Dr. R. Rox Anderson Highlights In-vivo Microscopy at Maui Derm Hawaii 2025

In-vivo microscopy that will change how dermatologists practice and potentially revolutionary drug delivery systems were among the technologies highlighted by R. Rox Anderson, MD, PhD, during “Innovation in Dermatology 2025: A Look into the Future of Dermatology” at the Maui Derm Hawaii 2025 meeting in Maui, Hawaii.

Dr. Anderson discussed the latest advances in medical technology from leading research centers around the world and how these therapies could impact aesthetic and medical dermatology in the future.

In-vivo microscopy, he said, has been “a long time coming and it’s really moving fast-forward.” It started with an optical coherence tomography (OCT) device 34 years ago that was deployed first for ophthalmology and then widely used for endoscopy, and has evolved now into a small, practical microscope for rapid quantitative imaging of circulating blood cells.

“This is a non-invasive CBC, taken in about 2 minutes,” Dr. Anderson said. “It will sit there and give you white count, and differentiate granulocyte series from the smaller lymphocyte series. I think this is transformative, right? It’s cheap. It’s available.”

Dr. Anderson said he already wants this technology for his children.

“This will change your practice,” he said.

Laser- and microneedle-assisted drug delivery was the next technology Dr. Anderson covered, though he warned that this application is off-label.

“I think this could be revolutionary,” he said. “And it’s amazing how sometimes revolutions are simple.”

Laser- and microneedle-assisted drug delivery can provide 10 to 10,000 times greater topical drug penetration, Dr. Anderson said, noting the various small molecules and biologics for which the technology could be used.

“In dermatology,” he said, “the ability to put these agents into the skin which normally don’t go in at all, I think, is where we are headed.”

Dr. Anderson also noted the possibility of lasers or microneedles for selective delivery.

The third technology he spoke about involved emerging nonsurgical strategies for cutaneous neurofibromas (cNF) of NF-1.

“The current treatments are surgical and destructive, and although they work, it’s too little too late,” he said.

One specific drug Dr. Anderson mentioned was a “soft” topical MEK inhibitor called NFX-179 that was shown in a phase 2 study to reduce cNF tumors.

“I’m actually more excited by this drug being useful for squamous cell carcinoma,” he said.

Another current trial involves skin cooling for improved tolerability for adults with small-to-medium cNF tumors.

“I was a little worried that the cooling would turn off the efficacy. It does not,” he said.