2021
From the Editor
Dr. Schwarzenberger is the former physician editor of DermWorld.
By Kathryn Schwarzenberger, MD, FAAD, December 1, 2021
Another year done. It probably wasn’t the year we had all hoped for, as we failed to tame the COVID beast, but we have seen progress with rising vaccination rates and, most recently, gaining the ability to vaccinate our children. Hopefully, this will be a huge step forward toward getting our children safely and consistently back into schools and onto the playgrounds, where they belong.
Any of you who see children have almost certainly encountered difficulties getting treatment coverage for some of our most challenging and impactful dermatologic diseases, including severe acne, vitiligo, and alopecia areata. In a previous edition of DermWorld, we discussed challenges involved in doing research on pediatric patients; for many years, research in children was considered unethical, until we realized that the failure to do research to establish safety of medication use in children was leading to more harm than good. Without research, we are left “flying blind,” well-intended, but with risk of bad consequences. Now we do research trials in children, but for many of our conditions, we still do not have FDA-approved treatments available. The consequences of this are significant. Some dermatologists are nervous about using off-label treatments in children. There are potential ethical concerns about doing so, and those who hold the purse strings, including private and government insurers often use the lack of FDA approval as an excuse to deny treatment. Children are disproportionally covered by Medicaid, which is chronically underfunded, and both access to care from dermatologists, as well as available treatments from state Medicaid formularies is often limited. So how do we ensure that our children get the equitable and available care that they deserve? We have some ideas, as well as some stories from some of our dermatologists on the front lines who are fighting for our kids. My heartfelt thanks go to them and all our pediatric dermatology colleagues for the work they are doing!
One of the harder things about getting older is knowing more and more people on the list of those we have lost. As I write this, I am heading on a plane to say goodbye to a dear friend, whose presence so positively impacted many of us during our training and careers. We lost several women in the past few months who were pioneers in the Women’s Dermatologic Society. I wish I could tell them how much their kindness and mentorship meant to those of us just starting out in our careers many years ago.
I love to end stories on a positive note, and this month, I found my inspiration on the last page. You have previously read my comments touting the work of our colleagues in the Climate Change and Environmental Issues Expert Resource Group who have done so much to help educate us, and others, about the potential impact of climate change to ourselves and our patients. I was blown away to read that an overwhelming majority of our colleagues believe climate change is a concern and that we, as dermatologists, should advocate for climate change-related health issues. The mandate seems clear, and I look forward to hearing more about what AAD leadership and the Board of Directors plan to do in support of this over the next few years. On a personal note, my concerns about climate change have pushed an electric vehicle to the top of my Christmas wish list. I can only hope Santa finds a stocking big enough to hold it!
My best to all of you at the end of this year. Be well.
