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  • Presentation

JAD Case Reports: New Therapies, Complications, and Practical Dermatology Cases

Description

The speaker highlights the value of JAD Case Reports as a practical, clinician-to-clinician resource that captures emerging treatments, unusual presentations, and real-world complications that often cannot be studied in large trials. A major theme is the expanding use of JAK inhibitors and dupilumab across difficult dermatologic diseases, including various forms of lichen planus, pyoderma gangrenosum, rheumatoid nodules, alopecia universalis, bullous pemphigoid, pemphigoid gestationis, Hailey-Hailey disease, dermatitis herpetiformis, and scleromyxedema, with several cases showing impressive or complete responses. The talk also emphasizes how to manage treatment failure, including switching within drug classes or recapturing response after relapse. In oncodermatology, the speaker reviews immune checkpoint inhibitor complications such as bullous disease and SJS/TEN-like eruptions, noting practical details like timing, response rates, and the difficult question of rechallenge. Another example involves hedgehog pathway inhibitors, where low-dose oral minoxidil and switching agents helped prevent recurrent hair loss. The talk closes by introducing new journal sections—Grand Rounds, procedural dermatology, and concise case-report literature reviews—aimed at making educational cases more accessible and useful for everyday clinical practice.

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Conclusions

  • The presentation concludes that case reports are especially valuable for identifying emerging treatment options and practical clues before large trials are available.
  • JAK inhibitors appear to be broadly effective for several difficult inflammatory dermatoses, including multiple lichen planus variants, pyoderma gangrenosum, and rheumatoid nodules.
  • When a patient initially responds to one JAK inhibitor but later relapses, switching to another JAK inhibitor in the same class may recapture benefit.
  • Dupilumab shows promise as a versatile treatment for several off-label conditions, including bullous pemphigoid, pemphigoid gestationis, Hailey-Hailey disease, dermatitis herpetiformis, and scleromyxedema.
  • For some diseases, dupilumab may be used as a steroid-sparing or treatment-limiting strategy, including in pregnancy, where it can help taper off prednisone safely.
  • Responses to dupilumab and other off-label biologic uses can be rapid and clinically meaningful, but some patients require ongoing therapy to maintain control.
  • Immune checkpoint inhibitor–related skin toxicities are uncommon overall but can be severe, persistent, and disruptive when they occur.
  • Dupilumab may help manage immune checkpoint inhibitor–induced bullous pemphigoid, though response may take about eight weeks and may not be universally durable.
  • Severe immune checkpoint inhibitor–associated reactions such as SJS/TEN-like eruptions create major uncertainty about rechallenge, which is sometimes possible but often limited by recurrence or patient reluctance.
  • Hedgehog-pathway inhibitor–associated alopecia may be manageable with low-dose oral minoxidil and/or switching agents, allowing cancer therapy to continue with less cosmetic distress.
  • The journal is expanding into new formats such as Grand Rounds, procedural dermatology, and case report plus literature review sections to improve educational value.
  • Overall, the central message is that sharing rare cases helps clinicians learn how to treat unusual diseases, manage adverse effects, and adapt therapies in real-world practice.
  • Topical Janus kinase inhibitors: A review of applications in dermatology.#10.1016/j.jaad.2018.04.018
  • JAK inhibitors in dermatology: The promise of a new drug class.#10.1016/j.jaad.2016.12.005
  • Successful treatment of recalcitrant cutaneous lichen planus and unusual variants with upadacitinib: A case series and a literature review of systemic Janus kinase inhibitors use in cutaneous lichen planus and lichen planopilaris.#10.1016/j.jdcr.2025.01.014
  • Treatment of recalcitrant hypertrophic lichen planus with upadacitinib.#10.1016/j.jdcr.2025.02.029
  • Oral lichen planus treated with upadacitinib: A case series.#10.1016/j.jdcr.2025.05.041
  • JAK inhibitors for the treatment of rheumatoid nodules.#10.1016/j.jdcr.2025.02.036
  • Evaluation of Dupilumab in Patients With Bullous Pemphigoid.#10.55788/14e0eea5
  • Dupilumab as a novel steroid-sparing treatment for pemphigoid gestationis: A new case report and review of literature.#10.1016/j.jdcr.2025.03.019
  • Patel D, Rosenberg J, Cohen J, et al., “Effective treatment of recalcitrant Hailey-Hailey Disease with dupilumab”.
  • Al-Khawaga S. et al., “Dermatitis Herpetiformis successfully treated with dupilumab.”#10.1016/j.jdcr.2025.03.037
  • A case of cutaneous angiosarcoma with intradermal metastases responding to PD-1 inhibition-based immunotherapy.#10.1016/j.jdcr.2025.05.046
  • Immune checkpoint inhibitor induced bullous pemphigoid treated with dupilumab.#10.1016/j.jdcr.2024.11.033
  • Stevens-Johnson syndrome-toxic epidermal necrolysis spectrum reactions to immune checkpoint inhibitor therapy and safety of rechallenge: A retrospective review.#10.1016/j.jdcr.2025.03.039
  • Low-dose oral minoxidil for the management of vismodegib-induced alopecia.#10.1016/j.jdcr.2025.07.030
  • Cortical bone fenestration with a Beaver scalpel blade to promote second intention healing of Mohs micrographic surgery scalp wounds: Report of 2 cases.#10.1016/j.jdcr.2025.11.052
  • Progressive scattered and reticular pigmentation lesions.#10.1016/j.jdcr.2025.08.016
  • Dowling Degos disease with a review of identified genes in family with multiple members affected.#10.1007/springerreference_40892