OR WAIT null SECS
5 dermatology takeaways from Maui Derm NP+PA Summer 2026, covering eczematous dermatitis, rosacea, blistering disease, hair loss, and pigmentation disorders.
Maui Derm NP+PA Summer 2026, held in Colorado Springs from June 24 to 27, brought together leading dermatologists to address diagnostic and treatment updates across numerous dermatologic conditions, including eczematous dermatitis, rosacea, autoimmune blistering disease, hair loss, and pigmentation disorders. From IL-13 inhibitor response as a patch testing gatekeeper to the expanding oral JAK inhibitor pipeline in vitiligo, this year's sessions reflected how targeted therapies are reshaping diagnostic sequencing across dermatology subspecialties.
Below, HCPLive rounds up 5 key takeaways NPs and PAs can apply in practice.
Matthew Zirwas, MD, of Bexley Dermatology, discussed how IL-13 inhibitor response now guides patch testing decisions in eczematous dermatitis. He starts with a detailed history of product and exposure changes, then trials dupilumab or lebrikizumab across 6 weeks and 3 doses before considering patch testing. Nonresponse or worsening signals likely contact dermatitis warranting testing.
Zirwas identified nickel and ammonium persulfate as the 2 most missed allergens, noting dietary nickel can drive systemic contact dermatitis and ammonium persulfate exposure often stems from hot tub chemicals, both frequently excluded from standard patch testing.
Hilary Baldwin, MD, from Atantla Health, used a single composite patient to trace rosacea from pediatric erythema through adult flushing, papulopustular disease, and late-stage phymatous and ocular involvement, matching treatment to each stage. Pediatric rosacea, affecting 4% or fewer children, is often missed because red cheeks appear benign. Background erythema responds to alpha agonists, flushing requires oral carvedilol or botulinum toxin, and telangiectasias need energy-based treatment. Papulopustular disease is the most treatable, with ivermectin, topical minocycline, and newer sub-antimicrobial oral options like Emrosi. Ocular rosacea responds to tetracyclines and topical ivermectin.
Donna Culton, MD, PhD, of UNC School of Medicine, addressed atypical presentations of autoimmune blistering diseases. Pemphigus often presents with chronic oral ulcers rather than classic flaccid blisters, while pemphigoid may have a prodromal phase resembling urticaria or eczematous dermatitis. Culton advised suspecting non-bullous pemphigoid in patients > 65 years with pruritic disease unresponsive to first-line treatment. She cautioned that serology can be falsely negative, particularly in anti-p200 pemphigoid, and that perilesional biopsy is essential for direct immunofluorescence. Following dupilumab's 2025 FDA approval for bullous pemphigoid, NPs and PAs can initiate treatment earlier, reserving referral for treatment failure or diagnostic uncertainty.
Benjamin Ungar, MD, of Mount Sinai's Alopecia Center of Excellence, called JAK inhibitors the biggest advance in hair loss treatment over the past 2 years, reshaping care for alopecia areata and scarring alopecia. 3 oral JAK inhibitors, baricitinib, ritlecitinib, and deuruxolitinib, are FDA-approved for severe AA, and Ungar's long-term data show no meaningful increase in cardiovascular or thromboembolic risk despite class-wide boxed warnings. He favors oral JAK inhibitors as first-line systemic therapy over traditional immunosuppressants. Low-dose oral minoxidil is increasingly used across hair loss subtypes, with hypertrichosis as the most common side effect. Ungar views nutraceuticals as adjunctive, useful mainly for patients with underlying nutrient deficiencies.
George Martin, MD, of the Dermatology and Laser Center of Maui, reviewed advances in vitiligo and melasma treatment. Topical ruxolitinib remains the only FDA-approved topical vitiligo therapy, showing durable, increasing repigmentation through 2 to 3 years of treatment, though extensive disease above 50% body surface area requires additional systemic therapy. Oral JAK inhibitors, including povorcitinib, ritlecitinib, and upadacitinib, are advancing in additional late-stage trials and are expected to replace pulse-dose dexamethasone for widespread active disease.
For melasma, Martin emphasized combining lightening topicals with procedural treatment, noting current sunscreens inadequately block visible light despite its role in pigmentation.
Related Content:
