Jennifer Holman, MD, FAAD, and her patient, Audrey Dean, discuss pearls and key take-aways from their experience managing atopic dermatitis. Jennifer Holman wraps up discussing anticipated therapeutic developments and unmet needs.
Jennifer Holman, MD, FAAD: What’s your advice to somebody, somebody like you, who is dealing with the same skin issues, skin disease?
Audrey Dean:Honestly, just try to seek help as early as you can because you don’t want it to get extremely bad. [It can affect your] quality of life; also [try] to have a good support system around you. I definitely would have needed something like this video or something when I was going through the thick of it. You don’t normally hear of a lot of young people going through that, all the skin issues, losing the hair. So the main thing [is to find] help as soon as you can and have a good support system.
Jennifer Holman, MD, FAAD: I think that’s key, that you’re not alone. And if you go see somebody and you don’t get help, go see somebody else, because there are board-certified dermatologists out there…help is out there. And if you’re dealing with atopic dermatitis, I can’t echo enough what Audrey’s saying. You’re not alone. There are plenty of physicians out there to help. Let us help you. And primary care physicians can get you started as well, help get you into a dermatologist, and get you on some of these safe and newer systemic therapies…. Atopic dermatitis can impact anyone at any stage of life. And sometimes it’s not a slam-dunk diagnosis. [It may be a] broken-down skin barrier that increased sensitization; it can just get worse and worse…. I agree, you’re not alone. There are support groups online as well. For those who may not have a family support system in place, is there anything you would have done differently, looking back on your journey over the past few years when you’ve been in the dermatologist's office?
Audrey Dean: Maybe when I first started noticing stuff, I [have asked] a couple more questions…. When I first saw it, I might have been thinking it had something to do with my HS [hidradenitis suppurativa]. [I may have been] thinking,“ Oh, maybe this is just a flare, it’ll go away.” So maybe just questioning a little more.….
Jennifer Holman, MD, FAAD: …At the follow-up I assumed your HS was doing fine, then I looked at you and your face was so broken out. I was like, “What’s going on?” And then you took off your scrub cap and showed me your arms, all those kinds of things. I almost needed you to wake me up a little bit, to say, “Hey, this is not just a follow-up. We’ve got to talk, there’s something new that’s getting worse.” It wasn’t new, but it was certainly evolving and getting a whole lot worse. [Have you read information online] about atopic dermatitis since you’ve been diagnosed?
Audrey Dean: A little bit. Not recently though.
Jennifer Holman, MD, FAAD: Because it’s not bothering you?
Audrey Dean: It’s not bothering me.
Jennifer Holman, MD, FAAD: Which is totally a great thing as well. You know, I think as physicians, we do face limitations. Even as dermatologists, especially dermatologists who may have been in practice for a lot longer, we tend to stay away from some of these newer therapies. We may be afraid of [adverse] effects, the monitoring, we may be uncertain to do those things. So I certainly think that there’s a limitation and definitely a lot of times primary care physicians aren’t comfortable with some of these therapies. But that’s why we’re specialists. We are comfortable [with these therapies]. And so even if you’ve seen a dermatologist who doesn’t offer systemic therapy for treatment of your atopic dermatitis, if it’s impacting your quality of life, you may need to find a dermatologist who does treat these diseases systemically because we’re very, very blessed to have options. And the cool thing is, as I said, the treatment of atopic dermatitis continues to evolve and evolve and evolve. We’re getting better and better at both diagnosing and managing this systemic inflammatory condition. How do I want the treatment to keep evolving? ….It’s super important that we take a minute to talk about quality of life as well, and itch is one of the biggest mediators. Sleep is another big question that we should be asking, mental health questions so that we’re getting the right referrals in place. And you know, some of these emerging therapies, the JAK inhibitor class, which is what you’re on, continue to evolve. The indications that we’re seeing coming down the pipeline and the efficacy, the safety data, all those things, it’s just very encouraging as a dermatologist to have a class of medications. You know, I feel like a little bit in residency when you’d have a [case of] dermatitis or piriformis, which is a blistering disease on the elbows. But you put them on dapsone and in 2 or 3 days, they think you’re a hero. I’m not a hero. I just got you on the right medicine. It’s been the same thing with you. I’m not a hero, but I was able to be your partner to get you on the right medicine. So I think that class is going to continue to change. And down the road, we will understand even more, the pathophysiology and the genetics of atopic dermatitis therapies…. We should be getting better and better, safer and safer, understanding how these disease processes work. It’s been an honor to be your partner along this journey. And hopefully we’re partners for years to come through what the next seasons of life look like, because this is one that down the road, when you’re ready to have a baby, we get to walk that one together. And you know, if you come off of medicine, what does that look like? We’ll do it together. It’ll be a fun time to go through. But thank you for letting me be your partner in treating this, [to be] your physician. And certainly thanks for participating tonight on a Friday night, because what better to do than talk about skin disease on a Friday night?
Audrey Dean: Exactly, so much fun.
Jennifer Holman, MD, FAAD: We hope you enjoyed watching this Dermatology Times episode of The Patient Perspective. If you enjoyed this conversation, certainly you can subscribe to the e-newsletters and receive information in your inbox about upcoming programs. There is lots of other great content from Dermatology Times for patients and certainly for practitioners as well. And thanks again for joining us.
Transcript was AI-generated and edited for clarity.