Derms and Conditions

Episódios

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  Anti-IL-23 Biologic Therapy: Expanding our Knowledge and Access for Patients with Psoriasis 23.07.2026 25min

  In this episode of Derms and Conditions, host James Q. Del Rosso, DO, welcomes E. James Song, MD, for a discussion of the IL-23 pathway and its enduring role in psoriasis management. Although therapeutic options continue to expand, IL-23 remains a central target because of its key role in the IL-23/Th17 axis, one of the primary drivers of psoriatic disease. Dr Song reviews the current IL-23 therapeutic landscape, comparing available agents that target the pathway through different mechanisms. He highlights important distinctions among therapies, including dosing intervals, molecular characteristics, binding affinity, and immunogenicity, while emphasizing that all have demonstrated strong efficacy and favorable safety profiles. The conversation also explores how these pharmacologic differences do—and do not—translate into meaningful clinical differences. The conversation also explores patient access, with Drs Del Rosso and Song discussing how route of administration and insurance coverage can significantly influence treatment selection, particularly for Medicare beneficiaries. They examine the practical advantages of health care provider-administered therapy, including more reliable treatment delivery, closer patient follow-up, and reduced financial barriers for some patients. The discussion also addresses expectations for treatment response, emphasizing that IL-23 inhibitors may require more time than other biologic classes to achieve maximal benefit. Dr Song shares practical insights into assessing early improvement, counseling slower responders, and supporting long-term treatment persistence. The episode concludes with a review of the safety profile of IL-23 inhibitors, including their role in psoriasis with peripheral psoriatic arthritis, while discussing areas where these therapies remain more limited, such as axial disease and uveitis. Tune in to the full episode to learn more about the IL-23 pathway, the similarities and distinctions among available therapies, practical access considerations, and setting realistic expectations for treatment response in everyday psoriasis care.
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  Topical Therapy for AD: How Can an AhR Agonist Make a Difference? 16.07.2026 25min

  In this episode of Derms and Conditions, host James Q. Del Rosso, DO, welcomes Alexandra Golant, MD, for a discussion on the evolving role of topical therapies in atopic dermatitis (AD). While systemic therapies have transformed care for patients with moderate to severe disease, this discussion explores how topical treatments remain essential, not only for managing flares but also for maintaining long-term disease control. Dr Golant reflects on how the topical treatment landscape has changed over the past several years. After decades in which topical corticosteroids remained the cornerstone of therapy, recent advances have introduced multiple nonsteroidal options with distinct mechanisms of action and improved suitability for chronic, proactive management. The conversation explores where topical corticosteroids continue to fit in modern AD management. Rather than viewing steroids as obsolete, Dr Golant advocates for a balanced approach that considers efficacy, access, and appropriate stewardship. She emphasizes that corticosteroids remain valuable for short-term use but encourages clinicians to transition thoughtfully to nonsteroidal therapies when appropriate. Dr Del Rosso and Dr Golant also review the expanding range of nonsteroidal topical therapies, including JAK inhibitors, PDE4 inhibitors, and the first-in-class aryl hydrocarbon receptor (AhR) agonist, tapinarof. Because AhR agonism represents an unfamiliar mechanism for many clinicians, Dr Golant explains how activation of this pathway not only reduces inflammatory signaling but also supports skin barrier function and antioxidant activity, helping address multiple aspects of AD pathophysiology. The discussion also examines emerging clinical experience with tapinarof in AD, including its once-daily dosing, favorable safety profile, and potential to provide durable disease control in some patients. Dr Golant highlights the importance of challenging outdated assumptions that nonsteroidal therapies are slower or less effective than topical corticosteroids, noting that newer agents can achieve meaningful improvements in itch and skin clearance while providing flexibility for long-term management. Tune in to the full episode to hear Drs Del Rosso and Golant discuss how they incorporate modern topical therapies into real-world AD management, where corticosteroids still have an important role, and why advances in nonsteroidal treatments are changing the way clinicians approach both acute flares and long-term disease control.
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  How Contactants Can Influence the Clinical Picture of AD 09.07.2026 33min

