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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.

Articles

Participants from the parent DELTA 1 and 2 studies maintained their disease control and observed a decrease in pain and itch over 52 weeks of treatment.

DELTA 3 Showcases Long-Term Safety and Efficacy of Delgocitinib for Chronic Hand Eczema

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.

Researchers have identified elevated eosinophil levels as a potential marker for chronic urticaria in pediatric patients.

New Study Reveals Risk Factors for Persistent Urticaria

and joined the MJH Life Sciences team in February 2023. She attended Kent State University and earned a Bachelor of Science degree in journalism with minors in public relations and creative writing. She enjoys making and listening to music, reading, and spending time with her cats, Astrid and Marceline.

At the 2025 AAD Annual Meeting, Alumis Inc. presented promising phase 2 STRIDE trial results for ESK-001, a TYK2 inhibitor showing sustained psoriasis improvements over 52 weeks.

ESK-001: A Conversation with Jörn Drappa, MD, PhD, of Alumis on Breakthrough Data and the Future of Psoriasis Treatment

As a featured clinician in EltaMD’s Derm Day campaign, Mona Gohara, MD, spoke about her connection with the brand and the work being done to unify dermatologists and promote skin health.

Celebrating the "Derm Difference": Mona Gohara, MD, on the Impact of National Dermatologist Day

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Earn CME credit and learn how to optimize a multimodal treatment approach for hidradenitis suppurativa.

3 Things You Should Know About HS Pathology and Management

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.

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Over time, there has been an increase in the use of the diagnostic code L23.8 for allergic contact dermatitis in Finland, while there has simultaneously been a decreased in the use of the L23.9, according to a 

The review demonstrated imprecise use of both codes, which may contribute to inaccuracies in data, research, and patient care.

, or ICD, outlines 9 codes  that may be used to categorize or define the origin of a patient's allergic contact dermatitis. These include adhesives, cosmetics, and chemical products, among others. L23.8 refers to contact dermatitis caused by agents not previously described in the other categories, while L23.9 describes contact dermatitis of unknown origin.

According to review authors Kämäräinen et al, a 2024 registry-based study published in the same journal reported a rapid increase in the use of L23.8 in Finland from 1998 to 2021 when defining and describing the cause of allergic contact dermatitis.

Considering this rapid increase, researchers sought to assess the use of codes L23.8 versus L23.9 and the implications imprecise use may have on national statistics, patient care, and more.

The review was performed with data from a single study center in northern Finland using data from 1998 to 2022. All patient data involving L23.8 or L23.9 codes were extracted and analyzed manually.

The L23.8 code was used for 472 patients, predominantly female (74.2%). Its usage increased significantly, especially after 2016, with dermatologists accounting for 78.6% of entries compared to 21.4% by residents.

In 85.1% of cases, L23.8 was used despite the identification of a specific allergen, which warranted a more precise sub-code. Dermatologists were more likely than residents to exhibit this pattern (89.0% vs 70.8%).

In 36.9% of cases, L23.8 was employed to document allergic contact dermatitis involving multiple allergens that should have been coded individually. Dermatologists were also more likely to use this approach (44.3% vs. 18.8%).

Allergens such as cosmetics (40.1%), drugs (22.8%), metals (18.6%), and rubber (8.9%) were frequently involved. Instances of improper L23.8 use were rare, such as its application for non-allergic contact dermatitis conditions or post-positive prick tests (n = 12 and n = 3, respectively).

The L23.9 code was used for 264 patients, again predominantly female (72.0%). Unlike L23.8, L23.9 was often applied in cases where diagnostic clarity was pending.

In 69.1% of cases, L23.9 was recorded before patch testing. Notably, 86% of these patients underwent patch testing within 3 months, indicating its role as a provisional code. In 12.6% of cases, L23.9 was used despite the presence of specific allergen information. Furthermore, 8.7% of cases involved multiple allergens that should have been coded individually.

