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Marie Bosslett is the assistant editor of 

 and joined the MJH Life Sciences team in October 2024. She attended Loyola University Maryland in Baltimore and earned a Bachelor of Arts in Communication with minors in marketing and writing. When she’s not writing, Marie enjoys going to concerts, reading on the beach, and spending time with friends and family.

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Researchers noted higher correlations in those who are prone to severe acne and post acne erythema (PAE).

Several Risk Factors, Including PAE, Associated with Acne Scarring in Thai Patients 

Maddi Hebebrand is an associate editor of 

and joined the MJH Life Sciences team in May 2024. She attended Baldwin Wallace University, studying Media Production and Film, and is now finishing her Masters in Digital Media through Ohio University. When she's not writing, Maddi loves to read, attend concerts and spend time with her family.

The review found AD can disrupt family life, as caregiving responsibilities can lead to stress, guilt, and reduced opportunities for shared activities.

A Family-Centered Approach to Managing AD

Kaitlyn Bader is the assistant managing editor of 

 and joined the MJH Life Sciences team in June 2022. She attended Otterbein University in Westerville, Ohio, and earned a Bachelor of Arts degree in literary studies with minors in creative writing and film studies. Prior to health care news, Kaitlyn worked in industrial marketing. She enjoys cooking, reading, and tending to her house plants.

Review some of the top highlights shared at physician assistant and nurse practitioner dermatology meetings in 2024.

Looking Back at Highlights From 2024 PA & NP Conferences

A reflection on 2024's dermatology advancements, from FDA approvals to expert insights, setting the stage for another transformative year in 2025.

Closing the Chapter on a Booming Year of Dermatology

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Patients are increasingly seeking to have benign lesions removed and today, there are a number of treatment options available to safely and effectively remove unwanted lesions. Suneel Chilukuri, M.D., reviewed these options during a presentation at the Fall Clinical Dermatology Conference held this week in Las Vegas.

Treatment options for benign lesions

Final Thoughts: The Importance of Comparative Studies in AD

Panelists offer concluding insights and emphasize the critical role of comparative studies in advancing atopic dermatitis treatment strategies.

clinical

Video Series

The Role of Micropeptides in Pre-Aging Skin Care

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association between genital skin cancers and lichen sclerosus

Lichen sclerosus, a noncancerous dermatologic condition, has been linked to genital skin cancers such as vulvar and penile squamous cell carcinomas (SCCs), as well as genital melanomas. About 4% of patients with lichen sclerosus may develop vulvar cancer.

Genital cancers, including vaginal melanomas, vulvar melanoma, and penile melanoma, are relatively rare but can be associated with feelings of shame, stigma, and discomfort. It is crucial for clinicians to encourage patients to report unusual signs and symptoms to facilitate early diagnosis and treatment.

Due to the quality-of-life impacts of genital skin cancers, it can be beneficial for dermatologists and gynecologists to collaborate together when necessary to optimize patient care and outcomes. 

What are your experiences with treating genital skin cancers or lichen sclerosus? Email us at 

Lichen sclerosus, a noncancerous dermatologic condition, is linked to genital skin cancers, including vulvar and penile squamous cell carcinomas and genital melanomas. Approximately 4% of lichen sclerosus patients may develop vulvar cancer. Genital cancers, though rare, can cause significant emotional distress. Clinicians should encourage patients to report unusual symptoms for early diagnosis and treatment. Collaboration between dermatologists and gynecologists is recommended to enhance patient care and outcomes, given the quality-of-life impacts of these cancers.

Click here to answer this week's skin cancer poll.

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POLL: How Often Do You Collaborate With Gynecologists Regarding Genital Skin Cancers?

In her second presentation at the 2024 Elevate-Derm West Conference, Jenny Murase, MD, talked about the Dermatologic Care of New Mothers. Her lecture covered important topics such as differential diagnosis, safety of medications, and conditions commonly found in breastfeeding mothers.

Murase discussed safe dermatologic treatments during lactation, especially for chronic conditions needing biologics.

Jenny Murase, MD: Providing Dermatologic Support in Postpartum Care

My name is Dr Jenny Murase, and I am the director of medical consultative dermatology at the Palo Alto Foundation Medical Group, and I'm associate clinical professor at UCSF. I just presented at NP Elevate in Arizona over the past few days on 3 presentations related to women's health and dermatology.

What did you cover during your session titled, "Dermatologic Care of New Mothers"?

