Peter Lio, MD 

Credit: Northwestern Feinberg School of Medicine

 treatment continues to expand beyond injectable biologics, even as clinicians still lack tools to match patients with the right therapy up front. Response rates with current interleukin (IL)-4 and IL-13 blockade remain good but not complete, leaving a meaningful share of patients under-treated despite an increasingly crowded pipeline.

A prospective validation study of the AdvanceAD-Tx 487-gene expression profile test examined patients starting or switching systemic therapy for moderate to severe disease.¹ Among those identified with a Janus kinase (JAK) inhibitor responder profile, 45.5% achieved EASI 90 by 3 months on JAK therapy versus 8.3% on Th2-targeted treatment (

Separately, the oral STAT6 degrader KT-621 produced median STAT6 reductions of 94% in skin and 98% in blood after 4 weeks in the Phase 1b BroADen trial.² Blood IL-31 fell 54% on average, the first reported IL-31 reduction from a drug targeting the IL-4/IL-13 pathway. These findings point toward a future where clinicians choose between JAK inhibitors, biologics, and oral options based on molecular profile rather than trial and error.

For now, testing logistics and limited practice experience keep gene expression profiling from routine use, and most clinicians still personalize care empirically, starting with a biologic and layering on topical therapy as needed. Peter Lio, MD, clinical assistant professor of dermatology and pediatrics at Northwestern University Feinberg School of Medicine and founding director of the Chicago Integrative Eczema Center, tracks this pipeline closely in his atopic dermatitis practice.

In the following interview, Lio spoke with 

 at LEADderm 2026 in Newport Beach, California, about where precision medicine in atopic dermatitis stands today:

: What drugs or disease states with new data or PDUFA dates excite you?

There's a tremendous amount happening in dermatology. My focus is generally on atopic dermatitis, and there are several exciting drugs and new developments happening. We've seen some programs shift. A couple of drugs, particularly in the OX40 pathway for atopic dermatitis, have been dropped, which is interesting in itself, to see pathways that maybe aren't positive. But the one I'm excited about is an oral agent coming for atopic dermatitis. It's still fairly early on, but what's exciting is it's an oral pathway similar to the IL-4 and IL-13 blockades, but taken orally, and it seems to be highly effective.

There are also some new topicals in early phases, including a topical botanical agent for atopic dermatitis that I'm particularly excited about, because a lot of my patients want something more natural. It has antimicrobial effects as well as anti-inflammatory effects. I think we're finally beginning to see enough choices to start having precision medicine discussions. We also have a new lab test that can help decide between a JAK inhibitor and a more Th2-focused biologic, whether a patient is a better candidate for one or the other. I'd argue it's not quite ready for primetime, at least in my practice. I don't know how to use it yet, but it's an amazing first step.

This is exactly the kind of groundwork where, instead of just guessing, we're able to get a sense of somebody from a skin scraping or a swab and say this pathway is going to be good for you, or this pathway might not be good for you, you're more likely to have a side effect or an issue and it's not going to work. All of those pieces we're hopefully going to be able to predict and have that precision and personalized medicine, which has always been the goal, but we just haven't had the tools until now.

: Can you describe the test, and how close are we to true precision medicine?

 I think the precision medicine journey is something that will probably never hit an end point. It's going to be a continuous journey of refinement and improvement, much like the virtuous cycle of drug development: we get a new medicine, it teaches us more about the underlying disease state, and that in turn allows us to refine and get better medicines. It's a building process. Rarely do we have a breakthrough that solves the whole thing; most of what I'm involved in never works that way, it's a slow process of iteration. We're seeing that with psoriasis now. We've moved so far with psoriasis and refined it so much, though we still don't really have personalization yet.

What we've found is we have agents so good for so many people that you don't really have to personalize; you can say one of these newer agents gives a really good chance you'll be clear or almost clear very quickly. With atopic dermatitis, the numbers are good, but they're not that good, so there's still a lot of unmet need, and more testing would help. That first test is very specific and looks at one pathway. It would be nice to understand more: is this patient primarily a skin barrier problem, an inflammatory pathway issue and if so where, or somebody who might benefit from microbiome manipulation, or all of the above? The other possibility, especially with diseases like atopic dermatitis, is they're somewhat messy, so maybe we'll never fully personalize it because it's multiple components, and we'll always have to think more holistically.

