Orit Markowitz, MD: Cutting Edge Dermatology - Without Cutting the Skin

Orit Markowitz, MD, is a board-certified dermatologist and the founder of OptiSkin. At the 2023 Society of Dermatology Physician Assistants (SDPA) Annual Fall Dermatology Conference, Markowitz presented 2 sessions: "Melanoma Diagnosis, Outcomes and Survival," and "Advanced Conditions."

Markowitz spoke with Dermatology Times® to discuss the highlights of her sessions, cutting edge dermatology without the need for any physical skin cutting, and more.

Transcript

Orit Markowitz, MD: Hi, I'm Dr. Orit Markowitz. I'm a board-certified dermatologist and I practice at OptiSkin Medical, which I am the founder of, in Manhattan, New York. I'm going to be presenting on subjects that I think are very close to my area of expertise or my passion, which is the cutting edge without the cutting. I specialize in skin cancer and non-invasive imaging.

The first topic that I have covered is melanoma staging and therapy, but I definitely have put my twist into it to go over, for example, with early diagnosis, or patients who are not necessarily candidates for advanced monitoring and therapy, that we have genetic expression profile testing, to help kind of figure out what to do with these patients. But also that if we have for example, a very large lentigo maligna, and it may be very difficult to surgically remove it, that we can use for example, dermoscopy and reflectance confocal microscopy, essentially, are non invasive tools to help monitor and manage these patients with imiquimod therapy. But some of the other highlights from the melanoma staging and therapy lecture is that we just go over some new findings within melanoma management, gut microbiome, for example: Don't give patients that are getting immunotherapy antibiotics, that we have adjuvant therapies for less advanced melanoma patients now, such as mRNA vaccines that are substantially changing the playing field, that we have targeted tumor therapies, etc. It's a constantly evolving target, which is fantastic, because we're aware that melanoma is one of the deadliest types of cancers, and so we want to be able to not only detect our patients early, but we also want to be able to manage them as best we can at any stage of disease.

My second lecture, of course, goes over cases with dermoscopy, speaking of early detection. It utilizes my approach, which is a color wheel approach, and don't worry, if you're colorblind, you can still use a color wheel approach. But the whole purpose to why I wrote a textbook with this approach was that amelanotic melanoma, which is one of the deadliest and most aggressive types of melanomas, and the most difficult to diagnose, frankly, definitely have certain colors and patterns, that if we look at them, we're able to diagnose them very, very early. That sort of was the precedent for creating that approach and just being able to take a step back and look at things a little bit outside the box so that we feel really confident in catching things early and using some useful tools and pearls, such as if something is really, really dark and doesn't have a lot of colors and is elevated, it's not cancer. Just having some really basic strategies so that we can better diagnose and feel competent managing our patients.

[Transcript has been edited for clarity.]

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