Sister Clinicians Highlight Cross-Specialty Collaboration in Dermatology and Podiatry

At the 2025 Elevate-Derm Fall Conference in Tampa, Florida, Shanna Miranti, MPAS, PA-C, and her sister, Larissa Schmidt, DPM, highlighted how often podiatry and dermatology overlap when clinicians are managing challenging skin and nail conditions. Their conversation demonstrated the practical value of exchanging insights across specialties and showed how those day-to-day intersections can improve patient care.

Miranti, a physician assistant at Riverchase Dermatology, participated in live SkinSync podcast recordings with co-host Buchi Neita, PA-C, facilitating on-stage discussions with several dermatology leaders. Interviewees included Hilary Baldwin, MD, on managing recalcitrant acne; Robert Micheletti, MD, on initiating biologic therapy in hidradenitis suppurativa; and Douglas DiRuggiero, DMSc, PA-C, on evolving biologic strategies in bullous pemphigoid. For Miranti, these sessions reinforced the importance of subspecialty expertise and collaborative care models.

Schmidt, a podiatrist at Celebration Foot & Ankle Institute, focused on biomechanics-driven skin and nail pathology, emphasizing that persistent calluses, digital deformities, or chronic nail changes often have underlying mechanical etiologies. She urged clinicians to look beyond isolated lesions and incorporate gait, structural abnormalities, and functional contributors into diagnostic reasoning. Her nail pathology session resonated strongly with dermatology attendees, particularly her emphasis on streamlining diagnosis, improving patient communication around slow nail growth cycles, and integrating simple office-based nail procedures into routine practice.

Both sisters highlighted the ongoing gap in nail disease comfort levels among dermatology clinicians. Miranti noted that nails remain an underdeveloped competency despite being central to the dermatologic scope, contributing to unnecessary referrals. Schmidt encouraged providers to develop foundational skills while also recognizing when a podiatric consultation is warranted, framing collaboration as essential rather than optional.

Schmidt, the immediate past president of the Florida Podiatric Medical Association, advised dermatology clinicians seeking local partners to engage with regional podiatric societies, emphasizing that podiatrists are enthusiastic collaborators as new therapies and technologies evolve. The sisters—third-generation podiatrists in their family—closed with a shared message: dermatology and podiatry share significant clinical overlap, and strengthening these interprofessional ties ultimately improves patient care across both specialties.

"I definitely encourage any nurse practitioners and physician assistants that might be struggling with podiatric dermatoses and or nail conditions to seek out a local podiatrist and develop that great collaborative working relationship," Miranti said.