Maybe great drugs will come to market, like with psoriasis, that obviate a lot of this. In other fields of medicine, particularly oncology, we've seen the biggest leaps in precision medicine, being able to understand tumor characteristics and say, you have this mutation, so this pathway is exactly what you need. That's really been the gold standard, and oncology is setting the tone for everybody else, but I don't think we're anywhere close to that yet with inflammatory conditions, which tend to be messier and, frankly, more interesting to me because of that.

We also have this whole world of over-the-counter products, which in Europe they might call dermo-cosmetics: cleansers, moisturizers, and skincare products we use often without as much data, though the science is rapidly progressing. I love being at conferences that showcase the science behind our OTCs, and I often feel we don't give them the same spotlight as drugs. Everybody focuses on a drug, but OTCs are undergoing their own renaissance, and it's been incredibly exciting to be part of that too.

: When did you first hear about precision medicine, and how has it evolved?

 We've always talked about and dreamed about precision medicine. In science fiction, somebody gets a body scan and knows exactly what's wrong. That's really the goal: personalizing to you what would be safe and effective, the right solution to your specific problem. We've always wanted that. We haven't had the tools, but now we're beginning to understand more of the genetics, and that's where the early work came with genetic diseases, where there was one gene, one protein, one mistake.

That opened the door, and for a minute everybody thought this is how all of medicine is going to be, we're going to solve it all. Then we quickly hit a wall: this isn't one gene, one protein, one disease. It's way more complicated, we can't find a gene mutation that's reliable, and it's different across populations and individuals. We've kind of understood some of those simpler diseases, for better or worse, and things like gene therapy are happening. But for these more complex diseases, we still have a ways to go. I hold out hope we're going to get there and understand them, even if they're multifactorial, and that's going to make it that much more satisfying when we do.

: Is the Castle test Dr. Swanson mentioned the one you meant?

Yes, that Castle [Biosciences] test is the one that helps us decide between a JAK inhibitor, which is broader, and a more targeted IL-4/IL-13 biologic. It's pretty good; it gives us a sense of which patient might do better with one or the other. Ultimately, the question it answers is whether a biologic would be enough for this patient, at least as a clinician how I interpret it. Smarter people might interpret it a little differently, but when I look at it as a clinician, it's: do I think I could get by with a biologic, which has a smaller safety profile and is a little easier to use?

The answer could sometimes be no, they're unlikely to do well with a biologic, so you have to use the bigger, more encompassing medicine, the JAK inhibitor, with the safety and tolerability issues it carries as well. We have to do lab monitoring and counsel a bit more about things like blood clots. So there's a potential bonus there. For me at this point, and it may change, and I'm excited for it to change and refine, I feel the logistics of the test and its potential to help me are fairly limited in usefulness right now. So I've often said, why not start with the biologic, and we can empirically know the answer pretty quickly?

Even if it doesn't fully help, sometimes the biologic will help a bit, and then I can add other things like topicals. I'm personalizing it a little more on what we might call a diagnosis ex juvantibus: what's helping them? I customize to the patient by trial and error, on an individual basis, to see if it's going to work. But I foresee a future when I'll be able to do a simple test and say you're not a good candidate for this, let's skip right to the good stuff.

Editor's Note: This transcript has been edited for grammar and clarity using artificial intelligence tools.

Silverberg JI, Eichenfield LF, Armstrong AW, et al. The 487-gene expression profile test guides systemic therapy selection to improve outcomes for patients with atopic dermatitis: results from a prospective trial. J Am Acad Dermatol. Published online February 16, 2026. doi:10.1016/j.jaad.2026.02.034.

Kymera Therapeutics. Kymera Therapeutics announces positive results from BroADen phase 1b clinical trial of KT-621, a first-in-class, oral STAT6 degrader, in patients with moderate to severe atopic dermatitis. Published December 8, 2025. Accessed September 10, 2026. 

https://investors.kymeratx.com/news-releases/news-release-details/kymera-therapeutics-announces-positive-results-broaden-phase-1b

Articles

Systemic therapy for moderate-to-severe atopic dermatitis is broadening beyond injectable IL-4/IL-13 biologics, yet upfront treatment selection remains largely empirical. A prospective validation of the AdvanceAD-Tx 487-gene expression profile identified a JAK-responder signature associated with higher and faster EASI 90 rates on JAK inhibition versus Th2-targeted therapy. In parallel, the oral STAT6 degrader KT-621 demonstrated deep STAT6 knockdown in skin and blood with concomitant IL-31 reduction. Practical barriers and limited clinical experience still constrain routine profiling adoption.

