Breakfast Symposium 2: Dermatological Conditions of the Foot and Ankle—2017 Update
Friday, July 28
Skin conditions on the lower extremities often are linked to systemic issues that also can present on the upper body. Podiatric physicians need to know the causes of these issues and the latest treatments available.
Stephen M. Schleicher, MD, will explore a range of dermatologic conditions and treatments during “Dermatological Conditions of the Foot and Ankle: 2017 Update.” Dr. Schleicher, of DermDOX Dermatology Center, Hazleton, PA, will discuss atopic dermatitis/eczema, psoriasis, psoriatic arthritis, abscesses, and stasis dermatitis, as well as some game-changing new treatments.
Also during the session, Tracey Vlahovic, DPM, will examine inflammatory skin conditions and the treatment of plantar warts.
The major advance in atopic dermatitis/eczema is the availability of two non-steroidal treatments. Dupilumab is an injectable that was approved by the FDA earlier this year. Crisaborole is a topical agent approved in 2016.
“Dupilumab is for individuals with moderate to severe eczema,” Dr. Schleicher said. “It is a revolution in the field of treatments for this condition. It is a biologic that alters some of the inflammatory factors associated with eczema, and those factors also can produce or cause eczema.
“Some individuals are concerned about prolonged steroid use on certain body parts, so crisaboroleis an alternative to treat eczema.”
Psoriasis can affect not only the skin, but the nails and joints, so it should be of interest to podiatrists, Dr. Schleicher said. Psoriatic arthritis affects 15–20 percent of people who have psoriasis.
“I will bring everyone up to date regarding treatments for psoriasis. There are new biologics that are being used. There is a new class of medications—IL-17 inhibitors,” he said. The new IL-17 inhibitors include secukinumab, ixekizumab, and brodalumab, which was recently approved by the FDA.
The presenters also will discuss the use of antibiotics to foster healing when draining abscesses, the misdiagnosis of stasis dermatitis as cellulitis, and signs of Lichen planus beyond the lower extremities.
“One of the things that is commonly encountered in all facets of medicine is misdiagnosis. A lot of misdiagnoses have to do with lack of training. If you are not exposed to these conditions, you are not going to have them pop into your head when you encounter one,” Dr. Schleicher said.
In contrast to Dr. Schleicher’s emphasis on systemic treatments, Dr. Vlahovic will examine the treatment of skin conditions using topical medications, as well as the treatment of plantar warts.
“With inflammatory skin conditions, I like to choose non-steroidal anti-inflammatory topical agents if the patient has already used topical corticosteroids,” Dr. Vlahovic said of her treatment preference.
In her review of the latest research on the treatment of plantar warts, Dr. Vlahovic will examine whether the human papillomavirus (HPV) genotype makes a difference when choosing a treatment plan. She also will compare the effectiveness of cantharone versus a YAG laser, and the use of immunotherapy injections.