Dermatology Weekly

In the Resident Takeover episodes of Dermatology Weekly, Cutis Resident Corner columnists Drs. Daniel Mazori, Elisabeth Tracey, and Julie Croley have discussed lifestyle issues such as burnout in residents as well as management concerns such as treating hidradenitis suppurativa. In this episode, Dr. Mazori counts down the top downloaded Resident Takeovers in 2019.

Psychodermatology, Episode 26: Drs. Tracey, Croley, and Mazori discussed the challenges of treating patients with both psychiatric and dermatologic diseases. They reviewed medical treatment modalities and considered when referral to a mental health professional is needed.

Effective communication with patients, Episode 16: The three residents discussed how to set expectations with patients about therapeutic management and provided communication strategies for improving compliance with therapy and ensuring patients have the correct instructions.

Being on-call as a dermatology resident, Episode 12: They talked about premade biopsy kits, tricks for achieving hemostasis in the hospital, portable electronic gadgets, and creative alternatives for basic items.

Prescribing combined OCs, Episode 20: In the most-accessed Resident Takeover of 2019, they talked about prescribing combined oral contraceptives (COCs). COCs have many uses in dermatology, but dermatologists often underutilize them and don't feel comfortable prescribing them. They also reviewed the basics of prescribing COCs for dermatologic conditions.

Hosts: Elizabeth Mechcatie, Terry Rudd

Show notes by: Jason Orszt, Melissa Sears, Elizabeth Mechcatie

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

Email the show: [email protected]

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Dr. Vincent DeLeo counts down the top downloaded peer-to-peer interviews of Dermatology Weekly in 2019. Along with his colleagues, Dr. DeLeo has covered important topics to help change the way dermatologists practice medicine, from treating rosacea in the skin of color population to understanding the sunscreen regulatory process for improving sunscreen ingredients.

Nail education, Episode 10: Dr. Shari Lipner discussed nail education gaps in the American Academy of Dermatology Basic Dermatology Curriculum and strategies to close the gaps to improve nail education for medical students and dermatology residents. Dr. Lipner also broke down the mnemonic for identifying nail melanomas.

Pediatric wart management, Episode 9: Dr. Nanette B. Silverberg provided a detailed treatment paradigm for managing pediatric warts. She also reviewed new and established treatment options in six therapeutic categories.

Rosacea in the skin of color population, Episode 18: Dr. Susan Taylor discussed how dermatologists can improve the diagnosis and treatment of rosacea in the skin of color population. She highlighted clinical clues to distinguish rosacea from mimickers such as connective tissue diseases, seborrheic dermatitis, cutaneous sarcoidosis, and acne vulgaris.

Sunscreen update, Episode 14: Dr. Candrice Heath interviewed Dr. Vincent DeLeo on the new sunscreen regulations issued by the U.S. Food and Drug Administration. Dr. DeLeo explained the complicated sunscreen regulatory process and provided tips for alleviating patient fears about sunscreen use.

Show notes by: Jason Orszt, Melissa Sears, Elizabeth Mechcatie

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 this resident takeover of the podcast, three dermatology residents—Dr. Elisabeth Tracey, Dr. Julie Croley, and Dr. Daniel Mazori—discuss how to talk with patients about hidradenitis suppurativa (HS) myths, tobacco use, and weight loss. They also provide strategies for managing flares and weigh medical vs. surgical treatment of HS.

We bring you the latest in dermatology news and research:

1. Atopic dermatitis in egg-, milk-allergic kids may up anaphylaxis risk Egg- and milk-allergic patients with atopic dermatitis had more incidents of anaphylaxis; no impact seen in cases of peanut allergies.

2: iPLEDGE vexes dermatologists treating transgender patientsIn a survey, half of dermatologists report uncertainties when registering transgender patients in iPLEDGE.

