Monthly dermatology bulletin — October 16, 2026

Colleagues: this issue covers September 16 to October 16, 2026; it also includes an FDA approval from September 14, flagged as outside the period. The month was dominated by the EADV Congress in Vienna (September 30 to October 3), and much of its data comes from industry-funded trials not yet published in peer-reviewed journals, so read it as preliminary. There were two relevant FDA decisions. From outside North America and Western Europe, this issue includes one trial conducted in China.

Atopic dermatitis, psoriasis and hidradenitis suppurativa

1. Zasocitinib beats deucravacitinib in plaque psoriasis (LATITUDE Atlas)

[Congress] [International; Japanese sponsor, Takeda]
In this randomized, multicenter, double-blind phase 3 trial, 606 adults with moderate-to-severe plaque psoriasis (301 on zasocitinib and 303 on deucravacitinib in the efficacy data) received zasocitinib 30 mg once daily or deucravacitinib 6 mg once daily, both TYK2 inhibitors. At week 16, PASI 100 (the primary endpoint) was 36.5% vs 13.9%, PASI 90 was 62.5% vs 34.0%, and sPGA 0 was 43.2% vs 18.5% (all p<0.001). There were no new safety signals; the most common adverse events across the LATITUDE program were upper respiratory tract infection, nasopharyngitis and acne.
Why it matters: it is a head-to-head comparison of two oral TYK2 inhibitors, and zasocitinib was superior to deucravacitinib on every reported outcome. But it ran only 16 weeks, had no biologic arm and comes from the manufacturer, and the full publication and regulatory approval are still pending.
https://www.takeda.com/newsroom/news-releases/2026/zasocitinib-superior-efficacy/
https://www.hcplive.com/view/eadv-2026-zasocitinib-tops-deucravacitinib-for-pasi-100-in-plaque-psoriasis

2. Icotrokinra sustains clearance at high-impact sites through two years (ICONIC-TOTAL)

[Congress] [International]
In the randomized, double-blind phase 3 ICONIC-TOTAL trial (311 patients randomized 2:1 to icotrokinra 200 mg daily or placebo; the placebo group switched to icotrokinra at week 16), the oral IL-23 receptor antagonist peptide achieved, in the icotrokinra arm at week 112, IGA 0/1 in 70%, complete genital clearance in 89% and a 71% improvement in nail mNAPSI. Responses held at the scalp, genitals, hands, feet and nails, and exposure-adjusted adverse event rates did not rise with longer exposure.
Why it matters: it adds two-year durability data at high-impact sites for an oral treatment. There is no comparator after week 16, topical therapy was allowed from week 52, and several authors are Johnson & Johnson employees.
https://www.hcplive.com/view/iconic-total-icotrokinra-high-impact-site-clearance-2-years

3. Nemolizumab: skin and itch control through three years in atopic dermatitis

[Congress] [International]
In the ARCADIA long-term extension interim analysis (n=1,903 adults and adolescents, week 152, observed cases), EASI-75 reached up to 91%, EASI-90 up to 75%, IGA 0/1 up to 67% and clinically meaningful itch relief up to 88%. In a post hoc analysis of 295 week-16 responders who continued treatment, 50% achieved EASI-100 at week 152. In the OLYMPIA extension in prurigo nodularis (508 patients enrolled at week 48, followed through week 148), more than 85% achieved clinically meaningful itch improvement. There were no new safety signals.
Why it matters: it adds durability data for the anti-IL-31 antibody to inform long-term decisions. The "up to" figures are observed cases, which overstate the effect because patients who drop out leave the analysis, and the data come from the manufacturer (Galderma).
https://www.galderma.com/news/eadv-2026-galdermas-new-data-nemluvio-three-years
https://www.hcplive.com/view/nemolizumab-sustains-atopic-dermatitis-skin-itch-control-through-3-years

4. Telikibart (GR1802), a new anti-IL-4Rα antibody, in atopic dermatitis

[Congress] [China]
This phase 3 trial at dozens of centers in China (NCT06216392) randomized 450 adults 2:1 to telikibart (299; a 600 mg loading dose, then 300 mg every 2 weeks) or placebo (151), with a 16-week double-blind period. At week 16, EASI-75 was 69.6% vs 22.5% and IGA 0/1 was 33.1% vs 6.6% (both p<0.0001). At week 52, in the open-label phase, EASI-75 exceeded 94% in both groups. Adverse events during the double-blind period occurred in 64.5% vs 57.6%, and the conjunctivitis rate was not reported.
Why it matters: it adds another antibody against IL-4Rα, the same target as dupilumab, although there was no head-to-head comparison with it. The population was exclusively Chinese, the 52-week phase was open-label, and conjunctivitis data are missing.
https://www.hcplive.com/view/eadv-2026-telikibart-attains-easi-75-70-week-16-atopic-dermatitis

