Elevate-Derm PA-NP Conference Day 4
Conference Reporters:
Madeline June, NP
Clara Wilson, PA-C
Energy from the Barbie and Ken Evening Event carried over into the final conference day, as attendees grabbed coffee and breakfast and settled into the lecture hall to hear our first speakers.
Dr. Jenny Hsiao and Dr. Jim Treat paired up to discuss surgical and medical management of hidradenitis suppurativa (HS) in adult and pediatric patients. Their talk covered when to transition from topicals to systemic therapy, new FDA-approved biologics, and when to utilize de-roofing or surgical excision. They also shared insights on managing patients with multiple comorbidities or genetic abnormalities.
Next, Dr. Christine Cornejo joined for “Field Cancerization of the Skin,” which she defines as “pro-tumorgenic changes that occur in skin exposed to a carcinogen, such as UV light.” She provided clear guidelines for the use of topical fluorouracil, imiquimod, acitretin, and capecitabine. She also discussed over-the-counter nicotinamide as a beneficial supplement for certain patients with a history of non-melanoma skin cancer.
Dr. Cornejo continued with a fascinating discussion on cutaneous T-cell lymphoma (CTCL), primarily mycosis fungoides. She reviewed how to recognize various cutaneous manifestations of CTCL (most common in the “double covered” areas), initiating appropriate workups, and developing an evidence-based approach to CTCL management. There are multiple treatment options ranging from conservative to aggressive based on the patient's presentation and goals.
A panel including Dr. Clarke, Dr. Cornejo and Dr. Hsiao presented clinical pearls from their careers. Dr. Clarke focused on autoimmune and immunobullous conditions, namely how to differentiate the clinical features of dermatomyositis, lupus, and systemic sclerosis. Dr. Hsiao emphasized the importance of building a rapport with HS patients before discussing more sensitive topics, such as weight, smoking, and sexual health. Dr. Cornejo shared interesting cases of skin cancers that presented as isolated pink lesions, as well as her approach to eruptive squamous atypia.
After a delicious lunch, we reconvened to hear Dr. Cornejo discuss merkel cell carcinoma. Often presenting as a painless, flesh-colored or bluish-red nodule, this rare and aggressive skin cancer has gained attention recently with the death of Jimmy Buffet. She went over her approach to staging, treatment, and post-surveillance.
Next, Dr. Clarke dove into the key cutaneous manifestations of dermatomyositis. She discussed when to initiate appropriate lab evaluation and how to screen for systemic manifestations. She answered common questions about ANA testing: when to order, recognizing the limitations, and interpreting the results in context of the patient.
To present “Melanoma Updates,” Dr. Cornejo returned to the stage and discussed the role of gene expression profiling in melanoma, identified the latest advances in melanoma treatment and reviewed the common dermatologic adverse effects of advanced melanoma therapies.
Coffee and dessert were served, followed by Dr. Clarke presenting “Skin Signs of Inflammatory Bowel Disease.” She provided an excellent description of the cutaneous manifestations of inflammatory bowel disease (IBD), the signs most associated with IBD, and when to screen for IBD in dermatology patients. She then discussed cutaneous lupus, including the key cutaneous manifestations, important labs, and systemic manifestations.
Our last speaker was Dr. Hsiao, who presented a lecture on “Difficult Cases in HS.” She went over the latest management approaches to treat complex HS patients before covering a topic that makes many providers nervous: dermatoses in pregnancy. She reviewed common dermatoses of pregnancy, how to develop a treatment plan, and discussed the potential impact of these skin conditions on a patient's pregnancy.
The conference concluded with a delightful farewell event in the Crystal Ballroom. This was the perfect opportunity for attendees to reflect on all the excellent speakers and events from the week, and look forward to the next Elevate-Derm conference–Boston, July 2024!
