March Clinical Considerations for NPs, PAs

Joe Gorelick, MSN, FNP-C, Dear Colleagues,

This month we’re looking at new allergy guideline recommendations, discuss whether or not ‘natural’ soap is milder and novel immunomodulators.

What do you do with Peanut allergic patients? Especially pediatrics with Atopic Dermatitis. Recently published guidelines are available to help us manage these patients. These findings may signal a change in practice, and recommends that children with severe atopic dermatitis or egg allergy need further evaluation so they can get early peanut exposure to prevent the development of peanut allergy. See Dr. Eichenfields article to learn more...

Soap is Soap and the term 'natural' does not infer that these 'natural' products are gentle or mild. The term soap means that it has detergent properties that can be harsh and eczema inducing to the skin. So don't be fooled by the term 'natural' and get a specific cleanser/wash/soap history from patients presenting with xerotic eczematous conditions. Dr. Draelos has some great pearls in her article.

The Era of Atopic Dermatitis is upon us! Over the last 10 years our therapeutic target has shifted from external topical therapeutics to repair barrier dysfunction to new targeted immunomodulatory agents targeting what we now understand to be an immune-driven disorder. Soon we will have the first systemic biologic agent available Dipixent, an IL-4 and IL-13 inhibitory. Other systemic agents will follow targeting JAK, PDE-4, IL-22, IL-23, and IL-17. Eucrisa a topical PDE-4 inhibitor is now available with other topical agents in development targeting JAK inhibition. So use this article to stay tuned and brush up on your immunology. These agents are coming soon.

Best,

Joe Gorelick, MSN, FNP-C, Dermatology Education Foundation Founder and Chairman