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and joined the MJH Life Sciences team in February 2023. She attended Kent State University and earned a Bachelor of Science degree in journalism with minors in public relations and creative writing. She enjoys making and listening to music, reading, and spending time with her cats, Astrid and Marceline.

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Rigorous pre-, intra-, and postoperative protocols help ensure safe, effective periocular laser treatments and reduce the risk of ocular complications.

Comprehensive Safety Measures Reduce Risk in Periocular Laser Treatments

Maddi Hebebrand is an associate editor of 

and joined the MJH Life Sciences team in May 2024. She attended Baldwin Wallace University, studying Media Production and Film, and received her Masters in Digital Media from Ohio University. When she's not writing, Maddi loves to read, attend concerts and spend time with her family. 

Abrocitinib significantly improves lesion severity and pruritus in moderate to severe AD, offering a promising treatment option for patients.

Abrocitinib Reduces Itch and Lesions in AD Trial

Our July cover story explores effective treatments for hidradenitis suppurativa, including procedural interventions and advanced therapies that enhance patient quality of life.

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Mitchell Hanson is a third-year MD/MPH candidate at the Medical College of Georgia with interests in public health, sexual and gender minority topics, and dermatology. He has presented at national and international conferences with publications in journals including 

. He currently functions as the UCSF Marcus Conant HIV Derm & LGBTQ+ Health Research Fellow, one of the American Academy of Dermatology Expert Resource Group on LGBTQ+ and Sexual and Gender Diverse Health Student Fellows, and as the vice chair for the AMA MSS Standing Committee on LGBTQ+ affairs.

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Aesthetic medicine embraces a holistic approach to skin quality, defining it through measurable categories that enhance personalized treatment strategies.

Skin Quality: Defined by Global Consensus, Delivered Through Personalized Treatment

Final Thoughts: The Importance of Comparative Studies in AD

Panelists offer concluding insights and emphasize the critical role of comparative studies in advancing atopic dermatitis treatment strategies.

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Beyond its physical effects on the skin, psoriasis is increasingly recognized for impacting patients’ emotional and psychological health. Individuals with psoriasis are more likely to suffer from depression, anxiety, and suicidal ideation compared with the general population. This burden is multifactorial, stemming from disease visibility, stigma, chronicity, and systemic inflammation.

Biologic therapies have transformed the management of psoriasis, and IL-17 inhibitors such as bimekizumab offer targeted control of disease activity. Given the FDA warning for suicidal ideation and behavior (SI/B) listed in bimekizumab’s prescribing information, clinicians may hesitate to use it in patients with a history of mood disorders.

 A closer look at the trial data, however, reveals that bimekizumab not only has a low risk of psychiatric adverse events but may also confer meaningful mental health benefits.

Bimekizumab’s SI/B Label Warning: What the Data Really Say

 for potential SI/B, data from 9 phase 2/3 clinical trials involving more than 7166 patient-years (PYs) of exposure paint a reassuring picture

 0.13 per 100 PYs with suicidal ideation at 0.08/100 PYs, suicide attempts at 0.04/100 PYs, and completed suicide at 0.01/100 PYs.

 These rates are comparable to or lower than those seen with other anti–IL-17 and IL-23 therapies (0.09-0.54/100 PYs and 0.09-0.19/100 PYs, respectively). For example, brodalumab—a therapy with a boxed SI/B warning—has an SI/B rate of 0.49/100 PYs.

 Bimekizumab trials included rigorous psychiatric monitoring via the electronic Columbia-Suicide Severity Rating Scale (eC-SSRS) and independent adjudication of cases by a neuropsychiatric adjudication committee.

Across the 9 studies, bimekizumab was associated with consistently low depression scores and favorable trends compared with placebo and active comparators

 At week 16, 92.9% of patients treated with bimekizumab scored 0 to 4 on the Patient Health Questionnaire-9 (PHQ-9) (no/minimal depression) vs 81.1% of patients who received a placebo.

 Only 1.2% of patients on bimekizumab scored greater than or equal to 10 on the PHQ-9 (moderate to severe depression) compared with 6.3% on placebo; severe depression (PHQ-9 ≥15) occurred in just 0.7% of treated patients vs 4.1% on placebo.

Mean PHQ-9 scores remained low through 144 weeks of follow-up, suggesting durable mental health benefits with continued treatment.

