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Medscape Professional Network

Official Podcast feed of MDedge Dermatology and Cutis Peer-to-Peer, part of the Medscape Professional Network. Weekly episodes include the latest in Dermatology News and peer-to-peer interviews with Doctor Vincent A. DeLeo, MD, and Dr. Candrice Heath, MD. Plus, resident discussions geared toward physicians-in-training. The information in this podcast is provided for informational and educational purposes only.

Dermatology Weekly

The COVID-19 pandemic has presented unique challenges for medical students applying to residency programs. In this episode, Candrice R. Heath, MD (@DrCandriceHeath), talks to Virginia Alvarado Jones, MD, MS (@GinaAlvaJones), and medical student Victoria Humphrey (@VictoriaSHumphrey) about their experience navigating the dermatology residency Match process during this application cycle. They provide tips and takeaways for the next group of applicants, including how to adapt to the virtual interview process and connect with mentors and fellow residents without regular in-person contact.
 
Dr. Heath also talks to residency program director Ilana Rosman, MD (@ilanarosman), about how the past year has opened the door for much needed changes in the residency application process (begins at 28:50). "We had two pandemics this year, right? We have COVID, and we have racial injustice. And I think that's not new. That's obviously not new at all. But I think it really has come to the forefront. And I think those two things together have made all of us much more cognizant of how we go about the process of residency selection and application making sure that we can make it equitable, inclusive, and sustainable moving forward," Dr. Rosman says. They also discuss a holistic approach to reviewing residency applicants and virtual mentorships.
 
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Host: Candrice R. Heath, MD (Temple University Hospital, Philadelphia)
 
Guests: Virginia Alvarado Jones, MD, MS (California Pacific Medical Center, San Francisco; University of Illinois at Chicago); Victoria Humphrey (University of Pittsburgh); Ilana Rosman, MD (Washington University, St. Louis)
 
Disclosures: Dr. Heath, Dr. Jones, and Dr. Rosman, as well as Ms. Humphrey, 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: podcasts@mdedge.com
 
Interact with us on Twitter: @MDedgeDerm

Residency match during the COVID-19 pandemic

Ethnic minorities and patients living in socioeconomically disadvantaged areas are disproportionately impacted by a growing national shortage of dermatologists. In this resident takeover, Sophie A. Greenberg, MD (Twitter: @sophiegreenberg; Instagram: @sophiegreenbergmd), talks to Soraya Azzawi, MD, about how dermatology residency can serve as an opportunity to address barriers to equitable care in these populations and enact change within the specialty: "There is a stark regional misdistribution of the dermatologic workforce, with specialists tending to concentrate in the urban areas, and more rural areas are largely underserved. And as we progress through residency and start thinking about the overall trajectory of our career, it's going to be important to consider how the imbalance of the dermatologic workforce will shape where we choose to practice and how that choice impacts vulnerable communities with the greatest unmet needs," Dr. Azzawi explains. They discuss various systemic factors that limit care in vulnerable communities and highlight ways that dermatology residents can work to better understand and meet the needs of underserved patient populations.
 
Article: https://www.mdedge.com/dermatology/article/238575/diversity-medicine/empowering-residents-address-socioeconomic-disparities
 
Downloadable PDF: https://cdn.mdedge.com/files/s3fs-public/CT107003043_e.PDF
 
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Host: Sophie A. Greenberg, MD (Columbia University Medical Center, New York)
 
Guest: Soraya Azzawi, MD (University of Miami/Jackson Memorial Hospital)
 
Disclosures: Dr. Greenberg and Dr. Azzawi 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: podcasts@mdedge.com
 
Interact with us on Twitter: @MDedgeDerm

Equitable access to dermatologic care

This week, Amber Atwater, MD, the immediate past president of the American Contact Dermatitis Society, reviews some highlights from the meeting, which was held in March.
 
Dr. Atwater, associate professor of dermatology at Duke University, Durham, N.C., discusses the 2021 "Contact Allergen of the Year," a chemical that has been linked to reactions associated with shin pads and is an emerging allergen that was the topic of a recent report in Dermatitis.
 
