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My AAD Conference

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Quick Summary

  • The author attended the annual American Academy of Dermatology Conference with over 18,000 attendees and found the exchange of ideas and techniques invigorating.
  • The post highlights major advances in treatment for melanoma and atopic dermatitis.
  • A patient with a very thick, locally spreading scalp melanoma had it excised and was referred to oncology; scans showed no internal metastases.
  • The patient received ipilimumab immunotherapy with weekly infusions for several months, resulting in complete disappearance of the melanoma with no return so far.
  • Newer PD-1 inhibitor immunotherapies (e.g., Keytruda) are expanding cancer treatment options, and Dupilumab is the first biologic for atopic dermatitis with manageable side effects like eye irritation and diarrhea.

I recently returned from my annual American Academy of Dermatology Conference. No fewer than 18,000 were in attendance from all over the world. The exchange of ideas and techniques with colleagues was exhilarating.  Here is a summary of a few impressions I took away.

We are in a new age of treatment for melanoma and atopic dermatitis.

I can personally attest to such a case regarding a patient of mine. Mr. Smith finally came to the office with his daughter and son-in-law, they had pushed him for years. He was a decorated veteran of Pearl Harbor.  He had a hard black knot on his bald head. When I saw it, I immediately became very sad. Tears came to my eyes, as I had such a nice time speaking to this jolly fellow. He also had many small dark dots near the area implying local spread.

Now, the prognosis of melanoma is judged by its thickness. More than 4 millimeters, about half the width of your fingernail, means a 90% death rate in a few years. His was more than 4mm just above the skin and there was more below! We took him back to the certified Surgery Center in our office and excised it. It was so deep even the pathologists cringed.

Indeed, it was a melanoma, and at this point, we sent him straight to the oncologist. They did all the studies and fortunately, he did not yet have any internal metastases. He was placed on a medicine called ipilimumab, part of a new cadre of immunotherapies for melanoma. He had weekly infusions of the medication for several months. A miracle! All the melanoma disappeared and has not returned.

There are many more such therapies now available called PD-1 inhibitors. They supercharge a person’s own immune cells to attack the cancer and they are being used now in many other forms of cancer. One brand name is Keytruda, but there are several others, and there are studies now using them in combination.

Atopic dermatitis has a first biologic therapy called Dupilumab. I have seen good results so far in one patient of mine, now 19 years old, who has had eczema since age 5. Side effects are eye irritation and diarrhea, both passing and controllable; better than itching all the time.

More to come in ensuing blogs.

To your health!

FAQ - Frequently Asked Questions

What is the AAD conference and who attends it?
The American Academy of Dermatology (AAD) Conference is an annual meeting where dermatology professionals gather to share research, techniques, and clinical experience. In this post, the author notes that no fewer than 18,000 people attended from all over the world. A big part of the value is the exchange of ideas with colleagues and seeing how new treatments are changing day-to-day care.
One major impression highlighted here is that we’re in a new age of treatment for melanoma and atopic dermatitis. The author also emphasizes how energizing it is to exchange ideas and techniques with colleagues from around the world. The post then illustrates that shift in melanoma care through a real patient experience and newer immunotherapy options.
This post specifically points to major advances in melanoma treatment, describing newer immunotherapies that help a patient’s own immune system attack cancer. It mentions ipilimumab as part of that newer group, and also notes that PD-1 inhibitors are now available and being used in other cancers as well. While atopic dermatitis is named as another area of progress, the detailed example in the post focuses on melanoma.
The post explains that melanoma prognosis is judged by how thick the tumor is. It states that more than 4 millimeters—about half the width of a fingernail—means about a 90% death rate in a few years. In the author’s example, the lesion was more than 4 mm above the skin with more below, which underscored how serious it was.
If you notice a hard, dark bump or new dark spots near an area—especially if it seems to be changing—don’t wait to get it examined. In the post’s example, the patient had a hard black knot on the scalp with nearby small dark dots that suggested local spread. The decision-focused takeaway is simple: getting evaluated sooner can matter, because thickness and spread influence prognosis and next steps.

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