Mental Health Benefits of Biologic Therapy in Psoriasis

The positive effects of biologics on mood are not unique to bimekizumab. Biologics offer more than skin-deep benefits—evidence points to direct improvements in mental health, particularly with IL-17 and IL-23 inhibitors:

 Registry data (eg, DermaReg-Pso) show that IL-17 and IL-23 inhibitors are associated with greater reductions in depressive symptoms than TNF-α inhibitors, even after adjusting for disease severity and quality of life.

 IL-17 inhibitors specifically improved core depressive symptoms, including pessimism, emotional numbness, and even suicidal ideation, suggesting a distinct neuropsychiatric impact.

 These effects may be mediated by downregulation of neuroinflammatory pathways, underscoring the role of systemic inflammation in mood disorders.

Efficacy and Long-Term Safety of Bimekizumab

Bimekizumab has demonstrated durable skin clearance with a manageable safety profile, both in trials and real-world use:

 In head-to-head trials, bimekizumab provided more days of complete clearance (PASI 100) over 52 weeks than secukinumab, ustekinumab, adalimumab, and etanercept.

 In pooled clinical trials, serious treatment-emergent adverse events occurred at 5.9/100 PYs, with low rates of major adverse cardiovascular events, malignancy, and inflammatory bowel disease. The most common adverse events included nasopharyngitis, oral candidiasis, and upper respiratory tract infections.

 A retrospective analysis (n = 51) showed similar safety signals. Fungal infections were the most frequent adverse event, with a 14% discontinuation rate. No SI/B events were reported; only 1 patient developed new-onset depression.

Clinical Considerations: Counseling and Coordinated Care

Dermatology clinicians play a key role in supporting both the mental and physical health of patients undergoing biologic therapy. Before initiating treatment, clinicians should conduct pretreatment screening using validated tools such as the PHQ-9 and the eC-SSRS to establish a mental health baseline. Open, clear communication is essential, such as addressing the FDA warning for SI/B directly while contextualizing it with supportive clinical trial and real-world data. For patients with a known psychiatric history, collaborative care is recommended, including timely referral to primary care providers or mental health professionals as appropriate.

Although bimekizumab carries a label warning for SI/B, clinical trial evidence supports a low risk and potential improvements in depression symptoms among treated patients. With its strong efficacy profile and favorable long-term safety, bimekizumab remains a valuable treatment for moderate to severe plaque psoriasis. Dermatology clinicians should feel confident in prescribing it while maintaining vigilance around mental health screening.

, is a board-certified dermatology physician assistant and medical writer in Connecticut.

Hołdrowicz A, Żebrowska A. Molecular link between psoriasis and depression-update on pathophysiology.

. 2025;26(6):2467. doi:10.3390/ijms26062467

Black C, Miller BJ. Meta-analysis of cytokines and chemokines in suicidality: distinguishing suicidal versus non suicidal patients. 

. 2015;78(1):28-37. doi:10.1016/j.biopsych.2014.10.014

Bimzelx. Prescribing information. UCB Inc; 2024. https://www.ucb-usa.com/bimzelx-prescribing-information.pdf 

Blauvelt A, Armstrong A, Merola JF, et al. Mental health outcomes in patients with moderate to severe psoriasis treated with bimekizumab: analysis of phase 2/3 randomized trials. 

, 2024;91(1):72-81. doi:10.1016/j.jaad.2024.02.039

Svedbom A, Ståhle M. Interleukin-17 and -23 inhibitors associated with direct effects on depressive symptoms in psoriasis: results from a register study. 

. 2023;103:adv7138. doi:10.2340/actadv.v103.7138

Warren RB, Donnelly K, Kiri S, et al. Long-term efficacy and safety of bimekizumab and other biologics in moderate to severe plaque psoriasis: updated systematic literature review and network meta-analysis. 

. 2024;14(11):3133-3147. doi:10.1007/s13555-024-01302-0

Gordon KB, Langley RG, Warren RB, et al. Bimekizumab safety in patients with moderate to severe plaque psoriasis: pooled results from phase 2 and phase 3 randomized clinical trials. 

. 2022;158(7):735-744. doi:10.1001/jamadermatol.2022.1185

Zangenah N, Vazquez-Machado M, Loranger N, Elshaboury S, Hashemi K, LaChance AH. Adverse events associated with bimekizumab for moderate-to-severe plaque psoriasis: a retrospective, multicenter, post-hoc analysis. 

