Primary Care&nbsp;&nbsp;&nbsp;

What is your treatment algorithm for treating patients with lichen planopilaris?

Do you find that hydroxyzine worsens cognitive symptoms in patients who are already susceptible to cognitive impairment (i.e., schizophrenia, ADHD, dementia)?

What therapies have you found most effective in providing rapid improvement in patients with erythrodermic atopic dermatitis?

How do you dose oral tranexamic acid for melasma?

Given the side effect profile and risk of relapse off oral TXA therapy, do you prefer pulse dosing (i.e., 3 months on, 3 months off) or continuous the...

What are some practical tips for caring for resource-limited patients with severe, Hurley Stage III hidradenitis suppurativa?

For instance - any tips regarding coordination of care/transportation, associated lymphedema management, wound care, and pain control would be welcome...

How do you counsel and manage joint pain after isotretinoin treatment?

Have you found dose adjustments to be effective?

Do you routinely recommend transition to dual PO antibiotic coverage for strep species and MRSA, for patients with purulent cellulitis and in the absence of culture data?

What treatment regime would you recommend for localized hyperhidrosis affecting the scalp that has failed topical aluminum chloride and oral glycopyrrolate?

Especially in the elderly population

What is your treatment algorithm for dissecting cellulitis of scalp?

Any experience with risankizumab as a treatment option?

How do you approach Pityriasis rubra pilaris that is retinoid resistant?

Do you have a preference for biologics or phosphodiesterase inhibitors?

What is your approach to young teenagers with acne who have extremely sensitive skin, cannot tolerate typical acne regimens, cannot tolerate oral antibiotics, and refuse Accutane?

How do you optimize retinopathy screening schedules for patients on hydroxychloroquine while also prioritizing cost-effectiveness?

This question is part of a collaboration with RheumMadness and is specifically in reference to: Cost Effectiveness of HCQ Screening.

What are your recommendations for managing perivascular dermatitis with eosinophils unresponsive to high-dose antihistamines, a prednisone taper, and topical steroids?

Would you send to allergy for omalizumab?

What treatment options would you recommend for a patient with severe generalized pustular psoriasis who has a history of colon cancer (s/p chemotherapy) and well-controlled HIV?

Currently on 6 mg dexamethasone daily post-hospitalization. Insurance is denying acitretin. Would an IL-23 inhibitor like Skyrizi be appropriate? Otez...

How do you approach treatment change in patients with psoriasis who have been stable on an IL-17 or IL-23 agent but then begin to have breakthrough skin disease?

Do you first try adding topicals or UV? At what point do you decide to switch biologics and at that point do you try to class switch to a different MO...

How would you manage active severe psoriasis in a patient planning pregnancy, who also has psoriatic arthritis with well-controlled joint symptoms on certolizumab pegol (anti-TNF therapy)?

Patient is already on topical high potency corticosteroids. Any updated safety data on IL-17, IL-23 in pregnancy?

Do you generally utilize calcium channel blockers on an as needed basis for patients with Raynaud's phenomenon?

Do you generally feel they work well? Have patients tried using this a few days before an activity, such as skiing? Especially for otherwise healthy, ...

How would you manage a patient with nonspecific clinical symptoms and pathology consistent with spongiotic and psoriasiform dermatitis other than oral JAK inhibitors?

What is your approach to diagnosis and treatment to intermittent cheilitis that does not respond to anti fungal therapy?

What is your approach to treating patients with chronically brittle nails?

How do you approach a patient with stoma bag adhesive allergic contact dermatitis?

How has the recently FDA-approved topical cantharidin altered your molluscum treatment algorithm?

Are you considering also using it for the treatment of warts?

How do you approach managing nausea and GI side effects when initiating methotrexate?

At what age are you comfortable to start prescribing spironolactone for acne in adolescent females?

What are the most effective treatments for flat warts on the face?

What is your preferred workup for a patient who has a biopsy consistent with “dermal hypersensitivity reaction”?

What treatment modalities have you tried for "dermal hypersensitivity reaction"?

