Questions discussed in this category
Do you reserve biologics for more systemic involvement? When do you initiate biologics such as secukinumab?
What changes do you make to your treatment approach to adapt to this altered disease state?
How do you balance concern for causing skin hypopigmentation with many of the traditional treatment modalities we have?
Are you aware of any data regarding relative risk of molluscum contagiosum infection in reference to DMARDs/biologics?
SLE manifestations include arthralgias and cytopenias which are stable. Previously did well on methotrexate, but developed GI side effects. HCQ is on ...
Given that Accutane can affect calcium homeostasis, would you recommend continuing Accutane or are additional steps or workup warranted?
Would you view this as a sign that disease is not adequately controlled despite labs and imaging suggesting no active vasculitis?
What specific settings and devices do you prefer to use?
Do you have a preference for biologics or phosphodiesterase inhibitors?
The patient has ongoing inflammatory arthritis despite methotrexate, apremilast, and jak inhibitor trials.
Would you be comfortable combining a TNFi with Rituxan in this patient?
What treatment regimen have you found most effective?
Do you recommend any lifestyle changes or prescribe oral azoles?
Any experience with topical r...
Do you start/trial them on another biologic or just rely on topical therapies?
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...
What treatment do you initiate before you have a clear diagnosis?
Drug elimination is often helpful, but some triggers are not easy to identify because they are found in food items.
When do you switch to steroid-sparing medications? What steroid-sparing therapies do you prefer?
Do you empirically treat itchy patients -with a non specific rash- for scabies without obvious clinical findings for scabies?
Do you use combination therapies such as betamethasone and calcipotriene foam?
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 ther...
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...
In which situations or patient populations do you find this useful? How is it sterilized?
What side effects do you highlight in conversation with them? How do you approach toxicity monitoring?
Are there patients that you find respond best to these therapies?
Mother's insurance plan has a high deductible and phototherapy is inconvenient (family lives 50 minutes away).
For instance - any tips regarding coordination of care/transportation, associated lymphedema management, wound care, and pain control would be welcome...
Would you combine antibiotics with isotretinoin?
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...
With no high-risk exposure do you repeat quant gold?
Do you order blood work to evaluate for underlying dyslipidemia or other metabolic diseases?
(preschool-aged patients)
Have you had success with deroofing or surgical excision? Is ILK the best option?
Is a BM biopsy a must when there is skin involvement?
If tryptase level is mildly elevated but less than 20 would you recommend a BM biopsy?
Have you recommended supplementing less common supplements such as zinc or selenium?
Do your recommendations differ depending on the fragrance category (i.e fragrance mix I, II or balsam of Peru)?
How do you navigate insurance coverage?
Are there any skin care products you would avoid in this population?
How has this impacted your counseling and management?
And if so how soon after do you start?
What treatment modalities have you tried for "dermal hypersensitivity reaction"?
What’s your preferred NSAIDs and next steps?
Is isotretinoin the only effective option?
This question is part of a collaboration with RheumMadness and is in reference to Pathogenic ANCA (RAVE Trial).
How should IVIG and either biologic injections or infusions be spaced?
Are you less likely to prescribe it for patients with dyslipidemia or autoimmune disease?
Have you had success with topical lovastatin or PDT?
(Refractory to mycophenolate, azathioprine, and methotrexate. UpToDate suggests thalidomide or IVIG with mixed efficacy, while there are some case rep...
And if so, what is your approach to the diagnosis?
Do you recommend any dietary changes or supplements? Do you modify your recommendations if the patient is breast feeding?
Have you tried any of the newer biologics?
Do you typically order a systemic workup? And, after topical corticosteroids, what other treatment options do you prefer?
Do you do blood work? Or do you rely on review of systems?
Are dilute bleach baths enough? Should they use any topical therapies? Is there a need for Staph decolonization with something like mupirocin?
Do you typically start the patient on hydroxychloroquine?
What work-up do you perform?
In what cases do you discontinue the medication?
Are there ways to overcome barriers in insurance coverage of this combination of treatments?
Any evidence behind this practice?
