Alexandra P Charrow, MD, FAAD, Discusses Complex Medical Dermatology, HS at AAD Annual Meeting

“I’m really excited to be part of that session,” Alexandra P. Charrow, MD, FAAD, told Dermatology Times about participating in the “Complex Medical Dermatology Cases: Pearls and Pitfalls” discussion at the 2025 American Academy of Dermatology Annual Meeting. Charrow was joined by colleagues Leslie Castelo-Soccio, MD, PhD, FAAD, Benjamin F. Chong, MD, MSc, FAAD, Christina Lam, MD, FAAD, and Robert Micheletti, MD, FAAD, who discussed issues such as vasculitis, pediatric dermatology, and rheumatology dermatology.

Charrow, director of the Hidradenitis Suppurativa and Neutrophilic Dermatosis Clinic, director of the Crohn’s and Ulcerative Colitis Dermatology Program, and assistant professor of dermatology at Harvard Medical School, appreciated the opportunity to share her expertise on hidradenitis suppurativa (HS) and help provide key and salient issues and solutions for practicing dermatologists. “Hidradenitis is really hot right now and there's a lot to cover,” she said. “There are 3 FDA-approved treatments for hidradenitis, 3-FDA approved biologic treatments, and I'll be speaking about ways to think about which ones to choose and in what circumstances as the first line and then a second and third line ways [in cases of treatment-refractory or failed their first treatment… How do we know when to move on to the next lines of treatment.”

It’s also important to think through the complexities that arise, Charrow added. Understanding how to manage paradoxical rashes is important, she said, as they are “pretty common amongst the FDA-approved treatments and even the non-FDA-approved treatments.”

Thinking through treatment decisions can be challenging because the field is lacking updated treatment guidelines, she told Dermatology Times. Nonetheless, it will be important to stay up to date with new research, as the field continues to grow.² “There are at least 5 treatments that are in phase 3 development or in phase 3 trials right now,” Charrow said. “Some of that data will be slowly trickling in through the AAD [annual meeting] and next year’s AAD [meeting]. I'm very excited to see what the results of those trials look like and how we can think about the next generation of treatments that may be available.”

“It's a really exciting time for research and an exciting time for all of us who treat hidradenitis, notwithstanding some of the budgetary constraints that are being put on us by the NIH right now and by the federal government,” she added.

In the meantime, Charrow said there are numerous resources for clinicians who have patients with HS, and the greater HS community is a supportive one. She pointed to the HS Foundation, noting that the organization has resources for clinicians, patients, and families. “There are prior authorization templates that are available that are extremely helpful for getting some of those drugs that are off label or that are on label but are still not being approved [by insurance] to get those medications approved for our patients.”

For clinicians looking to share resources with their patients, Charrow also recommended the HS Foundation’s patient support Papapya App. Apps like those are “helpful for patients in terms of working through their condition and learning more about it,” she told Dermatology Times.

When faced with difficult cases, clinicians likewise have resources to support them. “There are so many of us that treat hidradenitis now, which is really exciting, so you can always reach out to any of us,” Charrow said. “I think we're all very passionate about what we do and are always trying to help with challenging cases.” She also mentioned listservs that support professionals providing hidradenitis care, with dialogue and discussions from practicing dermatologists, mid-level providers, and surgeons.

In addition to sharing her experiences and expertise, Charrow looks forward to hearing from colleagues at the AAD annual meeting, which she sees as an opportunity to brush up on areas outside of HS. “Many of my colleagues will be presenting on complex, skin cancer, on dermoscopy,” she said. “Usually the sessions that I try to go to try to learn what's new in rosacea, what's new in melanoma care… the basics of my profession and also the complexities of those basics.

Hear more from the conversation with Dr Charrow, including her work with irritable bowel disease.

References

1. Charrow A. Complex medical dermatology cases: pearls and pitfalls. Presented at 2025 AAD Annual Meeting; March 7 – 11, 2025. Orlando, Florida.

2. Hebebrand M. New Data on Bimekizumab’s Long-term HS Efficacy. Dermatology Times. February 15, 2025. Accessed March 4, 2025.