Top Insights from 5 Influential Leaders at Maui Derm NP+PA Fall

At this year’s Maui Derm NP+PAFall Conference in Nashville, Tennessee, leaders in dermatology shared insights into the management and research of numerous conditions, including new and upcoming therapies, case studies, and data from ongoing clinical trials.

Sheila Fallon Friedlander, MD

To kick off the conference, Sheila Fallon Friedlander, MD, shared pearls from recent literature, a necessary way of staying up to date on the latest research and treatments in the field. Fallon Friedlander, of the Scripps Clinic in San Diego, California, focused on updates relevant to the pediatric patient population, including things to keep in mind or watch out for when dealing with complicated cases. A portion of her presentation concentrated on careful communication with families, especially in cases where dermatologists, nurse practitioners, or physician's assistants are the first to identify systemic disease. 

“When you have a kid with significant eczema and you're thinking about dupilumab, families are scared. They don't want to put their child on something that gets injected,” Fallon Friedlander said. “But if you have a conversation explaining the possibility of perhaps changing other problems that could develop in them, the family is going to look at it a little differently.”

Melodie Young, MSN, ANP-c,

While Melodie Young, MSN, ANP-c, of Mindful Dermatology in Dallas, Texas, has presented on psoriasis at Maui Derm for years, this was her first chance to present on psoriasis within the pediatric population. With new therapies at the forefront, Young said this was the perfect opportunity. “I thought it was important that we review what we're doing so that we can reset our decision-making when it comes to kids,” she said in an interview with Dermatology Times.

During her presentation, Young focused on comorbidities and differential disease manifestations associated with pediatric psoriasis. She noted that significant comorbidities, including obesity and increased use of psychotropic medications, are a major concern in children with psoriasis.Unlike adults, where skin manifestations typically precede arthritis, Young said 80% of pediatric cases present with psoriatic arthritis first.She said these pearls highlight the need for early intervention to improve long-term outcomes and quality of life for affected children and their families.

Raj Chovatiya, MD, PhD

Raj Chovatiya, MD, PhD, associate professor at the Rosalind Franklin University Chicago Medical School and founder and director of the Center for Medical Dermatology and Immunology Research in Chicago, presented on hidradenitis suppurativa (HS), which he says is the “definition of unmet need.”

Luckily, Chovatiya says that the pipeline for HS therapies is bustling with activity and clinicians will soon have multiple options available for their patients. "While we've had very limited options historically, the 1 approval we've had the past year is just 1 of many that are to come, and you're going to be seeing probably something new happening almost every year. It behooves you to pay really close attention to what's happening at the podium when you're following along with some of the experts, because this is going to get very complicated very quickly.”

Chovatiya says that once clinicians understand the mechanisms of these drugs, they will have a better educated guess on what will work best for each patient.

Julie Harper, MD

The October 2023 FDA approval of a triple fixed-dose combination acne treatment (Cabtreo; Ortho Dermatologics) was a gamechanger, according to Julie Harper, MD, a dermatologist in Birmingham, Alabama. Harper, along with Hilary Baldwin, MD, and James Del Rosso, MD, delivered a joint session on acne and rosacea.

“I think the triple has changed my practice a lot, and I was thinking about that over the last few days,” Harper said in an interview with Dermatology Times. “I think, over time, I am prescribing fewer oral antibiotics, and I guess that's in part about just wanting to be a responsible prescriber. If I don't have to use oral antibiotics, I don'twant to use them, but I have a drug in this triple that I think is superior in efficacy, and I do think it's well-tolerated.”

Harper also touched on oral contraceptives, acne scarring treatment, and isotretinoin considerations. To wrap up her portion of the session, she talked about “JAKne,” an acneiform eruption associated with certain medications. Harper says it is essential to understand this form of acne, as it may present differently from traditional acne and should not be dismissed.

Matthew Zirwas, MD

On the last day of the conference, Matthew Zirwas, MD, a board-certified dermatologist based at DOCS Dermatology in Columbus, Ohio, presented on contact dermatitis. During his presentation, Zirwas discussed the disease state, including diagnostic challenges and upcoming therapeutics.

Acrylates, a common allergy initiated by acrylic or dip nail powder, was a topic discussed in several presentations throughout the conference. “If you see someone who comes in with face, neck, or eyelid dermatitis. Take a look at their nails,” Zirwas suggested.

When diagnosing contact dermatitis, he says that patch tests aren’t always necessary. Instead, Zirwas encourages clinicians to use their best judgement, and consider having patients avoid potential allergens as a diagnostic tool instead.

As for new and upcoming therapies, he shared his excitement for JAK inhibitors as a treatment for patients with disease overlap of atopicdermatitis and contact dermatitis. “They can be a challenge, because if you can't legitimately say the patient also has a component of atopic dermatitis, then we're talking about off label use, which means we're not going to be able to cover by insurance,” Zirwas said.