Several speakers at ACR 2021 commented on the important role of drug levels in the management of these patients and cautioned against adding medicatio...
The disease is responsive to ablative lasers however laser treatments are not an option.
What labs do you order? How often do you order labs?
Have you ever needed to discontinue isotretinoin due to lab abnormalities?
Are there cases where food or environmental allergies significantly worsen eczema in children?
Does your treatment management differs for oral erosive lichen planus?
How would you approach patients with active malignancy on chemo and radiation?
If so, where can patients find it? And besides topical clindamycin, what other topicals do you find helpful for individual lesions?
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...
Do you refer them to Ophthalmology? Have you had to switch patients off of Dupixent due to their ocular side effects?
Should one restart lamotrigine or look for an alternative? If no other alternative available, is slow titration vs regular titration preferred?
Is a positive thimerosal test always a false positive?
Are there any medications that surgeons like discontinued before their procedure?
If so, how long before/after radiation?
Do you recommend any changes to their personal hygiene practices? or changes to their environment?
Especially after surgical procedures
Any success with hydroxychloroquine?
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?
When would you de-escalate therapy?
Does your evaluation hinge on nonresolution with warming? How extensive is your workup?
Does morphology guide your workup?
In your experience, do specific patient features predict a better response?
Especially in the setting of these being more narrow acting than tofacitinib, should we consider them safer than our old drugs?
Have you prescribed Rituximab and IVIG simultaneously for patients?
Other than inflammatory markers and following symptoms/exam, do you need any other specific monitoring for progression to systemic disease?
Do you prefer restarting the biologic with the loading or maintenance dosing?
Would you switch to itraconazole or perform fungal cultures?
When would you consider repeating the course of treatment?
Do you have a preferred sequence of therapies for diffuse skin limited MF?
Do you obtain vascular imaging routinely in these cases, and if so, do you use cross-sectional or invasive angiography?
In other words, do we think of TNFi induced lupus and TNFi induced psoriasis as a drug effect or a class effect?
Would you change rituximab maintenance dose or schedule?
In the ADVOCATE trial, patients were not re-dosed with rituximab.
E.g., MPO vs PR3, newly diagnosed vs relapsed, renal involvement. Acknowledge that the ADVOCATE study was not powered to detect these differences, but...
What if the patient has MGUS?
Do patients with type 1 cryoglobulins need a bone marrow biopsy as part of the work up?
If so, are there specific patient populations for which you would use this metric?
If you use both, how do you decide which to use for a particular patient?
This question is part of a collaboration with RheumMadness and is specifically in reference to: ADIRA Diet
