Dermatology Weekly

Dermatology News:

1. 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
2. Conservative parameters key to maximizing cosmetic laser results in skin of color (https://bit.ly/33dIhNn) Source: https://bit.ly/3jiLcd8
3. J&J's one-shot COVID-19 vaccine advances to phase 3 testing (https://bit.ly/33e07Qs)

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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

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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

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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

Episode 82 Dermatology News:

1. Biologics for psoriasis may also reduce coronary plaque (https://bit.ly/3ckjVEK) Journal article: https://bit.ly/3mRW2JE
2. Three-step approach may help relieve one of the itchiest vulvar conditions (https://bit.ly/33TeGI3)
3. Many Americans still concerned about access to health care (https://bit.ly/33TeGI3) Survey: https://bit.ly/3kO0DdF

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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

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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

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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

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:

1. No one-size-fits-all approach to tissue-tightening devices (https://bit.ly/32AsJmA)
2. New billing code for added COVID practice expense (https://bit.ly/3cb6oz9) AMA COVID-19 Billing PDF: https://bit.ly/32yaIVX
3. Physician income drops, burnout spikes globally in pandemic (https://bit.ly/3c2HAsY) Medscape Survey: https://wb.md/3klThhu

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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

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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 Weekly News:

1. Fatal pediatric melanomas diverse in presentation
2. Novel smart needle system designed to reduce the risk of filler complications
3. COVID Update: First randomized trial reassures on ace inhibitors and ARBs for COVID patients

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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

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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

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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

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: [email protected]

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:

1. Novel oral drug improves sunlight tolerance in patients with erythropoietic protoporphyra: https://bit.ly/34AeUWM
2. Large study finds no link between TCI use, skin cancer in patients with AD: https://bit.ly/3locNuS
3. Hong Kong man gets COVID-19 twice: https://bit.ly/3hvMzEt

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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

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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

This week in Dermatology News:

1. Persistent hair loss after radiation improved with minoxidil: https://bit.ly/2FFY1zx
2. Telemedicine checklist may smooth visits with older patients: https://bit.ly/3aLVsav
3. 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

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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

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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

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.

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This week in dermatology news:

1. 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
2. Study highlights potential advantages of tape strips over biopsy: https://bit.ly/33TTZxi Original source: https://bit.ly/30R4WOm
3. Botulinum toxin associated with antidepressant effects across indications, injection sites: https://bit.ly/2XVMd2m Original source: https://go.nature.com/3kGM38y

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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

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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

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

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This week in dermatology news:

1. New psoriasis guidelines focus on topical and alternative treatments, and severity measures: https://bit.ly/2DlBwyYJournal Article: https://bit.ly/39YsvYs
2. Medical Student in the UK creates handbook of clinical signs on darker skin: https://bit.ly/31lBqPJ
3. Biologics may delay psoriatic arthritis: https://bit.ly/2XxrEJc

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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

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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

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.

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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)

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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.

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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

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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