I think that lactation is an area where there really, in the past, hasn't been a lot of attention in the field. I remember 18 years ago when I was looking at how to redesign the women's health curriculum for the American Academy of Dermatology, I realized that there was literally no education on new mothers and issues regarding breastfeeding and really even safety of medications and lactation as well. That was definitely an area that I wanted to make sure was addressed at our academy meetings, because it's such a relevant issue for patient care. In the session that I gave, I talked about the differential diagnosis and the things we have to think about when a patient presents with mastitis, meaning inflammation of particularly the areola or nipple when breastfeeding. Those conditions include things like irritant contact dermatitis, allergic contact dermatitis, to things like lanolin, for example, that is in wool alcohol ointment or Aquaphor, that's oftentimes used to emulate the skin and protect the nipples. In addition, it can get secondarily infected with both Candida, a yeast, as well as Staphylococcus aureus, a bacterial infection. Finally, there's a condition called Raynaud phenomena. We were actually the first to develop an article on Raynaud phenomena summarizing patient data.There is a nursing center, and I work with Honor Fullerton Stone in Northern California to summarize patient data. We found that 20% of patients developed Raynaud phenomena, which means that there was a pain that was caused due to vasoconstriction. In the general population, about 20% of women have Raynaud phenomena, so it was interesting that it was kind of the same statistic when we looked at the mastitis patient. It's important to consider warming techniques. There's also a medicine called nifedipine that can be tried, particularly if there are color changes seen in the nipple and areola, such as from vasoconstriction. You can get both cyanosis, meaning a bluish color forming, or pallor, meaning a white color. Then also you can get vasodilation in response where the blood vessels open up, where it becomes more red, so it'skind of a red, white and blue, and so those are the main things on the differential diagnosis that should be considered when treating mastitis.

 What advice can clinicians give to new mothers facing debilitating skin conditions?

I have 3 children, and I can only imagine how hard it would be to have an underlying medical condition like bad atopic dermatitis with horrible itch or bad psoriasis, and be juggling that, in addition to the sleep deprivation from having to wake up every 3 to 4 hours to breastfeed. Families are wonderful if you have support. But for the mothers that don't have that support, hats off. It must be so difficult. One thing that I do really want to emphasize, because I just finished working with George Martin and running the Delphi consensus for the National Psoriasis Foundation. Phil Anderson is 1 of the people on our Delphi consensus. He's the founder of LactMed, so he knows more about lactation safety and medications, more than maybe anyone in the country. He really made the point that biologics, even including rituximab now, because before they were worried about B cell development with the rituximab, but even with rituximab, are safe in lactation. So certainly, any provider that's making a recommendation to stop a biologic in lactation, I really think that that is not doing the patient good service, especially if they're struggling to manage a chronic, debilitating condition that itch. Having chronic itch has a quality of life impact between having cystic fibrosis and having a kidney transplant, and you put that on top of being a new mother and waking up every 3 to 4 hours and having to care for a little creature that doesn't even know where their thumbs areand have to do everything for them. I mean, it's just ridiculous to me. I really think we need to be making sure that the dermatologic medication safety discussions are being held in a in a responsible manner that's giving them the care that they need.

[Transcript has been edited for clarity.]

Jennifer Murase, MD, emphasized the importance of dermatologic care for new mothers, particularly in the context of lactation. She highlighted the lack of attention historically given to this area and discussed differential diagnoses for conditions like mastitis, including irritant and allergic contact dermatitis, infections, and Raynaud phenomena. Murase also stressed the safety of biologics during lactation, advocating against discontinuation for breastfeeding mothers with chronic conditions. She underscored the need for responsible discussions on medication safety to ensure comprehensive care for new mothers.

Jenny Murase, MD, covered topics and pearls related to women’s health in a series of 3 presentations at the 

. One of her sessions, titled, “Baby Bumps: Understanding the Dermatoses of Pregnancy,” outlined how to safely and effectively treat the primary dermatoses exhibited or exacerbated during pregnancy.

Murase identifies 4 main pregnancy dermatoses—atopic eruption, polymorphic eruption, extrahepatic cholestasis, and pemphigoid gestationis—as "baby bumps."

"Baby Bumps": Jennifer Murase, MD, on Dermatoses During Pregnancy

What did you cover during your session titled, "Baby Bumps: Understanding the Dermatoses of Pregnancy"?