21779205151927821925204922193121212218762089821924176292188420979162851824017627214712061319512212471946021244192012065219770139392114521126128131688816960196722087620774208291927520834199622073813643168792054419552201401708619964154572019817689196941682619740196931764419545196951967716321198891989019728197857313168891353218315137301502512565196061708517935138421917119277147651628713940139411778213462169001618917909137311526518697149241043218375150721835818313183008473180011454517645181371680211477152501207017574181281800317686171861043814939170831328917272142581607417084168901654713892163561448316203161011373314256156871568813671113201327915063154541545615248140931501515011149409947145811481214664134711433114255130161129014425142531334314136135291408714126139371409514107124291393812696134231245413732138371149211499132371323212977130631296712797129251287712170114851278412695114821180111501114881148312586125661241612487124021148611491123821238112066121741213011681112019196109741046910275102671021894229531941794219169934886219010890388318886873985428686848585247314847783558282811881517327807180837931796779667816782673227737
Papers discussed in this category
N Engl J Med, 2020 Feb 13
The New England journal of medicine, 2010-07-15
Medicine (Baltimore),
The New England journal of medicine, 2010-07-15
J. Am. Coll. Cardiol.,
Arthritis and rheumatism, 1982-11
Arthritis and rheumatism, 2012-08
, 2019 Aug 06
Arthritis Rheum.,
Ann. Rheum. Dis., 2018 Apr 25
Ann. Rheum. Dis., 2017 May 25
Ann. Rheum. Dis., 2018 May 03
Medicine, 1976-05
Arthritis and rheumatism, 2010-01
J. Rheumatol., 2019 Sep 01
Annals of the rheumatic diseases, 2009-03
JAMA ophthalmology, 2014-12
Can J Ophthalmol,
J Am Acad Dermatol, 2016 Feb 03
JAMA network open, 2018-11-02
Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 2008-10
Clin Rheumatol, 2006 Dec 21
Rheumatol Int, 2020 Sep 18
Kidney international reports, 2018-03
Rheumatology (Oxford),
Journal of psoriasis and psoriatic arthritis, 2019-04
Front Pharmacol, 2019 Mar 26
Nat Rev Dis Primers, 2018 Aug 02
N Engl J Med, 2021 Feb 18
Int J Clin Pract, 2021 Mar 24
Mod Rheumatol, 2021 Feb 09
Heart Rhythm, 2020 Jun 28
Arthritis care & research, 2018-03
J Clin Rheumatol, 2020 Sep 18
Cureus, 2020 Aug 02
Ann Intern Med,
Ann Rheum Dis, 2011 Nov 29
Respir Med, 2012 Apr 09
Am J Respir Crit Care Med,
Autoimmunity reviews, 2009-02
Arthritis and rheumatism, 2013-07
Arthritis Rheumatol, 2021 Mar 24
Rev Med Interne, 2016 Oct 13
Arthritis Care Res (Hoboken), 2021 Mar 30
JAMA Dermatol,
Mod Rheumatol, 2020 Sep 17
Ann Rheum Dis, 2014 Feb 13
Ann Rheum Dis, 2019 Jan 04
Ann Rheum Dis, 2014 Apr 16
N Engl J Med, 2019 Dec 18
Seminars in arthritis and rheumatism, 2010-12
Clin Exp Rheumatol, 2012 Oct 17
Inflamm Bowel Dis,
Am J Clin Dermatol,
Radiographics : a review publication of the Radiological Society of North America, Inc, 2001
International journal of clinical rheumatology, 2010
Lupus science & medicine, 2014
The Journal of rheumatology, 2015-11
Ophthalmology, 2016-06
Lupus science & medicine, 2017
Journal of immunology research, 2017
Lupus science & medicine, 2018
Arthritis care & research, 2019-07
Clin Pharmacol Ther, 2018 Jun
Lupus Sci Med, 2016
Lupus Sci Med, 2016 Feb 01
Lupus Sci Med,
ACR Open Rheumatol, 2020 Oct 12
Arthritis Rheumatol, 2021 May 02
Ann Rheum Dis, 2012 Nov 10
Arthritis Rheum,
Lupus,
Arthritis Rheumatol, 2020 Jan 07
Lupus Sci Med, 2019
Int J Dermatol,
J Am Acad Dermatol,
Br J Dermatol, 2018 Oct 10
J Am Acad Dermatol, 2019 Mar 11
J Am Acad Dermatol, 2019 May 13
Dermatology,
Best practice & research. Clinical rheumatology, 2013-06
Dermatol Ther, 2016 Apr 12
JAMA Dermatol,
J Dermatol,
J Am Acad Dermatol, 2021 Jul 02
Ann Plast Surg,
Journal of psychiatric practice, 2018-11
Journal of the American Academy of Dermatology, 2019-05
Med Hypotheses, 2006 Nov 28
J Am Acad Dermatol, 2021 Apr 18
Prog Neuropsychopharmacol Biol Psychiatry,
Antimicrob Agents Chemother, 2008 Nov 17
Rheum Dis Clin North Am, 2020 Aug
Rheumatology (Oxford),
Am J Clin Dermatol,
JAMA Dermatol, 2022 Mar 01
Am J Clin Dermatol,
J. Clin. Oncol., 2004-04-15
