Michelle Bichchau Nguyen, MD, MBA, MPH, is an associate professor of dermatology at Tufts University School of Medicine and the director of Mohs Micrographic Surgery.


What Are the Biggest Drivers of Dissatisfaction in Dermatology? With Michelle Nguyen, MD, MBA, MPH

In a second interview segment recorded at the 

2026 American Academy of Dermatology (AAD) Annual Meeting

 in Denver, Michelle Bichchau Nguyen, MD, MBA, MPH, associate professor of dermatology at Tufts University School of Medicine and director of Mohs Micrographic Surgery, spoke with 

 about her practical guidance on the most common drivers of patient dissatisfaction in dermatology.

Specifically, Nguyen went into what early-career clinicians can do in order to build more meaningful, lasting connections with their patients. When asked to identify the single biggest driver of dissatisfaction in dermatology practices, Nguyen pointed directly to the challenge of high patient volume and the toll it can take on the quality of each of these encounters.

“[Just] the fact that you're sitting down and having a conversation instantly make patients feel like…it's worth it to wait three months to see you and paying the co-pays and all of that,” Nguyen expressed.

In a specialty where clinicians are routinely required to interact with large numbers of patients in relatively short windows of time, Nguyen pointed out, it becomes can be all the more critical to be intentional about making each these individuals feel heard and valued. Nguyen also described the physical act of sitting during a patient conversation, rather than standing at the door or typing at a workstation, as immediately making the clinician appear present and engaged.

Additionally, Nguyen reframed the time investment in rapport-building as a long-term strategic asset, as opposed to only a courtesy. Concerns left unaddressed in a single visit, she explained, tend to compound over time. This can make future encounters more difficult and the therapeutic relationship more fragile. Dermatology clinicians who invest upfront in building trust, she expressed, ultimately benefit from greater patient loyalty.

Turning to advice for early-career dermatologists specifically, Nguyen further highlighted an important dimension to her earlier guidance on listening: do not take negative feedback personally. Nguyen noted critical patient reviews can sting for clinicians, especially those who are newer. Rather than internalizing those situations as reflections of their worth as clinicians, Nguyen encouraged residents and junior physicians to mine each piece of criticism for a kernel of actionable truth.

Nguyen had no relevant financial disclosures of note.

Nguyen M. Ways to Improve Patient Experience with Surgery in Dermatology, With Michelle Nguyen, MD, MBA, MPH. HCPLive. March 27, 2026. 

https://www.hcplive.com/view/ways-improve-patient-experience-surgery-dermatology-michelle-nguyen-md-mba-mph

Gahona M, Prada SA, Chaparro D. Patient satisfaction as a quality indicator in dermatological care: cross-sectional study in two tertiary institutions with residency programs. An Bras Dermatol. 2025 Nov-Dec;100(6):501228. 

. Epub 2025 Nov 3. PMID: 41187473; PMCID: PMC12634491.

Videos

This interview at AAD 2026 highlights Nguyen's views on the biggest drivers of patient dissatisfaction in dermatology practice settings.

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Victoria Johnson joined MJH Life Sciences in 2020 and has written for NeurologyLive, CGTLive, and is now an assistant managing editor for HCPLive and RheumatologyLive. She doesn’t have enough time for her numerous hobbies. You can reach her at vjohnson@mjhlifesciences.com.

New 52-week data from a phase 3b trial of tildrakizumab (Sun Pharma, ILUMYA) in moderate-to-severe nail psoriasis, presented at the 

 held in Denver, Colorado, from March 27-31, show continued improvement in nail clearance and sustained response among early responders — extending results first reported at last year’s meeting.¹

The study (NCT03897075) is the first dedicated phase 3b trial of an IL-23 inhibitor in nail psoriasis, a manifestation affecting roughly 40–50% of patients with plaque psoriasis that remains among the most difficult-to-treat domains of the disease due to the slow growth rate of the nail plate and limited long-term clinical trial data.²

