High Stakes in Dermatology: Jackpot Insights from Fall Clinical 2024

Fall Clinical 2024 brought together the brightest minds in dermatology against the lively backdrop of Las Vegas. This year’s conference was packed with fresh insights, innovative treatments, and essential pearls aimed at advancing clinical practice.

Experts including Aaron Farberg, MD; Christopher Bunick, MD, PhD; Emmy Graber, MD, MBA; James Del Rosso, DO; James Song, MD; Joel Gelfand, MD; Mona Shahriari, MD, FAAD; Raj Chovatiya, MD, PhD; and Shawn Kwatra, MD, shared their expertise on emerging therapies, patient care strategies, and the latest research findings. Dive in for a comprehensive look at top pearls gleaned from clinicians at this year's meeting.

Aaron Farberg, MD

Farberg emphasized the importance of personalized education for early-career dermatologists, highlighting their future role in the field. He discussed advancements in melanoma prognosis, particularly the DecisionDX-Melanoma 31-GEP test, which enhances patient management by predicting outcomes.

Additionally, he introduced the DecisionDX-SCC 40-GEP test for cutaneous squamous cell carcinoma, aiding in risk stratification and treatment decisions. Farberg also highlighted efforts in developing gene expression profiling tests for inflammatory skin diseases and his commitment to supporting young dermatologists through the “Early Career Dermatology Initiative.”

Christopher Bunick, MD, PhD

Bunick emphasized a new standard of care in atopic dermatitis focused on achieving both skin clearance (EASI 90) and controlling itch. He highlighted a shift away from corticosteroids toward safer systemic therapies like JAK inhibitors, which have demonstrated long-term safety.

The LEVEL UP trial further showed that upadacitinib could benefit patients who do not achieve adequate results with dupilumab by week 16, suggesting clinicians should assess response milestones more closely.

Emmy Graber, MD, MBA

Graber shared key advancements in acne and rosacea treatments, emphasizing new 1726 nanometer lasers that precisely target sebum to reduce acne lesions by up to 80% without damaging the epidermis. She highlighted the positive impact of treating rosacea-related erythema with lasers, which significantly enhances patient quality of life.

Graber also discussed a triple-combination topical for acne that combines clindamycin, benzoyl peroxide, and adapalene, as well as an emerging rosacea treatment, DFD-29, a low-dose minocycline tablet expected to offer a new therapeutic option pending FDA approval.

Glynis Ablon, MD

Ablon presented key innovations in aesthetic dermatology, focusing on 5 notable devices and treatments. Highlights included a fibrin-based wound care product that enhances healing, an automated oscillation device for eye health, and a filler complication checklist for quick reference in practices.

She also introduced a painless transdermal infusion device and a radiofrequency stimulation device for non-invasive skin rejuvenation. Additionally, Ablon discussed advances in microneedling, gold particle technology for acne, and the promising potential of exosomes in dermatologic care.

James Del Rosso, DO

Del Rosso discussed several monoclonal antibodies and JAK inhibitors for treating skin conditions. He highlighted nemolizumab, approved for prurigo nodularis, which targets IL-31 to alleviate severe itching and skin thickening, with potential use in atopic dermatitis. Lebrikizumab and tralokinumab, both IL-13 inhibitors, show promise for atopic dermatitis, offering durable symptom relief and flexible dosing. Dupilumab remains a longstanding, reliable treatment with extensive safety data. Emerging therapies like remibrutinib, an oral BTK inhibitor, and bimekizumab, which targets IL-17A and IL-17F for psoriasis, further demonstrate the shift toward personalized dermatological care, while secukinumab is approved for hidradenitis suppurativa, highlighting the ongoing evolution of treatment options in the field.

James Song, MD

Song presented innovative treatments for alopecia areata and refractory dermatoses. He advocated for diphenylcyclopropane as a home-administered therapy for patients not suitable for oral JAK inhibitors. Song also discussed deucravacitinib, an allosteric TYK2 inhibitor, as a steroid-sparing option for refractory discoid lupus erythematosus.

He highlighted upadacitinib's effectiveness for refractory dermatomyositis and explored the role of biologics and JAK inhibitors in treating acantholytic disorders.

Joel Gelfand, MD

Gelfand shared insights on palmoplantar pustulosis and the comorbidities associated with psoriasis. He highlighted the treatment challenges of PPP, noting that over 20 therapies are often trialed with limited success. While apremilast shows some promise, its clinical significance remains uncertain.

Gelfand also discussed the inconclusive evidence regarding the efficacy of biologics in reducing psoriatic arthritis risk, emphasizing the potential of IL-23 inhibitors over TNF inhibitors. He advocated for integrated care models to manage cardiovascular risks in psoriasis patients, underscoring findings from the LITE study that demonstrated home-based phototherapy is as effective as office-based options, improving accessibility to treatment.

Mona Shahriari, MD, FAAD

Shahriari emphasized the importance of understanding itch pathways in conditions like prurigo nodularis and atopic dermatitis. Her presentations highlighted how addressing itch severity can significantly improve patient management and quality of life.

Shahriari also tackled the critical issue of disparities in diagnosing psoriatic disease in skin of color, advocating for collaborative care and inclusive clinical trials to enhance treatment outcomes. With a focus on practical insights and emerging treatment options, including new agents like deucravacitinib, she encouraged dermatologists to adopt a holistic approach to patient care.

Raj Chovatiya, MD, PhD

Chovatiya discussed his presentations on chronic hand eczema and early career challenges. He emphasized that chronic hand eczema is a common but often overlooked condition that requires better understanding and treatment options.

Chovatiya also highlighted the importance of flexibility in career development, advising early-career professionals to remain open to opportunities and tailor their conference experiences for networking and education. He encouraged attendees to identify relevant topics and engage with others in the field, noting that conferences can provide valuable insights into gaps in care and foster professional connections.

Shawn Kwatra, MD

Kwatra highlighted significant advancements in the treatment of atopic dermatitis and prurigo nodularis. He stressed the importance of assessing itch severity in all dermatology patients, as understanding shared inflammatory pathways—particularly involving cytokines like IL-4, IL-13, and IL-31—can improve treatment outcomes. Recent FDA approvals, including dupilumab and new agents like lebrikizumab and nemolizumab, offer expanded therapeutic options.

Kwatra advocated for using standardized itch assessments to enhance patient care and emphasized the benefits of non-steroidal topicals to avoid the long-term adverse effects of corticosteroids. Overall, he encouraged dermatologists to prioritize itch management in clinical practice.

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