Diagnostic Pearls and New Therapies in Connective Tissue Disease, With Michelle Min, MD

During the 2026 Society of Dermatology Physician Assistants (SDPA) Summer Dermatology Conference, the HCPLive editorial team spoke with Michelle Min, MD, MSCi, about the growing need for cross-specialty collaboration between dermatology and rheumatology clinicians during her session, “The Rheum-Derm Connection: Diagnostic and Therapeutic Pearls.”^1,2

In this interview, Min highlighted the growing momentum in rheum-dermatology, pointing to emerging therapies for conditions such as dermatomyositis and cutaneous lupus. She noted that patients with skin manifestations of rheumatologic diseases historically have had limited US Food and Drug Administration (FDA)-approved treatment options, but ongoing research and late-stage clinical development could significantly expand the treatment armamentarium.

Min also emphasized that dermatologists play a critical role in diagnosing autoimmune and connective tissue diseases, often identifying characteristic clinical findings before laboratory testing or biopsies provide definitive answers. The following Q&A interview highlights her responses to inquiries by HCPLive regarding the takeaways from this session at SDPA:

HCPLive: Are there any systemic agents you feel are important to highlight and that you hope clinicians are aware of, either recent or upcoming approvals?

Min: Yeah, that's a great question. It's a really exciting time for room derm right now, because there are a lot of new treatments that are in phase 3. There's 1 that's even likely to get approved by the FDA this August for dermatomyositis. It's a TKY2, JAK1 inhibitor, brepocitinib. It'll probably be available on the market the first week of September, so we have a lot of exciting advancements coming for a long time. When it came to skin manifestations of rheumatologic diseases, we actually had nothing FDA-approved. So technically, we've had a hydroxychloroquine anti-malarial for systemic lupus. It's not actually, if you look at the package insert, approved for skin lupus, of course.

We do use it, and then IVIG got approved in 2021 for dermatomyositis, but before that we had nothing approved for dermatomyositis. So it's exciting because there's a lot of research, and I think this is changing. Another great example is we have anifrolumab that was also approved in the last few years for systemic lupus, but not cutaneous lupus. There are there's an ongoing phase 3 clinical trial right now specifically looking at cutaneous lupus, and I'm very hopeful that we'll get an FDA indication.

It's already a drug that we're using off-label to help our patients with skin lupus. We know there are many, many patients where the skin lupus is actually the only manifestation of their lupus, or they might have systemic lupus, but the systemic lupus is actually doing all right; it's the skin lupus that's not doing well. Again, as derms, as we have more medications available for us to prescribe. I think we need to be able to take back some of these patients, because no one's going to care about skin disease more than the patient, of course.

HCPLive: Were there any other notable clinical pearls that you wanted to highlight from your session at the SDPA meeting?

Min: I really want to emphasize that the physical exam is so critical. Yes, biopsies can be helpful, additional lab tests can be helpful, but your clinical suspicion for a lot of these diseases trumps everything, and even for systemic diseases, again, derms can offer very unique treatments. A treatment that we'll talk about is botulinum toxin for Raynaud's phenomenon for severe systemic sclerosis patients. That's something that a rheumatologist is not going to be comfortable managing. Even as a [dermatology clinician], if you don't want to be the primary person managing systemic sclerosis, and that's understandable.

There are still treatments that you can offer as a dermatologist that a rheumatologist is not going to be able to. Another treatment that we'll be talking about is hyaluronidase injections around the mouth for scleroderma patients with oral microstomia. That's difficulty opening the mouth because the skin is so tight. Again, as derms, even if you're not the primary one prescribing a systemic medication that's outside of your comfort zone, being able to understand what we can offer that's unique from the rheumatologist is something that we're going to emphasize as well.

HCPLive: For any dermatologists, PAs, or NPs who are attending, would you point to a key takeaway you would like attendees to walk away from your talk with?

Min: The one that I mentioned, that their physical exam is powerful. I think a lot of [dermatology clinicians] feel like a rheumatologist will be able to better differentiate some of these autoimmune diseases, because autoimmune diseases are primarily what they do. But you'd be surprised. And it shouldn't be the case. No one should understand skin diseases better than dermatologists. I also want to emphasize that rheumatologists are concerned about the patient as a whole.

I mean, we all are concerned about patients as a whole, but they're looking at lab values, how the heart and lungs are doing. Obviously, those are very important things, but there have been instances where a rheumatologist has reassured a patient with a rheumatoid condition, saying, ‘Hey, your labs look great. Yes, your skin disease, it's on your face, it's disfiguring, it's scarring, but you're not going to die.’ The patient obviously is very bothered by a disfiguring skin disease, and so again, as derms, skin is our baby; that's the organ that we're the most worried about. I think it's a mistake for us as dermatologists just to assume the rheumatologists are going to care about the skin disease or be as aggressive about skin disease as much as dermatologists would.

HCPLive: Were there any other notable elements of your session that you hope clinicians walk away with?

Min: The other thing I want to emphasize is in dermatology, if a patient doesn't know their diagnosis, they may come to dermatology before they see rheumatology or primary care. If the primary problem is the skin, and a lot of times people come in thinking they have eczema but it's actually dermatomyositis, or they think that they have routine hair loss, but it's actually discoid lupus on the scalp.

You know, you never know what's going to land in your office, and I think it's really important for us to be equipped to be able to experience and be able to help make these diagnoses. [It’s also important] to make some of these rheum and derm diagnoses correctly early on. It can really be life-changing. We have a lot of power here to help patients, and we should remember that and utilize it.

Disclosures: Min had no relevant disclosures of note.

References

1. Min M. The Rheum-Derm Connection: Diagnostic and Therapeutic Pearls. Presented at SDPA Summer 2026. Jun 10-14, 2026.

2. Min M. Key Diagnostic and Therapeutic Pearls for Connective Tissue Disease, With Michelle Min, MD. HCPLive. June 14, 2026. https://www.hcplive.com/view/key-diagnostic-therapeutic-pearls-connective-tissue-disease-michelle-min-md.