Michael Cameron, MD, Reviews His Best Treatment Tips for Plaque Psoriasis and Pigmentary Disorders

Closing out the final day of sessions at the 2023 Fall Clinical Dermatology Conference for PAs and NPs, Michael Cameron, MD, presented his sessions “Start Today, Without Delay: An Oral Treatment for Any Adult With Plaque Psoriasis Regardless of Severity,” and “Pigmentary Disorders Update.” Cameron, an assistant professor of dermatology at Mount Sinai in New York City and founder of Cameron Dermatology LLC, sat down with Dermatology Times® to discuss his sessions’ key highlights.

During his apremilast (Otezla; Amgen) product theatre, Cameron stressed the importance of not categorizing a patient’s psoriasis as “mild” when speaking to them. What may seem like mild psoriasis is not mild to the patient and does not mean that they are not struggling. During Cameron’s pigmentary disorders discussion, he reviewed some of his top takeaways, including “take a step back and just describe the lesion” to accurately diagnose your patient.

Transcript

Cameron: All right, Michael Cameron. I'm the founder of Cameron Dermatology, which is in Manhattan. And I'm also an assistant clinical professor at Mount Sinai in New York.

Dermatology Times: What are a couple of takeaways from your session, "Start Today Without Delay: An Oral Treatment for Any Adult Patients With Plaque Psoriasis Regardless of Severity?"

Cameron: Yeah, so I think for the Otezla product theater, I think one of the main things I would want attendees to take away is that, you know, quote, unquote, "mild" psoriasis isn't mild to the patient. And so I just stress, you know, don't call it mild to the patient, you know, I'm trying to use the verbiage limited skin involvement, and that they can still have systemic involvement, even if they have limited skin involvement. And so mild is really a term for the FDA for regulatory and for clinical trials. Our mild patients still have a lot of unmet need. And so, you know, it's great that we have an Otezla agent that's now approved for mild to moderate quote unquote, psoriasis, because now we can treat them systemically. We know that there's a variety of systemic issues with psoriasis when it comes to cardiovascular and joint changes, and etc. And so it's really exciting that we now have something other than topical agents that we can use in that mild to moderate population. So that'll be the first thing. And then the second thing is just screening for psoriatic arthritis. And so when you see a psoriasis patient, you should use the PEST screening tool. So it's 5 questions, it takes 20 seconds to do. And it has a really high sensitivity. And so we know that with the PEST screening tool, you're going to catch 92% of psoriatic arthritis cases. And so if you start something like Otezla right away, then you're really going to help prevent the advancement of joint damage and things like that. And so just really making sure you screen all your psoriasis patients for psoriatic arthritis.

Dermatology Times: What are the highlights from your session, "Pigmentary Disorders Update?"

Cameron: Yeah, so I'm really looking forward to giving this talk. And so for pigmentary disorders, it's not a product theater. And so this is not promotional. And it's just really a holistic understanding of how do we go about diagnosing and managing pigmentary disorders. And so I think the main takeaway with this is to take a step back and just describe the lesion. And so when you're looking at a pigmentary disorder, you know, is a de pigmented or is it hypopigmented, or is it hyperpigmented? And so really in your mind telling yourself, you know, how do I describe this lesion? Because once you figure that out, that really helps with the diagnosis. And then the next thing I would say is, you know, look out for mimickers. And so I talked a lot about this in the talk, but for these pigmentary disorders that you know, things can look similar but slightly different. And if you know what to look for, you won't miss that. And so whether it's progressive macular or hypo melanosis versus tinea versicolor, those are treated very differently. And so I get patients all the time that have been misdiagnosed for this. And so I really want the attendees to kind of understand what to look for so that they don't miss the diagnosis.

Dermatology Times: What is the value of a meeting like Fall Clinical that brings together dermatologists, physician assistants, and nurse practitioners?

Cameron: These meetings are amazing. I mean, I think we're at a time in dermatology, where there's just so much innovation and advancement and we're getting new therapies every year for diseases with unmet need, whether it's vitiligo or alopecia areata or having orals for atopic dermatitis now, and so, there's just so much advancement in the field. And so it's really incumbent on all of us to attend these meetings so that we can continue to get more and more comfortable with all these new therapies.

[Transcript edited for clarity]