Pipeline News, Topical Steroids, and Views on PAs in Dermatology, With Cynthia Trickett, MPAS, PA-C

At the Society of Dermatology Physician Associates (SDPA) 2025 Fall Conference in San Antonio, Texas, the team at HCPLive spoke in an interview with session presenter Cynthia Trickett, MPAS, PA-C.1,2

Trickett is a frequent session presenter and currently works as a PA for North Dallas Dermatology Associates. She spoke with HCPLive about the SDPA conference, dermatology pipeline news, the value of collaboration and respect between dermatologists, PAs, and NPs, and other topics such as pipeline news and the diminishing need for topical steroids.

HCPLive: How has the 2025 SDPA Fall Conference been for you so far?

Trickett: I’m here in San Antonio, my hometown. I have been so lucky to spend a lot of this conference engaging with industry, and it's nice to see the shift in how our industry really wants to partner with us. They want to know what our thoughts are, how we learn, the capacity of how we learn, and what media we learn best in.

Every single time an industry partner has said, ‘What can we do, and what could we be doing more?’ I’ve thought, ‘Wow, that's a shift from how it's been in the past.’ So it's nice that they want to listen to our voices, because NPs and PAs in the dermatology space are going to outnumber the dermatologists, and they've come to realize that our voice is a powerful voice.

HCPLive: Do you feel like there's a growing awareness of the importance of PAs and MPs in the dermatology field?

Trickett: Well, based on my interactions with industry, absolutely. At this particular conference, I saw a decided and visual, and impactful dedication to educating new-to-practice physician assistants. There's a concept called ‘Emerging Scholars,’ and I've been fortunate enough that this is my fourth year doing it. Impacting the providers who are new to dermatology and [helping them to] learn more about psoriasis and psoriatic disease has been impressive.

I did not have this when I started dermatology in 1998, and I was forced to learn by digging through books and talking to my supervising physician. So these opportunities of learning are so advanced and amazing. I want everybody to take the chance to learn from them.

HCPLive: You mentioned that there were some recent data in the psoriatic disease space that you wanted to highlight as well while attending the SDPA meeting?

Tricket: Yes, some recent data show that we're getting even better at achieving higher clearance rates in skin and setting new benchmarks for what we consider acceptable treatment for psoriatic arthritis, which is awesome for our patients. [It is] clearing skin faster and improving joints faster, which is always a good thing for our patients. But also, new molecules are coming to the market, oral molecules are coming to the market, and better topicals are coming to the market. These are exciting times.

HCPLive: Are there any topical options for psoriatic diseases in particular that you wanted to highlight? How do you feel about the shift away from topical steroids?

Trickett: There's been a shift in dogma in using topical steroids, and that's a good thing for our patients, because long-term use of topical steroids was never the proper way to treat chronic inflammatory diseases. There are too many side effects, and some of them, if they have an adverse event, are not reversible. Once you get a stretch mark, it's there unless you cut it out, and nobody's going to do that. So, having these advanced topicals to use for longer periods of time, safer, more elegant once-a-day, and being able to use them in areas that we were very scared to use steroids before, the face, genitals, under the arms, in the folds, has been revolutionary, in my opinion.

HCPLive: Do you have any thoughts about topical steroid withdrawal (TSW)?

Trickett: Yes, I would say that if you're talking about large body surface areas, it's true. It’s absolutely a thing, and we probably don't ask about it as much as we could. But in our day-to-day, we're not seeing patients who have 60% body surface area very often, at least not in my practice, meaning 60% body surface area with their psoriasis, or 60% body surface area with their atopic dermatitis, etc. So I think the pendulum shift shifted.

We didn't know that it existed, and now everybody's scared of it. So the right answer is probably somewhere in the middle. We need to have a healthy respect; we need to be aware that it can happen, especially with using large body surface areas, but the other thing is that patients get steroids from lots of different places. They could have eye drops that are steroids. They could have inhaled steroids. They can have nasal steroids. They can buy 10 tubes of hydrocortisone over the counter. So we need to be a little more mindful on how much they are using and where else they are getting them.

HCPLive: What are your thoughts about some of the topical JAK inhibitors that are available?

Trickett: Right now, topical JAK inhibitors for atopic dermatitis have also been revolutionary for the same exact reason. We can't use steroids long-term. It's nice that we're getting the word out about steroid stewardship. We were learning about pain medicine stewardship. We learned about oral antibiotic stewardship. It's high time that we learn about topical steroid stewardship. And if there's a better way to treat long-term and chronic inflammatory diseases with fewer long-term side effects, we should be doing that.

The quotes contained in this Q&A summary were edited for the purposes of clarity.

Trickett had no relevant financial disclosures of note.

References

1. Trickett C. Hyperhidrosis: Impact, Diagnosis, and Evolving Treatments. Presented at the Society of Dermatology Physician Associates (SDPA) Fall Conference, November 5-9, San Antonio, TX.

2. Trickett C. Hosted by UCB: Transformative Treatment Results in Plaque Psoriasis and Psoriatic Arthritis with the First and Only Approved IL 17A and IL 17F Inhibitor. Presented at the Society of Dermatology Physician Associates (SDPA) Fall Conference, November 5-9, San Antonio, TX.