Measles Risk and MMR Vaccination Timing in Dermatology Patients on Immunosuppressive Therapy

The 2025-6 measles outbreak marked a significant resurgence of a vaccine-preventable disease, raising urgent public health concerns. The clinical implications of this outbreak for patients on immunosuppressive therapy, specifically in dermatology, remains poorly defined. This review addresses this gap, examining measles presentations and complications in immunosuppressed dermatology patients. We discuss diagnostic considerations specific to this population, in whom impaired humoral immunity can limited the reliability of standard testing. Finally, we propose a practical, dosing and pharmokinetic-based framework for MMR vaccination and post-exposure prophylaxis decisions across commonly used dermatologic therapies. This includes specifically biologics, targeted small molecules, and conventional immunosuppressants. Current public health guidance was largely developed from oncology, transplant, and rheumatology populations, leaving dermatologists without a clear or actionable plan for their patients. This review is intended to fill that gap and serve as a quick reference tool for dermatologists navigating measles risk in the context of immunomodulatory therapy.