Management of Type 2 Inflammation in Atopic Dermatitis - Episode 16
Closing out their discussion on the management of atopic dermatitis, expert panelists share clinical pearls and key takeaways from their discussion.
Peter A. Lio, MD: This has been wonderful. Thank you so much for this rich and informative discussion. Before we finalize and conclude, maybe we can get some final thoughts on this whole discussion. Dr Feldman, would you start us off?
Matt Feldman, MD: This is an exciting time. I’m probably the junior member of the team in terms of age. But I can see this drastic shift in our ability to treat what was a horribly impactful disease for all patients. We’ve been able to make so much progress, and there’s so much more progress to be made. These cutting-edge therapies that have just been approved—the large, lengthy pipeline for therapeutics—give us the ability to become more sophisticated in how we target these therapeutics to our patients. It’s a fun and exciting time.
Even in my short time in practice, I’ve seen leaps and bounds of improvement in how we can take care of these patients. I’m excited to have an option for these patients that I have confidence in.
Peter A. Lio, MD: Dr Jain?
Neal Jain, MD: I agree. We’ve come to this point where our understanding of biology has expanded dramatically. You can use a space analogy. We had little telescopes on the ground, but now we’ve got these amazing telescopes. That gives us this insight about what’s happening in our individual patients, and the ability to target therapies with what’s happening biologically is just amazing. Taking that a step further in the next decade is going to be exciting. Our patients will benefit and we’ll benefit from not only being able to nerd out about the science but also seeing the joy and the improvement from that scientific advancement.
Marc Serota, MD: There are some pearls that I’ll leave my colleagues with in terms of how I think about atopic dermatitis and how I manage atopic dermatitis. One is: don’t forget to ask what the movie looks like. It’s easy to walk into the room and think you can label someone’s severity. With some diseases, that’s true. With atopic dermatitis, it could have been really bad yesterday but really good today. These are the patients who pull out their phones and say, “Let me show you pictures of my skin.” We’ve all had that happen because they want to show you when it’s at its worst and not necessarily what they’re seeing today, which almost always turns out to be the best day of their year when they’re in the doctor’s office. Don’t forget to ask what the movie looks like.
Another thing, especially for my dermatology colleagues, is don’t forget to assess for their comorbidities, especially asthma. Just like psoriasis and psoriatic arthritis, you have to ask about their arthritis, or they won’t tell you. They also won’t tell you about their asthma unless you ask about it. You can really affect someone’s quality of life, for not just their atopic dermatitis but also their asthma, if you simultaneously assess for both. These are some things to keep in mind as you’re working your way through visits.
Another thing that’s really important and helpful when you’re seeing patients with atopic dermatitis is that these labor-of-love visits tend to slow you down in a busy clinic. Sometimes it’s hard to get the history efficiently from the patient, and there’s a lot of talking that usually has to happen during these visits. It’s great to have some analogies as you walk into the room to have in your mind so that the patient can still get the information they need without killing your whole day and taking up all your time in clinic. The analogy I like to remember is the military example. The immune system is like the military. You have different parts of the military, and 1 part is getting it wrong. If you don’t want to remember the full analogy, just remember to tell the patient the way the medicine works is it jams the radio signals of the allergic cells. That’s how it works.
If you have some of these things at your fingertips, it can make you more efficient and turn these labor-of-love visits into some of the most gratifying visits because you can really impact someone’s quality of life. Almost like no other disease that we see in our specialties, atopic dermatitis is 1 of the highest-impact quality-of-life diseases that we see in dermatology or in allergy immunology. It’s way ahead of things like asthma and other unrelated diseases that you would think would be more impactful. The itching of their skin and their rash is so impactful on their quality of life.
Peter A. Lio, MD: Thank you, everybody, so much for joining us, and thank you all for watching this HCPLive® Peer Exchange. If you enjoyed the content, please subscribe to the e-newsletters to receive upcoming Peer Exchanges and other great content right in your in-box.
Transcript edited for clarity.