In this episode of Cutaneous Miscellaneous, host Nicholas Brownstone, MD, welcomes Naiem Issa, MD, for an in-depth discussion on topical therapies in dermatology, covering both traditional treatments and the latest innovations, focusing on tapinarof and roflumilast.

The episode begins with a board review of eczematous and papulosquamous diseases, including CARP, asteatotic eczema, nummular dermatitis, and pityriasis rosea, highlighting key diagnostic clues, treatment approaches, and must-know information for residents.

They then explore the role of topical therapies in treating psoriasis and atopic dermatitis, emphasizing patient expectations, positioning treatments effectively, and the balance between topicals and systemic options. They provide insights into newer agents like tapinarof and roflumilast, discussing their mechanisms of action, clinical use, and combination strategies for enhanced efficacy.

The episode wraps up with practical pearls for residents, including how to navigate access issues, gain hands-on experience with new therapies, and stay updated on emerging therapies. Tune in for a high-yield discussion packed with clinical takeaways!

In this episode of Cutaneous Miscellaneous, host Nicholas Brownstone, MD, welcomes James Del Rosso, DO, to discuss the value of dermatology residents engaging with professional societies and how it can benefit their careers and patients.

They begin with a board review on topical and systemic retinoids, highlighting the common applications of the topicals tretinoin, adapalene, and tazarotene as well as an overview of systemic options like isotretinoin and acitretin.

They then discuss how residents can leverage professional societies, such as the American Acne and Rosacea Society and the National Psoriasis Foundation, to access networking opportunities, research grants, educational resources, and more. They explore how involvement in societies can support residents, provide resources for patients, and help dermatologists build connections and advance their careers.

Tune in to the full episode to learn how professional societies can support your journey through residency and beyond!

In this episode of Cutaneous Miscellaneous, host Nicholas Brownstone, MD, welcomes guest Stephanie Fabbro, MD, to explore the evolving role of artificial intelligence (AI) in dermatology, with practical applications for residents and early-career dermatologists.

They begin with a board review on cutaneous T-cell lymphoma (CTCL) and its most common form, mycosis fungoides (MF), highlighting key diagnostic features, histological findings, and hypopigmented variants in skin of color. They explore treatment options and clinical pearls for CTCL variants like Sézary syndrome and lymphomatoid papulosis.

The discussion then transitions to AI’s potential to enhance the residency experience. Dr Fabbro shares insights on using AI for clinical differentials, board prep, and residency candidate selection. She offers practical tips on leveraging AI for time management, staying current with dermatologic research, and simplifying tasks like clinic notes and contract reviews.

Tune in to learn how AI can transform your residency experience and support your journey into dermatologic practice!

In this episode of Cutaneous Miscellaneous, host Nicholas Brownstone, MD, welcomes Brad Glick, DO, to cover to an essential topic for residents and early-career dermatologists: practical approaches for incorporating the latest therapies and technologies into clinical practice.

They begin with a board review on psoriatic arthritis. Dr Glick highlights the importance of early evaluation and preventive therapies, shares practical tips on critical questions to ask in clinic, and emphasizes utilizing screening tools to aid in diagnosis.

The conversation then shifts to integrating new therapies and technologies into clinical practice. Dr Glick shares insights on adapting to advancements, from targeted biologics to precision tools like the Mind.Px patch, which uses molecular profiling to help dermatologists select the most effective psoriasis treatments for a given patient.

Tune in to the full episode for an in-depth look at the evolving landscape of dermatologic care, from board review essentials to real-world strategies for residents looking to adopt breakthrough therapies and tools.

In this episode of Cutaneous Miscellaneous, Dr. Nicholas Brownstone welcomes Dr Peter Lio, founding director of the Chicago Integrative Eczema Center, to discuss the 3 FDA-approved biologics for atopic dermatitis, focusing on the latest addition, lebrikizumab.

With more options for atopic dermatitis come new challenges for clinicians. Dr Lio offers practical insights on differentiating dupilumab, tralokinumab, and lebrikizumab, all targeting the IL-4/13 pathways but with distinct binding and dosing characteristics. He explains his decision-making process for starting biologics, discusses patient education on safety, and provides valuable strategies for navigating insurance.

For residents, Dr Lio shares tips on gaining hands-on experience with biologics, staying updated on upcoming treatments like OX40 inhibitors, and key board review topics, including the differences in binding sites, side effects, and dosing protocols of these agents.

Tune in to the full episode for high-yield information and clinical pearls for dermatologists navigating the evolving landscape of atopic dermatitis treatments!

Need help keeping track of all the approved medications discussed in this episode? Check out our quick-reference chart that includes essential details on FDA-approved ages, dosing, and mechanisms of action for biologics in atopic dermatitis and psoriasis.

In episode 30 of Cutaneous Miscellaneous, host Nicholas Brownstone, MD, welcomes April Armstrong, MD, Professor and Chief of Dermatology at UCLA, for a detailed discussion on oral therapies for psoriasis and their continued relevance in today's treatment landscape.

