Adam Harkiewicz, George Martin, T. Dickerson, Ann Deren-Lewis
The arrival of biologics has considerably improved the treatment of psoriasis and psoriatic arthritis; however, it can be difficult to identify which biologic(s) a patient will respond to without undergoing a trial-and-error approach. The current survey was designed to investigate biologic switching in the clinic and whether a biomarker test would assist in selecting the appropriate treatment for patients and improve psoriasis management. A survey of 157 nurse practitioner and physician assistant (NP/PA) advanced practice providers was conducted to assess (1) the frequency of biologic switching and (2) the perceived clinical utility of a biomarker test that stratifies psoriasis patients to predict biologic response. More than half of advanced practice providers (55%) indicated that psoriasis patients require at least two different biologics to achieve an adequate response to treatment, with 59% of respondents specifying that 10% to 30% of their patients switch biologics the first year of treatment. Ninety-six percent of respondents indicated that a biomarker test would likely improve their practice, with the majority of participants (84%) suggesting a biomarker test could improve their ability to determine the most appropriate therapy for their patients. Ninety-one percent indicated they would use a biomarker test (Mind.Px, Mindera Health, San Diego, California), and 63% said they would perform the test in their office. A biomarker test may help shift psoriasis management from a trial-and-error approach to precision care, thereby reducing the time to effective treatment and improving patient outcomes.
生物制剂的出现大大改善了银屑病和银屑病关节炎的治疗;然而，如果不经过反复试验的方法，很难确定患者对哪种生物制剂有反应。目前的调查旨在调查临床中的生物转换，以及生物标志物测试是否有助于为患者选择合适的治疗方法并改善牛皮癣的管理。对157名执业护士和医师助理(NP/PA)进行了一项调查，以评估(1)生物转换的频率;(2)对银屑病患者进行分层以预测生物反应的生物标志物测试的感知临床效用。超过一半的高级执业医师(55%)表示，牛皮癣患者至少需要两种不同的生物制剂才能达到对治疗的充分反应，59%的受访者指出，10%至30%的患者在治疗的第一年改用生物制剂。96%的受访者表示，生物标志物测试可能会改善他们的实践，大多数参与者(84%)认为生物标志物测试可以提高他们为患者确定最合适治疗方法的能力。91%的人表示他们会使用生物标记测试(Mind。Px, Mindera Health, San Diego, California)， 63%的人表示他们会在办公室进行测试。生物标志物测试可能有助于将牛皮癣管理从试错方法转变为精确护理，从而减少有效治疗的时间并改善患者的预后。
{"title":"A Survey of Nurse Practitioner and Physician Assistant Advanced Practice Providers Uncovers a Need for Precision Medicine in Psoriasis Management","authors":"Adam Harkiewicz, George Martin, T. Dickerson, Ann Deren-Lewis","doi":"10.58744/001c.84280","DOIUrl":"https://doi.org/10.58744/001c.84280","url":null,"abstract":"The arrival of biologics has considerably improved the treatment of psoriasis and psoriatic arthritis; however, it can be difficult to identify which biologic(s) a patient will respond to without undergoing a trial-and-error approach. The current survey was designed to investigate biologic switching in the clinic and whether a biomarker test would assist in selecting the appropriate treatment for patients and improve psoriasis management. A survey of 157 nurse practitioner and physician assistant (NP/PA) advanced practice providers was conducted to assess (1) the frequency of biologic switching and (2) the perceived clinical utility of a biomarker test that stratifies psoriasis patients to predict biologic response. More than half of advanced practice providers (55%) indicated that psoriasis patients require at least two different biologics to achieve an adequate response to treatment, with 59% of respondents specifying that 10% to 30% of their patients switch biologics the first year of treatment. Ninety-six percent of respondents indicated that a biomarker test would likely improve their practice, with the majority of participants (84%) suggesting a biomarker test could improve their ability to determine the most appropriate therapy for their patients. Ninety-one percent indicated they would use a biomarker test (Mind.Px, Mindera Health, San Diego, California), and 63% said they would perform the test in their office. A biomarker test may help shift psoriasis management from a trial-and-error approach to precision care, thereby reducing the time to effective treatment and improving patient outcomes.","PeriodicalId":93653,"journal":{"name":"Journal of dermatology for physician assistants : Official journal of the Society of Dermatology Physician Assistants","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88769461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JDPA Editorial Board Member Mallory Aycock, MPA, PA-C, interviews Esther Cohen, PA-C, recipient of SDPA’s Joe Monroe Lifetime Achievement Award. Esther has dedicated her life to the advancement of dermatology PAs. She graduated from PA school in 1974 and by 1980 was the one of the first dermatology PAs in the country at Johns Hopkins in Baltimore, Maryland. She has practiced clinical dermatology for 43 years.
