Appreciating the Evolution of Dermatologic Therapies: Teaching An Old Dog New Tricks

In this special episode of Derms and Conditions, Charlie Dunn, MD, chief resident at Kansas City University, steps in as the host to interview James Del Rosso, DO, offering a fresh perspective for our listeners. Together, they explore the evolution of dermatologic therapies and the understanding of disease states, providing valuable insights for both early-career dermatologists and seasoned practitioners alike. They begin with rosacea, with Dr Del Rosso explaining the historical perspective and highlighting a landmark article that classified the condition into subtypes. This classification system, although useful, has led to some confusion over the years. He discusses the condition’s complexity and the need to reconsider the traditional subtypes. He stresses the importance of evaluating patients individually, considering the phenotype presented during consultations, and understanding the interplay between erythema, papules, and pustules. The conversation then shifts to hidradenitis suppurativa (HS) and other disease states, with Dr Del Rosso emphasizing the need for therapies to evolve alongside our understanding of the disease. He points out that package inserts often lag behind current clinical practices, and highlighting the disconnect between FDA-approved prescribing information and real-world application and experience, encourages dermatologists to stay informed about the latest pathophysiological insights and therapeutic options. Advocating for a personalized approach to dermatologic care, they discuss recognizing that therapies within the same class can behave differently across various disease states and patient populations. They emphasize the value of real-world studies in capturing the practical application of treatments, contrasting with the controlled settings of phase 3 clinical trials. As the episode draws to a close, Drs Dunn and Del Rosso reflect on the dynamic nature of dermatologic practice, encouraging listeners to stay informed and adaptable. They highlight the importance of reassessing traditional approaches considering evolving evidence. This episode offers a comprehensive overview of the current landscape of dermatologic therapies, providing listeners with actionable insights and a deeper understanding of how to navigate the complexities of modern dermatologic practice.