Mar 12
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Diet and HS: JDD Buzz

By Medical Dermatology

Diet and HS

A review in the Journal of Drugs in Dermatology highlights diet as a promising adjunct in hidradenitis suppurativa (HS) management, with emerging evidence that targeted dietary changes may reduce inflammation and disease severity.

In this interview with Next Steps in Derm, the study’s authors outline the main takeaway: Several dietary strategies may benefit some patients. Avoiding dairy and brewer’s yeast has been associated with symptom improvement, likely by reducing hormonal and immune triggers linked to follicular plugging and inflammation. Diets that lower systemic inflammation—such as the Mediterranean diet and very-low-calorie ketogenic diet—have shown encouraging results in small studies. Limiting leucine-rich foods (e.g., meat, eggs, and dairy) may also help by reducing mTOR-driven pathways involved in HS lesion formation.

Addressing micronutrient deficiencies is another low-risk strategy. Supplementation with vitamin D or zinc in deficient patients has produced clinical improvement in some cases. In addition, intermittent fasting, including Ramadan-style fasting, has been associated with reduced inflammatory markers and lesion severity in a subset of patients.

Although most studies are small and further research is needed, the findings support diet as a personalized, noninvasive adjunct to medical therapy. Clinicians should move beyond general advice and consider discussing specific dietary patterns—such as Mediterranean, dairy-free, or brewer’s yeast–free approaches—with patients seeking to optimize HS control or reduce reliance on systemic medications.

Mar 04
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JAK Inhibitor Responses by Race: SOCU in the News

By Media Coverage

JAK inhibitor responses

An analysis presented at the 2025 Skin of Color Update explores whether JAK inhibitor responses differ by race in dermatologic diseases, such as atopic dermatitis (AD), vitiligo, and alopecia areata. Brett King, MD, PhD, examined outcomes by race and, when available, Fitzpatrick skin type (FST). Although no statistical testing was performed, numerical differences in response rates were observed, warranting further study.

Medscape’s news coverage of the session details phase 3 trial data for approved JAK inhibitors. In AD trials of abrocitinib, Black patients (8.8% of participants) had lower week 12 IGA 0/1 response rates compared with White patients (28% vs 43% at the 200 mg dose). Similar gaps were seen in pruritus reduction. In upadacitinib trials, Black patients showed nearly a 20% lower EASI-90 response than White patients at the 15 mg dose (24.1% vs 43.3%), though this difference diminished at 30 mg. Trials of ruxolitinib cream for AD also showed lower IGA 0/1 responses among Black patients compared with White and Asian patients.

However, this pattern did not hold in vitiligo trials of ruxolitinib cream, where Black patients had equal or higher response rates than other groups. Greater improvement was also observed in patients with darker Fitzpatrick skin types in some analyses. These findings raise questions about whether differences reflect biological variation, dosing, disease assessment challenges (such as recognizing erythema in darker skin), or even diagnostic inaccuracies, as highlighted by a reanalysis of alopecia areata trial photographs that identified misclassification in several Black patients.

Importantly, serious adverse events were rare across racial groups, and safety concerns associated with JAK inhibitors in rheumatoid arthritis trials have not appeared to translate to dermatologic populations.

Both Dr. King and Skin of Color Update Co-Chair Andrew F. Alexis, MD, MPH, FAAD, emphasized that these findings on JAK inhibitor responses are preliminary and hypothesis-generating. Larger, more diverse trials—particularly those stratified by skin type—are needed to determine whether true differences in treatment response exist and to improve disease assessment across diverse patient populations.

Feb 24
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Genetic Ancestry and Skin Disease: From the SOCU Poster Hall

By Medical Dermatology

genetic ancestry and skin disease

Skin of color dermatology is evolving beyond race-based categories as researchers explore connections between genetic ancestry and skin disease.

Research outlined in a poster presented at Skin of Color Update found that genetically inferred ancestry predicts gene expression differences more accurately than self-identified race, with more than 8% of highly expressed genes—and more than 19% of skin-related genes—showing variation between ancestry groups. These differences, including genes linked to conditions such as lichen planus and skin cancer, may influence disease risk, severity, and treatment response.

In this Next Steps in Derm commentary, poster author Emily Uh, BS, shares the clinical impact of these and other findings about genetic ancestry and skin disease. While genetic ancestry should complement—not replace—clinical evaluation and consideration of social factors, ancestry-informed research may help advance precision dermatology and improve care for diverse populations.