How do you manage polymorphic light eruption (PMLE)?

What is the maximum dose or treatment course of topical steroids that you generally recommend to avoid causing systemic adverse effects?

What circumstances would drive you to consider using an oral IL-23 inhibitor over parenteral options for the management of psoriasis and/or psoriatic arthritis?

This question is part of a collaboration with RheumMadness and is specifically in reference to: Bissonnette et al., PMID 38324484

What treatment modalities have you had success with for treating sebaceous hyperplasia?

What is your preferred oral regime with duration for treatment of onychomycosis?

How frequently can you repeat the oral course?

For patients on medications that are known to cause photosensitivity, would you counsel them to avoid laser hair removal or laser therapies?

What about for Effexor, specifically?

How do you counsel male patients with Androgenetic Alopecia who are trying to conceive about using oral or topical minoxidil?

What have you found to be effective for keratosis pilaris?

What therapies have you found most helpful for recalcitrant non-infectious cases of folliculitis?

How do you approach management of patients with psoriatic arthritis who have significant improvement in skin disease, but ongoing inflammatory arthritis despite multiple DMARDs and/or biologics?

Do patient co-morbidities impact when you prescribe oral jak inhibitors?

Are you less likely to prescribe it for patients with dyslipidemia or autoimmune disease?

How would you treat disseminated flat warts in an immunosuppressed patient with skin of color?

How do you balance concern for causing skin hypopigmentation with many of the traditional treatment modalities we have?

What is your approach to tapering treatments for patients with bullous pemphigoid?

What is your treatment approach to prevent progression of phymatous rosacea?

Is isotretinoin the only effective option?

What is your approach to managing the initial acne purge while on isotretinoin?

How long are you comfortable with keeping pediatric patients on oral antibiotics for acne?

Would you recommend continuing Accutane in a teenage female who has experienced a drop in calcium to 8.8 and reductions in albumin and protein levels one month into therapy?

Given that Accutane can affect calcium homeostasis, would you recommend continuing Accutane or are additional steps or workups warranted?

What is your treatment approach for hidradenitis suppurativa?

Do you reserve biologics for more systemic involvement? When do you initiate biologics such as secukinumab?

What is your experience with using dupilumab for alopecia areata?

What therapies have you found most effective for managing patients with Darier disease?

Are there any contraindications to starting a patient on Dupixent for prurigo nodularis if the patient is already on Xolair for asthma?

What is your recommended dosing regimen for propranolol in treating an infantile hemangioma after the proliferative phase?

Healthy kid <5 years old with hemangioma measuring 6 cm. No prior therapy was trialed. Lesions not growing or involuting.

What alternative medications other than dapsone would you consider for dermatitis herpetiformis in a sulfa-allergic patient?

In a pregnant patient with scarring alopecia (LPP or CCCA), what treatment options are available?

What oral treatment options would you offer a patient with severe onychomycosis who is also on methotrexate for another condition?

How would you manage a patient with progressive/refractory molluscum contagiosum who is well controlled on methotrexate for seropositive rheumatoid arthritis?

Are you aware of any data regarding relative risk of molluscum contagiosum infection in reference to DMARDs/biologics?

What is the youngest age and dose that you would consider for oral minoxidil?

Randolph & Tosti, PMID 32622136

How would you approach management of a patient with longstanding history of SLE, but having active psoriasis?

SLE manifestations include arthralgias and cytopenias which are stable. Previously did well on methotrexate, but developed GI side effects. HCQ is on ...

What is your approach for workup and management of prurigo nodularis?

What is your approach to managing Grover's Disease (Transient Acantholytic Dermatosis) that has failed topical steroids?

What dosing range of spironolactone do you prescribe for hormonal acne?

When would you pursue genetic testing for severe recalcitrant atopic dermatitis?

What treatment modalities have you had success with for treating recalcitrant warts?

How would you approach management of a patient who develops squamous cell skin cancer while on abatacept?

Patient has had previous failure of methotrexate. Would you switch to alternative (TNFi or Rituximab) or continue abatacept with regular dermatology...

