Dermatology experts gather in Prague for EADV symposium

More than 100 speakers led sessions exploring breakthroughs in viral infections and targeted skin therapies.

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Dermatologists from around the world descended on Prague last weekend for the European Academy of Dermatology and Venereology’s annual three-day symposium.

This year the program, which included 25 sessions and 101 speakers, had a specific focus on viral infections and emerging targeted therapies for inflammatory diseases.

There were also a series of “What’s New” sessions that highlighted the latest advancements across key areas of dermatology and venereology, including skin cancer, psoriasis, sexually transmitted infections, hidradenitis suppurativa and lupus.

The gathering also emphasised the importance of interdisciplinary collaboration, with several talks exploring how dermatologists are working alongside immunologists and virologists to better understand complex disease mechanisms.

Read on for some of the symposium highlights.

Dermoscopic innovations in hair, scalp and nail diagnosis

Experts highlighted the expanding diagnostic utility of trichoscopy and onychoscopy in managing complex hair, scalp and nail disorders.

Polish dermatologist Professor Lidia Rudnicka, head of the department and clinic of dermatology at the Medical University of Warsaw and honorary president of the Polish Dermatological, Society emphasised trichoscopy’s ability to differentiate scarring versus non-scarring alopecia, with vascular patterns and follicular features guiding systemic treatment decisions.

Rare but critical dermoscopic signs, such as polymorphic vessels in scalp metastases, were underscored for their diagnostic value.

“Metastases to the scalp may mimic alopecia areata or discoid lupus erythematosus,” she said.

Dr Juan Jimenez Cauhe, a Madrid-based clinical dermatologist and trichology expert, demonstrated a case-based, multimodal approach using trichoscopy alongside biopsy and imaging to differentiate inflammatory scalp disorders, while reinforcing its high sensitivity in detecting tinea capitis and distinguishing it from alopecia areata or trichotillomania.

“Trichoscopy is highly accurate for diagnosing tinea capitis and useful for differentiating it from alopecia areata and trichotillomania,” he said.

Nail-focused sessions by Dr Miroslav Dura, of Charles University in Prague and Dr Francesca Pampaloni, of the University of Bologna, illustrated the power of onychoscopy in distinguishing benign versus malignant nail tumours and inflammatory versus infectious nail changes.

Dr Dura presented six clinical nail cases using diagnostic polling to explore the diverse presentations of nail tumours. Cases ranged from benign lesions like subungual exostosis to invasive melanoma and a rare adnexal adenocarcinoma with late metastasis. One melanonychia case involved an intraepidermal melanocytic lesion of uncertain behaviour, managed with re-excision and long-term follow-up.

The session highlighted the importance of biopsy, dermoscopy and clinicopathological correlation in distinguishing tumours from trauma or pigmentary changes.

“Adnexal adenocarcinoma [not otherwise specified], is a diagnosis of exclusion reached only after ruling out other clear cell neoplasms and metastatic disease,” said Dr Dura.

Dr Pampaloni talked about the diagnostic and management value of onychoscopy alongside biopsy, culture, patch testing and clinical history in inflammatory nail disorders. 

Pustular nail psoriasis was identified by glomerular capillaries, lichen striatus by isolated nail dystrophy and acrylate-induced contact dermatitis confirmed by patch testing in a patient with onycholysis following gel nail use.

In other cases, psoriasis was distinguished from onychomycosis using splinter haemorrhages and yellow-orange discoloration, while long-standing nail changes were confirmed as onychomycosis through combined clinical and onychoscopic findings.

These sessions affirmed that trichoscopy and onychoscopy are non-invasive, high-yield tools that should be fully integrated into routine dermatologic evaluation to improve diagnostic accuracy, guide biopsy decisions and tailor treatment plans.

Pustular Psoriasis and Beyond: Innovations in Precision Dermatology

This session highlighted the evolving role of precision dermatology in reshaping the psoriasis treatment paradigm – delivering more targeted, data-informed and patient-centric care.

Experts spoke about groundbreaking advances in precision medicine for psoriasis, with a particular focus on pustular psoriasis (PP), disease modification strategies and the future of biomarker-driven, personalised care.

Dermatology Professor Johann Gudjonsson, of the University of Michigan Health, outlined the pathophysiology of generalised pustular psoriasis (GPP), distinguishing it from plaque psoriasis through its IL-36-driven, neutrophilic basis. Genetic and molecular profiling has clarified the key inflammatory pathways and established the IL-36 axis as a high-value therapeutic target. New biologics aimed at IL-36 modulation are demonstrating strong efficacy in reducing flares and stabilising disease.

Dr Satveer Mahil, a consultant dermatologist at St John’s Institute of Dermatology, Guy’s and St Thomas’ NHS Foundation Trust and reader at King’s College London, discussed disease modification in plaque psoriasis, emphasizing the benefit of early biologic intervention, especially within the first two years of disease onset or in biologic-naïve patients.

