The American Academy of Dermatology (AAD) has honored dermatologist Jonathan Silverberg, MD, PhD, MPH, FAAD, and sleep neurologist Hrayr Attarian, MD, as “Patient Care Heroes” for teaming up to provide coordinated, multidisciplinary care to patients with eczema. Both physicians practice medicine at the Northwestern Medicine Multidisciplinary Eczema Center in Chicago, which Silverberg formed in 2013.
Silverberg had considerable experience treating patients with eczema prior to launching the clinic, but recognized that uncoordinated care was a major obstacle to providing patients with the best possible care. People with eczema experience an array of symptoms that cross medical specialties, including difficulty sleeping due to itchiness, creating a vicious cycle of poor sleep and increased inflammation. Because itch affects both eczema and insomnia, treatment often requires a multidisciplinary approach involving allergists, neurologists, sleep specialists, and dermatologists. Silverberg recognized that outcomes would improve if specialists consulted together, rather than relying on patients to coordinate their own care.
“I had patients who were seeing me for their skin disease, someone else for their allergies, and someone else for primary care,” Silverberg says in a release. “There was no coordination between us, and as a result there were a lot of mixed messages.”
To improve coordination, Silverberg and Attarian now offer patients a single, comprehensive, 2- to 3-hour appointment. This allows physicians across different specialties to confer in real time, ultimately creating a comprehensive treatment plan and providing a better experience for patients.
“It is incredibly rewarding as a physician to work as part of a team, and to see how this coordination improves the care we provide to our patients,” Attarian says. “For one eczema patient who was having difficulty sleeping, we used a combination of light therapy and melatonin to naturally adjust her sleep cycle, which reduced her inflammation and itching.”
The AAD created the Patient Care Heroes program to recognize physicians who transform patients’ lives by utilizing their expertise and collaborating with other physicians to treat serious skin disease.
“Diseases don’t neatly align with individual medical specialties. They require care from multiple clinicians, and it’s crucial that our care reflects that,” says George J. Hruza, MD, MBA, FAAD, president of the AAD. “The approach practiced by Drs Silverberg and Attarian is more efficient for physicians, and most importantly, more effective for patients.”
PLEASE HELP ME.I believe I require a cross specialist team of a neurologist ,opthamologist, dermatologist ,sleep specialist , pain specialist, orthotic surgeon and infectious disease expert and psychologist and or psychiatrist to work together to help me No one field by themselves with me trying to co-ordinate and inform /plus wait times for appts is doing anything.
I can not go on living like this – it is a living nightmare.
Can you help me , please.
I live in rural western Australia and have for suffered with a skin disorder A couple of diagnoses – scleroderma, nodularis pruago , eczma ???? since 2011. I had a fall on some wood and got a scratch, it itched and then there were two and so on . My legs are covered in open sores, that I scratch even though I try desperately NOT too. I beg my fingers not to scratch the sores and fail nightly, sometimes clawing my legs bloody with what feels for all the world like an orgasm of relief . I rarely sleep for more than an hour or so at a time, often not at all, I feel so ashamed of the mess I make of myself. the sores now appear on my shoulders , uppers arms, and back, though they have been on forearms and have gone away??
In 2017 I had another fall and broke my left tibia /platella very badly , had a plate inserted and contracted golden staph in hospital, this moved into sepis and I had the wound opened cleaned 4 times. I was given Ciprofloxin and developed diplopia , was diagnosed by opthamologist with Occular myasthenia. I have constant vertigo and my balance is extremely poor. Plus biliousness) I developed chronic fatique and was diagnosed by hospital neuralogical dept with Myasthena Gravis .
In 2020 I developed chronic osteomyletis of Left knee and had the necrotic bone removed as part of a two part knee reconstruction. I await the next stage.
I still itch and scratch to a bloody mess , have unstoppable muscle spasm /cramps in my legs arms and face in the night and do not sleep. The Diplopia/Myasthenia/ chronic fatique and pain continues.
I am going nuts. I talk out loud to myself trying to myself stop scratching and relax my muscles.
I fear for my sanity . I have tried self medicating, drink and marihuana ( offers most help spasms, increases itching)
I have been on Steroids creams and steroids on and off since this began, even to the point of cataracts in my eyes . ( cataracts removed) To Pregablin for 4 years, Sifrol for spasms , fluoxetine for depression . I have been on anti biotics for 4 years. Just stopped with a very low bacteria count in my knee, but I am really paranoid it will flare up again and I will loose my leg.
For pain I have Tried Tramadol, Ibrubrofen , Codeine and Doxycyline, Steroids help to a point with the itchiness and sores, but weight game is untenable with requirement for acceptable weight and knee reconstruction. I aM OVERWEIGHT NOW BY 10 KG. mY SELF ESTEEM IS A T ROCK BOTTOM.
A warm bath in Epsom Salts sometimes offers relief. I spend a lot of time in the bath. Often all night. this is NOt good for the skin I know , but relief is now my main driver.
Now all my joints and my back are painful and it hurts to move and walk. I can no longer drive or walk further than 25metres without a real struggle and then I pay: with more spasms and pain , sleeplessness and itching and sores.
i AM UP SEEKING ANYTHING THAT MAY ASSIST.