Clinical Pearls on Systemic Agents for Psoriasis and Atopic Dermatitis, with J. Scott Boswell, MD

In a new interview conducted at the Dermatology Education Foundation (DERM) 2025 NP/PA CME Conference in Las Vegas, dermatologist J. Scott Boswell, MD, spoke about the most notable takeaways from his sessions at the meeting.

Boswell first discussed some of the highlights of his talk titled ‘Combining Systemic Treatment in AD, Psoriasis and More.’ He was asked about the session and some of the clinical pearls for clinicians in dermatology that hhe spoke about during his talk.

“[We discussed] how a lot of patients with complex skin disease, whether it be atopic dermatitis or psoriasis, may not respond just to one systemic agent,” Boswell said. “A lot of these patients may have a mix of cytokines responsible for the disease process going on in their skin. So we have biologics for psoriasis, we have biologics and systemic treatments like JAK inhibitors for atopic dermatitis, and soon we may need to be thinking as clinicians about using both to manage their disease process.”

In terms of clinical pearls, Boswell stressed the importance of not getting stuck in what he refers to as ‘monotherapy brain.’

“Sometimes, there at the exam room door right, before we walk in, we're thinking, ‘Is this patient better with what I put them on or am I going to change treatment?’” Boswell said. “Sometimes we need to stick with the systemic treatment and adjust some topicals…Sometimes we need to combine and have them stay on their current therapy, but add another systemic agent that addresses the cytokines and pathophysiology that's going on in their skin.”

Later, Boswell was asked about takeaways from his session on imitators of molluscum contagiosum and warts.

“This session, where I talk about works and molluscum imitators, is just a reminder that not everything may be molluscum,” Boswell explained. “For example, if you have a sick, immunosuppressed patient, maybe with AIDS, those molluscum like lesions might be cutaneous cryptococcosis. That is a very dangerous infection that is not molluscum, and those lesions should be biopsied…Just sort of think, ‘Does this clinical scenario fit with what I'm accustomed to seeing?’”

For any further information on Boswell’s sessions, view his video interview posted above. For more about clinical pearls highlighted at the meeting, view our latest conference coverage.

The quotes in this interview summary were edited for clarity.