Dermatology Times Hosts Inaugural Horizons in Advanced Practice Meeting

Dermatology Times recently launched its inaugural Horizons in Advanced Practice meeting in Las Vegas, Nevada. The exclusive, invite-only event brought together physician assistants and nurse practitioners from across the country to review complex atopic dermatitis and psoriasis patient cases led by experts in the specialty.

Attendees were led through patient cases by the chair of the meeting, Omar Noor, MD, FAAD, and co-chairs Lakshi Aldredge, MSN, ANP-BC, DCNP, FAANP, and Douglas DiRuggiero, DMSc, MHS, PA-C. Noor is a board-certified dermatologist and co-owner of Rao Dermatology in New York, New York, and a Dermatology Times Editorial Advisory Board member. Aldredge is a board-certified adult nurse practitioner at the VA Portland Healthcare System in the Dermatology Service and the director of the Primary Care NP Residency Program in Portland, Oregon. DiRuggiero is a board-certified physician assistant at the Skin Cancer & Cosmetic Dermatology Center in Cartersville, Georgia.

Objectives from the meeting included:

• Exploring the latest advancements and emerging treatments in atopic dermatitis and plaque psoriasis
• Participating in small-group sessions to discuss complex patient cases
• Engaging in peer collaborations and discussion to share practical experiences
• Gaining actional strategies for managing challenging cases
• Empowering rising professionals in the evolving dermatology landscape

The meeting began with opening remarks from Dermatology Times staff, Noor, Aldredge, and DiRuggiero. Attendees were then divided into smaller groups to attend 45-minute breakout sessions discussing atopic dermatitis and plaque psoriasis cases.

Breakout Session Round 1:

• Noor’s group reviewed a Medicare patient with chronic to severe plaque psoriasis, who was previously treated with adalimumab and was switched to risankizumab following a malignancy diagnosis. After enrolling in Medicare, the patient lost access to risankizumab, was subsequently lost to follow-up, and now presents with 35% BSA involvement.
  • After considering the patient’s treatment history and symptoms, the decision was made to initiate tildrakizumab 100mg subcutaneously at weeks 0 and 4 and every 12 weeks thereafter.
• DiRuggiero’s group reviewed an adult patient with moderate plaque psoriasis and psoriatic arthritis with low body surface area involvement. The patient had previously tried topical treatments, but now wants to try a biologic with a favorable safety profile.
  • After considering the patient’s preferences, the decision was made to initiate guselkumab 100mg subcutaneously at weeks 0 and 4 and every 8 weeks thereafter.
• Aldredge’s group reviewed an adult patient with moderate to severe atopic dermatitis who has had eczema since childhood and is experiencing significant quality of life issues due to persistent symptoms. The patient has cycled through multiple topical treatments and is seeking a therapy that can provide rapid relief and serve as a long-term solution. They are also concerned about the frequency of treatment.
  • After considering the patient’s treatment history and the severity of his condition, the decision was made to initiate a lebrikizumab 500mg subcutaneously initial dose (2 x 250mg injections) at week 0 and week 2, followed by 250mg once every 2 weeks until week 16.

Following the first breakout session, Aldredge and DiRuggiero led a discussion, “What’s on the Horizons for Advanced Practitioners in Dermatology” to discuss building clinical confidence and mentorship, navigating complex cases and utilizing resources, connecting with industry partners and pharmaceutical representatives, attending conferences, addressing gaps in immunology knowledge, and how to build meaningful industry relationships.

The second breakout session featured all moderate or moderate to severe atopic dermatitis cases.

From left to right: Omar Noor, MD, FAAD; Lakshi Aldredge, MSN, ANP-BC, DCNP, FAANP; Douglas DiRuggiero, DMSc, MHS, PA-C

Breakout Session Round 2:

• Noor’s group reviewed a 27-year-old female with moderate to severe atopic dermatitis since childhood and a 10-year history of asthma and allergic rhinitis. Atopic dermatitis has had a significant impact on her quality of life and mental health. Her asthma is often aggravated by episodes of worsening atopic dermatitis and more recently impacted by seasonality.
  • After considering the patient’s treatment history and comorbidities, the decision was made to initiate a dupilumab 600mg subcutaneously loading dose, followed by 300mg once every 2 weeks, plus the use of triamcinolone 0.1% cream.
• DiRuggiero’s group reviewed a 25-year-old female with moderate to severe AD who is experiencing significant itching that is negatively affecting her quality of life. She has tried dupilumab but did not achieve significant improvement. She is looking for a quick resolution of her symptoms.
  • After discussing options, the decision was made to discontinue dupilumab and initiate upadacitinib 15mg orally once daily, plus continued daily emollient use and topical tacrolimus as needed.
• Aldredge’s group reviewed a 12-year-old patient with moderate atopic dermatitis with 8% BSA and hand involvement. They are reluctant about using topicals on their hands.
  • After discussing options with the patient’s parents and considering their concerns about topical corticosteroids, the decision was made to initiate topical ruxolitinib 1.5% cream applied twice daily to affected areas, plus oral histamines for breakthrough itching.

Horizons in Advanced Practice ended with an empowering discussion among attendees on how pharmaceutical partners and representatives can better support physician assistants and nurse practitioners in their professional journeys.

Dermatology Times is committed to empowering dermatology physician assistants and nurse practitioners throughout their careers. For those interested in contributing written content or expert interviews, email DTEditor@mmhgroup.com for more information.

Stay tuned for more content from the meeting, including exclusive interviews with the chairs of the meeting and attendees. For more information on attending Dermatology Times events, subscribe to receive our eNewsletters and visit our Events page.