Tea Time: Can't-miss Dermatology Developments in 2025

Catch up on some of the most interesting and impactful developments of 2025, from research and new treatments for chronic hand eczema, emerging oral therapies for psoriasis and AD, and even advances in cosmetic dermatology. DEF Faculty and Advisory Council members weigh in on some of the key developments with an emphasis on clinical implications. And they look ahead to 2026. Plus, updates on trichoscopy and AI.

Featuring: Brad Glick, Darren West, Hillary Baldwin, Roman Bronfenbrener, Kara Gooding, Sandri Johnson, Linda Stein Gold, Joe Gorelick, Lisa Swanson, Ted Rosen, Gilly Munavalli, Matt Bruno, David Cotter

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Transcript

Transcript provided as a courtesy. It has not been reviewed or edited for accuracy. 

Announcer:

Welcome to the Dermalorian Podcast from the Dermatology Education Foundation. The Dermalorian Podcast is made possible with support from Johnson & Johnson. 2025 is sure to be remembered as yet another significant year for therapeutic advancements in dermatology. There were drugs approved for diseases that never had specific treatments, label expansions for previously approved medications, and promising research findings. We've gathered insights from DEF faculty and DEF advisory council members about some key updates and potential future developments. We begin with dermatologist Dr. Brad Glick and a look at two publications that caught his attention this year.Brad Glick:

Our colleague, Raj Dovotia, just published two months ago in dermatologic therapy, a great article on chronic hand eczema. He really delved into the different subtypes, seven or eight different subtypes, depending on how you interpret the presentations of chronic hand eczema. So that was one really unique component. But one of the things he talked about now, despite our colleague, Dr. David Cohens being probably the world expert in contact dermatitis and patch testing, one of the things he talked about is not delaying the treatment because of how you're trying to diagnose perhaps one of those three critical subtypes in chronic hand eczema. The atopic component, the irritant contact dermatitis component, and that true allergic contact dermatitis component to chronic hand eczema. So one of the things he talked about was, while it is important to consider patch testing, consider it down the road because we have the opportunity to treat our patients now with highly effective therapies, like with our newly approved dolgocitinib pan-JAK inhibitor for treating hand dermatitis.
Another article that I reviewed that is just published in this last month was a great publication in the rheumatology literature by Len Calabrese. And so he reviewed all of the three clinical trials, the phase three clinical trials for those therapeutics that are now FDA approved for treating hidradenitis suppurativa. And I found the article |interesting and I'll just summarize that one of the things he found, first of all, that all three of these agents are highly effective in treating our patients with hidradenitis suppurativa. We have a new agent in bimekizumab, which just approved in this past year, which I talked about in my presentation, but you'll find it very interesting that the data in this pan review and meta analysis basically showed adalimumab and bemekizumab kind of neck and neck and both highly effective and maybe actually adalidumab. Now again, not head to head, but somewhat superior to both dosing regimens for secukinumab at every two weeks and every four weeks, 300 milligrams subcutaneously. But by and large, all three therapeutics were found to be exceptional in managing our patients with HS.Announcer:

Dermatology physician assistant Darren West notes that evolution in the realm of chronic inflammatory skin disease is driving the specialty forward.Darren West:

Some of the biggest changes that I've seen in dermatology since I've been practicing for the past 25 years is inflammatory disease. It's incredible. It's almost mind blowing. We began doing dermatology pre-dawn ages, it seems like, way back when, early 2000s and before. And so we were writing immunosuppressants and we were just doing everything that we thought we could do to help patients just to get them better, but nothing ever really managed their disease very well. And if anything, it just had lots of side effects. And so with the event of the IL-23s, the IL-17s, the TNF-alpha inhibitors and all the psoriasis drugs, and now we're moving into this atopic dermatitis, inflammatory disease state condition. And now we're getting all the new drugs, the JAK inhibitors. It's incredible the amount of technology and the development and advancement in therapeutics that we've seen. So the landscape has completely changed.
And to me, it makes our job easier as providers. When a person comes in now and they're 75% covered in psoriasis or they're scratching head to toe and they're 60% BSA erythrodermic, we actually have a ways in which we can fix that and we can give them actually a good quality of life and a meaningful treatment that is safe and easy to manage. And so we never had that before. So since my dawn of existence in this derm field, I've seen an incredible swing from how we were treating before to how we are today. And we're even getting better and better. We're getting more unique mechanism of actions. We're becoming more and more effective and we're dialing in even more in detail on how to treat specific disease states, even orphan disease states, disease states we never thought we could ever treat in advances in vitiligo, just things that are just really amazing.
And so I'm excited and I just can't wait for the next five years because I just know it's going to be a completely different way of looking at it even again.Announcer:

In the rosacea space, dermatologist, Dr. Hillary Baldwin says a new systemic agent is the latest advancement in a somewhat stagnant field.Hillary Baldwiin:

We have one new product in rosacea. We have a new low dose extended release minocycline with 10 milligrams immediate release and 30 milligrams delayed release speeds within the capsule. Very similar to the anti-inflammatory dose doxycycline that we've had for so many years. So this new product has been demonstrated to have superior efficacy compared not only to the vehicle in the phase three trial, but also to the doxycycline modified release formulation. Of course, the question though is, is it an anti-inflammatory disorder concentration or is it actually acting as an antibiotic? So they went ahead and did a study where they did swabs of the skin and the vagina and the stool to look to see if there was any evidence of development of resistant organisms to minocycline and there was not. So it looks as though this new pill, just like modified release doxycycline, is a non-antibiotic dose, which of course would mean that it's safe and effective for long-term use.Announcer:

You're listening to the Dermalorian Podcast from the Dermatology Education Foundation. The Dermalorian podcast is made possible with support from Johnson & Johnson. For this episode's Dermalorian Clinical Clip, dermatologist Dr. Roman Bronfenbrener, provides practical guidance on the use of dermatoscopes to diagnose hair disorders.Roman Bronfenbrener:

Tricoscopy is a fantastic use of the dermatoscope. It's the same exact dermatoscope that you're otherwise using. You don't need another special device like a trichoscope. That is the dermatoscope that you already have. Even if you know nothing about what you're looking at with the dermatoscope when you're looking at someone's scalp, that patient will already perceive that you're looking much more than any provider that they've seen before because you're using dermoscopy. But in fairness, there are a lot of utilities and a lot of conditions where it can help make the diagnosis. The first thing that I look for if I'm evaluating alopecia is the absence or the presence of hair follicles. In any condition where there's a scarring process like implanopilaris, discoid lupus, folliculitis decalvans, you will see loss of follicular ostia. You'll have just a scar, you won't see the little black dots that you'll commonly see.
For example, if you're dealing with alopecia areata, which is not a scarring alopecia, you'll see the hair follicles are preserved. They might have hairs of varying sizes and lengths and architectures, but the fact that the hair is present gives you an idea of what you're dealing with. Another great utility is to distinguish between alopecia areata and trichotillomania because the clinical presentation can be very similar of those. And it's a perfect use of trichoscopy because if you look at trichotillomania, you will see broken hairs, you'll see trichorexis nodosa, you'll see broom hairs. And if you look at alopecia areata, you shouldn't have any of those features. Now, things can certainly coexist. There have been patients that have had two types of alopecia and dermoscopy or trichoscopy is a fantastic way to figure that out because you'll know, hey, this area looks different than this. You might need to do two biopsies instead of one to really get to the final diagnosis.Announcer:

Let's get back to our look at key developments of 2025. Dermatology physician assistant Kara Gooding welcomes developments in the treatment of eczema and psoriasis.Kara Gooding:

We have had an explosion of new therapeutics in dermatology. So we have Anzupgo, which is a pan-JAK for chronic hand eczema. So that is super exciting for us to be able to add to our treatment armamentarium. We've also had new biologics that have been added for treating psoriasis and atopic dermatitis within the last year or so. So nice to have additional treatment options for our patients. And then I'm also looking forward to some of the new oral therapeutics that we're going to have, particularly for atopic dermatitis and psoriasis. Although we have phenomenal drugs in the biologic space, we still have some room for some additional oral therapies, and I think we have those coming in the near future within the next year that are really exciting.Announcer:

Dermatology nurse practitioner Sandra Johnson says that JAK inhibitors have revolutionized dermatology practice.Sandra Johnson:

The non-steroidal anti-inflammatory immune-based medications, specifically JAK inhibitors, they revolutionize therapeutics, and I don't think we have even seen one tenth of what the medications can do. So when JAKs were coming into our space and we've been watching their data, I remember walking around saying that I was JAK static just for something revolutionary, something new with major implications across so many indications. For the future, I'm very excited about a new oral peptide coming around, an IL-23 blocker for psoriasis for both adolescents and adults. So that's one of the therapeutics that I'm watching closely. We have thought for a long time that maybe the space in psoriasis is a little crowded, but there's always unmet need. And this particular molecule has my sight set on it.Announcer:

For dermatologist, Dr. Linda Steingold, the therapeutic pipeline is a source of excitement.Linda Steingold:

We actually have a very exciting horizon for psoriasis therapy. We have some great topicals. We have some wonderful biologic areas, but the area that we have the most unmet need is in the oral space. And fortunately, we have a number of oral molecules that are in clinical trials. We had recently oral TYK2 inhibitor that was FDA approved, decravacitinib, and that's helped to fill an unmet need in giving us better efficacy with a good safety profile. There are other oral TYK2 inhibitors that are also being studied that might even have better efficacy than what we have currently. And then it's very exciting. We have an oral IL-23 inhibitor that's in phase three clinical trials, pretty much finished. And this is basically like taking a biologic with a pill. It's an oral agent and you take it on an empty stomach, usually with water. And this has been shown to have really, really good efficacy with the safety profile that we've come to expect with an IL-23 inhibitor.
So this is an area for the oral treatment armamentarium that has been unmet, and now I think we're going to have some really great treatment options.Announcer:

Dermatology nurse practitioner and DEF president, Joe Garelick, points out new data regarding IL inhibition and repair of damage from psoriatic joint disease.Joe Garelick:

So for children with psoriasis or active psoriatic arthritis, guselkumab's indication has reduced down to the age of six. Also, a few months back, there were some data published about radiographic progression of disease. And to date, before that, the IL-23 inhibitors in their labels did not show data that they were effective. It's stopping the progression of bony growth in the joints shown on X-ray pictures. So this new radiographic evidence showing that there's been less joint space narrowing in these clinical trials for psoriatic arthritis patients using guselkumab is published.Announcer:

Speaking of pediatrics, dermatologist Dr. Lisa Swanson highlights the impact of newer topical nonsteroidal drugs for kids.Lisa Swanson:

Love the new topical nonsteroidals. Love them so much because I used to have to spend a pretty significant amount of clinic time talking about steroid phobia and reassuring families that it's all about appropriate use and use the appropriate steroid in the appropriate place for the appropriate period of time. And now I can say, "Oh, you'd rather not use a steroid?" Okay, great. I have all of these options to offer you. And so I am so grateful for them. We've got tapinarof approved down to two. We've got roflumilast approved down to six, and we've got topical ruxolitinib approved down to 12. And we are eagerly anticipating seeing some label expansions for both roflumilast and ruxolitinib with approvals even in the younger patient space. And so these are wonderful, effective, non-stingy, burny, completely steroid-free products, and I am so happy to have them in my toolbox.Announcer:

Finally, in the medical field, dermatologist Dr. Ted Rosen is optimistic that off-label use of JAK inhibitors will expand with important benefits for many undertreated diseases.Ted Rosen:

We are so blessed to be in the era of JAK inhibitors. There's a small problem, yes. We already are using them for psoriasis and eczema and alopecia areata, but there are other areas where these drugs are incredibly effective. Now, what I can't do is I can't tell you which JAK inhibitor because there isn't enough data. I can't tell you the dose. There really isn't enough data. I can't tell you how long to continue the therapy. There isn't enough data, but there are cases, small case series, and a couple of real trials that show that JAK inhibitors off-label are very effective for the following processes. Granuloma annulare responds very well. Sarcoid, back against the wall where steroids, methotrexate, and TNF-alpha inhibitors didn't work. JAK inhibitors work for sarcoid. Takes a while. You have to give it time. There's no doubt that the TYK2 type of JAK inhibitors like decrevacitinib work for lupus, all kinds of lupus, whether it's cutaneous or systemic.
And then lichen planus also responds quite well to the JAK inhibitors. Again, we have ways to treat all of those diseases, but frequently our standard therapeutics, none of which, by the way, are FDA approved, but when our standard therapeutics don't work, it's nice to know that the JAK inhibitors might give us a shot at relieving symptoms and eradicating signs of those four and other diseases as well. There's early work to show that JAK inhibitors, particularly povacitinib, may be quite effective for hidradenitis suppurativa, for example. So I think this is the beginning of a brand new era with a whole class of extremely effective drugs. Last comment, because they're off-label right now, you will have to be your patient's advocate. You will have to obtain the approval of insurance companies to pay for these drugs because they are expensive. And what I typically do is I write a personalized letter, I explain what I want to treat with the patient's permission.
I include a picture to kind of pull at the heartstrings of the insurance executives who are looking at this appeal. And I also point out, I send them a reference or two to point out, I'm not the first person trying this in the entire world. This has been done and we have precedent that it'll work. Can you please, please give my patient a chance? That's how I phrase it. And more often than not, I'm successful.Announcer:

Of course, there have also been updates in cosmetic dermatology. Dermatologist, Dr. Gilly Munavali, addresses what's new in injectable neurotoxins.Gilly Munavali:

We have a new toxin that's letibotulinum toxin, which is the trade name is Letybo. And that was released earlier this year, probably four months ago. And that one is out of Korea. It has a lot of strong data. And what's unique about it is the onset is typically 24 to 48 hours or sometimes less. The unit is one to one with the typical botulinum toxin. And so we got a new inter-armamentarium to try to use for patients. We're finding Letybo to be useful for its time of onset, definitely for events that are coming up. Also, the cost is a little bit better for physicians, and so we can pass it on to our patients who might want to dip into toxins, but may not want to pay the full price for something like just Botox, so cosmetic.
The other one we're waiting on is a liquid toxin that should be coming. And that's interesting. I mean, it does obviate the need for having to reconstitute. So you don't have to worry about potentially making errors there. It comes premixed, ready to inject. So that saves us time and potential mistakes with that. Also, there are some areas where mixing compounds, for example, mixing in a hospital setting, ambulatory surgery setting, and in some states is not looked upon favorably. So you're buying a product that's ready to use out of the bottle.Announcer:

Despite these numerous advancements, unmet needs in dermatology remain, says dermatology physician assistant, Matt Bruno.Matt Bruno:

So we always want to know where's the greatest unmet need. And I think there's definitely some opportunities for advancement in medical derm for sure, particularly still in atopic dermatitis. We've had a lot of great advancements to date and innovation, but even things like STAT6 and OX40 and some of these newer therapies that are coming up I think are really exciting. I think the more opportunities and more options that we have to increase efficacy all the while maximizing safety, I think is paramount. But I would say a non-traditional unmet need opportunity would be the managed care front. So being able to make some meaningful change, whether that's through legislation or just using partnerships to get access, increase the access of these drugs for our patients.Announcer:

Artificial intelligence or AI has been a headline maker in 2025 in dermatology and beyond. In this episode's Dermalorian Derm Decoder, dermatologist Dr. David Cotter helps make sense of the most likely potential application of AI in dermatology.David Cotter:

Thinking about AI in dermatology and what's on the horizon, a lot of people are wondering, centering the conversation on image analysis and skin cancer detection or maybe therapeutic augmentation of knowing what the best treatment might be for a given patient. But in my opinion, that's not what is most important. The greatest promise of AI in dermatology is going to come from a research standpoint. If you think about it, we have millions of pieces of data, patient level granular data buried in EMRs. No human being or even armies of human beings could access that information and analyze it at the same level that a computer program could. We can use artificial intelligence to look at massive amounts of data across multiple different geographic regions, patient types, therapeutic landscapes to pull out trends and important components of treatment satisfaction, treatment response, biologic cycling to look what patients go on and off medications and how that looks from picking the next therapeutic for them. So there's many different touch points where AI can access big data and provide valuable insights that we couldn't get in any other way.Announcer:

Hopefully, this edition of the Dermalorian Podcast has provided you with valuable insights. If you like what you're hearing, follow us and spread the word. The Dermalorian Podcast is produced for the DEF by Physician Resources. We wish you a happy and healthy 2026.