In 4.9% of cases, L23.9 was used for conditions unrelated to allergic contact dermatitis, such as drug-induced dermatitis or phytophotodermatitis. Residents were more likely than dermatologists to misuse this code in such scenarios (7.1% vs. 2.5%).

The study revealed substantial imprecision in the use of both codes, particularly L23.8, where specific allergens were often identified but not documented with appropriate sub-codes. Similarly, L23.9 was frequently used as a placeholder during the diagnostic process or for non-allergic contact dermatitis conditions.

The review may have been limited by its single-center nature. 

However, Kämäräinen et al note these findings underscore the need for improved coding practices to enhance diagnostic precision and data utility. Proper utilization of specific codes could better support clinical decision-making, epidemiological tracking, and resource allocation.

"Since registry-based studies have become more common, diagnoses should be recorded as accurately as possible to the reliability and precision of future registry studies," authors wrote. "In this way, we could be better equipped to track patterns of allergies over time."

Kämäräinen J, Loukkola T, Mikkola J, et al. Imprecise coding in allergic contact dermatitis: a register-study from Northern Finland between years 1999 and 2022. 

American Academy of Allergy, Asthma & Immunology. Contact Dermatitis Codes: ICD-10. October 2018. Accessed January 7, 2025. 

https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Practice%20Management/finances-coding/Contact-Dermatitis-Codes-ICD10.pdf

Wikström V, Sinikumpu SP, Jokelainen J, Huilaja L. Incidence of allergic contact dermatitis in Finland 1998-2021: a nationwide registry-based study. 

The use of diagnostic codes L23.8 and L23.9 for allergic contact dermatitis in Finland has shown significant imprecision, impacting data accuracy and patient care. L23.8, meant for unspecified allergens, was often used even when specific allergens were identified, while L23.9 served as a provisional code pending diagnostic clarity. Dermatologists were more prone to misuse L23.8, whereas residents misused L23.9 more frequently. The study highlights the necessity for improved coding practices to enhance diagnostic precision, support clinical decision-making, and ensure reliable epidemiological tracking.

A Finnish review highlights imprecise use of L23.8 and L23.9 codes for allergic contact dermatitis.

Increased Use of L23.8 Code in Allergic Contact Dermatitis Highlights Need for Specificity in Diagnoses

When it comes to healthy skin care routines and habits, dermatology clinicians and organizations have a handful of mistakes and mishaps they recommend that patients avoid. This Skin Care Awareness Month, 

 has compiled a list of mistakes and ways to avoid them as provided by leading dermatology experts.

 Overwashing strips the skin of natural oils, leading to dryness and irritation. 

 Failing to wear sunscreen daily accelerates premature aging and increases the risk of skin cancer. 

 Results may take time, and switching products frequently may lead to skin irritation. 

 Popping pimples can cause scarring and worsen acne. 

What skin care mistakes do you commonly see patients make? Share with us by emailing

Maintaining a healthy skincare routine is crucial, and dermatology experts emphasize avoiding common mistakes. Over-cleansing can strip the skin of its natural oils, leading to dryness and irritation. Skipping sunscreen increases the risk of premature aging and skin cancer. An inconsistent skincare routine can cause irritation, as results take time to manifest. Picking and squeezing pimples can lead to scarring and exacerbate acne. Dermatology professionals encourage patients to adhere to these guidelines to maintain healthy skin and prevent long-term damage.

This Skin Care Awareness Month, Dermatology Times wants to hear your insights. Click here to answer this week's poll.

POLL: What Is The Most Common Skin Care 'Mistake' You Have Observed Among Your Patients?

 Case-Based Roundtable, led by Todd Schlesinger, MD, a board-certified dermatologist, board-certified Mohs surgeon, and cosmetic surgeon in Omaha, Nebraska, convened leading dermatologists and physician assistants to discuss complex cases of basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (CSCC). The discussion focused on patient management strategies, treatment modalities, and the role of multidisciplinary collaboration in addressing advanced cases.