  In this episode of Derms and Conditions, host James Q. Del Rosso, DO, welcomes Walter Liszewski, MD, for a discussion on the role of patch testing in patients with atopic dermatitis (AD), from the fundamentals of testing and interpretation to its application in patients with persistent or incomplete responses to therapy. Dr Liszewski explains why allergic contact dermatitis is frequently overlooked in dermatology practice and how it commonly overlaps with AD and irritant contact dermatitis. Because these conditions often appear clinically similar, Dr Liszewski explains that, unlike AD or irritant contact dermatitis, allergic contact dermatitis has a diagnostic test available, making patch testing an important tool when the underlying cause of eczema is uncertain. The conversation explores when patch testing should be considered in light of the absence of formal guidelines, with Dr Liszewski sharing his practical approach to identifying patients who may benefit from testing and how it can fit into the management of patients who continue to experience residual eczema despite advanced therapies. He also discusses the different reasons biologic-treated patients may have persistent disease and how patch testing can help distinguish allergic contact dermatitis from a more complex inflammatory phenotype. Dr Liszewski reviews practical considerations for preparing patients for patch testing, including which medications should be discontinued beforehand and which can generally be continued. He explains why he typically does not stop biologic therapy before testing, while outlining situations in which temporary interruption may be appropriate. The discussion also covers newer molecular testing that may provide additional information in difficult cases and introduces the "paraben paradox," an important concept illustrating how impaired skin barrier function can influence allergic responses. Tune in to the episode to gain a clearer understanding of when patch testing should be considered in patients with AD, learn how to approach patients with persistent or partial treatment responses, and learn practical considerations for preparing patients and optimizing test accuracy.
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  Unpacking My Dermatology Past: Sharing What I've Learned Along the Way to Improve Patient Care 18.06.2026 33min

  In this episode of Derms and Conditions, host James Q. Del Rosso, DO, sits down with Melinda Gooderham, MD, for a wide-ranging conversation about the evolution of dermatology, clinical research, and the therapeutic advances that have transformed patient care over the course of her career. Dr Gooderham reflects on how an early frustration with patient access to emerging biologic therapies led her into clinical research, a decision that not only expanded treatment opportunities for her patients but also shaped her professional focus on inflammatory skin diseases. She discusses how participating in clinical trials deepens understanding of both disease states and therapeutic mechanisms, often accelerating the development of clinical expertise. The conversation explores some of the most dramatic changes she has witnessed in practice, particularly the impact of JAK inhibitors across multiple dermatologic conditions. Dr Gooderham shares observations from alopecia areata, granulomatous diseases, dermatomyositis, and bullous pemphigoid, highlighting instances where treatment responses exceeded expectations and significantly improved patients’ quality of life. Dr Del Rosso and Dr Gooderham also discuss areas where therapeutic expectations have been more tempered, including in the role of oral PDE4 inhibitors in psoriasis, before turning to the future of dermatology. Topics include the emergence of highly effective oral therapies, the potential for extended-duration biologics, and how these advances may reshape treatment decision-making and patient preferences. They conclude with an important discussion on the growing emphasis on early intervention. As treatment options continue to expand, the challenge is increasingly not whether a disease can be treated, but whether patients can be identified and managed early enough to prevent irreversible consequences and optimize long-term outcomes. Tune in to the episode to hear Dr Gooderham's reflections on the therapies, discoveries, and clinical moments that have most influenced her career, along with her perspective on where dermatology may be headed next.
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  Managing HS: What A Difference A Year Makes! 04.06.2026 40min

  In this episode of Derms and Conditions, host James Q. Del Rosso, DO, welcomes back Michael Payette, MD, a dermatologist in private practice in Connecticut, for a wide-ranging discussion on the realities of managing hidradenitis suppurativa (HS) in clinical practice. Drawing from his experience running a dedicated HS clinic, Dr Payette reflects on what surprised him most after launching the practice, including the number of early-stage referrals and the growing recognition that even patients with relatively mild disease may benefit from more proactive care. The conversation highlights the importance of identifying HS earlier in its course, before patients develop irreversible scarring, sinus tracts, and other long-term sequelae. Drs Del Rosso and Payette discuss the logistical and emotional complexity of caring for patients with HS, emphasizing that meaningful visits cannot be compressed into a few minutes. Dr Payette shares how he structures conversations around realistic goal-setting, long-term therapeutic partnerships, and individualized treatment “buckets” ranging from topical and systemic therapies to lifestyle considerations, clinical trials, and surgery. The discussion also explores the psychological burden of HS, including how issues such as intimacy, work absenteeism, and social isolation often shape the patient experience as much as the physical disease itself. They also examines evolving treatment strategies for HS, including the challenges of managing patients in the mild-to-moderate range, the rationale for early intervention, and the growing role of combination therapy. Dr Payette shares insights on combining biologic and JAK inhibitor therapies in select patients, integrating GLP-1 agents into treatment plans, and balancing medical and surgical management to optimize outcomes. Throughout the discussion, both physicians emphasize the importance of empathy, collaboration, and helping dermatologists feel more comfortable initiating treatment for HS, even if they ultimately refer more advanced cases to specialized colleagues. Tune in to the episode to hear insights on building therapeutic relationships with patients with HS, approaching multifactorial disease management, recognizing opportunities for earlier intervention, and navigating the therapeutic landscape for this historically underserved disease state.
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  Oral Isotretinoin: Where Are We After 44 Years? 21.05.2026 28min