For more articles on skin of color dermatology, including research summaries and video interviews with leading experts, visit the Skin of Color page of Next Steps in Derm.

Feb 16
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Non-Scarring Alopecias: SOCU Interview with Dr. Victoria Barbosa

By Uncategorized

non-scarring alopecias

Non-scarring alopecias have many causes, from grooming practices to environmental exposure to genetic predisposition. In this Next Steps in Derm video interview from Skin of Color Update, Victoria Barbosa, MD, FAAD, addresses what dermatology clinicians should know about treating non-scarring alopecias. Dr. Barbosa, associate professor of medicine at the University of Chicago Pritzker School of Medicine, says it’s important for clinicians to take time with patients to counsel them about any behavioral modifications that can help prevent disease progression. Dr. Barbosa also outlines treatments, including JAK inhibitors for alopecia areata and oral minoxidil for female pattern hair loss. Additionally, she shares her approach to telogen effluvium, including hair loss that occurs with GLP-1 weight loss or bariatric surgery.

For more on non-scarring alopecias, join us on Saturday, June 27, for Hair and Scalp Disorders: The Rx Pad and Beyond, a virtual, one-day conference. The program provides a full-spectrum perspective on hair and scalp management, from diagnosis to therapeutics to nutrition and lifestyle factors. Led by recognized leaders, including co-chairs Adam Friedman, MD, and Amy McMichael, MD, every session emphasizes practical tools, decision-making, and real-world implementation. Register today!

Feb 10
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Vulvar Dermatoses: From the SOCU Poster Hall

By Uncategorized

vulvar dermatoses

Vulvar dermatoses are often underdiagnosed in women with skin of color. Cultural stigma, structural and educational barriers, and gaps in research and clinical training all play a role in limiting care. Patients may self-manage symptoms and only seek care when the disease becomes severe. Once they seek care, they may experience gaps in clinician understanding and recognition of the severity of the disease and its quality of life impacts. These clinical barriers may lead to undertreatment.

A poster presented at Skin of Color Update examined these challenges and highlighted the need for more equitable, culturally informed approaches to vulvar dermatoses. In this Next Steps in Derm commentary, lead author Grace Herrick shares the results of a comprehensive narrative review that identified challenges and barriers to care, including the experience of shame. She also outlines a paradigm shift in how dermatology clinicians should approach vulvar health in populations that have been historically marginalized.

Feb 04
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Hidradenitis Suppurativa in Patients with Skin of Color

By Sessions

hidradenitis suppurativa

Hidradenitis suppurativa (HS) is one of the most difficult-to-treat, chronic inflammatory diseases in dermatology, particularly for patients with skin of color. At Skin of Color Update, Tiffany Mayo, MD, led a case-based discussion highlighting earlier recognition, holistic management, and existing and emerging therapies for HS. She emphasized a simple, highly sensitive screening question to reduce diagnostic delays, which currently average 7–10 years, and reviewed the complex immunologic pathogenesis and systemic comorbidities associated with HS.

This session summary outlines practical takeaways, including the importance of reducing patient stigma by reframing misconceptions about causation, while setting realistic expectations — HS is a chronic, noninfectious disease requiring long-term management. Updated U.S. and European guidelines now support a structured, severity-based approach to treatment, incorporating both flare management and maintenance care. Dr. Mayo’s session emphasized holistic, patient-centered care and emerging therapies that can help reduce delays and improve outcomes.

Jan 29
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Psoriasis and Psoriatic Arthritis in Patients With Skin of Color

By Medical Dermatology

psoriasis and psoriatic arthritis in skin of color

Psoriasis doesn’t look the same on every skin tone—and recognizing that matters. Dr. Mona Shahriari, associate clinical professor of dermatology at Yale University School of Medicine, encourages clinicians to broaden their psoriasis color palette to improve diagnosis and care of psoriasis and psoriatic arthritis in skin of color.

In a video interview with Next Steps in Derm, Dr. Shahriari shares:

  • Key clues for diagnosing psoriasis in skin of color
  • The clinical domains of psoriatic arthritis and how early recognition can reduce diagnostic and treatment delays
  • Research insights on scalp psoriasis
  • How pigmentary sequelae impact quality of life

This is a must-watch for clinicians committed to more equitable care of psoriasis and psoriatic arthritis in skin of color.

