One disease.
From the Editor
Dr. Schwarzenberger is the former physician editor of DermWorld.
By Kathryn Schwarzenberger, MD, FAAD, July 1, 2025
If you had a magic wand and could cure one disease, what would you pick? Over the years, caring for patients with hidradenitis suppurativa (HS) has made me wish for that magic wand that could alleviate the suffering so many of my patients with this potentially painful and debilitating disease experience. When I first started my practice, we relied heavily on tetracycline antibiotics and intralesional corticosteroid injections and for many years, we saw nothing else rise up to help us in our fight. I am so grateful that the newer generation of clinical researchers and physician scientists have taken up the fight and we now have a growing armamentarium of treatment options for HS, including several biologics, with other agents being actively studied for safety and efficacy. We better understand the benefit of surgical intervention for some cases. We still have work to do to fully understand the pathogenesis of this debilitating condition, but it is encouraging to now have something to offer our patients that might actually decrease inflammation and hopefully slow disease progression. I predict that we will learn to treat this condition more aggressively from the start and hopefully, just hopefully, no future dermatologists, or patients, will need a magic wand to manage HS.
Magic would also be helpful when you have a great idea that you wish you could turn into a marketable product. Becoming a physician entrepreneur requires a skill set that most of us did not receive during our many years of dermatology training. Having a brilliant idea is only the first step; turning that concept into reality is a complex process requiring building a team, securing funding, and navigating potentially complex regulatory and legal issues. Despite these challenges, some of our colleagues have succeeded in making the leap into the entrepreneurial world and they have graciously shared their experiences with us this month in DermWorld. If you ever dreamed of making a similar leap, I’m sure you will enjoy their stories and, who knows, maybe they will inspire you!
Recent regulatory activity in several states has brought the discussion of chaperones to the forefront. My home state of Oregon now mandates that practices offer a trained chaperone for all examinations of sensitive areas, which include breasts, genitals, and perianal skin. Several other states have or are considering enacting similar regulations. Reactions among dermatologists to these mandates are mixed; while we all want patients to feel comfortable and safe during exams, not all agree that mandated chaperones uniformly accomplish this. The addition of chaperones can add an additional financial burden to practices, and having another individual in the exam room can change the feel and flow of the practice. However, both patients and physicians may benefit from the presence of an additional witness should either party make allegations of wrongdoing. Regardless of how you feel, chaperones appear to be here to stay.
One of the most enduringly popular columns in DermWorld is our Derm Coding Consult. I’ve been practicing for over 30 years now, and I still learn new things about coding all the time. I offer my appreciation to the Academy’s Senior Manager of Coding and Reimbursement Faith McNicholas for the valuable information she and the coding staff put together in their insightful and educational columns. Dermatologists work incredibly hard, and we want everyone to get paid for the work they do.
I wish everyone a happy Fourth of July and hope to see you at the upcoming Innovation Academy. Regardless of which baseball team you root for, Chicago is a wonderful town to enjoy a summer evening!
