Expert Interviews

Richard Rosenfeld, MD, MPH, MBA, lead author of new guidelines on sustained lifestyle change as central to treating, even reversing T2D, answers the question.

Monu Khanna, MD, discusses common medications, non-drug strategies, and holistic approaches to improve outcomes.

Richard Rosenfeld, MD, MPH, MBA, explains how clinical guidelines for diabetes remission from the American College of Lifestyle Medicine differ from and augment existing recommendations.

Dr Khanna discusses dosing challenges, metabolic issues, and potential complications from medications like acetaminophen.

Caissa Troutman, MD, discusses how clinicians can tailor management plans to reduce risk of developing T2D in patients with obesity.

A panelist emphasizes that shared decision-making in anaphylaxis management is essential, combining evidence-based guidelines with individual patient circumstances and preferences—especially regarding newer options like intranasal epinephrine—to ensure timely, confident use while addressing practical concerns, such as access, cost, and education.

A panelist highlights how neffy, a needle-free, portable intranasal epinephrine device, addresses key unmet needs by reducing needle anxiety, enabling easy use by nonmedical caregivers, offering longer shelf life and temperature stability, and improving timely administration to prevent severe anaphylaxis outcomes, as demonstrated in clinical case examples.

A panelist discusses that the intranasal epinephrine device causes only mild, expected adverse effects such as nasal discomfort and headache, avoids injection-related risks, demonstrates rapid symptom improvement in pediatric food challenge studies, and offers practical advantages such as higher heat tolerance for storage and a longer shelf life compared with traditional autoinjectors.

A panelist discusses a newly approved intranasal epinephrine device for treating anaphylaxis in both children and adults, highlighting its needle-free delivery using a nasal spray with an absorption enhancer that ensures effective, safe drug uptake comparable to injections—even under nasal congestion—offering a promising alternative to traditional epinephrine autoinjectors.

A panelist discusses how intranasal epinephrine represents a significant advance over traditional autoinjectors by eliminating needles, addressing user anxiety and real-world barriers, and potentially improving adherence and timely treatment in anaphylaxis emergencies.

A panelist discusses how barriers such as cost, fear of injections, and lack of confidence delay epinephrine use in anaphylaxis and explains how intranasal delivery and updated guidelines may reduce hesitation and improve timely, effective treatment through better education and accessibility.

A panelist discusses the critical importance of early epinephrine administration in anaphylaxis for preventing severe outcomes, explaining its multireceptor action and lifesaving potential, while highlighting how intranasal delivery could enhance timely use and empower caregivers with faster, more accessible treatment options.

A panelist discusses how intranasal epinephrine could transform anaphylaxis management by improving accessibility, reducing treatment delays, and addressing underuse of epinephrine—especially in pediatric and high-risk populations—while emphasizing the need for better education and more user-friendly interventions to improve outcomes.

Panelists discuss billing and coding procedures for skin scanning devices, focusing on the use of unlisted Current Procedural Terminology (CPT) 99 codes with proper documentation and modifiers, the importance of clear communication with billing teams, available educational resources to aid primary care settings, and operational considerations including scope-of-practice variations for device use among clinical staff.

Panelists discuss an interactive case session emphasizing the nuanced evaluation of suspicious skin lesions, highlighting tools such as the DermaSensor for risk scoring, the ugly duckling concept, and the importance of combining clinical judgment with technology to guide biopsy decisions and patient follow-up across diverse skin types.

Panelists discuss that decisions to forgo biopsy often weigh patient risk and lesion characteristics with noninvasive tools offering valuable reassurance; while familiarity with artificial intelligence (AI) aids varies, these technologies—used judiciously and alongside clinical expertise—can boost diagnostic confidence, though limitations and integration challenges remain.

Panelists discuss that successful adoption of artificial intelligence (AI) skin cancer detection tools requires proven effectiveness, easy integration into clinical workflows, appropriate reimbursement, and use as supportive aids that complement—not replace—clinical judgment.

Panelists discuss how visual examination remains the primary method for evaluating suspicious skin lesions in everyday practice, emphasizing clinical judgment, patient-reported changes, and the growing—but still limited—role of artificial intelligence (AI) tools, while underscoring the importance of vigilance, especially in high-risk and underserved populations with limited access to dermatology.

Panelists discuss the challenges of skin cancer evaluations, highlighting patient fears, systemic access barriers, and provider concerns about overreferral, while emphasizing the importance of clear communication, responsible resource use, and cautious adoption of emerging tools such as artificial intelligence (AI), with clinical judgment and trusted educational resources remaining central to care.

Panelists discuss the anxieties primary care providers face in skin cancer evaluation—particularly the fear of missing a malignancy—while highlighting challenges such as limited diagnostic confidence, delayed dermatology access, and disparities in underserved areas, emphasizing the need for better tools and support to empower frontline clinicians and improve early detection.

CD388, an investigational nonvaccine antiviral, demonstrated efficacy up to 76% against influenza in a cohort of more than 5000 healthy, unvaccinated adults.

Panelists discuss the vital role of primary care providers in early skin cancer detection, highlighting the need for improved diagnostic confidence, integration of artificial intelligence (AI) tools, and efficient workflows to overcome time and resource constraints, ultimately aiming to reduce delays and improve patient outcomes.

Atopic dermatitis is not just "another rash on the schedule. It could be the reason that patient doesn't leave the house," Shahriari says.

RAD 2025: Multidisciplinary collaboration at disease-specific meetings drives clinical and therapeutic progress in AD, Dr Yu told Patient Care.

Dermatologists aren't trained in mental health but once in practice they need to have a deep appreciation for the emotional impact of diseases like AD and a low bar for mental health referral.

At RAD 2025, Dr Yu shared hopes for more real-world data and targeted treatment approaches for chronic hand eczema.

RAD 2025: Yale dermatologist Mona Shahriari, MD, urged primary care clinicians to refer patients with AD who don't improve to prevent cumulative emotional burden.

RAD 2025: Expert insights on the psychosocial burden of AD, flexible dosing, and cross-specialty collaboration in pediatric care.

RAD 2025: Johann Gudjonsson, MD, PhD, on investigational AD treatments, including anti–IL-31 receptor antibodies, anti–IL-13 treatments, IL-4 receptor blockers, JAK inhibitors, and new topical agents.

RAD 2025: Brad Glick, DO, MPH, discusses the intensity of TSW symptoms and cautions against assuming there is mental health disturbance at work.