<p>The <strong>Society of Dermatology Physician Associates (SDPA) 23rd Annual Fall Dermatology Conference</strong> showcased why this meeting is a “must attend” for physician assistants and nurse practitioners. Sessions emphasized aggressive yet patient-fit plaque psoriasis management, connections between plaque psoriasis and other comorbidities, and the importance of psoriatic arthritis screening. New plaque psoriasis–related data on scalp outcomes, skin-of-color efficacy, and an oral IL-23R inhibitor in the pipeline rounded out a forward-looking program.</p> <p><br></p> <p><em>Following these presentations, featured expert Diego Ruiz Dasilva, MD, FAAD, was interviewed by </em>Conference Reporter<em> Associate Editor-in-Chief Christopher Ontiveros, PhD. Clinical perspectives from Dr Dasilva are presented here.</em></p>

The SDPA 23rd Annual Fall Dermatology Conference is the largest, most comprehensive physician assistant meeting in terms of drawing from the best-of-the-best physician and advanced practice provider speakers who talk about key topics, from the things that we see every day (eg, plaque psoriasis, atopic dermatitis, vitiligo, acne, and other common conditions) to the more difficult and rare conditions (eg, cutaneous lymphoma, pediatric dermatologic conditions, skin manifestations of rheumatologic diseases, and connective tissue diseases). It is a very comprehensive meeting that highlights what is important. Beyond the academic learning, which is excellent, there is a lot of networking, sharing advancements, product theaters, and advisory board meetings.

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There was a good representation of plaque psoriasis at this year’s SDPA conference. For example, Kenneth Gordon, MD, and his colleague Shikha Singla, MD, presented on plaque psoriasis and psoriatic arthritis during their session. Some of the topics highlighted by Dr Gordon were cardiovascular comorbidities in plaque psoriasis, the abundance of effective systemic treatments for plaque psoriasis, and how we may try to choose a treatment that best fits a patient’s lifestyle. By that, I mean taking into account the frequency of injections if we are talking about an injectable medication, coverage for skin vs arthritis (or both), and considering the use of an oral medicine if that is what a patient is looking for. He also discussed available data on the effectiveness of various treatments.

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There was certainly a stronger emphasis this year at the SDPA 23rd Annual Fall Dermatology Conference on being aggressive with treatment for plaque psoriasis. None of us as clinicians like to be pushy and to make patients feel forced to take a treatment, but I think that Dr Gordon put a strong emphasis on saying that we should, in an ethical sense, let patients know that treating plaque psoriasis is very important because the condition is not only skin deep. We need to educate patients on how plaque psoriasis is an issue of systemic inflammation, which also makes plaque psoriasis–related education important for other conditions, including cardiovascular disease. We have known this for some time now, but the importance of understanding systemic inflammation beyond the skin is slowly coming to the forefront. This has led to an emphasis on treating patients earlier and more effectively.

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During the presentation that followed Dr Gordon’s, Dr Singla talked about screening for psoriatic arthritis by dermatology providers, including the importance of asking patients about swollen and tender joints, stiffness that improves with activity, joint discomfort that becomes worse with inactivity, and the alleviation of discomfort as they get moving throughout the day. These are characteristic hallmarks of psoriatic arthritis.

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Moreover, Dr Gordon and Dr Singla also spent a decent amount of time discussing radiographic progression because that is heavily discussed in the dermatology space. It is difficult to show radiographic progression because even patients who are very symptomatic may not progress radiographically. There are also patients who do have severe disease on radiograph but not clinically. So, essentially, the radiographic measure of progression is an imperfect measure.

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There were several poster presentations at the SDPA meeting on plaque psoriasis that were excellent. One by Kristina Callis Duffin, MD, MS, and colleagues looked at deucravacitinib for patients with moderate to severe scalp psoriasis. The 52-week data from the phase 3b/4 PSORIATYK SCALP trial showed excellent clearance and safety with deucravacitinib. Results from cohort B of the phase 3 VISIBLE study, which looked at guselkumab in individuals with moderate to severe scalp psoriasis across all skin tones, were also presented in a poster by Amy McMichael, MD, et al. These results showed excellent clearance and safety data in patients with a variety of skin tones who had moderate to severe scalp psoriasis, consistent with the efficacy and safety data for guselkumab that have been presented in plaque psoriasis. Finally, there was a poster by Jennifer Soung, MD, and colleagues presented at the SDPA 23rd Annual Fall Dermatology Conference on the ICONIC-LEAD trial of icotrokinra, which is an IL-23R inhibitor in a pill form that would be the first of its kind if approved by the US Food and Drug Administration (FDA). The phase 3 study showed excellent 52-week skin clearance rates for adults and adolescents with moderate to severe plaque psoriasis. This is exciting because no one was really talking about an oral anti–IL-23 formulation 2 years ago.