Are you comfortable utilizing Stelara (ustekinumab) as biologic treatment of psoriasis for patients with a history of severe latex allergy?

Does the presence of psoriatic arthritis affect your decision to use an anti-IL-17 or IL-23 drug in your psoriasis patients?

How would you manage active psoriasis and psoriatic arthritis in patient on Rituximab and prednisone for MPO positive vasculitis?

The patient has ongoing inflammatory arthritis despite methotrexate, apremilast, and jak inhibitor trials.

What is your preferred protocol for squaric acid (SADBE) treatments for alopecia areata/totalis?

How do you determine the need to biopsy subcutaneous nodules in infants to rule out Infantile myofibromatosis?

For example, a 1 year old healthy female twin in whom a lesion appeared 6 mos ago and has been stable in size. On exam, left upper back 1.3cm x 1cm s...

How do you manage alopecia areata in children with >50% of hair loss that is unresponsive to intralesional or topical steroids?

What is your approach to deciding when to stop therapy for cutaneous Mycobacterium chelonae infections?

How would you counsel a patient with systemic sclerosis who wants to consider microneedling on the face or other skin which is not clearly involved with scleroderma?

What is your approach for severe SCLE in patients unable to tolerate HCQ?

What therapies do you recommend for patients with recalcitrant seborrheic dermatitis?

What treatment regimen have you found most effective? Do you recommend any lifestyle changes or prescribe oral azoles? Any experience with topical r...

How do you reassure families that no allergy testing is needed for urticaria?

How do you approach treating patients who develop psoriasis while on Dupixent?

Do you start/trial them on another biologic or just rely on topical therapies?

How do you counsel male patients with Androgenetic Alopecia who are trying to conceive about using dutasteride or finasteride?

How have you incorporated biologics targeting the IL-36 pathway (e.g. Spevigo) into your treatment algorithm for psoriasis?

What is your approach to management of hyperlipidemia in patients taking JAK inhibitors?

How would you approach management of a young male patient with discoid lupus who has had minimal response to hydroxychloroquine (and subtherapeutic whole blood levels) who continues to use tobacco products?

What is your experience managing patients with chronic spontaneous urticaria occurring only at night?

Female in her early 40s with chronic spontaneous urticaria occurring consistently only at night for the past 4 years. Lesions develop only at night wh...

How do you approach treating neuropathic itch?

What is your stepwise approach to a patient with erosive gingivitis?

What treatment do you initiate before you have a clear diagnosis?

In difficult cases, what is your approach to find a causative agent of fixed drug or fixed food eruption?

Drug elimination is often helpful, but some triggers are not easy to identify because they are found in food items.

How does omalizumab play a role in the armamentarium of atopic dermatitis?

Do you caution against starting biologics for psoriasis if patient has hepatitis A antibodies?

What treatments have you found most effective for cholestatic pruritus?

I have a patient with recently diagnosed primary biliary cholangitis/cirrhosis (PBC) with SSc. Her laboratory values are within normal limits, but end...

Is there a role for empiric scabies treatment in itchy patients without clear clinical signs of scabies?

Do you empirically treat itchy patients -with a non specific rash- for scabies without obvious clinical findings for scabies?

Are there situations in which you treat calcinosis cutis that is not symptomatic for the patient?

Given the lack of efficacy of most treatment options, do you generally try to treat calcinosis cutis that is not bothering the patient even if it is q...

What topicals have you had success with treating body acne?

Back and chest who deferred systemic antibiotic.

How long can you continue chronic low dose isotretinoin for refractory acne or other conditions?

Have you had experience continuing low dose Accutane past the goal dosage recommendation?

What topical therapies have you found most effective for managing scalp psoriasis?

Do you use combination therapies such as betamethasone and calcipotriene foam?

Do you wait on initiating biologic therapy for guttate psoriasis?

If so, how long?

What biologic for psoriasis do you prescribe most often in patients with a history of malignancy?

What therapies have you had success with in treating CARP when they have failed minocycline?

