DiscoverDermatology Weekly
Dermatology Weekly
Claim Ownership

Dermatology Weekly

Author: MDedge

Subscribed: 59Played: 459
Share

Description

Stay current on medical, surgical, and aesthetic dermatology developments with Dermatology Weekly, a podcast featuring news relevant to the practice of dermatology, and peer-to-peer interviews with Doctor Vincent A. DeLeo, who interviews physician authors from Cutis on topics such as psoriasis, skin cancer, atopic dermatitis, hair and nail disorders, cosmetic procedures, environmental dermatology, contact dermatitis, pigmentation disorders, acne, rosacea, alopecia, practice management, and more. Plus, resident discussions geared toward physicians in-training. Subscribe now.

The information in this podcast is provided for informational and educational purposes only.
49 Episodes
Reverse
Failure to recognize rosacea in the skin of color population presents an important gap in dermatology practice. Beginning at 10:06, Dr. Vincent DeLeo talks with Dr. Susan Taylor about how dermatologists can improve diagnosis and treatment of rosacea in this patient population. “I think that rosacea is underrecognized because it’s often confused for other disorders that occur commonly in skin of color populations,” Dr. Taylor explains. She highlights various clinical clues distinguishing rosacea from mimickers such as connective tissue diseases, seborrheic dermatitis, cutaneous sarcoidosis, and acne vulgaris. We also bring you the latest in dermatology news and research: 1. No increased risk of psychiatric problems tied to isotretinoin Arash Mostaghimi, MD, of Brigham and Women's Hospital in Boston discusses the study's findings and their implications.  2. FDA warning letters fall on Trump’s watch The Food and Drug Administration sent out one-third fewer warning letters to marketers of problematic drugs, devices, or food during the Trump administration's first 28 months. Things you will learn in this episode:  Overall, rosacea does not occur as commonly in skin of color patients as in white patients in the United States, but all types of rosacea can be observed in skin of color. The erythematotelangiectatic and papulopustular subtypes are most common in skin of color populations, with granulomatous rosacea occurring more frequently in black patients. Rosacea is underrecognized and underdiagnosed in skin of color patients because physicians often don’t appreciate that rosacea can and does occur in these populations. It also can be difficult to identify the erythema that is characteristic of rosacea in skin of color. Skin of color patients with rosacea often don’t present to dermatology for treatment because they have no awareness of the disease. Connective tissue diseases such as systemic lupus erythematosus and dermatomyositis can mimic rosacea in patients with skin of color. Seborrheic dermatitis and rosacea have similar clinical features and can occur concurrently in the same patient. Biopsy is needed to accurately distinguish between granulomatous rosacea and cutaneous sarcoidosis, as it can be a challenge to make the diagnosis clinically. Comedones, nodules, cysts, and postinflammatory hyperpigmentation are suggestive of acne vulgaris, as these findings are not observed in rosacea. Most of the same medications used in white patients with rosacea can be used for skin of color patients. The most important factor to keep in mind when treating rosacea in skin of color patients is that irritation from topical agents can lead to postinflammatory hyperpigmentation. “I don’t think you can go wrong being cautious and approaching therapy slowly in this patient population,” notes Dr. Taylor. Daily sunscreen use is important in all skin of color patients, particularly those with rosacea who may have facial skin that is more subject to burning or stinging or those who are photosensitive because of treatment with topical agents. Ultimately, dermatologists should rely on information garnered from patients when rosacea is suspected in skin of color. “I think the key here is you must think about rosacea when you see a skin of color patient who comes to you and complains of burning, tingling, stinging of the facial skin; sensitivity to products; redness of the skin; papules; and pustules. There are times when as clinicians you may not be able to appreciate the erythema, but rest assured that your patient can tell you if his or her facial skin is red.” Hosts: Elizabeth Mechcatie; Terry Rudd; Vincent A. DeLeo, MD (Keck School of Medicine of the University of Southern California, Los Angeles) Guest: Susan C. Taylor, MD (Perelman School of Medicine, University of Pennsylvania, Philadelphia) Show notes by Alicia Sonners, Melissa Sears, and Elizabeth Mechcatie. You can find more of our podcasts at www.mdedge.com/podcasts      Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeDerm
Are you and your staff prepared to handle ocular chemical injuries? Dr. Vincent DeLeo talks with Dr. Shawna K. Langley and Dr. Deborah Moon about common chemical agents used in the dermatology office that can be damaging to the eyes. Dr. Langley shares her experience with a patient who sustained a transient ocular injury following accidental exposure to aluminum chloride during a biopsy of a suspicious lesion on the cheek. Treatment protocols and prevention methods that dermatologists can implement to ensure the best outcome for patients also are discussed. We also bring you the latest in dermatology news and research: 1: Infections linked with transition to psoriatic arthritis 2: Social media use linked to acceptance of cosmetic surgery 3: Severity, itch improvements remain steady with ruxolitinib for atopic dermatitis   Things you will learn in this episode:  On average, approximately 7%-10% of all ocular traumas may be attributed to chemical burns. The two most important factors to consider when evaluating the extent of an ocular chemical injury include the properties of the chemical and the duration of exposure. Damage associated with exposure to acidic chemicals usually is limited to more superficial consequences, while exposure to alkaline chemicals can result in more serious long-term effects such as cataracts or glaucoma caused by deeper penetration of the eye structures. The most common immediate side effects of ocular chemical injuries include a sensation of burning (not necessarily immediate) or pain as well as redness or erythema of the eye and eventually vision changes. “One of the learning points to me was that if somebody complains that something has dripped in their eye, even if it doesn’t seem possible and it doesn’t really make sense, and if you had just worked with a caustic substance right before they said that, have them start flushing immediately anyway,” said Dr. Langley. The Roper-Hall classification outlines the prognosis based on grade of injury (grades I-IV). Immediate irrigation of the eye for 15-30 minutes is the most important variable, which will affect the patient’s long-term prognosis. “This is the one variable that will impact the long-term outcome the most for the patient,” said Dr. Langley. Always ask patients if they are wearing contact lenses, as chemicals trapped underneath can cause prolonged burning of the eye. Do not delay irrigation to remove contact lenses. Start irrigation immediately and remove the lenses when possible under irrigation. Emphasize urgent follow-up with an ophthalmologist following ocular chemical injuries sustained in the dermatology office. If an ophthalmologist is not immediately available, send the patient to the emergency department. Educate support staff about the potential for ocular injuries in the dermatology office and be prepared with the proper equipment to administer immediate treatment.   Hosts: Elizabeth Mechcatie; Terry Rudd; Vincent A. DeLeo, MD (Keck School of Medicine of the University of Southern California, Los Angeles)   Guests: Shawna K. Langley, MD (Loma Linda [Calif.] University Medical Center; Deborah J. Moon, MD (Kaiser Permanente Los Angeles [Calif.] Medical Center and the University of California, Irvine)   Show notes by: Alicia Sonners, Melissa Sears, 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  
Three dermatology residents — Dr. Elisabeth Tracey, Dr. Julie Croley, and Dr. Daniel Mazori — discuss tips for clear communication with patients in this special resident takeover of the podcast. Beginning at 6:11, they talk about challenges with topical therapies and setting expectations with patients. “We, as dermatologists, can optimize patient management by being effective communicators,” said Dr. Croley. They provide communication strategies for improving compliance with therapy and ensuring patients have the correct instructions, as well as clarifying patient misconceptions and the importance of maintenance treatment. We also bring you the latest in dermatology news and research: 1. Topical ruxolitinib looks good for facial vitiligo in phase 2 study. About half of patients on the two highest doses had a 50% improvement after 6 months of treatment. 2. Patients concerned about clinician burnout. Almost three-quarters of Americans are concerned about burnout among health care professionals. 