Clinical Pearls for Pediatric and Adult Dermatology–Omar Noor, MD

Omar Noor, MD, FAAD, kicked-off an enlightening presentation on pediatric and adult dermatology pearls Thursday with information on acne. Specifically, he outlined his thoughts and experiences related to using spironolactone in female patients. Additionally, he reviewed the approach to treatment for pregnant patients with acne including topical treatments, blue light, microdermabrasion, sulfur washes and masks. In the non-pregnant patient, Dr. Noor discussed helpful adjuncts for side effects when working with isotretinoin. He also reported using an increased dosage regimen of 200-250 mg/kg. Lastly, Dr. Noor encouraged participants to expand their differential diagnosis to include fungal acne and demodex folliculitis when patients do not respond to traditional treatments for acne.

Coverage: SDPA Annual Summer Dermatology Conference, June 22-25, 2023 – BOSTON

Next, hidradenitis suppurativa (HS) was featured. It is important to identify and diagnose HS in patients early in their disease to minimize scarring. Furthermore, it is essential to evaluate scarred areas on patients with HS for any evolution of squamous cell cancer lesions.  At this time, adalimumab is the only FDA approved biologic treatment for HS, but more options are in development. Further treatment regimens of HS include decolonizing, weight control and smoking cessation were reviewed.

The use of JAK inhibitors in dermatology was reviewed by Dr. Noor. He reports that he typically avoids the use of JAK inhibitors in patients who smoke and recommends checking triglyceride levels in all patients. While Dr. Noor has not personally seen the development of rhabdomyolysis in his patients who are taking JAK inhibitors, it is important to consider this with any new onset muscle pain or change in urine in this patient population.

Dr. Noor concluded his talk by focusing on how to be efficient educators in the clinical setting. He encouraged attendees to be lifelong learners and to share knowledge with colleagues.

When approaching patient education, he recommended providers utilize handouts. He said he believes less is more when it comes to facial regimens and that educating patients on how to properly apply their topical medications is an important educational piece often overlooked by providers. For example, patients might benefit from discussing approaches to topical application, such as using gloves, finger cots or saran wrap. Dr. Noor revealed that he likes to have a stool in every room so he can “sit” with every patient. Lastly, he said a biopsy can “go a long way in making the patient better” and may also serve as risk reduction for the provider.

By Sarah B.W. Patton, PA-C

Pictured: Omar Noor, MD, FAAD