Internal Medicine

General Dermatology   

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?

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

What specific settings and devices do you prefer to use? 

Do you have a preference for biologics or phosphodiesterase inhibitors? 

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?

When do you switch to steroid-sparing medications? What steroid-sparing therapies do you prefer?

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...

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

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

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

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)?

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

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

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

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

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?

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?

Does your evaluation hinge on nonresolution with warming? How extensive is your workup?

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


Papers discussed in this category


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,

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,

J. Clin. Oncol., 2004-04-15

Int J Radiat Oncol Biol Phys,

Arthritis Res Ther, 2021 Sep 04

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

JAMA dermatology, 2018-12-01

J Cutan Aesthet Surg, 2019 Apr-Jun

JAMA Dermatol, 2022 Aug 01

Dermatol Ther, 2021 May

Science advances, 2024 Jul 03

Annals of the rheumatic diseases, 2023 May 29

Journal of the American Academy of Dermatology, 2020-01

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

Transplant international : official journal of the European Society for Organ Transplantation, 2019 Oct 07

The British journal of dermatology, 2020 Apr 13