For the final round of 60 tips in 60 minutes, inflammatory skin diseases, rare infectious diseases, and with a few general life pearls were delivered. Mark Lebwohl, MD reviewed a few highly recalcitrant disease treatments including penicillin to decrease recurrence of cellulitis and timolol gel for chronic venous leg ulcers. Timolol ophthalmic solution (0.5%) applied topically can also be used for hypergranulation seen in hidradenitis suppurativa, Dr. Kirby told us. Other tips in the management of HS include utilizing the HS foundation website which has prior authorization templates for a variety of systemic drugs and laser hair removal. 

Dr. Stein Gold covered two RCTs for topical atopic dermatitis medications: roflumilast and tapinarof. She also reviewed promising long-term results from the 1726nm laser for acne in 104 subjects followed for 12 months. Lesion clearance and IGA were improved at the 12 month mark post treatment even compared to 3 months after completion of the regimen. A few new infectious etiologies were brought to our attention by Dr. Tomecki, including Orf virus, a pox virus, which leads to contagious ecthyma contracted from sheep, goats, oxen, and reindeer, as well as talaromycosis, a soil-dwelling fungus. 

Our hair loss pearls in this session were delivered by Dr. Leavitt who covered dutasteride in depth. He started by reviewing a series of patients with frontal fibrosing alopecia (n=224) who were followed for at least 12 months while on dutasteride or another systemic therapy, such as hydroxychloroquine, doxycycline, and isotretinoin. Those on dutasteride had higher stabilization rates than the other groups, around 60% in all scalp regions. Dutasteride for androgenic alopecia was also deemed superior to finasteride and minoxidil, but he recommended combination therapy for maximal benefit. Dr. Siegel gave us a helpful clinical pearl to scrape rather than clip nails for a KOH prep. Leaving us with a few real life warnings, he recommended backing up our documents and photos often and taking steps, like ultra-wideband technologies in tags and cards, to prevent us from losing our electronic devices for those of us who seem to misplace things all too often.