Table of Content

Current Issue

Spring/Summer 2025, Vol. 32 No. 1

Hong Kong J. Dermatol. Venereol. (2025) 32, 84-85


Reports on Scientific Meetings

HKSDV Annual Scientific Meeting 2024

Reported by JOL Yeung 楊藹琳

Date:   30 June 2024
Venue:   The Grand Ballroom, Kowloon Shangri-La, Hong Kong
Organiser:   HKSDV supported by HKSPD

Updates about novel treatment in dermatology: The important role of IL-4 and IL-13 to mediating chronic itch and type 2 inflammation in prurigo nodularis

Speaker: YW Yew
National Skin Centre, Singapore

L-4 and IL-13 have been implicated in the pathogenesis of chronic itch, a common symptom in prurigo nodularis (PN). Itch can be mediated by histaminergic and non-histaminergic pathways, with the latter playing a main role in chronic itch. Multiple factors such as co-existing diabetes mellitus, chronic dermatitis and neuropsychiatric conditions may aggravate the itch-scratch cycle, posing a challenge to achieve symptom control. Targeting cytokines IL-4 and IL-13 have therefore emerged as a promising therapeutic strategy. Biologic agents that block either IL-4 or IL-13 signaling have shown efficacy in reducing itch severity and improving skin lesions in clinical trials involving patients with PN. The lecture discussed a multimodal stepwise approach, split by neural and immunologic treatment pathoways of PN. In particular, dupilumab treatment has good efficacy against PN and a good safety profile. Prolonged treatment may be needed in order to maintain disease remission.

Learning points:

  • Type 2 inflammation, driven by cytokines IL-4 and IL-13, plays a central role in the pathogenesis of prurigo nodularis
  • Given the pivotal role of IL-4 and IL-13 in mediating chronic itch, targeting these cytokines has emerged as a promising treatment strategy.
  • Biologic agents that block IL-4 and IL-13 signaling have shown efficacy in reducing itch severity and improving skin lesions in clinical trials involving patients with prurigo nodularis.

Updates about novel treatment in dermatology: Shaping the future of chronic spontaneous urticaria through recent advancements

Speaker: J Fok
Box Hill Hospital, Eastern Health, Australia

Chronic spontaneous urticaria (CSU) is a chronic and debilitating disorder. A significant proportion of patients experience persistent symptoms despite maximum dosage of oral antihistamines, warranting more effective and targeted therapies. The lecturer stressed the importance of first confirming the correct diagnosis by thorough history taking before proceeding to a stepwise approach of management. In particular, not every case referred for “urticaria” is necessarily genuine urticaria – conditions such as urticarial vasculitis, erythema multiforme, urticaria pigmentosum, erythema marginatum and bullous pemphigoid etc. may present with urticarial symptoms and require a different management approach. The lecture touched on different biomarkers indicative of treatment response, then proceeded to introduce novel therapeutic strategies which included biologic agents, omalizumab and dupilumab, as well as novel small molecules, remibrutinib and rilzabrutinib. Of note, remibrutinib demonstrated a favourable safety profile across REMIX studies, including long term, with up to 52 weeks of treatment; demonstrating the potential to become an effective oral treatment option that may address unmet needs of patients with CSU inadequately controlled by second-generation H1 antihistamines.

Learning points:

  • Chronic spontaneous urticaria (CSU) is a disorder with great psychosocial burden.
  • At least 40% of patients with CSU do not respond to conventional first line therapy (i.e. maximum fourfold dosage of second-generation H1 antihistamines).
  • New therapeutic strategies e.g. novel small molecules show promising effects and safety profile across studies demonstrating the potential to become an effective oral treatment option.

Updates about novel treatment in dermatology: Improving outcome of long-term management of generalised pustular psoriasis – updates in evidence

Speaker: WH Chung
Department of Dermatology, Chang Gung Memorial Hospital, Taiwan

Generalised pustular psoriasis (GPP) is a chronic, heterogeneous, neutrophilic inflammatory disease with a predilection for middle-aged females. The chronicity and flare-related complications of the disease have resulted in a high psychosocial burden for patients. Flare-related complications of GPP include arthritis, skin infection, heart failure, pneumonia and death. Following initial treatment for GPP flares, 83% patients suffer from chronic symptoms such as skin lesions, scaling and erythema. The evidence guiding GPP treatment has been scarce until a recent update for a new treatment option, Spesolimab, which targets the IL-36 pathway in the pathogenesis of GPP. The Effisayil trial showed that spesolimab treatment led to rapid pustular and skin clearance in patients with GPP flares, which was sustained for up to 12 weeks.

Learning points:

  • GPP is a chronic systemic disease, characterised by episodes of widespread eruption of sterile, macroscopic pustules.
  • There is a high unmet need for treatments that rapidly and completely resolve the symptoms of GPP flares and prevent the recurrence of flares, with an acceptable safety profile.
  • Spesolimab 300 mg SC q4w after a 600 mg loading dose reduced both the risk and incidence of GPP flares, with a favourable safety profile.