Now there are 4, it kind of depends if you're a lumper or a splitter, but there are 4 primary dermatoses of pregnancy, that we call the baby bumps right of pregnancy. Then there's 1 that's a little bit more controversial, but it's thought it to be the fifth pregnancy dermatosis. The way that I think about them, I always think about what's causing it, and it helps me to remember what I need to do. The most common would be atopic eruption of pregnancy. I'll draw a little yin yang for my patients, where I have the cell mediated immunity on TH1 side. That's the soldiers of our immune system, fighting bacteria, viruses, and fungus.Then we haveTH2 on the other, the allergic arm of the immune system, estrogen causes a shift so that you become more TH2 and allergic dominant. I remember I was pregnant with my daughter, and I was talking about how you become more allergic, and you get atopic dermatitis more easily in pregnancy, and I was just sneezing like crazy, so allergic at the time. That conditionis by far and away, the most common. Polymorphic eruption of pregnancy, which is when the skin is being stretched. That's why it's going to occur later in pregnancy, and it's going to occur in areas where the skin is stretched, like the abdomen and the thighs, and both those have any implications to the fetus. Then we have extrahepatic cholestasis of pregnancy, and that is a condition that there is a strong genetic component, but there's no primary lesions in the skin. Everything is secondary. Everything is from scratching, and that's related to bile acids being high, and bile acids can affect the placenta. There are implications to the baby. And finally, there is a condition, herpes gestationis, or pemphigoid gestationis - there's 2 names for it. It has nothing to do with the herpes virus, and it's an autoimmune disease where the antibodies will attack the junction between the epidermis and the dermis, because the placenta and the skin are both epidermal in origin. The antibodies that are created that are attacking the skin can also affect the placenta and that could affect the pregnancy. We detect that by doing a biopsy. So when in doubt, you want to do bile acids and a biopsy, because those are the 2 that could have implications. There's also a condition, as I mentioned, this fifth dermatosis, a psoriatic condition. It's called impetigo herpetiformis, even though it has nothing to do with staphylococcus aureus and nothing to do with the herpes virus. That condition is, there is a new agent on the market, spesolimab, that is an IL-36 antagonist that's used for generalized pustular psoriasis of pregnancy. That is a newer therapeutic that can help with this, this, this pustule based rare eruption that occurs in pregnancy.

How can clinicians work together to provide holistic care for new mothers?

I think that there really has been a paradigm shift over the course of the past 10 to 15 years where we are developing a very patient-centric approach. It's almost like there's a whole care team that's surrounding the patient and providing many, many different facets of care. Whether it's nutritional care or obstetric care or dermatologic care, the specialist, the primary care, and then different forms of nursing that might be required, as well as acupuncturists and herbalists.We're all a team caring for the patient in terms of their particular needs and their desires for how they want to approach their care.When I think of holistic care, I think about how our electronic medical records are making it much easier for us to communicate, and I think that that's1 of the reasons why we can be more effective with this holistic care and be copying each other on the notes more easily and communicating. I know that patients really appreciate it when I'm in the room and I'm calling their doctor, or I'm typing a note to their doctor or their provider, the nurse, whatever it might be, so that they can see that communication is taking place. Then I feel like they feel like they're part of this team, and everyone's talking. I think 1 thing that the providers can do is kind of make that effort to make a point that they're reaching out.It doesn't have to be done later in the day when they don't even know you're communicating, show that you are kind of bringing in the troops and calling in the team and communicating with the team so that they know that they're the center of that team. It's also very important, I think, for all dermatology providers, to have a lactation consultant in the area that they know. Because lactation, the nursing, I should say, is an art. It really is just the exact latch, which is the position of the baby's mouth and head. It's a very subtle art and limiting the trauma to the nipples in our patients with sensitive skin, whether they have atopic dermatitis or psoriasis, because psoriasis can koebnerize, meaning it forms in areas of trauma on the nipple. The nipples need to be in very excellent shape, especially atopic dermatitis, right before delivery, in order to limit pain and lactation, consultants can certainly help you.

Dr. Jennifer Murase presented on the dermatoses of pregnancy at the 2024 Elevate-Derm West Conference, focusing on conditions like atopic eruption, polymorphic eruption, extrahepatic cholestasis, and pemphigoid gestationis. She emphasized the importance of understanding the underlying causes and potential fetal implications. Murase also highlighted the significance of holistic care for new mothers, advocating for a patient-centric approach involving a multidisciplinary team. Effective communication among healthcare providers, facilitated by electronic medical records, enhances patient care and ensures comprehensive support for new mothers.

Murase identifies 4 main pregnancy dermatoses—atopic eruption, polymorphic eruption, extrahepatic cholestasis, and pemphigoid gestationis—as "baby bumps." 

