The role of aryl hydrocarbon receptor agonists in the management of inflammatory skin diseases: An expert consensus panel

Fuente: PubMed "bee"
Dermatol Online J. 2026 Jun 30;32(3). doi: 10.25251/ha2gbq97.ABSTRACTBACKGROUND: Inflammatory skin diseases, including psoriasis and atopic dermatitis, require long-term management strategies that balance efficacy with safety. The 2025 American Academy of Dermatology guidelines encourage the judicious application of topical corticosteroids when their use is deemed necessary and for short durations of therapy. Recent availability of newer nonsteroidal topical therapies that are effective and safe, including for prolonged durations and on sensitive skin sites, has prompted a need for evidence-based guidance for clinicians in real-world practice. Tapinarof, a first-in-class, nonsteroidal aryl hydrocarbon receptor (AhR) agonist, was approved by the US Food and Drug Administration for the treatment of plaque psoriasis in adults and atopic dermatitis in patients aged 2 years and older in 2022 and 2025, respectively; however, its optimal place in therapy remains to be established.OBJECTIVE: To develop expert consensus statements on the role of AhR agonists in the management of inflammatory skin diseases.METHODS: A literature search produced 31 articles meeting inclusion criteria that were independently reviewed by an 11-member expert panel that convened on January 19, 2026. A modified Delphi process was used to develop 9 consensus statements.CONSENSUS RECOMMENDATIONS / KEY FINDINGS: AhR agonists represent a distinct therapeutic class with a unique multimodal mechanism involving immune modulation across Th1/Th2/Th17/Th22 pathways, skin barrier normalization, and antioxidant activity; tapinarof demonstrates a favorable safety profile with no restrictions on anatomic site, body surface area, or duration of use; tapinarof may be used concomitantly with systemic therapies; tapinarof is appropriate as both initial and long-term therapy for psoriasis in adults and atopic dermatitis in patients aged 2 years and older; and nonsteroidal topical therapies are preferred for chronic inflammatory skin diseases, particularly on the face and intertriginous areas.CONCLUSION: AhR agonist therapy offers a clinically meaningful, advanced nonsteroidal option that addresses key limitations of traditional topical therapies in inflammatory skin disease management.PMID:42522513 | DOI:10.25251/ha2gbq97