Clinical Trial Data Signal a New Era for Atopic Dermatitis, Melanoma, and Psoriasis

Leading voices in adult and pediatric dermatology convened in Hawaii for Maui Derm Hawaii 2026 to examine pivotal clinical trial data, evolving therapeutic strategies, and practical considerations shaping modern dermatologic care. Hensin Tsao, MD, PhD, professor of dermatology at Harvard Medical School, the director of both the Massachusetts General Hosptial (MGH) Melanoma and Pigmented Lesion Center and the MGH Melanoma Genetics Program, and the head of the Skin Cancer Genetics Laboratory at the Wellman Center for Photomedicine at MGH, joined Sheila Fallon Friedlander, MD, professor of clinical pediatrics and medicine (dermatology) at the University of California, San Diego School of Medicine and director of the Dermatology Fellowship Training Program at Rady Children’s Hospital, in presenting “Dermatology in Review,” which spanned conditions including atopic dermatitis (AD), melanoma, psoriasis, eczema, and congenital and pediatric skin disorders, underscoring a period of rapid innovation across the field.¹

Advances in Adult Dermatology

A major focus of the session was the continued expansion of targeted therapies for inflammatory skin disease. Tsao reviewed data from the phase 3 ROCKET Ignite (NCT05398445) and ROCKET Horizon (NCT05651711) trials evaluating rocatinlimab (AMG 451/KHK4083; Amgen, Kyowa Kirin), an investigational therapy targeting the OX40 pathway, in patients with moderate to severe AD. Both trials met their primary end points, with statistically significant improvements in Eczema Area and Severity Index-75 (EASI-75) and Investigator’s Global Assessment (IGA) scores of 0 or 1 at week 24.

“I will say the rocatinlimab significantly improves skin clearance, itch, pain, and quality of life in moderate to severe AD, which is a very positive statement,” Tsao said in the session. “Clinical response increases over time through week 24 without evidence of early plateau, and the OX40 receptor pathway and targeting does selectively, sort of, lead to this resolution, and it is an interesting new pathway to talk about.”

Patients also experienced meaningful quality-of-life gains, and efficacy was observed even among those with prior treatment failures. Adverse event rates were low, and clinical responses were sustained over the study period, though limitations included relatively short trial duration, complex rescue protocols, and limited pediatric data.

Overall, Tsao explained that rocatinlimab signals the emergence of a new therapeutic class in AD management. “This is a new therapeutic class in AD, and it could potentially reshape long-term disease management and control,” he said.

Shifting to melanoma, Tsao presented long-term data that further reinforced the durability of immunotherapy. Final 10-year outcomes from a landmark phase 3 trial comparing nivolumab plus ipilimumab, nivolumab alone, and ipilimumab alone in unresectable stage III or IV melanoma demonstrated clear survival advantages with checkpoint inhibition.²

Ten-year overall survival rates reached 43% with combination therapy and 37% with nivolumab monotherapy, compared with 19% for ipilimumab alone. While combination therapy conferred the greatest benefit—particularly in BRAF-mutant disease—it also carried higher toxicity and discontinuation rates. Notably, patients who survived 3 years had a high likelihood of surviving to 10 years, redefining expectations for long-term melanoma outcomes and highlighting the growing relevance of oncodermatology, according to Tao.

In contrast, outcomes for acral melanoma remain poor. A retrospective analysis reviewed during the session showed limited responses to existing checkpoint inhibitors, with a median overall survival of just 17 months. Tai said the findings emphasize the urgent need for earlier detection strategies and novel targeted therapies, particularly given biological and ethnic disparities associated with this melanoma subtype.

Several additional therapeutic advances were highlighted. Phase 3 data showed that a topical JAK inhibitor cream was more effective and better tolerated than oral isotretinoin for chronic hand eczema, offering a promising nonsystemic alternative. In psoriasis, oral IL-23 inhibition achieved biologic-level efficacy across multiple trials, supporting a broader shift toward highly targeted oral agents with favorable safety profiles. Tao also discussed a phase 3 study in high-risk resected cutaneous squamous cell carcinoma, which demonstrated that adjuvant pembrolizumab significantly improved 2-year disease-free survival, strengthening its role as a standard-of-care option.

Key Updates in Pediatric Dermatology

Friedlander focused on evidence-based prevention and early intervention strategies in pediatric dermatology, particularly for AD. “I decided not to go through every article that might be of importance to you, because I don't think you'll go home with that,” she said in the session. “I wanted to focus on what you're going to use in the here and the now in your office. What's going to be most useful to you day to day?”

Consensus recommendations now emphasize regular bathing with immediate emollient application and early proactive use of topical therapies to prevent flares. Recent randomized trials suggest early daily emollient use may modestly reduce eczema incidence in infants, without reported harms.

For children with established AD and food allergies, early systemic therapy, including dupilumab and JAK inhibitors, may interrupt progression along the atopic march, with data supporting both efficacy and safety even in vaccination-age children.

Friedlander also addressed melanoma risk in children with large or giant congenital melanocytic nevi. Certain genetic profiles, including NRAS mutations and BRAF fusions, confer higher risk, and targeted therapies may be appropriate in select cases. Updated surveillance recommendations include early MRI and enrollment in dedicated registries, particularly for children with prior cancer therapies.

She also highlighted that evolving nomenclature in inherited skin disease reflects advances in genetic understanding, with conditions increasingly classified based on molecular defects rather than clinical appearance alone.

Looking Ahead in Dermatology

Targeted systemic therapies, evidence-based prevention, and refined surveillance strategies are reshaping dermatologic care across the lifespan, according to the speakers. As innovation accelerates, clinicians are encouraged to integrate emerging evidence with patient-centered decision-making to optimize outcomes in both adult and pediatric populations.

References

1. Tao H, Friedlander SF. Dermatology in review. Presented at: Maui Derm 2026; January 25-29, 2026; Maui, HI.

2. Wolchok JD, Chiarion-Sileni V, Rutkowski P, et al; CheckMate 067 Investigators. Final, 10-year outcomes with nivolumab plus ipilimumab in advanced melanoma. N Engl J Med. 2025;392(1):11-22. doi:10.1056/NEJMoa2407417