Dermatology Weekly

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

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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.

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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

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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 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.

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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

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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

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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

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.

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This week in Dermatology News:

1. Lifestyle changes may explain skin lesions in pandemic era patients
2. Study highlights benefits of integrating dermatology into oncology centers
3. Republican or Democrat, Americans vote for face masks

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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

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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. Skin patterns of COVID-19 vary widely
2. First validated classification criteria for discord lupus erythematosus unveiled
3. 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.

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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

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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

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.

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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

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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

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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

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.

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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?

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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

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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

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.

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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?

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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.

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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

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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

Physicians face unique challenges with regard to mental health but often are resistant to seeking professional treatment. In this special crossover episode, Guest Host Dr. Candrice Heath (@drcandriceheath) talks with Dr. Lorenzo Norris from the MDedge podcast Psychcast and psychiatrist Dr. Nicole Washington (@drnicolepsych) about common stressors and mental health conditions they encounter when treating the physician population. They discuss how dermatologists can evaluate and protect their mental health, particularly during the coronavirus disease 2019 (COVID-19) pandemic. "We will have to show ourselves some grace and realize that there are going to be some days where we don't do as well as we think we should do, because we all have very high expectations for ourselves," Dr. Washington advises.

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We also bring you the latest in dermatology news and research:

• Authors of picosecond laser review predict more widespread use of the technology
• California wildfires caused uptick in clinical visits for atopic dermatitis
• COVID-19 update: distancing works, N95 respirators work better

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Key takeaways from this episode:

• Common mental health disorders in physicians include anxiety spectrum disorder, depression, and substance use. Burnout and demoralization often present as precursors to these syndromes.
• Physicians have a higher suicide rate than do the general population, with an estimated 300-400 physicians dying by suicide each year. "If there are that many who actually complete, how many more are there who walk around with the thoughts daily who don't complete? How many are there who we don't include in the numbers that we have as far as the anxiety and depression and substance abuse because that relies on either them admitting to it or seeking treatment for it? The numbers I think are much larger," Dr. Washington says.
• Economic uncertainty and financial stress brought on by fewer patient visits has created new anxiety for dermatologists that was not there before the COVID-19 pandemic.
• Some physicians feel guilty that they are not on the front lines of the COVID-19 pandemic. "They are feeling as if they're watching their peers jump in and be in the game ... and they're kind of just sitting on the bench. I've had multiple physicians talk about the guilt that they feel or feeling as if they aren't doing enough and really being harder on themselves about their lack of action on the front lines, and that is affecting their mental health," Dr. Washington observes.
• The amount of work physicians have taken on to keep outpatient care afloat during the pandemic can become a source of stress. "Many of my colleagues, even though they're not necessarily seeing COVID patients, their workloads have increased tremendously ... it's like the volume has gone down, but the stress of everything -- and meetings and constant information and education -- has gone up. So I kind of like to think sometimes COVID is everywhere and it just kind of depends on in what shape or form you have to deal with it," Dr. Norris points out.
• The biggest thing dermatologists can do to protect their mental health is to be honest about their feelings and be willing to reach out and get professional assistance.
• Because dermatology often is perceived as the "happiest" specialty among medical professionals, dermatologists may not be pursuing treatment for their mental health because they feel bad about saying they are having a hard time. "Don't let your circumstances or what you think people see as your circumstances stop you from reaching out," Dr. Washington advises.

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

Guests: Lorenzo Norris, MD (George Washington University, Washington); Nicole Washington, DO, MPH (Elocin Psychiatric Services)

Disclosures: Dr. Heath reports no conflict of interest. Dr. Norris reports no conflict of interest. Dr. Washington reports 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

Patients may be relying more on over-the-counter (OTC) skin care products during the current health crisis due to limited access to dermatologists. In this resident takeover, Dr. Daniel Mazori talks to Dr. Sophie Greenberg about selection of OTC topicals to avoid potential adverse effects. "I started looking into regulation and safety data and realized there's a gap in formal treating on this topic, so I wanted to provide a guide to residents so they can be adequately informed," Dr. Greenberg explains. They discuss how the Food and Drug Administration categorizes and regulates OTC products as well as resources to learn more about common ingredients in OTC topicals.