Peter Lio, MD, breaks down AdvanceAD-Tx testing and oral STAT6 degrader KT-621 in the atopic dermatitis pipeline.

Q&A: Precision Medicine's Next Steps in Atopic Dermatitis, With Peter Lio, MD

Artificial intelligence (AI) is moving quickly from novelty to clinical tool in 

. A 2024 study comparing ChatGPT and physician responses to patient portal dermatology questions found the chatbot's answers rated favorably against physician-written replies for quality and empathy.¹ Comparative work in this area continues to find AI-generated responses performing on par with, and at times ahead of, dermatologist-written answers on accuracy and tone.

Early-stage innovation is advancing alongside this technology, increasingly channeled through physician-led investment networks. SKiN Angels, an angel-investor group made up of dermatologists and other clinicians in the skin space, has evaluated more than 300 early-stage companies and funded over 30 since its founding roughly two years ago.² The group frames its mission around shaping the field rather than financial return alone.

Clinicians face real tradeoffs as adoption accelerates. AI can ease documentation and messaging burden and support patient education, but it remains capable of catastrophic errors in health contexts, so human oversight stays essential for the foreseeable future. Overreliance also raises concerns about eroding the reading, writing, and clinical reasoning skills trainees need to build independently.

Peter Lio, MD, is clinical assistant professor of dermatology and pediatrics at Northwestern University Feinberg School of Medicine and founding director of the Chicago Integrative Eczema Center. He addressed both SKiN Angels and AI's clinical role during a session at LEADderm 2026. In the following Q&A interview, Lio spoke with 

 at LEADderm 2026 in Newport Beach, California, about both topics:

: What is the title of the talk you're giving today at LEADderm?

 Today we're going to be introducing SKiN Angels. It stands for the Strategic Knowledge and Investment Network Group, and we're a group of angel investor dermatologists and other people in the dermatology and skin space. Similar to the show Shark Tank, we have founders and companies at a very early stage come to us, and they're usually asking for advice, connections, and oftentimes early angel investments. We've been operating for about two years now, and it's been incredibly exciting. Well over 300 companies have presented to us, and we've funded more than 30 of them.

: What does the presentation cover, and what are its major takeaways?

Today we're going to talk about the genesis of SKiN Angels: why it came about, why there's a need, and why so many people are getting interested in starting their own product lines, companies, and software services. All of these different people are coming to us, and it has been an incredibly exciting time, particularly in the skin space. Tech startups have their own ecosystem of venture capitalists, but if you're in the skin space, you can be floating around a little more, and this really includes everything from OTC products to drugs to even devices. We're going to present that, and a couple of our companies are going to give short pitches so people get a sense of what it feels like when they present an idea, and how it would feel to be in the shoes of someone who has to decide whether to support them, throw in with them, or pass.

: What are your hopes for what SKiN Angels ultimately leads to?

The biggest thing about it, and we say this in our introductory video to members and potential members, is if you ask your financial advisor, they'd say this is crazy, don't do it. It's not about making money. That would be an amazing side effect if we have some big successes and can share that with the founders, but really, it's about shaping the world of dermatology, and ultimately shaping the world around us. We can take good people we believe in, that we trust, that we think are going to do something great, find their ideas at an early stage, and help fan the flames so they can do great things. Even if we can help just a little, sometimes that's all you need: a tiny bit of encouragement, a tiny bit of support, networking, and money can actually change the world. At least that's what I believe, and that's our central thesis.

: Why did you choose to give a talk on AI in dermatology?

AI has been thrust upon me and all of us. Whether you like it or not, it's coming up a lot, and there are a lot of questions around it. For me, I'm always looking for solutions to problems and new tools, and wherever you stand on AI, there's no doubt it's a very powerful tool that can solve some of these problems. There are a couple of areas I'm looking at. One is patient support. I call this the guidance gap: what happens between doctor visits, where you see your patient, give them a plan, and then you might not see them again for weeks or months, and they have questions and concerns in the middle. What often happens is portal messages and phone calls, and that's really exhausting.

Being able to leverage AI in that capacity could be really powerful. The other piece is how we as doctors can use AI and prompting to learn, teach, and move ourselves forward. We think about the historical ways we've learned, from presentations at conferences, publications, and posters, but now we have new things, including prompting. Asking a good question of AI can be really important. If you ask a bad question, you might not get the wrong answer, but you might get a misleading one that's not quite what you wanted. So it's about refining this skill for doctors and people in medicine and healthcare in general to use AI as best we can.