Be on the lookout for more video interviews with Skin of Color Update faculty that will be posted to the blog in the coming months.

Jan 23
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Recent Dermatology Drug Approvals: SOCU in the News

By Medical Dermatology

recent dermatology drug approvals

Dermatologists have an increasing number of FDA-approved drugs at their disposal, including therapeutics for patients with skin of color. In an article by the American Journal of Managed Care, Skin of Color Update Conference Co-Chair Andrew F. Alexis, MD, FAAD, gave an update on recent drug approvals in dermatology, including atopic dermatitis (AD), hidradenitis suppurativa, and plaque psoriasis.

The article, which covered Dr. Alexis’s Skin of Color Update session on recent drug approvals, highlighted the approval of tapinarof cream 1% for AD in patients age 2 and older. In the phase 3 ADORING trials, nearly half of treated patients achieved clear or almost clear skin by week 8, with durable, treatment-free intervals observed in longer-term data. Importantly, efficacy and safety were consistent across racial and ethnic subgroups.

Other newly approved topical therapies include roflumilast foam for plaque psoriasis, delgocitinib cream as the first steroid-free topical JAK inhibitor for chronic hand eczema in adults, and ruxolitinib cream for moderate AD in young children, all demonstrating statistically significant improvements versus vehicle and good tolerability, including in diverse patient populations.

The article also covered advances in biologics. Lebrikizumab, an IL-13 inhibitor for moderate-to-severe AD, showed durable skin clearance and improvements in hyperpigmentation. Nemolizumab, targeting the IL-31 receptor, improved skin clearance in AD when combined with topical therapies. For HS, bimekizumab demonstrated sustained efficacy through 48 weeks. Additionally, dupilumab received new approvals for chronic spontaneous urticaria and bullous pemphigoid, marking major progress for conditions with historically limited treatment options.

Dr. Alexis is quoted as saying it was an “extraordinary year” in dermatology. The new therapies are already influencing clinical practice and appearing in clinical guidelines, resulting in meaningful advances for conditions that disproportionately affect patients with skin of color.

Jan 15
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Insurance Coverage of Hair Loss Treatments: JDD Buzz

By Medical Dermatology

insurance coverage of hair loss treatments

Hair loss treatments are in demand in 2026, including by patients of color. Dermatologists have a robust toolbox of prescription therapies, yet with any remedy in dermatology, insurance coverage is crucial for adherence. Unfortunately, insurers often deem hair loss therapies cosmetic despite their quality of life impact. Without insurance coverage of hair loss treatments, patients must decide if they’re willing to make financial sacrifices to regrow hair and improve their self-esteem.

A recent Journal of Drugs in Dermatology editorial analyzes insurance coverage of hair loss treatments and the impact on patients, including the underserved. In a Next Steps in Derm Commentary, author Kimberly S. Salkey, MD, shares her analysis of coverage by the top five largest health insurance companies by number of insured members. Dr. Salkey brings attention to this treatment barrier and provides tips for helping patients gain access when insurance coverage is denied.

Jan 07
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Alopecia Care for Head-Covering Women

By Medical Dermatology

head-covering women

For head-covering women, hair loss can have profound psychosocial, cultural, and spiritual consequences. In fact, emotional distress and fear of feeling exposed can lead these women to delay care. A poster presented at Skin of Color Update shares the experiences of head-covering women with alopecia and how dermatology should adapt to provide more respectful care.

The poster outlines how hair loss in women who wear head coverings is not simply a medical issue. Through qualitative studies, patient narratives, and dermatologic literature, the authors reveal what happens when a person’s hair loss is hidden from public view.  Head-covering women still experience grief, anxiety, and fear of stigma at the loss of hair. Barriers to care commonly include discomfort uncovering hair, lack of privacy, unease with male clinicians, and concerns about clinical photography.

The poster also outlines strategies that can improve care. These strategies include offering same-gender examiners, ensuring private exam spaces, clearly communicating each step of the visit, and respecting patient preferences around modesty and documentation. The poster authors contend that dermatology clinicians should acknowledge the religious and emotional significance of hair and adopt more culturally responsive practices. As such, dermatology clinicians can build trust and reduce delays in diagnosis, which in turn, lead to more compassionate, effective alopecia care.

For an interview with the poster’s lead author, read this Next Steps in Derm commentary.

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