Dermatology

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2025 ACR Guideline for the Treatment of SLE

Jack Cush, MD

The ACR has released its 2025 Systemic Lupus Erythematosus (SLE) treatment guidelines and consensus-based good practice statements, applicable to children and adults with SLE. 

Overall, the goals of SLE management are to achieve remission or a low level disease activity, reduce

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Using publicly available FAERS safety data, drug-induced photosensitivity (DIP) - among 17+ million safety reports, there 20,236 linked to DIP. The most common wereimmunosuppressants, monoclonal Abs, neoplastic agents, including adalimumab, adapalene, secukinumab, fingolimod https://t.co/zA9UdYASKB
Dr. John Cush @RheumNow( View Tweet )
Lupus Clinical Slides: Set 1 https://t.co/zFQqHfl8Ch https://t.co/kvVNAS17ec

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Dr. John Cush @RheumNow( View Tweet )
Lupus QD Clinic - Rhupus dsDNA+ SLE Plus CCP+ RA = Rhupus https://t.co/lyV7fgd1vp https://t.co/Ptw0dmyqCj

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Dr. John Cush @RheumNow( View Tweet )
The ANA pattern I hate #DFS Why Dense fine speckled should R/O #SLE But mimicking patterns that MAY Have #lupus AC-2 pattern mimickers ex AC-4 Machine learning models to help ▶️improved accuracy Fast saving hrs #Artificial #intelligence May Choi #LUPUS2025 @RheumNow https://t.co/9tk80ZOAWg

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Janet Pope @Janetbirdope( View Tweet )
Any ‘toll’ in #toll #like #receptors 7,8 in #SLE Cutaneous #lupus In #systemic or #cutaneous wk16 Rx PBO V #enpatoran No obvious dose response - all 3 dose >PBO Safe so far improves IFN No toll to pay! 👍 But need Ph3 data #LUPUS2025 @EricFMorand @RheumNow https://t.co/2DDztlVsUm

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Janet Pope @Janetbirdope( View Tweet )
Vitiligo affects up to 2% of people globally; more in blacks & hispanics than whites & more common in women > men. The prevalence has increased over time. Oral corticosteroids are most frequently prescribed, followed by other immunosuppressive drugs https://t.co/wNh6z3lKg1 https://t.co/hQo9sNn4kg

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Biologics in Pregnancy Patients With Autoimmune Disease

Jack Cush, MD

A large cohort, claims data study shows that among pregnant women receiving biologic therapies for autoimmune conditions, 72% continued their biologics pregnancy, more so among inflammatory bowel disease (IBD) patients than those with rheumatoid arthritis (RA), psoriasis (PsO) or psoriatic

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Panacea of Prednisone & Cannabis (5.16.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal and regulatory reports from this week on RheumNow.com.  Interesting trends and results with prednisone in lupus, cannabis in RA and opioid deaths too!

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J&J announced results of Phase 3 ICONIC-TOTAL study of qd icotrokinra, an oral IL-23 receptor inhibitor, in 311 ps w/ difficult scalp and genital psoriasis (PSO) -success in 57%; skin clearance in 66% & genital psoriasis resp in 77% treated https://t.co/WftyEcDh8u https://t.co/Ydy37Eo0jX

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Full read overview of Discoid Lupus. https://t.co/G6lXWTRSFn https://t.co/yjVsDg0D5d

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TONIGHT! Tuesday Night Rheumatology: 🔓 Lupus Unlocked: Cutaneous SLE Join us for a discussion of the diagnosis, management, and latest insights into cutaneous manifestations of SLE. Featuring: Dr. Victoria P. Werth Dr. Matilda Nicholas Dr. Anthony Fernandez Dr. Christopher https://t.co/l0QjM9obk2
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Full read overview of Discoid Lupus. https://t.co/aXgveR2NwF https://t.co/9JK6CNqedO