  In this episode of Tea with Dr. D, host James Q. Del Rosso delivers a solo “Spilling the Tea” segment that revisits oral isotretinoin through a longitudinal lens, connecting its early clinical foundations to present-day practice. Framing isotretinoin as a “winding road,” Dr Del Rosso reflects on its 1982 approval, early safety observations, and the evolution of risk management strategies, including the iPLEDGE program. While concerns around psychiatric effects, inflammatory bowel disease, and teratogenicity have shaped prescribing behaviors, he emphasizes that most patients tolerate therapy well when appropriately monitored. A central theme is the value of foundational knowledge. Dr Del Rosso highlights considerations that remain highly relevant, including dosing flexibility, relapse patterns, treatment duration, and importantly, the impact of absorption on outcomes. Conventional formulations require adequate dietary fat for optimal bioavailability, and suboptimal fat intake may contribute to perceived treatment failure or relapse. He also reviews evolving data on dosing strategies, noting that a range of daily doses can achieve clearance. The priority, however, is durability of response. Clinicians are encouraged to focus on cumulative exposure and to individualize therapy, extending duration or adjusting dose as needed to maintain clearance. Newer formulations, including lidose and micronized isotretinoin, may help mitigate variability in absorption and improve consistency, though access and cost remain considerations. Additional insights address relapse risk and the importance of evaluating possible underlying contributors such as androgen excess. Laboratory monitoring practices have also evolved, with a more streamlined approach focusing on key parameters like liver enzymes and triglycerides, alongside strict adherence to pregnancy prevention protocols. Ultimately, the episode reinforces that while isotretinoin prescribing has modernized in certain respects, many core principles remain unchanged. Thoughtful dosing, attention to absorption, and individualized management are essential to optimizing long-term outcomes. Tune in to the episode to revisit the clinical foundations of isotretinoin, refine your approach to dosing and duration, and learn practical strategies for improving treatment consistency and long-term acne clearance.
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  The Life of Leon: How He Succeeds and He Makes It Look Easy 07.05.2026 30min

  In this episode of Derms and Conditions, host James Q. Del Rosso, DO, welcomes Leon Kircik, MD, for a wide-ranging conversation that traces Dr Kircik’s journey from his upbringing in Turkey to building a thriving dermatology practice and research center in Louisville, Kentucky, and ultimately becoming one of the leading educators in the field.  Dr Kircik reflects on the early influence of his father, whose emphasis on discipline and hard work shaped his approach to both medicine and business. After immigrating to the United States and completing dermatology training at the University at Buffalo, he recognized an oversaturated market in New York City and made the strategic decision to establish his practice in Louisville. There, he prioritized including access for Medicaid patients and offered extended hours to better meet patient needs. The discussion also explores the operational realities of running a high-functioning clinical research center. Dr Kircik shares insights into meeting both the administrative and logistical demands, particularly in the context of clinical studies, highlighting the importance of protocol adherence, consistent investigator presence, and delivering high-quality data to maintain industry trust. A notable portion of the conversation focuses investigator-initiated studies (ISS). While resource-intensive and carrying greater responsibility, Dr Kircik views ISS as an opportunity to answer clinically meaningful questions that industry-sponsored trials may not be able to address, ultimately contributing to scientific advancement and professional growth. Tune in to the episode to hear more of Dr Kircik’s reflections on building a multifaceted career as well as personal lessons ranging from real estate investments to maintaining professional commitments while recovering from a serious injury, all grounded in a consistent theme of resilience and sustained effort over time.
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  How Does Modern-Day Compounding Create Uncertainty, Inconsistency & Risk to Patients?  30.04.2026 26min

