Noreen Galaria, MD, is a board-certified and fellowship-trained dermatologist based in the Washington, D.C. area with over 20 years of experience. She is the founder of Inner Glow Vitamins and practices at Galaria Plastic Surgery & Dermatology.

Discussing Challenges of Work in Dermatology Today, With Noreen Galaria, MD

 podcast, Noreen Galaria, MD, a board-certified dermatologist and the founder of Inner Glow Vitamins, and private practice clinician, discussed the growing impact of misinformation in dermatology and how it is shaping patient interactions in clinical practice.

Galaria emphasized that one of the most pressing challenges today is the influence of social media, where patients often arrive more informed, but not necessarily accurately informed, about their skin health. While some individuals present with helpful baseline knowledge, others may have encountered misleading or even harmful content online, requiring clinicians to actively guide them.

Galaria highlighted that dermatology is particularly susceptible to misinformation due to the highly individualized nature of skin care. Unlike other areas of medicine where treatment approaches may be more standardized, dermatologic care varies widely based on factors such as skin type, tone, and environmental exposure.

As a result, widely shared recommendations or trending products may not translate effectively or safelyacross different patients. She noted that part of her role now involves helping patients distinguish between what is trending and what is scientifically supported, while reinforcing that treatment plans must be tailored to the individual. This challenge is especially evident in areas such as sunscreen use, where misinformation has led some patients to question or avoid well-established preventive measures.

Beyond misinformation, Galaria also elaborated on her clinical interest in supplementation and internal approaches to skin health, particularly in the context of photoprotection. She described how her experience practicing in Utah, where rates of skin cancer are among the highest in the US prompted her to explore additional preventive strategies for patients who were already adhering to standard recommendations such as sunscreen and protective clothing but continued to develop skin cancers. This led her to investigate oral antioxidants, including polypodium leucotomos, as adjunctive measures to support skin protection from within.

Galaria detailed her work in developing antioxidant-based supplements designed to complement traditional photoprotection strategies, emphasizing the importance of rigorous research and formulation to ensure clinical efficacy. She also highlighted emerging data on supplementation for pigmentary disorders such as melasma, noting that adjunctive use of targeted antioxidant formulations may enhance treatment outcomes when combined with conventional therapies.

Overall, this segment underscored both the challenges and opportunities facing modern dermatology, with Galaria emphasizing the need for clinicians to navigate misinformation while embracing evolving, evidence-based approaches that integrate topical and internal strategies to optimize patient care.

Editor’s note: This segment was summarized with the help of AI tools.

Videos

This segment of the latest episode of the Skin of Color Savvy podcast highlights key challenges faced by Galaria in her dermatology practice.

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Nonstatin Prescriptions Increasing, Still Behind Statins in ASCVD, With Michael Blaha, MD, MPH

prescription has expanded substantially among patients at risk for 

atherosclerotic cardiovascular disease (ASCVD)

, according to a recent study; however, it still has not closed the gap with statins.

A plethora of recent research has reinforced the efficacy of nonstatin LLTs in the reduction of ASCVD risk, and several therapies have received approval to lower LDL-C and other atherogenic lipoproteins. Among these are ezetimibe, bile acid sequestrants, PCSK9 inhibitors, bempedoic acid, fibrates, icosapent ethyl, and niacin. Additionally, recently published guidelines have recommended the addition of nonstatin LLTs when statin therapies are insufficient. However, implementation has lagged behind that of statins over the years.

“In some cases, clinicians think of statins as a simple yes or no,” Michael Blaha, MD, MPH, professor of cardiology and epidemiology, director of clinical research for the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, and co-author of the present study, told 

. “Of course, the new guidelines are really going to push people to think more about LDL goals. Statins will remain the cornerstone of therapy, but maybe only step 1. Maybe you need step 2 or step 3 after that, with the addition of nonstatin therapy and, of course, more appreciation of statin intolerance and how best to handle that."