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Dr. John Cush @RheumNow( View Tweet )
Tuesday Night Rheumatology: 🔓 Lupus Unlocked: Cutaneous SLE Join us for a discussion of the diagnosis, management, and latest insights into cutaneous manifestations of SLE. Featuring: Dr. Victoria P. Werth Dr. Matilda Nicholas Dr. Anthony Fernandez Dr. Christopher Richardson https://t.co/UNazbo9TuZ
Dr. John Cush @RheumNow( View Tweet )
Single-centre retrospective study, 27 children with refractory juvenile dermatomyositis (jDM) Rx with baricitinib (F/U of 25 mos)-- 77% (21/27) improved skin rashes (62% complete resolution) & Dz activity improved (6 vs 0.8, p<0.01) 70% (19/27) achieved inactive disease https://t.co/rRlhoY9O4q
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Vitamin D Headlines (5.9.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports and lupus highlights from the past week on RheumNow.com. Triple positivity, the gut and CRPS, and hope for better outcomes with Vitamin D therapy. 

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Hyperpigmentation in SLE Young complex SLE patient develops blue-grey/slate colored hyperpigmentation on her arms and legs - From? Features Dr. Jack Cush https://t.co/yoKU7rJp8y https://t.co/Kh0tZLJ8SX

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Dr. John Cush @RheumNow( View Tweet )
Tuesday Night Rheumatology: 🔓 Lupus Unlocked: Cutaneous SLE Join us for a discussion of the diagnosis, management, and latest insights into cutaneous manifestations of SLE. Featuring: Dr. Victoria P. Werth Dr. Matilda Nicholas Dr. Anthony Fernandez Dr. Christopher Richardson https://t.co/w7cYVNUI9t
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An emulation trial shows that Humira biosimilars (Amjevita & Imraldi) were equivalent to Humira in psoriasis & achieving PASI <=2, both for new biologic starts and for biologic switchers. https://t.co/8lTGGs2rbP https://t.co/T6rTJ5ESj2

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Dr. John Cush @RheumNow( View Tweet )
Bullhead Sign in #SAPHO Syndrome ▶️Synovitis, ▶️Acne ▶️Pustulosis ▶️Hyperostosis ▶️Osteitis 👉🏽https://t.co/ownI4Q543w via @MayoProceedings https://t.co/FXlTtmsDDX

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Dr Ai Lyn Tan @DrAiLynTan( View Tweet )
✅ Management of #REFRACTORY skin manifestations in patients with #LUPUS ➡️ my practical tips 💪 for #PANLAR2025 🇲🇽 https://t.co/KnJO0eXI4W

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Laurent ARNAUD @Lupusreference( View Tweet )
JAMA Pt Education handout - Scleroderma https://t.co/UpK24WfyNF

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Osteoarthritis Risky Business (4.18.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and Journal reports from this week on RheumNow.com.  Osteoarthritis patients have unique risks and synovial fluid WBC numbers can tell you when to worry about septic arthritis in gout and pseudogout patients.

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The Increasing Cost of First-Line Biologics for Plaque Psoriasis

Jack Cush, MD

A national commercial claims analysis of first-line use of biologics in biologic−naive plaque psoriasis patients found a near doubling of net treatment costs from 2007 to 2021 ($21 236 to $47 125). Despite the increasing costs, the 2021 average cost could have been 44% lower if the lowest-

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JAMA Pt Education handout - Scleroderma https://t.co/UpK24WfyNF

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Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

A Domain-Based Approach to the GRAPPA Psoriatic Arthritis Treatment Recommendations

Laura Coates
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With their publication in June 2022 (1), the 3rd iteration of the Group for Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) Treatment recommendations for Psoriatic Arthritis (PsA) may have set a record or sorts.

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Pain in Psoriatic Arthritis

Philip Mease, MD
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Pain is typically ranked by both patients and physicians as the most important symptom of psoriatic arthritis (PsA) to assess and treat. Although the predominant concept of the etiology of pain in PsA is that of inflammation in peripheral joints, entheses, and bone signaling through peripheral nociceptive fibers, perceived as pain in the central nervous system, it is actually more complex than that. The ability of a treatment to ameliorate pain is one of the principle measures of its effectiveness. Thus pain improvement or worsening are key determinants of shared decision making about treatment in PsA.  Read Post
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