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.


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 

2026 American Academy of Dermatology (AAD) Annual Meeting

 in Denver. She was asked by HCPLive 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 

Nguyen had no relevant financial disclosures of note.

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. 

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 tips for clinicians in dermatology practices who want to improve patient communication and satisfaction.

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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.

Nephrology

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.

IgA Nephropathy

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

Articles

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

Plaque Psoriasis

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.

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.

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

A deep learning model applied to routine electrocardiograms (ECGs) identified 

chronic obstructive pulmonary disease (COPD)

 months before clinical diagnosis, according to a new study.

The approach, validated across multiple cohorts, suggests a potential role for artificial intelligence (AI)-enhanced ECG analysis as a scalable screening tool in routine clinical care.

, investigator Monica Kraft, MD, from the Icahn School of Medicine at Mount Sinai, emphasized the clinical importance of earlier recognition. She noted that identifying patients with early or subclinical COPD could create opportunities for timely intervention, particularly smoking cessation and initiation of therapies aimed at slowing disease progression.

“I think what's happened in the past is when we've done lung function screening [and] testing, oftentimes the lung function…in the clinic looks very normal,” Kraft said. “You can imagine [a] scenario where patients are smoking, they have their lung function done, it looks normal, and they think,’ Hey, this is great. I can keep smoking.’ Whereas, if we have a mechanism that demonstrates that there may actually be some lung damage going on because of what the EKG shows, then there may be an opportunity to really educate the patient that it's really important that they make a lifestyle change now in order to avoid future problems down the road.”

COPD remains a leading cause of morbidity and mortality worldwide, with delayed diagnosis representing a persistent challenge. Symptoms are often nonspecific in early disease, and confirmatory testing, primarily spirometry, can be underutilized due to logistical and resource constraints.

 Current guidelines do not recommend routine screening in asymptomatic individuals, further contributing to underdiagnosis.

In this study, Kraft and colleagues developed a convolutional neural network (CNN) model trained on > 760,000 ECGs from > 67,000 patients across the Mount Sinai Health System, with additional validation in an independent cohort from the UK Biobank.

 The model demonstrated consistent performance, with AUROC values of 0.80 in internal testing, 0.82 in external validation, and 0.75 in the UK Biobank cohort.

The model’s predictive signal appeared to precede clinical diagnosis. Analyses showed that ECG-based predictions could identify COPD-related changes approximately 6 to 15 months before formal diagnosis, suggesting the model is capturing early physiologic alterations rather than late-stage disease alone.¹ Kraft highlighted that this window may be clinically actionable for high-risk individuals, such as active smokers, where earlier counseling and intervention could alter disease trajectory.

The model leverages subtle ECG features associated with pulmonary vascular and cardiac changes seen in COPD. Explainability analyses indicated a focus on P-wave morphology, consistent with early right atrial and pulmonary vascular alterations.

 While such changes are typically recognized in advanced disease, the application of AI enables detection of patterns not readily discernible to clinicians interpreting individual ECGs.

The clinical implications of this approach lie in its potential integration into existing workflows. ECGs are widely available, low-cost, and routinely performed across inpatient and outpatient settings. As Kraft noted, this creates an opportunity for patients undergoing ECGs for unrelated indications to be flagged for further pulmonary evaluation, which is valuable in health systems with limited access to spirometry or populations less likely to undergo formal testing.

However, the model is not intended to replace spirometry, which remains the diagnostic standard for COPD. Rather, it may function as a triage or decision-support tool, identifying patients who warrant confirmatory testing.

Investigators highlighted several limitations, including reliance on ICD-coded diagnoses, declining performance over time, and modest correlations with spirometry, suggesting the model may reflect cumulative cardiopulmonary changes more than early airflow limitation alone.

The team noted that prospective validation is needed to determine whether earlier detection via AI-ECG translates into improved clinical outcomes. Kraft underscored this, noting that the next phase of research will involve identifying at-risk patients in real time, conducting comprehensive clinical evaluations, and assessing whether early interventions, such as smoking cessation or pharmacologic therapy, alter disease progression.

“We still have some work to do. The algorithm, just creating it and applying it, is step 1,” Kraft said. “Step 2 is now to see how it applies to patients moving forward so [not] quite in the hands of clinicians yet, but we hope it will be very soon.”

Vaid A, Sharma J, Jiang J, et al. Automated diagnosis of chronic obstructive pulmonary disease using deep learning applied to electrocardiograms. 

https://doi.org/10.1016/j.ebiom.2025.106066

World Health Organization. Chronic obstructive pulmonary disease (COPD). 

https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd)

US Preventive Services Task Force. Screening for chronic obstructive pulmonary disease: recommendation statement. 

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


Pulmonology

Infectious Disease condition center page is a comprehensive resource for clinical news and insights on respiratory health. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for asthma, COPD, interstitial lung disease, COVID-19, and more.

COPD

COPD condition center page, resources on the topics of medical news and expert insight into chronic obstructive pulmonary disease can be found. Content includes articles, interviews, videos, podcasts, and breaking news on COPD research, treatment, and drug development.

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

Diagnosing and Managing Exocrine Pancreatic Insufficiency

To diagnose exocrine pancreatic insufficiency, clinicians should combine careful "detective work" on symptoms and risk factors with imaging and fecal elastase testing, while recognizing the test's limitations, especially with watery stools, and not relying on it in isolation. 

"So making the diagnosis of EPI at the beginning can be very challenging... it's super important to do the detective work, look for risk factors... you really have to take your time if you want to make this diagnosis early," said Andres Gelrud, MD, a gastroenterologist at Baptist Health Miami Cancer Institute, part of Baptist Health South Florida, in an interview with HCPLive.