Challenges in Managing Advanced Skin Cancers

Participants highlighted the frequent presentation of advanced BCC and CSCC in older, immunosuppressed, or neglected cases. The complexities of treating older patients in nursing homes or those with extensive actinic damage were discussed. Many panelists noted that family reluctance or a patient’s inability to undergo aggressive interventions can complicate treatment decisions.

Another challenge is diagnosing and managing high-risk squamous cell carcinoma in areas that are difficult to access, such as the scalp, ears, or lower extremities. Participants shared cases of misdiagnosed or overlooked lesions that had progressed to locally advanced or metastatic disease.

Multidisciplinary Approach to Skin Cancer Management

The roundtable emphasized the importance of a multidisciplinary approach, including dermatologists, Mohs surgeons, oncologists, and radiation specialists, in managing high-risk and advanced cases. Some practitioners noted difficulties in securing timely oncology referrals, particularly in nonmetropolitan areas, which can lead to delays in care.

“The problem isn’t just access to treatment—it’s knowing who to refer to. Not all oncologists handle skin cancer,” they said.

Attendees debated the role of dermatologists in initiating systemic therapies. Although some dermatologists reported their experiences with prescribing hedgehog pathway inhibitors (HPIs), others noted a preference for surgical intervention. For locally advanced and metastatic CSCC, checkpoint inhibitors such ascemiplimab were recognized as an important option, though access to infusion centers and specialist referral remains a barrier.

Treatment Modalities and Decision-Making in Advanced BCC and CSCC

Surgery remains the standard of care for most BCC and CSCC cases. However, neoadjuvant strategies using HPIs were discussed as a means of reducing tumor burden before surgery. Some panelists favored medical therapy for patients with multiple lesions to avoid extensive surgical procedures that could lead to high morbidity.

“The biggest knowledge gap in dermatology is what to do when surgery isn’t the answer—what is the standard of care for advanced cases?” attendees said.

HPIs, including vismodegib and sonidegib, were discussed as options for patients with multiple recurrent BCCs or those with Gorlin syndrome. Although effective, panelists acknowledged that adverse events such as dysgeusia, muscle cramps, and alopecia limit patient adherence. Strategies such as intermittent dosing and L-carnitine supplementation were highlighted as ways to improve tolerability.

Cemiplimab, a PD-1 inhibitor, has become an essential tool in managing advanced CSCC. The roundtable reviewed clinical trial data supporting its use and presented real-world cases demonstrating significant tumor regression. However, concerns regarding immune-related adverse events, including fatigue, pruritus, and endocrinopathies, underscored the need for careful patient selection and monitoring.

Several panelists mentioned the use of gene expression profiling tests such as Castle Biosciences’ Decision Dx-SCC to stratify CSCC risk and guide treatment decisions. Although not universally adopted, these tools were noted to aid in determining the necessity of sentinel lymph node biopsies and additional surveillance.

“The biggest challenge isn’t just treating these cancers; it’s ensuring patients follow through with care, whether it’s surgery, systemic therapy, or ongoing surveillance,” an attendee said.

The discussion concluded with a call for standardized guidelines and decision-making algorithms to aid clinicians in managing complex skin cancers. Participants stressed the need for better education on systemic therapies and integration with oncology and radiation specialists.

Emerging treatment strategies, including combination therapies and novel immunotherapies, hold promise for improving patient outcomes. Integrating genetic profiling and artificial intelligence in dermatologic oncology may further refine patient selection and personalized treatment approaches.

“We need an American algorithm for advanced skin cancer—not just guidelines but a step-by-step decision tree for dermatologists,” attendees said.

 Case-Based Roundtable provided valuable insights into the evolving landscape of BCC and CSCC management. By fostering collaboration and education, dermatologists can enhance patient care and optimize outcomes for those facing high-risk skin cancers.

The expert discussion focused on patient management strategies, treatment modalities, and the role of multidisciplinary collaboration.

Multidisciplinary Approaches to Advanced BCC and CSCC

Hyperhidrosis is not rare. According to the 

, approximately 385 million people worldwide live with hyperhidrosis.

In fact, they note that the amount of people living with chronic, excessive sweating is even higher than the amount of people living with other dermatologic conditions like psoriasis.

