Physician Spotlight: Bruce H. Thiers, MD, FAAD

As 2020 draws to a close, Bruce H. Thiers, MD, FAAD, President of the American Academy of Dermatology, reflects on some of the biggest dermatology stories of the year. Not surprisingly, COVID-19 and its devastating impact on practices tops the list, but despite the pandemic, 2020 saw significant advances in treating many common skin diseases. Here’s what Dr. Theirs, also a distinguished professor in the Medical University of South Carolina Department of Dermatology and Dermatologic Surgery in Charleston, SC, had to say.

What was the biggest advance in atopic dermatitis in 2020?

Bruce H. Thiers, MD: I think the big news in atopic dermatitis is all the new drugs in development, including biologics and JAK inhibitors. In many ways we are where the psoriasis market was about 10 years ago when all of a sudden we had so many new treatments to offer our patients. There are also new topicals in development that will give us options beyond topical steroids.

What was the biggest advance in psoriasis in 2020?

Dr. Thiers: We now have available about a dozen unique biologics to treat psoriasis, and the biosimilars are coming! How they will impact price and availability remains to be seen. As with atopic dermatitis, new nonsteroidal topical preparations are on the way.

What was the biggest advance in acne in 2020?

Dr. Thiers: Topicals with new mechanisms of action are highly sought after. Clascoterone cream, which targets the androgen receptors in skin, is the first topical acne drug with a new mechanism of action in nearly 40 years. Also, a topical minocycline foam has been approved for both acne and rosacea, a notable advance as many dermatologists have been reluctant to use minocycline systemically.

What was the biggest advance in skin cancer in 2020?

Dr. Thiers: The biologic era has reached into cutaneous oncology, with the use of cemiplimab for advanced cutaneous squamous cell carcinoma, avelumab for advanced Merkel cell carcinoma, and mogamulizumab for cutaneous T cell lymphoma. We also have new treatment algorithms to alleviate the bothersome adverse effects of the Hedgehog inhibitors.

How did COVID-19 affect the practice of dermatology?

Dr. Thiers: Initially the pandemic had devastating effects on dermatology practices as many had to shut down entirely. The combination of high fixed overhead costs and lack of revenue is not a pretty picture. Government assistance and guidance from the Academy were invaluable in helping us through the darkest days in the spring. We eventually adapted through the increased use of telemedicine and by instituting policies to protect our patients and ourselves while reopening our practices.

What was the biggest dermatology story of the year?

Dr. Thiers: Overall it was clearly the COVID-19 pandemic and its effect on our specialty. The cancellation of our annual and summer meetings was unprecedented. Kudos to the Academy staff for arranging an outstanding VMX (Virtual Meeting Experience) event on very short notice to meet the educational needs of our members.

What is the most exciting innovation in the pipeline for next year?

Dr. Thiers: An effective COVID-19 vaccine.

In dermatology, 2020 was the year…

Dr. Thiers: …to forget!