Derms and Conditions

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Hear from the leading dermatologists and experts as they discuss the hottest topics in dermatology. Tune in for clinical practice tips and treatment pearls you can implement quickly and efficiently into your busy practices!

  1. Oral Isotretinoin: Where Are We After 44 Years?

    7 HR AGO

    Oral Isotretinoin: Where Are We After 44 Years?

    In this episode of Tea with Dr. D, host James Q. Del Rosso delivers a solo “Spilling the Tea” segment that revisits oral isotretinoin through a longitudinal lens, connecting its early clinical foundations to present-day practice. Framing isotretinoin as a “winding road,” Dr Del Rosso reflects on its 1982 approval, early safety observations, and the evolution of risk management strategies, including the iPLEDGE program. While concerns around psychiatric effects, inflammatory bowel disease, and teratogenicity have shaped prescribing behaviors, he emphasizes that most patients tolerate therapy well when appropriately monitored. A central theme is the value of foundational knowledge. Dr Del Rosso highlights considerations that remain highly relevant, including dosing flexibility, relapse patterns, treatment duration, and importantly, the impact of absorption on outcomes. Conventional formulations require adequate dietary fat for optimal bioavailability, and suboptimal fat intake may contribute to perceived treatment failure or relapse. He also reviews evolving data on dosing strategies, noting that a range of daily doses can achieve clearance. The priority, however, is durability of response. Clinicians are encouraged to focus on cumulative exposure and to individualize therapy, extending duration or adjusting dose as needed to maintain clearance. Newer formulations, including lidose and micronized isotretinoin, may help mitigate variability in absorption and improve consistency, though access and cost remain considerations. Additional insights address relapse risk and the importance of evaluating possible underlying contributors such as androgen excess. Laboratory monitoring practices have also evolved, with a more streamlined approach focusing on key parameters like liver enzymes and triglycerides, alongside strict adherence to pregnancy prevention protocols. Ultimately, the episode reinforces that while isotretinoin prescribing has modernized in certain respects, many core principles remain unchanged. Thoughtful dosing, attention to absorption, and individualized management are essential to optimizing long-term outcomes. Tune in to the episode to revisit the clinical foundations of isotretinoin, refine your approach to dosing and duration, and learn practical strategies for improving treatment consistency and long-term acne clearance.

    29 min
  2. The Life of Leon: How He Succeeds and He Makes It Look Easy

    7 MAY

    The Life of Leon: How He Succeeds and He Makes It Look Easy

    In this episode of Derms and Conditions, host James Q. Del Rosso, DO, welcomes Leon Kircik, MD, for a wide-ranging conversation that traces Dr Kircik’s journey from his upbringing in Turkey to building a thriving dermatology practice and research center in Louisville, Kentucky, and ultimately becoming one of the leading educators in the field.  Dr Kircik reflects on the early influence of his father, whose emphasis on discipline and hard work shaped his approach to both medicine and business. After immigrating to the United States and completing dermatology training at the University at Buffalo, he recognized an oversaturated market in New York City and made the strategic decision to establish his practice in Louisville. There, he prioritized including access for Medicaid patients and offered extended hours to better meet patient needs. The discussion also explores the operational realities of running a high-functioning clinical research center. Dr Kircik shares insights into meeting both the administrative and logistical demands, particularly in the context of clinical studies, highlighting the importance of protocol adherence, consistent investigator presence, and delivering high-quality data to maintain industry trust. A notable portion of the conversation focuses investigator-initiated studies (ISS). While resource-intensive and carrying greater responsibility, Dr Kircik views ISS as an opportunity to answer clinically meaningful questions that industry-sponsored trials may not be able to address, ultimately contributing to scientific advancement and professional growth. Tune in to the episode to hear more of Dr Kircik’s reflections on building a multifaceted career as well as personal lessons ranging from real estate investments to maintaining professional commitments while recovering from a serious injury, all grounded in a consistent theme of resilience and sustained effort over time.

    30 min
  3. How Does Modern-Day Compounding Create Uncertainty, Inconsistency & Risk to Patients? 

