Harrison Nguyen, MD, MBA, MPH, is a double board-certified dermatologist/Mohs micrographic surgeon and clinical researcher in Houston, Texas.

Harrison Nguyen, MD, MBA, MPH

Individualizing Treatment Selection in Atopic Dermatitis, With Harrison Nguyen, MD, MBA, MPH

2026 Revolutionizing Atopic Dermatitis (RAD) Conference

 in Nashville, Harrison Nguyen, MD, MBA, MPH, spoke in an interview on the importance of individualized treatment selection in atopic dermatitis following his portion of a session at the meeting, highlighting ways in which clinicians should tailor therapy decisions to the unique needs of each patient.

 interview, Nguyen identified quality of life as the single most important factor influencing his decision to escalate treatment from topical therapies to systemic options. While disease severity remains an important consideration, he noted that the impact of atopic dermatitis on sleep, daily functioning, work, and school often provides the clearest indication that additional intervention may be necessary. He also pointed to the burden of topical therapy itself, particularly among caregivers of pediatric patients, as an important but sometimes overlooked factor when evaluating treatment needs.

“The burden of having to apply topicals can be really challenging for caregivers,” Nguyen said. “We really want to understand the patient's journey [and] impacts on quality of life. Then from there, we also go into things like preferences, comorbidities, and of course, manifestations of disease.”

Beyond quality-of-life considerations, Nguyen described selection of treatments as being increasingly guided by different patient-specific factors. The factors include comorbid conditions, the preferences of individuals, and the anatomic distribution of one’s atopic dermatitis. For example, involvement of regions such as the head and neck, hands, or feet may impact the therapeutic choices clinicians make and help them to determine which available options are most appropriate for a given individual.

Nguyen also pointed to the rapidly expanding therapeutic landscape as having changed his approach to disease management. Rather than following a rigid treatment sequence, he highlighted the value of “meeting patients where they are” in their disease journey. In practice, he noted, this can mean recognizing when a patient’s disease burden warrants systemic therapy from the outset rather than requiring them to progress through multiple topical treatments first.

While Nguyen noted biologics often function as his preferred first-line systemic agent, he also noted the growing role of Janus kinase (JAK) inhibitors for select patients who may see benefit from that mechanism of action. The expanding number of available therapies, he explained, has created new opportunities to personalize care rather than rely on a one-size-fits-all treatment approach.

Nguyen had no relevant financial disclosures of note.

Nguyen H, Bunick C, Cotter D, Shahriari M. Medical Crossfire and Clinical Case Challenge. Session presented at: 2026 Revolutionizing Atopic Dermatitis Conference; June 17-19, 2026; Nashville, TN.

Nguyen H. Emerging Evidence in Atopic Dermatitis Management, With Harrison Nguyen, MD, MBA, MPH. HCPLive. June 19, 2026. 

https://www.hcplive.com/view/emerging-evidence-atopic-dermatitis-management-harrison-nguyen-md-mba-mph

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Nguyen urges clinicians to consider patient's disease presentation, comorbidities, treatment goals, and preferences when making therapeutic decisions.

Emerging Evidence in Atopic Dermatitis Management, With Harrison Nguyen, MD, MBA, MPH

Harrison Nguyen, MD, MBA, MPH, founder of Harrison Dermatology & Research Group in Houston, Texas, spoke with HCPLive about the inccreasing complexity, and level of opportunity, within the atopic dermatitis treatment space, following his session titled “Medical Crossfire” at the 

Revolutionizing Atopic Dermatitis (RAD) Conference 2026

Speaking with the editorial team, Nguyen described the modern era of treatment as a “golden revolution” in atopic dermatitis care. He hoted clinicians can now access an increasing array of topical and systemic medications, though 1 of the central questions facing providers is finding out which treatment is best for which patient. Increasingly, decisions related to medications are being guided not only by disease severity but also by underlying immunologic mechanisms, comorbidities, and individual patient characteristics, he noted.

“[For] each therapy, we're understanding more and more about their biologic behavior, how they behave in certain manifestations of atopic dermatitis, and of course, which patient would benefit the most based on those characteristics,” Nguyen expressed.

In his session, he presented the case of an adolescent patient with atopic dermatitis and a strong family history of atopic disease. The patient’s family history included asthma, food allergies, allergic rhinitis, and chronic spontaneous urticaria—conditions linked through shared type 2 inflammatory pathways. According to Nguyen, such cases underscore the importance of evaluating atopic dermatitis within the broader context of systemic inflammatory disease rather than viewing it solely as a cutaneous condition.

During the debate-style session, Nguyen argued in favor of dupilumab as the preferred systemic therapy for this particular patient. He explained that the biologic’s dual inhibition of interleukin (IL)-4 and IL-13 may offer advantages for patients with significant type 2 inflammatory burden. While IL-13 plays an important role in atopic dermatitis pathogenesis, Nguyen pointed to IL-4 as being involved in many immune processes, including antibody class switching and Th2-mediated inflammation, making it a critical therapeutic target.

