This Week in Dermatology — Jul 3, 2026

Welcome to This Week in Dermatology. This week we are covering seven notable papers spanning novel oral therapeutics for psoriasis, hair loss interventions, and complex dermatopathological entities. Let's dive in.

We begin with a major development in the management of moderate-to-severe plaque psoriasis. In the British Journal of Dermatology, researchers shared the one-year results from the phase three, placebo- and active comparator-controlled trials known as ICONIC-ADVANCE one and two [1]. These trials evaluated icotrokinra, a targeted oral peptide that precisely blocks the interleukin-23 receptor. Across these studies, which randomized over fifteen hundred participants, skin clearance rates among those receiving icotrokinra increased through week twenty-four and remained highly durable through week fifty-two. Specifically, roughly seventy to seventy-five percent of participants exhibited clear or almost clear skin, and about half demonstrated completely clear skin during weeks twenty-four to fifty-two. Furthermore, among the participants who achieved clear or almost clear skin at week sixteen, about eighty-five to ninety percent maintained that response at one year. The safety profile was highly reassuring, showing similar adverse event rates to placebo through week sixteen and lower rates than deucravacitinib through week twenty-four, with no new safety signals emerging through week fifty-two. While oral agents like icotrokinra expand our systemic toolkit, managing long-term safety in patients with comorbidities remains a primary clinical focus. This week, the Journal of the American Academy of Dermatology featured two studies addressing these safety considerations. The first is a fifteen-year multicenter cohort study evaluating the comparative risk of hepatitis B and C reactivation after treatment with biologics and targeted synthetic disease-modifying antirheumatic drugs in patients with psoriasis and psoriatic arthritis [2]. The second study in the same journal investigated the safety of biologic therapy specifically in psoriasis patients with a history of malignancy [3]. Together, these publications underscore the necessity of balancing high-efficacy systemic treatments with individualized viral and oncological risk assessments.

Next, we turn to hair loss, a frequent and challenging presentation in daily dermatological practice. The Journal of the American Academy of Dermatology published a retrospective cohort study using the TriNetX database to explore comparative alopecia outcomes [4]. This study compared the risk and rates of hair loss following the placement of copper versus hormonal intrauterine devices, offering valuable real-world data for clinicians counseling patients on contraceptive choices and hair preservation. Meanwhile, addressing treatment modalities for hair loss, the Journal of the European Academy of Dermatology and Venereology published a comparative study on androgenetic alopecia [5]. This trial investigated the therapeutic efficacy of combining microneedling with adipose-derived mesenchymal stem cell exosomes compared to monotherapy, seeking to determine if this combination approach yields superior clinical outcomes for patients experiencing pattern hair loss.

Moving from inflammatory conditions to complex clinical pathology, our next papers shed light on rare vascular and neoplastic presentations. In the British Journal of Dermatology, researchers presented a case-series analysis of thirty-six patients to better define the clinicopathological features of lymphocytic thrombophilic arteritis and its relationship with livedoid vasculopathy [6]. The cohort, which had a high proportion of patients of Asian descent, primarily presented with widespread livedo racemosa, while less common manifestations included neuropathy, petechiae, macular pigmentation, and ulceration. The investigators found a significant association between clinical ulceration and superficial dermal vessel involvement on biopsy. Histologically, all cases demonstrated a neutrophil-poor lymphocytic perivascular infiltrate with fibrinoid change in the deeper dermis or upper subcutis. Crucially for clinicians, while treatments targeting vascular fibrin deposition were effective for managing other disease manifestations such as ulceration, none of the cases showed a response in their livedo racemosa, suggesting that livedo is highly likely to persist. The authors conclude that lymphocytic thrombophilic arteritis has distinctive features and may lie on a spectrum with livedoid vasculopathy. Additionally, in the realm of cutaneous oncology, the Journal of the American Academy of Dermatology published an analysis from an MD Anderson cohort investigating genomic predictors of perineural invasion in cutaneous squamous cell carcinoma [7]. This research aims to identify molecular and genomic markers that can help dermatologists and dermatopathologists predict aggressive perineural behavior, potentially guiding more precise surgical and adjuvant treatment decisions.

If you only have time for one paper this week, make it the one-year results of the ICONIC-ADVANCE trials evaluating icotrokinra [1]. This targeted oral peptide represents a potential shift in how we approach moderate-to-severe plaque psoriasis, offering biologic-like durability and efficacy in a convenient, once-daily oral format.

Here are the key takeaways from this week in Dermatology. First, once-daily oral icotrokinra demonstrates robust and highly durable skin clearance through one year, with up to three-quarters of patients achieving clear or almost clear skin and no new safety signals. Second, lymphocytic thrombophilic arteritis appears to exist on a spectrum with livedoid vasculopathy; while antithrombotic therapies can successfully treat manifestations like ulceration, clinicians should counsel patients that livedo racemosa is highly likely to persist. Third, when evaluating alopecia, keep an eye on emerging data comparing copper versus hormonal intrauterine devices, as well as the potential of combining microneedling with adipose-derived stem cell exosomes for androgenetic alopecia. And finally, risk stratification in cutaneous squamous cell carcinoma continues to advance with investigations into genomic predictors of perineural invasion.

That's your roundup for This Week in Dermatology. The full transcript and references are available on the episode page in your AudioScholar library. This is an AI-curated summary — for clinical decisions, always consult primary sources and current guidelines. See you next week.

If this weekly briefing is useful, follow the show in your podcast app so new episodes arrive automatically. And for audio briefings on your own clinical questions and papers, visit audioscholar dot C C.

This is an automated summary generated by artificial intelligence, which can make mistakes. Always review the original source materials.