This cross-sectional study utilized IQVIA’s National Prescription Audit, which collects data from January 2019 to December 2024. Bhala and colleagues quantified dispensed prescriptions for ezetimibe, bempedoic acid, and the fixed-dose combination of bempedoic acid and ezetimibe, as well as alirocumab, icosapent ethyl, and evolocumab. Older nonstatins without recent cardiovascular outcome data were excluded.

Investigators recorded roughly 94.8 million nonstatin and 1.35 billion statin prescriptions dispensed between 2019 and 2024. Annual nonstatin prescriptions rose by roughly 10.7 million (10.9 to 21.6 million), while statin prescriptions increased by roughly 18.2 million (217.3 to 235.5 million). Additionally, the ratio of nonstatin to statin prescriptions rose from 1:20 in 2019 to 1:11 in 2024. Blaha and colleagues also grouped prescribers as cardiology, endocrinology, primary care physicians (PCPs), advanced practice practitioners (APPs), and others. The team used American Medical Association Physician Masterfile counts to estimate prescriptions per active clinician for a specialty-specific comparison.

Of the included nonstatin therapies, ezetimibe was the dominant therapy throughout the study period, reaching about 15.3 million prescriptions annually and accounting for roughly 2/3 of all nonstatin prescriptions. Bempedoic acid likewise rose from 39,600 prescriptions in 2020 to 395,202 in 2024; however, overall volume was consistently lower than other therapies. Evolocumab prescriptions rose from 757,000 in 2019 to 3.56 million in 2024 (absolute increase roughly 2.81 million). Alirocumab prescription volumes rose through 2023, but decreased again in 2024; similarly, icosapent ethyl rose from 2019 to 2022 before declining through 2024.

After normalization per 100 clinicians, cardiologists exhibited the highest prescribing intensity for all nonstatin therapies. In 2024, cardiologists wrote roughly 98 ezetimibe prescriptions per 100 clinicians, versus 21 per 100 among PCPs. For evolocumab, cardiologists covered 48 prescriptions per 100 clinicians, compared to roughly 2-3 per 100 among PCPs and APPs.

According to Blaha and colleagues, these prescription trends align with recent guideline emphasis on combination LDL-C-lowering strategies, as well as rapidly accumulating evidence for ezetimibe, PCSK9 inhibitors, and bempedoic acid. However, the team also noted that nonstatins continue to represent only a small share of overall LLT use.

“I think the education gap is closed – really, it’s more of an implementation gap now. Sometimes, that’s resistance from the patient, or statin intolerance, or similar things,” Blaha said. “I think the next step is with the patients who are unwilling to take a statin, or unable to take a statin, or unable to take a maximal dose of a statin. How can we implement nonstatin therapies in an evidence-based way?”

Editors’ Note: Blaha reports disclosures with Bayer, Boehringer Ingelheim, Eli Lilly, Genentech, Merck & Co., Novartis, and others.

Burka S, Dzaye O, Cao T, et al. US trends in prescribing nonstatin lipid-lowering therapy, 2019-2024. 

Kamanu C, Karalis DG. The Role of Non-Statin Lipid Lowering Therapies to Reduce ASCVD Events in Primary Prevention. 

Blaha discusses his study analyzing nonstatin prescriptions from 2019-2024, highlighting the need for further clinical implementation of modern guidelines.

Cardiology

Cardiology condition center page is a comprehensive resource for clinical news and insights on cardiovascular and cardiometabolic diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for heart disease and cardiovascular events, as well as associated diabetes, renal failure, and more...

Dyslipidemia

Atherosclerotic Cardiovascular Disease

Laurie Keefer, PhD, is a clinical health psychologist and professor of medicine at Icahn School of Medicine at Mount Sinai.

Risankizumab’s 1 Year Improvement in HRQL and Wellbeing For Crohn’s Disease

1-year results from ASPIRE-CD suggest risankizumab (Skyrizi) may improve general well-being and health-related quality of life (HRQL) in adults with moderately to severely active 

 2026, including improvements in sexual health, work productivity, daily activity levels, life enjoyment, and treatment satisfaction 1 year after patients started taking risankizumab.

