One of the hardest things I ever say to a patient is: “I am sorry, but there is no treatment for your condition.”
In this world of scientific dominance, it is hard for the patient to imagine that there are no options — or that all possible options have been exhausted without success. Failure as a physician is difficult. I want to run and knock on the door of the nearest pharmaceutical company and tell them that I have a patient who I need to help!
“Could you develop something that would make me a better physician in the eyes of my patient?” I’d ask.
“Could you do it quickly? Because my patient is in pain with accompanying emotional distress. This situation is very important to both my patient and me! Please do something!”
I find it a sobering thought that I could do little as a dermatologist without prescription medications. I rely on excellent pharmaceuticals to provide excellent results that will, in turn, allow my patient to see that I really am an excellent dermatologist. There is no doubt that I am dependent on innovation in the pharmaceutical industry to advance my ability to treat patients. However, the innovation in dermatology is now coming through other areas of medicine laterally.
For example, many biologics were originally developed for rheumatology and introduced for psoriasis indications. These same biologics are being tested for other dermatology indications, like atopic dermatitis and hidrandenitis suppurativa. This type of drug development still results in excellent dermatologic treatments, but we need to encourage primary pharmaceutical interest in dermatologic indications.