The multicenter, randomized, double-blind, placebo-controlled study enrolled 99 adults with moderate-to-severe plaque psoriasis and concurrent nail involvement, defined by a modified Nail Psoriasis Severity Index (mNAPSI) score of ≥20 and a ViSENPsO score of ≥3. Patients received tildrakizumab 100 mg or placebo; those originally randomized to placebo crossed over to tildrakizumab at week 28.¹

The primary endpoint of mNAPSI 75 response at week 28  was met, with 25.5% of tildrakizumab-treated patients achieving ≥75% improvement from baseline versus 4.5% in the placebo arm (

 = .003). Additionally, 29.4% of tildrakizumab-treated patients achieved a ViSENPsO score of 0 (normal) or 1 (minimal) with a ≥2-point decrease from baseline, compared to 4.2% with placebo (

Among 72 patients who completed the study through week 52, of which 40 were originally randomized to tildrakizumab and 32 originally to placebo, response rates in the continuous tildrakizumab arm continued to increase beyond week 28. The mNAPSI 75 response rate rose from 25.5% at week 28 to 41.2% at week 52, and 76.9% of week-28 mNAPSI 75 responders maintained that response at week 52.¹

A similar trajectory was observed for the ViSENPsO endpoint. The proportion achieving normal or near-normal nails increased from 29.4% at week 28 to 43.1% at week 52, with 60.0% of week-28 ViSENPsO responders sustaining that response at week 52.¹

The continued gains between weeks 28 and 52 are consistent with the biology of nail psoriasis treatment: fingernails take approximately 6 months to fully regenerate, meaning the full benefit of anti-inflammatory therapy on nail architecture emerges gradually and is often not captured at earlier timepoints.²

Investigator Paul Yamauchi, MD, PhD, President and Director of Dermatology, Dermatology Institute and Skin Care Center, and colleagues saw that safety through week 52 was consistent with tildrakizumab's established profile. Serious adverse events (AEs) occurred in 3 patients (5.9%) originally randomized to tildrakizumab. AEs of special interest were reported in 2 patients (3.9%) — 1 injection-related reaction and one case of pruritus. Missing data were imputed as nonresponse throughout.¹

Tildrakizumab selectively binds the p19 subunit of IL-23, suppressing downstream signaling through the Th17 axis that drives both cutaneous and nail manifestations of psoriasis. The drug is approved in the United States, Australia, Japan, and Europe (as ILUMETRI, marketed by Almirall) for moderate-to-severe plaque psoriasis. Sun Pharma also recently received Food and Drug Administration (FDA) acceptance of an sBLA for tildrakizumab in active PsA, with a PDUFA date of October 29, 2026, based on positive topline results from the INSPIRE-1 and INSPIRE-2 phase 3 trials.

Data from the AAD 2026 presentation represent the complete 52-week dataset for this nail psoriasis study. Full publication in a peer-reviewed journal is anticipated.

Yamauchi P, et al. Efficacy and safety of tildrakizumab in patients with moderate-to-severe psoriasis affecting the nails: a multicenter, randomized, double-blind, placebo-controlled phase 3b trial. Presented at: 2026 AAD Annual Meeting; March 27–31, 2026; Denver, CO. Poster #72762

Renert-Yuval Y, Guttman-Yassky E, et al. Nail psoriasis: an updated review of currently available systemic treatments. 

Articles

Tildrakizumab is US FDA-approved for treating adults with moderate-to-severe plaque psoriasis who are candidates for systemic therapy or phototherapy.

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The HCPLive plaque psoriasis page is a resource for medical news and expert insights on psoriasis. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for psoriatic disease, and more.

Tildrakizumab Sustains Nail Psoriasis Efficacy Through 52 Weeks in Phase 3b Extension Data

Ways to Improve Patient Experience with Surgery in Dermatology, With Michelle Nguyen, MD, MBA, MPH

Patient experiences with dermatology practices and, especially, with surgery often require clear communication as well as gentle guidance by clinicians seeking to improve patient satisfaction.

Michelle Bichchau Nguyen, MD, MBA, MPH, associate professor of dermatology at Tufts University School of Medicine and director of Mohs Micrographic Surgery, addressed this topic in her session presented at the 

 to speak on some of her tips for patient satisfaction improvements.

