Understanding Immunologic Pathways Builds Clinician Confidence

Eileen Cheever, PA, a dermatology physician assistant at Clearview Dermatology in Massachusetts, spoke with Dermatology Times at the Elevate Summer Meeting in San Diego, California, where she serves as a founding advisory board member and medical director. Cheever discussed why understanding the immunologic pathways underlying dermatologic disease can strengthen clinical decision-making, patient education, and confidence when recommending treatment. She also highlighted the importance of advocating for appropriate systemic treatment in pediatric psoriasis.¹

Immunologic Pathways as a Foundation for Practice

Cheever said immunology has become fundamental to modern dermatology, making it increasingly important for clinicians to understand the pathways underlying both the diseases they treat and the therapies they prescribe.

So much of what we do in dermatology is immunology nowadays, — Cheever

Sessions at Elevate explored the immunologic and pathologic pathways involved in conditions including atopic dermatitis and psoriasis. Cheever said understanding these pathways provides clinicians with a foundation that extends beyond selecting a treatment. It can also help them more clearly and succinctly explain a diagnosis, disease process, and therapeutic approach to patients.¹

She encouraged clinicians to continue studying the immunology behind the conditions they routinely encounter, noting that a strong understanding of the science can translate directly into greater confidence during patient conversations.

Scientific Confidence Can Strengthen Patient Trust

Cheever connected a clinician’s understanding of a therapy’s mechanism with the ability to confidently counsel patients at the point of treatment decision-making.

When clinicians understand why a therapy works and how it relates to the underlying disease pathway, she said, they are better equipped to explain their recommendations to patients. That confidence can be particularly valuable when discussing therapies patients may initially be hesitant to start.²

That really does go a long way in instilling trust in patients buying into the treatment you’ve recommended — Eileen Cheever, PA

Her takeaway for clinicians was straightforward: Understand the science behind the disease and its treatments. That knowledge can inform not only therapeutic decisions but also how effectively clinicians communicate those decisions to patients.

Advocating for Systemic Therapy in Pediatric Psoriasis

Cheever also discussed lessons from a lecture on pediatric psoriasis that she presented with a colleague at Elevate. One message in particular resonated with attendees: “Kids only have one childhood.”

For children living with psoriasis and other chronic dermatologic diseases, Cheever encouraged clinicians to consider the effect that effective treatment can have on their lives and not allow apprehension surrounding systemic therapies to prevent appropriate treatment.^1,2

“Don’t be afraid to take the reins and be that child’s advocate to really embrace some of these systemic and biologic medications we have to really change the trajectory of these kids’ lives,” Cheever said.²

She urged dermatology clinicians to become comfortable with the systemic and biologic therapies available for pediatric patients and to advocate for their use when clinically appropriate.

“Really, just lean in and don’t be afraid to really grasp these medications and help our patients when they come to see us,” Cheever said.

References

1. American Academy of Dermatology. Pediatric psoriasis guideline. American Academy of Dermatology. Accessed August 10, 2026.
2. Castelo-Soccio L, Kim W, Hammers CM, et al. Pediatric psoriasis: biologics and oral small molecule inhibitors in modern therapy. J Am Acad Dermatol. 2025;92(3):504-515. https://pubmed.ncbi.nlm.nih.gov/39950181/