“In the current climate…access to care is a major challenge and this means that in turn, this may impact the long-term outcomes… particularly in terms of limiting the chances of later disease modification,” she said.

Professor Jo Lambert, of the Ghent University Hospital Belgium, shared insights on emerging therapies, including next-generation oral agents (TYK2 inhibitors, PDE-4 inhibitors and IL-23 blockers) and novel pathways such as aryl hydrocarbon receptor modulators.

She also pointed to non-inferiority of personalised dosing and the rise of AI-driven treatment dashboards to individualise care, minimise overtreatment and reduce long-term drug burden.

In the closing lecture to this session, Professor Michel Gilliet, chair of the Department of Dermatology, University of Lausanne, Switzerland, talked about molecular profiling, describing it as essential for guiding therapy and refining diagnoses.

He outlined three distinct psoriasis endotypes (Th17, IFN-1 and neutrophilic) and showed how profiling can correct misdiagnoses, identify non-responders and track immune shifts that impact therapeutic success.

“Precision medicine is the future for psoriasis,” he said.

Next-gen treatments: from injectables to ingestibles

Oral therapies targeting key inflammatory pathways are offering promising alternatives to traditional injectable biologics.

Professor Tiago Torres, of the University of Porto, Portugal, turned the spotlight on oral IL-17 and IL-23 inhibitors, describing them as the next wave in psoriasis care.

“We may start to see a move from injectables to ingestibles for the treatment of psoriasis,” said Dr Torres.

Highlighting data from ongoing clinical trials, Dr Torres noted that oral small molecules, including tyrosine kinase 2 (TYK2) inhibitors and IL-23 receptor antagonists, have demonstrated significant skin clearance rates in patients with moderate to severe plaque psoriasis.

These agents provide comparable efficacy to existing biologics, with added benefits in patient convenience, reduced immunogenicity and simplified administration protocols.

Two standout classes include:

• TYK2 inhibitors (e.g., deucravacitinib), which selectively modulate intracellular signalling with a strong safety and efficacy profile.
• Oral IL-23 receptor antagonists, which block upstream inflammatory signalling and may allow for once-daily dosing.

Dr Torres said these oral agents could help address persistent barriers such as needle aversion, adherence issues and limited biologic access in some regions.

Inside hidradenitis suppurativa: imaging, immunology, and impact

These insights underscore a shift toward data-driven, stratified care in HS, offering hope for improved long-term outcomes and better quality of life for patients with this debilitating condition.

Experts presented new data positioning hidradenitis suppurativa (HS) as a complex, immune-mediated disease with distinct clinical and molecular endotypes. Advances in diagnostics, imaging and immunomodulation are reshaping how HS is assessed and treated, with a growing emphasis on early, targeted intervention.

Associate Professor Thrasyvoulos Tzellos, of the Arctic University of Norway, emphasised the need for more sensitive and clinically relevant HS outcome measures. He said IHS4-55, a refined scoring system better reflected disease dynamics by weighting nodules, abscesses and tunnels, particularly in fistulising disease.

Professor Tzellos also advocated for integrating patient-reported outcomes like pain, quality of life and work productivity to guide holistic management.

“We need outcomes that reflect not just what physicians see, but what patients live, capturing both disease control and human impact,” he said.

Dr Alessandra Michelucci, of the University of Pisa, Italy, focused her presentation on the clinical value of ultra-high-frequency ultrasound (UHFUS) in detecting subclinical tunnels, structures often missed during routine exams but predictive of recurrence and treatment resistance.

“Ultrasound doesn’t just guide the hand; it sharpens the eye. In the operating room, it becomes the surgeon’s second sight,” she said.

She said UHFUS improved surgical planning and outcomes by enabling precise mapping, especially when paired with biologics. Doppler imaging added further value in monitoring post-operative inflammation and relapse in visually healed areas.

Associate Professor Francesca Prignano, of the University of Florence, Italy, reframed HS as a heterogeneous inflammatory spectrum, rather than a single disease.

She described two primary endotypes—one driven by Th1/Th17 immune pathways, often associated with obesity and systemic inflammation.

Mechanistic drivers include tertiary lymphoid structures (TLSs) and TNF-alpha–mediated fibroblast loops, with environmental and genetic modifiers like microbial dysbiosis and smoking influencing disease expression. This endotype model offers a foundation for precision medicine in HS.

Professor Christos Zouboulis, director of the departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Centre, Germany, presented a pipeline update of HS therapeutics, linking transcriptomic data to biologic targets.

TNF-alpha inhibitors remain central, while IL-17 inhibitors are showing strong efficacy in reducing IHS4 scores and resolving tunnels. Other promising targets include IL-1, IL-36, IL-12/23 and JAK-1, expanding the therapeutic toolkit for HS.

See more of the highlights here.

The countdown is now on for the EADV’s major annual congress – to be held this year in Paris from 17-20 September. The congress will include more than 180 scientific sessions, over 600 expert speakers, 25-plus dedicated subspecialty tracks and 10 plenary lectures.

More information about the congress is available here.