Part 3 of 3: Our Practical Playbook When Skin & Gut Don’t Read the Same Treatment Plan What happens when the skin is crystal clear…but the Crohn’s disease didn’t get the memo? 👀 In the final chapter of our special Derm × GI crossover conversation, our Faculty Dr. Perry Grewal and Dr. Jesse Siffledeen get practical about what happens after the prescription is written. From treat-to-target monitoring and follow-up cadence to the very real influence of insurance requirements, our experts unpack how they decide whether a therapy is truly working—and what to do when different organ systems are telling very different stories. 🧩 Great skin, active gut? 🧩 Controlled IBD, stubborn psoriasis? 🧩 One therapy, two diseases…or occasionally two therapies? The conversation explores how clinicians prioritize competing treatment targets without sacrificing what matters most to the patient, why success may need to be measured beyond a single organ system, and where communication between specialties becomes essential. And perhaps the simplest clinical pearl of the entire series? Ask the questions—and don’t be afraid to pick up the phone. Because when inflammatory disease crosses specialties, the best care probably should too. 🎯 Learning Objectives After listening to this episode, participants should be able to: 1. Describe practical approaches to monitoring treatment response across dermatologic and gastrointestinal inflammatory diseases, including the role of early clinical follow-up and objective assessment. 2. Evaluate therapeutic options when disease control differs across organ systems, such as controlled psoriasis with active IBD or controlled IBD with persistent skin disease. 3. Discuss the limitations of organ-specific treatment targets and incorporate patient priorities, disease severity, and multisystem outcomes when defining therapeutic success. 4. Recognize how payer and insurance requirements can influence treatment selection, reassessment schedules, access, and consideration of dual therapy. 5. Identify key questions that dermatology and gastroenterology clinicians can ask to recognize disease manifestations outside their own specialty and facilitate timely referral. 6. Apply practical strategies for multidisciplinary co-management, including direct clinician-to-clinician communication and collaborative treatment decision-making. 🔥 In This Episode 🔬 Treat-to-target: when should you actually reassess? 🎯 One patient, two organs: does success require both to be at target? 🔄 Great skin, active gut—or vice versa: when do you switch? 💊 Dual therapy: useful tool or access nightmare? 💰 When insurance starts influencing the clinical calendar 🗣️ Why asking about the gut–skin–joint connection matters 📞 The underrated power of simply calling your colleague 🤝 Why multidisciplinary care needs to move from concept to everyday workflow #SkinAndJoints #Dermatology #Gastroenterology #IBD #CrohnsDisease #Psoriasis #SkinGutAxis #TreatToTarget #Biologics #IL23 #InflammatoryDisease #MultidisciplinaryCare #PrecisionMedicine #PatientCentredCare #MedicalEducation #HCPeducation SUPPORTED BY AN IME GRANT FROM JnJ Johnson and Johnson. ABOUT Dr. Parbeer Grewal Dermatologist, Edmonton, AB Dr. Parbeer Grewal completed his Bachelor of Science undergraduate degree at the University of Alberta with a specialization in Psychology and graduated with distinction. He completed his Doctorate of Medicine degree at the University of Alberta and graduated with Special Training in Research. He completed dermatology training at the University of Alberta and became a Fellow of the Royal College of Physicians and Surgeons of Canada and a board-certified Fellow of the American Academy of Dermatology. Dr. Grewal is an Associate Clinical Professor within the University of Alberta’s Faculty of Medicine - Dermatology. In addition to working at Rejuvenation, he is a consulting physician for the University of Alberta Hospital, the Royal Alexandra Hospital, the Grey Nuns Hospital and the Misericordia Hospital. Dr. Grewal has participated in over 60 clinical research trials for a multitude of dermatology conditions and medications. In addition, Dr. Grewal serves on multiple national and international scientific advisory boards, is a distinguished peer reviewer for medical journals and has published both journal articles and book chapters in dermatology. He has specific interests in psoriasis, acne, eczema, warts, skin cancers, rashes and moles. He offers a wide range of topical and systemic therapy along with surgical and aesthetic services. ABOUT Dr. Jesse Siffledeen, MD, FRCPC Gastroenterology, Edmonton, AB Dr. Siffledeen is a clinical professor in the Division of Gastroenterology at the University of Alberta. He is also currently the past-president of the Alberta Society of Gastroenterology. He has established a large clinical IBD practice in Edmonton and is the director of the South Edmonton Gastroenterology Research Unit, serving as principal investigator and collaborator on several IBD-related clinical trials for over 20 years. He is an active collaborator in the Edmonton IBD research community and as a member of the Canadian IBD research consortium. Dr. Siffledeen completed his Gastroenterology studies at the University of Alberta in 2010 and inflammatory bowel disease research/Master’s degree at the University of Oxford in 2011.
