Patch Testing & JAK Inhibitor Optimization for Atopic Dermatitis
Dermatologist Highlights Advances in Contact Dermatitis and JAK Inhibitor Therapy at Elevate-Derm
Park City, UT – At the 2025 Elevate-Derm Summer Conference, Walter Liszewski, MD, a board-certified dermatologist and associate professor of dermatology at Northwestern Feinberg School of Medicine, shared key insights into managing challenging dermatological conditions, focusing on contact dermatitis and the practical submission of JAK inhibitors for atopic dermatitis (AD). Liszewski emphasized that while some treatments can be “overwhelming,” they hold transformative potential for patients.
Optimizing Contact dermatitis Management Through Comprehensive Patch Testing
In his session, “Contact Dermatitis Conundrums,” Liszewski underscored the notable benefits of comprehensive patch testing for individuals suffering from chronic dermatitis. He cautioned against an over-reliance on limited commercial kits, such as the TRUE Test, noting that their restricted allergen panels can lead too missed diagnoses. For patients who experience persistent flares despite initial treatment and testing, Liszewski strongly recommended referral to a patch testing specialist for more extensive allergen panels.
A crucial aspect of post-patch testing care, liszewski highlighted, involves a detailed review of the patient’s product usage.He pointed out that patients often overlook hidden allergens, such as fragrance molecules, which may not be clearly indicated on product labels. Clinicians play a vital role in assisting patients to identify personal care items and topical treatments containing their specific allergens. Liszewski stressed that without targeted avoidance counseling, even accurate patch test results may not lead to clinical enhancement due to the often non-intuitive and misleading nature of consumer labeling.
JAK Inhibitors: Practical Integration and Dosing Strategies for Atopic Dermatitis
Liszewski’s second session, “JAK Inhibitors: Practical Tips for Integration Into practice,” delved into the clinical nuances of employing JAK inhibitors in the treatment of AD. Despite existing black box warnings, Liszewski argued that these agents should not be automatically withheld based solely on demographic risk factors, such as age over 50 or the use of oral contraceptives. He asserted that with appropriate monitoring, JAK inhibitors can provide rapid and significant improvements, especially for patients who have not responded to biologic therapies.
Furthermore, Liszewski encouraged clinicians to confidently escalate JAK inhibitor dosing. He cited large-scale extension trial data indicating minimal additional safety concerns with increased doses, while demonstrating significant gains in itch reduction, sleep quality, and skin clearance. He shared that none of his patients who transitioned from biologics to JAK inhibitors expressed regret, underscoring the importance of individualized therapeutic decision-making.
“We certainly know, based on large-scale extension trial data, that when you increase the dose of things like Rinvoq or Cibinqo, rates of side effect increase are very minimal, but the improvement in quality of life, the improvement in itch, and the improvement in sleep goes up tremendously, and the benefits outweigh the risks,” Liszewski concluded.
References
- Liszewksi W. Contact dermatitis: a panel discussion on challenging cases. Presented at: 2025 Elevate-derm summer Conference; July 24-28; park City, UT.
- Liszewksi W. JAK inhibitors: practical tips for integration into practice. Presented at: 2025 Elevate-derm Summer conference; July 24-28; Park City, UT.