"Baby Bumps": Jenny Murase, MD, on Dermatoses During Pregnancy

"If there's one thing I can ask you to do today, it's to stop writing systemic corticosteroids for atopic dermatitis patients," said Christopher Bunick, MD, PhD, in a session at the 

2024 Fall Clinical Dermatology Conference

Bunick, associate professor of dermatology and translational biomedicine at the 

’ 2024 Winter Editor in Chief, joined colleagues Brad Glick, DO, MPH, and Alexandra Golant, MD, in a CME satellite symposium titled, "Is EASI 75 Good Enough or Can We Do Better? Elevating Efficacy and Long-Term Safety With JAK Inhibitors in Moderate-to-Severe Atopic Dermatitis."

During the session, Bunick emphasized that overreliance on corticosteroids is not only outdated but potentially harmful when better, more targeted therapies are available for atopic dermatitis (AD).

The Case Against Systemic Corticosteroids

One study presented by clinicians highlighted that about 20% of patients with AD are still receiving systemic corticosteroids, with 24% of these on long-term therapy. This usage contradicts the 

American Academy of Dermatology guidelines

, which recommend against the long-term use of corticosteroids due to their potential adverse effects and suboptimal efficacy compared to newer treatments.

Research has shown that the adverse event rates associated with systemic corticosteroids—including malignancy—are significantly higher than those for alternative treatments like methotrexate and newer biologics. The TARGET-DERM registry, for example, highlights the pressing need for dermatologists to reassess their prescribing habits, especially when safer and more effective therapies are available.

"It's not the most efficacious, it's not the most safe, and we have a world with advanced systemic therapies, 5 of them approved, soon to be 6," Bunick emphasized. "You don't need this."

The presentation also highlighted the concept of therapeutic inertia, where dermatologists may continue to prescribe a medication despite a lack of sufficient patient response. The panel noted that many patients are not reaching optimal treatment targets, with 30% to 40% failing to achieve desired outcomes. 

"You have to be willing to know when to say this medicine isn't good enough for the patient and to move on," Bunick said. "I think the best way to do it is imagine you or the patient. Do you want your doctor to keep you on a medicine that isn't hitting optimal targets?"

The discussion moved toward the long-term efficacy of newer treatments, specifically oral Janus Kinase (JAK) inhibitors like upadacitinib (Rinvoq; AbbVie). Data from the 

 indicated that 35% to 51% of patients experienced significant itch reduction and achieved EASI 90 by 140 weeks. Additionally, 74% to 85% of patients maintained EASI 90 after 140 weeks. Even those who reached moderate treatment targets after week 16 continued to show improvement, suggesting robust long-term efficacy for these therapies.

The findings also included insights from the head-to-head study of upadacitinib versus dupilumab (Dupixent; Sanofi and Regeneron). Data indicated that at week 4, patients not achieving moderate targets could be dose escalated, leading to better outcomes. For example, among patients who switched from dupilumab to upadacitinib, 67% achieved EASI 75 within 4 weeks, and by week 32, 80% reached EASI 75. In contrast, only 9% of patients treated with dupilumab reached the benchmark by week 16. 

Research indicates that the adverse event rates associated with systemic corticosteroids—including malignancy—are significantly higher than those for alternative treatments like methotrexate and newer biologics.

Panelists concluded that the landscape of AD treatment is rapidly evolving, presenting dermatologists with a unique opportunity to improve patient care. By shifting away from systemic corticosteroids and adopting advanced therapeutic options, clinicians can better meet the needs of their patients and help them achieve optimal health outcomes.

Bunick C, Glick B, Golant A. Is EASI 75 Good Enough or Can We Do Better? Elevating Efficacy and Long-Term Safety With JAK Inhibitors in Moderate-to-Severe Atopic Dermatitis. Presented at Fall Clinical Dermatology Conference; October 24-27, 2024; Las Vegas, Nevada.

Singh JA, Wells GA, Christensen R, et al. Adverse effects of biologics: a network meta-analysis and Cochrane overview. 

. 2011;2011(2):CD008794. Published 2011 Feb 16. 

The discussion at the 2024 Fall Clinical Dermatology Conference emphasized the need to move away from systemic corticosteroids for atopic dermatitis (AD) due to their outdated and potentially harmful nature. Despite guidelines against their long-term use, a significant percentage of patients still receive them. Newer treatments, such as JAK inhibitors, offer better efficacy and safety profiles. The panel highlighted therapeutic inertia as a barrier to optimal treatment outcomes and advocated for adopting advanced therapies to improve patient care and achieve better health outcomes in AD management.

Clinicians presented a panel-style session at Fall Clinical, touching on the drawbacks of topical steroid use and alternatives in AD patients.

Jeff Craven

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