Dermatology Update: The New, The Old, The Common and The Rare

Nicotinamide, administered at 500 mg twice daily, provides a 14% reduction in non-melanoma skin cancer risk, with the greatest efficacy observed when initiated immediately following the first diagnosis. While JAK inhibitors like ruxolitinib cream demonstrate effectiveness for pediatric atopic dermatitis, clinicians must navigate systemic absorption concerns and boxed warnings. Regarding pruritus, network meta-analyses suggest nemolizumab offers superior itch reduction for prurigo nodularis, though clinical assessment remains subjective and prone to anchoring bias. Emerging therapies like the IL-23 receptor-binding peptide icotrokinra show potential superiority over existing oral options for plaque psoriasis, while avapritinib provides a novel treatment pathway for systemic mastocytosis. Managing patients with overlapping psoriasis and atopic dermatitis requires a nuanced approach, with JAK inhibitors serving as a versatile first-line option when targeted biologics fail to address the mixed clinical presentation.