PracticalDermatology

The past year brought about a host of therapeutic innovations and advances that, when taken together, are changing the way doctors diagnose, treat, and monitor such conditions as acne, psoriasis, atopic dermatitis (AD), and other pediatric skin diseases. It’s been a year of game changers and new beginnings, all of which have been highlighted in Practical Dermatology’s Clinical Focus column throughout 2016.

Our Clinical Focus columnists now look back at what we learned in 2016 and shed some light on what we can look forward to in 2017 and beyond.

Robust Acne Pipeline

“The most exciting news in acne is the robust pipeline of new acne drugs in development,” says Joshua Zeichner, MD, FAAD, Assistant Professor and Director of Cosmetic and Clinical Research in the Department of Dermatology at Mount Sinai Medical Center in New York. “From nitric oxide to sebum inhibitors, the next few years will bring acne treatments that work in different and novel mechanisms from what we currently have available.”

Other big acne news in 2016 included the approval of Allergan’s Aczone (dapsone) Gel, 7.5%, a once-a-day prescription topical treatment for patients 12 years of age and older and the publication of new American Academy of Dermatology guidelines for the management of acne vulgaris. The guidelines call for combining antibiotics and topicals for the treatment of moderate-to-severe acne. Once a course of antibiotics is complete, patients should continue using topical treatments to manage their condition, the guidelines state. Topical medications, such as retinoids and benzoyl peroxide, also may be combined to create an effective treatment regimen. For severe acne or moderate acne that does not respond to other therapy, the guidelines recommend oral isotretinoin.

New Psoriasis Drugs

There was a flurry of activity on the psoriasis front in 2016 with the FDA approval of three biosimilar drugs that target psoriatic disease as well as Taltz (ixekizumab) for adults with moderate-to-severe plaque psoriasis. “This is the first time we have ever seen complete clearing on the label at 12 weeks,“ says Jerry Bagel, MD, Director of the Psoriasis Treatment Center of Central New Jersey.

What’s more, a now robust body of evidence showing that psoriasis is more than skin deep is changing how doctors see other diseases, such as AD, vitiligo, rosacea, and acne, Dr. Bagel says.

“Given the growing list of comorbidities associated with psoriasis, the onus is on dermatologists to collaborate and coordinate care with primary care physicians and other specialists, namely psychiatrists, cardiologists, and obstetrician/gynecologists,” he wrote in Practical Dermatology® magazine’s May 2016 issue. “Treating psoriasis and its associated complications and comorbidities takes a team effort. Ultimately, this approach will improve quality of life as well as skin, joint, and overall health for our patients.”

New Thinking About AD

“This has been a tremendous year for AD,” asserts Peter Lio, MD, a Clinical Assistant Professor of Dermatology & Pediatrics at Northwestern University Feinberg School of Medicine and a partner of Medical Dermatology Associates of Chicago.” We are about to see a wellspring of new treatment options come to the market, including the first biologic for AD.”

In particular, “the exciting phase 3 data for dupilumab and crisaborole came out, and perhaps just as importantly, there is renewed excitement in finding treatments for this terrible disease with a formidable pipeline.”

Underpinning these therapeutic innovations are real advancements in the understanding of AD, he says: “From new insights about staphylococcus and its delta-toxin, to a clearer vision of the inflammatory cascade, it seems like all eyes are on AD and the future is looking incredibly bright.” n