“[What] patient care even more than that is how they are treated before, during and after the visit,” Nguyen explained.

Nguyen's core message suggested surgical outcomes, while essential, are not necessarily what patients will remember the most. What matters more to them, she pointed out, is how they are treated at every stage of the encounter, suggesting the need for clear, step-by-step explanations of what a procedure involves.

Throughout her interview, Nguyen also made a strong case for the underappreciated role of staff in shaping the surgical experience. She noted the considerably increased time staff spend with patients compared to the time patients spend with physicians. She described empowering them to educate, comfort, and answer questions independently as a direct investment in the satisfaction of patients.

Nguyen was asked for a single distilled pearl from her talk for newer clinicians and she pointed to one piece of advice: ask and listen. Rather than leading with only information, Nguyen encouraged dermatology clinicians to first figure out what a patient is actually concerned about, then address those specific concerns rather than defaulting to a standard script.

For any additional information on these tips, view the full interview segment posted above. To learn more about sessions and new data presented at AAD, view the 

Queen D, Trager MH, Samie FH, et al. Patient Satisfaction of General Dermatology Providers: A Quantitative and Qualitative Analysis of 38,008 Online Reviews. JID Innov. 2021 Aug 19;1(4):100049. 

This interview at AAD 2026 highlights tips for clinicians in dermatology practices who want to improve patient communication and satisfaction.

Abdallah Geara, MD, is an Associate Professor of Clinical Medicine at the University of Pennsylvania.

Corey Cavanaugh, DO, is an academic nephrologist at the Cleveland Clinic. 

2 IgA Nephropathy Experts Explain Clues For Early Intervention and Diagnosis

Two experts in nephrology are emphasizing the importance of identifying early clinical signs of IgA nephropathy (IgAN), often described as a silent disease.

“Clinicians should pay close attention to hypertension—especially in younger patients—and microscopic hematuria, again particularly in younger individuals,” said Corey Cavanaugh, DO, an academic nephrologist at the Cleveland Clinic, in an interview with HCPLive. “This is largely a young person’s disease, and it can be easy to explain these findings away or attribute them to something other than IgA nephropathy, since they’re relatively nonspecific. That’s why it requires a high index of suspicion and an astute clinician, particularly among non-nephrologists. It can be very subtle.”

Since these early findings are often attributed to benign or transient causes, diagnosis can often wind up delayed. By the time a majority of patients are diagnosed with IgAN, 50% to 75% have already progressed to chronic kidney disease (CKD) stage 3. At this point, eGFR falls below 60 mL/min/1.73 m² and structural kidney damage becomes irreversible, underscoring a need for earlier intervention. 

IgAN’s symptoms can be clinically silent before they progress to worsened stages, including non-visible hematuria, proteinuria, impaired kidney function, or hypertension. In one recent analysis, approximately 60% of IgAN cases were detected incidentally through hematuria or proteinuria identified on routine urinalysis. As a result, clinicians must rely heavily on measurable markers to assess disease activity and progression risk, with proteinuria remaining one of the most important indicators of long-term outcomes.

“When it comes to prognostication, we have to integrate clinical markers—serum creatinine, proteinuria, and hypertension—with demographic factors, including age and ethnicity, as well as histologic markers,” said Abdallah Geara, MD, Associate Professor of Clinical Medicine at the University of Pennsylvania, in an interview with HCPLive. “Bringing these together allows us to create a risk assessment for each patient, which then guides the next step in treatment. As therapies continue to evolve, the treatment algorithm has changed quite a bit over the last few years and will likely keep evolving.”

As the IgAN treatment landscape is experiencing a therapeutic revolution, this approach to risk stratification is becoming increasingly important. With 5 recently approved agents across distinct mechanistic pathways, therapeutic options are no longer the primary limitation. Instead, the focus is shifting toward earlier identification and precise risk assessment to ensure these therapies are deployed at a stage when they can have the greatest impact.

Editor’s Note: Abdallah reports relevant disclosures with Amgen, GlaxoSmithKline, Novartis, and others. Cavanaugh reports relevant disclosures with Otsuka Pharmaceutical Co, Novartis Pharmaceutical Corporation, Travere Therapeutics, and Vera Therapeutics.