  In this episode of Derms and Conditions, host James Q. Del Rosso, DO is joined by Stefan Weiss, MD for a focused discussion on compounding in dermatology, an area that often operates with less visibility but carries important clinical implications. The conversation centers on the regulatory and practical differences between 503A and 503B compounding pharmacies, with particular attention to 503A facilities, where customized medications are prepared based on individual prescriptions. They outline key concerns with this model, including variability in formulation, lack of standardized testing, and limited oversight compared with FDA-approved therapies. Unlike commercially developed medications, compounded products are not required to undergo stability testing, penetration studies, or clinical trials, raising questions about consistency, efficacy, and safety. A recurring theme is the challenge of knowing exactly what patients receive. Without controls on formulation integrity or bioavailability, clinicians may encounter variability not only between pharmacies, but even between batches from the same source, highlighting how this uncertainty can complicate treatment decisions. The episode also contrasts compounded therapies with FDA-approved options, using topical clascoterone as an example of a rigorously tested, standardized formulation. While both speakers acknowledge that compounding has a role, particularly in addressing unmet or niche patient needs, they note that its use today has expanded beyond its original intent. Tune in to the episode to hear how clinicians can approach compounded therapies with greater scrutiny, balance their use against standardized treatments, and make more informed decisions in everyday dermatology practice.
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  Changing Conversations in Acne Management 16.04.2026 35min

  In this episode of Derms and Conditions, host James Q. Del Rosso, DO, is joined by Heather Woolery-Lloyd, MD, for a treatment-focused discussion on acne management in an era where patient expectations, product awareness, and regimen complexity continue to rise.   The conversation opens with a shift many dermatologists are seeing in practice: patients arriving more informed and more influenced by social media, asking detailed questions about ingredients, formulations, and skin care routines. This evolving dynamic requires clinicians to not only select effective therapies but also contextualize an expanding array of over-the-counter and adjunctive options.   Dr Woolery-Lloyd and Dr Del Rosso revisit foundational therapies such as benzoyl peroxide, addressing concerns around benzene and reinforcing its continued role as a reliable, effective agent. They emphasize the importance of formulation and tolerability, noting that lower concentrations (around 4% or less) can offer similar efficacy with reduced irritation when well-formulated.   A central theme is the growing importance of the skin barrier and microbiome in acne management. The speakers highlight how barrier-supportive skin care, including moisturizers and adjunctive products, can improve both tolerability and clinical outcomes. They underscore that regimen success often depends on the full system of care, not just prescription therapies.   The discussion also explores newer over-the-counter formulations, including polyhydroxy acids for gentle exfoliation, multifunctional moisturizers targeting post-inflammatory hyperpigmentation, and emerging adjuncts like hypochlorous acid sprays (particularly useful for truncal acne).   Throughout, the episode reinforces a practical message: effective acne management today requires thoughtful integration of prescription therapies, formulation science, and patient-centered skin care guidance. Tune in to the episode to hear how clinicians are navigating increasingly informed patients, optimizing tolerability without sacrificing efficacy, and building acne regimens that account for both therapeutic impact and real-world adherence.
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  Acne Therapy: It’s Not Just the Tools You Have—It’s How You Use Them! 02.04.2026 26min

  In this episode of Derms and Conditions, host James Q. Del Rosso, DO, is joined by Hilary Baldwin, MD, for a treatment-focused discussion on acne management, with particular attention to how newer topical therapies are reshaping treatment approaches. They begin by reflecting on how patient expectations and therapeutic options have shifted over the past decade. Dr Baldwin highlights improvements in topical formulations that have enhanced both efficacy and tolerability, allowing many patients with mild to moderate and even some severe acne to be managed with topicals alone. This shift has also reduced reliance on prolonged oral antibiotic use. They next address practical considerations, including access and adherence. Dr Baldwin discusses the role of specialty pharmacies in helping ensure patients receive prescribed therapies without substitution and the importance of providing specific skin care recommendations to minimize irritation and improve outcomes. A key focus of the conversation is topical clascoterone, a first-in-class androgen receptor inhibitor that targets the androgen-sebum pathway and reduces sebum production progressively over time. They emphasize the benefit of initiating it early and setting appropriate expectations with patients, as its therapeutic effects build over 2 to 3+ months. Both clinicians advocate pairing clascoterone from the outset with a combination of topical agents that addresses other pathophysiologic cascades in acne to provide early visible improvement while supporting longer-term disease control. Other agents, such as benzoyl peroxide, topical retinoids, and clindamycin, are available in combination topical formulations to allow for ease of use, including a triple-combination topical gel.    They also discuss strategies for simplifying complex regimens, especially for younger patients, and review admixture data supporting compatibility between clascoterone and other topical agents. Tune in to the episode for practical pearls on designing combination topical regimens, setting realistic expectations with patients, and applying these strategies to optimize acne management. Disclaimer: This podcast is not intended to provide diagnosis, treatment, or medical advice. Content provided in this podcast is for educational purposes only. Please consult with a physician regarding any health-related diagnosis or treatment.
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  Attention to Lupus is Long Overdue! Better Understanding of Disease Leads to Better Therapies 19.03.2026 31min

