In this episode of Derms and Conditions, host Dr James Del Rosso speaks with Dr Linda Stein Gold, Director of Dermatology at Henry Ford Health, to unpack one of dermatology’s most frustrating and multifactorial conditions: chronic hand eczema.They explore why chronic hand eczema isn’t a single disease but a spectrum of overlapping etiologies—ranging from atopic dermatitis and irritant or allergic contact dermatitis to more elusive triggers. Dr Stein Gold shares practical strategies for teasing out potential causes, discusses some potential limitations of patch testing, and highlights the importance of patient history and thorough skin assessment.The conversation also covers current treatment approaches, from topical corticosteroids to systemic therapies, and introduces delgocitinib cream, a pan-JAK inhibitor under FDA review, as a unique and valuable nonsteroidal option. Drs Stein Gold and Del Rosso explain how its broad immunomodulatory action may help address the condition’s diverse inflammatory pathways while remaining well tolerated, even on fissured skin.Whether you're managing stubborn cases or looking for updates on investigational therapies, this episode offers practice-ready recommendations for clinicians and a reminder not to overlook the emotional toll of hand eczema on patients’ daily lives.

Linda Stein Gold, MD

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Wrapping Our HANDS Around Managing Chronic Hand Eczema

In this episode of Derms and Conditions, Dr James Q Del Rosso is joined by Dr April Armstrong, Chair of Dermatology at UCLA, for a thorough discussion of oral therapies for plaque psoriasis—what’s new, what still works, and how to choose the right treatment for the right patient.They kick off with a practical discussion on older systemic options like methotrexate and cyclosporine, including when these tried-and-true agents still have a place in modern practice. From there, Dr Armstrong walks through the evolving role of apremilast, particularly in hard-to-treat variants like palmoplantar pustulosis and in patients with milder disease who prefer oral options. The pair then take listeners through the clinical data behind deucravacitinib, a selective TYK2 inhibitor, highlighting its strong efficacy, minimal lab monitoring, and newly released five-year safety results.The conversation also covers real-world patient selection, payer considerations, and how clinicians can use guidelines to support access to newer therapies. Whether you’re looking to refine your psoriasis treatment strategy or better counsel patients on long-term safety, this episode delivers practical pearls you can use in clinic tomorrow.

April W. Armstrong, MD, MPH

Oral Therapy for Psoriasis: Valuable Insights from April in April!

In this episode of Derms and Conditions, Dr James Q. Del Rosso shifts gears from clinical dermatology to something equally important but rarely discussed—legal and financial planning. He’s joined by his longtime friend and dermatopathologist, Dr Clay Cockerell, who also happens to be a licensed attorney with a passion for educating physicians about estate planning.Packed with practical insights, humor, and a few personal anecdotes, this episode offers a must-hear legal primer for dermatology professionals at any career stage.&nbsp;

Clay Cockerell, MD

Whom Do You Trust? Learn More About Trusts & Wills

In this episode of Derms and Conditions, Dr James Q. Del Rosso welcomes back his longtime friend and pediatric dermatology expert, Dr Lisa Swanson. Together, they explore the rapidly evolving treatment landscape for pediatric atopic dermatitis, with a focus on newly approved non-steroidal topical therapies.&nbsp;

In this episode of Derms and Conditions, Dr James Q. Del Rosso welcomes back his longtime friend and pediatric dermatology expert, Dr Lisa Swanson. Together, they explore the rapidly evolving treatment landscape for pediatric atopic dermatitis, with a focus on newly approved non-steroidal topical therapies.&nbsp;Dr Swanson shares her insights on tapinarof 1% cream, now FDA-approved for patients as young as two years old, and topical roflumilast 0.15% cream, approved down to age six. The duo discusses how aryl hydrocarbon receptor (AhR) agonism makes tapinarof effective in both atopic dermatitis and psoriasis, likening its action to a “SNOO” that adjusts to soothe inflammation.&nbsp;They also dive into data from the ADORING 1 and ADORING 2 phase 3 trials, highlighting tapinarof’s rapid reduction in itch and its positive impact on sleep—critical outcomes for both children and their parents. Dr Swanson offers real-world anecdotes about the sleep-depriving toll of pediatric eczema and how effective therapies can restore rest for the entire family.&nbsp;The conversation touches on skin of color considerations, including how atopic dermatitis may present differently and why diverse representation in clinical trials is essential. Dr Swanson underscores the importance of tactile assessments and shares practical pearls for evaluating eczema severity across skin types.&nbsp;Finally, they explore safety and tolerability, emphasizing tapinarof’s low risk of systemic absorption, even in young children prone to thumb-sucking or hand-to-mouth behavior.&nbsp;Tune in for clinical pearls, new treatment insights, and a few laughs between two dermatology BFFs.

