{"href":"https://api.simplecast.com/oembed?url=https%3A%2F%2Fskinandjointspodcast.simplecast.com%2Fepisodes%2Fcrossborder2026part2lasvegas-l6dhx_5p","width":444,"version":"1.0","type":"rich","title":"Cross-Border Talk: Know When to Fold ’Em — Rethinking Steroids & Eczema Care (Part 2)","thumbnail_width":300,"thumbnail_url":"https://image.simplecastcdn.com/images/017450d4-6458-4a10-9297-ca289770dc2d/cb18d9f5-6f49-4a15-89dc-5d20a38485e7/xborderssf.png","thumbnail_height":300,"provider_url":"https://simplecast.com","provider_name":"Simplecast","html":"","height":200,"description":"🇨🇦🇺🇸 Cross-Border Talk: High Fives, Higher Standards — Rethinking the Treatment Finish Line (Part 2 of 2)\n\n🎰 What happens in Vegas doesn't always stay in Vegas—especially when it could change how we treat patients! \n\n🇨🇦 Team Canada and 🇺🇸 Team USA are back for Round 2!\n\nLive from Fall Clinical 2026 in Las Vegas, Canadian dermatologist Dr. Andrei Metelitsa and American dermatologist Dr. Christopher Bunick return to the Skin and Joints Podcast for Part 2 of our Cross-Border Talk series.\n\nThis time we're raising the stakes—and the standard of care.\n\n🤔 What good is a better eczema score if your patient still can't sleep, work, or even shake someone's hand?\n\nOur experts go beyond skin clearance to explore why minimal disease activity, patient-reported outcomes, and real-world functionality should be central to how we define treatment success in atopic dermatitis and chronic hand eczema.\n\n🔬 Diving deeper into the AD Hand study, they unpack emerging tralokinumab data showing meaningful improvements in quality of life and hand function. But how quickly should patients expect results? And when is an improving partial response good enough—or a signal to rethink the treatment plan?\n\n🩺 Then comes the ultimate cross-border real world clinical challenge: a 38 year old nurse whose painful hand eczema threatens her ability to work, despite optimized topical therapy. Would Team Canada and Team USA approach treatment differently? When is it time to escalate therapy—and what happens once patients finally achieve clear skin?\n\n💡 From biologics and JAK inhibitors to shared decision-making, irritant avoidance, and the intriguing question of what happens after patients achieve clear skin, this conversation serves up practical clinical pearls—with a few laughs along the way.\n\n🙌 Two countries. One treatment goal. Helping patients high-five with confidence again!\n\n\n\n🎯 Learning Objectives\n\nFollowing this episode, healthcare professionals should be able to:\n\nRedefine meaningful treatment success: Discuss the clinical value of minimal disease activity and more stringent treat-to-target goals, integrating skin clearance, itch control, and patient-reported outcomes rather than relying solely on conventional disease severity scores.\n\nTranslate clinical trial findings into real-world outcomes: Interpret findings from the AD Hand study examining tralokinumab's impact on Dermatology Life Quality Index (DLQI) and Hand Eczema Impact Scale (HEIS) outcomes, and consider their relevance to daily functioning and quality of life.\n\nSet realistic treatment expectations: Evaluate the significance of early responses, continued improvement over time, and partial treatment responses when counselling patients with atopic hand eczema, while recognizing the importance of ongoing skin care and irritant avoidance.\n\nNavigate treatment escalation in high-burden disease: Apply a patient-centred approach to clinical decision-making in patients with functionally debilitating atopic hand eczema, including consideration of biologics, JAK inhibitors, occupational factors, concomitant therapies, and differences in treatment availability across Canada and the United States.\n\nLook beyond achieving clear skin: Explore emerging considerations for long-term disease control, maintenance strategies, dosing flexibility, and potential treatment de-escalation once patients achieve meaningful disease control, while recognizing the limits of current evidence.\n\n\n\n🎲 The stakes are high, the clinical pearls are plenty, and the borders are open for debate.\n\nBecause at the end of the day, successful eczema treatment isn't just about how the skin looks—it's about what patients can finally get back to doing. 🙌\n\n#SkinAndJoints #CrossBorderTalk #FallClinical2026 #AtopicDermatitis #ChronicHandEczema #ADHand #JAKs #MinimalDiseaseActivity #PatientReportedOutcomes #Dermatology #TreatToTarget\n\n\n\n\n\nSUPPORTED BY AN IME GRANT FROM LEO Pharma.\n\n\n\n\n\nAbout Dr. Christopher Bunick MD, PhD.\nDermatologist  | New Haven, CT, USA \n\nBIOGRAPHY\n\nDr. Christopher Bunick is an Associate Professor of Dermatology and Translational Biomedicine at Yale University School of Medicine. Clinically, he specializes in general medical dermatology and dermatologic surgery. He also performs unique dermatologic research studying the three-dimensional structures of skin-related proteins using x-ray crystallography and cryo-electron microscopy. Dr. Bunick received his B.S. at Vanderbilt University (Nashville, TN), and his M.D. and Ph.D. degrees at Vanderbilt University School of Medicine. His PhD research studied the three-dimensional structures of calcium-binding proteins and proteins involved in DNA repair processes (e.g. the skin disease xeroderma pigmentosum). He completed medical internship, dermatology residency, and a dermatology research fellowship (mentored by Nobel Laureate Dr. Thomas A. Steitz) at the Yale University School of Medicine (New Haven, CT). He performs lab research with the goal of better understanding the structure-function relationship of proteins involved in normal and diseased skin and dermatologic therapeutics. His work emphasizes translation of biochemical and structural research findings into clinically meaningful and practice-changing discoveries. His work to date has advanced the field’s understanding of: (i) the molecular mechanisms of the human skin barrier; (ii) assembly mechanisms of intermediate filaments, like keratin and vimentin, leading to patents for new cytoskeleton-targeted therapeutics; (iii) the biochemical basis for antibiotic activity and resistance in Cutibacterium acnes and acne vulgaris; (iv) the structure-function relationships of anti-IL23 psoriasis biologics and how that impacts clinical efficacy; (v) the structure-function relationships of multiple dermatologic therapeutics, including atopic dermatitis biologics, Janus kinase inhibitors, PDE4 inhibitors, and more. Chris’ research has pioneered a new focus in dermatology on fundamental biochemistry and structural biology, particularly around connecting the atomic resolution mechanisms of action of a therapeutic to its clinical performance and safety. Complementing his basic science research, Chris has and continues to lead multiple dermatology clinical trials at the Yale Center for Clinical Investigation.\n\n\n\nAbout Dr. Andrei Meteitsa MD, FRCPC, FAAD.\nDermatologist  | Calgary, AB\n\nAndrei Metelitsa, MD, FRCPC is a board-certified dermatologist in both Canada and United States. He is Co-Director of the Institute for Skin Advancement in Calgary, Alberta and serves as a Clinical Associate Professor at the University of Calgary. He completed his dermatology training at the University of Alberta, followed by 1 year fellowship training in Lasers and Cosmetic Surgery with SkinCare Physicians in Boston, under the direction of world-renowned faculty from Harvard University and Yale University.\n\nDr. Metelitsa is an author of a dermatology book, as well as more than 40 book chapters and articles. His major cosmetic interests include laser surgery, non-surgical fat reduction and facial rejuvenation. He is also an avid skin cancer researcher, with a particular interest on epidemiology in Canada. Dr. Metelitsa has received more than 35 academic, research, leadership and volunteer awards throughout his career.\n\n\nSUPPORTED BY AN IME GRANT FROM LEO Pharma.\n\n\n\n"}