Joining Dr. Atwater, Raina Bembry, MD, a dermatitis fellow at Duke University, provides the results of a study of shoe allergens she presented at the meeting. which found that about 20% of shoe allergens are not detected with the current screening series. Dr. Atwater and Dr. Bembry are first and second authors of this paper, respectively; other authors are members of the North American Contact Dermatitis Group.
 
Dr. Atwater also reviews the results of a study on the potential role of expanded series patch testing in residual facial dermatitis in patients treated with dupilumab (which received the Gold Alexander A. Fisher Resident Award at the meeting), a study on patterns of contact allergy in Black and White patients in Philadelphia over 10 years (which received the Silver Fisher Resident Award), a study of contact dermatitis information on different social media sites, and results of NACDG patch test results from 2017 to 2018.
 
Dr. Atwater disclosed receiving the Pfizer Independent Grant for Learning & Change and consulting for Henke. Dr. Bembry had no disclosures.
 
References:
 
 https://www.mdedge.com/dermatology/article/237677/contact-dermatitis/contact-allergen-year-found-foam-shin-guards-footwear
 
 https://www.mdedge.com/dermatology/article/237834/contact-dermatitis/check-all-components-cases-suspected-shoe-allergy
 
 https://www.mdedge.com/dermatology/article/237899/contact-dermatitis/contact-dermatitis-content-varies-among-social-media
 
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You can find more of our podcasts at http://www.mdedge.com/podcasts 
 
Email the show: podcasts@mdedge.com

Highlights from the 2021 American Contact Dermatitis Society Meeting

Recent studies have highlighted poor representation of darker skin types in dermatology textbooks and online resources. Vincent A. DeLeo, MD, talks to Jules B. Lipoff, MD (@juleslipoff), about the general paucity of images of skin of color in learning resources as well as an overrepresentation of darker skin types in material about sexually transmitted infections. "We should be teaching our students and our residents. It shouldn't be just a skin of color lecture. Skin of color should be through every lecture. We should be showing how everything presents in every skin type," Dr. Lipoff notes. They also discuss the flaws in the Fitzpatrick skin type system.
 
Article: https://www.mdedge.com/dermatology/article/236888/diversity-medicine/distribution-skin-type-diversity-photographs-aad
 
Downloadable PDF: https://cdn.mdedge.com/files/s3fs-public/CT107003157.PDF
 
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Host: Vincent A. DeLeo, MD (University of Southern California, Los Angeles)
 
Guest: Jules B. Lipoff, MD (department of dermatology, University of Pennsylvania, Philadelphia)
 
Disclosures: Dr. DeLeo is a consultant for Estée Lauder. Dr. Lipoff 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: podcasts@mdedge.com

Educational photographs need to better represent the entire patient population

In 2019, the two CPT codes for skin biopsies were replaced with six new codes that specify biopsy technique and associated procedural complexity. Vincent A. DeLeo, MD, talks to medical student Sheena Desai and Rebecca I. Hartman, MD, MPH, about this CPT change and its effect on the frequency of shave versus punch biopsies in both private and academic practices. "The average dermatologist needs to be cognizant of the fact that changing reimbursements may hypothetically influence [the] provider's decision on what biopsy type to perform," Ms. Desai notes. They also explain how this data can be extrapolated at a national scale.
 
Article: https://www.mdedge.com/dermatology/article/236840/practice-management/comparison-shave-and-punch-biopsy-utilization-among
 
Downloadable PDF: https://cdn.mdedge.com/files/s3fs-public/CT107003151.PDF
 
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Host: Vincent A. DeLeo, MD (University of Southern California, Los Angeles)
 
Guests: Sheena Desai, BS (department of dermatology, Brigham and Women's Hospital, Harvard Medical School, both in Boston); Rebecca I. Hartman, MD, MPH (department of dermatology, Brigham and Women's Hospital, Harvard Medical School, and the department of dermatology, Jamaica Plain (Mass.) Veterans Affairs Medical Center)
 
Disclosures: Dr. DeLeo is a consultant for Estée Lauder. Ms. Schwartzberg and Dr. Hartman 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: podcasts@mdedge.com

Coding and reimbursement changes for skin biopsies

COVID-19 affects multiple organ systems, and skin manifestations are prevalent. Dr. Vincent DeLeo talks to medical student Lauren Schwartzberg and Ann Lin, DO, about both common and rare cutaneous presentations of COVID-19. "I think it's important to look at the unexplained rashes a little differently now than ever before the COVID era ... a thorough history of COVID-19 exposures and perhaps even COVID-19 testing should be considered," Ms. Schwartzberg notes. They also discuss differences in presentation seen in adult and pediatric patients.
 
