Dermatology Weekly

Dermatology News:

1. International expert group agrees on redefining psoriasis severity https://bit.ly/3a6a7PJ
2. 'Impressive' results with neoadjuvant T-VEC in advanced melanoma: https://bit.ly/39UEwA3
3. CDC shortens COVID-19 quarantine time to 10 or 7 days, with conditions: https://bit.ly/3qGIGSn

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Procedural interventions in pediatric patients require special tools. Vincent A. DeLeo, MD, talks to Craig N. Burkhart, MD, MS, MPH, about dermatologic procedures in children, such as laser treatment of birthmarks or excisional mole removal. When considering general anesthesia use in children, Dr. Burkhart reflects that, "if [the patient is] a child that sits for a vaccination without a problem, they're definitely ready to have minor surgery awake. If ... you have to pull them out from behind the bed, they're definitely a child that is not ready." They also discuss the importance of informed consent in teenaged patients.

Article: https://www.mdedge.com/dermatology/article/231231/pediatrics/pediatric-procedural-dermatology

Downloadable PDF: https://cdn.mdedge.com/files/s3fs-public/CT106005253.PDF

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Hosts: Nick Andrews, Vincent A. DeLeo, MD (University of Southern California, Los Angeles)

Guest: Craig N. Burkhart, MD, MS, MPH (department of dermatology, University of North Carolina at Chapel Hill, and Burkhart Pediatric & Adolescent Dermatology, Cary, N.C.)

Disclosures: Dr. DeLeo is a consultant for Estée Lauder. Dr. Burkhart reports no conflict of interest.

Show notes by: Allegra Sparta, Melissa Sears

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You can find more of our podcasts at http://www.mdedge.com/podcasts

Email the show: [email protected]

Dermatology News:

1. Expanded indications likely for apremilast: https://bit.ly/3lx1zTZ
2. Neoadjuvant immunotherapy combo produces high response rate in melanoma: https://bit.ly/33Dx0Wr
3. Blood glucose on admission predicts COVID-19 severity in all: https://bit.ly/39yJjXS

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Advances in noninvasive skin imaging present new opportunities for inclusion and equitable treatment of patients with skin of color. In this episode, Candrice R. Heath, MD (@DrCandriceHeath), talks to Josèe Smith and Steven Daveluy, MD, about the use of optical coherence tomography (OCT) to establish a baseline for all skin types can improve how dermatologists process pathology in the skin. They review various factors that influence OCT results and how results differ based on Fitzpatrick skin type, age, and level of sun exposure. They also highlight the benefits of noninvasive imaging versus biopsy in clinical practice. "[Even] though skin cancer is less common in skin of color, we know that melanoma and other types of skin cancer are usually diagnosed at later stages and more complicated stages, and so having earlier ways of detecting skin cancer in skin of color I think is really important for the future," Ms. Smith explains.

Ms. Smith and Dr. Daveluy's poster from the Skin of Color Society (@SkinOfColor) Scientific Symposium won the Crowd Favorite award.

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Hosts: Nick Andrews; Candrice R. Heath, MD (Temple University Hospital, Philadelphia, Pennsylvania)

Guests: Josèe Smith, BS (Wayne State University, Detroit); Steven Daveluy, MD (Wayne State University and Wayne County Medical Society of Southeast Michigan, Detroit)

Disclosures: Dr. Heath, Ms. Smith, and Dr. Daveluy report no conflicts of interest.

Show notes by: Alicia Sonners, Melissa Sears

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You can find more of our podcasts at http://www.mdedge.com/podcasts

Email the show: [email protected]

Interact with us on Twitter: @MDedgeDerm

Dermatology News:

1. Merino wool clothing improves atopic dermatitis, studies find: https://bit.ly/3fFHQQI
2. Tildrakizumab for psoriasis shows durable efficacy over 5 years: https://bit.ly/3l1Z0c9
3. AMA takes on vaccine misinformation, physician vaccines, racism: https://bit.ly/33ee0O2

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Nail unit squamous cell carcinoma (SCC) is difficult to diagnose or suspect clinically because of its tendency to present as nonspecific nail plate changes. The tumors usually are painless and asymptomatic, leading to a delay in diagnosis. In this resident takeover, Daniel R. Mazori, MD, talks to Mohammed Dany, MD, PhD, about nail unit SCC and the importance of early diagnosis to avoid local destruction and bone invasion. "Usually, any subungual lesion in an immunosuppressed individual, especially if it is chronic and nonhealing, would prompt a biopsy," Dr. Dany explains. They also discuss other risk factors and potential causes for nail unit SCC, with a particular focus on human papillomavirus infection, as well as treatment options including surgery.

