Personalizing Psoriasis Care in Older Adults

At the recent Dermatology Times Horizons in Advanced Practice meeting in Tampa, Florida, conference chairs Omar Noor, MD; Lakshi Aldredge, MSN, ANP-BC, DCNP; and Douglas DiRuggiero, DMSc, MHS, PA-C, reviewed complex atopic dermatitis, type 2 inflammation, psoriasis, chronic hand eczema, and hidradenitis suppurativa patient cases to an exclusive group of dermatology nurse practitioners and physician assistants in 6 breakout groups.

Noor, a board-certified dermatologist and co-owner of Rao Dermatology in New York and a Dermatology Times editorial advisory board member, first presented “Case-Based Conversations on Type 2 Inflammation in Dermatology.” In his second breakout session, Noor presented “Personalized Paths to Control.” Among attendees, he discussed 3 patient cases of psoriasis and his treatment approach for each.

Stay tuned to Dermatology Times for a deep dive into each chair’s sessions, as well as more interviews with Aldredge and DiRuggiero.

Interview With Omar Noor, MD

Q: Can you provide an overview of your second Horizons in Advanced Practice breakout session on tailoring psoriasis treatments?

Noor: We've been talking about psoriasis for many years, but what's interesting is that as we talk more about treatment options for psoriasis, we get smarter, we get more detailed, we get more unique, and we get more clinically relevant. At the end of the day, a lot of the science can help let us know and appreciate how our patients are improving from the medications. But now that we have so much data and we're just smarter, we can help better identify patients based on their age, comorbidities, and if patients have metabolic syndrome, where their psoriasis is on their body. We have medications like tildrakizumab that has specific scalp data, which might help us lean in one direction versus another, or if it's even just about access. If we have a Medicare patient that we know falls into this donut hole of $2000 a year for most of their biological options, there can be another alternative biologic option, such as tildrakizumab, where the patient can get this advanced systemic therapy at a reasonable cost, if not $0.

Q: What were some of the key discussion points from attendees?

Noor: Something one of the attendees brought up that sat very importantly with me is how we talk about our older patients and how we see them in the office. We see what it takes to care for them and how important it is to keep their skin and their inflammation under control, and how much it bothers them, along with a lot of the other issues that they're dealing with. We want to make things easier for them. One of the physician assistant attendees spoke about injections or treatment in the office, where we administer the treatment as the patient comes in.

The daughter who came with the attendee’s patient, who was about 70 to 80 years old, mentioned how this was relieving a burden of hers and of her family's. They had been responsible for the injections previously, and it was a lot for them. They were dealing with a lot with their elderly parent, and to be able to bring that parent in for us to take charge of that treatment allowed the patient to stay on the medication, continue consistent dosing that was appropriate, they did not miss their dosing, and we took charge of delivery of the medication, therefore taking care of everything; she really appreciated that. And I thought, wow, we're always looking at the medication and its positives for the patient, but we also have to keep in mind that it affects the entire family unit.

Q: What is the value of speaking and writing opportunities for clinicians?

Noor: This is dermatology. We're blessed to be in such a wonderful field where we can affect so many patients' lives. We have so many wonderful treatment options, and we see a whole myriad of different dermatologic cases every day in our offices. Having the advantage of working with a company like Dermatology Times, you have the ability to write articles. You can learn quite a bit from Dermatology Times. I advise you to reach out if you have an interesting case, an interesting discussion, or if there's something that you feel might be positive to dermatology, which is what we do every day. Come together, come to Dermatology Times, and reach out and find an avenue that works for you because Dermatology Times offers many different options for a lot of different providers.

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