Primary Care

Dermatology   

Questions discussed in this category



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...

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

Any experience with risankizumab as a treatment option? 

Do you have a preference for biologics or phosphodiesterase inhibitors? 

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

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

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...

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, ...

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

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

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 workups warranted?

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

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

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 ...

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

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

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...

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.

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

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

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...

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

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

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

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

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

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...

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

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

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

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

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)?

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...

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...

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

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

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

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?

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?

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

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

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

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

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?

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...

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...

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

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

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

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

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

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

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?

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

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

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

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

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

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

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


Papers discussed in this category


J. Am. Coll. Cardiol.,

Journal of psoriasis and psoriatic arthritis, 2019-04

Front Pharmacol, 2019 Mar 26

Respir Med, 2012 Apr 09

Am J Respir Crit Care Med,

Seminars in arthritis and rheumatism, 2010-12

Clin Exp Rheumatol, 2012 Oct 17

Inflamm Bowel Dis,

Am J Clin Dermatol,

Int J Dermatol,

J Am Acad Dermatol,

Br J Dermatol, 2018 Oct 10

Dermatologic therapy, 2018-11

J Dermatolog Treat, 2020 Apr 23

Dermatol Ther (Heidelb), 2019 Nov 20

JAMA Dermatol,

N Engl J Med,

Ann Plast Surg,

Journal of investigational allergology & clinical immunology, 2007

Int Arch Allergy Immunol, 2018 Sep 25

Dermatol Surg,

Arch Dermatol,

Cureus, 2021 Jun 03

JAAD Case Rep, 2022 Aug 11

Arthritis and rheumatism, 2013-07

Am J Clin Dermatol,

Arthritis care & research, 2014-08

Intern Med J, 2022 Mar 16

Support Care Cancer, 2019 Dec 13

Journal of the American Academy of Dermatology, 2014-01

Dermatol Ther (Heidelb), 2015 Aug 25

JAAD Case Rep, 2021 Aug 18

Arthritis Res Ther, 2021 Sep 04

JAAD Int, 2022 Mar 29

Dermatology, 2021 Aug 04

Dermatol Ther, 2020 Sep 15

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

JAMA dermatology, 2017-08-01

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

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

JAAD case reports, 2020 Aug 20

Science advances, 2024 Jul 03

Annals of the rheumatic diseases, 2023 May 29

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

Journal of the American Academy of Dermatology, 2019-06

Journal of the American Academy of Dermatology, 2019-03-28

JAAD case reports, 2019 May 08

Dermatitis : contact, atopic, occupational, drug, 2020 Jan/Feb

Annals of the rheumatic diseases, 2018-09

Arthritis & rheumatology (Hoboken, N.J.), 2019-02

RMD open, 2020 Feb

Trials, 2022 Sep 05

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

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

Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia, 2019 Feb 04

The Journal of allergy and clinical immunology, 2016 Jul 14

JAMA pediatrics, 2020 Jan 01

The British journal of dermatology, 2020 Apr 13

Journal of fungi (Basel, Switzerland), 2019 Sep 04

Autoimmunity reviews, 2009-02

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

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

Autoimmunity reviews, 2023 Dec 20

Expert review of anticancer therapy, 2009-01

Lancet Gastroenterol Hepatol, 2023 Feb 01

JAMA internal medicine, 2017 Nov 01

Annals of the rheumatic diseases, 2024 Jan 11

Dermatology and therapy, 2024 Jun 11

Ann Rheum Dis, 2014 Feb 13

The New England journal of medicine, 2024 Feb 08

Arthritis & rheumatology (Hoboken, N.J.), 2021 Apr 26

Ophthalmology, 2016-06