{"title":"Amplifying Our Collective Voice: Seasoned Derm PA Who Wrote First Prescription Following PA Prescribing Authority Law in Maryland Shares Experience, Advice","authors":"Mallory Aycock","doi":"10.58744/001c.85086","DOIUrl":"https://doi.org/10.58744/001c.85086","url":null,"abstract":"JDPA Editorial Board Member Mallory Aycock, MPA, PA-C, interviews Esther Cohen, PA-C, recipient of SDPA’s Joe Monroe Lifetime Achievement Award. Esther has dedicated her life to the advancement of dermatology PAs. She graduated from PA school in 1974 and by 1980 was the one of the first dermatology PAs in the country at Johns Hopkins in Baltimore, Maryland. She has practiced clinical dermatology for 43 years.","PeriodicalId":93653,"journal":{"name":"Journal of dermatology for physician assistants : Official journal of the Society of Dermatology Physician Assistants","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73899419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There is a need to address the productivity-salary gap for PAs in healthcare. This can be achieved by implementing transparent billing practices and adjusting PA salaries to reflect their contributions to patient care. By doing so, PAs can be compensated in proportion to their professional efforts caring for patients.
{"title":"Addressing the Productivity-Salary Gap for PAs in Healthcare","authors":"Cynthia F. Griffith","doi":"10.58744/001c.84327","DOIUrl":"https://doi.org/10.58744/001c.84327","url":null,"abstract":"There is a need to address the productivity-salary gap for PAs in healthcare. This can be achieved by implementing transparent billing practices and adjusting PA salaries to reflect their contributions to patient care. By doing so, PAs can be compensated in proportion to their professional efforts caring for patients.","PeriodicalId":93653,"journal":{"name":"Journal of dermatology for physician assistants : Official journal of the Society of Dermatology Physician Assistants","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90087245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The purpose of this article is to review the psychosocial effects of atopic dermatitis. It is important for providers to identify the psychosocial comorbidities associated with atopic dermatitis to provide well rounded patient care. A PubMed literature search was conducted with search terms “atopic dermatitis,” “psychosocial,” and “comorbidities.” Filters were set to articles published after 2015 and limited to clinical and systematic reviews, meta-analysis, and clinical trials. This yielded nine articles. A second search was performed using the terms “atopic dermatitis,” “anxiety,” and “depression” with similar parameters and 41 studies were revealed. Additional searches were performed in Medline and the Cochrane library with the same key terms. Several quality studies showed that atopic dermatitis is associated with increased risk of anxiety, depression, attention deficit hyperactivity disorder, suicidality, and decreased quality of life. Additional research is needed to determine the relationship between atopic dermatitis and obsessive-compulsive disorder, and schizophrenia. Many studies proposed pruritus and sleep deprivation as primary factors in increasing mental health comorbidities of atopic dermatitis. Dermatology providers should screen for associated comorbidities of atopic dermatitis and refer for appropriate treatment as necessary. Aggressive treatment of atopic dermatitis can improve overall quality of life and subsequently lessen the rate of associated comorbidities.
{"title":"Beyond the Surface: The Psychosocial Effects of Atopic Dermatitis","authors":"Kara Mudd","doi":"10.58744/001c.84270","DOIUrl":"https://doi.org/10.58744/001c.84270","url":null,"abstract":"The purpose of this article is to review the psychosocial effects of atopic dermatitis. It is important for providers to identify the psychosocial comorbidities associated with atopic dermatitis to provide well rounded patient care. A PubMed literature search was conducted with search terms “atopic dermatitis,” “psychosocial,” and “comorbidities.” Filters were set to articles published after 2015 and limited to clinical and systematic reviews, meta-analysis, and clinical trials. This yielded nine articles. A second search was performed using the terms “atopic dermatitis,” “anxiety,” and “depression” with similar parameters and 41 studies were revealed. Additional searches were performed in Medline and the Cochrane library with the same key terms. Several quality studies showed that atopic dermatitis is associated with increased risk of anxiety, depression, attention deficit hyperactivity disorder, suicidality, and decreased quality of life. Additional research is needed to determine the relationship between atopic dermatitis and obsessive-compulsive disorder, and schizophrenia. Many studies proposed pruritus and sleep deprivation as primary factors in increasing mental health comorbidities of atopic dermatitis. Dermatology providers should screen for associated comorbidities of atopic dermatitis and refer for appropriate treatment as necessary. Aggressive treatment of atopic dermatitis can improve overall quality of life and subsequently lessen the rate of associated comorbidities.","PeriodicalId":93653,"journal":{"name":"Journal of dermatology for physician assistants : Official journal of the Society of Dermatology Physician Assistants","volume":"92 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76800005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A review of the literature is a summary of the current understanding of a specific topic or condition that serves to educate and/or aid the reader by presenting and synthesizing previously published scholarly sources. This article discusses how to conduct a literature review using current databases to collect and evaluate a range of sources, such as peer-reviewed professional and academic journal articles and textbooks and organize findings into a manuscript.