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Things you will learn in this episode:

• Dispel the myths of HS. Some patients may worry that HS is contagious or infectious, sexually transmitted, or a result of poor hygiene. "I think this often stems from misinterpretation of the fact that HS is multifactorial and may implicate skin flora in part of the pathogenesis," Dr. Croley says. "I think this really highlights the importance of patient education."
• When recommending smoking cessation, avoid sounding accusatory and discuss how tobacco use has been correlated with HS. "I like to follow this by asking about the patient's personal smoking status," Dr. Croley explains. "I find the strategy useful in making the patient feel comfortable about talking about this topic."
• Suggest weight-loss strategies to address obesity in HS, such as diet, exercise, and referral to a nutritionist, to give patients strategies to achieve that goal.
• Adopt a policy that allows patients who experience a flare to visit the clinic without an appointment. "I think part of it is giving them the anticipatory guidance that flares may happen, probably will happen," says Dr. Mazori.
• Consider prescribing short courses of either oral antibiotics or oral steroids in the event that patients with HS experience a flare.
• Reserve surgery for severe or refractory disease.
• Laser hair removal (eg, with the Nd:YAG laser) is helpful for mild to moderate disease. Evidence supports using this intervention for treating affected areas and the pilosebaceous unit. For patients who cannot afford laser treatment, suggest cosmetic clinics that are affiliated with a residency program, "because I think in general those tend to make it more accessible," Dr. Mazori suggests.

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Hosts: Elizabeth Mechcatie, Terry Rudd

Guests: Elisabeth (Libby) Tracey, MD (Cleveland Clinic Foundation, Ohio); Julie Ann Amthor Croley, MD (The University of Texas Medical Branch at Galveston); Daniel R. Mazori, MD (State University of New York Downstate Medical Center, Brooklyn)

Show notes by: Jason Orszt, Melissa Sears, Elizabeth Mechcatie

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

Email the show: [email protected]

Interact with us on Twitter: @MDedgeDerm

Dermatologists often are the first to notice allergic contact dermatitis exposure patterns in the pediatric population. Vincent DeLeo, MD, talks with Dr. Margo Reeder, Dr. Amber Reck Atwater, and Jennifer M. Tran about patch test practices in children for the diagnosis of ACD. Because children have unique product and environmental exposures, panels should be customized based on the patient's exposure history. "Not only is ACD prevalent in children but also that the allergen profile is unique when compared to adults," advises Dr. Reeder.

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We bring you the latest in dermatology news and research:

1. Repeat LTBI testing best in patients taking biologics with new risk factors Just 1.2% of patients taking biologics with negative tuberculosis test results converted to positive results in annual tuberculosis screenings.
2. More states pushing plans to pay for telehealth care But fair payment remains a challenge for providers.

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Things you will learn in this episode:

• Two studies – the North American Contact Dermatitis Group and the Pediatric Contact Dermatitis Registry – have shown positive patch test reactions in children at rates of 57% and 48%, respectively.
• Improve patch testing your pediatric patients by learning about nuances such as their unique exposures and how to work with the smaller surface area of their skin.
• Take a thorough history by asking parents to "walk through a day in the life of their child" to uncover exposures from personal care products, topical medications, hobbies, and any individuals who interact with them. "It's where you truly have to bring out your inner Sherlock Holmes to determine what and where potential allergens are," Ms. Tran advises.
• Common allergens found in the pediatric population include nickel, cobalt, neomycin, balsam of Peru, lanolin, fragrance mix I, and propylene glycol.
• Reassure worried children about patch testing by providing education and using distraction techniques. "We have photos, including photos of kids undergoing patch testing that we can show before we apply the patches just to show them exactly what's going to happen," Dr. Reeder says. "Distraction is important too."
• Currently, three pediatric patch test screening series are available: T.R.U.E. Test, North American Pediatric Patch Test Series, and Pediatric Baseline Patch Test Series. Consult the Table online for information on these forms of patch testing.
• Allergen exposure can occur from sports equipment, jewelry, braces, keys, zippers, school chairs, electronics, and toys. "Musical instruments have also been implicated in contact dermatitis in children," Dr. Atwater adds, "and believe it or not, toilet seat dermatitis has also been reported."
• Consider patch testing in atopic dermatitis when the patient's dermatitis has changed, is significantly different, or involves new areas of the skin.

Guests: Margo Reeder, MD (department of dermatology, University of Wisconsin, Madison); Amber Reck Atwater, MD; (department of dermatology, Duke University, Durham, N.C.); Jennifer M. Tran (department of dermatology, University of Wisconsin, Madison)

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Show notes by Jason Orszt, Melissa Sears, Elizabeth Mechcatie

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

Email the show: [email protected]

Interact with us on Twitter: @MDedgeDerm

Hidradenitis suppurativa literature has expanded in the last few years, but there is still a delay in diagnosis for most patients due to a lack of familiarity with the condition. Dr. Vincent DeLeo talks with Dr. Alexandra P. Charrow about treatment recommendations based on disease severity and for patient lifestyle modifications.

