Case Reports Lead PA to Biologic After Years of Isotretinoin

After nearly 10 years on isotretinoin with minimal improvement, Sharon Doering, PA-C, tried a biologic after reading about its use in a case report. Within 2 weeks, the patient saw a dramatic change in her skin. Doering described the case and the importance of continued learning in an interview with NP/PA Connect at the 3rd Annual Horizons in Advanced Practice meeting, held October 23, 2026, in Atlanta, Georgia.

Doering, a physician assistant from Atlanta with 26 years of clinical experience, attended the meeting and shared her reflections on the cases, science, and collegial exchange it offered.

Using Case Reports When No FDA-Approved Option Exists

The patient was new to Doering’s practice and had what she called a difficult, uncommon condition with no FDA-approved treatment. While reading a journal, Doering came across case reports describing the use of a biologic in that condition. The drug itself was already established, and Doering started the patient on it.

“In 2weeks, she has never seen such improvement in her skin,” Doering told NP/PA Connect. That early response could change the patient’s long-term regimen as well, she said. “It’s going to allow her to stop the isotretinoin eventually, which is super exciting.”

Why Ongoing Learning Matters for Dermatology PAs

Doering described herself as a continual student who loved school and has never stopped reading or attending meetings. She sees that habit as essential for clinicians at every career stage, whether newly practicing or seasoned.

“The most important thing is just to never stop reading and never stop attending meetings and collaborating with your colleagues,” she said. That collaboration includes knowing whom to call when a case falls outside her own experience. “Just having the resources and the ability to phone a friend, people who maybe have more pediatric experience or geriatric experience, it’s nice to have a community that you also know well,” Doering said.

Biologics, Oral Peptides, and the Future of Chronic Skin Disease Care

A highlight of Horizons for Doering was learning the science behind newer biologics and oral peptides, then working through that science with colleagues in the field. “I have been in practice for 26 years and to see where we’ve come in chronic recurrent disease treatments, including psoriasis and atopic disease, is extremely exciting,” she said.

She sees room for progress on 2 fronts, both in combining therapies that have been available for years and in finding new applications for newer agents. Gaining deeper insight into the mechanisms behind the chronic diseases clinicians treat every day, she said, supports both.

“This is a very exciting time to work in dermatology,” Doering said.

To learn more from NP/PA colleagues, visit Dermatology Times NP/PA Connect and register attend Derm Nexus: The Inflammatory Disease and Innovations Congress for NP/PAs.