Highlights from the 2026 NC Dermatology Association Summer Meeting

Top Practice Pearls from the 2026 NCDA Summer Meeting

By Paul Shim, MD

NCDA 2026 High-Yield Notes – Day 1

1. Perimenopause (Melissa Mauskar, MD)

• For Genitourinary Syndrome of Menopause: Consider cream if sexually active, tablets if post-menopausal/less active, estradiol ring for perimenopausal.
• Topical estrogen induces collagen production on sun-protected skin only; the response is absent in chronically photodamaged skin such as the face (PMID: 18794456).

2. Pediatric Dermatology Pearls & Updates (Liesl M. Patteta, MD)

• Saturated saline soak for refractory plantar warts: daily 30-min immersion in saturated (~35–40% salt) saline × 8 weeks (PMID: 41072585).
• There are associations between periorificial dermatitis and combined OCP (HR 1.23), hormonal IUD (HR1.22), copper IUD (1.52), progesterone implant (1.23) in patients aged 18-52 years (PMID: 41577191).

3. Delusional Disorders in Dermatology (Emily F. Cole, MD, MPH)

• Treat the underlying primary skin disease in addition to the delusion. Many patients have a real responsive dermatosis (PN, eczematous, CPUO) or a neuropathic/drug-related process whose sensations they misattribute.
• Code diplomatically since open notes can erode trust: 2 (paresthesia/formication), L29.8 (other pruritus), L28.1 (PN), L30.8 (other specified dermatitis). Antipsychotics work: aripiprazole or olanzapine first-line (start low, uptitrate); pimozide effective but more side effects.

4. Updates in Cutaneous Oncology (David R. Carr, MD, MPH)

• For high stage cutaneous squamous cell carcinoma, Mohs has decreased 5-year cumulative incidence of local recurrence, nodal metastasis, distant metastasis, disease-specific-death, compared to Wide Local Excision (PMID: 41671454).
• For cutaneous squamous cell carcinoma, the highest yield period for detection of nodal metastasis and distant metastasis is within first 2 years (PMID: 38971189).

5. Beyond Antihistamines: Practical Approaches to Managing Itch (Emily F. Cole, MD, MPH)

• Chronic itch is usually non-histaminergic – which is why antihistamines fail. Rule of thumb: itch >6 weeks without wheals = look past histamine (IL-4/13/31, JAK-STAT, substance P, CGRP, TRPV1, opioid receptors). Phenotype the itch (inflammatory vs. neuropathic/neurogenic vs. systemic) before choosing therapy.
• JAK inhibitors give the fastest itch relief (days) but carry class boxed warnings — reserve for severe/refractory with shared decision-making (PMID 36736457).

NCDA 2026 High-Yield Notes – Day 2

1. Surgical Tips & Tricks (David R. Carr, MD, MPH)

• Ergonomics: Tuck chin, shoulders down/back, engage core; microbreaks 1–2 min every 20–40 min. Consider rotational flexion of the neck as another opportunity for improvement.
• Consider spraying Cavilon No Sting Barrier Film (3M) prior to sterilizing the surgical site to avoid losing the Gentian Violet surgical site markings.

2. HS Procedures (Liesl M. Patteta, MD)

• Consider using Bovie on coagulation mode for dissection to minimize bleeding.
• Post-op pain ladder: Acetaminophen/ibuprofen → duloxetine 30 mg → tramadol 50 mg.

3. A Lot of Pathology (Austin Ivey, DDS, MD)

• When evaluating for candidiasis, consider coated tongue on differential. Candida culture is low utility as candida exists as normal flora.
• For angular cheilitis treat both Staph (Mupirocin) and Candida (Nystatin).
• Consider foreign-body reaction (pyogenic granuloma) at old wisdom-tooth sites from compounded ointments.

4. Vulvar Dermatology (Melissa Mauskar, MD)

• 10-45% of patients with atopic dermatitis have genital involvement (PMID: 33666290).
• For vulvar lichen simplex chronicus, if itching at nighttime or significantly affecting life consider using systemic medications (Duloxetine, PMID: 39812844) (Dupilumab, PMID: 30627621).

5. Dentistry For Physicians (Austin Ivey, DDS, MD)

• Platelet-rich fibrin may be slightly more efficacious than platelet-rich plasma for facial rejuvenation (PMID: 41190633).
• “Supervised neglect”. If patients refuse a certain aspect of care and develop complications from it, you may still be vulnerable to litigation (see 2009 Dentist’s Advantage malpractice case and Spiegal Leffler case).

NCDA 2026 High-Yield Notes – Day 3

1. Legal Aspects of Practicing Medicine (Sima Jain, MD)

• For medical malpractice, Statute of Limitations is 3 years but Statute of Repose is 4 years (exception: foreign body left in body).
• A private physician’s website must comply with the ADA. Even patients who are not established in your practice may be able to file a lawsuit.

2. Coding Trends and Updates in Dermatology (Faith C. McNicholas, RHIT)

• Different insurance plans within a single insurance company may have different definitions and coverages of what may be medically necessary (e.g. destruction of benign lesions) and this should be counseled to the patient prior to delivery of care.

3. Rewiring The Stressed Brain: The Neuroscience of Burnout and Resilience (Sima Jain, MD)

• Kirtan Kriya is a meditation technique that can be performed 12 minutes a day that may help burnout, improve sleep, reduce anxiety (PMID: 26445019).