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Dermatology Weekly

Author: Medscape Professional Network

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Official Podcast feed of MDedge Dermatology and Cutis Peer-to-Peer, part of the Medscape Professional Network. Weekly episodes include the latest in Dermatology News and peer-to-peer interviews with Doctor Vincent A. DeLeo, MD, and Dr. Candrice Heath, MD. Plus, resident discussions geared toward physicians-in-training. The information in this podcast is provided for informational and educational purposes only.
117 Episodes
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Dermatology News: Non-Whites remain sorely underrepresented in phase 3 psoriasis trials (https://bit.ly/3jmv2ia) Women make progress in pediatric dermatology leadership (https://bit.ly/35nNdir) Survey: Doctors lonely, burned out in COVID-19 (https://bit.ly/3dKwhXg)   *  *  * Psoriasis patients who are pregnant or those seeking a medication-free treatment may benefit from phototherapy. Vincent A. DeLeo, MD, talks to George Han, MD, PhD, and Jashin J. Wu, MD, about the joint guidelines from the American Academy of Dermatology and National Psoriasis Foundation for psoriasis treatment with phototherapy. They provide tips for getting patients started on phototherapy and discuss different devices for at-home or in-office use. While discussing avoidance of treatment pitfalls, Dr. Han notes that “documentation really is key when you’re doing phototherapy, and that’s one of the nice things about some of the newer phototherapy units. They’ll actually be linked up to a computer control that automatically keeps the treatment record.” Article: https://www.mdedge.com/dermatology/article/226940/psoriasis/translating-2019-aad-npf-guidelines-care-management-psoriasis Downloadable PDF: https://cdn.mdedge.com/files/s3fs-public/CT106002082.pdf *  *  * Hosts: Nick Andrews, Vincent A. DeLeo, MD (University of Southern California, Los Angeles) Guests: George Han, MD, PhD (Icahn School of Medicine at Mount Sinai, New York); Jashin J. Wu, MD (Dermatology Research and Education Foundation, Irvine, Calif.) Disclosures: Dr. DeLeo is a consultant for Estée Lauder. Dr. Han and Dr. Wu report conflicts of interest with numerous sources in industry. Show notes: Allegra Sparta, Melissa Sears *  *  * You can find more of our podcasts at http://www.mdedge.com/podcasts Email the show: podcasts@mdedge.com
In this week’s podcast, Dermatology News columnist Leslie S. Baumann, MD, interviews James J. Leyden, MD, emeritus professor of dermatology at the University of Pennsylvania, Philadelphia, about his significant ​research contributions in the field of dermatology, including finding the cure for diaper rash and the development of retinoids for acne and photoaging. Dr. Leyden also recounts his experience working with Albert Kligman, MD, at the University of Pennsylvania and how they changed the way the world treats acne with lots of contemplation, observation, perseverance, and a little luck. *  *  * 1. The interesting history of dermatologist-developed skin care  (https://www.mdedge.com/dermatology/article/227534/aesthetic-dermatology/interesting-history-dermatologist-developed-skin?channel=27928) 2. More on the history of dermatologists and skin care (https://www.mdedge.com/dermatology/article/229052/aesthetic-dermatology/more-history-dermatologists-and-skin-care) *  *  * Hosts: Nick Andrews; Leslie S. Baumann, MD (Skin Type Solutions, Miami) Guest: James J. Leyden, MD (University of Pennsylvania, Philadelphia) Disclosures: Dr. Baumann is CEO of Skin Type Solutions. Dr. Leyden did not report any conflicts of interest. Show notes: Elizabeth Mechcatie *  *  * You can find more of our podcasts at http://www.mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeDerm
Dermatology News: Shingrix effective in older adults with preexisting immune-mediated disorders (https://bit.ly/2GrMy7z) New treatment options show promise for centrifugal cicatricial alopecia (https://bit.ly/36Dq2TL) Children's share of new COVID-19 cases is on the rise (https://bit.ly/34CNEoM) *  *  *       Managing a private medical practice has changed drastically in 2020. In this episode, Candrice Heath, MD (@DrCandriceHeath), talks to Caroline Robinson, MD (on Instagram @crobinsonmd; on Twitter @crobinsonmd1), about her experience opening a new dermatology practice during the COVID-19 pandemic. They discuss important safety measures when establishing the office work flow, including offering virtual visits, streamlining patient intake procedures, cleaning examination rooms, and hiring new employees. They also discuss the role of social media in building a successful dermatology practice. “When you think about where people are looking for doctors now ... they’re turning to social more than ever. ... I would say that [half] of the patients that we’ve seen have been either from social media in some way, shape, or form, and then [half] have found me from my previous work within the city,” Dr. Robinson explains. *  *  * Hosts: Nick Andrews; Candrice R. Heath, MD (Temple University Hospital, Philadelphia) Guests: Caroline Robinson, MD (Tone Dermatology, Chicago) Disclosures: Dr. Heath reports no conflict of interest. Dr. Robinson is the CEO/Founder of Tone Dermatology. Show notes by: Alicia Sonners, Melissa Sears *  *  * You can find more of our podcasts at http://www.mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeDerm
Dermatology News: Review finds evidence for beta-blockers for some rosacea symptoms (https://bit.ly/3kX91rB) Source:  https://bit.ly/2HKWJUX 2019 review: https://bit.ly/36jWvOL Conservative parameters key to maximizing cosmetic laser results in skin of color (https://bit.ly/33dIhNn) Source: https://bit.ly/3jiLcd8 J&J’s one-shot COVID-19 vaccine advances to phase 3 testing (https://bit.ly/33e07Qs) *  *  * Dermatology residents are utilizing apps for up-to-date and accurate information. Vincent A. DeLeo, MD, talks to Orit Markowitz, MD, and medical student Cynthia Chan about the regulation of mobile medical apps, with an emphasis on the three apps most frequently used by residents. “I do think that while we have to be hesitant in incorporating these technologies, I also think that the silver lining is that it’s going to help us also come up with better ways to standardize our education,” Dr. Markowitz reflects. Dr. Markowitz and Ms. Chan also discuss how residents and clinicians can be more diligent about the apps they’re using to get health information. Article: https://www.mdedge.com/dermatology/article/226938/health-policy/applying-knowledge-evidence-and-regulation-mobile-apps Downloadable PDF: https://cdn.mdedge.com/files/s3fs-public/issues/articles/ct106002076.pdf *  *  * Hosts: Nick Andrews, Vincent A. DeLeo, MD (University of Southern California, Los Angeles) Guests: Orit Markowitz, MD (department of dermatology, Mount Sinai Health System, New York; department of dermatology, State University of New York, Brooklyn; and the department of dermatology, New York Harbor Healthcare System); Cynthia X. Chan, BS (Geisel School of Medicine at Dartmouth, Hanover, N.H.) Disclosures: Dr. DeLeo is a consultant for Estée Lauder. Dr. Markowitz and Ms. Chan report no conflict of interest. Show notes: Allegra Sparta, Melissa Sears *  *  * You can find more of our podcasts at http://www.mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeDerm
Episode 82 Dermatology News: Biologics for psoriasis may also reduce coronary plaque (https://bit.ly/3ckjVEK) Journal article: https://bit.ly/3mRW2JE Three-step approach may help relieve one of the itchiest vulvar conditions (https://bit.ly/33TeGI3) Many Americans still concerned about access to health care (https://bit.ly/33TeGI3) Survey: https://bit.ly/3kO0DdF *  *  * Dermatology residents identify studying as one of the main culprits leading to burnout during residency. In this resident takeover, Daniel R. Mazori, MD, talks to Sophie A. Greenberg, MD, (@sophiegreenberg) about the firehose of information that dermatology residents encounter and how to optimize the use of the sources available for studying, particularly during COVID-19 from greater access to webinars and other online conferences. “Especially at the beginning [of residency], it’s easy to feel like there’s too much to learn. ... I would also anticipate some trial and error throughout residency so don’t let this get you frustrated. Some struggle is necessary in order to find your groove,” Dr. Greenberg explains. They also discuss how studying changes over the course of residency, from building the foundation of knowledge in the first year to deepening and consolidating the information in later years in preparation for the board examination. Article: https://www.mdedge.com/dermatology/article/228544/practice-management/studying-dermatology-residency?channel=64 Downloadable PDF: https://cdn.mdedge.com/files/s3fs-public/CT106002023_e.pdf *  *  * Hosts: Nick Andrews; Daniel R. Mazori, MD (State University of New York, Brooklyn) Guests: Sophie A. Greenberg, MD (department of dermatology, Columbia University Medical Center, New York) Disclosures: Dr. Mazori and Dr. Greenberg report no conflict of interest. Show notes by: Allegra Sparta, Melissa Sears *  *  * You can find more of our podcasts at http://www.mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeDerm
As lockdown restrictions are lifted, many dermatologists are resuming elective cosmetic procedures. Candrice Heath, MD, (@DrCandriceHeath) talks to Anthony M. Rossi, MD, (@DrAnthonyRossi) about the procedures patients are seeking while they have downtime as well as how physicians can safely treat these patients and conduct follow-up. They also discuss the prevalence of mask acne, known as “maskne,” during the pandemic. “We’re starting to put people on these acne regimens again. ... People who haven’t dealt with acne in a while or really never had it, we have to be putting them on a retinoid, a good skin regimen, because of all the irritation [and] the occlusion—[maskne] is real,” Dr. Rossi explains. This week in dermatology news: No one-size-fits-all approach to tissue-tightening devices (https://bit.ly/32AsJmA) New billing code for added COVID practice expense (https://bit.ly/3cb6oz9) AMA COVID-19 Billing PDF: https://bit.ly/32yaIVX Physician income drops, burnout spikes globally in pandemic (https://bit.ly/3c2HAsY) Medscape Survey: https://wb.md/3klThhu *  *  * Hosts: Nick Andrews; Candrice R. Heath, MD (Temple University Hospital, Philadelphia) Guests: Anthony M. Rossi, MD (Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine, New York) Disclosures: Dr. Heath and Dr. Rossi report no conflicts of interest. Show notes by: Alicia Sonners, Melissa Sears *  *  * You can find more of our podcasts at http://www.mdedge.com/podcasts       Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeDerm
Dermatology Weekly News: Fatal pediatric melanomas diverse in presentation Novel smart needle system designed to reduce the risk of filler complications COVID Update: First randomized trial reassures on ace inhibitors and ARBs for COVID patients  *  *  * The National Resident Matching Program reported that U.S .medical school seniors who matched into dermatology applied to a median of 90 programs and attended nine interviews last year, which is disadvantageous for applicants of lower socioeconomic backgrounds. Vincent DeLeo, MD, talks to Shari Lipner, MD, PhD about the interview process during COVID-19. “It’s important to try to level the playing field in this difficult time. ... While it may be possible to do live interviews in the same fashion with people from our home institutions, it really wouldn’t be fair to do that in light of the fact that many of these candidates are going to have to do the interviews virtually.” Dr. Lipner also discusses dermatology rotations for medical students and tips for applicants. Article: https://bit.ly/3k5DHGL *  *  * Hosts: Nick Andrews, Vincent A. DeLeo, MD (University of Southern California, Los Angeles) Guest: Shari R. Lipner, MD, PhD (department of dermatology, Weill Cornell Medicine, New York) Disclosures: Dr. DeLeo is a consultant for Estée Lauder. Dr. Lipner reports no conflict of interest. Show notes by: Allegra Sparta, Melissa Sears *  *  * You can find more of our podcasts at http://www.mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeDerm
Episode 79, the top resident takeovers of 2020 (so far). We count down the top downloaded resident interviews of Dermatology Weekly in 2020. So far this year, a variety of topics affecting residents have been covered—from the impact of training during COVID-19 to the use of low-dose naltrexone to over-the-counter (OTC) topicals in dermatology and Muir-Torre syndrome. Dermatology residency during a pandemic, Episode 73: Dr. Candrice Heath talked to three dermatology residents—Dr. Brittany Oliver (on Instagram: @dr.dermatic), Dr. Sophie Greenberg (@sophiegreenberg), and Dr. Julie Croley (@DrSkinandSmiles)—about their experiences navigating through dermatology residency during the COVID-19 pandemic. They shared their perspectives from different areas of the country on how the current health crisis has impacted their training and responsibilities. Low-dose naltrexone, Episode 52: Dr. Daniel Mazori talked to Dr. Nadine Shabeeb about the benefits of off-label low-dose naltrexone (LDN) for the treatment of inflammatory skin conditions. Dr. Shabeeb provided a practical perspective on prescribing LDN in the dermatology setting and discussed how to counsel patients about potential side effects, including concerns about its abuse potential. OTC topicals, Episode 65: Dr. Daniel Mazori talked to Dr. Sophie Greenberg about selection of OTC topicals to avoid potential adverse effects. They discussed how the Food and Drug Administration categorizes and regulates OTC products as well as resources to learn more about common ingredients in OTC topicals. Muir-Torre syndrome (MTS), Episode 61: Dr. Daniel Mazori talked to Dr. Mohammed Dany about the pathogenesis of MTS and its associated malignancies. They also reviewed diagnostic clues and tools for dermatologists when treating patients with solitary sebaceous tumors. Host: Nick Andrews Dr. Croley, Dr. Dany, Dr. Greenberg, Dr. Heath, Dr. Mazori, Dr. Oliver, and Dr. Shabeeb report no conflicts of interest. Show notes by: Melissa Sears, Alicia Sonners You can find more of our podcasts at http://www.mdedge.com/podcasts       Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeDerm
Dermatology is an academically rigorous specialty, which is a major source of stress for many residents. Daniel Mazori, MD, talks to Nadine Shabeeb, MD, MPH about dermatology resident wellness and burnout. They discuss stressors for burnout in dermatology residents. “I do think that on a day-to-day basis the major stressor for me in residency is probably related to the amount of studying that we need to do,” Dr. Shabeeb reports. They also provide strategies for improving resident wellness by addressing the four areas of well-being. Article: https://bit.ly/2FMEGNf Downloadable PDF: https://bit.ly/2QaXkAj This week in dermatology news: Novel oral drug improves sunlight tolerance in patients with erythropoietic protoporphyra: https://bit.ly/34AeUWM Large study finds no link between TCI use, skin cancer in patients with AD:  https://bit.ly/3locNuS Hong Kong man gets COVID-19 twice: https://bit.ly/3hvMzEt *  *  * Hosts: Nick Andrews; Daniel R. Mazori, MD (State University of New York Downstate Medical Center, Brooklyn) Guests: Nadine Shabeeb, MD, MPH (University of Wisconsin Hospital and Clinics, Madison) Disclosures: Dr. Mazori and Dr. Shabeeb report no conflict of interest. Show notes by: Alicia Sonners, Melissa Sears *  *  * You can find more of our podcasts at http://www.mdedge.com/podcasts      Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeDerm
This week in Dermatology News: Persistent hair loss after radiation improved with minoxidil: https://bit.ly/2FFY1zx Telemedicine checklist may smooth visits with older patients: https://bit.ly/3aLVsav FDA authorizes COVID-19 saliva test: https://bit.ly/34g7pUw Dermatologists write more antibiotic prescriptions per individual clinician than other physicians, mostly to treat acne and rosacea. Dr. Vincent DeLeo talks to Dr. James Del Rosso about antibiotic use in dermatology. “Antibiotics are part of our armamentarium; they’re very important. … Primarily we’re using [antibiotics] for these inflammatory dermatoses that are not infections, and we’re prescribing them for a longer period of time,” Dr. Del Rosso explains. Dr. Del Rosso outlines acne therapies commonly associated with resistance and discusses when to use antibiotics for acne. Article: https://bit.ly/2Eb7Hl9 Downloadable PDF: https://bit.ly/2Yg4ibw *  *  * Hosts: Nick Andrews, Vincent A. DeLeo, MD (Keck School of Medicine of the University of Southern California, Los Angeles) Guest: James Q. Del Rosso, DO (JDR Dermatology Research/Thomas Dermatology, Las Vegas and Henderson, Nev.) Disclosures: Dr. DeLeo is a consultant for Estée Lauder. Dr. Del Rosso has served as an advisor, consultant, and speaker for Almirall, Bausch Health (Ortho Dermatologics), EPI Health, Foamix (Menlo Therapeutics), Galderma Laboratories, and Mayne Pharma. He also has served as a research investigator for Almirall, Bausch Health (Ortho Dermatologics), Foamix (Menlo Therapeutics), and Galderma Laboratories. Show notes: Allegra Sparta, Melissa Sears *  *  * You can find more of our podcasts at http://www.mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeDerm
COVID-19 has had profound effects on the financial stability of academic institutions, resident training, and patient care. Candrice Heath, MD (@DrCandriceHeath) talks to Erin Boh, MD, and Dirk Elston, MD, about emergency response plans in the academic setting as well as how institutions have been using teledermatology and managing resident education. “Our institution is doing quite well because we’ve actually jumped headlong and feetfirst into COVID research. . . . Our research dollars have increased double percentwise because of that," Dr. Boh said. *  *  * This week in dermatology news: Cutaneous clues linked to COVID-19 coagulation risk: https://bit.ly/31Ik4Ne Research letter: https://bit.ly/3kCnWIn Skin manifestations of COVID-19: https://bit.ly/2XUonnL Study highlights potential advantages of tape strips over biopsy: https://bit.ly/33TTZxi Original source: https://bit.ly/30R4WOm Botulinum toxin associated with antidepressant effects across indications, injection sites: https://bit.ly/2XVMd2m Original source: https://go.nature.com/3kGM38y *  *  * Hosts: Nick Andrews; Candrice R. Heath, MD (Temple University Hospital, Philadelphia) Guests: Erin Boh, MD, PhD (Tulane University, New Orleans); Dirk M. Elston, MD (Medical University of South Carolina, Charleston) Disclosures: Dr. Heath, Dr. Boh, and Dr. Elston report no conflicts of interest. Show notes by: Alicia Sonners, Melissa Sears *  *  * You can find more of our podcasts at http://www.mdedge.com/podcasts       Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeDerm  
Military dermatologists play a unique role in managing acne because they need to consider the medical readiness of servicemembers during treatment. Dr. Justin Bandino, president of the Association of Military Dermatologists, talks to Dr. Catherine Brahe and Dr. Kristopher Peters about avoiding antibiotics or systemic drugs that can limit a servicemember’s operational duty status, which can be applied to civilian health care to help slow the spread of antibiotic resistance. They highlight uses of pulsed-dye laser therapy. “I would hope that many of us in the military setting could take advantage of our ability to use this variety of lasers and treatment modalities so we can contribute to the literature and make them a little more mainstream, and then maybe in the future some of them can be covered by insurance and can be used a little more frequently,” Dr. Peters explains. Article: https://bit.ly/31gQ62GDownloadable PDF: https://bit.ly/39WcZwp *  *  * This week in dermatology news: New psoriasis guidelines focus on topical and alternative treatments, and severity measures: https://bit.ly/2DlBwyYJournal Article: https://bit.ly/39YsvYs Medical Student in the UK creates handbook of clinical signs on darker skin: https://bit.ly/31lBqPJ Biologics may delay psoriatic arthritis: https://bit.ly/2XxrEJc *  *  * Hosts: Nick Andrews, Justin P. Bandino, MD (San Antonio Uniformed Services Health Education Consortium, Tex.) Guests: Catherine Brahe, MD (Naval Medical Center, Portsmouth, Va., and 3rd Battalion 6th Marines, Camp Lejeune, N.C.); Kristopher Peters, DO (Madigan Army Medical Center, Tacoma, Wash.) Disclosures: Dr. Bandino, Dr. Brahe, and Dr. Peters report no conflict of interest. Show notes by: Alicia Sonners, Melissa Sears *  *  * You can find more of our podcasts at http://www.mdedge.com/podcasts       Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeDerm
Unlike most other cutaneous neoplasms, extramammary Paget disease (EMPD) manifests as a chronic erythematous patch. In this resident takeover, Dr. Daniel Mazori talks to Dr. Mohammed Dany about the diagnosis of primary vs secondary EMPD and the importance of screening patients for metastasis or other underlying malignancies. They also discuss the pathogenesis of EMPD and highlight future treatment targets. “The best studies that show potential are the studies focusing on PD-1 [programmed cell death receptor 1] pathway, or the checkpoint pathway. I think there is a lot of potential with immunotherapy for EMPD,” Dr. Dany explains. *  *  * This week in dermatology news: * Americans getting more sunburns (https://bit.ly/33iNOD1) * Nine states have no board-certified pediatric dermatologist, analysis reveals (https://bit.ly/3faY5Do)  * Is the presence of enanthem a clue for COVID-19? (https://bit.ly/39F2bSV)  (JAMA Research Letter: https://bit.ly/3hNZnpK) *  *  * Things you will learn in this episode: * Extramammary Paget disease characteristically presents as an erythematous patch in sites with abundant apocrine glands, such as the vulvar, scrotal, or perianal skin. “Usually the typical story would be, this is a rash that has been treated as eczema for many years but it just doesn’t go away, and it is only until the dermatologist gets a biopsy that the diagnosis of [EMPD] is made,” Dr. Dany explains. * Classic biopsy findings include pagetoid spread through the epidermis with larger cells that have blue cytoplasm, dysmorphia, and nuclear atypia. It may appear similar to other pagetoid entities such as melanoma, intraepidermal sebaceous carcinoma, or squamous cell carcinoma in situ. * Primary and secondary EMPD present in clinically and prognostically different ways, but it is difficult to discern the 2 entities based on histology. * Extramammary Paget disease requires long-term follow-up to monitor for