. 2025;20:54-55. doi:10.1016/j.jdin.2025.02.001 

Psoriasis significantly impacts patients' mental health, increasing risks of depression and anxiety. Biologic therapies, particularly IL-17 inhibitors like bimekizumab, have revolutionized psoriasis management. Despite FDA warnings for suicidal ideation and behavior (SI/B), bimekizumab shows low psychiatric adverse event rates and potential mental health benefits. Clinical trials reveal low depression scores and durable mental health improvements. Bimekizumab demonstrates superior skin clearance and a manageable safety profile. Dermatology clinicians should conduct mental health screenings and provide coordinated care, ensuring informed discussions about SI/B risks and benefits with patients.

Although bimekizumab carries a precaution for suicidal ideation and behavior, current data suggest it may improve mental health outcomes for patients with psoriasis. 

Beyond the Label: Evaluating Bimekizumab’s Mental Health Profile in Psoriasis Treatment

A recent announcement from VYNE Therapeutics highlights the evolving clinical trajectory of VYN202, an investigational oral BD2-selective BET inhibitor. The drug, which is being developed for immune-mediated diseases, including moderate to severe plaque psoriasis, encountered a clinical hold in April 2025 after nonclinical data in dogs raised safety concerns.

 However, the company says updated findings and preliminary human data suggest that VYN202 may still hold significant potential in treating immune-driven dermatologic and rheumatologic conditions.

The FDA imposed a clinical hold on VYNE’s phase 1b study following the observation of testicular toxicity in a nonclinical toxicology study involving dogs. Notably, the no-observed-adverse-effect level established in female animals supported continued testing in female patients at 0.25-mg and 0.5-mg doses. The higher 1-mg dose was excluded from the amended trial design due to a less favorable toxicological margin. The FDA has since lifted the clinical hold for these 2 lower doses—but only in female subjects—pending additional toxicology data to support resumption in male participants.

The hold prompted VYNE to unblind early clinical data, enabling preliminary evaluation of safety and efficacy outcomes across the limited number of patients already enrolled.

The phase 1b study enrolled 7 subjects in total—6 received VYN202 (across 0.25-mg, 0.5-mg, and 1-mg doses), and 1 received a placebo. Safety results from this small cohort were encouraging: No treatment-emergent serious adverse events, no study discontinuations due to adverse events, and no hematologic toxicities such as thrombocytopenia or lymphocytopenia were reported.

Importantly, all VYN202-treated subjects experienced some clinical improvement in psoriasis symptoms, including scalp involvement. Reductions in Psoriasis Area and Severity Index scores ranged from approximately 27% after 1 week to as high as 90% at week 8, suggesting a potential dose- and time-dependent response.

Serum biomarkers also showed promising trends. Pro-inflammatory cytokines commonly associated with plaque psoriasis—including IL-17A, IL-17F, IL-19, and IL-22—decreased by up to 83% in treated patients, whereas no significant changes were observed in the placebo subject. VYNE says these molecular improvements bolster the hypothesis that VYN202 exerts immunomodulatory effects by selectively targeting BD2, a domain implicated in inflammatory signaling.

Interestingly, researchers reported 2 subjects presenting with concurrent psoriatic arthritis. One (treated with VYN202 0.5 mg) reported a 4-point reduction on the joint pain numeric rating scale by week 2, accompanied by a 48% reduction in serum C-reactive protein—a key biomarker in rheumatic disease. The subject who received a placebo reported no such improvement, further suggesting potential for broader therapeutic application of VYN202 beyond cutaneous psoriasis.

Despite these positive signals, VYNE has opted to discontinue enrollment in the current psoriasis-focused phase 1b study. This decision is framed as both a risk mitigation strategy and a cost-saving measure, intended to extend the company’s cash runway into the fourth quarter of 2026. VYNE plans to redirect attention toward other immune-mediated conditions and will await top-line results from its ongoing phase 2b trial of repibresib (formerly VYN201) in nonsegmental vitiligo before announcing next steps for VYN202.

VYN202’s early clinical data suggest potential as a novel, orally available, BD2-selective BET inhibitor with immunomodulatory effects in plaque psoriasis and possibly psoriatic arthritis. Although animal toxicology concerns have necessitated a temporary, sex-specific pause in clinical advancement, the company states the compound’s strong efficacy signals and biomarker improvements support continued exploration in immune-mediated conditions. Future development will hinge on further safety clarification and strategic alignment with unmet needs in dermatology and beyond.

