Dr. Alexandra Golant takes a few minutes to discuss some highlights from her lecture Recent Advances in Atopic Dermatitis: New Insights & Treatment Strategies at the 2nd Annual Elevate-Derm Alliance Summer Conference at the Grand Hyatt Deer Valley in Park City, Utah.

In this video

Dr. Golant emphasizes that atopic dermatitis is "so clinically heterogeneous" that "no two patients with this disease look exactly the same." She points out that the bright red erythema in textbooks doesn't show up in darker skin, where it looks dustier or violaceous, and that presentations shift by age. When a diagnosis gets tricky or atypical, she goes back to basics: is the rash spongiotic, chronic, and itchy? Absent itch is a "hard stop" for her, since it's almost always a component of AD.

She is enthusiastic about the newer non-steroidal topicals, which she says finally rival — or beat — steroids on efficacy with better tolerability and steroid-free long-term use, helping the field move away from "the tub of love." On systemics, she calls dupilumab the gold standard that paved the way, alongside IL-13 inhibitors and nemolizumab for the intensely itchy patient. For JAK inhibitors, she walks patients through the boxed warning with context — naming the five risks but grounding them in the drug-specific data for an otherwise healthy AD patient — because "if you don't, the internet will." She likes that the safety updates keep coming back "boring."

  • Go back to basics on diagnosis: look for a spongiotic, chronic, itchy rash — no itch is a "hard stop" for AD.
  • Recognize that erythema reads as dusty or violaceous in darker skin, and that presentations vary by age and chronicity.
  • New non-steroidal topicals now offer efficacy rivaling steroids with better tolerability and safer long-term use — a reason to abandon the one-pound triamcinolone jar.
  • Frame biologic and JAK options as a menu for shared decision making; dupilumab remains the gold standard, with IL-13 inhibitors and nemolizumab for very itchy patients.
  • When discussing JAKs, walk patients through the boxed warning up front but contextualize the real risks (zoster, slight non-melanoma skin cancer bump) for their specific history — and note that boring safety updates are good news.