Peter Lio, MD

In the final episode, “Improving Access to Advanced Nonsteroidal Topical Therapies in Inflammatory Dermatoses,” the panelists explored practical strategies for overcoming barriers to advanced nonsteroidal topical therapies and discussed how these treatments are reshaping long-term disease management. Building on the consensus statement addressing affordable access, the expert faculty examine the challenges patients and clinicians face when attempting to obtain newer targeted topical treatments and review resources that may help improve treatment accessibility.

This episode, titled “The Evolving Role of Nonsteroidal Topicals in Inflammatory Dermatoses,” features panelists discussing the efficacy of advanced targeted topical therapies and their growing role in the long-term management of inflammatory skin diseases. Building on previous discussions of safety and tolerability, the expert faculty review evidence supporting both the short-term and long-term effectiveness of nonsteroidal topical treatments across multiple inflammatory dermatoses.

In “The Safety of Advanced Topical Therapies in Inflammatory Dermatoses,” our panel explores the consensus statements evaluating the short- and long-term safety of advanced targeted topical therapies for inflammatory skin diseases. The expert faculty review the growing body of clinical trial evidence supporting several nonsteroidal topical treatments, including roflumilast, tapinarof, ruxolitinib, crisaborole, and delgocitinib, and discuss how these therapies have expanded treatment options across multiple inflammatory dermatoses.

In this episode, “Understanding Corticosteroid-Related Medical-Legal Risks in Inflammatory Dermatoses,” the expert faculty explore the consensus statement addressing the medical-legal considerations associated with corticosteroid prescribing and the importance of responsible corticosteroid stewardship in clinical practice. The panel discusses how growing awareness of corticosteroid-related adverse events has implications not only for patient safety, but also for clinician accountability and risk management.

Peter Lio, MD, discussed how stress, sleep disruption, and patient-centered communication can influence pediatric atopic dermatitis management during a recent Skin and Psych podcast interview.

This episode, titled “Moving Beyond Long-Term Topical Corticosteroid Use in Inflammatory Dermatoses,” features panelists discussing the evolving role of topical corticosteroids in the management of chronic inflammatory skin diseases. Building on the consensus statement that topical corticosteroids should not be routinely prescribed for long-term use in chronic conditions, the expert faculty examine the distinction between acute flare management and long-term disease control.

In “Reducing Treatment Burden in Inflammatory Dermatoses,” our panel explores the practical challenges associated with managing chronic inflammatory skin diseases using multiple topical corticosteroids. Building on the consensus statement that the use of different corticosteroids for different body areas can create significant burden for patients, the expert faculty discuss how increasingly complex treatment regimens can negatively impact adherence, disease control, and the overall patient experience.

In this episode, “Understanding Corticosteroid Risks in Inflammatory Dermatoses,” the expert faculty explore the key findings from a recent consensus paper evaluating the risks associated with topical and systemic corticosteroid therapy and the role of advanced targeted topical treatments in inflammatory skin diseases. The panel reviews the methodology behind the expert consensus process, including the comprehensive literature review and evidence-based approach used to develop recommendations for clinical practice.

Welcome back to another Dermatology Times Between the Lines series. In this episode titled, “Rethinking Long-Term Management of Inflammatory Dermatoses,” the expert faculty discuss the chronic, relapsing nature of inflammatory skin diseases and how advances in our understanding of underlying inflammation have influenced treatment goals. The panel explores commonly encountered inflammatory dermatoses, including atopic dermatitis, psoriasis, and seborrheic dermatitis, and examines how durable disease control has become an increasingly important objective in clinical practice.

At RAD 2026, Peter Lio, MD, discussed shared decision-making strategies and emerging microbiome-targeted therapies for atopic dermatitis.

Peter Lio, MD, explains how shared decision-making and newer nonsteroidal topicals and systemic options are reshaping pediatric eczema care, easing steroid worries.

Highlighting conditions like lichen planus, which has no FDA-approved treatments, Lio underscores why clinicians must be comfortable prescribing beyond the label.

Panelists discuss how dermatologists should expand their therapeutic scope beyond traditional steroids and calcineurin inhibitors to embrace newer nonsteroidal options, while emphasizing that treating pediatric atopic dermatitis requires the same principles as adult care and encouraging broader provider participation, including pediatricians, to address access challenges.

