Fall Clinical 2026: The Data and Expert Advice Shaping Dermatology Practice

Fall Clinical 2026 packed 4 days of data, debate, and hands-on guidance into Las Vegas, and the faculty were direct about what updates can help impact your practice. Dermatology Times heard from Joel Gelfand, MD, MSCE; Angela Fitch, MD; Raj Chovatiya, MD, PhD, MSCI; Aaron Farberg, MD; Christopher Bunick, MD, PhD; Jennifer Hsiao, MD; Ahmad Naim, MD; Todd Schlesinger, MD; Neal Bhatia, MD; Shannon Trotter, DO; Glynis Ablon, MD; and Iltefat Hamzavi, MD. Their takeaways span psoriasis to skin cancer, from an oral IL-23 receptor blocker holding clearance through 2 years to a nonsurgical option for superficial basal cell carcinoma, organized by topic below.

Psoriasis: Durability Data, GLP-1 Combinations, and Topical Gains

Johnson & Johnson presented 2-year ICONIC-LEAD data for icotrokinra (Icotyde), a once-daily oral peptide blocking the IL-23 receptor. At least 72% of patients with moderate to severe plaque psoriasis held Psoriasis Area and Severity Index (PASI) 90 from week 64 through week 112, and at least 44% held PASI 100. Among PASI 90 responders withdrawn at week 24, 85% regained PASI 90 within 24 weeks of retreatment.¹

Eli Lilly and Company reported exploratory phase 3b TOGETHER-PsO data for ixekizumab (Taltz) plus tirzepatide (Zepbound) in adults with psoriasis and obesity or overweight. By week 36, combination therapy altered 482 proteins and 467 genes vs 140 and 16 with ixekizumab alone. According to Lilly, changes in a subset of neutrophil-associated markers mediated part of the additional PASI response.²

Joel M. Gelfand, MD, MSCE, of the University of Pennsylvania Perelman School of Medicine, said in an interview that clearing the skin does not resolve residual systemic inflammation. “We all had this hope if we just cleared the skin, everything would turn to normal,” he said. He described blood pressure reductions of about 8 to 10 mm Hg in TOGETHER-PsO and called the metabolic benefits “dramatic.”

Angela Fitch, MD, chief medical officer of Knownwell and past president of the Obesity Medicine Association, said GLP-1 medications act directly on inflammatory pathways, “not just because of the weight management.” She advised counseling patients on chronic therapy, as metabolic benefits fade when medication stops. Dermatologists uncomfortable prescribing can still start the conversation and refer to obesity medicine or primary care, she said.

Topical and monitoring data rounded out the program. A poster on roflumilast cream and foam 0.3% (Zoryve; Arcutis Biotherapeutics) from the DERMIS-1/2 and ARRECTOR trials showed greater improvement in sexual function and personal relationships vs vehicle, including in patients with genital involvement. A retrospective study of biologic-treated patients with psoriasis, psoriatic arthritis, or hidradenitis suppurativa (HS) found liver function test elevations and related treatment changes were rare.

Atopic Dermatitis: Biologic Choice, Switching, and JAK Inhibitor Safety

Raj Chovatiya, MD, PhD, MSCI, of Rosalind Franklin University Chicago Medical School, said the first priority for a systemic-ready patient with atopic dermatitis (AD) is getting them on a systemic therapy. “There really are no wrong answers as long as you’re able to get your systemic therapy ready patient on a systemic therapy,” he said. He urged clinicians to compare data for the IL-13 agents dupilumab (Dupixent; Regeneron and Sanofi), tralokinumab (Adbry; LEO Pharma), and lebrikizumab across trial design, populations, outcomes, and safety.