Int J Radiat Oncol Biol Phys,
Eur J Dermatol,
Arthritis Res Ther, 2021 Sep 04
Journal of the American Academy of Dermatology, 2011-05
Lupus, 2016 May 27
Clin Exp Rheumatol, 2013 Aug 02
J Rheumatol, 2022 Aug 01
Dermatol Ther, 2014 Aug 12
Medicine (Baltimore), 2019 Dec
J Clin Invest, 2013 Nov 15
Clinical pharmacokinetics, 2018-12
Frontiers in immunology, 2018
Clinical immunology (Orlando, Fla.), 2020 Jul 15
The Pediatric infectious disease journal, 2018 Oct
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2017 Nov 03
The Journal of rheumatology, 2012-01
JAAD Case Rep, 2019 Oct 10
Arthritis Care Res (Hoboken), 2022 Aug 04
JAMA dermatology, 2018-10-01
,
Archives of dermatology, 2002 Sep
JAMA dermatology, 2018-12-01
J Cutan Aesthet Surg, 2019 Apr-Jun
JAMA Dermatol, 2022 Aug 01
Proceedings of the National Academy of Sciences of the United States of America, 2010 Apr 19
Dermatol Ther, 2021 May
Current rheumatology reviews, 2019
Am J Clin Dermatol, 2022 Jun 23
Ann Afr Med, 2020 Jul-Sep
Arch Dermatol, 2006 Mar
Clin Rev Allergy Immunol, 2010 Apr
Lupus, 2020 Mar 19
N Engl J Med, 2022 Oct 06
Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG, 2023 Feb 11
Clinical rheumatology, 1988 Sep
Journal of the American Academy of Dermatology, 1987 Apr
Journal of the American Academy of Dermatology, 2020 May 19
Science advances, 2024 Jul 03
Annals of the rheumatic diseases, 2023 May 29
Clinical and experimental dermatology, 2021 Mar 09
JAAD case reports, 2019 Mar 01
Dermatologic therapy, 2020 May 03
The Journal of allergy and clinical immunology, 2012 Feb 14
Lupus, 2019-05
Journal of the American Academy of Dermatology, 2020 Apr 28
The British journal of dermatology, 2003 Jul
Journal of the American Academy of Dermatology, 2020-01
Journal of the American Academy of Dermatology, 2020 Apr 26
Journal of drugs in dermatology : JDD, 2023 Oct 01
Journal of the American Academy of Dermatology, 2003-04
Annals of the rheumatic diseases, 2024 Mar 18
Ann Rheum Dis, 2020 Dec 17
Journal of the American Academy of Dermatology, 2023 Dec 07
JAMA dermatology, 2020 May 01
Photodermatology, photoimmunology & photomedicine, 2023 Dec 07
Clinical and experimental dermatology, 2024 Apr 23
Allergy, 2021 Oct 20
Allergy, asthma & immunology research, 2020 Sep
The journal of allergy and clinical immunology. In practice, 2018 Jul-Aug
Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 2009 Nov 23
American journal of clinical dermatology, 2022 Sep 15
The Journal of allergy and clinical immunology, 2022 Sep 30
Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 2023 Dec 18
Transplant international : official journal of the European Society for Organ Transplantation, 2019 Oct 07
The British journal of dermatology, 2020 Apr 13
Arthritis care & research, 2016 Jan
Lupus, 2014 Feb 06
Annals of the rheumatic diseases, 2023 Oct 12
Journal of the American Academy of Dermatology, 2015 Jan 30
Journal of the European Academy of Dermatology and Venereology : JEADV, 2016 Dec 20
American journal of clinical dermatology, 2020 Aug
Arthritis care & research, 2023 Nov 28
Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 1995-02
The journal of allergy and clinical immunology. In practice, 2021 Mar
The journal of allergy and clinical immunology. In practice, 2021 Apr 20
The journal of allergy and clinical immunology. In practice, 2020 Mar 13
The journal of allergy and clinical immunology. In practice, 2024 Feb
N Engl J Med,
Autoimmunity reviews, 2023 Dec 20
Antibiotics (Basel, Switzerland), 2023 May 29
Clinical kidney journal, 2016 Nov 10
Expert review of anticancer therapy, 2009-01
Lancet Gastroenterol Hepatol, 2023 Feb 01