
At AAD 2026, Lauren Madigan, MD, presented long-term PIONEER trial extension data and urged clinicians to sharpen their recognition of 2 clonally driven inflammatory diseases: indolent systemic mastocytosis and VEXAS syndrome.
Lauren Madigan, MD, is an associate professor of dermatology at the University of Utah.

At AAD 2026, Lauren Madigan, MD, presented long-term PIONEER trial extension data and urged clinicians to sharpen their recognition of 2 clonally driven inflammatory diseases: indolent systemic mastocytosis and VEXAS syndrome.

Dr. Madigan highlights the evolving treatment landscape by discussing promising clinical trial data for second-generation KIT inhibitors, like bezaclastinib and elenestinib, which offer high selectivity and limited CNS penetration. She reinforces the "practice pearl" that nearly all adults with fixed skin lesions have systemic disease, emphasizing that these lesions are distinct from transient hives and require lifelong vigilance.

Dr. Madigan presents the case of a 50-year-old woman with refractory indolent systemic mastocytosis whose severe gastrointestinal and cutaneous symptoms persisted despite a high medication burden of antihistamines, cromolyn sodium, and oral steroids.

Dr. Madigan explains that for a patient with newly diagnosed indolent systemic mastocytosis (ISM), initial management focuses on best supportive therapies like cetirizine and cromolyn sodium while emphasizing that an epinephrine auto-injector is a mandatory component of care due to high anaphylaxis risks.

Systemic mastocytosis often hides behind common symptoms; learn why early, team-based diagnosis and tailored staging prevent delays and risks.

In a Derm Dispatch discussion, Renata Block, DMSc, MMS, PA-C, and Lauren Madigan, MD, review practical strategies for diagnosing and managing cutaneous mastocytosis across age groups.

Systemic mastocytosis often hides behind common symptoms; learn why early, team-based diagnosis and tailored staging prevent delays and risks.

Learn how skin clues reveal systemic mastocytosis early, from subtypes to KIT D816V mutations that guide targeted treatment.

Lauren Madigan, MD, shares vital insights on complex dermatology, emphasizing accurate diagnoses and the importance of diversity in dermatologic imagery.