Outside of disease control, Nguyen noted emerging data suggesting potential implications of the targeted treatment of atopic dermatitis for the broader atopic disease spectrum. He noted growing interest in whether treatments such as dupilumab could impact the development or progression of related conditions, including asthma and allergic rhinitis, particularly among patients at elevated risk.

Nguyen’s session reflected the growing level of personalization of atopic dermatitis management, with drug selection becoming more closely tied to a patient’s immunologic profile, family history, and risk for associated type 2 inflammatory conditions.

At RAD 2026, Nguyen speaks on key highlights from his “Medical Crossfire” session, touching on the atopic dermatitis treatment landscape.

The Cost of Delay: How Prior Authorization Is Impacting Dermatology

 today, clinicians have access to an unprecedented array of biologics and targeted treatments designed to dramatically improving outcomes for individuals living with chronic inflammatory skin diseases such as atopic dermatitis, psoriasis, and hidradenitis suppurativa (HS).

However, according to 3 dermatologists interviewed by 

, gaining patients access to these drugs has evolved into a more and more complicated procedure. This, they and others in the field have noted, is due to prior authorization requirements, ‘step therapy’ protocols, and formulary restrictions caused by insurers and pharmacy benefit managers, also known as PBMs.

Prior authorization, the process by which health insurance plans go over and approve or deny various types of covered health services or medications, has evolved from an occasional administrative task into a routine part of practice management in dermatology.

 In this feature, the issues many clinicians have with the prior authorization process is explored, along with the potential need for future reforms.

Harrison Nguyen, MD, MBA, MPH, managing director of Harrison Dermatology & Research Group, was 1 such clinician who spoke with 

 about this complicated process as a substantial burden on both physicians and staff. While physicians may identify the most appropriate medication for a patient early in the visit, Nguyen highlighted the securing of a treatment’s approval as often requiring extensive paperwork, repeated communication with insurers, and dedicated personnel focused solely on navigating the authorization process.

Shannon Trotter, DO, known for her work with DOCS Dermatology Group, spoke with 

 about prior authorization, describing it as having long been a challenge in dermatology, though she highlighted the growing role of artificial intelligence (AI) in the process as both positive and negative. While AI tools can allow practices to better streamline submissions and diminish their own administrative workload, Trotter described insurers as also beginning to use similar technologies, creating what she described as an ongoing back-and-forth between providers and payers.

Outside of administrative burdens, all 3 of these clinicians emphasized the impact these barriers can have on patient care. Trotter pointed to step therapy requirements as a frequent source of delays, noting that patients may be required to try and fail therapies for months prior to gaining access to the medication their clinician originally recommended. During such time, a patient may continue experiencing symptoms that interfere with work, sleep, overall quality of life, or even becoming more debilitating.

Nguyen described formulary changes as also potentially forcing patients to switch from therapies that may already be working well. While some transitions occur without issue, he noted patients with conditions such as atopic dermatitis and HS can sometimes report disease worsening or loss of treatment response when required to shift between treatments for non-clinical reasons. In certain cases, Nguyen noted, interruptions in therapy can make future treatment far more challenging.

Matthew Zirwas, MD, a board-certified dermatologist at Dermatologists of Greater Columbus, spoke even more adamantly against prior authorization as a practice. Zirwas pointed to the growing number of available therapies as having intensified prior authorization challenges. He pointed to PBM rebate structures and limited transparency surrounding formulary decisions as key drivers of the issue, suggesting that treatment preferences often do not align with what clinicians believe is best for patients. Additionally, he noted his own view of the need for reforms that allow for incentives among PBMs to shift, as well as the need for more transparency.

Despite differences in emphasis, all 3 clinicians agreed that reform is needed. Proposed solutions included greater transparency around formulary and rebate decisions, streamlined authorization processes, improved peer-to-peer review systems, and reforms to step therapy requirements.

Overall, each of these 3 leaders in the field spoke in favor of a reduction of unnecessary barriers as helpful to ensure patients are given the right treatment at the right time, while nevertheless expressing the need to preserve access to the therapeutic advances known to have shaped the modern dermatologic landscape.

Disclosures: Trotter, Nguyen, and Zirwas had no relevant disclosures of note.

Amann ST, Shah ED, Wilson LJ. An Overview of the Challenging Process of Prior Authorization: Medical Necessity for a Better Way. Clin Gastroenterol Hepatol. 2024 Dec;22(12):2362-2366. doi: 10.1016/j.cgh.2024.09.001. Epub 2024 Sep 18. PMID: 39303798; PMCID: PMC11604005.

Sharma SP, Russo A, Deering T, Fisher J, Lakkireddy D. Prior Authorization: Problems and Solutions. JACC Clin Electrophysiol. 2020 Jun;6(6):747-750. doi: 10.1016/j.jacep.2020.04.022. PMID: 32553230.