: What data points or key elements do you discuss in the talk?

Yes, I try to bring it to real life. We've done a couple of studies where we took real patient queries, cleaned them of any identifiable health information, and kept the essence of the question. We put those into different AI models, and then had an international group of dermatologists rank the responses. Spoiler alert: the AI is generally incredible. It does a great job, answers beautifully, in a balanced and careful way, and honestly, many times better than we ourselves as dermatologists would do. Like it or not, it's a powerful tool, and now we can show the data.

On the other hand, to keep it fair and balanced, I also discuss some of the catastrophic and dangerous errors AI can make in these contexts. When you're dealing with somebody's health, a mistake carries big ramifications, so we talk about some of the types of errors it can make. They're getting better, but even though it isn't human, it's still prone to errors, and there are specific kinds it can still make. We have to be careful, and ideally we're always going to need some human oversight, at least for the foreseeable future.

: Are you concerned AI could outsource how students gain knowledge and experience?

 I'm always worried, and the world is changing very rapidly. I don't know if we'll be able to predict the implications and impact on people and development, especially kids, but there's no doubt we can't escape it. We can't put the genie back in the bottle, but you're right, it can make people lazy. It can make people lose the ability to read carefully, because someone who's already established, who knows how to write and read carefully, can use it as a tool more naturally. They can correct it and say, that's goofy, I don't understand what you're saying there, fix this.

Whereas if you're just trusting it, or treating it as an infallible source, you're much more likely to make a huge catastrophic error and skip the groundwork yourself. We're going to need in-person, real-life sessions with people to really know what they know: here's a pencil and paper in a quiet room, I need to see what you actually know. Otherwise, it's so easy to just ask AI to tell you about an essay or help put it together, and that's a real danger we're going to have to face.

Editor's Note: This transcript has been edited for grammar and clarity using artificial intelligence tools. Lio had no relevant disclosures of note.

Reynolds K, Nadelman D, Durgin J, Ansah-Addo S, Cole D, Fayne R, Harrell J, Ratycz M, Runge M, Shepard-Hayes A, Wenzel D, Tejasvi T. Comparing the quality of ChatGPT- and physician-generated responses to patients' dermatology questions in the electronic medical record. Clin Exp Dermatol. 2024;49(7):715-718. doi:10.1093/ced/llad456.

Lio P. Introducing SKiN Angels: The Strategic Knowledge and Investment Network Group. Presented at: LEADderm 2026; August 29-30, 2026; Newport Beach, CA.

Artificial intelligence is rapidly becoming a practical dermatology adjunct, with comparative studies showing chatbot-generated portal-message responses can match or exceed physicians on quality, empathy, and tone. Concurrently, clinician-led capital is shaping early innovation via SKiN Angels, which has reviewed 300+ companies and funded 30+ across OTC, drugs, devices, and software. Key opportunities include reducing documentation burden and closing the “guidance gap” between visits through AI-supported patient messaging. Persistent risks—catastrophic clinical errors and trainee skill atrophy—necessitate disciplined prompting and ongoing human oversight.

Peter Lio, MD, discusses SKiN Angels dermatology investing and AI's growing role in patient care and clinician education.

Q&A: SKiN Angels and AI's Growing Role in Dermatology, With Peter Lio, MD

Precision medicine in dermatology remains an ongoing, iterative process rather than a single breakthrough, according to Peter Lio, MD.

Psoriasis treatment has advanced enough that highly effective agents reduce the need for personalization, while atopic dermatitis still carries substantial unmet need.

Oncology remains the gold standard for precision medicine, but inflammatory skin diseases are more complex and multifactorial, complicating similar progress.

 continues to evolve through incremental refinement rather than a single defining breakthrough, according to Peter Lio, MD, speaking at the 2026 LEADderm conference following his sessions.

Lio, clinical assistant professor of dermatology and pediatrics at Northwestern University Feinberg School of Medicine and founding director of the Chicago Integrative Eczema Center, described the process as a virtuous cycle in which new medicines deepen understanding of disease biology, which in turn informs the development of better therapies.

The Present and Future of Precision Medicine in Dermatology, With Peter Lio, MD

Lio contrasted the current state of precision medicine across 2 major inflammatory skin diseases. In psoriasis, he noted treatment has advanced substantially, though true personalization remains limited, largely because available agents are effective enough for most patients without requiring tailored selection. In atopic dermatitis, Lio said outcomes remain less consistent, reflecting continued unmet need and a case for more sophisticated diagnostic testing.

