Exploring a Rapidly Evolving Therapeutic Landscape

The recent Maui Derm NP+PA Fall 2025 conference gathered leading clinicians to share the latest developments in the diagnosis and management of complex skin diseases, poised to inform attendees and enhance the standard of care. With a focus on practical, case-based insights, the sessions covered cutaneous oncology, atopic dermatitis (AD), psoriasis, rare dermatoses, and other conditions.

Immunotherapy Advances in Skin Cancer

George Martin, MD; Ted Rosen, MD; and Kurt Gautier, PA-C, focused on the practical, case-based management of a broad spectrum of skin cancers in their update on cutaneous oncology. A highlight centered on the use of clinical case studies to illustrate nuanced approaches to diagnosis and treatment. For actinic keratoses (AKs), Martin and the panel discussed optimizing field therapies, including the use of tirbanibulin (Klisyri; Almirall) and 5-fluorouracil enhanced with topical calcipotriene to improve outcomes and shorten treatment duration.

“These are really important cases to take a look at,” Martin noted. “We find that AKs are pretty much a daily treatment occurrence in our practice, so getting it right is important.”

Photodynamic therapy (PDT) was also a central theme—specifically, innovations in pain mitigation and techniques to enhance efficacy. The session also tackled superficial basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs), especially when they are located on sensitive areas such as the face. The presenters discussed nonscarring, cosmetically conscious therapies, with a special focus on PDT as a viable alternative to surgical options in these scenarios.

Elena Hawryluk, MD, PhD, offered key insights into the evolving landscape of pediatric dermatology and melanoma management during her pigmented lesion clinic. Hawryluk highlighted updates from the Children’s Oncology Group, emphasizing the newly released guidelines on pediatric cutaneous melanoma, atypical Spitz tumors, and non-Spitz melanocytomas. She also shared an enthusiastic overview of developments transforming treatment for patients with stage III and IV melanoma, including adjuvant and neoadjuvant immunotherapy, combination checkpoint inhibition strategies, adoptive cell therapy using tumor-infiltrating lymphocytes, and the emerging role of personalized immunotherapy and messenger RNA vaccines.

A Rapidly Expanding Therapeutic Toolbox for AD

Leigh Ann Pansch, MSN, FNP-C, DCN; Colleen Cotton, MD; Sheila Fallon Friedlander, MD; Walter Liszewski, MD; and Vikash Oza, MD, presented an update on AD. A major focus was the updates to the AD guidelines, reflecting significant progress since the last iteration. Notably, 4 new therapies—tapinarof (Vtama; Organon), roflumilast (Zoryve; Arcutis Biotherapeutics), nemolizumab (Nemluvio; Galderma), and lebrikizumab (Eblgyss; Eli Lilly) —received strong recommendations. Many of these treatments are approved for pediatric patients with AD as young as 12 years, broadening therapeutic options for clinicians treating younger populations. Liszewski further highlighted the increasingly nuanced treatment landscape for AD, emphasizing the need for personalized approaches.

“It’s really exciting to be a dermatologist in 2025, particularly someone who specializes in AD, because we have so many new drugs,” he said in an interview with Dermatology Times. Although biologics and JAK inhibitors have revolutionized care, he noted that some patients with severe or atypical presentations remain recalcitrant to monotherapy. For this subset, Liszewski recommends considering combination therapy with an oral JAK inhibitor and a biologic agent. He also stressed the importance of diagnostic certainty, including ruling out allergic contact dermatitis with patch testing before escalating therapy.

Systemic Implications in Psoriasis and Psoriatic Arthritis

In the psoriasis and psoriatic arthritis talk, Martin was joined by Stephanie Simmerman, DNP, APRN-C; Jennifer Cather, MD; M. Elaine Husni, MD; and Mary Larijani, MD. The session was structured around 15 case studies, spanning mild plaque psoriasis to more severe and complex variants, including erythrodermic psoriasis, generalized pustular psoriasis, and psoriasis in special populations such as pregnant women, patients with cancer, and patients with obesity. Simmerman highlighted the growing role of nonsteroidal topical therapies in treating psoriasis, especially in sensitive areas and among pediatric and adolescent patients. Although topical steroids remain a mainstay, newer innovations offer effective alternatives with fewer limitations.

“That’s a session that really gets very real, very practical, and it’s sort of expert opinion on how to manage patients with a myriad of presentations of psoriasis and psoriatic arthritis,” Martin said.

This year’s literature review, a favorite session among both attendees and presenters, also touched on new data. Douglas DiRuggiero, DMSc, MHS, PA-C; Rosen; and Cotton presented a study involving over 250 patients that revealed an increased incidence of non–smoking-related lung abnormalities, such as ground glass opacities. These newly identified associations with pulmonary disorders are expanding the known systemic implications of the disease.

Tackling Rare Dermatoses With Modern Tools

In “Outside the Box: Treating the Uncommon Dermatosis,” Liszewski focused on lichen planus and lichen sclerosus, conditions that, although not the most common in dermatology, often present significant diagnostic and therapeutic challenges. In the talk, Liszewski emphasized that hydroxychloroquine can be effective in treating various forms of lichen planus. However, treatment success varies. He advised clinicians to begin with topical treatments and escalate care, including performing a biopsy, if patients do not respond. He also noted the chronic and sometimes intractable nature of oral lichen planus, which often requires multiple therapeutic trials before achieving symptom control.

Margaret Bobonich, DNP, FNP-C, DCNP, FAAN, shared valuable insights during her session on blistering diseases. Copresenting with Donna Colton, MD, PhD, Bobonich emphasized the diagnostic challenges of blistering diseases such as bullous pemphigoid. She noted that many patients may present with urticarial plaques rather than blisters, which can complicate early diagnosis. A key highlight of the session was the discussion of the first FDA-approved therapy for bullous pemphigoid, dupilumab (Dupixent; Regeneron Pharmaceuticals, Inc, and Sanofi), marking a significant shift away from long-standing reliance on systemic steroids like prednisone.

“Now we have these options and these treatments, and it’s just very, very exciting to see what’s going to happen,” Bobonich said.