Stoneman S, Teh JW, O’Shaughnessy MM. IgA nephropathy in adults. 

. Published online January 26, 2026. doi:10.1001/jama.2025.25020

Kidney Disease: Improving Global Outcomes (KDIGO) Glomerular Diseases Work Group. KDIGO 2021 clinical practice guideline for the management of glomerular diseases. 

. 2021;100(4S):S1-S276. doi:10.1016/j.kint.2021.05.021

Corey Cavanaugh, DO, and Abdallah Geara, MD, separately share their perspectives on the clinical clues for IgAN diagnosis, including hypertension and microscopic hematuria.

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The HCPLive nephrology page is a resource for medical news and expert insights on kidney disease. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments in nephrology, and more.

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The HCPLive Berger disease page is a resource for medical news and expert insights on IgA nephropathy. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments in Berger disease, and more.

Strategic Alliance Partnership

Tim Smith joined the MJH Life Sciences team in 2022 and is currently an associate editor for HCPLive. He is also the executive producer of two podcasts: Skin of Color Savvy and The Medical Sisterhood. Previously, he was the producer of the Lungcast podcast. He graduated from UC Berkeley and worked in multimedia journalism as a staff writer prior to joining MJH. You can contact him at tsmith@mjhlifesciences.com.

New long-term findings from an ongoing open-label extension study assessing spesolimab-sbzo (Spevigo) in adults with 

These data, announced by LEO Pharma on March 27, may provide encouraging evidence suggesting this biologic drug can meaningfully diminish patients’ GPP flare burden over several years of use. The data were also commented on by trial investigator Arash Mostaghimi, MD, MPH, assistant professor of dermatology at Brigham & Women’s Hospital.

“Together these findings highlight the complementary roles of IV and SC [spesolimab] in the long-term management of GPP, supporting a treatment approach that helps address the full course of this chronic and unpredictable disease,” Mostaghimi said in a statement.

GPP is characterized as a systemic, neutrophilic inflammatory skin condition marked by recurring, unpredictable flares resulting from chronic underlying disease activity. The disease can lead to substantial management challenges among patients given its heterogeneous clinical course and the potential severity of its acute exacerbations.

The EFFISAYIL ON study is an open-label extension trial lasting 5 years and designed to look at the long-term efficacy, safety, and tolerability of subcutaneous (SC) spesolimab in individuals who had previously taken part in either the EFFISAYIL 1 or EFFISAYIL 2 pivotal studies. The preliminary data from this extension study suggests spesolimab may substantially curb patients’ flare frequency over time.

Before entering the EFFISAYIL clinical program, those involved reported a mean flare rate of 2.0 per year. With long-term SC spesolimab treatment, the figure dipped to a cumulative mean of .13 flares per year. Among the 118 individuals treated with at least 3 years of spesolimab, nearly 75% were found by Mostaghimi et al to have remained completely flare-free throughout the period.

For the subset of subjects who did report flares during EFFISAYIL ON, intravenous (IV) spesolimab appeared to provide effective rescue therapy. Of the 131 total enrolled patients, 21 (16.0%) required IV spesolimab to manage 36 discrete flare events.

 At the first week, half of treated flares were shown to have attained a GPP Physician Global Assessment (GPPGA) pustulation subscore of 0 (clear), increasing to 58.3% by the second week. A GPPGA total score of 0 or 1 (suggesting clear or almost clear skin) was achieved in 41.7% of flare treatments at the first week and 55.6% at the second.

Additionally, the release by LEO Pharma suggests spesolimab’s preliminary safety profile is broadly consistent with what has previously been established for spesolimab.

 Among those included in the SC arm, 4.2% were found to have discontinued the drug due to adverse events (AEs). Among those in the IV arm, serious AEs were noted in 36.6%, with treatment cessation being attributed to AEs occurring in 4.6%.

Overall, these findings on long-term spesolimab injections for GPP were part of LEO Pharma's broader presence at AAD 2026. The data encompassed 17 accepted abstracts spanning the company's dermatology portfolio and pipeline.

