SPD 2025: Research Highlights, Personalized Treatment, and Barriers to Care

This year, the Society for Pediatric Dermatology (SPD) held its 50th Annual Meeting between July 23 and July 26, 2025, in Seattle, Washington. The SPD 2025 Annual Meeting covered topics in the field of pediatric dermatology, including new safety and efficacy findings on treatment options, research on tailoring treatment options among patients with skin of color, and how social determinants of health (SDOH) impact patients and families with various skin conditions.

Evaluating the Safety and Efficacy of Ruxolitinib in Pediatric Patients

At SPD 2025, 2 poster presentations from the TRuE-AD3 (NCT04921969) study highlighted the long-term benefits of as-needed ruxolitinib cream (Opzelura; Incyte Corporation) for children aged 2 to 11 years with mild to moderate atopic dermatitis (AD). In children with moderate or more extensive disease at baseline, both 0.75% and 1.5% concentrations of ruxolitinib cream led to sustained skin clearance (Investigator’s Global Assessment 0/1 in up to 74.6% of patients) and reduced affected body surface area to approximately 2% at week 52, with no serious treatment-related adverse events (AEs).1 A second analysis showed that among children who continued into the 44-week long-term safety period, more than 80% achieved clear or almost clear skin at least once, maintaining this response during most visits. Notably, children spent nearly half the follow-up period off treatment due to lesion clearance, underscoring the efficacy and convenience of as-needed dosing. These results support ruxolitinib cream as a safe, effective, and flexible long-term treatment option for pediatric AD.

A third poster evaluated ruxolitinib cream in children and adolescents with AD and provided reassuring evidence that the topical Janus kinase (JAK) inhibitor carries a low risk of serious AEs.2 Drawing on data from 8 clinical trials involving 767 patients aged 2 to 17 years and over 500 patient-years of exposure, the analysis found no reports of major adverse cardiovascular events, thromboembolic events, malignancies, or deaths. Only 2 serious infections occurred—both in patients using the 1.5% strength—and neither was deemed drug-related. Application site reactions were rare, and systemic absorption remained low even with extensive body surface area application. Importantly, plasma concentrations stayed well below thresholds associated with JAK-related myelosuppression. These findings distinguish topical ruxolitinib from its systemic counterparts, suggesting it is a safer alternative for long-term use in pediatric dermatologic care.

Treating Acne in Patients of Color

During a SPD session, Jenna Lester, MD, director of the skin of color program and associate professor of clinical dermatology at the University of California, San Francisco, highlighted the importance of culturally informed, patient-centered acne care for patients of color.4 Lester outlined how hair care practices, including the use of oils and pomades common among patients with Afro-textured hair, can contribute to acne but should not be dismissed outright. Instead, she recommended practical, respectful strategies such as switching to water-based products or limiting oil application to hair ends.

Lester also highlighted the profound impact of post-inflammatory hyperpigmentation (PIH), which disproportionately affects patients of color and often leads to psychosocial distress. Lester noted some criticism of the 2024 acne guidelines for prioritizing scarring and psychological burden as criteria for isotretinoin use and urged clinicians to treat PIH as a scarring equivalent and consider early systemic treatment. Additionally, she stressed the importance of sun protection with products containing iron oxide and zinc oxide to manage PIH effectively.

“Post-inflammatory hyperpigmentation should be treated aggressively and at the same time as acne, or in sequence, depending on what you decide,” said Lester. Lester also addressed disparities in treatment access and called for routine screening for bullying among pediatric acne patients, especially those from marginalized backgrounds, to ensure a holistic and equitable approach to care.

The Impact of SDOH in Pediatric Dermatology

During the SPD session, Sarah Coates, MD, FAAD, assistant clinical professor of dermatology at the University of California, San Francisco, and director at Zuckerberg San Francisco General Pediatric Dermatology, highlighted the profound influence of SDOH on pediatric dermatologic outcomes and called for systemic solutions to address disparities in care.5 Coates outlined how factors such as financial hardship, low health literacy, limited access to care, and adverse childhood experiences can worsen conditions like eczema, psoriasis, and hidradenitis suppurativa. She urged clinicians to move beyond standard social history questions and adopt a “3 As” framework—awareness, assistance, and adjustment—to screen for social risks, tailor treatment plans to patients’ circumstances, and connect families to resources. Strategies such as simplifying patient education materials, leveraging telemedicine, and incorporating patient navigators were recommended to improve access and adherence.

To prepare the next generation of dermatologists, Coates introduced a formal SDOH curriculum, complete with a dedicated health equity chief resident role, aimed at equipping trainees to deliver more equitable, compassionate care. Her message was clear: Addressing social drivers is essential not only for improving skin health but also for fostering stronger patient relationships and reducing provider burnout.

“I hope that what you've taken away is that children are really a unique population,” said Coates. “Things like social risk, social drivers, and adverse childhood experiences are really important, including for skin disease. [Hopefully] you'll consider this when you're formulating your care plans, and you'll consider screening for this.”

REFERENCES

1. Steinzor P. Ruxolitinib cream shows long-term AD control in children aged 2 to 11 years. AJMC®. July 24, 2025. Accessed August 4, 2025. https://www.ajmc.com/view/ruxolitinib-cream-shows-long-term-ad-control-in-children-ages-2-to-11
2. Steinzor P. AJMC. Across 8 trials, ruxolitinib cream shows favorable safety in pediatric AD. July 25, 2025. Accessed August 4, 2025. https://www.ajmc.com/view/across-8-trials-ruxolitinib-cream-shows-favorable-safety-in-pediatric-ad
3. Lester J. Acne in children of color. Presented at: Society for Pediatric Dermatology Annual Meeting; July 23-26, 2025; Seattle, WA.
4. Coates, S. Identifying and addressing social and structural drivers of health. Presented at: Society for Pediatric Dermatology Annual Meeting; July 23-26, 2025; Seattle, WA.