In this episode of Derms and Conditions, host James Q. Del Rosso, DO, is joined by Steven Daveluy, MD, for a wide-ranging conversation that connects oncodermatology, teledermatology, and integrative approaches to patient care.

The discussion opens with Dr Daveluy’s work in an oncodermatology clinic and the critical role dermatologists play in managing cutaneous side effects from cancer therapies. He explains that while oncologists may be inclined to pause or discontinue cancer treatment in the face of severe skin reactions, dermatologists are uniquely positioned to identify, manage, and mitigate these effects, often allowing patients to remain on life-saving therapy and achieve better oncologic outcomes.  

The conversation then shifts to teledermatology, highlighting the Veterans Affairs health system’s leadership in expanding access, particularly for rural patients. Dr Daveluy describes his team-based model in which dermatoscopy is standardized across sites, allowing frontline clinicians to submit high-quality images for rapid dermatologic input.

Clinical pearls follow, including management of epidermal growth factor receptor-inhibitor eruptions with tetracyclines and selective use of agents such as isotretinoin or dapsone to keep patients on cancer therapy. Importantly, brisk skin reactions may correlate with positive tumor response, reinforcing the goal of treating through, rather than stopping, therapy.

The episode concludes with an exploration of integrative dermatology. Dr Daveluy advocates for consideration of evidence-based supplements, thoughtful discussion of diet and stress, and careful counseling rather than dismissing patient interest. Case examples illustrate both benefit and harm, underscoring the importance of third-party testing and drug–supplement awareness. A final reflection on mind-body medicine through practices like “laughter yoga” highlights tools that can help patients reframe flares and improve quality of life, even when disease activity is beyond their control.

Tune in to the episode to hear expert insights on managing cancer-therapy–related skin reactions, expanding access through teledermatology, and thoughtfully integrating complementary approaches into everyday dermatology practice.