365 Days in Retrospect

Ah, December. A perfect time to look back over the year and reflect — preferably in front of a cozy fire with my beverage of choice in hand, but that’s besides the point. In 2002 dermatology made some big strides. I thought it would be interesting to speak to a number of dermatologists in a variety of settings to get their perspectives on what they thought was the biggest development in dermatology in 2002. Here’s what they had to say. Dr. Steven Feldman -Biggest Development in 2002: I’d have to say it’s our use of biologicals in dermatology. Etanercept (Enbrel), infliximab (Remicade) and, hopefully soon alefacept (Amevive), will change the way we treat patients who have severe inflammatory skin diseases. Dr. Michael Gold - Biggest Development in 2002: The most important thing in 2002 has been the approval of Botox. It’s the first time in years that we’ve had a new substance available for soft tissue work that has been FDA approved. Botox is the first home run we’ve had in dermatology as far as a cosmetic products are concerned. It works fast; it works well. Also, Botox works in other areas besides its FDA approved application for treating glabellar lines. Dr. Amor Khachemoune -Biggest Development in 2002: The following drugs really took center stage: alefacept (Amevive), denileukin diftitox (Ontak), which has been approved for patients with cutaneous T-cell lymphoma, efalizumab (Raptiva), etanercept (Enbrel), and infliximab (Remicade). Dr. Mark Lebwohl - Biggest Development in 2002: In my opinion, it has been the recognition by the pharmaceutical and insurance industries and the world at large that psoriasis is a serious disease. I think this has been evident by the approval of etanercept (Enbrel) for psoriatric arthritis and with the development of alefacept (Amevive), efalizumab (Raptiva) and infliximab (Remicade), which have all presented very impressive results in clinical trials. Also, in 2002, we saw Medicare double phototherapy reimbursements. All of these factors grouped together provide a much more positive picture for treating patients with psoriasis now and in the future. Dr. Philip Werschler - Biggest Development in 2002: The events following 9/11, when anthrax was circulated in the U.S. mail system were a wake-up call to me personally. As a physician, I was horrified that someone could intentionally do such a cowardly thing to innocent people. As a dermatologist, I was proud that our specialty took a lead role in the recognition, diagnosis, and treatment of the infectious disease. I was also impressed by the way our Academy leadership took the initiative in helping educate all physicians on the manifestations of cutaneous anthrax. Dermatologists across the country — indeed around the world — can take pride that when called upon to do their role in the defense of the nation, we as a specialty, were willing and prepared to contribute. God bless America. Dr. Phillip Williford - Biggest Development in 2002: I think our specialty is being trivialized by cosmetic pursuits. I don’t want to see this trivialization eclipse our most important focus. So important to us these last years are the discovery of chemicals that have so many applications in treatment of disease from psoriasis to Crohn’s disease and can do so by targeting the inherent immune defect that perpetuates the disease. Basic bench research turned into therapy by private companies looking for market and profit is emblematic of how the capitalist system works when it works well. It is also the future for dermatology; to conquer heretofore difficult diseases through science and intellect without forgetting the why: the patient.