Article: https://www.mdedge.com/dermatology/article/231900/hair-nails/nail-unit-squamous-cell-carcinoma-updates-diagnosis-surgical?channel=64

Downloadable PDF: https://cdn.mdedge.com/files/s3fs-public/CT106005011_e.PDF

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Hosts: Nick Andrews; Daniel R. Mazori, MD (State University of New York, Brooklyn)

Guests: Mohammed Dany, MD, PhD (Department of Dermatology, University of Pennsylvania, Philadelphia)

Disclosures: Dr. Mazori and Dr. Dany report no conflict of interest.

Show notes by: Allegra Sparta, Melissa Sears

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You can find more of our podcasts at http://www.mdedge.com/podcasts

Email the show: [email protected]

Interact with us on Twitter: @MDedgeDerm

Dermatology News:

1. Low threshold to biopsy atypical lesions may ID vulvar melanoma early, experts say https://www.mdedge.com/dermatology/article/231855/gynecologic-cancer/low-threshold-biopsy-atypical-lesions-may-id-vulvar
2. Chronic inflammatory diseases vary widely in CHD risk https://www.mdedge.com/dermatology/article/231815/cad-atherosclerosis/chronic-inflammatory-diseases-vary-widely-chd-risk
3. 'Hospital at home' increases COVID capacity in large study https://www.mdedge.com/dermatology/article/232113/coronavirus-updates/hospital-home-increases-covid-capacity-large-study

The COVID-19 pandemic has brought many longstanding health disparities to the forefront, particularly within the field of dermatology. In this episode, Candrice R. Heath, MD (@DrCandriceHeath) talks to Susan C. Taylor, MD, and Lynn McKinley-Grant, MD, about the impact dermatologists can have in reducing health care barriers among skin of color populations. They emphasize the importance of race-concordant visits and reflect on ways to foster diversity, equity, and inclusion in the dermatology workforce, beginning at the training and residency levels. "[We know] that minority dermatologists serve in underserved communities, that they accept public insurance or no insurance at all. They care for patients with particularly poor health status and are really committed to caring for patients of their own race. So it behooves all of us to examine ... how we can make a change and increase racial ethnic diversity within the specialty of dermatology," Dr. Taylor explains. They also highlight how organizations such as the American Academy of Dermatology and the Skin of Color Society, among others, are working to institute meaningful change within the specialty.

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Hosts: Nick Andrews; Candrice R. Heath, MD (Temple University Hospital, Philadelphia)

Guests: Susan C. Taylor, MD (University of Pennsylvania, Philadelphia); Lynn McKinley-Grant, MD (Howard University, Washington)

Disclosures: Dr. Heath reports no conflict of interest. Dr. Taylor is vice president of the AAD. Dr. McKinley-Grant is president of the Skin of Color Society.

Show notes by: Alicia Sonners, Melissa Sears

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You can find more of our podcasts at http://www.mdedge.com/podcasts

Email the show: [email protected]

Interact with us on Twitter: @MDedgeDerm

Dermatology News:

1. Who's at risk for depression on isotretinoin?: https://bit.ly/32AioXp
2. Topical tapinarof effective in pivotal psoriasis trials: https://bit.ly/3pma0o0
3. Methotrexate users need tuberculosis tests in high-TB areas: https://bit.ly/3f0DcMV

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Keeping up with the literature on atopic dermatitis (AD) is a challenge, with eight new articles posted on PubMed a day in 2020. Vincent A. DeLeo, MD, talks to Lawrence F. Eichenfield, MD, about quality of life in pediatric AD patients and how the condition affects parents/guardians, particularly in the form of sleep disturbances. Dr. Eichenfield also discusses studies that explore the impact of bathing frequency on the severity of AD as well as notable treatment advances in topical and systemic therapies in recent years. Reflecting on future research, Dr. Eichenfield posited if "recognizing significant disease early and instituting our more aggressive therapies early, will that change the development of comorbidities and will that burn out the disease more quickly or get sustained remission or cure as compared to just waiting?"

Article: https://bit.ly/3f0DrHP

Downloadable PDF: https://bit.ly/3lzuUy1

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Hosts: Nick Andrews, Vincent A. DeLeo, MD (University of Southern California, Los Angeles)

Guest: Lawrence F. Eichenfield, MD (division of pediatric dermatology, departments of dermatology and pediatrics, University of California, San Diego, and Rady Children's Hospital, San Diego)

Disclosures: Dr. DeLeo is a consultant for Estée Lauder. Dr. Eichenfield is an investigator for AbbVie, LEO Pharma, Pfizer, Regeneron, and Sanofi Genzyme. He also is a consultant for Almirall, Dermavant Sciences, Dermira, DS Biopharma, Eli Lilly, Forte Biopharma; Galderma Laboratories, Incyte, LEO Pharma, Novartis, Ortho Dermatologics, Otsuka Pharmaceutical, Pfizer, Regeneron Pharmaceuticals, and Sanofi Genzyme.