3. Antimalarial may be effective, safe for erosive oral lichen planus. Hydroxychloroquine sulfate may be an effective and relatively safe treatment option for moderate to severe oral lichen planus. Things you will learn in this episode: Review expectations of therapy with patients, such as an intense inflammatory response to topical 5-fluorouracil for actinic keratosis, to ensure that patients remain compliant with the therapy but also feel they can trust you as their physician. If patients are hesitant to use topical minoxidil because they are concerned with the length of time they’ll have to use it, use a metaphor for another lifelong commitment such as brushing your teeth. “What I started actually doing is calling topical minoxidil toothpaste for your hair,” said Dr. Mazori. Talk to patients about spot-treating with acne or applying topical medication appropriately for psoriasis. “A particular challenge in dermatology with topical medications is not just whether or not they use it or pick up the prescription but how they use it,” said Dr. Tracey. Talk to patients about underapplication of sunscreen. Recommend a physical blocker if patients express concerns about systemic absorption. Write down instructions to ensure patients have the relevant information. The teach-back method of communicating with patients often is taught in medical school and ensures that the patients have understood what you’ve said, but it doesn’t ensure that they retained it. Strategies such as having medical students write the instructions or copying notes from your electronic medical record to print for patients can help save time. Emphasize the importance of maintenance treatment for conditions such as intertrigo, seborrheic dermatitis, or onychomycosis to prevent recurrence. Give patients both the trade name and generic name to ensure they use the correct medication. Hosts: Elizabeth Mechcatie, Terry Rudd Guests: Elisabeth (Libby) Tracey, MD (Cleveland Clinic Foundation); Julie Ann Amthor Croley, MD (University of Texas Medical Branch at Galveston); and Daniel R. Mazori, MD (State University of New York, Brooklyn). Show notes by Melissa Sears, Alicia Sonners, and 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
In this episode, Dr. Vincent DeLeo discusses artificial intelligence (AI) with Dr. Babar Rao, beginning at 10:12. Cognitive computing, which mimics human thought processes to analyze data, can be used along with other advances in AI to support clinical decision-making and physician-patient interactions. Where is dermatology in this world of AI? Dr. Rao discusses clinical scenarios in which AI can be implemented to improve patient outcomes, including hair transplantation and skin cancer evaluation. He also forecasts the future of AI in dermatology. We also bring you the latest in dermatology news and research: 1. Scabies rates plummeted with community mass drug administration. 2. Teletriage connects uninsured with timely dermatologist care, plus an interview with study investigator Cory Simpson, MD, PhD, a dermatologist at the University of Pennsylvania, Philadelphia. The study was presented at the World Congress of Dermatology. 3. Response endures in cemiplimab-treated patients with cutaneous squamous cell carcinoma. Things you will learn in this episode:  Cognitive computing not only processes data but makes sense out of the data from multiple perspectives, including human-computer interactions, vision, and language processing. Computer-aided robots can be used to maximize outcomes in hair transplantation. Artificial intelligence (AI) software can be used to analyze biopsy slides to help make skin cancer diagnoses. Electronic medical records allow physicians to input patient data, which can be helpful from a billing and insurance standpoint, but these systems currently are not able to support physicians in making clinical decisions or in choosing treatment plans based on the available patient data. Over the next 10 years, it will become common for clinical decisions to be made based on evidence and data gathered from AI systems and not from research articles or textbooks alone. Hosts: Elizabeth Mechcatie; Terry Rudd; Vincent A. DeLeo, MD (Keck School of Medicine of the University of Southern California, Los Angeles) Guest: Babar Rao, MD (Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey) Show notes by Alicia Sonners, Melissa Sears, and 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