  In this episode of Derms and Conditions, host James Q. Del Rosso, DO, welcomes Joseph Merola, MD, for a clinically focused discussion on updates in cutaneous lupus erythematosus (CLE). Long considered an area with limited therapeutic progress, CLE is gaining renewed attention as advances in disease biology and immunopathogenesis begin to inform new therapeutic approaches. They begin by discussing the importance of early recognition, particularly for scarring forms such as discoid lupus erythematosus, where permanent damage often drives diagnosis rather than earlier inflammatory changes. To help clinicians recognize disease activity sooner, Dr Merola shares a practical mnemonic (PASTE) highlighting features including follicular plugging, atrophy, scarring, telangiectasia, and erythema. They next discuss the clinical nuances of subacute cutaneous lupus erythematosus, including the need to evaluate for drug-induced disease. Medications such as hydrochlorothiazide and over-the-counter proton pump inhibitors may act as triggers and require careful medication history review. They next review current and emerging treatment strategies. While first-line therapy remains centered on antimalarials such as hydroxychloroquine, attention is increasingly turning toward targeted therapies approved for other immune-mediated diseases. For example, anifrolumab, which inhibits type I interferon signaling and is approved for systemic lupus, has demonstrated activity in cutaneous lupus and is being evaluated in dedicated trials. Similarly, the TYK2 inhibitor deucravacitinib, approved for psoriasis and psoriatic arthritis, has shown signals of efficacy for lupus-associated skin disease in early studies. They then discuss investigational therapies being developed specifically for lupus pathways. Among these is litifilimab, a monoclonal antibody targeting plasmacytoid dendritic cells to reduce type I interferon signaling. With fast-track designation and emerging clinical data, litifilimab highlights ongoing efforts to develop therapies directed at key immunologic drivers of both cutaneous and systemic lupus. Tune in to the full episode to hear diagnostic pearls for recognizing CLE earlier, strategies for identifying drug-induced disease, and perspectives on emerging therapies under investigation for cutaneous lupus.
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  Modern Training Of Future Dermatologists: Maintaining Core Fundamentals In A Rapidly Changing Educational Landscape 12.03.2026 23min

  In this episode of Derms and Conditions, host James Q. Del Rosso, DO, welcomes Michelle Tarbox, MD, for a candid discussion about the realities of leading a dermatology department and training the next generation of dermatologists. Dr Tarbox reflects on the vision she brought to her role as department chair and the principles that guide her approach to residency education. Central to that philosophy is cultivating enthusiastic, lifelong learners. While a strong grounding in foundational dermatology, including historical therapies, is essential, she emphasizes that residents must also be fluent in emerging therapies and evolving evidence. She highlights the value of conferences, podcasts, and other modern educational resources that help clinicians remain current while connecting learning to real-world practice. The conversation also explores the growing influence of artificial intelligence (AI) in medicine. Dr Tarbox notes that AI tools are becoming increasingly accessible and may support educational development and information gathering. However, she cautions that technology should complement, not replace, clinical judgment. Both clinicians agree that medical students and residents must learn to critically evaluate AI-generated content, verify references, and take responsibility for the work they sign their names to. She shares practical strategies for mentoring trainees in this area, including careful citation review and clear expectations around responsible AI use. Finally, she reflects on the leadership lessons she has learned since becoming chair, including the importance of communication, collaborative decision-making, and balancing ambitious ideas with institutional realities. Tune into the episode to hear Dr Tarbox share insights on dermatology leadership, residency education, responsible use of emerging technologies, and the behind-the-scenes decisions that shape the training of future dermatologists.
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  Challenging Recycled Dogma: Fine-Tuning Accuracy to Improve Patient Care 05.03.2026 34min

  In this episode of Derms and Conditions, host James Q. Del Rosso, DO, welcomes David Seiter, FNP-C, for a wide-ranging discussion on challenging dermatologic dogma and integrating emerging evidence into clinical decision-making. They begin with Seiter sharing his approach to reviewing new literature, encouraging clinicians to look beyond mainstream dermatology journals to cross-disciplinary publications to help reshape long-held assumptions. Using lichen planus as an example, he revisits the entrenched association between diffuse lichen planus and hepatitis C. While many clinicians routinely test for hepatitis C in these patients, new data suggest the association is uncommon. More compelling, however, is the emerging link between persistent, widespread lichen planus and underlying malignancy. Seiter outlines how he thoughtfully screens for red flags and gaps in preventive care without alarming patients prematurely, reinforcing the importance of looking beyond a single lab test. The conversation then shifts to acanthosis nigricans, where traditional teaching centers on hyperglycemia and diabetes risk. Seiter explains why acanthosis nigricans is more accurately viewed as a marker of hyperinsulinemia rather than elevated A1c. He discusses incorporating HOMA-IR calculations to identify early insulin resistance, particularly in adolescents whose A1C may remain normal for years. Both clinicians stress that a “normal” A1C should not prematurely reassure patients when cutaneous markers signal metabolic risk. Additional topics include reconsidering intralesional triamcinolone as the default therapy for keloids, with discussion of emerging data on intralesional insulin as a potentially lower–adverse event alternative, and a pragmatic conversation about JAK inhibitor safety. Comparing adverse event data across agents, they emphasize individualized risk assessment, careful monitoring, and shared decision-making over reflexive fear of boxed warnings. Tune into the episode to explore how questioning assumptions, broadening your literature review, and contextualizing risk can sharpen your clinical reasoning and elevate patient care in everyday dermatology practice.
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  How to Manage Acne From the Start: Practical Tips on Integrating Newer Topical Approaches 26.02.2026 31min

  In this episode of Derms and Conditions, host James Q. Del Rosso, DO, welcomes Lisa Swanson, MD, to explore how acne management continues to evolve and how newer topical therapies can be integrated thoughtfully from the outset. They begin with Dr Swanson highlighting an important clinical reality: acne is presenting at increasingly younger ages, prompting earlier conversations about skin care routines and long-term strategies. At the same time, dermatologists now have several truly novel topical options, an uncommon development in acne therapeutics over the past decade. Using a typical adolescent patient as a reference point, she then outlines the range of options she reviews in clinic: foundational topical regimens (retinoids, benzoyl peroxide combinations, clascoterone, topical minocycline foam, or fixed triple combinations), selective short courses of oral antibiotics, consideration of oral probiotics based on emerging data, and hormonal approaches in appropriate female patients. She emphasizes tailoring mechanisms when combining therapies; for example, pairing hormonal therapy with a topical that offers a complementary pathway. Dr Del Rosso revisits the 4 pillars of acne pathophysiology, highlighting androgen-driven sebum production as an upstream contributor. This leads to a focused discussion on clascoterone as the first topical androgen receptor inhibitor and how targeting sebum early may alter lesion development. Both clinicians stress that clascoterone is best viewed as foundational rather than adjunctive therapy, emphasizing the importance of setting realistic expectations on time to peak efficacy. The conversation also covers tolerability, barrier considerations, twice-daily adherence, and admixture data with common topical agents. Clinical pearls include setting early follow-ups to reinforce adherence, aligning office staff messaging, and using shared decision-making to balance patient priorities like oil control and pore appearance with mechanistic treatment goals. Tune in to the episode to hear real strategies for initiating acne therapy with intention, integrating newer topicals early, and guiding patients toward regimens that are both physiologically sound and sustainable in everyday practice.
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  Walking Through a Work Week With Dr Daveluy: Lessons Learned 19.02.2026 34min

  In this episode of Derms and Conditions, host James Q. Del Rosso, DO, is joined by Steven Daveluy, MD, for a wide-ranging conversation that connects oncodermatology, teledermatology, and integrative approaches to patient care. The discussion opens with Dr Daveluy’s work in an oncodermatology clinic and the critical role dermatologists play in managing cutaneous side effects from cancer therapies. He explains that while oncologists may be inclined to pause or discontinue cancer treatment in the face of severe skin reactions, dermatologists are uniquely positioned to identify, manage, and mitigate these effects, often allowing patients to remain on life-saving therapy and achieve better oncologic outcomes. The conversation then shifts to teledermatology, highlighting the Veterans Affairs health system’s leadership in expanding access, particularly for rural patients. Dr Daveluy describes his team-based model in which dermatoscopy is standardized across sites, allowing frontline clinicians to submit high-quality images for rapid dermatologic input. Clinical pearls follow, including management of epidermal growth factor receptor-inhibitor eruptions with tetracyclines and selective use of agents such as isotretinoin or dapsone to keep patients on cancer therapy. Importantly, brisk skin reactions may correlate with positive tumor response, reinforcing the goal of treating through, rather than stopping, therapy. The episode concludes with an exploration of integrative dermatology. Dr Daveluy advocates for consideration of evidence-based supplements, thoughtful discussion of diet and stress, and careful counseling rather than dismissing patient interest. Case examples illustrate both benefit and harm, underscoring the importance of third-party testing and drug–supplement awareness. A final reflection on mind-body medicine through practices like “laughter yoga” highlights tools that can help patients reframe flares and improve quality of life, even when disease activity is beyond their control. Tune in to the episode to hear expert insights on managing cancer-therapy–related skin reactions, expanding access through teledermatology, and thoughtfully integrating complementary approaches into everyday dermatology practice.
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  Navigating the Twists and Turns: From Residency Training to Department Chair with Several Stops In Between  12.02.2026 32min