What treatments do you consider for cholinergic urticaria refractory to high dose H1 blockers and omalizumab?

In your experience, what has been the most effective form of field therapy for your patients with higher burdens of actinic keratoses?

And what factors push you towards the selection of a specific treatment modality?

What is your experience with using 5 alpha reductase inhibitors in females of childbearing age for androgenetic alopecia?

Dutasteride versus Finasteride

What is your treatment algorithm for actinic cheilitis?

What topical therapies have you found most effective? Have you found laser therapy to be effective?

How do you counsel patients on the risks and benefits of an IL-23 agent versus an IL-17A or IL-17A/F agent?

What side effects do you highlight in conversation with them? How do you approach toxicity monitoring?

How have you incorporated new psoriasis therapies such as deucravacitinib and bimekizumab into your hierarchy of psoriasis treatments?

Are there patients that you find respond best to these therapies?

Do you discontinue IL-17A, IL-17A/F, or IL-23 blockade in pregnant patients with psoriasis?

How does the location or type of psoriasis affect your initial biologic choice?

Is narrow-band ultraviolet B (nbUVB) phototherapy contraindicated or recommended with caution in patients with a personal history of melanoma?

What are the best biologics for a pediatric patient with extensive guttate psoriasis that is poorly controlled on topicals?

Mother's insurance plan has a high deductible and phototherapy is inconvenient (family lives 50 minutes away).

For how long would you treat Klebsiella aerogenes folliculitis of the face manifesting as a cystic lesion?

Would you combine antibiotics with isotretinoin?

How frequently do you recommend skin cancer screens in your patients with kidney transplants who are on immunosuppression?

How do you approach patients that develop atopic dermatitis while on biologics for psoriasis?

I have an elderly patient with a history of biopsy-proven psoriasis on IL-17 biologic therapy. She has developed an intense itch without a primary ras...

What lifestyle modifications do you recommend for patients with hidradenitis suppurativa?

What treatment modalities have you had success with for treating extensive molluscum in the pediatric population?

What lab monitoring and frequency do you recommend in an otherwise healthy young patient on biologics for psoriasis?

With no high-risk exposure do you repeat quant gold?

How do you approach treating disseminated granuloma annulare?

Do you order blood work to evaluate for underlying dyslipidemia or other metabolic diseases?

6 Answers available

How do you determine which patients you prescribe 5-fluorouracil vs 5-fluorouracil with calcipotriene for actinic field disease?

Do you favor one treatment over the other? Do you find one treatment more effective than the other?

How do you manage atopic dermatitis in pediatric patients who has failed dupilumab?

(preschool-aged patients)

How do you approach HS patients with persistent HS lesions on the trunk?

Have you had success with deroofing or surgical excision? Is ILK the best option?

What is your treatment algorithm for managing porokeratosis?

What is your preferred topical retinoid for acne?

I.e., specific brands

What is your approach to monitoring for hepatic fibrosis in chronic methotrexate use?

Do you frequently order liver biopsies for these patients?This question is part of a collaboration with RheumMadness and is specifically in reference ...

How do you counsel patients on preventing and treating "maskne"?

What nutritional supplements do you recommend for patients with hair loss?

Have you recommended supplementing less common supplements such as zinc or selenium?

What exfoliative regimen do you recommend for patients with recurrent plantar keratoderma?

What recommendations do you offer for patients who have nail longitudinal ridging?

What scented alternatives do you recommend patients with fragrance allergies try to replace perfumes/colognes?

Do your recommendations differ depending on the fragrance category (i.e fragrance mix I, II or balsam of Peru)?

What treatments have you found to be most effective for granulomatous rosacea?

What biologics have you found to be most effective in treating hidradenitis suppurativa?

How do you navigate insurance coverage?

Do you recommend testing for HPV in patients with oral lichen planus?

What dosing range of doxycycline do you recommend for short-term and long-term management of ocular rosacea?

How do you screen alopecia patients to determine whether they are appropriate candidates for JAK inhibitors?