Just how common is hyperhidrosis in real-world comparisons?

The prevalence of hyperhidrosis is much higher in younger populations than in the general population, with 8.8% of individuals between the ages of 18 to 39 years old living with the condition. 

When comparing these statistics to everyday, common occurrences like hair color, the number of people with hyperhidrosis is greater than the 1% of individuals with natural red hair and 2% of individuals with natural blond hair. 

Despite how common hyperhidrosis is, it is estimated that 27% of those with the condition never receive a diagnosis.

 wants to hear from you. What percentage of the global population is estimated to have hyperhidrosis?

 to share your hyperhidrosis insights or research.

Albert. Fact check: Hyperhidrosis - International Hyperhidrosis Society: Official site. Home - International Hyperhidrosis Society. October 24, 1970. Accessed November 16, 2023. 

https://www.sweathelp.org/home/news-blog/542-fact-check-hyperhidrosis.html

Hyperhidrosis affects approximately 385 million people globally, surpassing the prevalence of other dermatologic conditions like psoriasis. It is notably more common in younger populations, with 8.8% of individuals aged 18 to 39 experiencing the condition. Comparatively, hyperhidrosis is more prevalent than natural red or blond hair, which affects 1% and 2% of the population, respectively. Despite its prevalence, 27% of those with hyperhidrosis remain undiagnosed. The article encourages engagement during Hyperhidrosis Awareness Month to share insights and research on the condition.

Click here to answer this week's poll for Hyperhidrosis Awareness Month.

Polls 

POLL: What Percent of the Global Population is Estimated to Have Hyperhidrosis?

“When you have a hemangioma—a infantile hemangioma that's larger, more what we call 

, not round, patterned, often syndromic—what is the role of laser in those children? And especially the timing—should we be thinking about potentially lasering earlier than we traditionally have?” Denise W. Metry, MD, FAAD, a dermatologist in South Texas practicing at Driscoll Children's in Corpus Christi, tackled those and other controversial issues in lasers and infantile hemangiomas at the 2025 American Academy of Dermatology Annual Meeting.

The use of lasers in treating infantile hemangiomas, particularly larger, segmental lesions, remains a topic of debate among dermatologists, Metry told 

in an exclusive interview. Although laser therapy has been a mainstay in managing port wine birthmarks, its role in segmental infantile hemangiomas has historically been limited due to concerns over ischemia and ulceration, she explained.

Understanding the Controversies in Lasers and Infantile Hemangiomas 

“There is some data from about 20 years ago that really discouraged people from lasering those types of hemangiomas early, because the laser technology just wasn't where it is today,” Metry said. “We've now got cooling devices, we've got beta blockers, and we know what the risks are in these babies, which are really ischemia and ulceration.”

Ultimately, she told attendees they need to balance laser use pros with its cons.

Although it can be difficult to distinguish between a port wine birthmark and a segmental infantile hemangioma, early differentiation is crucial, as treatment approaches differ significantly, Metry added. She reminded attendees that port wine birthmarks are well-demarcated, solid, and uniform, whereas hemangiomas tend to be more telangiectatic and evolve over time. Misclassification can lead to inappropriate treatment plans.

In contrast to port wine birthmarks, hemangiomas are dynamic lesions. “We know hemangioma tissue occurs as a result of hypoxia, and there are probably vascular changes that explain that. They're prone to ulceration and ischemia,” she said.

Fortunately, Metry noted there are great resources for dermatologists treating these lesions, such as the Hemangioma Investigator Group’s website (hemangiomaeducation.org) as well as journal articles.

For continued conference coverage, expert insights, and breaking news, 

 1. Metry DW. Laser for Complicated Segmental Infantile Hemangiomas: Who, What, Where, and Why Presented at: the American Academy of Dermatology Annual Meeting; March 7-11; Orlando, Florida.

Denise W. Metry, MD, FAAD, explored the controversies in using lasers in infantile hemangiomas at the AAD Annual Meeting.

Martina Porter, MD

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