Dermatology
Clinical insights on skin conditions, dermatologic procedures, and treatment approaches from practicing dermatologists.
Recent Discussions
How do you approach managing perioperative anxiety in Mohs patients?
Great question. Music, stress balls, having your team engage in conversations with the patient, and other distraction techniques are helpful. Some patients may need medications such as Halcion to help with anxiety but this should be given after the patient signs consent and has a verified driver aft...
Do you generally utilize calcium channel blockers on an as needed basis for patients with Raynaud's phenomenon?
Can certainly help when patients have conditions that trigger Raynaud's. If otherwise healthy, I discuss keeping the extremities protected from excessive cooling.
What laboratory studies do you routinely order when evaluating a patient with interface dermatitis on biopsy?
Rule out lupus.
For patients with xanthelasma, aside from a lipid panel, do you perform any additional lab workup or send referrals?
Agree that recurrence is common, but there are no data that a high cholesterol or increased serum lipid is associated with them.
Do you offer prophylactic antibiotics or valacyclovir prior to ablative laser therapy?
All ablative resurfacing, especially perioral region, should be prescribed valacyclovir as outbreaks can be devastating, especially if it's their first one.
Do you typically excise cellular dermatofibromas?
I don't see a reason to remove them beyond cosmetic reasons or patient preference.
Is anyone doing Nemluvio q3 weeks?
There is no contraindication to more frequent dosing than every 4 weeks, assuming you can get coverage. It's a tad easier for flex dosing using the PN indication and documenting weight >90 kg. In that case, the patient can get two 30 mg injections every 4 weeks, but what I've done for patients that ...
Can any superficial chemical peels be safely used for patients with preadolescent comedonal acne which is not responding to typical topical therapies?
Yes, salicylic acid chemical peels can be used in this age group and are both safe & effective.
How do you choose between various JAK inhibitors in the management of alopecia areata?
Mostly, the first line is baricitinib as it has been approved the longest. However, if a patient has lipid abnormalities at baseline, you could consider ritlecitinib, which does not impact the lipid profile. At the same time, however, ritlecitinib interacts with statins and other CYP3A and 1A2 medic...
For large infantile hemangiomas treated with timolol, do you have any concerns about systemic absorption?
For a large infantile hemangioma, I would opt to treat with oral propranolol instead of topical timolol, as it has better and more consistent efficacy. Additionally, oral propranolol is a weight-based medication with well-established dosing, while topical timolol applied to large hemangiomas may hav...