Do you utilize a standardized script or questionnaire and if so, what types of questions are you including? Would you use JAK inhibitors in patients w...

What is your treatment algorithm for neurotic excoriations?

What duration do you feel comfortable maintaining for the pediatric population on topical calcineurin inhibitors?

For example - keeping a baby under 1 year on tacrolimus ointment for 3 months BID

What is your preferred management for eruptive vellus hair cysts?

Do you avoid the use of hydroxychloroquine in patients with psoriasis and/or psoriatic arthritis?

Do you have concerns with the use of oral contraceptives in patients on JAK inhibitors given the black box warning for thromboembolic events?

How has this impacted your counseling and management?

Any concern for lupus flare in patients undergoing laser hair removal?

What recommendations do you provide to isotretinoin patients about delaying cosmetic procedures (lasers, fillers, botox) once they have reached their goal dose?

Do you recommend a six-month wait period? Have you had patients that developed poor outcomes due to pursuing cosmetic procedures too early after compl...

Do you transition to a topical retinoid after a patient completes a course of isotretinoin?

And if so how soon after do you start?

6 Answers available

What recommendations do you make for patients with lower abdomen eczema from nickel in their belt buckle?

What treatment modalities have you had success in treating perioral or periorbital dermatitis when they have failed Topical calcineurin inhibitor and oral antibiotics?

What is your approach to patients with SLE who develop a rash after hydroxychloroquine initiation?

How do you treat significant keloidal acne scarring on the back of a teenager?

What is your approach for disease activity monitoring in patients with sarcoidosis?

What's your treatment algorithm for notalgia paresthetica?

What’s your approach to recurrent “idiopathic” Erythema Nodosum that failed NSAIDs?

What’s your preferred NSAIDs and next steps?

Do you have to remove gold dental crowns if patch testing reveals a gold allergy?

How do you counsel patients on the risks versus benefits of JAK inhibitors for the treatment of alopecia?

How do you compare safety to other oral immunosuppressants such as Methotrexate, CellCept, or Azathioprine?

How do you counsel patients with alopecia on the timing of response and what sort of outcomes they should expect with JAK inhibitors?

What is your experience with ritlecitinib and how does it compare to baricitinib?

Do you prescribe fluocinolone in peanut oil in patients with peanut allergies?

What is your approach to treating genital lichen sclerosus that is not responding to super-potent topical steroids?

How do you utilize JAK inhibitors in combination with other therapies to manage alopecia?

How do you perform patch testing in patients who are allergic to adhesives?

What is your approach to treatment of skin-limited cryoglobulinemic vasculitis in patients with Sjogren's syndrome who lack evidence of neurological or renal involvement?

How do you manage recurrent urticarial lesions in a patient with underlying connective tissue disease that is otherwise well-controlled?

How do you approach treating patients with delusions of parasitosis who can not tolerate an antipsychotic?

What therapies have you found most effective for treating lower extremity DSAP?

Have you had success with topical lovastatin or PDT?

Does Dupixent interfere with patch testing?

https://www.jaad.org/action/showPdf?pii=S0190-9622%2824%2903329-2

How do you manage acne relapses after isotretinoin?

Are there special recommendations for the use of hydroxychloroquine and methotrexate together?

What is your approach to treating patients with lichen planopilaris who do not respond to hydroxychloroquine?

What alternative antibiotics or other therapies do you recommend for patients with papulopustular rosacea and a tetracycline allergy?

Do anti-inflammatory topicals such as niacinamide or sulfur-based products help with this type of rosacea?

What treatments do you recommend and how do you counsel patients with postpartum hair loss?

Do you recommend any dietary changes or supplements? Do you modify your recommendations if the patient is breast feeding?

Do you recommend patients discontinue spironolactone after a certain number of years?

How do you counsel patients who report a history of a lidocaine allergy?

What treatments and resources have you found helpful for ichthyosis vulgaris patients?

What dosing range of oral minoxidil do you prescribe for patients with hair loss?

Have any patients reported side effects?

What treatments would you recommend for patients with chronic urticaria who have minimal improvement with anticholinergics and Xolair?