Article: https://www.mdedge.com/dermatology/article/235467/infectious-diseases/cutaneous-manifestations-covid-19
 
Downloadable PDF: https://cdn.mdedge.com/files/s3fs-public/CT107002090.PDF
 
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Host: Vincent A. DeLeo, MD (University of Southern California, Los Angeles)
 
Guests: Lauren Schwartzberg, OMS-IV (New York Institute of Technology College of Osteopathic Medicine, Old Westbury); Ann Lin, DO (department of dermatology, St. John's Episcopal Hospital, Far Rockaway, N.Y.)
 
Disclosures: Dr. DeLeo is a consultant for Estée Lauder. Ms. Schwartzberg and Dr. Lin 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: podcasts@mdedge.com

Cutaneous clinical signs of COVID-19

Recent surveys show that dermatologic examinations tend to neglect the genital area. In this resident takeover, Sophie A. Greenberg, MD (@sophiegreenberg), talks to Margaret Maria Cocks, MD, PhD (@Margaret_Cocks), about the lack of focus on the genital area in the total-body skin examination (TBSE), especially in female patients, and the paucity of training on genital examinations in residency. "While [melanoma] is rare, a lot of the time when genital melanomas are identified, they're often found later and more aggressive stages ... partially that might be because this area is not routinely examined by any care provider," Dr. Cocks notes. They also discuss practical tips for including the genital area in the TBSE while focusing on patient comfort as well as diseases that may be overlooked by omitting the genitals in a TBSE.
 
Article: https://www.mdedge.com/dermatology/article/236692/practice-management/genital-examination-dermatologic-practice?channel=28253
 
Downloadable PDF: https://cdn.mdedge.com/files/s3fs-public/CT107002029_e.pdf
 
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Host: Sophie A. Greenberg, MD (department of dermatology, Columbia University Medical Center, New York)
 
Guests: Margaret Maria Cocks, MD, PhD (department of dermatology, University of Utah, Salt Lake City)
 
Disclosures: Dr. Greenberg and Dr. Cocks 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: podcasts@mdedge.com
 
Interact with us on Twitter: @MDedgeDerm

Don't overlook the genitals during a total-body skin examination

Dr. Murad Alam, professor of dermatology and chief of cutaneous and aesthetic surgery in the department of dermatology at Northwestern University, Chicago, discusses recently released evidence-based recommendations on preventing and treating adverse events from injectable fillers.
 
A recent paper outlines recommendations from an American Society for Dermatologic Surgery (ASDS) multidisciplinary task force. The paper was published in the February issue of Dermatologic Surgery (Dermatol Surg. 2021 Feb 1;47(2):214-26).
 
Dr. Alam also provides an overview of a new patient safety database – the Cutaneous Procedures Adverse Events Reporting (CAPER) system -- a collaboration between Northwestern's department of dermatology and the ASDS Association (ASDSA).
 
Dr. Alam is a past ASDS president and current chair of the ASDSA's Federal Affairs Work Group. He had no disclosures.
 
References:
 
 ASDS issues first filler safety recommendations
 
 Dermatologic surgeons debut adverse event reporting database
 
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You can find more of our podcasts at: http://www.mdedge.com/podcasts 
 
Email the show: podcasts@mdedge.com
 
Interact with us on Twitter: @MDedgeDerm

Injectable fillers: Treating and preventing adverse events with Dr. Murad Alam

Medical professionals play an important role in educating the public about COVID-19 vaccination. In this episode, Dr. Candrice Heath (@DrCandriceHeath) talks to A. Shadi Kourosh, MD, MPH (@AskDermMD), and Maritza I. Perez, MD, about the impact of the COVID-19 vaccine on dermatology practices. Dr. Kourosh explains how dermatologists can counsel patients on timing of cosmetic procedures such as fillers in relationship to vaccination. They also discuss skin reactions. "I think a take-home message is that there are a variety of different [skin] reactions but that we know what they are and that they're manageable. So the most important thing is that everyone go ahead and get vaccinated – that we as a medical community need to send our patients a message that these reactions are not in any way an obstacle to vaccination," Dr. Kourosh advises. Dr. Kourosh and Dr. Perez also discuss how in-office procedures have changed as more patients and physicians are vaccinated.
 