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Are you a fan of our podcast? Recommend it to a friend on Twitter by tagging @MDedgeDerm, and we'll give you a shout-out in our next episode.

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We bring you the latest in dermatology news and research:

1. Certolizumab safety profile varies widely across indicationsSystemic corticosteroid use and body mass index affect the risk of serious adverse events with certolizumab.
2. Naturopaths emphasize role of diet in atopic dermatitis Allopathic and naturopathic providers diverge in opinions on the role of diet in cause and treatment of AD.

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Things you will learn in this episode:

• Many patients with hidradenitis suppurativa present to the ED because they have a severe flare. "We find that patients have a very long lag time from when they come in to all these different specialists and to the emergency department and the time in which they're given a definitive diagnosis," according to Dr. Charrow.
• Monitor for severe infection. "Hidradenitis is a complicated condition because it is a chronic inflammatory condition, and for that reason, patients will often have labs that mimic an infection," said Dr. Charrow.
• The Hurley staging system, used in both surgical and clinical settings, can be used for HS and is divided into three disease stages: stage I is isolated nodules or isolated abscesses; stage II is wide areas separated by sinus tracts or scarring; and stage III includes multiple lesions with near-diffuse involvement and formation of sinus tracts and scarring.
• Recommend lifestyle modifications, such as taking medications for smoking cessation that are not nicotine replacements, as these could aggravate disease; avoiding hair removal strategies that cause regrowth and the possibility of developing ingrown hairs; and avoiding progestin-only and first-generation oral contraceptives.
• Use a short course of antibiotics to control flares for Hurley stage I disease. A longer course of an antibiotic, such as tetracycline for 3-6 months, can be used to prevent further flaring.
• Consider a combination of spironolactone and tetracycline for Hurley stage II. Depending on whether these medications work, adalimumab also can be considered for stage II.
• Medications for Hurley stages I and II can be used for stage III, but if these are ineffective, providing care could be "tough" because the clinician might need to negotiate with insurance companies for other medications such as infliximab. "There's only one medication that has been FDA approved for hidradenitis and that's Humira, and only 50% of the patients in the pioneer trial demonstrated significant improvement, which means that there's half of patients who have no FDA-approved treatment for their disease," Dr. Charrow noted. "We are reaching for things for which there is no FDA approval but for which there is some pretty good evidence."
• Consult a table of treatment considerations for HS based on severity, which is available online.
• Ensure that patients with HS feel safe and have an emotional outlet during the visit because they can have a high psychiatric and psychological comorbidity profile. "The disease can be exceptionally isolating. Many patients find they can't work, they can't live normal lives . . . It's helpful to be mindful of just how stigmatizing this condition can be," Dr. Charrow advised.

Hosts: Elizabeth Mechcatie, Terry Rudd

Guests: Alexandra P. Charrow, MD, MBE (Brigham and Women's Hospital, Boston)

Show notes by: Jason Orszt, Melissa Sears, Elizabeth Mechcatie

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Email the show: [email protected]

Interact with us on Twitter: @MDedgeDerm

This week's episode features highlights of the AAD 2019 Summer Meeting.

Adam Friedman, MD, takes a closer look at nanotechnology from a dermatology perspective. Topical therapies often "have a very hard time getting to where they need to be, and nanotechnology, just by size alone, can really offer some unique benefits," says Dr. Friedman, professor of dermatology and the interim chair of the dermatology department at George Washington University, Washington.

Justin Ko, MD, director and chief of medical dermatology, Stanford (Calif.) Health Care, spoke with MDedge reporter Ted Bosworth about the use of augmented intelligence in dermatology. Dr. Ko is the coauthor of the American Academy of Dermatology's position statement on augmented intelligence, which was released in May 2019.

Henry W. Lim, MD, Henry Ford Hospital, Detroit, spoke with MDedge reporter Kari Oakes about potential environmental effects of sunscreen ingredients (particularly coral reef bleaching), as well as the FDA's widely reported sunscreen absorption study published in May – and whether sunscreen use may be contributing to the increase in frontal fibrosing alopecia.

Andrew Alexis, MD, professor and chair of the department of dermatology, Mount Sinai St. Luke's, New York, provided practical information on treating hyperpigmentation in an interview with MDedge reporter Ted Bosworth. He details his views on the length of time he considers the use of hydroquinone-based therapies to be safe, as well as the use of non–hydroquinone based.