VYNE Therapeutics provides update on VYN202 program. News release. Globe Newswire. April 25, 2025. Accessed July 7, 2025. 

https://www.globenewswire.com/news-release/2025/04/25/3068263/0/en/VYNE-Therapeutics-Provides-Update-on-VYN202-Program.html?f=22&fvtc=5&fvtv=46688798

VYNE Therapeutics provides program update on oral BET inhibitor VYN202. News release. VYNE Therapeutics. July 2, 2025. Accessed July 7, 2025. 

https://vynetherapeutics.com/uncategorized/vyne-therapeutics-provides-program-update-on-oral-bet-inhibitor-vyn202/

VYN202, an investigational oral BD2-selective BET inhibitor by VYNE Therapeutics, faced a clinical hold due to testicular toxicity observed in dogs. The FDA has lifted the hold for lower doses in female subjects, pending further toxicology data for males. Early phase 1b results showed no serious adverse events and promising efficacy in psoriasis, with significant reductions in PASI scores and pro-inflammatory cytokines. Despite positive signals, VYNE has paused the current study to focus on other immune-mediated conditions, awaiting further safety data and strategic alignment.

VYNE Therapeutics updates on VYN202, revealing promising early results in psoriasis treatment despite a clinical hold due to safety concerns.

VYNE Unblinds Early VYN202 Data After Safety Pause

Generalized pustular psoriasis (GPP) is driven by unregulated activation of the IL-36 inflammatory pathway in the skin, largely due to genetic mutations in genes such as 

. These mutations contribute to a cascade of pro-inflammatory signals, culminating in the recruitment of neutrophils and pustule formation.

Spesolimab, a monoclonal antibody that targets the IL-36 receptor, is the first therapy specifically approved for treating GPP. Previous research has shown that spesolimab can rapidly suppress IL-36–related molecular activity during acute GPP flares.

 However, its impact on patients' skin during remission, or nonflare periods, had not been well understood until now.

Recent findings from a biomarker substudy of the phase 2b Effisayil 2 clinical trial (NCT04399837) provide new insights into the role of spesolimab in maintaining disease control between flares.

 Of the 123 participants in the main trial, 18 consented to optional skin biopsies, and 7 provided samples across all time points over the 48-week study period. Based on unsupervised clustering analyses and baseline characteristics, these patients were determined to be representative of the overall cohort.

Among the 7 patients analyzed in depth, 5 did not experience a flare during the study. Of these, 4 received spesolimab at 300 mg subcutaneously every 4 weeks (following a 600-mg loading dose), and 1 received 150 mg every 12 weeks (after a 300-mg loading dose). In contrast, the 2 patients who experienced a flare had received a placebo. At study entry, all patients had a GPP Physician Global Assessment score of 1, indicating almost clear skin, although some still displayed mild signs of inflammation.

Gene expression profiling revealed that 6 of the 7 patients had elevated levels of pro-inflammatory genes at baseline, including those previously identified as IL-36 responsive. Researchers noted that this suggests the presence of ongoing subclinical inflammation even when skin appears nearly clear. These findings were especially notable in patients who had previously received systemic nonbiologic treatments for GPP.

Importantly, patients receiving the higher-dose spesolimab regimen demonstrated significant suppression of pro-inflammatory gene signatures by week 48. In fact, 3 of the 4 patients on this regimen showed near-complete normalization of these molecular markers and did not experience flares. These findings indicate that spesolimab not only treats active disease but may also play a critical role in preventing future flares by targeting underlying inflammation.

Interestingly, the presence or absence of mutations in 

 did not appear to influence response to spesolimab or changes in gene expression. Functional studies using CRISPR/Cas9 knockout models of 

 in keratinocytes showed increased sensitivity to IL-17A and IL-36G stimulation, reinforcing the idea that these mutations may contribute to heightened inflammatory responses in affected patients.

This study suggests that patients with GPP harbor residual inflammatory activity in their skin even during clinically inactive periods. Spesolimab maintenance therapy appears effective in suppressing this activity, aligning with the broader results of the Effisayil 2 trial, which demonstrated reduced flare risk with long-term treatment.

Although these findings are promising, the study is limited by its small sample size and the low number of participants with known IL-36 pathway gene mutations. Nonetheless, researchers stated that the results support the use of spesolimab as a maintenance therapy and highlight its potential to modify the course of GPP beyond treating acute flares. They suggested that further large-scale studies are warranted to confirm these findings and optimize treatment strategies for this complex disease.

