New biologic therapies, radiation treatments and growing use of technology all look set to make waves in dermatology in 2024, while the campaign for more training places also looks set to ramp up.

The limbic asked four leading experts for their quick fire takes on what to look out for in the year ahead, with all predicting major changes.

Professor Rodney Sinclair, University of Melbourne and Sinclair Dermatology

What’s something that changed practice in dermatology in 2023?

Professor Rod Sinclair

New treatments for atopic dermatitis. The atopic dermatitis treatments (Dupilumab and upadacitinib) are already PBS listed and changing the lives of thousands of patients.  Newer treatments (abrocitinib) are currently under evaluation.

What’s something likely to shape dermatology in 2024?

The first alopecia areata treatment is TGA approved (baricitinib) and ritlecitinib is under evaluation.

Baricitinib is being assessed for the PBS and if approved this will change the lives of thousands of Australians impacted by alopecia areata.

Vitiligo treatments are emerging but still a few years away.

Dr Adriene Lee, Melbourne dermatologist and ACD president

What’s something that changed practice in dermatology in 2023?

Dr Adriene Lee

The return to practice following the lifting of COVID-19 restrictions has seen the profession incorporate a balance of teledermatology and face to face consultations on a permanent basis to deliver the highest quality of patient care and in so doing best meet community needs within the constraints of ongoing workforce shortages.

The increasing availability and improved access to biologic agents for common inflammatory skin disorders, such as psoriasis and atopic dermatitis has continued to improve our management of these conditions, resulting in better outcomes for our patients.

What’s something likely to shape dermatology in 2024?

College’s ongoing advocacy for additional training positions to address workforce shortage, with a focus on rural and regional areas, will continue to be a priority and key to shaping the future dermatology workforce.

The introduction of newer biologic agents for atopic dermatitis and for other inflammatory and immune disorders will further impact and improve our management of our patients with chronic dermatologic disorders, provided we can access these for our patients.

The ongoing evolution of artificial intelligence and technology has the potential to impact all aspects of medicine. Being at the forefront of these opportunities will help shape the future of our practice and ensure these technologies are used safely and effectively to enhance clinical care.
Professor Dedee Murrell, Sydney dermatologist and UNSW academic

What’s something that changed practice in dermatology in 2023?

There are two new treatments approved for epidermolysis bullosa, Filzuvez (oleogel-SD) to speed up wound healing and beremagene geperpavec (B-VEC) collagen VII for recessive dystrophic epidermolysis bullosa.

What’s something likely to shape dermatology in 2024?

We may see biologics approved for blistering diseases, JAK inhibitors becoming available for alopecia areata and vitiligo.

Associate Professor Helmut Schaider, University of Queensland and JustSkin

What’s something that changed practice in dermatology in 2023?

Associate Professor Helmut Schaider

Queensland has the highest rate of skin cancer in the world. Precursor and early UV- induced skin cancer like actinic keratoses, Bowen’s disease or intraepidermal carcinoma (IEC) are hard to treat as part of field skin cancerization. Topical treatments like flurouracil (Efudix) are modestly effective with resistance to treatment developing over time. Grenz rays, low kilovoltage radiation, is used effectively in other states like NSW and Victoria, to clear precursor lesions in a field. We at JustSkin are the first in Queensland to offer Grenz rays for field skin cancerisation treatment.

What’s something likely to shape dermatology in 2024?

At JustSkin we continue to treat overt skin cancers like BCCs and SCCs with superficial radiation therapy (SRT). Whereas SRT can eradicate single lesions, the addition of Grenz rays will clear the entire field of precursor and fully blown skin cancers. This long sought combined treatment strategy for UV exposed skin will be a game- changer in older patients with moderate to severe field skin damage, refractory to conventional field treatments like flurouracil or photodynamic therapy.  SRT is particularly suited to treat large volumes of skin with field change, where surgery is improbable particular in the elderly population.