Dermatology

Oral TYK2 inhibitor ICP-332 shows rapid AD control over 4 weeks with fibrinogen decreases as key safety signal

In this phase 2, 4-week RCT, adults with moderate-to-severe atopic dermatitis received oral ICP-332 80 mg, 120 mg, or placebo once daily. Both ICP-332 doses produced large EASI reductions at week 4 (about 70–80%) versus modest improvement with placebo (~17%). EASI-75 rates were substantially higher with ICP-332 (64% for both doses) than with placebo, indicating robust short-term disease control. Treatment-emergent adverse events were common but mild or moderate; decreased blood fibrinogen was the most frequent laboratory abnormality. The trial supports TYK2 inhibition as a fast-acting systemic option, but fibrinogen monitoring and longer-term safety data will be essential. 1

Switching dupilumab nonresponders to upadacitinib yields high skin and itch responses by week 32

In LEVEL UP period 2, 208 dupilumab inadequate responders with moderate-to-severe AD were switched to oral upadacitinib with possible dose escalation. By week 32, 79.6% achieved EASI-75 and 58.7% achieved EASI-90, with almost 20% reaching complete clearance (EASI-100). Among patients with significant baseline itch, 60.2% had ≥4-point WP-NRS improvement and 37% reached WP-NRS 0/1 by week 32. Approximately 26.8% achieved simultaneous EASI-90 and WP-NRS 0/1, indicating near-complete control of skin and itch in over one-quarter. No new safety signals emerged, supporting upadacitinib as a step-up option when dupilumab fails to meet treatment targets. 2

LC-OCT markedly improves specificity for BCC and superficial subtype versus dermoscopy

This prospective bedside study evaluated 214 clinically equivocal lesions using dermoscopy and LC-OCT prior to histologic confirmation. For distinguishing BCC from imitators, LC-OCT matched dermoscopy’s high sensitivity (98%) but greatly improved specificity (90% vs 37%). For identifying superficial BCC, LC-OCT showed higher sensitivity (72% vs 62%) and specificity (97% vs 84%) than dermoscopy. Improved subtyping accuracy may support more confident selection of nonsurgical therapies for superficial BCC and reduce unnecessary biopsies. The findings favor integrating LC-OCT into diagnostic workflows for equivocal lesions where treatment choice hinges on accurate BCC subtyping. 3

Brentuximab vedotin active in advanced MF/SS with low CD30, though responses are time-limited

This multicenter retrospective series included 32 patients with advanced MF/SS and low CD30 expression (<10%) treated with standard-dose brentuximab vedotin. All were heavily pretreated, with a median of three prior systemic therapies and over one-third previously receiving chemotherapy. Overall response rate was 53.1%, with 12.5% complete and 40.6% partial responses; 18.8% had stable disease. Median progression-free survival was 4.0 months, and median time to next treatment was 7.25 months, indicating relatively short response durability. Results suggest brentuximab vedotin remains a viable option even at low CD30 levels, but expectations should be tempered regarding PFS. 4