Bachelez H, Choon SE, Marrakchi S, et al. Inhibition of the interleukin-36 pathway for the treatment of generalized pustular psoriasis. 

 2019;380(10):981-983. doi:10.1056/NEJMc1811317

Morita A, Strober B, Burden AD, et al. Efficacy and safety of subcutaneous spesolimab for the prevention of generalised pustular psoriasis flares (Effisayil 2): an international, multicentre, randomised, placebo-controlled trial. 

2023;402(10412):1541-1551. doi:10.1016/S0140-6736(23)01378-8

Krueger JG, Sarkar MK, Lebwohl MG, et al. Targeting the IL-36 receptor with spesolimab mitigates residual inflammation and prevents generalized pustular psoriasis flares. 

. Published online July 1, 2025. doi:10.1172/JCI188530

Generalized pustular psoriasis (GPP) is primarily driven by genetic mutations leading to unregulated IL-36 pathway activation. Spesolimab, a monoclonal antibody targeting the IL-36 receptor, is the first approved therapy for GPP, showing efficacy in both acute flares and remission periods. A sub-study of the EFFISAYIL 2 trial revealed that spesolimab effectively suppresses subclinical inflammation, reducing flare risk. The study highlighted that ongoing inflammation persists even during remission, and spesolimab's maintenance therapy could modify GPP's course. Further large-scale studies are needed to confirm these findings.

Spesolimab effectively targets the IL-36 receptor, reducing inflammation and preventing flares in generalized pustular psoriasis, offering new hope for patients.

Data Show Spesolimab Maintains Skin Clarity Between GPP Flares

OJM Group’s David Mandell, JD, MBA, shares financial planning strategies for physicians facing new tax laws and market volatility.

Think Like a CEO: Financial Tips for Physicians

Navigating Financial Uncertainty: OJM Group Shares Wealth Planning Strategies for Physicians

, David Mandell, JD, MBA, a founding partner of 

, offered insights into how physicians—particularly dermatologists—can better manage their finances amid evolving tax laws and ongoing market volatility.

OJM Group, a multidisciplinary wealth management firm focused on serving physicians nationwide, emphasizes strategic financial planning to mitigate risks and maximize long-term value. During the interview, Mandell highlighted a key theme: the importance of proactive, informed decision-making in today’s shifting financial landscape.

Adapting to Market Volatility and Tax Law Changes

Mandell noted that the second quarter of the year exemplified extreme market swings, moving from bear market territory to record highs in just a few months. “That volatility,” he said, “we expect to continue.” Such fluctuations, although unsettling, present both risks and opportunities. Mandell advised physicians to resist the urge to make reactive decisions, such as exiting the market prematurely, which can result in missed gains and long-term setbacks. Instead, he encouraged strategies like tax-loss harvesting, gain harvesting, and revisiting portfolio contributions during downturns.

Regarding taxation, although new federal tax laws are still being analyzed, Mandell assured that many tried-and-true strategies remain relevant. He stressed the importance of understanding one’s business structure—whether an S Corp, C Corp, or disregarded entity—and using it to maximize tax treatment. Qualified retirement plans such as 401(k) plans, Simplified Employee Pension Individual Retirement Accounts, and defined benefit plans also continue to offer significant advantages.

Mandell emphasized the need for physicians to adopt a CEO mindset regarding their careers and practices. This includes knowing when to delegate and when to consult specialists. For those starting a practice or looking to expand, Mandell recommended working with professional consultants and leveraging resources for business planning, real estate decisions, equipment acquisition, and exit strategies such as private equity deals or group mergers.

OJM Group’s resources are designed to empower physicians without expecting them to become financial experts themselves. “Our goal is to open eyes to opportunities,” Mandell said, “not to turn physicians into attorneys or advisors.” To support this, OJM offers a suite of free resources, including a monthly newsletter, educational webinars, their book series, and a podcast titled 

Physicians, particularly dermatologists, can enhance financial management amid market volatility and evolving tax laws by adopting strategic wealth planning. OJM Group emphasizes proactive decision-making to mitigate risks and maximize long-term value. Physicians should avoid reactive market exits and consider strategies like tax-loss harvesting. Understanding business structures and utilizing qualified retirement plans remain crucial for tax optimization. Adopting a CEO mindset, physicians should delegate and consult specialists for business planning. OJM Group provides resources to empower physicians without requiring them to become financial experts.

Bianca Viscomi, MD

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