In this special takeover episode, guest host Dr. Candrice Heath talks to Dr. Vincent DeLeo about the new sunscreen regulations issued by the US Food and Drug Administration (FDA), beginning at 7:54. Despite heightened concerns about the safety of sunscreen ingredients brought on by these new regulations, the FDA still recommends sunscreen use as an important component of sun protection. “They’re not saying that any of these [ingredients] are necessarily dangerous by any means,” Dr. DeLeo explains, “simply that they need more data.” Dr. DeLeo breaks down the complicated sunscreen regulatory process and provides tips for alleviating patient fears about sunscreen use. He also addresses recent concerns in the media about systemic absorption of sunscreen ingredients. We also bring you the latest in dermatology news and research: 1. AAD issues position statement addressing sexual, gender minority health, featuring an interview with Klint Peebles, MD, co-author of the position statement and co-chair of the AAD's LGBTQ/SGM Expert Resource Group. Dr. Peebles is on twitter @DrKlintPeebles. 2. Tick-borne disease has become a national issue. Things you will learn in this episode:  Sunscreens are regulated by the FDA as over-the-counter drugs. The first proposed rule for sunscreens was issued by the FDA in 1978 with 21 approved chemical agents that were generally recognized as safe and effective (GRASE). A number of preliminary rules have been issued over the last few decades, but a final monograph has never been provided. The 2011 sunscreen final rule included 16 ingredients that were considered GRASE and outlined labeling and testing methods for sunscreens. In the 1970s, consumers typically only used sunscreens 3 to 4 days per year during beach vacations. Today, health care professionals recommend more frequent use of sunscreens with higher sun protection factors, which has led the industry to use sunscreen ingredients at higher concentrations. An important component of the new sunscreen regulations is the requirement of maximal usage trials (MUsTs) to evaluate absorption of sunscreen ingredients into the skin and systemic circulation. Of the 16 approved sunscreen ingredients, only zinc oxide and titanium dioxide are recognized as GRASE per the FDA’s new guidelines. The remaining ingredients are not necessarily considered dangerous but will have to undergo industry testing so the FDA can determine their safety and efficacy. “My guess is that [the final monograph] is going to take years,” Dr. DeLeo speculates. “It will without question cost the industry money to do these tests, so my guess is that when this all shakes out, we will have fewer sunscreens on the market, and those sunscreens almost surely will be more expensive.” In 2014, Congress passed the Sunscreen Innovation Act to encourage the FDA to create a process to fast track the approval process for sunscreen ingredients used in Europe and other countries. Due to media coverage of the new sunscreen regulations and the complicated nature of the approval process, many patients may limit their use of sunscreens. Dermatologists should be prepared to dispel patient fears and give advice on which products are safe to use. The FDA’s recent findings on systemic absorption of sunscreen ingredients were intended to provide risk assessment guidelines for future industry testing, but more data are needed before any true risk can be established. Hosts: Elizabeth Mechcatie; Terry Rudd; Candrice R. Heath, MD (Lewis Katz School of Medicine, Temple University Hospital, Philadelphia)  Guest: Vincent A. DeLeo, MD (Keck School of Medicine of the University of Southern California, Los Angeles)  Show notes by Alicia Sonners, Melissa Sears, and 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    
In this episode, Dr. Vincent DeLeo talks to Dr. Eden Lake about outpatient management and follow-up recommendations for adverse drug reactions (ADRs), beginning at 11:28. There’s a lot of literature on what to do for an inpatient who has an ADR, but what do you do once they’re discharged? Dr. Lake reviews the clinical features of three serious ADRs — AGEP (acute generalized exanthematous pustulosis), DRESS syndrome (drug rash with eosinophilia and systemic symptoms), and SJS/TEN (Stevens-Johnson syndrome/toxic epidermal necrolysis) — and provides preliminary guidelines for outpatient dermatology care. We also bring you the latest in dermatology news and research: 1. Systematic review indicates cutaneous laser therapy may be safe during pregnancy. 2. Dr. Raymond Cho discusses the promise molecular profiling shows for treating unusual skin rashes. Dr. Cho, a dermatologist and geneticist at the University of California, San Francisco, based his comments on his presentation at the annual meeting of the Society for Investigative Dermatology. 