disease recurrence or further development of malignancies. “Every patient newly diagnosed with EMPD deserves a full workup for malignancy screening,” Dr. Dany explains. * There currently is no formal staging system or treatment guidelines for EMPD. “Wide local excision has been the default in the past, but recurrence rates were very high,” Dr. Dany notes. * More research is needed to understand the pathogenesis of EMPD, but data have shown that the PD-1/PD-L1 pathway may play an important role in future therapies. * Intralesional immunotherapies can be effective in treating EMPD in sensitive areas of the body. *  *  * Hosts: Nick Andrews; Daniel R. Mazori, MD (Brigham and Women’s Hospital, Boston) Guests: Mohammed Dany, MD, PhD (University of Pennsylvania, Philadelphia) Disclosures: Dr. Mazori reports no conflict of interest. Dr. Dany reports no conflict of interest. Show notes: Alicia Sonners, Melissa Sears *  *  * You can find more of our podcasts at http://www.mdedge.com/podcasts      Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeDerm
To celebrate the 50th anniversary of Dermatology News, we are looking back at how the field has changed since that first issue in January 1970. The focus in episode 73 is infectious disease. There’s a lot to be grateful for but there are also challenges like antibiotic resistance that weren’t on the radar of dermatologists decades ago. In this episode, Nick Andrews welcomes Theodore Rosen, MD, to discuss the past, future, and current state of ID Dermatology. You can read more about the past 50 years of ID by clicking this link: https://bit.ly/3hri3v2 You can learn more about Dr. Rosen by clicking this link: https://bit.ly/2CtdmSU *  *  * What will your dermatology residency look like in the midst of coronavirus disease 2019 (COVID-19)? In this episode, guest host Dr. Candrice Heath talks to Drs. Brittany Oliver (@dr.dermatic), Sophie Greenberg (@sophiegreenbergmd), and Julie Croley (@DrSkinandSmiles) about their experiences navigating through dermatology residency during the COVID-19 pandemic. They share their perspectives from different areas of the country on how the current health crisis has impacted their training and responsibilities. They also provide tips for incoming dermatology residents on how to adapt their expectations to the post-COVID environment. “It was so rewarding and I was really anxious to get in and help, hearing about all the stories about exhausted physicians and patients who needed care, so I really felt called to be in the center of it and I’m really happy I could give back in that way,” Dr. Greenberg said of working with COVID-19 patients in New York City. Key takeaways from this episode: Drs. Oliver, Greenberg, and Croley describe how their roles and duties as dermatology residents have changed as their institutions have prepared for surges of COVID-19 patients. They discuss the impact of the lockdown and shifting priorities within their hospitals on their learning structure and educational opportunities, including lectures and dermatopathology training. “Our didactics were converted to Zoom once the lockdown began. . . . Some attendings volunteered to give us extra lectures because our clinics were not operating in the normal way. It helped compensate to make sure we’re getting enough education and training,” Dr. Greenberg says. Teledermatology services have been crucial to continuing patient care during the pandemic. Drs. Oliver, Greenberg, and Croley talk about the challenges and benefits of using telemedicine both now and in the future. “I am glad to be getting the exposure now so that I can use the experience on a few different platforms, and then wherever I land for my first job, I can hopefully adapt quickly to whatever it is they’re using,” Dr. Oliver says. They offer advice for new dermatology residents who are coming into a residency experience that looks different now than what they expected because of COVID-19. “Everything’s changing on a day-to-day basis: the COVID situation’s changing, the rules and policies are changing in our hospital, what was protocol yesterday might not be protocol today. . . . I think just having patience, being adaptable, and just realizing that hey, everybody is going through the exact same thing . . . is really the best advice I would have for people,” Dr. Croley emphasizes. They reflect on medical knowledge and skills they otherwise would not have learned without their experience as dermatology residents during the COVID-19 pandemic. Residency typically is a time to get to bond with co-residents and lean on family and friends for support through stressful times. Drs. Oliver, Greenberg, and Croley discuss ways they have been staying connected with people during the lockdown and while social distancing. *  *  * Hosts: Nick Andrews; Candrice R. Heath, MD (Temple University Hospital, Philadelphia, Penn.) Guests: Brittany Oliver, MD (Hospital of the University of Pennsylvania, Philadelphia); Sophie A. Greenberg, MD (Columbia University Medical Center, New York, NY); Julie Ann Amthor Croley, MD (The University of Texas Medical Branch at Galveston) Disclosures: Drs. Heath, Oliver, Greenberg, and Croley report no conflicts of interest. Show notes: Alicia Sonners, Melissa Sears *  *  * You can find more of our podcasts at http://www.mdedge.com/podcasts      Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeDerm
Dermatology residents must be knowledgeable about dermatologic conditions presenting in patients of various ethnic backgrounds. Dr. Vincent DeLeo talks to Drs. Abigail Cline, Susan Taylor, and Amy McMichael about improving and expanding multiethnic training in dermatology residency. “Now that I’m in residency, it has become very clear how different presentations in skin of color can be, and I can really see the importance of proper training in a racially diverse population,” says Dr. Cline. They discuss ways to ensure that dermatology trainees get adequate exposure to conditions affecting ethnic skin and highlight the role of the Skin of Color Society in reducing racial disparities within the specialty. *  *  * This week in Dermatology News: 1. Topical PDE-4 inhibitor for psoriasis effective in phase 2b trial Original story: https://bit.ly/38YtdV3 2. Subcutaneous nemolizumab eases itching for atopic dermatitis Original story: https://bit.ly/3j3U3jp NEJM article: https://bit.ly/32icCdG 3. About 1/3 of older Americans receive shingles vaccine Original story: https://bit.ly/2Cyz9rY CDC report: https://bit.ly/2WmhOJK  *  *  * Key takeaways from this episode: There is a lack of minority representation in dermatology educational materials such as textbook photographs, which often are heavily skewed toward lighter skin types. Results from a recent survey revealed that dermatology residents in the Midwest and Northwest were not seeing a diverse patient population: “[Residents] in the Northeast, Southeast, and Southwest tended to see more diverse patients, and so they didn’t feel the need for continued lectures or skin of color clinics, but the respondents within the Midwest and the Northwest really wanted to see these patients and really wanted to see what these dermatoses look like in skin of color,” Dr. Cline explains.  To ensure dermatology trainees get adequate exposure to diverse populations, home programs can allow residents to travel and rotate to other programs where they can get firsthand experience diagnosing skin of color patients. The Skin of Color Society aims to reduce racial disparities in dermatology through a variety of programs, including its annual scientific symposium, mentorship program, and research grants. Skin of color centers throughout the United States allow dermatology residents to rotate through and work with large numbers of skin of color patients. “[They also provide] an opportunity for trainees to see patients who are very satisfied with race-concordant visits—that is, the patient and the provider are of the same racial group—so they can observe what goes into making that type of interaction very successful and rewarding for the patient,” says Dr. Taylor. Practicing dermatologists can make a positive impact by mentoring high school, college, or medical students who do not have social capital as well as contributing a gift to societies with mentorship programs that provide opportunities for residents. Dermatologists can create diversity within their own practices to improve patient access to care. “You can be great at what you do, you can be a fantastic dermatologist but still not be culturally competent, so looking at what that really means—how to understand populations that are different from you culturally, how to look at perhaps having individuals in your practice that can make those patients more comfortable . . . whether they may be your nurses or your intake people . . . just sort of looking around and seeing how you can diversify your own space so that when others come they feel like you know what you’re talking about, and I think that’s really the goal overall,” explains Dr. McMichael.    Hosts: Nick Andrews; Vincent A. DeLeo, MD (Keck School of Medicine of the University of Southern California, Los Angeles) Guests: Abigail Cline, MD, PhD (New York Medical Center, New York, and Wake Forest School of Medicine, Winston-Salem, North Carolina); Susan C. Taylor, MD (University of Pennsylvania Perelman School of Medicine, Philadelphia); Amy J. McMichael, MD (Wake Forest Baptist Medical Center, Winston-Salem, North Carolina)  Disclosures: Dr. DeLeo is a consultant for Esteé Lauder. Drs. Cline, Taylor, and McMichael report no conflict of interest. Show notes by: Alicia Sonners, Melissa Sears *  *  * You can find more of our podcasts at http://www.mdedge.com/podcasts      Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeDerm
Nutrient deficiencies present clinically in the skin, hair, and nails. Dr. Vincent DeLeo talks to Dr. Bridget Shields about the dermatologist’s role in managing nutritional dermatoses in hospitalized patients. “As dermatologists, we’re trained to recognize subtle detail, and we may be the first or really the only physicians to pick up on the seemingly minor cutaneous manifestations of underlying nutritional disease,” Dr. Shields explains. She highlights key nutrient deficiencies and risk factors that dermatologists may routinely encounter. *  *  * This week in Dermatology News: Lifestyle changes may explain skin lesions in pandemic era patients Study highlights benefits of integrating dermatology into oncology centers Republican or Democrat, Americans vote for face masks *  *  * Key takeaways from this episode: Undernutrition in hospitalized patients is relatively common but often goes unrecognized because it may develop slowly over months to years. “Early identification and treatment of nutritional deficiencies can drastically improve patient morbidity and mortality and decrease systemwide health care costs,” Dr. Shields explains. It can be easier for dermatologists to diagnose and screen for nutrient deficiencies if they are able to identify at-risk patients. “Some really common medical conditions serve as risk factors that I think we routinely overlook as providers,” Dr. Shields notes. Dietary habits can predispose patients to nutrient deficiencies and therefore should be included as part of the patient’s history. The oral mucosa can provide important insight into a patient’s underlying metabolic and overall systemic health. Hospitalized patients often take in less calorically than they do at baseline. “I think working with a nutritionist can be really important to ensure a patient has appropriate macro- and micronutrient composition of any supplementation provided,” notes Dr. Shields. In most cases, treating the underlying nutrient deficiency will simultaneously treat the associated cutaneous manifestations. Skin-directed topical therapies can be useful in the right context but should not be used alone without the associated nutrient supplementation. More research is needed on how nutritional manipulation may impact the skin and serve as an adjunct to therapy with more traditional medication regimens.   