Panelists discuss how future therapies should aim to provide faster symptom relief than the current 4- to 8-week timeframe, offer longer-lasting depot effects requiring less frequent application, and accelerate the regulatory process for extending safe adult medications to younger pediatric populations.

At Elevate-Derm Fall, Peter Lio, MD, discussed how flexible clinical reasoning and an expanding therapeutic pipeline, particularly hidradenitis suppurativa and atopic dermatitis, are reshaping patient management heading into 2026.

At the Elevate-Derm Fall Conference, Peter Lio, MD, highlighted practical strategies for corticosteroid stewardship, the expanding role of nonsteroidal topicals, and emerging opportunities in early-age indications that are reshaping pediatric inflammatory dermatoses care.

Panelists discuss how comprehensive caregiver education forms the foundation of successful treatment, involving dispelling internet misinformation, demonstrating proper application techniques like fingertip units, addressing steroid fears, and establishing realistic expectations about long-term management rather than seeking quick cures.

Panelists discuss how they determine when to escalate to systemic therapies by focusing on patient-reported outcomes rather than clinical appearance alone, asking about flare frequency and typical vs bad days, while emphasizing the importance of continuing topicals alongside systemics with potential for future de-escalation.

Panelists discuss how twice-daily dosing represents the biggest adherence challenge and how simplifying regimens from multiple location-specific medications to single versatile treatments significantly improves adherence, with once-daily formulations being much more manageable for busy families.

Panelists discuss how roflumilast demonstrated 25% Investigator’s Global Assessment (IGA) success at 4 weeks in the Integument PED trial with impressive long-term results showing 73% Eczema Area and Severity Index (EASI-75) achievement at 56 weeks, while highlighting its excellent tolerability profile with no black box warning, no folliculitis, and minimal stinging compared with previous phosphodiesterase-4 inhibitors.

Panelists discuss how tapinarof showed strong efficacy in the Adoring trials, with 45% to 46% Investigator’s Global Assessment (IGA) success and 55% to 60% Eczema Area and Severity Index (EASI-75) achievement at 8 weeks. However, they question real-world adherence to daily application over such extended periods and note folliculitis as a notable adverse effect occurring in over 5% of patients.

Panelists discuss how ruxolitinib cream demonstrated impressive efficacy in the TRU83 trial, with over 50% of patients achieving near-complete clearance at 8 weeks using the 1.5% formulation, while acknowledging that the Janus kinase (JAK) inhibitor’s broad mechanism makes its effectiveness unsurprising despite concerns about the boxed warning.

Peter Lio, MD, believes that collaboration between science and industry is vital for translating research into meaningful patient benefits.

Discover essential dermatology insights from experts at the Fall Clinical Conference 2025, featuring innovative treatment tips and patient care strategies.

Recent FDA approvals for topical roflumilast and ruxolitinib down to age 2 mark major milestones in managing pediatric AD, according to Peter Lio, MD.

Panelists discuss how they incorporate both steroids and nonsteroidals from the initial visit by limiting steroid use to 1 to 2 weeks followed by long-term nonsteroidal maintenance, while noting the need for more vehicle formulations and lower age indications to better serve younger patients with limited treatment options.

Panelists discuss how extensive body surface area involvement in pediatric patients affects topical prescribing decisions, with high coverage areas often requiring systemic therapy consideration. They also discuss how location-specific factors like sensitive areas (face, groin) influence the choice toward nonsteroidal agents over topical steroids.

Peter Lio, MD, describes Fall Clinical as an energizing, high-level dermatology meeting focused on practical takeaways and collaboration.

Panelists discuss how the current topical standard of care has evolved from traditional topical steroids developed in the 1960s to include newer nonsteroidal options like ruxolitinib (Janus kinase [JAK] inhibitor), roflumilast (phosphodiesterase-4 [PDE4] inhibitor), and tapinarof (aryl hydrocarbon receptor agonist), with steroids now serving as bridge treatments rather than long-term maintenance therapy.

Panelists discuss how atopic dermatitis presents differently across pediatric age groups. Infants show lesions on cheeks and extensor surfaces, whereas older children develop more typical flexural patterns. They also discuss how the condition significantly impacts the quality of life for patients and caregivers through sleep disruption, school performance issues, and ongoing parental stress.