, hidradenitis suppurativa, and pediatric alopecia areata. Registration is complimentary – plus you can earn CME!

We hope to see you at this interactive event that’s sure to provide you with practical takeaways you can immediately apply in clinic.

Improve your knowledge and provide hyperhidrosis patients with hope and healing.

Oct 07
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Patient Buzz: Eczema & Mental Health

By Medical Dermatology

eczema and mental health

In recognition of October as Eczema Awareness Month, we consider the mental health implications of eczema. In this Next Steps in Derm Patient Buzz, dermatologist and clinical psychologist Richard Fried, MD, PhD, shares what clinicians should know about eczema’s mental health impact.

Learn what mental health symptoms are common in eczema patients and how to broach the subject in your patient interactions. Find out how Dr. Fried directs his patients who are looking for help in improving their eczema-related mental health. 

Register for ODAC 2026 for the latest guidance in treating eczema and other inflammatory skin conditions.

Sep 23
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Secukinumab Therapeutic Cheat Sheet

By Medical Dermatology

secukinumab

ODAC shares practical, clinically relevant updates in medical dermatology. Our partner Next Steps in Derm shares this new cheat sheet for prescribing and managing patients on secukinumab.

Learn secukinumab’s mechanism of action and dermatologic uses. Know side effects, and warnings and precautions. Plus find out what baseline lab monitoring you should order.

The Secukinumab Therapeutic Cheat Sheet is available online and in a downloadable and printable PDF.

Register for ODAC and learn the latest in treating psoriasis, psoriatic arthritis, hidradenitis suppurativa, and other dermatologic conditions where secukinumab is a treatment option.

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