American Academy of Dermatology, March 7 to 11

The annual meeting of the American Academy of Dermatology was held from March 7 to 11 in Orlando, Florida, and attracted clinicians, academicians, allied health professionals, and others interested in dermatology. The conference highlighted recent advances in the diagnosis and management of dermatological conditions.

During one presentation, Joshua Cook, M.D., of the Columbia University Irving Medical Center in New York City, noted that targeting insulin resistance and hyperinsulinemia is important not only for the treatment of obesity and diabetes, but potentially also independently for improving metabolism-related inflammatory skin diseases like psoriasis and hidradenitis suppurativa.

Cook discussed the tight epidemiologic connection between obesity, type 2 diabetes, and inflammatory skin diseases, especially psoriasis. The mechanistic basis of this connection is likely due to insulin resistance and/or hyperinsulinemia. Cook noted that hyperinsulinemia likely drives excessive proliferation and inflammation of skin lesions in psoriasis and other inflammatory skin diseases, even in the setting of systemic insulin resistance.

“We are currently performing clinical studies to better understand the role of insulin action in psoriasis,” Cook said. “Health care providers should strongly consider screening patients with overweight/obesity and inflammatory skin diseases with hemoglobin A1c, fasting glucose, and lipid profiles. Treatment of obesity and type 2 diabetes with glucagon-like peptide-1 receptor agonists may improve inflammatory skin disease activity (an area of active research). There may also be roles for metformin and pioglitazone in inflammatory skin disease treatment in select patients.”

Abstract

During another presentation, Daniel Charles Butler, M.D., of the University of Arizona College of Medicine in Tucson, discussed the connection between itch and aging.

Butler discussed how itch is very common in the older adult population. He noted there are many etiologic contributors to itch, including the immune system, the skin barrier, and the cutaneous nerves, all of which are uniquely impacted by aging.

“As practicing clinicians, we need to substantiate itch as a real, impactful but targetable symptom and disease,” Butler said. “The connection between age and itching allows us to target contributing etiologies with available treatments. For example, itch in older adults is often multifactorial with immunologic changes and neuropathic changes. This allows us to use treatment to target multiple contributors.”

Butler disclosed financial ties to the pharmaceutical industry.

Abstract