A fecal elastase-1 result below 200 µg/g is considered abnormal, with values below 100 µg/g indicating a high likelihood of EPI and levels between 100 and 200 µg/g considered indeterminate, though false positives are common when stool is watery or diluted, underscoring the need to interpret results in clinical context.¹

Once the diagnosis is made, clinicians should promptly initiate adequately dosed pancreatic enzyme replacement therapy taken with meals and evaluate for fat-soluble vitamin deficiencies, bone disease, and diabetes. Per the 2023 AGA Clinical Practice Update, PERT should be initiated at a minimum of 40,000 USP units of lipase per main meal in adults, with half that dose for snacks, adjusted based on meal size and fat content and taken during the meal — not before or after. For patients on non-enteric-coated preparations, concurrent H2 blocker or PPI therapy is recommended.² This combination both relieves malabsorptive symptoms and addresses the broader metabolic consequences of EPI.

Symptoms of EPI are often nonspecific and overlap with other gastrointestinal conditions, including irritable bowel syndrome, inflammatory bowel disease, celiac disease, and small intestinal bacterial overgrowth. Despite this, fewer than 7% of patients with chronic pancreatitis or pancreatic cancer are tested for EPI. This gap is significant given that EPI develops in approximately 20% of patients after acute pancreatitis, rising to 30% after severe episodes, and in 47–76% of those with autoimmune pancreatitis.³ As a result, clinicians should remain alert to symptoms such as bloating, diarrhea, and unexplained weight loss.

Monitoring after treatment initiation should focus on clinical response rather than repeat fecal elastase testing, which is not a reliable indicator of treatment efficacy. Per the AGA's Best Practice Advice, markers of successful PERT include reduction in steatorrhea and gastrointestinal symptoms, weight gain, improved muscle mass and function, and normalization of fat-soluble vitamin levels (A, D, E, and K). Baseline measurements of BMI, quality of life, and fat-soluble vitamins should be obtained at diagnosis, along with a baseline DEXA scan repeated every one to two years given EPI's association with metabolic bone disease.²

"Once we start to supplement the patient with pancreatic enzymes, you see that the symptoms very, very quickly start to resolve... as soon as you start to take the enzymes, the symptoms very, very fast start to improve," said Gelrud.

Whitcomb DC, Buchner AM, Forsmark CE. AGA clinical practice update on the epidemiology, evaluation, and management of exocrine pancreatic insufficiency: expert review. 

. 2023;165(5):1292-1301. doi:10.1053/j.gastro.2023.07.007

Capurso G, Traini M, Piciucchi M, Signoretti M, Arcidiacono PG. Exocrine pancreatic insufficiency: prevalence, diagnosis, and management. 

. 2019;12:129-139. doi:10.2147/CEG.S168266

Gastroenterology

Gastroenterology condition center page is a comprehensive resource for clinical news and insights on digestive and GI conditions. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for 

, IBS and IBD, Crohn's disease, and more.

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.

Allergy

Allergy condition center page is a comprehensive resource for clinical news and insights on allergic and inflammatory diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for food and seasonal allergies, as well as allergic asthma and related conditions.

Anaphylaxis

The HCPLive anaphylaxis page is a comprehensive resource for clinical news and insights on acute allergic reactions. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for preventing anaphylaxis, and more.

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.

Atopic Dermatitis

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.

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.

Video Series

Targeted Therapy in ISM: Shared Decision-making, Safety, and Early PIONEER Data

Positive stool test? Learn why follow-up colonoscopy is often covered and how clinics tackle cost, time-off, and transport barriers.

Addressing Access Barriers in Colorectal Cancer Screening

Role of patient-reported outcomes in trials and practice, criteria for escalation beyond supportive care, and the paradigm shift introduced by selective KIT D816V inhibition, including avapritinib.

When Supportive Care Is Not Enough: Patient-Reported Outcomes and Escalation to Targeted Therapy

See how FIT cutoffs change accuracy, why Cologuard raises sensitivity

Individualizing When to Stop Colorectal Cancer Screening

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.


Psychiatry

Psychiatry condition center page is a comprehensive resource for clinical news and insights on mental illnesses. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for depression, schizophrenia, bipolar disorder, anxiety, and more.

Major Depressive Disorder

Major Depressive Disorder condition center page, resources on the topics of medical news and expert insight into depression can be found. Content includes articles, interviews, videos, podcasts, and breaking news on MDD research, treatment, and drug development.

Pain

The HCPLive pain page is a resource for medical news and expert insights on pain medicine. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for acute pain, chronic pain, addiction medicine, and more.

Chronic Pain

On the HCPLive chronic pain page, resources on the topics of medical news and expert insight into pain treatment can be found. Content includes articles, interviews, videos, podcasts, and breaking news on chronic pain, and more.

Microglial Remodeling Links Chronic Pain to Depression, With Xiao Xiao, PhD

FDA News

Type 2 Diabetes

Endocrinology

The HCPLive endocrinology page is a comprehensive resource for clinical news and insights on endocrine system conditions. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for diabetes, hormonal disease, and more.

FDA Approves Insulin Icodec (Awiqli) as First Once-Weekly Basal Insulin for Type 2 Diabetes

Janiene Luke, MD, is a clinical professor and residency program director
at the department of dermatology for Loma Linda University Medical Center.

Janiene Luke, MD, co-chair of the Skin of Color Society (SOCS) Scientific Symposium, speaks about complex cases in dermatology and other topics covered at the meeting.

Latest News

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

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

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