May Clinical Considerations for NPs, PAs

Joe Gorelick, MSNDear Colleagues,

Our May Clinical Considerations take a look at a treatment approach to hidradenitis suppurativa, the impact of atopic dermatitis on pediatric patients and a way to prevent mycosis fungoides progression.

I'm sure many of us struggle to effectively and adequately meet the treatment goals of our patients with hidradenitis suppurativa (HS). Evidence supports combined treatments to target the many factors tied to HS. In this article, Dr. Freidman suggests using multiple therapeutic agents simultaneously to gain control of this physically deforming and psychosocially debilitating condition. A comprehensive and pragmatic approach to treating HS is clearly described that encompasses all stages of the disease. 

Do you send Atopic Dermatitis (AD) patients home with Instructional handouts? To achieve optimal results in pediatric AD patients, complicated bathing and topical medication application regimes are prescribed. For these treatments to be effective, families of children with AD must follow the directions for administering the medications and treatment. Dr. Schachner suggests that it is imperative to provide written instructions in the implementation of these regimes. We should all remember the importance of the patient and family education component of the office visit when treating patients with AD. 

Mycosis Fungoides (MF) is often tough to diagnosis and the disease itself is difficult to treat. When the diagnosis is made early, what are your next steps? A novel therapeutic modality, when implemented in early stage disease, may prevent disease progression.  MF results from abnormal regulation of the immune system as it affects the skin. Therefore it makes sense to consider a targeted therapy to normalize the cytokine imbalance. Extracorpreal photophereisis (ECP) is a targeted approach that corrects the cytokine imbalance. Perhaps ECP may evolve into the primary intervention for early stage MF. Learn more about MF and ECP in DR. Lewis' article and case study. 

Best,

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