{"title":"How to Conduct a Review of the Literature","authors":"P. Jones","doi":"10.58744/001c.85085","DOIUrl":"https://doi.org/10.58744/001c.85085","url":null,"abstract":"A review of the literature is a summary of the current understanding of a specific topic or condition that serves to educate and/or aid the reader by presenting and synthesizing previously published scholarly sources. This article discusses how to conduct a literature review using current databases to collect and evaluate a range of sources, such as peer-reviewed professional and academic journal articles and textbooks and organize findings into a manuscript.","PeriodicalId":93653,"journal":{"name":"Journal of dermatology for physician assistants : Official journal of the Society of Dermatology Physician Assistants","volume":"149 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72429144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lauren E. Miller, MPAS, PA-C, SDPA President (2022-2023), discusses finding and connecting with “why,” meaning the purpose and values of a person and mission of an organization. This concept, which comes from the book Start with Why: How Great Leaders Inspire Everyone to Take Action, by Simon Sinek, has been a guiding light during Miller’s presidency.
Lauren E. Miller, mpa, PA-C, SDPA主席(2022-2023)，讨论了寻找和联系“为什么”，意思是一个人的目的和价值观以及组织的使命。这个概念来自西蒙·斯涅克的《从为什么开始:伟大的领导者如何激励每个人采取行动》一书，在米勒担任总统期间一直是一盏指路明灯。
{"title":"Unlocking the Power of Purpose: Simon Sinek’s “Start with Why” and the Evolving Nature of Our Why","authors":"Lauren E. Miller","doi":"10.58744/001c.85089","DOIUrl":"https://doi.org/10.58744/001c.85089","url":null,"abstract":"Lauren E. Miller, MPAS, PA-C, SDPA President (2022-2023), discusses finding and connecting with “why,” meaning the purpose and values of a person and mission of an organization. This concept, which comes from the book Start with Why: How Great Leaders Inspire Everyone to Take Action, by Simon Sinek, has been a guiding light during Miller’s presidency.","PeriodicalId":93653,"journal":{"name":"Journal of dermatology for physician assistants : Official journal of the Society of Dermatology Physician Assistants","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80271984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Botulinum toxins (BTX), predominately BotulinumtoxinA, have been used for medical and aesthetic purposes since 1997. With nearly eight billion treatments performed worldwide for aesthetic purposes alone, there is extensive post-market experience with this drug. The known mechanism of action (MOA) of the local neurotransmitter blockade of acetylcholine lasts approximately 90 days. However, patients frequently report symptom and wrinkle relief beyond the 90-day period. There is extensive evidence that peripherally injected BTX, even at low aesthetic doses, induces structural and functional changes in the human brain. The MOA in the central nervous system (CNS) is presently unclear, with several proposed hypotheses to include the Social Feedback Hypothesis (SFH), Facial Feedback Hypothesis (FFH) and Emotional Proprioception (EP), Monoamine Theory and Brain-Derived Neurotrophic Peptide (BDFP), and Neuronal Transport Hypothesis. With the ability to modify the CNS, BTX for aesthetic use may become a novel treatment for CNS disorders, such as major depressive disorder (MDD). Over 30% of persons diagnosed with MDD had inadequate response to first-line treatments. Over 30% of persons diagnosed with treatment resistant depression (TRD) attempt suicide. BotulinumtoxinA may offer an effective adjunctive treatment of MDD/TRD.