3. Some "slime"-related contact dermatitis is allergic. Things you will learn in this episode:  Adverse drug reactions are very common in dermatology, particularly in the inpatient setting. There are approximately 2 million serious ADRs per year in the United States with more than 100,000 deaths. Acute generalized exanthematous pustulosis (AGEP) develops very quickly after exposure to an insulting medication but generally is considered self-limiting and benign. Internal involvement has been seen in up to 20% of patients. DRESS syndrome (drug rash with eosinophilia and systemic symptoms) is a severe morbilliform drug eruption that can persist for months after discharge from the hospital. It presents with systemic symptoms such as eosinophilia, but any visceral organ can be involved. SJS/TEN are overlapping conditions with mucosal involvement and cutaneous exfoliation of a necrotic epidermis. Mortality rates are high, and treatment in a burn unit is recommended. Visceral involvement in AGEP patients may be similar to DRESS syndrome and requires more long-term follow-up. Adverse drug reactions are trauma to the skin and therefore can be associated with an isomorphic phenomenon. DRESS syndrome requires laboratory testing, particularly for glucose and thyroid-stimulating hormone levels, as well as a thorough review of systems in the outpatient setting. Taper high-dose steroids in DRESS syndrome patients in the outpatient setting very slowly. Ocular and pulmonary function should be monitored for 1 year after diagnosis of SJS/TEN. Patients also should undergo psychologic evaluation due to high rates of posttraumatic stress disorder. Hosts: Elizabeth Mechcatie; Terry Rudd; Vincent A. DeLeo, MD (Keck School of Medicine of the University of Southern California, Los Angeles)  Guest: Eden Lake, MD (Loyola University Medical Center, Maywood, Ill.) Show notes by Alicia Sonners, Melissa Sears, and 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 Rate us on iTunes!  
In this episode, three dermatology residents — Dr. Daniel Mazori,  Dr. Julie Croley, and Dr. Elisabeth Tracey — discuss items they keep in their on-call bags in this special resident takeover of the podcast. Beginning at 14:50, they talk about premade biopsy kits, tricks for achieving hemostasis in the hospital, portable electronic gadgets, and creative alternatives for basic items. They also discuss bedside diagnostics and unique cases while being on-call. “After rotating through the consult service, you really do grow as a dermatologist,” reports Dr. Croley. “You see rare things; you see severe disease processes. You learn to be efficient and self-sufficient.”  We also bring you the latest in dermatology news and research: 1. Study finds inconsistent links with aspirin, nonaspirin NSAIDs, and reduced skin cancer risk. 2. Justin M. Ko, MD, MBA, of Stanford (Calif.) University discusses the American Academy of Dermatology's position statement on augmented intelligence. Dr. Ko is director and chief of medical dermatology for Stanford Health Care at Stanford Medicine, Redwood City, Calif. He is the chair of the AAD's Ad Hoc Taskforce on Augmented Intelligence, which wrote the position statement. 3. Prior authorizations for dermatology care nearly doubled in the last 2 years at one center. Things you will learn in this episode: Recommendations on what type of bag to use for your on-call bag. Premade biopsy kits are key for your on-call bag so that you can perform shave or punch biopsies. Tricks for obtaining hemostasis in the hospital. The utility of dermatoscopes has been expanding in recent years, and it can be a helpful bedside electronic device. Purple surgical markers can be used as a topical antimicrobial. Normal saline or honey can be used if you run out of Michel solution. Nonmedical items to keep in your on-call bag may include a handheld guide for drug eruptions and consult templates. Examples of unique cases of misdiagnosed Stevens-Johnson syndrome, highlighting the expertise of dermatologists: “In our field, especially as a consultant, our expertise can be so crucial in the care of complex patients.” Be comfortable with bedside diagnostics such as Tzanck smear to diagnose viral infections and a positive Nikolsky sign for staphylococcal scalded skin syndrome. Hosts: Elizabeth Mechcatie, Terry Rudd Guests: Daniel R. Mazori, MD (State University of New York, Brooklyn); Julie Ann Amthor Croley, MD (the University of Texas Medical Branch at Galveston); and Elisabeth (Libby) Tracey, MD (Cleveland Clinic Foundation). Show notes by Melissa Sears, Alicia Sonners, and Elizabeth Mechcatie. Contact us: podcasts@mdedge.com Twitter: @MDedgeDerm Rate us on iTunes! To subscribe to this podcast and more, go to mdedge.com/podcasts.