Part 3 of 3: Our Practical Playbook When Skin & Gut Don’t Read the Same Treatment Plan
What happens when the skin is crystal clear…but the Crohn’s disease didn’t get the memo? 👀
In the final chapter of our special Derm × GI crossover conversation, our Faculty Dr. Perry Grewal and Dr. Jesse Siffledeen get practical about what happens after the prescription is written.
From treat-to-target monitoring and follow-up cadence to the very real influence of insurance requirements, our experts unpack how they decide whether a therapy is truly working—and what to do when different organ systems are telling very different stories.
🧩 Great skin, active gut?
🧩 Controlled IBD, stubborn psoriasis?
🧩 One therapy, two diseases…or occasionally two therapies?
The conversation explores how clinicians prioritize competing treatment targets without sacrificing what matters most to the patient, why success may need to be measured beyond a single organ system, and where communication between specialties becomes essential.
And perhaps the simplest clinical pearl of the entire series? Ask the questions—and don’t be afraid to pick up the phone.
Because when inflammatory disease crosses specialties, the best care probably should too.
🎯 Learning Objectives
After listening to this episode, participants should be able to:
🔥 In This Episode
🔬 Treat-to-target: when should you actually reassess?
🎯 One patient, two organs: does success require both to be at target?
🔄 Great skin, active gut—or vice versa: when do you switch?
💊 Dual therapy: useful tool or access nightmare?
💰 When insurance starts influencing the clinical calendar
🗣️ Why asking about the gut–skin–joint connection matters
📞 The underrated power of simply calling your colleague
🤝 Why multidisciplinary care needs to move from concept to everyday workflow
#SkinAndJoints #Dermatology #Gastroenterology #IBD #CrohnsDisease #Psoriasis #SkinGutAxis #TreatToTarget #Biologics #IL23 #InflammatoryDisease #MultidisciplinaryCare #PrecisionMedicine #PatientCentredCare #MedicalEducation #HCPeducation
SUPPORTED BY AN IME GRANT FROM JnJ Johnson and Johnson.
ABOUT Dr. Parbeer Grewal
Dermatologist, Edmonton, AB
Dr. Parbeer Grewal completed his Bachelor of Science undergraduate degree at the University of Alberta with a specialization in Psychology and graduated with distinction. He completed his Doctorate of Medicine degree at the University of Alberta and graduated with Special Training in Research. He completed dermatology training at the University of Alberta and became a Fellow of the Royal College of Physicians and Surgeons of Canada and a board-certified Fellow of the American Academy of Dermatology.
Dr. Grewal is an Associate Clinical Professor within the University of Alberta’s Faculty of Medicine - Dermatology. In addition to working at Rejuvenation, he is a consulting physician for the University of Alberta Hospital, the Royal Alexandra Hospital, the Grey Nuns Hospital and the Misericordia Hospital. Dr. Grewal has participated in over 60 clinical research trials for a multitude of dermatology conditions and medications. In addition, Dr. Grewal serves on multiple national and international scientific advisory boards, is a distinguished peer reviewer for medical journals and has published both journal articles and book chapters in dermatology.
He has specific interests in psoriasis, acne, eczema, warts, skin cancers, rashes and moles. He offers a wide range of topical and systemic therapy along with surgical and aesthetic services.
ABOUT Dr. Jesse Siffledeen, MD, FRCPC
Gastroenterology, Edmonton, AB
Dr. Siffledeen is a clinical professor in the Division of Gastroenterology at the University of Alberta. He is also currently the past-president of the Alberta Society of Gastroenterology. He has established a large clinical IBD practice in Edmonton and is the director of the South Edmonton Gastroenterology Research Unit, serving as principal investigator and collaborator on several IBD-related clinical trials for over 20 years. He is an active collaborator in the Edmonton IBD research community and as a member of the Canadian IBD research consortium.
Dr. Siffledeen completed his Gastroenterology studies at the University of Alberta in 2010 and inflammatory bowel disease research/Master’s degree at the University of Oxford in 2011.