Shanna Miranti, MPAS, PA-C, Shares Expert Acne and Pediatric Dermatology Insights

“We want dermatology PAs to know that sometimes it's not enough to just prescribe one topical generic medication. If we are going to use combination therapy, we really want to try to check each one of those 4 pillars of acne pathogenesis when creating regimens for our patients with acne,” said Shanna Miranti, MPAS, PA-C, in an interview with Dermatology Times at the 2024 Society of Dermatology Physician Associates (SDPA) Fall Conference in Las Vegas, Nevada.

Miranti, a board-certified physician assistant at Riverchase Dermatology in Naples, Florida, and Dermatology Times’ Summer 2024 Editor in Chief, kicked off the conference on the first day in a collaborative session with Hilary Baldwin, MD, medical director of the SDPA conference, to discuss “Acne Insights: Expert Strategies and Solutions From the Pros.”

Later in the week, Miranti presented “Pediatric Dermatology: Basics, Tips & Tricks.” In her interview, Miranti also discussed the collaborative nature of the SDPA conference, emphasizing the supportive environment fostered by key opinion leaders and supportive physicians such as Baldwin. Miranti also expressed excitement about future advancements in managing atopic dermatitis, particularly the wealth of therapeutic options now available for both topical and systemic treatments, which are transforming care for patients with moderate to severe disease.

To keep up with all conference coverage from SDPA Fall, click here. To receive updates and top insights from the meeting, subscribe to our eNewsletters for clinical pearls straight to your inbox.

Miranti’s Take-Home Pearls

1. Comprehensive Acne Management via the 4 Pillars of Pathogenesis

Miranti and Baldwin emphasized treating acne by focusing on its 4 key pathogenic factors:

1. Follicular hyperkeratinization
2. C. acnes proliferation
3. Inflammation
4. Excessive sebum production

Miranti highlighted the importance of addressing multiple pillars simultaneously, advocating for combination therapies tailored to acne severity (mild, moderate, or severe) and patient-specific concerns like scarring. She referenced the groundbreaking triple-combination topical launched in 2024 (Cabtreo), which targets 3 of the 4 acne pillars: reducing bacteria, inflammation, and follicular plugging. Additionally, clascoterone cream (Winlevi), the only topical targeting sebum production, was presented as an effective option to round out comprehensive treatment plans. These advancements improve therapeutic outcomes and patient compliance.

2. Advocating for Increased Focus on Pediatric Dermatology

Miranti underscored the critical need for dermatology PAs to engage in pediatric dermatology, citing a stark disparity: there are only approximately 400 board-certified pediatric dermatologists available to serve 74 million children in the US. She inspired attendees to embrace pediatric dermatology as a rewarding subspecialty, emphasizing the joy and fulfillment of treating children. Her presentation aimed to increase enthusiasm among PAs, particularly those new to dermatology, to meet the growing demand for pediatric care.

3. Education for New Dermatology Clinicians

Miranti tailored her pediatric dermatology lecture to beginner PAs and NPs, offering foundational knowledge and an overview of the 10 most common dermatologic conditions in children. This session provided practical insights into newly available therapies, addressing the knowledge gap many clinicians face early in their dermatology careers. Miranti emphasized the role of conferences like SDPA in disseminating cutting-edge treatments and peer-driven learning that clinicians often miss during formal education.

4. Excitement Around Atopic Dermatitis Innovations

Looking ahead to 2025, Miranti expressed enthusiasm for advancements in managing atopic dermatitis, particularly in pediatric populations. She highlighted the expanding arsenal of therapeutic options, from topicals to systemic treatments, allowing clinicians to tailor interventions to varying severities. With these innovations, dermatology clinicians are well-equipped to address this challenging condition comprehensively, offering solutions that balance efficacy and patient-specific needs.

Miranti’s engaging lectures at SDPA 2024 served as an inspiration for dermatology PAs, combining foundational education with cutting-edge developments in acne and pediatric dermatology. Her collaborative approach with Baldwin set a tone of mentorship and collegiality for the conference, fostering a commitment to excellence in patient care