Have you tried any of the newer biologics?

How do you manage pityriasis lichenoides chronica (PLC)?

Do you typically order a systemic workup? And, after topical corticosteroids, what other treatment options do you prefer?

How do you monitor patients with cutaneous lupus for progression to SLE?

Do you do blood work? Or do you rely on review of systems?

What recommendations do you provide to patients with sensitive skin that can not tolerate retinoids more than a few times per week?

How do you counsel parents of children with atopic dermatitis about preventing recurrent Staph infections?

Are dilute bleach baths enough? Should they use any topical therapies? Is there a need for Staph decolonization with something like mupirocin?

How do you manage injection site reactions in patients on subcutaneous biologics such as TNF inhibitors?

In what cases do you discontinue the medication?

How do you approach longitudinal melanonychia of one fingernail in a pediatric patient?

When tapering moderate to high doses of long term steroids do you routinely monitor for adrenal insufficiency?

Do you attempt to taper fully or maintain at a low dose?

Do you use apremilast in combination with biologic DMARDs for psoriatic arthritis and/or psoriasis?

Are there ways to overcome barriers in insurance coverage of this combination of treatments?

With the increasing reports of correlation of frontal fibrosing alopecia and titanium dioxide sunscreens, do you advise patients against the use of micronized sunscreens on the face?

What oral therapies do you most commonly recommend for skin cancer prevention?

Is close observation a reasonable option for elderly patients with a small basal cell carcinoma of the face?

How do you manage eyebrow and eyelash involvement in patients with alopecia areata?

At what age do you recommend annual skin exams in a patient without a personal or family history of skin cancer?

Any evidence behind this practice?

What prescription or over-the-counter therapies have you found effective for helping vitiligo patients cover active areas?

When do you prescribe topical JAK inhibitors for adult patients with atopic dermatitis?

Do you prescribe JAK inhibitors as first-line treatments? Do you perform any lab monitoring?

How do you approach treating nail lichen planus?

What topical therapies do you most commonly prescribe for rashes near the eyes?

What is your treatment algorithm for patients with lichen planus?

What screening recommendations do you provide for patients with a Nevus of Ota with ocular involvement?

How do you counsel patients on preventing nail damage with constant pedicures/manicures and nail polish?

Do all patients initiating omalizumab need to have it administered in a healthcare setting?

What treatments have you found helpful in treating recurrent aphthous ulcers?

What treatment options do you recommend to patients with microstomia secondary to scleroderma?

Have you tried hyaluronidase?

What lab monitoring do you perform for patients taking isotretinoin?

What labs do you order? How often do you order labs? Have you ever needed to discontinue isotretinoin due to lab abnormalities?

What topical and oral therapies do you prescribe for patients with recalcitrant melasma?

How do you manage patients with hand dermatitis recalcitrant to potent topical steroids?

How do you approach screening for additional malignancies in patients with a history of CTCL?

There have been reports suggesting that patients with CTCL may be at increased risk for other malignancies.

When do you refer pediatric patients with eczema to an allergist?

Are there cases where food or environmental allergies significantly worsen eczema in children?

What is your treatment approach to persistent chillblains lesions in the absence of systemic lupus?

What treatments have you found to be most effective in treating oral lichen planus?

Does your treatment management differs for oral erosive lichen planus? How would you approach patients with active malignancy on chemo and radiation?

How do you manage patients with alopecia totalis who are not candidates for JAK inhibitors?

Have you had success using resorcinol 15% topically for limited hidradenitis?

If so, where can patients find it? And besides topical clindamycin, what other topicals do you find helpful for individual lesions?

Is there an effective treatment for severe radiation fibrosis of the skin after radiotherapy to the breast or other areas?

I have heard of long-term pentoxifylline and Vitamin E daily combination that can prevent and even reverse radiation fibrosis (Delanian et al., PMID 1...

What therapies have you found most effective in treating teenagers with recurrent CARP?

How do you manage polymorphous eruption of pregnancy (formerly PUPPP)?