Among week 16 responders to nemolizumab (Nemluvio; Galderma) in the ARCADIA long-term extension, 80% reached 90% improvement in Eczema Area and Severity Index (EASI 90) and 80% reached an itch-free or nearly itch-free state at week 152. Additionally, 76% had clear or almost clear skin and 50% had complete clearance.³

A post hoc analysis of LEVEL UP and HEADS UP found no skin lesion flares through 16 weeks after patients switched from dupilumab to upadacitinib (Rinvoq; AbbVie), an oral Janus kinase (JAK) inhibitor, following an inadequate response. Itch flares occurred in 3.6% to 4.8% of eligible patients, and the HEADS UP subgroup included only 28 patients.⁴

A retrospective claims analysis presented as a poster found dupilumab was associated with a significantly lower risk of atopic march progression than systemic corticosteroids across every pediatric age group.⁵ In an interview, Aaron S. Farberg, MD, described the AdvanceAD-Tx gene expression profile test for atopic dermatitis as a way to “molecularly align our therapy with the patient’s disease.”

Christopher G. Bunick, MD, PhD, of Yale School of Medicine and editor in chief of Dermatology Times, presented long-term JAK inhibitor safety data in a symposium. “Seven-year safety rates of those drugs in atopic dermatitis are no higher than the rates of apremilast in psoriasis or psoriatic arthritis,” he said, referring to upadacitinib and abrocitinib. Reassuring data, he cautioned, “doesn’t mean you can relax as a physician and not do your job.”

Hidradenitis Suppurativa: Expectation Setting and Care Gaps

Jennifer Hsiao, MD, of the University of Southern California, said initial success in HS means fewer, smaller, shorter flares rather than clear skin. She asks patients to track drainage, pain, and new lesions between visits. “Treatment expectation setting [is] really important for treatment adherence,” she said.

Hsiao reassesses at 3 to 4 months and explains the timeline at the first visit. Because few HS therapies exist, she cautioned against cycling through them too quickly. “You don’t want to miss out on one where maybe they can ultimately achieve a good response, but you just didn’t hang in there long enough,” she said.

Two UCB-funded claims analyses highlighted access gaps in HS. Symptom-defined HS prevalence was similar between males and females, which may suggest underdiagnosis in males, and rural patients were less likely than urban patients to see a dermatologist.^6,7

Ahmad Naim, MD, chief medical officer of Sun Pharmaceuticals North America, framed the stakes for the field. “I’m very fond of saying that HS is the new psoriasis,” he said. Naim noted psoriasis posed a similar challenge 30 years ago, and diagnosis alone in HS can take a long time.

Skin Cancer: Red Light PDT for Superficial BCC and cSCC Immunotherapy

The FDA approval of aminolevulinic acid hydrochloride gel 10% (Ameluz) with red light photodynamic therapy (PDT) for superficial basal cell carcinoma (BCC) was a top takeaway for several faculty. Todd Schlesinger, MD, of the Clinical Research Center of the Carolinas, outlined the regimen. “So now we can use photodynamic therapy with red light, 3-hour incubation, and 2 to 4 cycles to treat superficial basal cell carcinoma,” he said.

Neal Bhatia, MD, named the pretibial surfaces, behind the ears, and around the eyes as sites where surgery may be difficult. “This is a good option for patients who may not be surgical candidates,” he said. Farberg agreed. “Not every patient wants their skin cancer cut out,” he said.

For actinic keratosis, Bhatia’s theme was “thinking in terms of ‘and’ instead of ‘or,’” sequencing cryotherapy, topical cycles, and PDT. Schlesinger said sequential PDT, tirbanibulin, and other topicals suit a chronic condition. He urged setting patients up for twice-yearly PDT.

Shannon Trotter, DO, of DOCS Dermatology in Central Ohio, said about 5% of cutaneous squamous cell carcinoma (cSCC) cases become difficult to treat. “We’re really the quarterbacks in skin cancer,” she said, urging dermatologists to know pembrolizumab (Keytruda; Merck), cemiplimab (Libtayo; Regeneron), and cosibelimab (Unloxcyt; Sun Pharma). Schlesinger added adjuvant cemiplimab is an option after surgery and radiation for high-risk locally advanced disease.

Trotter also discussed proposed Medicare cuts after the American Academy of Dermatology Association Legislative Conference. “What it boils down to essentially is a patient access issue,” she said. She directed clinicians to saveskincancercare.org to sign the community petition.

