New medications for eczema – an update from the American Academy of Dermatology annual conference 2018

 

Dr Georgina Lyons - Hope Dermatology

 

 

Dr Georgina Lyons talks all new things in eczema.

Reporting from the AAD meeting San Diego 

 

“I have just returned from sunny San Diego, where the American Academy of Dermatology held their annual scientific meeting this year. As the largest dermatology conference in the world the AAD meeting is always a wonderful opportunity to hear from the best dermatologists in America and catch up on all the latest advances in dermatology (many of which are released in the U.S. first before making their way to Australia).

This year there were several exciting developments in terms of new treatments available for eczema, including the biologic Dupilimumab for widespread recalcitrant eczema and the new non-steroid topical cream Crisaborole. Whilst not yet on the PBS these medications were approved for use in Australia by the TGA earlier in the year, and will hopefully soon be government subsidised for treatment of eczema in Australia.

Also, it turns out that vinegar doesn’t just go well with fish and chips – vinegar baths for eczema were discussed as a simple and effective alternative or adjunct to bleach baths in treating flares and preventing secondary infection. I am looking forward to trying this out with some of my patients!”

Light at the end of the tunnel for alopecia areata sufferers

We talk alopecia areata

Alopecia areata is an autoimmune disease with a complex genetic basis. There may be a pattern in the family of this type of hair loss but often it can appear in patients where there is no history of hair loss at all! It typically presents with patchy hair loss and can progress to total baldness. Hair loss can extend to other areas of the body such as the eyebrows, eyelashes and body hair. It can have a big impact on patients’ well-being. Treatment is often challenging but can include creams/lotions and injections if the hair loss areas are mild. If the area of hair loss is a bit more substantial, then consideration of oral medications and even immunosuppressive drugs may be needed. 

Trials on the use of medications called JAK inhibitors such as astofacitinib and ruxolinitib are on their way with early encouraging results. These medications have been used in other autoimmune diseases such as rheumatoid arthritis and trials are also on their way for psoriasis. Their safer profile and tolerability is much better when compared with currently used systemic therapies. A quick response may occur within 4 weeks which makes a world of difference to our patients. More than 75% of patients responded with at least 50% hair regrowth by week 12. But patients may need to continue therapy long term due to likely relapse if the treatment is discontinued.”