Previewing Fall Clinical PA & NP Conference With James Del Rosso, DO

The Fall and Winter Clinical dermatology meetings are known for their comprehensive educational sessions and world-class faculty. Next week, dermatology providers will be gathering in Orlando, Florida, for the 2023 Fall Clinical Dermatology Conference for PAs & NPs.

James Del Rosso, DO, a practicing dermatologist and research director at JDR Dermatology Research in Las Vegas, Nevada, senior vice president of clinical research and strategic development at Advanced Dermatology & Cosmetic Surgery in Maitland, Florida, and senior director of the Dermsquared clinical advisory board, recently spoke with Dermatology Times® to preview his sessions as well as the conference itself.

At the conference, Del Rosso will be presenting “What You Really Need to Know About Rosacea,” “What's Coming Up Next,” and “What's New in the Medicine Chest.” Additionally, stay tuned next week for another exclusive interview with Del Rosso where he discusses his upcoming seminar on topical management of atopic dermatitis and psoriasis with Linda Stein Gold, MD.

Transcript

Del Rosso: Hi, I'm Jim Del Rosso here in Las Vegas, Nevada. I’m very excited that last night, my Las Vegas Golden Knights won game 6 against the Dallas Stars who were pesky, but we beat them, fortunately. And we're going to be in the Stanley Cup Finals against the Florida Panthers. So, I am extremely happy. I even have my logo on today. Anyway, we're not here to talk about that. But that's got me pumped up. So anyway, I'm Jim Del Rosso. I'm one of the co-directors, I’m actually listed as a senior co-director because I've been doing it from the beginning with Darrell Rigel and Mark Lebwohl, along with some of the co-directors we've now added, which is a great group of people for what is now called Dermsquared. It used to be FRED, the Foundation for Research and Education in Dermatology. It's now under this new platform called Dermsquared. And one of the things offered are many different meetings such as the Fall Clinical dermatology meeting in Las Vegas. And then we have Winter Clinical Hawaii, and now Miami and a board-immersion course, a residents meeting, and this physician assistant and nurse practitioners that are in dermatology, a meeting coming up that's specifically for them in Orlando, Florida. So, I'm very proud to be a part of that and work with the group and try to bring cutting edge, for lack of a better term, to everyone and give a lot of collegiality, a lot of chance to interact, but really talk about education that's going on now. But also remind people that just because something's new doesn't mean it's better. We have a lot of existing therapies that we learn more about. And so we try to integrate everything, right? The word we like to use nowadays is diversity. And we like to have the diversity to include everything that we know is going to work and get rid of the things that no longer are of assistance to us. But anyway, that's what the meeting is about. I'm proud to be a part of it.

I am going to be talking about rosacea at that meeting, and really like to focus on it because people still struggle with it. We all do, just by human nature, we go in the room and we base it on what we're seeing and what we're hearing. But the clinical manifestations of rosacea: papules, red papules, pustules, erythema, telangiectasias, they kind of get mixed together [when we] see a patient coming in often during a flare. And it's hard to separate what's actually contributing to all of those individual features. And some of them are harder to see when a patient has a flare of vasodilation and papules and pustules. You can't always see all the little linear telangiectasias, that when they're better, they point, and don't like those particular things. So [my talk] is really to help these clinicians, some of them young, some of them not so young, many of them have been around awhile working in dermatology practices and working with some great supervisee physicians, but to really differentiate those features, and tailor your therapy to try to address each of those individual features, especially the ones that are bothering to patients because they're going to require different things. I talk a lot about persistent facial erythema, which is misunderstood and has some specific therapies also. And it's not all medical therapy, there are physical devices.

Then in “What's New in the Medicine Chest”, I go through a lot of newer therapies, try to make reference to things that have been around for a while and how they also fit in. So we're going to be talking about topical clascoterone, which is an androgen receptor inhibitor, there have been some misconceptions about that, which I'm going to clarify. And then also I talk about the combination of benzoyl peroxide with tretinoin, both of them microencapsulated, which is truly a distinct type of vehicle technology that allows us to combine benzoyl peroxide with tretinoin in the same formulation, which has never been done before. And that encapsulation is distinctly different. So, we have to specify it, even though there's a push not to use brand names. Sometimes that push is not the real evidence-based information. Some of these vehicle technologies do offer distinct differences from other brands and generics that are available. So if we want to be truly evidence-based, like our academician colleagues tell us, who say don't use generic names, sometimes they're flat wrong. Only use generic names, sometimes that flat wrong, because sometimes the branded formulations are distinctly different and offer some efficacy or tolerability advantages that the others do not have. So evidence-based means what's correct not whether it's brand or generic. So we go through some of that. Then some of the new nonsteroidal agents like topical tapinarof, topical roflumilast, topical ruxolitinib. Tapinarof and roflumilast are the last approved for plaque psoriasis, but are under evaluation for atopic dermatitis. Roflumilast also, for seborrheic dermatitis, and ruxolitinib for atopic dermatitis. Too much to talk about right here, but a lot of differentiating features.

Then on the systemic side, monoclonal antibodies, we have dupilumab, we have tralokinumab, and now we have coming lebrikizumab, all for moderate to severe atopic dermatitis, not adequately controlled by prior systemic therapies or topical therapies. Patients who just need to get better. And there are differences between those agents and I'll try to bring those to light. And then of course, the Janus kinase inhibitors, which is a very broad discussion about distinguishing some of these agents that we have for atopic dermatitis. We upadacitinib and abrocitinib orally, there are some differences between both of those, but these are very effective for moderate to severe and refractory cases of atopic dermatitis, and can offer sometimes an increment of greater efficacy. And this has been shown in studies than what we might be achieving with the monoclonal antibodies in some cases, some safety considerations, and laboratory monitoring to consider which the monoclonal antibodies do not have. And then, of course, tyrosine kinase 2 inhibition with deucravacitinib, an oral agent approved for plaque psoriasis that really is where the patient needs a systemic therapy, but offers a definite differentiation and efficacy compared to what we've had before and some safety considerations compared to some of the conventional immunosuppressives like methotrexate and cyclosporine. And of course, the anti IL-17 A and F agent, bimekizumab, has a plethora of data, comparative data, extremely effective for psoriasis. But some thoughts about candida, candida infections, usually oral thrush, and in most cases, we're able to manage that regardless of what anti IL-17 agent we're using. So that's a mouthful. It may be too much information for this, but it really lets you know. Chime in and see what Jim Del Rosso can bring to you. And if you like it, great if you don't let me know, and I'll try to do better the next time. Thank you.

[Transcript edited for clarity]