Douglas DiRuggiero, DMSc, MHS, PA-C, on the Evolving Landscape of Dermatologic Care

At the Maui Derm NP+PA Fall 2025 Conference in Nashville, Tennessee, Douglas DiRuggiero, DMSc, MHS, PA-C, board-certified physician assistant at the Skin Cancer & Cosmetic Dermatology Center in Rome, Georgia, shared insights on research from the past year alongside Ted Rosen, MD, and Colleen Cotton, MD.¹ The literature review highlighted major advances in infectious diseases, pediatric dermatology, and immune-mediated skin disorders, including atopic dermatitis (AD) and psoriasis.

A key update in AD was a longitudinal study examining the atopic march in pediatric patients treated with dupilumab. The study demonstrated a decreased incidence of asthma in these patients, suggesting the potential for early biologic intervention to alter disease progression. While data on allergic rhinitis were less conclusive, the findings mark a promising development in comorbidity management.

In psoriasis, newly identified associations with pulmonary disorders are expanding the known systemic implications of the disease. A study involving over 250 patients revealed an increased incidence of non-smoking-related lung abnormalities, such as ground-glass opacities, raising awareness of potential respiratory risks in psoriasis populations.

Emerging therapeutics also took center stage, according to DiRuggiero. He highlighted off-label dermatologic applications of metformin—notably for acne and possibly non-melanoma skin cancer prevention—and oral roflumilast, a PDE-4 inhibitor originally approved for COPD. In a trial, oral roflumilast demonstrated efficacy comparable to methotrexate in achieving PASI 75 and PASI 90 responses in patients with psoriasis. Beyond the lecture, DiRuggiero praised the Maui Derm conference for its emphasis on evidence-based medicine and high-caliber faculty.

“Information is given to us in a very digestible format that I can then take and share with my NP and PA friends that are in my practice and find ways to talk about this with my patients themselves,” DiRuggiero noted.

DiRuggiero also expressed enthusiasm about the rapid evolution of targeted therapies, noting that today’s dermatology landscape allows clinicians to offer effective, safer treatments across multiple chronic inflammatory conditions—from hidradenitis suppurativa to bullous pemphigoid.

“A lot is on the horizon, and the best is definitely yet to come,” he said.

Looking ahead, DiRuggiero is passionate about advancing the role of NPs and PAs in dermatologic research. He encourages colleagues to publish, participate in clinical trials, and take on leadership roles in shaping future therapies. With more opportunities and support from industry and academic societies, DiRuggiero believes advanced practice providers are poised to make lasting contributions to the field.

Stay tuned to Dermatology Times all weekend for exclusive conference coverage and expert insights from Maui Derm NP+PA Fall.

References

1. Cotton C, DiRuggiero D, Rosen T. Literature 2025 in Review. Presented at: Maui Derm NP+PA Fall 2025; September 20-23, 2025; Nashville, Tennessee.