Show notes by: Allegra Sparta, Melissa Sears

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You can find more of our podcasts at http://www.mdedge.com/podcasts

Email the show: [email protected]

Dermatology News:

1. No lab monitoring needed in adolescents on dupilumab: https://bit.ly/34YAqV0
2. Birch bark derivative gel found effective for EB, in phase 3 study: https://bit.ly/385LFge
3. Skin symptoms common in COVID-19 'long-haulers: https://bit.ly/385LFge

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Peer-to-peer

Underrepresented minority (URM) students often lack the resources needed to successfully navigate careers in medicine. In this episode, Candrice Heath, MD, (@DrCandriceHeath) talks to Alfredo Siller, MD, and Amit Pandya, MD, about the influence of social and cultural capital on a URM applicant's competitiveness for dermatology residency programs. They discuss factors that impede diversification during the residency selection process and suggest potential solutions to promote equity among dermatology program applicants. "It is important when looking at residency candidates to value factors such as cultural competence, language skills, distance traveled, grit, having overcome adversity, and also look at the applicant and say: 'Is this individual more likely to go work in an underserved community?' Because that's where our patients need us," Dr. Siller explains.

Dr. Siller's poster from the Skin of Color Society (@SkinOfColor) Scientific Symposium won Best Poster for Advancing Skin of Color Dermatology "Facing the Future Award."

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Hosts: Nick Andrews; Candrice R. Heath, MD (Temple University Hospital, Philadelphia)

Guests: Alfredo Siller Jr, MD (Center for Clinical Studies, Webster, Texas); Amit G. Pandya, MD (University of Texas Southwestern Medical Center, Dallas; Palo Alto Foundation Medical Group, Mountain View, Calif.)

Disclosures: Dr. Heath reports no conflict of interest. Dr. Siller reports no conflict of interest. Dr. Pandya is a consultant for Arcutis Biotherapeutics, AVITA Medical, Chromaderm, the Immune Tolerance Network, Incyte, Pfizer, Viela Bio, and Villaris Therapeutics. He also is an investigator for Aclaris Therapeutics, the Immune Tolerance Network, Incyte, and Pfizer. He also has stock options in Clarify Medical and Tara Medical Enterprise.

Show notes by: Alicia Sonners, Melissa Sears

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You can find more of our podcasts at http://www.mdedge.com/podcasts

Email the show: [email protected]

Interact with us on Twitter: @MDedgeDerm

Dermatology news:

1. Data on potential risks of COVID-19 in psoriasis patients limited, but reassuring: https://bit.ly/3jwNc0Q
2. Red hair in women linked to elevated CRP levels in Nurses' Health Study: https://bit.ly/2HyJRSb
3. Rinse and repeat? Mouthwash might mitigate COVID-19 spread: https://bit.ly/2HKjF6w

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Dermatologists must feel comfortable and confident in diagnosing skin conditions in patients with skin of color, which begins during residency. In this resident takeover, Daniel R. Mazori, MD, and Nadine Shabeeb, MD, MPH, discuss how images of skin of color are greatly underrepresented in dermatology education resources, specifically textbooks and online resources. "We really rely on our textbooks for images and photographs of disease entities that we may not see that often clinically, and so if all of our patients are not represented in our resources and if we're not seeing those patients in clinic, we're really not ever going to be able to accurately learn and diagnose certain skin diseases," Dr. Shabeeb explains. She also talks about her efforts to improve and strengthen the skin of color curriculum and provide antiracism resources within her residency program.

Article: https://bit.ly/3kvBTHo

PDF: https://bit.ly/35CfF0a

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Hosts: Nick Andrews; Daniel R. Mazori, MD (State University of New York, Brooklyn)

Guests: Nadine Shabeeb, MD, MPH (University of Wisconsin–Madison)

Disclosures: Dr. Mazori and Dr. Shabeeb report no conflict of interest.

Show notes by: Alicia Sonners, Melissa Sears

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You can find more of our podcasts at http://www.mdedge.com/podcasts

Email the show: [email protected]

Interact with us on Twitter: @MDedgeDerm

Dermatology News:

1. Non-Whites remain sorely underrepresented in phase 3 psoriasis trials (https://bit.ly/3jmv2ia)
2. Women make progress in pediatric dermatology leadership (https://bit.ly/35nNdir)
3. Survey: Doctors lonely, burned out in COVID-19 (https://bit.ly/3dKwhXg)

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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

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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

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You can find more of our podcasts at http://www.mdedge.com/podcasts

Email the show: [email protected]

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.

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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)

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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

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You can find more of our podcasts at http://www.mdedge.com/podcasts

Email the show: [email protected]

Interact with us on Twitter: @MDedgeDerm

Dermatology News:

1. Shingrix effective in older adults with preexisting immune-mediated disorders (https://bit.ly/2GrMy7z)
2. New treatment options show promise for centrifugal cicatricial alopecia (https://bit.ly/36Dq2TL)
3. Children's share of new COVID-19 cases is on the rise (https://bit.ly/34CNEoM)

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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.

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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

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You can find more of our podcasts at http://www.mdedge.com/podcasts

Email the show: [email protected]

Interact with us on Twitter: @MDedgeDerm