“Patch testing can seem very scary and overwhelming, but it can be transformative for patients,” Walter Liszewksi, MD, said in an interview at the 2025 Elevate-Derm Summer Conference in Park City, Utah.
Liszewksi, a board-certified dermatologist and associate professor of dermatology at the Northwestern Feinberg School of Medicine in Chicago, Illinois, presented numerous sessions at the 4-day conference. In his interview, Liszewski presented key highlights on contact dermatitis, patch testing, JAK inhibitors for atopic dermatitis (AD), and dosing techniques.
In his first session, “Contact Dermatitis Conundrums,” Liszewski emphasized that comprehensive patch testing is extremely beneficial for patients with chronic dermatitis. He cautioned against overreliance on limited commercial kits such as the TRUE Test, which, while convenient, may miss relevant allergens due to their narrow panels. For patients who continue to flare despite treatment and initial patch testing, referral to a patch testing specialist for expanded allergen panels is strongly recommended.
An important clinical responsibility following patch testing, he noted, is a thorough review of patient products. Patients often fail to recognize hidden allergens such as fragrance molecules that may not be clearly labeled. Clinicians should assist patients in identifying personal care items and topical therapies that contain their specific allergens. Liszewski mentioned that without targeted avoidance counseling, even accurate patch test results may not translate to clinical improvement, given the non-intuitive and potentially misleading nature of consumer labeling.1
In his second session, “JAK Inhibitors: Practical Tips for Integration Into Practice,” Liszewski tackled the clinical nuances of using JAK inhibitors in AD. Although black box warnings exist, he argued that these agents should not be categorically withheld from patients based solely on demographic risk factors (eg, patients aged over 50 years, use of oral contraceptives). According to Liszewksi, with appropriate monitoring, JAK inhibitors offer rapid and often dramatic improvements, especially in patients who are refractory to biologics.
He also advised clinicians not to hesitate in escalating JAK dosing, as large-scale extension trial data demonstrate minimal added safety concerns with increased doses and significant gains in itch reduction, sleep quality, and skin clearance. He shared that none of his patients switching from a biologic to a JAK regretted the decision, affirming the value of individualized therapeutic decision-making.2
“We 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.