In this episode, Dr. Vincent DeLeo talks to Dr. Robert G. Micheletti about managing patients with calciphylaxis, a rare but potentially fatal condition classically seen in patients with end-stage renal disease (ESRD). Early recognition and diagnosis of calciphylaxis are essential to reducing morbidity and mortality. Dr. Micheletti describes the clinical features of calciphylaxis that dermatologists may encounter bedside, noting that biopsy often is nondefinitive. “It’s a tough disease to have," Dr. Micheletti explains, "which is why you do need multidisciplinary care and the help of a good dermatologist to be able to make the diagnosis and address the wound situation.”  We also bring you the latest in dermatology news and research: Atopic dermatitis in adults is associated with increased risk of dementia. U.S. measles total sees smallest increase in 2 months. Dr. Dee Anna Glaser, professor in the department of dermatology, Saint Louis University, discusses diagnosis and treatment advice for hyperhidrosis. Things you will learn in this episode:  Although calciphylaxis commonly is associated with ESRD, nonuremic calciphylaxis can be triggered by other clinical factors in a subset of patients without ESRD. Risk factors for calciphylaxis include various medications, clotting disorders, and autoimmune diseases, whether the patient also has ESRD. The clinical presentation of calciphylaxis depends on the point at which the area is examined. Early stages of calciphylaxis may present as a tender subcutaneous nodule, while late stages may present with more severe pain and ulceration. Maintain a high index of suspicion for calciphylaxis in patients with ESRD on chronic dialysis presenting with severely painful livedoid plaques or retiform purpura, particularly in fat-rich body sites. Biopsy often is nondiagnostic because of insufficient tissue sample size. Calcium stains will help highlight areas of vascular calcification, but “don’t assume just because the biopsy doesn’t show calcification that it is not calciphylaxis.” To improve diagnostic accuracy, biopsy specimens should be evaluated by experienced dermatopathologists who have seen calciphylaxis before. End-stage renal disease patients with calciphylaxis who are not currently on dialysis may benefit from starting it. Dermatologists should work in conjunction with nephrologists to optimize dialysis and other medications to treat underlying issues associated with calciphylaxis in the setting of ESRD. Data-driven diagnostic criteria and management guidelines for calciphylaxis are needed to improve patient care. The Society for Dermatology Hospitalists is working on pooling cases of calciphylaxis to generate a data-driven model of factors associated with the diagnosis. Hosts: Elizabeth Mechcatie; Terry Rudd; Vincent A. DeLeo, MD (University of Southern California, Los Angeles).  Guest: Robert G. Micheletti, MD (Departments of Dermatology and Medicine, University of Pennsylvania, Philadelphia). Show notes by Alicia Sonners, Melissa Sears, and Elizabeth Mechcatie. Contact us: podcasts@mdedge.com Twitter: @MDedgeDerm Rate us on iTunes! To subscribe to this podcast and more, go to mdedge.com/podcasts.    