They begin with a board review of 2 classic therapies, methotrexate and cyclosporine, breaking down their mechanisms of action, dosing protocols, key adverse effects, and important monitoring guidelines.

They then explore methotrexate’s continued use, particularly for uninsured patients, and cyclosporine’s role as a short-term “bridging” therapy for patients in crisis. They review acitretin, discussing its risks, chemopreventive benefits, and lab monitoring requirements; apremilast, highlighting its safety and lack of required lab monitoring; and deucravacitinib, a TYK-2 inhibitor noted for its unique mechanism, long-term efficacy, and suitability for challenging psoriasis types.

Tune in to hear expert guidance on navigating these oral therapies, practical tips for residents, and updates on how each therapy fits into modern psoriasis care!

In episode 29 of Cutaneous Miscellaneous, our host, Nicholas Brownstone, MD, is joined by dermatologist Graham Litchman, DO, and Tobin Dickerson, PhD, chief scientific officer and cofounder of Mindera Health, to explore an innovative technology in psoriasis management.

Drs Brownstone and Litchman begin with a board review on HPV and warts, highlighting key HPV types, their associated warts, and helpful mnemonic devices to aid memorization.

They then discuss Tobin Dickerson’s development of the Mind.Px dermal patch, a groundbreaking tool designed to optimize treatment decisions for psoriasis patients. Dr Litchman shares his approach to selecting biologics and how the Mind.Px test integrates into clinical workflows, from improving prior authorization to enhancing patient outcomes. The episode concludes with a look at the MATCH1 and STAMP2 studies validating this technology and advice for residents on getting involved with this cutting-edge tool.

Tune in for essential board review tips and to learn how the Mind.Px dermal patch is shaping the future of psoriasis treatment!

References:

1. Strober B, Bukhalo M, Armstrong A, et al. Interim clinical utility findings of a transcriptomic psoriasis biologic test demonstrate altered physician prescribing behavior and improved patient outcomes. SKIN J Cutan Med. 2022;6(6):458-462. doi:10.25251/skin.6.6.2

1. Bagel J, Wang Y, Montomery P III, et al. A machine learning-based test for predicting response to psoriasis biologics. SKIN J Cutan Med. 2021;5(6):621-638. doi:10.25251/skin.5.6.5

In episode 28 of Cutaneous Miscellaneous, our host, Nicholas Brownstone, MD, gets to know Anthony Rossi, MD, dermatologist and Mohs micrographic surgeon at Memorial Sloan Kettering Cancer Center and founder of his own skin care line Dr. Rossi DERM MD®.

They start with a board review on Mohs surgery, covering critical indications and the appropriate use criteria from the American College of Mohs Surgery. They also discuss patient characteristics that favor Mohs surgery and when to consider antibiotic prophylaxis.

They then discuss starting a skin care line post-residency. Dr Rossi shares insights on creating a dermatologist-approved line, weighing the pros and cons of starting from scratch versus private labeling. He provides strategies for differentiating in a saturated market, observing trends, and developing a business model that focuses on repeat customers.

Tune in to the full episode for Dr Rossi ‘s valuable pearls and pitfalls for dermatologists interested in launching their own skin care lines and how to blend business acumen with dermatologic expertise!

In episode 27 of Cutaneous Miscellaneous, our host, Nicholas Brownstone, MD, speaks with Stephen Lewellis, MD, PhD, FAAD, founder and owner of Above & Beyond Dermatology based in Wisconsin. 

The episode begins with board review on the diagnosis and treatment of adult and pediatric pityriasis rubra pilaris (PRP). Dr Brownstone offers a helpful way to remember the different pediatric forms of diseases. 

Dr Brownstone then asks Dr Lewellis to discuss the topic of direct care dermatology. Dr Lewellis discusses the theory behind direct care dermatology, the principles behind this care model, and the advantages and disadvantages. Dr Brownstone asks Dr Lewellis about his personal experience transitioning from an employed position to a direct care practice and offers advice for others considering the same.  

In episode 26 of Cutaneous Miscellaneous, our host Nicholas Brownstone, MD, chats with Harrison Nguyen, MD, MBA, MPH, FAAD, FACMS, Managing Director of Houston Skin and Ahuva Cices, MD, Assistant Professor of Dermatology at Icahn School of Medicine at Mount Sinai in front of a live audience during the Real World Dermatology For Residents Conference at the Sahara Hotel and Casino in Las Vegas, NV.

Dr Brownstone asks for advice on preparing for the APPLIED exam. Dr Nguyen discusses his perspective on preparing for the exam while Dr Cices offers her favorite resources. The group also discusses how to prepare for the Kodachromes and the dermatopathology portion of the

exam. Dr Brownstone asks Dr Nguyen specifically about infectious disease and pharmacology on the APPLIED exam and how to handle the JAAD CME articles. Dr Nguyen and Dr Cices then discuss their exam preparation schedules.

The episode continues with many more high-yield pearls on preparing for the APPLIED exam along words of encouragement from the special guests.

The episode ends with the panel discussing their favorite things about a trip to Las Vegas!

Listen now for high-yield tips on how to ace the APPLIED exam!