Seemal R. Desai, MD, who is on the faculty at the University of Texas Southwestern Medical Center, Dallas, talked with MDedge editor Elizabeth Mechcatie about the treatment of patients with pigmentary disorders. The increasing interest in pigmentary disorders, particularly in patients with skin of color, "continues to be something that's very relevant and very valid" to dermatologists, said Dr. Desai, who is the immediate past president of the Skin of Color Society.

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Show notes by: Elizabeth Mechcatie

For more MDedge Podcasts, go to mdedge.com/podcasts

Email the show: [email protected]

Interact with us on Twitter: @MDedgeDerm

Mohs micrographic surgery (MMS) entails many controversies – from specialty certification to the types of tumors treated. Three dermatology residents – Dr. Julie Croley, Dr. Elisabeth Tracey, and Dr. Daniel Mazori – discuss MMS for melanoma and other tumors as well as reimbursement for and the cost-effectiveness of the procedure. They also highlight controversies surrounding the Mohs Appropriate Use Criteria (AUC). "It appears further investigation is needed to elucidate and optimize solutions to many of the current controversies associated with Mohs micrographic surgery," Dr. Croley says.

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Are you a fan of our podcast? Recommend it to a friend on Twitter by tagging @MDedgeDerm, and we'll give you a shout out in our next episode.

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We bring you the latest in dermatology news and research:

1. Apremilast for Behçet's oral ulcers: Benefits maintained at 64 weeksReassuring results of a long-term extension of the phase 3 RELIEF trial.
2. Melanoma incidence drops in younger age groups Fewer teens and young adults developed melanoma between 2006 and 2015, while incidence increased in older adults.
3. In Oregon, 'war on melanoma' takes flight A research project hopes to shrink melanoma mortality by emphasizing education, screening.

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Things you will learn in this episode:

• The 5-year survival in metastatic rates for melanomas treated with Mohs micrographic surgery (MMS) with frozen sections were the same or better when compared with historical controls treated with conventional wide local excision.
• Immunostaining in melanoma may improve accuracy but includes many challenges: It is time-consuming, reagents can be costly and could expire, some cases are equivocal, clinicians' exposure to immunostaining education is limited, and training is required to interpret margins. "So there are a lot of barriers to using immunostaining," Dr. Croley says, "but I think it has a lot of potential in the future."
• Utilization of MMS has increased in recent years, possibly due to superior efficacy for appropriately chosen cases and it is being expanded to treat other tumors such a melanoma and Merkel cell carcinoma.
• There is wide variation in mean number of Mohs stages among dermatologic surgeons. Mailing out individual reports of practice patterns to high-outlier physicians resulted in a reduction in mean stages per tumor as well as an associated cost savings when compared with outlier physicians who did not receive these reports.
• Codes for MMS are frequently reviewed by a Relative Value Scale Update Committee, and the procedure is listed as a potentially misvalued service according to the Centers for Medicare & Medicaid Services. "Reimbursements for Mohs surgery and reconstructive surgery have gone down by more than 20% in the last 15 years – at least, in part, as a result of this scrutiny," Dr. Tracey states.
• Mohs AUC has been criticized for classifying most primary superficial basal cell carcinomas as appropriate for MMS and for not considering variables such as operating on multiple tumors on the same day and operating on a tumor that is incorporating into an adjacent wound.
• Specialty certification in MMS has been a split issue. "Proponents have argued that certification could bring more consistency and decrease divisiveness among dermatologists," Dr. Mazori says. "Opponents of certification have argued that it could disenfranchise many dermatologists."

Hosts: Elizabeth Mechcatie, Terry Rudd

Guests: Julie Ann Amthor Croley, MD (University of Texas Medical Branch at Galveston); Elisabeth (Libby) Tracey, MD (Cleveland Clinic Foundation); Daniel R. Mazori, MD (State University of New York, Brooklyn)

Show notes by: Jason Orszt, Melissa Sears, Elizabeth Mechcatie

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For more MDedge Podcasts, go to mdedge.com/podcasts

Email the show: [email protected]

