What’s New in Dermatology for Pigmentary Disorders, with Andrew Alexis, MD, MPH

In another segment of his interview with HCPLive at the American Academy of Dermatology (AAD) Annual Meeting, Andrew F. Alexis, MD, MPH, highlights the biggest takeaways from his ‘What’s New in Dermatology’ presentation regarding treating pigmentary disorders.

Alexis, who serves as professor of clinical dermatology and vice-chair for diversity and inclusion at Weill Cornell Medicine, was asked about the major highlights of his talk regarding pigment-related dermatologic conditions. First, he touched on hyperpigmentation.

“There's so many new and exciting things to talk about with respect to pigmentary disorders,” Alexis said. “I started with hyperpigmentation, where we have a number of non-prescription agents that we can now consider particularly for long-term management of hyperpigmentation. We know that there are limitations to the long-term use of hydroquinone, namely, exogenous organosis being the limitation for excessive and long-term use. So we increasingly need alternatives to hydroquinone for longer-term management.”

To address this, Alexis highlighted 3 non-prescription agents that he noted are available now, including topical cysteamine, topical thiamidal, and Melasyl.

“It's exciting to see that there are controlled studies for treating melasma and post-inflammatory hyperpigmentation, with some of these agents, in particular Melasyl…” Alexis said. “So we're seeing an increasing number of comparative studies. Cysteamine, in a newer formulation of 7.5% with isobionic amide, also has a comparative study versus triple combination modified Kligman's formula with hydroquinone, retinoid, and corticosteroid, showing comparable results to that gold standard treatment.”

Later, Alexis highlighted long term data on recent treatments developed for individuals with vitiligo. First, he highlighted ruxolitinib 1.5% cream in particular.

“What I really like about the long term data is it demonstrates patients that might not have shown a significant response in the short term, such as at 6 months, but then go on to show very robust responses at 1 year or 2 years of ongoing therapy,” Alexis said. “So it really speaks to the benefits of continuous, long-term therapy with topical ruxolitinib. I also talked about the addition of phototherapy to accelerate the responses to topical JAK inhibitor therapy with ruxolitinib. We have some newer data showing patients who, in the first 12 weeks, fail to get greater than a fail to get at least a facial VASI25. But then, narrow band UVB is added, and what we saw is an accelerated response rate post narrowband UVB.”

For more information from Alexis’s talks at AAD, view the full video posted above. To learn more from the conference itself, view our latest conference coverage.

The quotes contained here have been edited for clarity. Examples of Alexis's disclosures include the following: Consultant (Fees/Honoraria): AbbVie, Amgen, Boehringer Ingelheim, Canfield Scientific, Eli Lilly, Janssen, Janssen Scientific Affairs, LEO Pharma, L'Oréal USA, Pfizer, Symrise; Other (Equipment/Financial Benefit): Aerolase (Equipment), Elsevier, Medscape, Springer Science & Business Media, UpToDate, Wiley-Blackwell.