Atopic Dermatitis Considerations With Peter Lio, MD

Peter Lio, MD, clinical assistant professor of dermatology and pediatrics at Northwestern University Feinberg School of Medicine in Chicago, Illinois, and founder of the Chicago Integrative Eczema Center, spoke with Dermatology Times® at South Beach Symposium (SBS) 2023 regarding his atopic dermatitis sessions. Lio presented “Diet: How it Impacts The Skin and How to Help” and “The Not So Talked About: Comorbidities, QoL and Unmet Needs.”

Transcript:

Peter Lio, MD: I'm Peter Lio. I'm a clinical assistant professor of dermatology and pediatrics at Northwestern University. I'm also a founding partner of Medical Dermatology Associates of Chicago. It was really exciting to be part of the Advisory Committee for LiVDerm. There are so many things happening right now in dermatology. And I really think we're seeing a change in the way that we learn, a change in the way that conferences are put on. They're much more rapidly changing in terms of information and getting bite-sized presentations. I think we're going away from sort of the monolithic long, hour long presentations where people would drone on about something. And we're really trying to get this just in time information that is super up to date. And I think in a much more intimate environment too.

Dermatology Times®: What are a few highlights from your session, "Diet: How it Impacts the Skin & How to Help?"

Lio: One of the hardest things that I deal with my practice is talking about diet and kind of managing patients expectations versus sort of what is my reality as a clinician, and I think three take homes for the diet session is first, we can't totally discount it. So the sort of the middle path is the way; if you tighten the string too much it will break if you tighten it not enough, the instrument will not play, it's the middle path. You can't say it's all diet, because generally speaking, it's not except for a couple of very specific conditions. But you also can't totally dismiss it because it often does play a role. The second piece is that we want to try to do everything else that is more accessible before we go to diet, because there are very real problems if we start having people exclude foods from their diet. And the third one is we can do all these things while still emphasizing the importance of eating healthy. I want people to eat good, healthy foods, ideally more of a plant-based, whole foods, less processed diet because we know that can contribute to inflammation and just ill health in general. So we can do all these things. It's a little bit of a juggling act, but I really think that leads to optimal care.

Dermatology Times®: What are the take-home points of your session, "The Not so Talked About Comorbidities, QoL, and Unmet Needs?"

Lio: There are so many unmet needs in dermatology, and in particular, in atopic dermatitis. There are all these comorbidities that go beyond the skin. So everything from the mental health issues to the allied allergic conditions like asthma and hay fever, and conjunctivitis. And what we find is that these lead to a vicious cycle of depression and anxiety and poor performance in school and work. So I think the big take home for me is that we have to ask, because many, many times patients are not going to volunteer these, so you have to ask about them. We really also then want to do something on that we don't want to just check a box and say, "yep, they sure have it, have a great day!" We want to try to make sure they're connected with people that can help them and provide the support they need. And although that is challenging, make no mistake, I do think there are resources for patients and families to get some extra support, including the National Eczema Association, which is a nonprofit group designed to support patients and families. So we want to make sure we're doing that. And the third piece, I think, is that we want to make sure that we're following up so we can do something to get them better and then check on those as well. We're checking their disease state, but also how are those comorbidities and in theory, everything should run together. If we've gotten their skin better, most of the time we find these other comorbidities are actually improving along with it at least to some degree.

Transcript edited for clarity