LEO Pharma Announces New Long-Term Data for SPEVIGO® (spesolimab-sbzo) Injection in Adults with Generalized Pustular Psoriasis at AAD 2026. LEO Pharma. March 27, 2026. 

https://www.businesswire.com/news/home/20260327527368/en/LEO-Pharma-Announces-New-Long-Term-Data-for-SPEVIGO-spesolimab-sbzo-Injection-in-Adults-with-Generalized-Pustular-Psoriasis-at-AAD-2026

Smith T. Subcutaneous Spesolimab Effective for Generalized Pustular Psoriasis Symptoms. HCPLive. March 18, 2025. Accessed March 27, 2026. 

https://www.hcplive.com/view/subcutaneous-spesolimab-effective-generalized-pustular-psoriasis-symptoms

These new data on spesolimab (Spevigo) in adults with generalized pustular psoriasis highlight long-term findings with the treatment.

EFFISAYIL ON: New Long-Term Data Released on Spesolimab Injection for GPP

Monica Kraft, MD, is Murray M. Rosenberg Professor of Medicine and System Chair for the Department of Medicine at Mount Sinai Health System and the Icahn School of Medicine at Mount Sinai.

Deep learning applied to routine ECGs identified COPD up to 15 months earlier, supporting earlier intervention and risk stratification strategies.


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AI-ECG Model Detects COPD Months Before Diagnosis, With Monica Kraft, MD

Andres Gelrud, MD, is a gastroenterologist at Baptist Health Miami Cancer Institute, part of Baptist Health South Florida

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Diagnosing and Managing Exocrine Pancreatic Insufficiency, With Andres Gelrud, MD

Patrick Campbell is the editorial director of HCPLive. Patrick has spent years spearheading coverage surrounding cardiometabolic health and rheumatic disease for MJH Life Sciences. Before joining MJH Life Sciences in 2019, he spent time as a beat reporter and/or multimedia specialist with the Pocono Record, Star News Group, and NJ Advance Media. He is the executive producer for multiple HCPLive podcasts, including Diabetes Dialogue, Don't Miss a Beat, Kidney Compass, Medical Ethics Unpacked, The Medical Sisterhood, and Skin of Color Savvy. 


Follow him on Twitter @RealPatCampbell or reach him via email at PCampbell@mjhlifesciences.com.

AstraZeneca's investigational IL-33–targeting antibody tozorakimab met its primary endpoint in both the phase III OBERON and TITANIA trials.

IL-33 Inhibitor Tozorakimab Cuts COPD Exacerbations in Phase 3 Trials

The FDA has approved a labeling update for 1 mg epinephrine nasal spray  permitting use in any patient weighing 33 lbs or more.

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FDA Removes Age Requirement for Epinephrine Nasal Spray, Now Based on Weight Alone

A post-hoc analysis of phase 3 trials found tapinarof cream 1%  produced skin clearance and itch relief as early as week 1 in patients aged 2 years and older.

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Tapinarof Cream Clears Skin, Eases Itch Within 1 Week in Kids as Young as 2 Years

Shared decision-making around initiating targeted therapy, key safety considerations for avapritinib, and core efficacy and safety findings from the 6‑month randomized phase of the PIONEER trial.

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Xiao Xiao, PhD, from the Behavioral and Cognitive Neuroscience Center at Fudan University.

Study shows microglia-driven hippocampal remodeling may connect chronic pain to depression, highlighting the importance of timing for behavioral interventions.


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Latest News

What Are the Biggest Drivers of Dissatisfaction in Dermatology? With Michelle Nguyen, MD, MBA, MPH

Tildrakizumab Sustains Nail Psoriasis Efficacy Through 52 Weeks in Phase 3b Extension Data

Ways to Improve Patient Experience with Surgery in Dermatology, With Michelle Nguyen, MD, MBA, MPH

2 IgA Nephropathy Experts Explain Clues For Early Intervention and Diagnosis

EFFISAYIL ON: New Long-Term Data Released on Spesolimab Injection for GPP