Hosts: Nick Andrews; Vincent A. DeLeo, MD (Keck School of Medicine of the University of Southern California, Los Angeles) Guest: Bridget E. Shields, MD (University of Pennsylvania Perelman School of Medicine, Philadelphia) Disclosures: Dr. DeLeo is a consultant for Esteé Lauder. Dr. Shields reports no conflict of interest. Show notes by: Alicia Sonners, Melissa Sears *  *  * You can find more of our podcasts at http://www.mdedge.com/podcasts      Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeDerm  
This week in Dermatology News:  Skin patterns of COVID-19 vary widely First validated classification criteria for discord lupus erythematosus unveiled Phase 3 COVID-19 vaccine trials launching in July Dr. Vincent DeLeo counts down the top downloaded peer-to-peer interviews of Dermatology Weekly in 2020. So far this year, Dr. DeLeo and his colleagues have covered a diverse group of topics impacting the way dermatologists practice medicine, particularly during the COVID-19 pandemic—from the continued use of biologics in psoriasis patients to adopting teledermatology to recommending hair products for African American women. Teledermatology, Episode 63: Dr. Candrice Heath talked to Dr. George Han about how dermatologists can adapt their clinical practice to conduct quality teledermatology visits with their patients. They discussed potential use cases for teledermatology during the current health crisis and beyond as well as how to address technological barriers to care. Hair care products for African American women, Episode 60: Hair salon closures during the coronavirus pandemic have left women of African descent to care for their own hair at home. Dr. Lynn McKinley-Grant and Dr. Susan Taylor talked about hair care products these patients can use so that dermatologists can help African American women take care of their hair and manage dermatologic conditions. Biologics during the COVID-19 pandemic, Episode 57: Patients with severe psoriasis may be at higher risk for infection because of increased inflammation in the body. Dr. Lawrence Green discussed how to counsel patients who are taking biologics to control their psoriasis during the COVID-19 pandemic. *  *  * Hosts: Nick Andrews, Vincent A. DeLeo, MD (Keck School of Medicine of the University of Southern California, Los Angeles) Disclosures: Dr. DeLeo is a consultant for Estée Lauder. Show notes by: Alicia Sonners, Melissa Sears *  *  * You can find more of our podcasts at http://www.mdedge.com/podcasts      Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeDerm
Compounding medications allows physicians to customize formulations for individual patients. In this resident takeover, Daniel R. Mazori, MD, talks to Nadine Shabeeb, MD, MPH, about compounding topicals in dermatology. They discuss clinical scenarios in which these treatments may be warranted as well as potential drug combinations. “What’s cool about compounding for [conditions such as acne, rosacea, and hyperpigmentation] is that there are oftentimes multiple etiologies that lead to patients developing those conditions, and with compounding you can mix multiple things together to target some of those different factors,” Dr. Shabeeb says. They also discuss potential disadvantages and regulations for compounded medications. *  *  * This week in Dermatology News: Pilot study shows apremilast effective for severe recurrent canker sores For urban-based African Americans, proximity to a dermatologist varies by ZIP code Vulvar melanoma is increasing in older women *  *  * Key takeaways from this episode: Compounding is a way of mixing or combining different medications and formulations that are not commonly available at most pharmacies. Advantages of topical compounded medications include simplifying treatment regimens, prescribing treatments for rare conditions that are not commonly available, bypassing potential insurance issues, and creating topical versions of oral medications. Safety and efficacy data for compounded medications are lacking. “This is usually because of the unique nature of what’s being compounded, because multiple different things are oftentimes combined together, so there’s no published data about how safe and also how efficacious these are compared to just one single formulation being used,” Dr. Shabeeb explains. Compounded medications are not covered by insurance, and out-of-pocket cost may be prohibitive for some patients. “That being said, it may be lower than the cost of a branded medication that’s not covered by insurance, but it may be more than a generic medication that is covered by insurance,” Dr. Shabeeb says. Compounding pharmacies follow safety standards set by the U.S. Pharmacopeia, and the U.S. Food and Drug Administration prohibits physicians from prescribing compounded medicines that are approved, adulterated, or misbranded drugs. “Compounded medications can’t mimic a branded medication. It has to be either a unique formulation, or combination, or strength,” Dr. Shabeeb explains. Compounding pharmacists can be a great resource for dermatologists in terms of combining appropriate treatments for patients. Hosts: Nick Andrews; Daniel R. Mazori, MD (State University of New York Downstate Medical Center, Brooklyn) Guests: Nadine Shabeeb, MD, MPH (University of Wisconsin Hospital and Clinics, Madison) Disclosures: Dr. Mazori reports no conflict of interest. Dr. Shabeeb reports no conflict of interest. Show notes by: Alicia Sonners, Melissa Sears *  *  * You can find more of our podcasts at http://www.mdedge.com/podcasts      Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeDerm
Photodynamic therapy (PDT) has become a preferred treatment of field cancerization. Dr. Vincent DeLeo talks to Dr. Martin Miller about results from a split-sided study evaluating the efficacy of CO2 laser ablative fractional resurfacing pretreatment followed by conventional PDT for treatment of actinic keratoses (AKs). They discuss the clinical benefits of PDT for treatment of AKs as well as future directions for this combination therapy for nonmelanoma skin cancers. *  *  * We also bring you the latest in dermatology news and research: High-fat, high-sugar diet may promote adult acne It's official: COVID-19 was bad for health care business If you reopen it, will they come? *  *  * Key takeaways from this episode: Photodynamic therapy (PDT) provides consistent predictable results and healing periods without variations in response seen with topical therapies. In a split-sided study, pretreatment with CO2 laser ablative fractional resurfacing in combination with conventional PDT showed increased efficacy of AK clearance vs. conventional PDT alone. This combination therapy showed clearance of superficial basal cell carcinoma, but nodular basal cell carcinoma and squamous cell carcinoma in situ persisted at 6 months. Side effects of treatment included hypopigmentation in face and scalp areas on the laser-treated side. Future directions for treatment may include aminolevulinic acid gel 10% with standard PDT as well as combination with a red-light source to achieve deeper penetration into the skin. Hosts: Nick Andrews, Vincent A. DeLeo, MD (Keck School of Medicine of the University of Southern California, Los Angeles) Guest: Martin B. Miller, MD (University of California, San Francisco) Disclosures: Dr. DeLeo is a consultant for Estée Lauder. Dr. Miller received grant support and study drug from DUSA Pharmaceuticals Inc. Show notes by: Alicia Sonners, Melissa Sears *  *  * You can find more of our podcasts at http://www.mdedge.com/podcasts      Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeDerm
Full-body skin examinations (FBSEs) are routine in dermatology practice but can create anxiety for some patients. Dr. Vincent DeLeo talks to Dr. Atieh Jibbe about reducing patient anxiety caused by FBSEs based on results from a patient questionnaire. They discuss factors that may contribute to patient anxiety and common body areas that patients prefer to exclude from FBSEs. They also provide tips for residents in training. “If you walk a patient through the exam as you’re doing it, it makes them feel a little bit more in control of the situation rather than just unexpectedly revealing certain parts of their body,” Dr. Jibbe explains. *  *  * We also bring you the latest in dermatology news and research: Biologics may carry melanoma risk for patients with immune-mediated inflammatory disease Atopic dermatitis in adults, children linked to neuropsychiatric disorders Should healthcare workers wear masks at home? *  *  * Key takeaways from this episode: Patients may have differences in comfort level during FBSEs, based on factors such as religious practices, the sex of the clinician, or concerns about undressing and/or wearing a gown. It is important to recognize and discuss potential concerns with patients before starting the exam. “Oftentimes, I think the lack of acknowledgment of [a patient’s] anxiety or the lack of acknowledgment of the fact that we are doing a sensitive exam can make people feel more uncomfortable,” Dr. Jibbe explained. Results from a pre-encounter patient questionnaire indicated there was a female predominance in exclusion of certain body parts examined and preference for being asked what areas they wanted examined. “Also we found that more females [reported] a [positive] change in their anxiety level after the postexamination survey,” Dr. Jibbe noted. When asked which areas to exclude from FBSEs, the genitals were most commonly excluded among both men and women. Other areas included the buttocks, breast/chest, legs, feet, and abdomen. It is important for clinicians to identify themselves as soon as they walk into the examination room to reduce patient anxiety. “Patients are more apt to be more comfortable if they know who you are, your name, what your role is in the health care profession, and what you’re doing for them,” Dr. Jibbe advises. Begin the exam by asking the patient to point out the areas or lesions he/she is worried about: “That immediately gives you a segue to go start an exam, and I feel that a patient would be more comfortable if they’re indicating on their body what they want you to start looking at, and then you can transition to the full-body skin exam from there,” Dr. Jibbe says. *  *  * Hosts: Nick Andrews; Vincent A. DeLeo, MD (Keck School of Medicine of the University of Southern California, Los Angeles) Guest: Atieh Jibbe, MD (University of Kansas Medical Center, Kansas City) Disclosures: Dr. DeLeo is a consultant for Esteé Lauder. Dr. Jibbe reports no conflict of interest. Show notes by: Alicia Sonners, Melissa Sears *  *  * You can find more of our podcasts at http://www.mdedge.com/podcasts      Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeDerm
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