HRQoL, Treatment Satisfaction With Risakizumab in ASPIRE-CD, With Laurie Keefer, PhD


Addressing An Unmet Need in Crohn’s Disease With ASPIRE-CD

ASPIRE-CD is an ongoing, observational, prospective, longitudinal patient survey study evaluating real-world experiences of adults with moderately to severely active CD who are treated with risankizumab in clinical practice, with investigators citing the importance of these patient-centered outcomes.

“To rigorously measure fatigue, extra-intestinal manifestations, and the impact on sexual function was the first time that we were able to look at and ask about that. The fact that it was even measured systematically, proactively as part of the study, was a huge addition,” said study investigator and abstract presenter Laurie Keefer, PhD, a clinical health psychologist and professor of medicine, psychiatry, and biomedical sciences at the Icahn School of Medicine at Mount Sinai, in an interview with 

. “Often, those symptoms are pushed aside as not super important, or they're an afterthought.”

Before initiating risankizumab intravenously and after 52 weeks, APIRE-CD participants completed surveys addressing life enjoyment, the negative impact of CD on sexual interest/activity, and satisfaction with treatment, which were evaluated using a 4-week recall and Likert scales. Additional data collection included the Short Form (SF)-12 version 2 Health Survey and the Work Productivity and Activity Impairment Questionnaire: CD (WPAI: CD).

ASPIRE-CD included 286 patients, of which 74.5% completed the Week 52 survey (n = 213), and 86.4% remained on risankizumab (n = 184). The trial population was 57.0% female, had a mean age of 45 years, 90.2% were White, and 75.2% were biologic- or Janus kinase inhibitor-experienced.

At Week 52, 77.0% of patients reported improvement in life enjoyment since starting risankizumab:

Among patients indicating sexual interest/activity, the proportion who reported being at least somewhat satisfied with their sex life increased from 35.5% at baseline to 51.5% at Week 52 (

< .001). The proportion of patients reporting that CD had no negative impact on their sexual interest/activity increased from 31.6% to 51.2% (

Overall satisfaction with CD treatments improved from 50.0% at baseline

Investigators noted an increase to 86.9% among all survey completions:

Including a 92.4% among patients remaining on risankizumab at Week 52:

“When we push patients to take medications, they want you to set expectations. How long will it take for me to feel better? What should I be looking for? And with fatigue and pain, a little bit of relief early on can go a long way for patient optimism, hope for the future, and a sense of confidence about being able to manage it,” Keefer said. “That conversation, the shared decision making that goes on by being able to say 2 weeks, you know, might not be a perfect outcome, but you're going to start to feel better, is gold for patients.”

Investigators also observed significant improvements in the physical component summary of the SF-12v2 with a baseline of 46.2 [9.40] compared to a Week 52: 49.8 [9.4] (

<.001) and all domains of the WPAI through Week 52.

Editor’s Note: Keefer reports relevant disclosures with Ardelyx, Trellus Health, Fzata, AbbVie, and others.

Lauren Keefer. RISANKIZUMAB IMPROVES HEALTH-RELATED QUALITY OF LIFE IN ADULTS WITH CROHN'S DISEASE: YEAR 1 RESULTS FROM THE ASPIRE-CD STUDY. Poster presented at: Digestive Disease Week; May 2-5, 2026; Chicago, IL.

Keefer L. HRQoL, Treatment Satisfaction With Risakizumab in ASPIRE-CD, With Laurie Keefer, PhD. HCPLive. Published October 29, 2025. Accessed May 5, 2026. 

https://www.hcplive.com/view/hrqol-treatment-satisfaction-with-risakizumab-aspire-cd-with-laurie-keefer-phd

1-year results from ASPIRE-CD suggest risankizumab (Skyrizi) improves HRQL, well-being, and treatment satisfaction in adults with Crohn's Disease.

