What changed recently

The January 2026 update to the living EuroGuiDerm atopic eczema guideline re-voted the systemic treatment chapters and redrew the treatment algorithms for adults and for children and adolescents. Azathioprine and alitretinoin recommendations were withdrawn, mycophenolate and omalizumab were moved to past therapies, and new guidance was added on vaccination, switching between drugs, dose interval adjustment, and pregnancy and breastfeeding.

The EuroGuiDerm update revises the 2016 European S3 acne guideline around three priority questions: when to choose isotretinoin over systemic antibiotics, how long antibiotics should run and when to use hormonal therapy or spironolactone, and how to position the newer topicals trifarotene and clascoterone. It also revises advice on benzoyl peroxide safety, choice of systemic antibiotic, treatment in pregnancy and isotretinoin dosing, leaving the rest of the 2016 text in place.

The February 2025 partial update to the living EuroGuiDerm psoriasis guideline changed recommendations in the viral hepatitis chapter and rewrote the pregnancy and wish-for-child chapter around new data, adding pregnancy content to the main recommendations and decision grid. It also revised the laboratory monitoring advice for deucravacitinib.

The 2024 diagnostics update to the European melanoma guideline lowered the threshold for whole-body staging: CT or PET-CT combined with brain MRI is now advised from stage IIB/C rather than from stage IIC as in the 2022 version. It also sets out when BRAF V600 mutation testing is indicated and endorses sequential digital dermoscopy, whole-body photography and reflectance confocal microscopy in selected high-risk patients.

The 2025 focused update adds four new recommendations to the 2023-2024 AAD atopic dermatitis guidelines, covering therapies approved after those documents were written: the topicals tapinarof and roflumilast and the biologics lebrikizumab and nemolizumab. Tapinarof 1% cream received a strong recommendation for adults.

The 2024 AAD guideline replaced the 2016 version with 18 graded recommendations plus five good practice statements, adding the newer topical agent clascoterone as a conditional option and giving strong support to benzoyl peroxide, topical retinoids, topical antibiotics and oral doxycycline. It pushed multimodal combination therapy and advised against topical antibiotic monotherapy for antibiotic stewardship reasons.

The 2023 European BCC update was triggered by a new clinical classification and by therapies that postdated the 2019 guideline, notably electrochemotherapy and immunotherapy. It positions hedgehog pathway inhibitors as first-line systemic treatment for locally advanced and metastatic BCC and adds anti-PD-1 immunotherapy as a second-line option for patients who progress on, cannot tolerate, or have a contraindication to them.

The joint AAD-NPF series was the first rewrite of the 2008-2011 AAD psoriasis guidelines in over a decade, produced with the National Psoriasis Foundation. It devoted a dedicated section to biologic agents with updated timelines for judging treatment response, and broadened the scope to comorbidity screening, paediatric psoriasis, phototherapy, non-biologic systemics and topical therapy.

The 2019 AAD guideline replaced the 2011 version, realigning staging with the updated AJCC system and reworking how biopsy, pathology reporting and sentinel lymph node biopsy findings feed into management. It also revised the use of laboratory, molecular and imaging tests during initial work-up and follow-up of asymptomatic patients.

The 2014 IDSA update abandoned the 2005 layout of antibiotic lists organised by spectrum of activity in favour of short empiric regimens selected by infection type and severity, supported by an algorithm keyed to whether the infection is purulent. It was aligned with the IDSA MRSA guideline and added substantial new guidance on skin and soft tissue infections in immunocompromised patients.