Catching Up With Karan Lal, DO, MS FAAD

Dermatology Times caught up with Karan Lal, DO, MS, FAAD, double-board certified dermatologist in Scottsdale, Arizona, to delve into the developments in his practice leading up to the 2024 American Academy of Dermatology (AAD) Annual Meeting in San Diego, California. Lal shared insights into his exploration of investigational avenues, including increased involvement in clinical trials and the incorporation of novel therapeutic agents. As he reflects on the dynamic environment of dermatological advancements showcased at the AAD meetings, Lal offered a glimpse into the intersection of research, clinical practice, and patient care.

Dermatology Times: What is new in your practice since the last AAD Meeting?

Lal: So since the last AAD, I've really been trying to do a lot more investigational things. SoI'm doing more clinical trials in the office. Now, I'm using a lot of new agents that have been around for the past 2 years that you guys see here at the event, on-label and off-label and seeing how things work. Because I think, ultimately, we're so lucky.We have so many tools that we can create recipes for people and actually get people better with their disease, with so many more options.It's kind of fun to play around the kitchen with all the therapeutic modalities we have now. I think AAD is a really good time to see what people are doing.It's like show off season, so you get to see all the stuff that has translated from the lab, into the translational setting, into the clinical setting.

Dermatology Times: What will you remember from the 2024 AAD Annual Meeting?

Lal: I just attended a talk on the pediatric M&M (morbidity and mortality), which was a great talk and they looked at difficult cases and cases that we learned from, where things may have gone wrong. It was interesting to see all the new therapies that people are using. You know that when I was a resident, they were case reports.They were just being published, and to see that the treatments used in treating many of these inflammatory systemic diseases in the inpatient setting is cool and fascinating. I think. Also, it was interesting to learn about some of the cases they discussed difficult-to-manage infantile hemangiomas, which I see daily, which are often not difficult to manage. But in retrospect, thinking about where things can go wrong, and how things may change. Some of the other newer therapies that people are using to treat infantile hemangiomas with—I think that's really exciting.

Dermatology Times: Tell us about a recent challenging case you have had and pearls to share from it.

Lal: As a pediatric dermatologist, occasionally, I see things that are let go for some time. So, I recently had a case of a patient that had been seen for a bump on their finger. It was a young kid under the age of 5. It was a pretty benign looking bump, you know, skin color, movable, on the knuckle and I was like, “Something seems off, you know, it's been there for a year, the mom says it's gone, but the kid is also growing.” Andso I biopsied it.It was originally thought by someone as being a benign fibromatosis, but it actually ended up being a type of sarcoma.That kind of made me think back for a little bit andI'm so glad I biopsied it, you know, because it was getting bigger, and I listened to the mom. We did genetic testing.There's actually a fusion protein associated with this, and that opens up the idea that there may be a therapeutic target that could salvage this kid's finger. So interesting cases, a lot of again, you know, genetic testing and pathology [are needed]. It's like the whole works coming together. Difficult cases come in, and when they come, they don't often look that difficult. It could be something benign. So now I always say,“Nothing looks as simple as it is.” I always try to think 3 times before being like, “Oh, my gosh, could this now be something else?” Because now I'm going to be on the radar for this.

Dermatology Times: How can dermatology clinicians utilize LinkedIn year-round between AAD meetings?

Lal: I think the beauty of LinkedIn, which is very underutilized, is that a lot of us do a lot of great things. And it's really important to showcase those things, because people learn from them. I follow a lot of people, especially in the itch realm—they're really good about sharing their research on LinkedIn. SoI'm always learning about the new basic science about these pathways for itch. And vice versa. I try to put things out there to showcase some of whatI've done with my patients, publications, et cetera. Because sometimes we can't get to all of these things like just by reading a journal. But when you go on LinkedIn, you can see what people are up to these days. Are there any new clinical trials are being promoted? I will post my clinical trials. If there are local dermatologists and patients that would benefit from a clinical trial, they'll send their patients to me for that specific condition. I think it's a really good way to connect with colleagues in a professional manner, and see what else is going on, what they're doing, show what you're doing. And really also like I said, just collaborate virtually, because I feel like it's easier than coming to 1 big meeting every single year.

Dermatology Times: What are your takeaways from the 2024 AAD Annual Meeting?

Lal: I'm really lucky to be a part of a field that's continuously growing. I think, unlike other specialties in medicine, I feel like in 1 year, there's so many new things that happen. And it'svery exciting. It'skind of like when you see a squirrel, and you're the dog and see the squirrel out the window. I feel like every time I come to this meeting, everything is shiny and there are a lot of new things. We get new data every year, different patient populations, a lot of studies. There are many doing skin of color studies now. So,we're getting real-world skin of color data from a lot of these drugs that we've had for the past 5 years.So I think we're evolving the way we think about people and we're being more humanistic as opposed to just like,“this applies to everybody.”

As the 2024 AAD Annual Meeting comes to a close, Dermatology Times wants to know what treatment pearls, research, and practice management tips you are taking home with you. We’d love to hear from you! Email DTEditor@mmhgroup.com.