Lisa Swanson, MD

Atopic Dermatitis in Kids: Non-Steroidal Advances with Dr. Lisa Swanson

In this episode of Derms and Conditions, host Dr James Q. Del Rosso returns from the 2025 Winter Clinical Dermatology Conference – Miami® with a deep dive into some of the standout posters presented at the meeting.

In this episode of Derms and Conditions, host Dr James Q. Del Rosso returns from the 2025 Winter Clinical Dermatology Conference – Miami® with a deep dive into some of the standout posters presented at the meeting.&nbsp;Dr Del Rosso begins the review with new insights on topical clascoterone 1% cream and its impact on the skin barrier, tolerability, and sebum reduction. He explores recent studies showing that clascoterone does not compromise the permeability barrier or increase transepidermal water loss—key considerations for its use alongside other acne treatments like benzoyl peroxide and topical retinoids.&nbsp;The analysis shifts to a comparative study on a triple combination acne therapy featuring clindamycin 1.2%, adapalene 0.15%, and benzoyl peroxide 3.1%, which demonstrated superior efficacy over dual-combination formulations. Dr Del Rosso breaks down early activity data, inflammatory and non-inflammatory lesion reductions, and how polymeric emulsion technology enhances both efficacy and tolerability.&nbsp;He also highlights new data on topical roflumilast for atopic dermatitis in younger patients (ages 2-5) and explores the recent FDA approval of tapinarof 1% cream for atopic dermatitis down to age two. Posters on itch and sleep improvements in pediatric patients, as well as efficacy in skin of color, provide valuable clinical insights.&nbsp;Tune in for this rapid-fire breakdown of key posters, packed with data-driven takeaways to enhance your dermatology practice.

Poster Power: A Review of Selected Highlights from WCM25

In this special live episode of Derms and Conditions, recorded at the 2025 Winter Clinical Dermatology Conference - Hawaii®, host Dr James Q. Del Rosso welcomes Dr April Armstrong, chief of dermatology at UCLA, and Dr David Cohen, dermatologist at NYU Langone, to break down the key takeaways from this year’s meeting.

In this special live episode of Derms and Conditions, recorded at the 2025 Winter Clinical Dermatology Conference - Hawaii®, host Dr James Q. Del Rosso welcomes Dr April Armstrong, chief of dermatology at UCLA, and Dr David Cohen, dermatologist at NYU Langone, to break down the key takeaways from this year’s meeting.&nbsp;The discussion kicks off with chronic hand eczema, a condition that can be difficult to diagnose and treat due to its multiple causes. Dr Cohen highlights emerging data on new treatment options, including dupilumab, topical JAK inhibitors like ruxolitinib, and upcoming therapies like delgocitinib. They explore whether these newer therapies could be effective across different causes of hand eczema, even when an allergen isn’t clearly identified.&nbsp;Dr Armstrong then shifts the conversation to the next frontier in psoriasis treatment, including new oral therapies that are pushing efficacy to higher levels. They discuss IL-23 receptor antagonists, IL-17 inhibitors, and TNF inhibitors in development, as well as 5-year safety and efficacy data for deucravacitinib, which shows no long-term need for routine monitoring. The group also tackles the evolving treatment landscape for hidradenitis suppurativa (HS), where combination therapy is emerging as a key strategy. Dr Armstrong shares insights into guidance from the HS Foundation and the potential of pairing JAK inhibitors with IL-17 or TNF inhibitors for refractory cases.&nbsp;They wrap up with practical pearls from the conference, including extended terbinafine treatment durations for fungal infections, pediatric biologic use around live vaccines, and the latest treatment options for molluscum contagiosum.&nbsp;Tune in to this information-packed episode for expert insights and clinical updates straight from Winter Clinical 2025!

April Armstrong, MD, MPH

David Cohen, MD, MPH

Highlights from Winter Clinical Hawaii 2025: Recorded Live on The Big Island

In this episode of Derms and Conditions, host James Q. Del Rosso, DO, welcomes Lawrence Green, MD, clinical professor at George Washington University and practicing dermatologist, to discuss the evolving landscape of hyperhidrosis and the latest FDA-approved therapy, sofpironium bromide gel.

