Beyond Guidelines: Brian Kim, MD, on the Rapidly Evolving Itch and Dermatology Treatment Landscape

The treatment landscape for itch-related conditions is expanding rapidly, and dermatologists may need to rethink how they approach clinical decision-making to keep pace, Brian Kim, MD, told Dermatology Times. Kim, professor of dermatology and vice chair of research at the Icahn School of Medicine at Mount Sinai, shared his perspective on the state of the field at the 2026 American Academy Annual Meeting.

Emerging Therapies for Itch

"There's a lot of new stuff in itch," Kim said, pointing to several developments that stood out to him.

Kim highlighted nemolizumab (Nemluvio; Galderma) as a standout performer in the itch space. He noted that Galderma increased its sales forecast on the strength of the drug's efficacy across prurigo nodularis and atopic dermatitis, and that follow-on assets are already in development targeting IL-31 in new ways, including one from Attovia Therapeutics, a company he advises.

On the mast cell targeting front, Kim pointed to remibrutinib (Rhapsido; Novartis) as generating significant attention at the meeting. With the recent FDA approval for chronic spontaneous urticaria and strong phase 3 data in chronic inducible urticaria, the drug's speed of effect on itch caught his attention. "The itch effects are one of the most striking things about it," he told Dermatology Times. "You see improvement within a week." He also noted that MRGPRX2 antagonists from companies like Evommune and Septerna are being showcased at the meeting, also with interest in urticaria. Additional JAK inhibitors targeting itch conditions such as prurigo nodularis are also on the horizon, he said.

Moving Beyond Treatment Guidelines

Kim's broader observation from the meeting went beyond any single drug class. With treatment options proliferating across psoriasis, atopic dermatitis, urticaria, and beyond, he argued that the field has outgrown the guideline model. "I just don't think it's going to be guidelines anymore," he said in an interview with Dermatology Times. "Because the guidelines will be outdated the moment you print it."

In its place, he sees personalized medicine taking hold. Rather than defaulting to a clear first-line agent, clinicians will need to weigh patient-specific factors, priorities, and disease characteristics to guide treatment sequencing. "It's really going to be a lot more about understanding a lot about what the drugs do, having experience with it in the clinic, and really taking much more of a personalized medicine approach," Kim said.

He pointed to the recent approval of an oral IL-23 antagonist for psoriasis as an illustration of how quality of life considerations are influencing treatment strategies alongside clinical efficacy. Injectable options already exist, but injections may seem intimidating or simply not preferred for some patients. "Having an oral option suddenly enhances the quality of life for our patients in a new way," he told Dermatology Times.

Dermatology's Footprint in Drug Development

Kim also offered a striking data point on dermatology's growing influence in the broader medical landscape. Despite representing roughly 1% of the physician workforce, the specialty has accounted for approximately 10% of FDA approvals in recent years. "That's a big shift for the AAD from 20 years ago, even 10 years ago," he said.

The implication for practicing dermatologists is clear, according to Kim: "You just can't sit comfortably saying, okay, this is what we do and this is what we always do. It's just going to change every quarter," he said.

References

1. Kim B. Hot Topics. Presented at the 2026 American Academy of Dermatology Annual Meeting; March 27-31, 2026; Denver, Colorado.
2. Kim B. Chronic Urticaria: What's New. Presented at the 2026 American Academy of Dermatology Annual Meeting; March 27-31, 2026; Denver, Colorado.