Sampathkumar G. Rethinking prior authorization: bridging clinical needs and administrative burdens. Am J Manag Care. 2026 Feb 1;32(2):e31-e33. doi: 10.37765/ajmc.2026.89883. PMID: 41759204.

Kyle MA, Song Z. The Consequences and Future of Prior-Authorization Reform. N Engl J Med. 2023 Jul 27;389(4):291-293. doi: 10.1056/NEJMp2304447. Epub 2023 Jul 22. PMID: 37486761; PMCID: PMC10676707.

Wang Y, Levy JF, Mattingly TJ 2nd, Anderson G. Prior Authorization and Associated Delays and Denials of Branded Medication Dispensation. JAMA Health Forum. 2026 Apr 3;7(4):e260760. doi: 10.1001/jamahealthforum.2026.0760. PMID: 41996105; PMCID: PMC13090851.


This video feature highlights the views of dermatologists on prior authorization, step therapy, and issues related to these processes.

Harrison Nguyen, MD, MPA, MPH, sat down with the 

2025 Society of Dermatology Physician Associates (SDPA) Fall Conference

 in San Antonio, to discuss his session ‘From Basement Membrane to Bedside: The Science & Strategy of Bullous Diseases.’

Nguyen, who serves as a clinical assistant professor of dermatology at Baylor College of Medicine, spoke in previous interviews on managing chronic spontaneous urticaria (CSU) and cutaneous vasculitis.

 In this interview segment, he touched on bullous disease and provided tips for clinicians on treating various blistering disorders.

Discussing Treatment Strategies for Blistering Disorders, With Harrison Nguyen, MD, MBA, MPH

“If we in dermatology don't take take care of blistering disease patients who will and listening to disease patients can be it's can be really scary for patients and their families,” Nguyen expressed. “And we need to be able to recognize these, perform the appropriate workup, and then be able to get patients on the right treatments.”

Nguyen highlighted many different blistering disorders, noting the distinction he hopes clinicians will make between pemphigus and pemphigoid.

“The difference between the 2 has to do with where the antibodies are binding and causing the split in the skin,” Nguyen explained. “Is it intraepidermal, or is it subepidermal? Interepidermal is more suggestive of a pemphigus reaction. Subepidermal is more suggestive of a pemphigoid reaction. Bullous pemphigoid is probably the most common type in the pemphigoid family, and it can be really itchy. It can have an impact on quality of life.”

Nguyen noted the importance of identifying these conditions and getting patients on the proper treatments in terms of both controlling the disease and being tolerable and safe long-term.

“We received our first FDA-approved treatment for bullous pemphigoid, and that's dupilumab,” Nguyen said. “I highlight the data for why dupilumab received approval for bullous pemphigoid patients. What was important to see is that by treating patients with bullous pemphigoid with dupilumab, we may not completely take away other adjunctive treatments. We may still need to use corticosteroids from time to time, but it reduces the amount of corticosteroids that we need to use, and improves the patient's quality of life.”

Nguyen highlighted the US Food and Drug Administration (FDA) approval of dupilumab (Dupixent) as a significant success for the dermatology field and for patients with bullous pemphigoid.

“We need more tools for these forgotten diseases that patients really suffer from,” Nguyen said. “There are more treatments in the pipeline. We need more investigation into it, and hopefully can get more funding to investigate this. It's relative to some of our other inflammatory conditions, like atopic dermatitis or psoriasis, the number of patients affected by blistering diseases is smaller. But that being said, this is a tremendously impactful condition, and I hope that research will continue to grow for these patients.”

For further information on the topics presented by Nguyen, view his full interview segment posted above. To learn more about sessions at SDPA, view the latest coverage.

The quotes used in this summary were edited for the purposes of clarity.

Nguyen H. From Basement Membrane to Bedside: The Science & Strategy of Bullous Diseases. Presented at the Society of Dermatology Physician Associates (SDPA) Fall Conference, November 5-9, San Antonio, TX.

Nguyen H. What Are the Hallmarks of Cutaneous Vasculitis? With Harrison Nguyen, MD, MBA, MPH. HCPLive. November 10, 2025. Accessed November 12, 2025. 

https://www.hcplive.com/view/what-are-hallmarks-cutaneous-vasculitis-harrison-nguyen-md-mba-mph

Nguyen H. Immune Pathways Driving Chronic Spontaneous Urticaria, With Harrison Nguyen, MD, MBA, MPH. HCPLive. November 10, 2025. Accessed November 12, 2025. 

https://www.hcplive.com/view/immune-pathways-chronic-spontaneous-urticaria-harrison-nguyen-md-mba-mph

In this interview with Nguyen, Nguyen highlights takeaways from From 'Basement Membrane to Bedside: The Science & Strategy of Bullous Diseases.'

Harrison Nguyen, MD, MBA, MPH

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