In this episode of Derms and Conditions, host James Q. Del Rosso, DO, welcomes Lawrence Green, MD, clinical professor at George Washington University and practicing dermatologist, to discuss the evolving landscape of hyperhidrosis and the latest FDA-approved therapy, sofpironium bromide gel.&nbsp;Dr Green highlights that an estimated 16 million people in the US experience clinical hyperhidrosis, with axillary hyperhidrosis being the most frequently reported. However, a significant challenge is patient reluctance to discuss symptoms, often due to embarrassment or frustration with ineffective or irritating treatments. Dr Green suggests raising awareness through social media, office signage, and intake forms to help identify more patients needing care.&nbsp;The discussion then shifts to treatment options, including botulinum toxin, devices such as the Brella SweatControl Patch and the energy-based miraDry, and pharmacologic therapies.&nbsp;They explore anticholinergic treatments in depth, explaining how sofpironium bromide gel differs from traditional glycopyrrolate wipes. While glycopyrrolate wipes can be messy, highly saturated, and prone to causing systemic absorption from contact with the hands, sofpironium bromide gel is applied via an applicator in a metered dose, reducing unintended exposure and improving application precision. Unlike glycopyrrolate, which affects muscarinic M1 receptors found throughout the body, sofpironium targets muscarinic M3 receptors, which are more specific to sweat glands, reducing the likelihood of systemic side effects.&nbsp;They next review clinical trial methodologies for hyperhidrosis, including the Hyperhidrosis Disease Severity Measure and gravimetric sweat production assessments, noting that they favor patient-reported outcomes over objective sweat measurements, as perceived symptom relief is the most important assessment for this condition.&nbsp;Tune in to the full episode to hear expert insights on identifying and treating hyperhidrosis with new and emerging therapies that improve both efficacy and the patient experience.

Lawrence Green, MD

“Don’t Sweat It,” You Say? With Once a Day, There Is a Way!

In this episode of Derms and Conditions, host James Del Rosso, DO, welcomes Ron Vender, MD, Associate Clinical Professor of Dermatology at McMaster University, to discuss practical strategies for psoriasis treatment and the management of chronic hand dermatitis.

In this episode of Derms and Conditions, host James Del Rosso, DO, welcomes Ron Vender, MD, Associate Clinical Professor of Dermatology at McMaster University, to discuss practical strategies for psoriasis treatment and the management of chronic hand dermatitis.&nbsp;They begin with Dr Vender sharing his 90/70/40 rule, a numeric approach to evaluating biologic efficacy in psoriasis. He explains that across biologic agents, PASI75 responses typically reach 90%, PASI90 responses reach 70%, and PASI100 responses about 40%, providing a useful benchmark for evaluating treatment success. With many biologics showing similar efficacy and strong safety profiles, this method can help guide selection.&nbsp;They also discuss how comorbidities impact biologic choices, with Dr Vender noting he avoids TNF inhibitors in patients with multiple sclerosis, latent tuberculosis, malignancy, or hepatitis, though they remain a preferred option for women of childbearing potential. He advises caution when using IL-17 inhibitors in patients with a history of inflammatory bowel disease. While tuberculosis screening remains routine, he questions its necessity for anti-IL-17 and IL-23 inhibitors, given their lack of association with latent TB reactivation.&nbsp;The discussion then moves to chronic hand dermatitis, with Dr Vender stressing thorough history-taking, including identifying occupational exposures, and diagnostic testing, including patch testing and scrapings. He highlights alitretinoin, an oral retinoid specifically approved for chronic hand dermatitis, as an effective and well-tolerated treatment option. They conclude with a discussion on protective measures for chronic hand dermatitis, including hypoallergenic gloves, cotton liners, and emollient barrier creams.&nbsp;Tune in to the full episode to hear expert insights on optimizing psoriasis treatment and managing chronic hand dermatitis in clinical practice.

Ron vender, MD

How to Streamline Study Data to Improve Selection of Therapy for Patients

In this episode of Derms and Conditions, James Del Rosso, DO, welcomes Dustin Portela, DO, a private practice dermatologist in Boise, ID, and well-known social media presence, to discuss the challenges and responsibilities of dermatologists engaging online while maintaining professional integrity.

In this episode of Derms and Conditions, James Del Rosso, DO, welcomes Dustin Portela, DO, a private practice dermatologist in Boise, ID, and well-known social media presence, to discuss the challenges and responsibilities of dermatologists engaging online while maintaining professional integrity.&nbsp;Dr Portela shares how he unintentionally became an influencer, initially using social media to market his new practice without a budget. His following grew as he provided accurate, engaging, and evidence-based dermatologic education, evolving into a broader platform for both patients and clinicians.&nbsp;They discuss combatting misinformation, as much of the skin care advice online comes from nonmedical sources. Dr Portela emphasizes that his goal is to provide science-backed, accessible information, mirroring the guidance he offers in the clinic. He recommends the AAD website, DermNet, and YouTube’s certified health professionals as trusted resources and uses AI tools like ChatGPT to simplify patient education, though he stresses the importance of reviewing content for accuracy before sharing.&nbsp;They also address legal considerations, with Dr Portela advising dermatologists to avoid direct medical advice online and instead keep recommendations general and educational. He cautions that malpractice policies typically do not cover social media activity, making it crucial to understand liability risks.&nbsp;Finally, they discuss brand partnerships, with Dr Portela emphasizing authenticity and trust. He only endorses products he has personally used and recommended in practice, ensuring his audience receives honest, unbiased information.&nbsp;Tune in to the full episode for insights on navigating social media responsibly, protecting credibility, and effectively leveraging online platforms for dermatologic education.

