New Dermatologic Therapies Make Waves at Maui Derm 2026

The landscape of dermatology is rapidly evolving, with innovative therapies emerging for the management of complex and often refractory skin diseases. In a lively, wide-ranging session at Maui Derm Hawaii 2026, Ted Rosen, MD, professor of dermatology at Baylor College of Medicine, and chief of dermatology service at Michael E. DeBakey Veterans Affairs Medical Center, along with Neal Bhatia, MD, director of clinical dermatology at Therapeutics Clinical Research, and chief medical editor for Practical Dermatology, explored recent advances and pipeline developments across pediatric atopic dermatitis (AD), chronic urticaria, bullous pemphigoid, hand eczema, psoriasis, hidradenitis suppurativa (HS), prurigo nodularis, alopecia areata, vitiligo, and acne.¹

A New Era for Pediatric Atopic Dermatitis and Hives

Updates in AD focused on newly available steroid-free topical options for children aged 2 to 5 years, along with improved foam formulations designed for difficult-to-treat areas such as the scalp. Bhatia emphasized the growing importance of patient-centered end points, including rapid itch relief—the so-called “sprint effect,” often evident by day 7—and sustained maintenance of therapeutic benefit.

Chronic spontaneous urticaria (CSU) also received significant attention. The speakers underscored the importance of recognizing disease subtypes and tailoring therapy accordingly. Remibrutinib (Rhapsido; Novartis), a newly available, FDA-approved, oral Bruton tyrosine kinase (BTK) inhibitor for adults, offers an alternative to dupilumab and traditional antihistamines.² Clinical data suggest promising efficacy in disrupting the itch cycle, although responses among omalizumab-naive patients were more modest in some studies.

“Now with remibrutinib, we can go to the sample cabinet, give them tablets, and say, ‘All right, shots or pills, which way do you want to go?” Bhatia said.¹ “This is 18 and up for now, but remibrutinib has a lot of opportunities.”

Breakthroughs in Bullous Pemphigoid and STIs

Bullous pemphigoid (BP), a notoriously challenging autoimmune blistering disorder, is seeing improved outcomes with dupilumab. The preferred treatment strategy involves initial disease control with corticosteroids, followed by a gradual taper and dupilumab maintenance—an approach associated with high rates of durable remission and significant reductions in pruritus.

The session also touched on antibiotic resistance in sexually transmitted infections (STIs), an escalating concern. Two investigational agents represent much-needed additions to the therapeutic pipeline, with potential applications beyond STIs: zoliflodacin (Nuzolvence; Innoviva Specialty Therapeutics), a single-dose oral granule, and gepotidacin (Blujepa; GSK), a novel oral therapy with activity against gram-positive pathogens.

“They are brand-new antibiotic classes, although both of them were topoisomerase 2 inhibitors,” Rosen explained in the session. “Zoliflodacin is a single dose; its granules dissolve in water. Gepotidacin comes in 750-mg tablets, and you take a 3-gram dose, and 12 hours later, you take a second 3-gram dose. For STDs, most of the time, ideally, it’s single-dose, so you treat the patient before they leave your site.”

JAK Inhibition: Expanding Horizons

Hand eczema, particularly in patients with underlying atopic disease, remains an area of substantial unmet need. Delgocitinib (Anzupgo; LEO Pharma), a pan-JAK inhibitor, is emerging as a new option, demonstrating symptom improvement within 2 weeks and meaningful gains in quality of life for patients who have failed topical steroids. Off-label use of topical JAK inhibitors, including ruxolitinib (Opzelura; Incyte) cream, is also gaining traction for conditions such as granuloma annulare, cutaneous sarcoidosis, and frontal fibrosing alopecia.

Transforming the Treatment of Psoriasis, Prurigo Nodularis, and HS

One of the most notable advances discussed was icotrokinra (Conmana; Betta Pharmaceuticals), the first oral IL-23 receptor blocker for moderate to severe psoriasis. Clinical trials suggest it may outperform existing JAK inhibitors in achieving “clear” or “almost clear” skin.

For patients with prurigo nodularis (PN)—a condition marked by severe itch and limited treatment options—several promising therapies are on the horizon. Povorcitinib (INCB54707; Incyte Corporation), a highly selective JAK1 inhibitor, and Vixarelimab (KPL-716; Kiniksa Pharmaceuticals), a dual IL-31/OSMRβ antibody, have both demonstrated dose-dependent and sustained improvements in pruritus and lesion clearance.

HS, another refractory disease, is also benefiting from therapeutic innovation. JAK1 inhibitors and ruxolitinib cream have shown efficacy, with evidence supporting higher-dose regimens for improved outcomes. Extension studies continue to reinforce long-term safety, while IL-1–blocking agents and extended half-life biologics are advancing through development.

Emerging Therapies in Alopecia, Acne, Vitiligo, and Lupus

Patients with alopecia areata are achieving clinically meaningful hair regrowth with pan-JAK inhibitors, marking a major shift in disease management. In acne, denifanstat (TVB-2640/ASC40; Sagimet Biosciences), a fatty acid synthase inhibitor, targets sebum production at its source and has shown encouraging results in early studies.

Vitiligo, lupus, and other inflammatory dermatoses are likewise poised to benefit from an expanding arsenal of JAK, TYK2, and interleukin-targeted therapies designed to address disease-specific immune pathways.

Shifting the Dermatology Paradigm

Both presenters stressed that innovation in dermatology must extend beyond efficacy alone. They urged clinicians to advocate for patients by prioritizing quality-of-life improvements rather than focusing narrowly on cost containment. As the therapeutic pipeline continues to expand, dermatologists are better equipped than ever to treat complex diseases that once lacked effective options while maintaining a strong emphasis on safety and patient-centered care.

Taken together, these developments position 2026 as a potential watershed year for dermatology, significantly expanding the therapeutic armamentarium and setting new standards for the management of chronic skin disease.

References

1. Rosen T, Bhatia N. New drugs and therapies in 2026. Presented at: Maui Derm 2026; January 25-29, 2026; Maui, HI.
2. McNulty R. FDA approves remibrutinib for chronic spontaneous urticaria. AJMC^®️. September 30, 2025. Accessed January 26, 2026. https://www.ajmc.com/view/fda-approves-remibrutinib-for-chronic-spontaneous-urticaria