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Risankizumab’s 1 Year Crohn's Disease Improvement in HRQL and Wellbeing in ASPIRE-CD

Physician and CEO, Chicago Allergy Center, and board director at American Lung Association

World Asthma Day 2026: Uncontrolled Disease and Racial Disparities Demand Structural Solutions, With Juanita Mora, MD

 affects an estimated 27 to 30 million Americans — with a substantial proportion remaining inadequately controlled despite available therapies — World Asthma Day 2026 offers an opportunity to reckon with the structural and systemic forces that are keeping effective treatment out of reach for the patients who need it most, according to Juanita Mora, MD.

Mora, an allergist-immunologist at Chicago Allergy Center and attending physician at Advocate Illinois Masonic Medical Center in Chicago, Illinois, emphasized that uncontrolled asthma in the United States is not primarily a treatment gap but an access and equity gap. The most striking illustration of that inequity is the racial disparity in asthma mortality: according to federal surveillance data, Black American adults are more than twice as likely to die from asthma compared with US adults overall, and Black American children are approximately 3 to 4 times more likely to die from asthma than their white peers — disparities that persist despite decades of therapeutic advances and that Mora characterized as preventable.

She identified several overlapping structural barriers driving these outcomes. Lack of health insurance remains a fundamental obstacle, leaving many patients without reliable access to prescription medications and specialist care. The cost of asthma medications — including both daily controller inhalers and biologic therapies for severe disease — is a second distinct barrier, one Mora noted she has been actively engaged in addressing through advocacy efforts. Geographic access to specialists is a third constraint: patients in many communities must travel 30 or more miles to reach an allergist or pulmonologist, or navigate insurance networks that severely limit specialist options. Language barriers in clinical settings add further complexity for non-English-speaking patients, particularly in Hispanic and other immigrant communities.

Mora outlined several mechanisms she sees as capable of materially reducing these barriers. Telehealth — which expanded substantially during the pandemic and has demonstrated utility in asthma management — allows specialists to reach patients who cannot travel, and she called for continued support for telehealth reimbursement policies that make this access sustainable. Expanded insurance coverage, including coverage for all patients regardless of immigration or income status, was framed as the most foundational change needed. On the technology side, she highlighted 2 developments she sees as particularly promising: ultra-long-acting biologic formulations that reduce the dosing frequency burden and may improve adherence in patients with limited health system touchpoints, and digital smart inhalers that track medication use in real time, allowing clinicians to identify adherence gaps and patients to recognize when controller therapy is being used inadequately.

Environmental determinants received explicit attention. Mora called for reduction in outdoor air pollutants — including ozone and particulate matter — as well as targeted indoor air quality interventions, particularly around household smoking. Both exposures are disproportionately concentrated in urban and lower-income communities, compounding the biologic susceptibility to poorly controlled asthma in precisely those populations that also face the greatest barriers to specialist access and affordable medication. She framed these environmental and structural factors not as background context but as core clinical determinants — ones that clinicians cannot address alone and that require coordinated policy and public health responses.

“I think world asthma day also calls for a day that we have to talk about health equity and disparities in health that we currently exist in the United States,” Mora said.

Mora has no relevant disclosures to report.

Office of Minority Health, US Department of Health and Human Services. Asthma and Black/African Americans. Updated 2025. Accessed May 2026. 

https://minorityhealth.hhs.gov/asthma-and-blackafrican-americans

Black Americans bear a disproportionate burden of asthma mortality, and clinicians and policymakers must address a number of factors to make meaningful progress.


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The HCPLive asthma page is a comprehensive resource for clinical news and insights on asthmatic disease. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for allergic and severe asthma, and more.

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Nicole Beaulieu Perez, PhD, RN, PMHNP-BC, an assistant nursing professor at NYU Rory Meyers College of Nursing

Monocyte Aging Links to Non-Somatic Depression Symptoms, With Nicole Perez, PhD

Depression heterogeneity may obscure biologically meaningful signals, but new data suggest monocyte-specific epigenetic aging could help differentiate symptom domains. In an interview with 

, Nicole Beaulieu Perez, PhD, RN, PMHNP-BC, an assistant nursing professor at NYU Rory Meyers College of Nursing, said the findings reinforce a central clinical reality: "Depression is not a monolith,” with distinct symptom profiles potentially reflecting different underlying mechanisms.