In this episode, Dr. Vincent DeLeo talks to Dr. Shari Lipner about nail education gaps in the American Academy of Dermatology Basic Dermatology Curriculum. Although the curriculum is designed to introduce medical students to essential concepts in dermatology, nail-related topics such as diagnostic techniques, biopsy procedures, and skin cancers of the nail unit are inadequately covered. Dr. Lipner discusses strategies to close these gaps and improve nail education for medical students and dermatology residents. She also breaks down the mnemonic for identifying nail melanomas. We also bring you the latest in dermatology news and research: 1. Gentamicin restores wound healing in hereditary epidermolysis bullosa. 2. Measles complications in the U.S. unchanged in posteradication era. 3. Dr. Adam Friedman outlines oral treatment options for hyperhidrosis. Things you will learn in this episode:  A thorough full-body skin examination should include the skin, hair, and scalp, as well as the nails. Even while the patient is initially speaking, pay attention to the nails. Many dermatology residents and attendings are not familiar with the ABCDEF nail melanoma mnemonic, which is more complex than the mnemonic for cutaneous melanoma. There is a gap in educating dermatology residents on nail biopsies and surgical procedures. Nail education can be improved by encouraging medical students and residents to be aware of the nails, get comfortable with the nails, and incorporate nails into the didactics during medical school and training. More lectures at national and local conferences and hands-on learning also are helpful. “By understanding nails, both diagnosis and management, potentially we can improve patients' quality of life, and it can also be lifesaving in the case of malignancies.” Hosts: Elizabeth Mechcatie; Terry Rudd; Vincent A. DeLeo, MD (Keck School of Medicine of University of Southern California, Los Angeles)  Guest: Shari R. Lipner, MD, PhD (Weill Cornell Medicine, New York, New York)  Show notes by Alicia Sonners, Melissa Sears, and Elizabeth Mechcatie. Contact us: podcasts@mdedge.com Twitter: @MDedgeDerm Rate us on iTunes!
In this episode, Vincent DeLeo, MD, talks to Nanette B. Silverberg, MD, about the successful management of warts in the pediatric population. Warts are superficial viral infections of the skin that are extremely common in children and account for a large proportion of pediatric dermatology office visits. Although over-the-counter treatments for warts are widely available to patients, they are not universally effective. Dr. Silverberg outlines a detailed treatment paradigm for managing pediatric warts and reviews a variety of new and established treatment options in six therapeutic categories. She also reviews the latest human papillomavirus (HPV) vaccine recommendations for children. We also bring you the latest in dermatology news and research: 1. Sunscreen ingredients found in bloodstream, but health impact unknown. 2. Females with acne stay on spironolactone longer than antibiotics in real-world usage study. 3. Employed physicians now outnumber independent doctors. Things you will learn in this episode:  Warts are benign epidermal lesions caused by infection with HPV, which replicates in skin cells to induce a state of hyperkeratosis. There are more than 200 types of HPV, and warts have variable clinical and histologic features depending on type and location. The incidence of pediatric warts appears to peak in preadolescence. Children with atopic dermatitis may be at higher risk for developing warts and other extracutaneous infections. Warts in the setting of AD may indicate that a child is prone to other dermatologic or allergic conditions. Most warts in children are transmitted in close household, classroom, or sports settings. Evaluation for signs of sexual abuse always is warranted in children presenting with condyloma. Dermatologists should be aware of respiratory complications associated with HPV infection in children. The majority of warts likely will spontaneously resolve, but those that spread or do not resolve following observation or traditional therapies may require alternative treatment mechanisms. Treatment options for pediatric warts generally fall into six therapeutic categories: destructive, immune stimulating, immune modulating, irritant therapy, vascular destructive, and nitric oxide releasing. The therapeutic ladder for warts in children consists of seven rungs, beginning with diagnosis. If the clinical presentation is not clear, suspected warts should be biopsied prior to treatment to avoid unnecessary procedures or exacerbation of the condition. Avoid painful procedures in children. The most recent HPV vaccine offers broad protection and should be offered to both girls and boys before they become sexually active. The dosing schedule should be reviewed with the pediatrician. Cohosts: Elizabeth Mechcatie; Terry Rudd; Vincent A. DeLeo, MD (Keck School of Medicine of University of Southern California, Los Angeles) Guest: Nanette B. Silverberg, MD (Icahn School of Medicine at Mount Sinai, New York, New York) Show notes by Alicia Sonners, Melissa Sears, and Elizabeth Mechcatie. Contact us: podcasts@mdedge.com Twitter: @MDedgeDerm Rate us on iTunes!
loading
Comments 
loading
Download from Google Play
Download from App Store