5. Tilrekimig, a trispecific antibody (IL-4, IL-13 and TSLP), in phase 2

[Congress] [Sponsor: Pfizer, USA]
In the interim analysis of Pfizer's randomized, double-blind, placebo-controlled phase 2 study of 188 biologic-naive adults with EASI ≥16, week-16 EASI-75 ranged from 48% to 63% across doses vs 9% to 20% with placebo (all p<0.003). Even the 50 mg every-4-weeks dose (23 patients) achieved 48%. According to investigator Eric Simpson, there was no conjunctivitis signal through 16 weeks.
Why it matters: blocking three pathways at once is conceptually new, and every-four-weeks dosing is appealing. It is a small, 16-week phase 2 study, and whether it beats current biologics remains to be shown in phase 3.
https://www.hcplive.com/view/tilrekimig-atopic-dermatitis-phase-2-eric-simpson
https://www.pfizer.com/news/press-release/press-release-detail/pfizers-tilrekimig-shows-significant-skin-clearance-phase-2

6. Izokibep in hidradenitis suppurativa: responses on stringent endpoints

[Congress] [International]
This global, randomized, double-blind phase 3 trial (NCT05905783) randomized 258 patients with moderate-to-severe hidradenitis to izokibep 160 mg weekly, an IL-17A inhibitor, or placebo. It met its primary endpoint of HiSCR75 at week 12, although the release gives no figure for it. In a separate IHS4 analysis at week 12: IHS4-55 was 49.1% vs 33.6%, IHS4-90 23.6% vs 8.1% and IHS4-100 17.5% vs 6.4%. According to the company, patients on continuous izokibep kept improving through week 32.
Why it matters: the results on stringent thresholds are encouraging, but the absolute difference is moderate, the primary-endpoint figure is missing, and the source is a company release. It does not change practice yet.
https://mfn.se/a/affibody/affibody-announces-new-izokibep-data-at-eadv-2026-demonstrating-efficacy-across-patient-subgroups-and-stringent-clinical-endpoints

Skin cancer and melanoma

7. FDA approves Ameluz with photodynamic therapy for superficial basal cell carcinoma

[Regulatory FDA] [USA] [Outside the period: September 14]
The FDA approved aminolevulinic acid 10% gel (Ameluz) with BF-RhodoLED red-light illumination for adults with superficial basal cell carcinoma. In the randomized, double-blind, vehicle-controlled phase 3 trial (187 adults: 145 on Ameluz and 42 on vehicle, both with PDT), composite clinical and histological complete response of the main target lesion 12 weeks after the final cycle was 66% vs 5%, and histological clearance was 76% vs 19%.
Why it matters: it offers an FDA-approved nonsurgical option for superficial lesions. The comparator was vehicle, not surgery or imiquimod, and there are no long-term recurrence data. Surgery remains the standard.
https://www.globenewswire.com/news-release/2026/09/14/3361199/0/en/biofrontera-announces-fda-approval-of-ameluz-red-light-pdt-for-the-treatment-of-superficial-basal-cell-carcinoma.html
https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/208081s040lbl.pdf

8. Sun protection in children of melanoma survivors: the FLARE trial

[Clinical trial] [USA]
In this randomized trial, published in JAMA Dermatology on October 7, 364 dyads of melanoma survivors and their children aged 8 to 17 received either a family-based telehealth intervention (180) or an active educational control program (184). There was no difference in the primary outcome, change in sunburn occurrence across two postintervention assessments, although the intervention improved sun-protective behaviors through the second assessment.
Why it matters: the trial was negative on its primary outcome, an honest reminder that educational interventions change behaviors but not necessarily sunburns. In the Caribbean it is useful as a model for family counseling.
https://doi.org/10.1001/jamadermatol.2026.3877

Alopecia, vitiligo and pediatric dermatology

9. FDA approves baricitinib for severe alopecia areata from age 12

[Regulatory FDA] [USA]
On September 25, the FDA extended the baricitinib (Olumiant) indication to adolescents aged 12 and older with severe alopecia areata. In the adolescent cohort of the phase 3 BRAVE-AA-PEDS trial (257 adolescents randomized 1:1:1; median baseline SALT 100), SALT ≤20 at week 36 was reached by 42% on 4 mg, 27% on 2 mg and 5% on placebo, and SALT ≤10 by 37%, 21% and 2%. The recommended dose is 2 mg, which can be raised to 4 mg if response is inadequate. The drug keeps the JAK inhibitor boxed warning.
Why it matters: it widens the systemic options for adolescents, for whom ritlecitinib was already available. The European Commission had already approved it in April. Long-term safety in minors and cost in our setting must be weighed.
https://investor.lilly.com/node/54961
https://www.hcplive.com/view/fda-approves-baricitinib-for-adolescents-with-severe-alopecia-areata