  In this episode of Derms and Conditions, host James Q. Del Rosso, DO, sits down with Laura Ferris, MD, to explore the path to, and realities of, serving as a department chair in academic dermatology. They begin with Dr Ferris describing the motivations that led her to consider a leadership role, sharing the self-reflective questions that guided her thinking, including how to continue growing professionally, how care delivery can be improved, and where she could make the greatest long-term impact. The conversation then turns to stepping into the chair role itself. Dr Ferris introduces the idea of a “listening tour,” and the value of meeting with faculty and staff early, understanding what matters most to them, and easing fears that change will disrupt what they value in their work. She stresses that a department’s success depends on shared ownership, not top-down decision-making. They next discuss building productive relationships beyond the academic setting, particularly with community dermatologists. Dr Ferris describes her department’s noncompetitive approach, focusing on clinical excellence, referral partnerships, and aligning care so patients are matched with the right expertise. A key portion of the discussion centers on working effectively with advanced practice providers (APPs). Dr Ferris outlines her department’s physician-to-APP model, highlighting mentorship, collaboration, and thoughtful delegation to ensure high-quality care. The episode concludes with Dr Ferris sharing her goals for the future, including reducing silos, strengthening integration between clinical care and research, expanding translational efforts, and improving access for underserved and rural populations through tools like e-consults. She emphasizes the importance of engaging faculty, residents, and learners in shaping a shared vision and turning ideas into action. Tune in to the episode to hear practical leadership insights, real-world lessons on collaboration, and thoughtful perspectives on guiding a dermatology department through growth and change.
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  Mast Cell Disease: The Elusive Instigator You’re Likely to See but Not Recognize 05.02.2026 32min

  In this episode of Derms and Conditions, host James Q. Del Rosso, DO, welcomes Lauren Madigan, MD, associate professor of dermatology at the University of Utah, for a focused exploration of mast cell disease, an often underrecognized but clinically significant group of disorders that dermatologists may encounter on the front lines. The conversation begins with mast cell biology, including their origin in the bone marrow, tissue-specific phenotypes, and roles beyond classic allergic disease. Dr Madigan explains how mast cells contribute to immune defense and wound healing, with Dr Del Rosso noting how infrequently they are discussed in routine dermatology training despite their relevance across multiple conditions. They then explore mastocytosis across the age spectrum, contrasting pediatric presentations (many of which remit by adolescence) with adult-onset disease, where cutaneous findings often signal systemic involvement. Dr Madigan reviews current National Comprehensive Cancer Network guidance, emphasizing that most adults presenting with cutaneous mastocytosis will have some degree of systemic disease and may warrant more detailed testing for accurate staging, prognostic differentiation, and management choices. The discussion highlights the heterogeneity of systemic mastocytosis, from indolent forms to advanced disease with organ involvement or associated hematologic neoplasms. The episode also covers practical diagnostic and workup considerations, including laboratory evaluation, KIT mutation testing, and biopsy considerations. Dr Madigan stresses the importance of experienced dermatopathology interpretation and thoughtful site selection to optimize diagnostic yield. Treatment strategies are discussed through a pragmatic lens, ranging from symptom-directed therapies to cytoreductive and targeted tyrosine kinase inhibitors, with an emphasis on individualized care based on disease subtype, symptomatology, and prognosis. The episode closes with resources to help dermatologists navigate diagnostic assistance and treatments via specialty centers and clinical trials. Listen to the episode to deepen your understanding of mast cell disease, sharpen your diagnostic approach, and gain practical guidance on evaluation, staging, and management strategies, both for real-world practice and for determining when referral to specialized care is warranted.
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  From the Benchtop to the Treatment Room: Important Questions Answered About Topical Clascoterone 29.01.2026 23min