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Host: Candrice R. Heath, MD (Temple University Hospital, Philadelphia)
 
Guests: A. Shadi Kourosh, MD, MPH (Harvard Medical School, Boston; Massachusetts General Hospital, Boston); Maritza I. Perez, MD (University of Connecticut, Farmington; Icahn School of Medicine at Mount Sinai, New York)
 
Disclosures: Dr. Heath reports no conflict of interest. Dr. Karoush reports no conflict of interest. Dr. Perez 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: podcasts@mdedge.com
 
Interact with us on Twitter: @MDedgeDerm

Timing matters: Planning cosmetic procedures around COVID-19 vaccination

Before the COVID-19 pandemic, telemedicine largely was underutilized in dermatology. Vincent A. DeLeo, MD, talks to George Han, MD, PhD, about the progression of the reimbursement process and the roadblocks encountered with the expansion of telemedicine. "To me, telemedicine really represents the opportunity to make a dent in access to care ... expanding our access to care, especially in underserved areas in places where a lot of people have barriers, people of lower socioeconomic status, skin of color ... there's a lot of populations out there where we're just not able to get the level of coverage and access to dermatologic care that we want," Dr. Han notes. They also discuss the emergence of direct-to-consumer telemedicine services and how dermatology practices can compete.
 
Article: https://www.mdedge.com/dermatology/article/235459/infectious-diseases/reimbursement-teledermatology-during-covid-19-public
 
Downloadable PDF: https://cdn.mdedge.com/files/s3fs-public/CT107002061.PDF
 
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Host: Vincent A. DeLeo, MD (University of Southern California, Los Angeles)
 
Guest: George Han, MD, PhD (Icahn School of Medicine at Mount Sinai, New York)
 
Disclosures: Dr. DeLeo is a consultant for Estée Lauder. Dr. Han 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: podcasts@mdedge.com

Teledermatology beyond the COVID-19 pandemic

Dermatology News:
 
 1. International expert group agrees on redefining psoriasis severity

 2. 
https://bit.ly/3a6a7PJ 3. 'Impressive' results with neoadjuvant T-VEC in advanced melanoma: 
https://bit.ly/39UEwA3 4. CDC shortens COVID-19 quarantine time to 10 or 7 days, with conditions: 
https://bit.ly/3qGIGSn 
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Procedural interventions in pediatric patients require special tools. Vincent A. DeLeo, MD, talks to Craig N. Burkhart, MD, MS, MPH, about dermatologic procedures in children, such as laser treatment of birthmarks or excisional mole removal. When considering general anesthesia use in children, Dr. Burkhart reflects that, "if [the patient is] a child that sits for a vaccination without a problem, they're definitely ready to have minor surgery awake. If ... you have to pull them out from behind the bed, they're definitely a child that is not ready." They also discuss the importance of informed consent in teenaged patients.
 
Article: https://www.mdedge.com/dermatology/article/231231/pediatrics/pediatric-procedural-dermatology
 
Downloadable PDF: https://cdn.mdedge.com/files/s3fs-public/CT106005253.PDF
 
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Hosts: Nick Andrews, Vincent A. DeLeo, MD (University of Southern California, Los Angeles)
 
Guest: Craig N. Burkhart, MD, MS, MPH (department of dermatology, University of North Carolina at Chapel Hill, and Burkhart Pediatric & Adolescent Dermatology, Cary, N.C.)
 
Disclosures: Dr. DeLeo is a consultant for Estée Lauder. Dr. Burkhart 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: podcasts@mdedge.com

Pediatric procedural dermatology plus, CDC shortens quarantine and 'impressive' results with neoadjuvant T-VEC in advanced melanoma

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