Interact with us on Twitter: @MDedgeDerm

Vitiligo is not the only condition that can lead to depigmentation; there are other conditions that dermatologists see less commonly that can result in vitiligolike depigmentation, such as photolichenoid dermatitis. Consider underlying diagnoses such as human immunodeficiency virus when treating patients with photolichenoid dermatitis. Dr. Vincent DeLeo talks with Dr. Nada Elbuluk about the common causes and clinical presentation of photolichenoid dermatitis. Dr. Elbuluk emphasizes the importance of screening for underlying medical conditions by describing a case of a photolichenoid eruption in a patient with undiagnosed HIV. "It's fascinating to see patients like this who remind us that depigmentation or pigmentary changes can be associated with underlying medical conditions," advises Dr. Elbuluk. "Keeping that kind of differential in the back of our minds is really important so we don't miss important underlying diagnoses such as HIV."

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We bring you the latest in dermatology news and research:

1. Patients taking TNF inhibitors can safely receive Zostavax

Investigators found no confirmed varicella infection cases at 6 weeks.

2. AAD-NPF pediatric psoriasis guideline advises on physical and mental care

Topics in this guideline for pediatric psoriasis include systemic and topical treatments, management of comorbidities, and quality of life.

3. Expert reviews strategies for diagnosing, treating onychomycosis

The ideal treatment for onychomycosis would not pose a systemic risk to the liver, heart, or other organs, and would not require lab monitoring.

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Things you will learn in this episode:

• Common histopathologic findings of photolichenoid dermatitis include a dense bandlike lymphocytic infiltrate in the superficial papillary dermis abutting the upper dermis, which can be accompanied by an interface change at the dermoepidermal junction.
• NSAIDs and sulfamethoxazole-trimethoprim are the most common medications that cause photolichenoid eruptions, particularly in patients with HIV, among others.
• Patients with HIV who have photolichenoid eruptions typically have advanced HIV or AIDS with a low CD4 count.
• Taking a photosensitizing medication is not required to develop a photolichenoid eruption in patients with HIV.
• Biopsy patients who have photolichenoid eruptions can confirm that there is no underlying medical condition. "When our patient came in, actually we were worried more about discoid lupus," Dr. Elbuluk describes. "So as part of that [work-up], we ordered an ANA." Laboratory workup should include HIV and a hepatitis panel.
• Consider HIV when seeing a patient with a photodistributed eruption that is more lichenoid or presents with depigmentation. Ask screening questions about sexual history and order bloodwork. "This is a really good case and example of how we, as dermatologists, can be so instrumental in diagnosing internal disease," Dr. Elbuluk adds.

Guest: Nada Elbuluk, MD (formerly of the department of dermatology at New York University; currently with the University of Southern California, Los Angeles)

Show notes by: Jason Orszt, Melissa Sears, Elizabeth Mechcatie

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For more MDedge Podcasts, go to mdedge.com/podcasts

Email the show: [email protected]

Interact with us on Twitter: @MDedgeDerm

Pediatric atopic dermatitis (AD) is more prevalent in African American children. Dr. Lynn McKinley-Grant, president of the Skin of Color Society, talks with Dr. Amy McMichael about the quality-of-life impact on pediatric patients with AD as well as skin care in this patient population. They also discuss the clinical presentation of AD in the skin of color population. "We have to open our minds up to all of the ways that atopic dermatitis can look in every skin type," Dr. McMichael says. "Then we don't miss it, and we don't minimize how severe it is when we're taking care of those patients."

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We bring you the latest in dermatology news and research:

1. Nemolizumab for prurigo nodularis impresses in phase 2b study Interleukin-31 signaling is a promising therapeutic target in prurigo nodularis.

2. Acoustic pulse boosts laser tattoo removal Device "clears" skin cells after single passes and allows single office visits to pack more punch.

3. Severe psoriasis associated with increased cancer risk, mortalityBecause these were associations only, any underlying mechanism is still unclear.

