Resistance is futile.
From the Editor
Dr. Schwarzenberger is the former physician editor of DermWorld.
By Kathryn Schwarzenberger, MD, FAAD, June 1, 2024
Perhaps, if one is fighting the Borg. (If you don’t understand the reference, my apologies, but you are truly missing out.) Hopefully, we still have a chance to fight what is, unfortunately, a growing resistance to antifungal therapies. For years, many of us associated antimicrobial resistance with bacteria, and certainly this remains a concern that should guide us to use antibiotics both wisely and judiciously. I like to think that our collective interest in avoiding antibiotics has pushed us to find better treatments for skin diseases in which antibiotics have long played a key role, particularly acne vulgaris. Certainly, there is more awareness now than there was in the dark ages when I trained. However, the possibility that antifungal agents could also develop resistance was not often voiced as a concern until more recently. Antifungal resistance is proving to be a significant clinical problem, with resistant Candida species causing a substantial number of hospital-related illnesses and sadly, even deaths. Closer to home, dermatologists are encountering treatment-resistant dermatophyte infections, which might be suspected in some by their clinical severity, but in other cases recognized only when they fail to respond to our usual treatments. You may have already encountered these, but if not, will almost certainly do so in the future. Hopefully, our feature article “Fighting fungi” will help arm you for this inevitability. It has certainly made me think about steps I might be able to take to be a better steward of our antifungal agents!
Since when do authors have to pay to publish? And can you trust an article if the authors paid to have it published? All good questions for which we have some answers this month in our feature article “Information freeway.” Contributing writer Andrea Niermeier explores the changes that have happened over the past few decades that have resulted in an explosion of new journals, many of which are online and open access. The rise of the internet, digital publishing companies, and social and political decisions to ensure that information is accessible to all are among the driving forces and, in 2024, authors in many settings will be asked to pay to publish. As with many paradigm changes, there are both potentially good — and less good — consequences that may result and I hope you will enjoy reading about them as much as I did.
What else is hot? Our Editorial Advisory Workgroup stays on top of some remarkably interesting topics this month, and I thank several of our Mayo Clinic colleagues for helping us better understand allergic contact dermatitis to botanicals. “Natural” is not always better (but we already knew that…after all, poison ivy is completely natural!).
The federal PHE (Public Health Emergency) for COVID-19 officially ended just over a year ago. I never thought I would be comfortable in public again without a mask, yet here I am, about to board a plane with no mask in my backpack. I am not sure if this speaks to human resilience or plain stupidity, but the post-COVID stress disorder (PCSD) for most of us seems to be fading. Changes made during COVID might still impact your practice, and there are ongoing regulatory changes that you should be aware of, which we cover this month in our final feature. Hopefully, they will help soon make COVID a distant memory and perhaps give you some thoughts about future advocacy topics for our organization! Come join your colleagues and the Academy leadership at the 2024 Legislative Conference in Washington, D.C., Sept. 8-10! We need your voice!