What Would Better Precision Testing Look Like in Atopic Dermatitis?

Lio said current testing tools remain narrowly focused on single pathways, limiting clinicians' ability to distinguish between patients whose disease is driven primarily by skin barrier dysfunction, inflammatory pathway activity, microbiome disruption, or a combination of factors. He noted atopic dermatitis may ultimately resist full personalization due to its multifactorial nature, requiring a more holistic treatment approach even as future therapies continue to improve outcomes broadly.

How Does Dermatology Compare With Oncology on Precision Medicine?

Lio identified oncology as the field furthest along in precision medicine, citing its ability to match specific tumor mutations to targeted pathway-based therapies. He said inflammatory skin diseases remain considerably messier and more complex by comparison, which he noted makes them more scientifically interesting despite the added difficulty. Lio also highlighted the growing evidence base behind over-the-counter dermatologic products, including cleansers and moisturizers, describing their scientific development as a parallel renaissance that receives less attention than prescription drug advances.

Reflecting on the evolution of precision medicine, Lio noted early enthusiasm stemmed from single-gene, single-protein genetic diseases, which initially suggested a broader medical revolution before more complex, multifactorial conditions revealed the limits of that model. He expressed continued optimism precision medicine will eventually extend to complex inflammatory diseases as understanding of their multiple contributing pathways matures.

Dawkins M. Why Dermatologists Should Have a Seat at the Investment Table, With Manju Dawkins, MD. HCPLive. August 30, 2026. Accessed September 1, 2026. 

https://www.hcplive.com/view/why-dermatologists-should-have-seat-investment-table-manju-dawkins-md

LEADderm. About LEADderm: the missing curriculum. 

Videos

Peter Lio, MD, discusses why precision medicine has advanced further in psoriasis than atopic dermatitis, and what oncology can teach dermatology.

, held August 29-30 in Newport Beach, California, Peter Lio, MD, clinical assistant professor of dermatology and pediatrics at Northwestern University Feinberg School of Medicine and founding director of the Chicago Integrative Eczema Center, previewed his session introducing Skin Angels, the Strategic Knowledge and Investment Network Group.

The group brings together dermatologists and other skin-space experts to evaluate early-stage companies with founders pitching for advice, connections, and early angel investment.

Skin Angels and the Atopic Dermatitis Pipeline, With Peter Lio, MD

Skin Angels has been operating for close to two years, according to Lio. More than 300 companies have presented to the group, and members have funded more than 30 of them, spanning over-the-counter products, drugs, and devices. Dermatologist Manju Dawkins, MD, founder of Thimble Health, also spoke with HCPLive at the meeting about her own path into the group.1

"If you ask your financial advisor, they would say this is crazy, don't do it. It's not about making money. That would be an amazing side effect if we can have some big successes and share that with the founders, but really it's about shaping the world of dermatology and ultimately shaping the world around us," Lio said.

Lio said interest in dermatology-specific investing has grown as more clinicians launch their own product lines, software, and services, an ecosystem he said the tech industry already has through its own venture-capital networks. His session includes short pitches from a few Skin Angels companies, giving attendees a sense of what it feels like to evaluate a founder and decide whether to invest.

Lio said the group's central thesis is even modest support, whether encouragement, networking, or capital, can meaningfully help a promising idea take shape. He described the mission as identifying good people with strong ideas early and helping them succeed.

Beyond Skin Angels, Lio also spoke about where he sees momentum in atopic dermatitis. He highlighted an oral agent in early development designed to work through the same interleukin-4 and interleukin-13 pathways as existing biologics, along with a topical botanical agent carrying antimicrobial and anti-inflammatory effects.

He also pointed to a new lab test intended to help clinicians choose between a JAK inhibitor and a T-helper-2-focused biologic. Lio said the test marks an early but meaningful step toward precision dermatology, though he does not consider it ready for routine practice yet.

Dawkins M. Why Dermatologists Should Have a Seat at the Investment Table, With Manju Dawkins, MD. HCPLive. August 30, 2026. Accessed August 31, 2026. 

LEADderm. About LEADderm: the missing curriculum. leadderm.org.

Peter Lio, MD, on Skin Angels, a dermatology-focused angel-investing group that has evaluated over 300 companies and funded more than 30.