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Things you will learn in this episode:

• African American children with AD (aged 2-17 years) have a 1.5-fold higher chance of being absent for 6 days in a 6-month school period than do non-Hispanic children, and they have higher chronic absenteeism, compared with white children.
• Some parents/guardians purchase topical products with fragrances that are inappropriate for patients with AD. "Consumers have no idea what's good, so they just buy them and they use them," Dr. McMichael says. "They can often make things a lot worse."
• Resident training should focus on learning how skin diseases present in all skin types. "You do have to be cognizant of pigment being present and wonder, 'OK, is this postinflammatory or is this truly inflammatory?' " Dr. McMichael advises.
• For children who want to engage in athletics, treatment should be more aggressive. Consider using systemic treatments more readily or prescribing dupilumab (Dupixent). "We have to be cognizant of when flares occur that perhaps these patients should not participate in activities at that time, but if they want to -- and certainly it's healthy to do so -- then we need to step up to the plate and treat them appropriately," emphasizes Dr. McMichael.
• Patients with AD have a higher prevalence of contact sensitization to fragrances, including balsam of Peru. It is essential to find out what products your patients with AD are using on their skin. Ask them such questions as: What are you using to cleanse your face? What are you using as a moisturizer? Do you put anything else on your face or skin?
• Debunk inaccurate information that your patients and parents are consuming about AD medications. "You have to encourage them that it's not all about steroids. We have other options now and that they need to consider them," Dr. McMichael adds.

Hosts: Lynn McKinley-Grant, MD (Howard University College of Medicine, Washington, DC)

Guests: Amy McMichael, MD (department of dermatology, Wake Forest University, Winston-Salem, N.C.)

Show notes by: Jason Orszt, Melissa Sears, Elizabeth Mechcatie

For more MDedge Podcasts, go to mdedge.com/podcasts

Email the show: [email protected]

Interact with us on Twitter: @MDedgeDerm

How can you integrate decision-making resources into your clinical practice? In this resident takeover of the podcast, three dermatology residents — Dr. Daniel Mazori, Dr. Elisabeth Tracey, and Dr. Julie Croley — discuss clinical decision support tools such as scoring systems and other resources available for dermatologists. These tools should be used as a supplement, not as a substitute for one's clinical judgment. "The optimal treatment for patients in a complex medical system requires not just coming to the correct diagnosis and using your clinical judgment to make a decision but effectively communicating that decision to the insurance companies [and] to the primary team that's taking care of them on the inpatient service. ... Some objective data can really be useful in those situations," advises Dr. Tracey.

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We bring you the latest in dermatology news and research:

1. No tacrolimus/cancer link in atopic dermatitis in 10-year study

2. PASI-75 with ixekizumab approaches 90% in pediatric psoriasis study

3. NAM offers recommendations to fight clinician burnout

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Things you will learn in this episode:

• Evaluate for psoriatic arthritis with the Psoriasis Epidemiology Screening Tool (PEST). "It's the kind of thing that I'll use in addition to asking a patient with psoriasis questions about symptoms like joint pain and morning stiffness," Dr. Mazori says.
• Consider UpToDate.com and VisualDx.com for clinical decision support, to formulate differential diagnoses, and as a resource for patient education. "The other day, I had a patient who was diagnosed with scabies," Dr. Tracey explains. "We were counseling the patient on how to decontaminate their environment. I wanted to get the exact number of hours their belongings needed to be in a plastic bag or how to wash their clothes. So, we went on UpToDate and read it together in the clinic."
• The SCORTEN system predicts hospital mortality from Stevens-Johnson syndrome/toxic epidermal necrolysis and is useful for the primary team. "I've found it useful ... as a measure of risk to communicate to the primary team, even the patient's family," Dr. Mazori says. But the SCORTEN isn't perfect. "There are studies that have found it can overestimate or underestimate mortality," he warns.
• To differentiate cellulitis from pseudocellulitis in adult patients, consider the ALT-70 score. "It gives me an objective measure of risk to communicate to the primary team in support of one diagnosis or another in addition to my clinical judgment," advises Dr. Mazori.
• The Mohs Appropriate Use Criteria (AUC) helps guide decision making for Mohs micrographic surgery, but it has been scrutinized for classifying most primary superficial basal cell carcinomas as appropriate for treatment, omitting important European trials, and for having ratings that are based on expert opinion rather than evidence.
• The MyDermPath+ app can assist clinicians in forming differentials based on histopathologic patterns.

Hosts: Elizabeth Mechcatie, Terry Rudd

Guests: Daniel R. Mazori, MD (State University of New York Downstate Medical Center); Elisabeth (Libby) Tracey, MD (Cleveland Clinic Foundation); Julie Ann Amthor Croley, MD (University of Texas Medical Branch at Galveston)

Show notes by: Jason Orszt, Melissa Sears, Elizabeth Mechcatie

For more MDedge Podcasts, go to mdedge.com/podcasts

Email the show: [email protected]

Interact with us on Twitter: @MDedgeDerm