Dustin Portela, DO

Dermatology & Social Media: Tips on Engaging with Accuracy and Integrity

In this episode of Derms and Conditions, host James Q. Del Rosso, DO, welcomes Michael Payette, MD, a dermatologist in private practice at Central Connecticut Dermatology, to discuss practical approaches to managing hidradenitis suppurativa (HS). Dr Payette shares his experience establishing a dedicated HS clinic and provides insights into addressing diagnostic delays, patient education, and emerging treatments.

In this episode of Derms and Conditions, host James Q. Del Rosso, DO, welcomes Michael Payette, MD, a dermatologist in private practice at Central Connecticut Dermatology, to discuss practical approaches to managing hidradenitis suppurativa (HS). Dr Payette shares his experience establishing a dedicated HS clinic and provides insights into addressing diagnostic delays, patient education, and emerging treatments.&nbsp;They begin by discussing the importance of outreach and education to raise awareness of HS among non-dermatology health care providers, such as OB-GYNs and urgent care practitioners, highlighting how early referral and intervention can prevent long-term complications such as scarring and sinus tract formation.&nbsp;They then explore the role of GLP-1 therapies and biologics in HS treatment. Dr Payette shares his multimodal approach, explaining how GLP-1s address an underlying cause of inflammation while biologics target active inflammation. He outlines practical tips for managing insurance approvals and counseling patients on the benefits and potential side effects of these therapies.&nbsp;The episode also covers strategies for discussing lifestyle changes, such as weight loss and smoking cessation, while being sensitive to patient challenges. Dr Payette notes that combining weight reduction with biologics can often yield good outcomes, helping patients achieve better disease control and remission.&nbsp;Tune in to the full episode to learn how a systematic, patient-centered approach to HS management can improve outcomes for this challenging condition.

Michael Payette, MD

Hidradenitis Suppurativa: Can You Move the Needle to Achieve Better Outcomes?

In this episode of Derms and Conditions, host James Q. Del Rosso, DO, welcomes Mona Shahriari, MD, associate director of clinical trials at Central CT Dermatology and assistant clinical professor at Yale University, to discuss the challenges of treating pregnant and breastfeeding patients, particularly those with atopic dermatitis (AD).

In this episode of Derms and Conditions, host James Q. Del Rosso, DO, welcomes Mona Shahriari, MD, associate director of clinical trials at Central CT Dermatology and assistant clinical professor at Yale University, to discuss the challenges of treating pregnant and breastfeeding patients, particularly those with atopic dermatitis (AD).&nbsp;The conversation addresses a crucial yet often unclear topic for dermatologists: balancing safety and efficacy when managing AD in patients during pregnancy and lactation. Dr Shahriari emphasizes the importance of addressing uncontrolled inflammation, which can have potential consequences for both the mother and baby, such as premature birth and maternal sleep disruption. She shares insights into the physiological changes during pregnancy, including the shift from a Th1 to a Th2 immune state, and how this can impact conditions like AD and psoriasis.&nbsp;The discussion highlights the limited data available for systemic treatments in this population, as pregnant women are excluded from clinical trials. Despite this, therapies like dupilumab and cyclosporine are discussed for their safety profiles, with dupilumab often considered when patients need effective control with minimal risk. Dr Shahriari also addresses strategies to involve partners in treatment decisions, ensuring patients feel supported and informed.&nbsp;Drs Del Rosso and Shahriari emphasize the importance of open communication with patients, managing risk tolerance, and understanding the nuances of systemic treatment in pregnancy and lactation. Dr Shahriari shares real-world cases, including the use of dupilumab in a pregnant patient with severe AD and counseling a patient with psoriasis who unintentionally administered a biologic injection during the first trimester.&nbsp;Tune in to the full episode for practical guidance on navigating these complex cases and balancing patient care with available evidence. This episode is a must-listen for dermatologists managing pregnant or breastfeeding patients with inflammatory skin conditions.

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