“We see all the time in practice how patients present with a variety of presentations,” Perez said. “We know there's over 200 possible combinations of symptoms that get us that disorder of depression. What's been less clear is how those presentations have been linked differentially to underlying biology. What goes with that is that we see all the time that patients respond differently to medications that target different mechanisms, even though they have the same diagnosis. This study…is consistent with what we're seeing in that we found that the epigenetic aging and monocytes using this new clock monocyte age acceleration showed differential associations when we looked at symptoms of depression that were considered non-somatic.”

Non-somatic symptoms include profound hopelessness and anhedonia. Meanwhile, the study did not show a link between monocyte age acceleration and somatic symptoms, including fatigue and the inability to fall asleep.

“When we actually drill down and look at a symptom resolution lens of what symptoms people are experiencing, we see biological differences, and specifically in this study, having to do with the accelerated aging of monocytes,” she added.

The study analyzed 440 participants from the Women’s Interagency HIV Study, including 261 women with HIV (mean age, 43.7 years), evaluating associations between epigenetic age acceleration (EAA) and depressive symptoms measured by the Center for Epidemiologic Studies Depression Scale (CES-D). Investigators compared a monocyte-derived clock (MonoDNAmAge) with a multi-tissue clock (HorvathDNAmAge), focusing on symptom domains rather than total scores.

In adjusted models, monocyte EAA was associated with non-somatic depressive symptoms (

=.018), with particularly strong associations for anhedonia (

=.007). No associations were observed for somatic symptoms such as fatigue or sleep disturbance at the domain level. Horvath-based EAA was not associated with total or domain-specific depressive symptoms.

Although the findings do not alter current diagnostic criteria for major depressive disorder (MDD), they support a more granular approach to symptom assessment. Perez noted that clinicians already differentiate symptom patterns in practice, but existing frameworks and tools may not adequately capture this heterogeneity.

She pointed to limitations of total scores from commonly used scales such as the CES-D. These instruments aggregate symptoms across multiple domains, despite depression being a multidimensional construct encompassing affective, cognitive, and somatic features.

“Someone could have the same score at 2 different time points but totally different symptoms,” Perez said. “It’s misleading to think that necessarily their symptoms are the same over time.”

Biomarker Potential and Biological Context

The study also advances interest in monocyte epigenetic aging as a potential biomarker for depression. However, its clinical role remains uncertain. Because the analysis was cross-sectional, it cannot determine whether monocyte EAA reflects a state marker of current symptom burden or a trait marker of vulnerability.

The findings may be particularly relevant for populations with elevated inflammatory burden. Women living with HIV experience greater rates of depression and chronic comorbidities, alongside social and structural stressors that may contribute to “biological weathering,” a process linking environmental adversity to accelerated aging.

The selective association between monocyte aging and non-somatic symptoms supports emerging models of depression subtypes, including inflammation-related phenotypes characterized by anhedonia and affective disturbance. By contrast, the absence of associations with somatic symptoms highlights the importance of domain-specific analyses. Overall, the study suggests that aligning biological measures with specific symptom dimensions may improve signal detection and advance precision psychiatry.

“I don't think it's ready for prime time yet,” Perez said. “What we're seeing here is that folks [who] have distinct presentations are going to have different biological mechanisms at play.”

Perez NB, Xu K, Xu Y, et al. Monocyte Epigenetic Age Acceleration is Linked to Non-Somatic Depressive Symptoms in Women with and Without HIV. 

In this interview, Perez discusses data linking monocyte epigenetic age acceleration to non-somatic depressive symptoms.


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Alex Hillenbrand is an assistant editor for 

. She earned her BA in English from Lafayette College in 2023 and went on to write for pop culture, entertainment, and sports media outlets before joining MJH Life Sciences in 2025. In her free time, Alex enjoys cooking, going on walks, and meeting new people. Contact her at mjhlifesciences.com.