{"title":"Botox: Beauty and Brains","authors":"Donell D. Deremer","doi":"10.58744/001c.84325","DOIUrl":"https://doi.org/10.58744/001c.84325","url":null,"abstract":"Botulinum toxins (BTX), predominately BotulinumtoxinA, have been used for medical and aesthetic purposes since 1997. With nearly eight billion treatments performed worldwide for aesthetic purposes alone, there is extensive post-market experience with this drug. The known mechanism of action (MOA) of the local neurotransmitter blockade of acetylcholine lasts approximately 90 days. However, patients frequently report symptom and wrinkle relief beyond the 90-day period. There is extensive evidence that peripherally injected BTX, even at low aesthetic doses, induces structural and functional changes in the human brain. The MOA in the central nervous system (CNS) is presently unclear, with several proposed hypotheses to include the Social Feedback Hypothesis (SFH), Facial Feedback Hypothesis (FFH) and Emotional Proprioception (EP), Monoamine Theory and Brain-Derived Neurotrophic Peptide (BDFP), and Neuronal Transport Hypothesis. With the ability to modify the CNS, BTX for aesthetic use may become a novel treatment for CNS disorders, such as major depressive disorder (MDD). Over 30% of persons diagnosed with MDD had inadequate response to first-line treatments. Over 30% of persons diagnosed with treatment resistant depression (TRD) attempt suicide. BotulinumtoxinA may offer an effective adjunctive treatment of MDD/TRD.","PeriodicalId":93653,"journal":{"name":"Journal of dermatology for physician assistants : Official journal of the Society of Dermatology Physician Assistants","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87568371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Society of Dermatology Physician Assistants Summer 2023 Digital Abstracts","authors":"","doi":"10.58744/001c.85087","DOIUrl":"https://doi.org/10.58744/001c.85087","url":null,"abstract":"SDPA Presents Summer 2023 Digital Abstracts from SDPA Annual Summer Dermatology Conference June 22-25, 2023, Westin Copley Place, Boston, Massachusetts","PeriodicalId":93653,"journal":{"name":"Journal of dermatology for physician assistants : Official journal of the Society of Dermatology Physician Assistants","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72677707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Snakes, spiders, and ticks are among the most common creatures in the United States whose bites can lead to serious medical complications. Although the systemic sequelae are often nonspecific, many of these zoonotic exposures exhibit specific dermatologic manifestations that can be key to their diagnosis and treatment. The goal of this article is to increase clinician knowledge and skill in identifying the dermatologic findings of several snake-, spider-, and tick-borne conditions in order to provide prompt disease-specific medical treatment.
{"title":"Dermatologic Manifestations of Common Zoonotic Exposures","authors":"Janelle Bludorn, E. Palmer, Andre Braima","doi":"10.58744/001c.84259","DOIUrl":"https://doi.org/10.58744/001c.84259","url":null,"abstract":"Snakes, spiders, and ticks are among the most common creatures in the United States whose bites can lead to serious medical complications. Although the systemic sequelae are often nonspecific, many of these zoonotic exposures exhibit specific dermatologic manifestations that can be key to their diagnosis and treatment. The goal of this article is to increase clinician knowledge and skill in identifying the dermatologic findings of several snake-, spider-, and tick-borne conditions in order to provide prompt disease-specific medical treatment.","PeriodicalId":93653,"journal":{"name":"Journal of dermatology for physician assistants : Official journal of the Society of Dermatology Physician Assistants","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89348406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Psoriasis is a chronic, multisystemic, inflammatory disease that exhibits a wide array of clinical presentations and is associated with high disease burden. Advancements in our understanding of the pathophysiology of psoriasis have led to the development of novel therapeutic modalities known as biologics that inhibit the action of pro-inflammatory cytokines, offering a more targeted therapeutic approach and improved safety profile compared to traditional systemic agents. Psoriasis disease severity is usually the main driver when it comes to selecting the appropriate biologic for any given patient; however, with an increasing number of biologics from which to choose, one pressing question that is increasingly more common in clinical practice is, “How do we select the ‘right’ treatment for each patient?” We performed a review of the literature on biologic use in patients with psoriasis with a focus on specific systemic comorbidities. Here, we summarize currently available recommendations based on available studies.
{"title":"Biologics and Psoriasis: Treatment Selection with a Focus on Patient Comorbidities","authors":"Eduardo A. Michelen-Gómez, Z. C. Chiesa Fuxench","doi":"10.58744/001c.73861","DOIUrl":"https://doi.org/10.58744/001c.73861","url":null,"abstract":"Psoriasis is a chronic, multisystemic, inflammatory disease that exhibits a wide array of clinical presentations and is associated with high disease burden. Advancements in our understanding of the pathophysiology of psoriasis have led to the development of novel therapeutic modalities known as biologics that inhibit the action of pro-inflammatory cytokines, offering a more targeted therapeutic approach and improved safety profile compared to traditional systemic agents. Psoriasis disease severity is usually the main driver when it comes to selecting the appropriate biologic for any given patient; however, with an increasing number of biologics from which to choose, one pressing question that is increasingly more common in clinical practice is, “How do we select the ‘right’ treatment for each patient?” We performed a review of the literature on biologic use in patients with psoriasis with a focus on specific systemic comorbidities. Here, we summarize currently available recommendations based on available studies.","PeriodicalId":93653,"journal":{"name":"Journal of dermatology for physician assistants : Official journal of the Society of Dermatology Physician Assistants","volume":"145 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79720348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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