Derms on Drugs

AI Crosses the Prescription Line

The Goldilocks Biologic

Tiny Vesicles, Big Claims

Cuts, Switches, and Eight Extra Hairs

The 2025 Antibiotic Prophylaxis in Dermatologic Surgery (APDSAS) advisory statement simplifies clinical practice by restricting prophylaxis to mucosal or infected skin procedures, effectively removing previous requirements for groin or lower-extremity second-intent healing. Regarding atopic dermatitis, treatment persis...

Blood, Sweat, and Hives

Chronic Spontaneous Urticaria (CSU) requires a diagnosis of exclusion primarily based on clinical history rather than routine laboratory testing. Dr. Marc Serota, a specialist in pediatrics, dermatology, and allergy, emphasizes that for classic cases, immediate treatment is more effective than extensive workups. Labora...

Paging Dr. Telederm

Inpatient teledermatology bridges the critical gap in dermatological care for the vast majority of U.S. hospitals lacking on-site specialists. By utilizing asynchronous store-and-forward technology, dermatologists can provide expert management recommendations, significantly reducing diagnostic discordance and unnecessa...

Tregs, Tape, and Tresses

The RESOLVE-AD trial for moderate-to-severe atopic dermatitis introduces respegaldesleucin, an IL-2 receptor agonist designed to restore immune homeostasis by expanding regulatory T cells. While the drug shows a 61% mean reduction in EASI scores, concerns persist regarding its long-term safety and the potential for mal...

Don’t Wait for the Tunnels

Early systemic intervention for Hidradenitis Suppurativa (HS) prevents irreversible structural damage, such as tunneling and scarring, which significantly diminishes long-term quality of life. Dr. Chris Sayed emphasizes that waiting for advanced disease stages lowers the potential for achieving high-level clinical resp...

Patch Me If You Can

Managing undifferentiated dermatitis requires balancing clinical intuition with practical diagnostic strategies. While some advocate for a "clear, patch test, avoid, treat" protocol to identify specific allergens before initiating systemic therapies like dupilumab, others argue that immediate systemic intervention is o...

The Clot Thickens

Hidradenitis suppurativa (HS) treatment and melanoma management protocols dominate this clinical discussion. Povercitinib, an oral JAK1 inhibitor, demonstrates statistically significant efficacy in phase 3 trials for HS, showing improved outcomes over 54 weeks despite a modest separation from placebo and manageable saf...

The Long and Short of Male Genital Disease

Male genital disease, specifically lichen sclerosus and its progression to penile cancer, requires a shift in clinical perspective. Lichen sclerosus is a clinical diagnosis caused by chronic exposure to urine in uncircumcised men rather than an autoimmune process. Management involves ultra-potent topical steroids and b...

Three Sheets to Tofa

Tofacitinib has emerged as a cost-effective, off-label treatment option for refractory dermatologic conditions, though its safety profile requires nuanced clinical judgment. Data from the Oral Surveillance trial in rheumatoid arthritis patients indicates elevated risks for major adverse cardiovascular events (MACE), ma...

Creams, Screams, and Measles

Pediatric dermatology has evolved significantly with the introduction of new topical treatments for atopic dermatitis, including Opzelura, Zoryve, and Vtama. These agents offer improved efficacy and tolerability compared to traditional steroids and calcineurin inhibitors, though clinicians must carefully balance potenc...

Can We Stop Referring CSU?

Chronic Spontaneous Urticaria (CSU) management has evolved significantly, with international guidelines now positioning omalizumab, remibrutinib, and dupilumab as primary treatment options alongside antihistamines. Extensive diagnostic testing for CSU is largely redundant, as results rarely alter clinical management; p...

The Gray Zone Strikes Again

Image-Guided Superficial Radiation Therapy (IGSRT) for non-melanoma skin cancer costs significantly more than Mohs micrographic surgery, prompting recent Medicare coding restrictions to limit medically unnecessary ultrasound simulations. Beyond surgical costs, clinical research identifies "satellite nevi"—moles located...

Making Nails Sexy Again

Managing challenging nail conditions requires a high index of suspicion, particularly for longitudinal melanonychia in adults, where a single pigmented nail necessitates investigation to exclude melanoma. Biopsy procedures, such as matrix shaves or punches, should target the origin of the pigment, while monitoring for ...

Clinical Controversies: Screening, Patch Testing & Physician Burnout

Population-based skin cancer screening fails to demonstrate a significant reduction in melanoma mortality, indicating that future efforts should prioritize risk-stratified approaches over universal exams. Clinical practice faces mounting pressure from a 153% increase in patient portal messaging, which, alongside unreal...

What If the Biopsy Picked the Biologic?

Dermatology diagnostics and therapeutic strategies for inflammatory skin conditions, particularly the differentiation between eczema and psoriasis, remain central to clinical practice. Dr. William Damsky from Yale University highlights the utility of RNA in situ hybridization (RISH) biomarker staining to clarify ambigu...

Don't Blame the Canary

Physician burnout stems significantly from moral distress, where systemic barriers—such as bureaucratic insurance hurdles and administrative burdens—prevent clinicians from providing optimal care. Research indicates that approximately 39% of physicians experience high moral distress, which correlates strongly with emot...

Bad Ideas, Good Outcomes, and Thin Melanomas

Thin melanomas, despite their low thickness, present significant recurrence risks when characterized by high mitotic rates, tumor-infiltrating lymphocytes, or the absence of a radial growth phase. Clinical management of Hidradenitis Suppurativa (HS) may benefit from adding oral oxybutynin to adalimumab, as sweat reduct...