From 30 Tips to 3 Key Insights from 3 Experts

Ahead of their presentation at the 2025 Fall Clinical Dermatology Conference, 3 panelists from the session titled, "30 Tips in 30 Minutes" shared their top 3 pearls they think every clinician needs to know. From setting realistic therapeutic timelines to tackling insurance barriers, these insights are sure to help you in your practice as early as Monday

Brad Glick, DO, MPH, FOACD

Glick, a board-certified dermatologist at Glick Skin Institute, director of the Dermatology Residency at the Larkin Health System Palm Springs Campus, and clinical assistant professor of dermatology at the FIU Herbert Wertheim College of Medicine in Miami, Florida, provided tips focused on systemic therapy and a novel use for botulinum toxin.

1. Stick with Therapeutics for Long-Term Response: Also at Fall Clinical 2025, Glick presented 3-year data for lebrikizumab and 5-year data for deravacitinib. He told Dermatology Times that this tip leads into his next, and often come as a package deal.
2. Encourage Continued Treatment Despite Minor Fluctuations: Patients who respond to therapy should be encouraged to continue, even if they experience minor “dips” in their response.
3. Botulinum Toxin Use in Post-Surgical Scars: Citing a recent meta-analysis published earlier this year, Glick discussed the use of botulinum toxin to improve the appearance of post-surgical scars. He suggested that injecting small amounts of botulinum toxin around the surgical scar can reduce the muscular impact and tensile impact that stretches the skin and affects the scar's appearance over time.

E. James Song, MD, FAAD

Song, the director of clinical research and chief medical officer at Frontier Dermatology, shared tips on chronotherapy for JAK inhibitors, the influence of sodium in inflammation, and strategies for navigating insurance denials.

1. Optimal Timing for JAK Inhibitor Administration: Due to the body's natural circadian rhythm, cytokines that cause inflammatory diseases (like TNF alpha, IL-1, IL-6, and IL-13) tend to peak at night. Since JAK inhibitors have a short half-life, timing the drug to this peak may maximize efficacy. Song cited a rheumatoid arthritis study on baricitinib that showed patients who took the drug in the evening were nearly twice as likely to achieve an ACR20 response compared to those who took it in the morning.
2. The Role of Diet, Specifically Sodium, in Inflammatory Skin Diseases: Recent publications highlight the connection between sodium and inflammatory pathways, specifically showing it can amplify TH17 and TH2 inflammation, which are central to psoriasis and atopic dermatitis, respectively. In fact, an article in JAMA noted that patients excreting more sodium in their urine were far more likely to have a diagnosis of atopic dermatitis, have active flares, and have more severe disease.
3. Using a Secondary Diagnosis to Address Cosmetic-Related Insurance Denials: To combat insurance denials for conditions like vitiligo or alopecia areata that are sometimes incorrectly deemed "cosmetic", Song recommends using a specific secondary diagnosis code. He noted the code that he thinks "carries the most weight" is the Disorder Involving Immune Mechanism code: D89.9.

Peter Lio, MD

Lio, director of the Chicago Integrative Eczema Center and a clinical assistant professor at Northwestern University, Feinberg School of Medicine, offered tips centered on comprehensive patient communication, minimizing procedure-related anxiety, and holistic care.

1. Writing Out a Comprehensive Patient Action Plan: Lio creates a printed action plan for each patient, which he considers foundational to his practice. The plan details what to do in the morning and in the evening, establishes an order of operations, and links to specific products.
2. Addressing Needle and Procedure Phobia: Lio emphasizes the importance of minimizing the pain, discomfort, and anxiety surrounding procedures, ranging from blood draws to biopsies or wart freezing. He noted data suggests that procedures are more successful when good pain mitigation is used.
3. Incorporating the Mind-Body Connection: While not a replacement for systemic treatments, adjunctive mind-body techniques can be a supportive piece of treatment. For example, habit reversal therapy provides a replacement behavior for scratching itchy skin. Examples include making gentle circles, tapping fingers, or using a fidget toy/worry beads.

For complete coverage of the Fall Clinical Dermatology Conference 2025, visit our conference coverage page.