JAAD CME Part 2: Clinical Evidence and Safety Considerations for GLP-1 Receptor Agonists in Dermatology

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have revolutionized the treatment of type 2 diabetes mellitus and obesity by improving glycemic control, reducing body weight, and lowering cardiometabolic risk. Beyond their metabolic effects, GLP-1RAs may exert anti-inflammatory and immunomodulatory effects, spurring investigation into dermatologic applications. Early clinical evidence, largely case reports, small cohorts, and short-duration trials, suggest GLP-1RAs may improve outcomes in chronic inflammatory skin disease, particularly psoriasis and hidradenitis suppurativa (HS), and may be associated with improved wound-healing endpoints in observational studies. Reported benefits include reductions in Psoriasis Area and Severity Index scores, improved HS disease activity and patient-reported symptoms, and fewer wound complications in retrospective datasets; effects may reflect both direct immunomodulation and indirect metabolic benefits (weight loss and reduced systemic inflammation). However, evidence remains limited by small samples, heterogeneity in agents/dosing, and confounding by comorbid diabetes/obesity and concurrent therapies. Clinicians must also consider systemic and cutaneous adverse events, including gastrointestinal intolerance, biliary disease, retinopathy risk with rapid glycemic improvement, and dermatologic reactions (e.g., pruritus, drug eruptions, alopecia, acne). Larger, longer-term randomized trials are needed to define efficacy, mechanisms, and safety in dermatologic indications.