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We also bring you the latest in dermatology news and research:

• New rosacea clinical management guidelines focus on symptomology
• Dermatologists saw small income drop before pandemic
• Remdesivir shortens COVID-19 time to recover in published study

Things you will learn in this episode:

• Choosing the wrong OTC products can cause or exacerbate skin conditions, such as allergic contact dermatitis, eczema, and acne, or even result in systemic toxicity.
• The FDA categories for OTC products that are most relevant to dermatology include drugs (both prescription and nonprescription medications), cosmetics, soaps, and dietary supplements. Each category has its own unique set of regulations.
• Drugs include topical steroids, antibiotic ointments, acne treatments, antifungals, and sunscreens. "Most of these products were previously available by prescription only but became available over-the-counter after sufficient postmarketing safety information," says Dr. Greenberg.
• Regulations for chemical sunscreens currently are in flux in light of data that demonstrate serum levels above the FDA limit for drugs that are exempt from further testing for carcinogenicity.
• The FDA prohibits use of 11 categories of ingredients in all cosmetics but does not require approval, testing, or disclosure of safety data prior to products going to market. "A lot of patients and lay public have expressed concerns over the safety of over-the-counter [cosmetics], especially since regulation varies across the world," Dr. Greenberg notes.
• It is important to be vigilant and educate patients about imported cosmetics containing ingredients such as clobetasol that can be harmful if used incorrectly. "When we prescribe [products containing these ingredients], we have a chance to counsel patients on how to properly use [them], but the fact that people can purchase them over-the-counter is very scary," Dr. Greenberg says.
• Soap is categorized independently by its ingredients and its intended purpose to be used as a cleansing agent.
• The FDA evaluates safety and labeling of dietary supplements before marketing but does not directly test these products. "Clinicians can refer patients to third-party agencies that verify ingredients and test for contaminants. ... since there have been reports of supplements not containing the ingredients that they said they contain or containing toxins or potential allergens," Dr. Greenberg explains.
• The Environmental Working Group's Healthy Living app allows users to scan a product's barcode to see all of its ingredients and safety rating.
• Clinicians can scan pharmacy aisles to familiarize themselves with available OTC products and also try products on themselves to better understand and address patient concerns. "You can get samples at conferences or purchase different products each time you restock your own supply," Dr. Greenberg recommends.

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

Guests: Sophie A. Greenberg, MD (Columbia University Medical Center, New York)

Disclosures: Dr. Mazori reports no conflicts of interest. Dr. Greenberg reports 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

In the news portion of episode 64, Nick Andrews welcome Dr. Amy Paller, MD, to discuss the different dermatologic manifestations of COVID-19 especially as it pertains to pediatric patients.

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Grand Rounds are not only a teaching opportunity but also a vital patient care activity. Dr. Vincent DeLeo talks to Dr. William Huang about results of a study that surveyed how patients perceive clinical case-viewing sessions in dermatology. "I think we can easily lose track of [the patient's experience] because it is something very routine for us as an activity that we have participated in as medical students, as residents, and as faculty, but for the invited patient this is something strange, like something they saw on a medical television drama," Dr. Huang explains. They discuss how patients felt before vs after participating in Grand Rounds as well as patients' suggestions for how to improve the process.

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Things you will learn in this episode:

• The goal of Grand Rounds is to get clinical opinions from a number of different physicians at the same time to achieve better outcomes in patients with conditions that are difficult to diagnose or treat.
• Patients were surveyed before and immediately after participating in clinical case-viewing sessions to assess their feelings and attitudes regarding this activity. "We could not find where this had been looked at before in our specialty," Dr. Huang explains.
• Patients generally felt that participating in clinical case-viewing sessions met their expectations and was a beneficial experience. "They were also very likely to participate again, which demonstrates that they had a good experience overall," Dr. Huang says.
• Anxiety went down after participating in Grand Rounds vs before, but patients' feelings of being a science experience or guinea pig went up after the session was over.
• It is important to recognize that patients generally are not familiar with the process of Grand Rounds and may not know what to expect or how it benefits them. "Communicate to the patient before they are scheduled what the session will actually entail from start to finish to follow-up," Dr. Huang recommends.

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Hosts: Nick Andrews; Vincent A. DeLeo, MD (Keck School of Medicine of the University of Southern California, Los Angeles)

Guest: William W. Huang, MD, MPH (Wake Forest School of Medicine, Winston-Salem, N.C.)

Disclosures: Dr. DeLeo is a consultant for Esteé Lauder. Dr. Huang reports 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