10. Upadacitinib in nonsegmental vitiligo: repigmentation keeps rising through week 76 (Viti-Up)

[Congress] [International]
In the phase 3 Viti-Up-1 and Viti-Up-2 trials (614 patients at 90 sites, randomized 2:1 to upadacitinib 15 mg or placebo for 48 weeks, followed by an open-label extension), among patients continuing upadacitinib F-VASI75 rose from 33.1% at week 48 to 55.1% at week 76 in Viti-Up-1, and from 27.6% to 47.4% in Viti-Up-2. T-VASI50 at week 76 was 42.5% and 40.1%.
Why it matters: it confirms that repigmentation is slow and keeps increasing beyond one year. These are observed cases from an open-label extension, with no p values, and the data come from AbbVie. According to AbbVie, upadacitinib is already approved in the European Union for nonsegmental vitiligo in candidates for systemic therapy.
https://www.dermatologytimes.com/view/repigmentation-with-upadacitinib-continues-through-week-76-in-non-segmental-vitiligo

11. Ritlecitinib in vitiligo: repigmentation and stabilization (TRANQUILLO and TRANQUILLO 2)

[Congress] [International]
In the phase 3 TRANQUILLO 2 trial (1,567 adults, ritlecitinib 100 mg daily), F-VASI75 at week 52 was 21.9% vs 2.4% with placebo and T-VASI50 was 13.0% vs 2.4%. In TRANQUILLO (607 patients aged 12 and older, 50 mg daily), F-VASI75 was 12.5% vs 2.5%. According to investigator Iltefat Hamzavi, about 80% of treated patients remained stable, vs about 60% on placebo.
Why it matters: facial repigmentation is modest, but disease stabilization is an outcome that matters to patients. The figures are not comparable with those of upadacitinib (different trials and analyses), no p values were reported, and the full publication is still pending.
https://www.hcplive.com/view/ritlecitinib-stabilizes-vitiligo-tranquillo-trial-iltefat-hamzavi-md
https://www.dermatologytimes.com/view/ritlecitinib-improves-repigmentation-in-nonsegmental-vitiligo

Infectious dermatology, dermoscopy and artificial intelligence

No news from the period on fungal infections, scabies, leprosy, cutaneous leishmaniasis, dermoscopy or diagnostic AI.

Cross-cutting

12. Undeclared clobetasol in over-the-counter skin products bought online

[Publication]
In this study, published in JAMA Network Open on October 8, researchers screened 18 over-the-counter skin products marketed online for 28 corticosteroids and antifungals. Six (33.3%) contained undeclared clobetasol, two of them also with an antifungal, at concentrations of about 0.01% to 0.46%; the highest was more than nine times the 0.05% strength of FDA-approved clobetasol. None of the active ingredients found appeared on the labels.
Why it matters: the sample is small and nonrandom, but the finding is highly relevant in the Dominican Republic and Latin America, where unregistered "lightening" and combination creams circulate. Ask about them in perioral dermatitis, atrophy or tinea incognito.
https://doi.org/10.1001/jamanetworkopen.2026.38654

Upcoming meetings and dates

• October 21–25, 2026: American Dermatological Association Annual Meeting, Philadelphia.
• November 5–8, 2026: American Society for Dermatologic Surgery Annual Meeting, San Diego.
• November 6–8, 2026: SHSA 2026, Hidradenitis Suppurativa Foundation, Tucson.
• November 19–22, 2026: 63rd Annual American Society of Dermatopathology Meeting, Atlanta.
  https://www.dermatologytimes.com/view/dermatology-times-conferences-meetings-calendar-2026

Monthly dermatology bulletin — October 2026

12 verified items from September 16 to October 16 (one of them, an approval from September 14, flagged as outside the period): EADV 2026, JAMA Dermatology, JAMA Network Open and two FDA decisions.

Three worth your time:
• Zasocitinib vs deucravacitinib in psoriasis (n=606): PASI 100 of 36.5% vs 13.9% at week 16. It is a head-to-head comparison of two TYK2 inhibitors, but it is short and unpublished.
• Baricitinib, FDA-approved from age 12 for severe alopecia areata: SALT ≤20 in 42% on 4 mg vs 5% on placebo. Long-term safety data in adolescents are still lacking.
• Telikibart, an anti-IL-4Rα antibody tested in China (n=450): EASI-75 of 69.6% vs 22.5%. Chinese-only population, and no conjunctivitis data.

Full bulletin, with a critical reading of each study and links to its sources:
https://boletinesmedicos.com/en/dermatology/2026-10-16.html

#Dermatology #AtopicDermatitis #Psoriasis #AlopeciaAreata #EADV2026

Psoriasis: zasocitinib beat deucravacitinib, with PASI 100 of 36.5% vs 13.9%. The FDA approved baricitinib from age 12 for alopecia areata (SALT ≤20: 42% vs 5%). October bulletin: https://boletinesmedicos.com/en/dermatology/2026-10-16.html