Articles

COBRA findings suggest 1 day of antibiotic treatment is preferred in acute cholangitis after adequate biliary drainage compared to longer guidelines.


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Hepatology

Shorter Antibiotic Treatment After Adequate Biliary Drainage Non-Inferior in Acute Cholangitis

Edward Barnes, MD, MPH, is an associate professor of medicine in the division of gastroenterology and hepatology and co-director of the Multidisciplinary Inflammatory Bowel Diseases Center at the University of North Carolina at Chapel Hill.

Edward Barnes, MD, MPH, explains mirikizumab’s strong remission and durable response in Crohn’s disease patients after anti-TNF failure, supporting second-line use.

VIVID Post Hoc Analysis Supports Mirikizumab After Anti-TNF Failure in Crohn’s Disease

Maria Abreu, MD, is Executive Director of the F. Widjaja Inflammatory Bowel Disease Institute at Cedars-Sinai.

Maria Abreu, MD, breaks down efficacy and safety data for dual-target co-antibody JNJ-4804, offering a potential new option for heavily pretreated UC patients.

DUET-UC Data Highlight Potential of Dual-Pathway Targeting in Refractory Ulcerative Colitis

Ryan Livingston joined the MJH Life Sciences team in March of 2025, shortly after graduating from TCNJ with a bachelor’s degree in English. He enjoys creative writing, reading, and scuba diving. He can be reached at rlivingston@mjhlifesciences.com.

Catch up on key clinician insights, major FDA decisions, groundbreaking trial results, and more.

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8 Endocrinology Headlines You Missed in April 2026

Abigail Brooks is an assistant managing editor for 

She joined MJH Life Sciences in August 2023 shortly after graduating from Monmouth University where she earned her BA in Communication with a concentration in Public Relations/Journalism and later an MA in Interactive Digital Media. She enjoys traveling, running, and reading books. She can be reached at abrooks@mjhlifesciences.com.

The phase 3 FUZION trial found guselkumab achieved increased fistula remission rates than placebo in perianal fistulizing Crohn's disease.

Guselkumab Shows Efficacy in Perianal Fistulizing Crohn's Disease in Phase 3 FUZION Trial

Updated results from the NordICC trial build upon previous 10 year findings and shed further light on once-only colonoscopy as a primary screening modality.

NordICC: Single Colonoscopy Cuts Colorectal Cancer Incidence but Not Mortality at 13 Years

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.

In the ongoing JADE EXTEND trial, long-term treatment with abrocitinib led to sustained skin clearance and other improvements through 112 weeks.

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Atopic Dermatitis condition center page, audiences can find a variety of coverage mediums for medical news and updates, including articles, video interviews, podcasts, and breaking news on dermatitis research, treatment, and drug development.

Abrocitinib Therapy Effective in Patients with Atopic Dermatitis at 2 Years

JNJ-4804 phase 2b results showed higher week-48 remission rates in refractory ulcerative colitis and Crohn disease.

JNJ-4804 Phase 2b Data Show Higher Week-48 Remission in Refractory UC, Crohn Disease

Phase 4 dupilumab data show improvements in esophageal distensibility and disease-related structural changes and inflammation in the esophagus in EoE.

REMODEL: Dupilumab Improves Esophageal Distensibility in EoE at 24 Weeks

Long-term LUCENT-3 data show mirikizumab sustained disease clearance in ulcerative colitis through 4 years of treatment.

Latest News

Discussing Challenges of Work in Dermatology Today, With Noreen Galaria, MD

Nonstatin Prescriptions Increasing, Still Behind Statins in ASCVD, With Michael Blaha, MD, MPH

Risankizumab’s 1 Year Crohn's Disease Improvement in HRQL and Wellbeing in ASPIRE-CD

World Asthma Day 2026: Uncontrolled Disease and Racial Disparities Demand Structural Solutions, With Juanita Mora, MD

Monocyte Aging Links to Non-Somatic Depression Symptoms, With Nicole Perez, PhD