The symptoms can be really miserable.I try to control it with antihistamines (don't find these helpful in most cases) and topical steroids, but that d...

Would you consider using a JAK inhibitor in combination with an IL 23 inhibitor in cases of severe psoriasis, psoriatic arthritis, or axial spondyloarthritis that is refractory to multiple biologic DMARDs?

What topical therapies do you find are most effective for treating inverse psoriasis in areas of the body with thinner skin?

How do you manage long-term xerosis and xerophthalmia in patients who have completed a course of isotretinoin?

Isotretinoin provides a permanent benefit to acne because it atrophies sebaceous glands. My assumption is that it leaves the skin and eyes permanently...

How do you approach treating acute and chronic Demodex folliculitis?

Is long-term oral ivermectin ok? What topical therapies other than topical ivermectin do you recommend/prescribe?

What recommendations do you provide to patients who develop ocular side effects with Dupixent?

Do you refer them to Ophthalmology? Have you had to switch patients off of Dupixent due to their ocular side effects?

What topical and oral therapies do you prescribe for patients with papulopustular rosacea?

How do you determine if a positive thimerosal patch test isn't a false positive?

Is a positive thimerosal test always a false positive?

Do you recheck screening labs (ESR, BUN/Cr, urinalysis, ANA, etc) for patients with recurrent small vessel vasculitis of unknown origin with each flare?

Do you commonly recommend oral minoxidil, dutasteride, or a combination of both for patients with androgenic alopecia?

I prefer dutasteride for its safety and efficacy compared with minoxidil which can interact with different drugs and food. Also, minoxidil is a hyper...

How would you evaluate and treat an older teenage patient with severe perioral dermatitis with histology demonstrating a granulomatous dermatitis and all stains have come back negative?

What is your treatment approach to patients with confluent actinic keratoses on lower extremities?

Does topical 5FU cause eruptive keratoacanthomas or have any other concerning side effects?

What is your approach to ongoing assessment and medication tapering in well controlled discoid lupus without systemic features?

What prescription or over-the-counter therapies do you recommend for patients with side effects from vismodegib?

Have you had success with therapies such as L- carnitine and other remedies?

What topical therapies and procedures do you recommend for patients with atrophic acne scarring?

How do you approach treating patients with acne keloidalis nuchae who do not respond to a potent topical steroid or retinoid?

What diet modifications do you recommend for patients with acne to help prevent breakouts?

What is your approach to using apremilast for psoriatic arthritis in patients with history of depression?

What topical or oral treatments do you recommend for patients with recurrent MRSA infections?

Do you recommend any changes to their personal hygiene practices? or changes to their environment?

How do you monitor a patient with scleroderma during pregnancy?

What dressings do you recommend for patients with hidradenitis suppurativa to help prevent friction and collect drainage from open areas?

Especially after surgical procedures

What is your treatment approach for steroid-refractory necrobiosis lipoidica?

Any success with hydroxychloroquine?

How do you approach treating patients with erythema nodosum recalcitrant to NSAIDs?

What maintenance therapies do you most commonly recommend for patients with improving genital lichen sclerosis?

What recommendations do you provide if there is concern that the patient is beginning to flare? Have you prescribed any of the new JAK inhibitors?

How do you approach the treatment of bullous cutaneous lupus?

When would you de-escalate therapy?

What treatments would you recommend for rosacea patients with persistent, soft/non-fibrotic cysts on the dorsal nose recalcitrant to chronic doxycycline and topical therapies?

What therapies do you use in patients with cutaneous lupus recalcitrant to topical steroids?

How do you manage nausea in the setting of hydroxychloroquine use?

Where do oral and topical JAK inhibitors fit into your treatment algorithm and approach to atopic dermatitis?

When should you discontinue narrow band UVB when a patient is in clinical remission from patch stage mycosis fungoides?

What is your approach to a young adult patient with significant nail psoriasis and not much cutaneous disease?

What are some of your preferred treatment options for managing facial papules that occur in the setting of lichen planopilaris?

