Eric Ruderman, MD: 20 Years of Combined Psoriatic Derm-Rheum Care

A dermatology-rheumatology clinic that Eric M. Ruderman, MD, helped launch at Northwestern University Feinberg School of Medicine nearly 20 years ago has grown into a weekly practice for jointly managing psoriatic disease, a model increasingly documented in the literature as a way to speed diagnosis and improve coordination of care.¹

Ruderman, associate chief for clinical affairs in Northwestern's Division of Rheumatology, spoke with RheumatologyLive about how he co-founded the clinic with dermatologist Kenneth B. Gordon, MD, now at the Medical College of Wisconsin, after the 2 began collaborating on psoriasis-related clinical trials.

The idea took shape after Ruderman, then new to the institution, connected with Gordon, who had been active in psoriasis clinical trials; the 2 decided to see patients together rather than simply co-manage them from separate offices. What began as 1 of the first joint clinics of its kind in the country has grown alongside patient demand, moving from occasional sessions to a weekly clinic as referrals increased.

The clinic now runs one morning per week, pairing a rheumatology fellow and dermatology resident with attending physicians from both specialties, who see patients together and make treatment decisions in real time.

“It truly is shared decision making, which is a bit of a buzzword now, but frankly, it’s just good medical care,” Ruderman said, adding that the joint-visit format spares patients from having to relay treatment decisions between two separate offices. Patients also avoid becoming the go-between for two physicians who might otherwise coordinate only by phone or written note, according to Ruderman. That structure has also driven referral growth, with community dermatologists increasingly sending patients with joint complaints directly into the clinic rather than to rheumatology alone.

Ruderman noted the model also helps distinguish true psoriatic arthritis activity from overlapping, non-inflammatory contributors such as fibromyalgia or osteoarthritis, a distinction that changes management, since the answer in those cases is not escalation to a different biologic but an added, targeted therapy. A retrospective review of a similar combined rheumatology-dermatology clinic found that 14 of 34 patients (41.2%) referred for suspected psoriatic arthritis were ultimately found to have a different diagnosis, most often osteoarthritis or myofascial pain.² He cautioned that community dermatologists do not always make this distinction, sometimes assuming any joint pain in a psoriasis patient reflects psoriatic arthritis. He encouraged rheumatologists without access to a formal joint clinic to build informal referral relationships with local dermatologists as an alternative path to coordinated care.

References

1. Ruderman EM, Gordon KB. Combined dermatology/rheumatology clinics for management of psoriatic disease: current state. Rheum Dis Clin North Am. 2025;51(3):537-544. https://doi.org/10.1016/j.rdc.2025.05.009

2. Odega UK, Omesiete W, Carlson A, Flowers RH. Characterising alternative diagnoses to psoriatic arthritis in a rheumatology-dermatology combined clinic. Australas J Dermatol. Published online August 21, 2025. https://doi.org/10.1111/ajd.14585