  In this episode of Derms and Conditions, host James Q. Del Rosso, DO, is joined by Zoe Draelos, MD, for an in-depth discussion of 3 practical questions surrounding topical clascoterone, informed by studies Dr Draelos helped conduct. Together, they translate study findings into real-world considerations for using clascoterone as part of combination acne regimens. The conversation begins with the role of formulation and vehicle design, addressing a common concern in acne management: barrier disruption and application-site irritation. Unlike retinoids or benzoyl peroxide, clascoterone is an androgen receptor inhibitor formulated in a vehicle shown to sustain and slightly increase moisture content in the skin, supporting  barrier function while remaining compatible with other topical acne therapies. Data evaluating transepidermal water loss and corneometry demonstrate that the finished, marketed formulation sustains skin moisturization, reinforcing its barrier-friendly profile. The discussion then turns to real-world use, where clascoterone is frequently combined with other topical agents. An admixture stability study examined whether clascoterone degrades, or causes degradation of, commonly used acne treatments such as benzoyl peroxide, clindamycin, adapalene, and retinoids. Using chromatographic and mass spectrometric analysis, the study confirmed that clascoterone remains stable and compatible when layered with these agents. Finally, Dr Draelos reviews clinical data demonstrating progressive sebum reduction in patients with mild to moderate acne, measured using standardized sebumeter technology. Sebum levels decreased beginning around 12 weeks and continued to decline through 52 weeks, paralleling reductions in acne lesions, oily appearance, and visible pore size. Together, these findings clarify how clascoterone works at the target organ level and why its clinical benefits extend over time. Tune in to the episode to hear how these studies answer key mechanistic and practical questions about clascoterone, and how its barrier-friendly formulation, combination compatibility, and sustained sebum reduction may inform everyday acne management in clinical practice.
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  Young Guns in Dermatology 2: Being a Dermatology Detective 22.01.2026 26min

  In this episode of Derms and Conditions, host James Q. Del Rosso, DO, is joined by Nicholas Brownstone, MD, practicing dermatologist and host of the Cutaneous Miscellaneous podcast, for a case-based discussion on how dermatologists think through challenging presentations and refine their diagnostic approach. Together, they offer takeaways that residents, early-career dermatologists, and experienced clinicians alike can apply when faced with complex or ambiguous cases. The episode opens with a challenging pustular eruption in a 30-year-old male initially labeled as Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN). Through a stepwise reassessment, the discussion walks through acute generalized exanthematous pustulosis versus generalized pustular psoriasis, highlighting latency periods, biopsy limitations, recurrence patterns, and the clinical clues that ultimately prompted a shift in diagnosis and management. The case also surfaces practical access barriers, including insurance denial of spesolimab due to tuberculosis testing requirements, and explores how evolving guidance contrasts with current labeling realities. Subsequent cases broaden the scope to mucocutaneous eruptions, clarifying distinctions among erythema multiforme, Mycoplasma-induced rash and mucositis/reactive infectious mucocutaneous eruption, and SJS/TEN. A key takeaway discussed is the importance of prioritizing drug causality when classic triggers and timelines are present, even in the setting of concurrent infection, to avoid potentially catastrophic outcomes. The final case focuses on neonatal lupus and explores how recognizing characteristic cutaneous findings can lead to appropriate evaluation for systemic involvement and timely referral, even when skin disease itself is self-limited. Tune into the episode to follow expert clinicians as they reason through diagnostic uncertainty, rethink initial assumptions, and highlight the small diagnostic details that can meaningfully change disease management.
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  Greatest Hits of Derms and Conditions 2025 18.12.2025 28min

  In this 2025 Year in Review solo episode of Derms and Conditions, host James Q. Del Rosso, DO, reflects on the standout conversations, clinical insights, and new formats that shaped the series over the past year. Dr Del Rosso opens by highlighting the launch of Tea with Dr. D, a sister vodcast that brings expert discussions to video, incorporating slides and procedural footage. He spotlights an episode with HS expert Lauren Lam, MD, who walks through comprehensive hidradenitis suppurativa management from patient check-in through long-term care. He also reviews Spilling the Tea with Dr. D, a hybrid audio-video mailbag format that addresses listener-submitted clinical questions. He then revisits key moments from the core Derms and Conditions series, beginning with Michael Payette, DO, who discussed building a dedicated HS clinic, collaborating with nondermatology providers, and his early adoption of GLP-1 agents for inflammatory disease management. Additional highlights include an episode with E. James Song, MD, on modern nb-UVB phototherapy units and practical guidance for safe implementation, as well as a unique discussion with Clay Cockerell, MD, JD, on estate planning considerations for physicians. Vitiligo emerged as a recurring focus in 2025, with expert insights from Seemal Desai, MD, and Pearl Grimes, MD, covering disease assessment, treatment timelines, topical ruxolitinib, oral therapies, phototherapy, and running a dedicated vitiligo center. Dr Del Rosso also revisits episodes on extended-release minocycline for rosacea, oral JAK inhibitors in older adults, challenging case-based discussions, evolving approaches to photoprotection and skin care counseling, and emerging therapies across alopecia areata, hyperhidrosis, tyrosine kinase 2 inhibition in psoriasis, and chronic hand eczema, including a recent FDA approval. Tune in to the full episode for a look back at a year of clinically relevant education aimed at supporting dermatologists in everyday practice.