What is your approach to starting and monitoring methotrexate in elderly patients?

What is your approach to treating patients with melasma that does not respond to hydroquinone-based topical therapies?

How do you manage patients with twenty nail dystrophy of unclear etiology?

How do you manage patients with yellow nail syndrome?

What are your preferred treatment methods other than topical Vitamin E and azole antifungals?

How often do you order imaging to assess for possible degenerative joint disease in the spine in patients with neuropathic itch?

What is your approach to treating patients with chronic pruritus of unclear etiology?

What is your preferred OCP protocol when the aim is reduction of sebum production in teenage female acne?

How do you approach treating younger patients with early female pattern hair loss?

Would starting spironolactone be a good option?

When do you prescribe clascoterone cream for your acne patients?

In your experience, do specific patient features predict a better response?

What is your experience with iontophoresis for hyperhidrosis?

How do you approach treating necrobiosis lipoidica, especially cases that have ulcerated?

Do you scale up 2nd generation anti-histamines to 4x daily in acute urticaria in the pediatric population as you do in adults?

For kids experiencing moderate to severe urticaria that improve with single-dose antihistamine, do you scale up the manufacturer packaging dosages up ...

How do you manage patients with erosive pustular dermatosis?

What are your preferred treatment options for patients with chronic non-healing leg ulcers?

How do you manage patients with recurrent periorificial dermatitis?

What therapies do you recommend for preventing keloid recurrence after surgical resection?

How do you counsel patients regarding the cardiovascular and cancer risks associated with tofacitinib?

What is your approach to treating patients with dupilumab induced facial redness?

Do you recommend the HPV vaccine for patients with recalcitrant verruca vulgaris?

How do you manage patients with chronic flushing that do not respond to beta-blockers?

How do you manage patients with bullous pemphigoid who have IgE autoantibodies to BP180?

How do you manage patients with rapidly progressing vitiligo?

How do you manage patients with chemotherapy-induced paronychia?

How do you manage psoriasis in pregnant patients?

How do you approach restarting biologics for psoriasis patients who have discontinued therapy for 3-6 months?

Do you prefer restarting the biologic with the loading or maintenance dosing?

How do you approach patients with onychomycosis that does not respond to terbinafine and prolonged courses of fluconazole?

Would you switch to itraconazole or perform fungal cultures? When would you consider repeating the course of treatment?

How do you manage patients with suspected chronic contact dermatitis and negative patch testing?

Have you found success in managing refractory hidradenitis suppurativa with ertapenem?

How do you manage patients with chronic telogen effluvium?

Is it ever reasonable to switch to a different TNFi as opposed to switching to an agent in a different class in a case of TNFi induced lupus or psoriasis?

In other words, do we think of TNFi induced lupus and TNFi induced psoriasis as a drug effect or a class effect?

What is your methotrexate initiation strategy in DMARD-naive RA patients?

Specifically: starting dose, rapidity of up-titration, frequency of lab monitoring, frequency of office visits, and timing of assessment for treatment...

What would be your next step in management of a dermatomyositis patient on hydroxychloroquine and methotrexate whose skin is still active?

Muscle disease is quiescent and no other manifestations such as ILD

What type of surveillance would you recommend following resection of primary mucinous carcinoma of the skin?

What treatment options are available for patients with spondyloarthritis who develop biologic-induced psoriasis?

Are you recommending the mRNA COVID-19 vaccines to your patients with immune mediated inflammatory diseases?

How do you screen for colon cancer in patients with Behcet syndrome with colonic involvement?

How do you manage calcium and vitamin D supplementation in patients with sarcoidosis on chronic steroids?

How do you counsel patients who ask if there are any dietary modifications they can make to help control their autoimmune disease?

This question is part of a collaboration with RheumMadness and is specifically in reference to: ADIRA Diet

Do you use hydroxychloroquine for prevention of neonatal lupus in patients with a positive SSA who are planning on becoming pregnant?

Do you adjust PSA for finasteride use when determining prostate cancer stage and risk category?

If this upstages the patient, do you modify treatment recommendations?