As our communities continue to feel the increased impact of Coronavirus, we want to let you know our office will remain open and will be seeing patients as usual. Your safety and our staff’s health are our top priority.
Below are 3 links. One for our current office policies, another with our new Telehealth Now option and the last with biologics information. Thanks for you support.
There is no guidance at this time from the Centers of Disease Control (CDC) or the Department of Public Health on how psoriasis patients should respond to the Coronavirus (Covid-19) epidemic, nor are there good studies in the literature for physicians to use as a basis for recommendations. As a result, we at UDSCC have no advice that we can give that is based on proven data. The following has been shared by Dr. Jeffery Sobell, a well renowned psoriasis expert. Both Dr. Patrick Retterbush and Dr Lauren Whalen agree with the following:
For psoriasis patients on biologics (Enbrel, Humira, Remicade, Cimzia, Stelara, Cosentyx, Taltz, Siliq, Tremfya, Ilumya, Skyrizi)
For patients who have been healthy on their biologic up to now with no obvious increase in infection rate, continuing therapy LIKELY WILL NOT increase their risk of contracting the virus. Furthermore, if an infection should occur, it is NOT LIKELY that their ability to fight the infection will be affected. But, of course, as with any significant infection, patients should hold future doses until they fully recover.
With that being said, if psoriasis patients are still concerned and would rather hold their biologic medication for now, that is certainly a reasonable option. But keep in mind the following two issues:
1) For patients on Cyclosporine and Methotrexate, Dr. Sobell advises to reduce the dose to the lowest possible that still adequately controls their symptoms. For patients on Otezla, as it is not associated with a high risk of infection, it is reasonable to continue at the current dose. But, should a significant infection occur while under any of these three treatments, Dr. Sobell would hold future doses of all three of these medications until the infection has completely resolved.
2) For patients on Acitretin, this medication does not impair the immune system so it is acceptable to continue.
Our best defense against infection is proper hand hygiene and avoidance of close contact with people showing signs of respiratory illness.
If you have specific concerns about your psoriasis therapy and Covid-19, please contact our office.
You finally made an appointment to see your dermatologist, and that spot that you were worried about comes back as a skin cancer. Your doctor recommends that you have Mohs Micrographic Surgery. How do you know that you are choosing the right Mohs Micrographic Surgeon?
Accreditation Council for Graduate Medical Education (ACGME) can be looked at as the gold standard of training for medical doctors in the United States. It is a council that monitors, accredits, and holds medical residencies and fellowships to the highest standards. You want to make sure that your Mohs Micrographic Surgeon completed an ACGME fellowship training program that is an additional 1-2 years of training after a dermatology residency. The ACGME recognizes fellowship programs that are approved by the American College of Mohs Surgery.
The American College of Mohs Surgery makes sure that your surgeon has had extensive post-residency training in Mohs Micrographic Surgery, Procedural Dermatology, Dermatologic Oncology, and Dermatologic Reconstruction. In order to be a member, your physician would have completed hundreds and sometimes thousands of peer-reviewed cases.
Members of the American College of Mohs Surgery not only act as your surgeon and pathologist, but also act as your reconstructive surgeon. Members of the ACMS have extensive training in Dermatologic Reconstruction and are able to complete your reconstruction after tumor clearance under local anesthesia in the office.
Don’t be fooled by providers that have only taken a weekend course. When you choose a surgeon that is a member of the American College of Mohs Surgery, you can rest assured that their skill has been acquired through extensive training and experience, not overnight!
Dr. Patrick Retterbush is our ACGME fellowship trained Mohs Surgeon at University Dermatology and Skin Cancer Center in Athens, Georgia. He completed his training at the University of North Carolina under Brad Merritt, MD and Raj Varma, MD, experts in Mohs Micrographic Surgery and Dermatologic Reconstruction.