Alopecia, Vitiligo, Acne, and Aesthetics: Practical Guidance

Glynis Ablon, MD, of UCLA, recommended screening every aesthetic patient for body dysmorphic disorder (BDD) before treatment. Screening matters, she said, because BDD is “really a lot more common than clinicians realize.” For alopecia, she advised confirming the diagnosis, starting early, and combining modalities, with 6 to 12 months to judge response.

Iltefat Hamzavi, MD, of Henry Ford Health, reserves topical ruxolitinib for localized, stable vitiligo, defined as less than 10% body surface area. “Once you’re going beyond 10%, you’re putting a lot of cream on somebody, you’re gonna have a risk of side effects, so it’s better to go to oral,” he said. He avoids oral JAK inhibitors in patients with active cardiovascular risk, high body mass index, smoking, a strong family history, or very high cholesterol.

In acne, Bunick highlighted the lower phototoxicity risk of sarecycline vs doxycycline and minocycline. For patients who relapse despite an adequate isotretinoin course, he suggested micronized isotretinoin. “Think about the micronized isotretinoin because there really are variabilities in gut absorption we just can’t account for yet scientifically,” he said.

What Fall Clinical 2026 Means for Your Practice

Three threads ran through the topics covered at Fall Clinical. Durability and long-term safety anchored the psoriasis and AD data, with follow-up reaching 2 to 7 years. Metabolic health moved closer to the center of psoriatic disease care.

Nonsurgical options also expanded in skin cancer, and expectation setting emerged as a practical lever in HS, alopecia, and aesthetics. Naim said it plainly. “Long-term data, I think dermatologists will always ask for,” he told Dermatology Times.

The pipeline stayed busy. “There are so many new molecules in the pipeline. I can’t even go through them all,” Farberg said of psoriasis, and Schlesinger expects more nonsurgical options for skin cancer.

For all content from Fall Clinical, click here.

References

1. New Johnson & Johnson Icotyde (icotrokinra) long-term data demonstrate robust 2-year results in the treatment of adults and adolescents with plaque psoriasis. News release. Johnson & Johnson. October 9, 2026. Accessed October 19, 2026. https://www.jnj.com/media-center/press-releases/new-johnson-johnson-icotyde-icotrokinra-long-term-data-demonstrate-robust-2-year-results-in-the-treatment-of-adults-and-adolescents-with-plaque-psoriasis
2. Eli Lilly and Company. New phase 3b data on Lilly’s Taltz (ixekizumab) and Zepbound (tirzepatide) advance understanding of the interconnected immune and metabolic biology in adults with psoriasis and obesity. Published October 9, 2026. Accessed October 19, 2026. https://investor.lilly.com/news-releases/news-release-details/new-phase-3b-data-lillys-taltz-ixekizumab-and-zepbound-0
3. Galderma. Fall Clinical 2026: Galderma presents new three-year Nemluvio data showing deep and lasting responses in atopic dermatitis. Published October 8, 2026. Accessed October 19, 2026.
4. Zirwas MJ, Ruiz Dasilva D, Shahriari M, et al. Switching to upadacitinib monotherapy was associated with minimal or no flares following inadequate response to dupilumab in patients with moderate-to-severe atopic dermatitis. Presented at: 2026 Fall Clinical Dermatology Conference; October 8–11, 2026; Las Vegas, NV
5. Simpson EL, Paller A, Eichenfield LF, et al. Modification of atopic march progression in dupilumab-treated pediatric atopic dermatitis patients in the United States: a retrospective, real-world study. Poster presented at: Fall Clinical Dermatology Conference 2026; October 8–11, 2026; Las Vegas, NV
6. Lev-Tov H, Ingram JR, Hsiao J, et al. Sex-specific and age-adjusted prevalence of hidradenitis suppurativa: results from Komodo US claims data suggest sex parity of HS symptoms. Poster presented at: 2026 Fall Clinical Dermatology Conference; October 8-11, 2026; Las Vegas, NV
7. Achter E, Aweh G, Antonucci M, et al. Social determinants of health in rural versus urban patients with hidradenitis suppurativa. Poster presented at: 2026 Fall Clinical Dermatology Conference; October 8-11, 2026; Las Vegas, NV