    30 APR

    How Does Modern-Day Compounding Create Uncertainty, Inconsistency & Risk to Patients? 

    In this episode of Derms and Conditions, host James Q. Del Rosso, DO is joined by Stefan Weiss, MD for a focused discussion on compounding in dermatology, an area that often operates with less visibility but carries important clinical implications. The conversation centers on the regulatory and practical differences between 503A and 503B compounding pharmacies, with particular attention to 503A facilities, where customized medications are prepared based on individual prescriptions. They outline key concerns with this model, including variability in formulation, lack of standardized testing, and limited oversight compared with FDA-approved therapies. Unlike commercially developed medications, compounded products are not required to undergo stability testing, penetration studies, or clinical trials, raising questions about consistency, efficacy, and safety. A recurring theme is the challenge of knowing exactly what patients receive. Without controls on formulation integrity or bioavailability, clinicians may encounter variability not only between pharmacies, but even between batches from the same source, highlighting how this uncertainty can complicate treatment decisions. The episode also contrasts compounded therapies with FDA-approved options, using topical clascoterone as an example of a rigorously tested, standardized formulation. While both speakers acknowledge that compounding has a role, particularly in addressing unmet or niche patient needs, they note that its use today has expanded beyond its original intent. Tune in to the episode to hear how clinicians can approach compounded therapies with greater scrutiny, balance their use against standardized treatments, and make more informed decisions in everyday dermatology practice.

    27 min
  4. Changing Conversations in Acne Management

    16 APR

    Changing Conversations in Acne Management

    In this episode of Derms and Conditions, host James Q. Del Rosso, DO, is joined by Heather Woolery-Lloyd, MD, for a treatment-focused discussion on acne management in an era where patient expectations, product awareness, and regimen complexity continue to rise.   The conversation opens with a shift many dermatologists are seeing in practice: patients arriving more informed and more influenced by social media, asking detailed questions about ingredients, formulations, and skin care routines. This evolving dynamic requires clinicians to not only select effective therapies but also contextualize an expanding array of over-the-counter and adjunctive options.   Dr Woolery-Lloyd and Dr Del Rosso revisit foundational therapies such as benzoyl peroxide, addressing concerns around benzene and reinforcing its continued role as a reliable, effective agent. They emphasize the importance of formulation and tolerability, noting that lower concentrations (around 4% or less) can offer similar efficacy with reduced irritation when well-formulated.   A central theme is the growing importance of the skin barrier and microbiome in acne management. The speakers highlight how barrier-supportive skin care, including moisturizers and adjunctive products, can improve both tolerability and clinical outcomes. They underscore that regimen success often depends on the full system of care, not just prescription therapies.   The discussion also explores newer over-the-counter formulations, including polyhydroxy acids for gentle exfoliation, multifunctional moisturizers targeting post-inflammatory hyperpigmentation, and emerging adjuncts like hypochlorous acid sprays (particularly useful for truncal acne).   Throughout, the episode reinforces a practical message: effective acne management today requires thoughtful integration of prescription therapies, formulation science, and patient-centered skin care guidance. Tune in to the episode to hear how clinicians are navigating increasingly informed patients, optimizing tolerability without sacrificing efficacy, and building acne regimens that account for both therapeutic impact and real-world adherence.

    35 min
  5. Acne Therapy: It’s Not Just the Tools You Have—It’s How You Use Them!

    2 APR

    Acne Therapy: It’s Not Just the Tools You Have—It’s How You Use Them!

    In this episode of Derms and Conditions, host James Q. Del Rosso, DO, is joined by Hilary Baldwin, MD, for a treatment-focused discussion on acne management, with particular attention to how newer topical therapies are reshaping treatment approaches. They begin by reflecting on how patient expectations and therapeutic options have shifted over the past decade. Dr Baldwin highlights improvements in topical formulations that have enhanced both efficacy and tolerability, allowing many patients with mild to moderate and even some severe acne to be managed with topicals alone. This shift has also reduced reliance on prolonged oral antibiotic use. They next address practical considerations, including access and adherence. Dr Baldwin discusses the role of specialty pharmacies in helping ensure patients receive prescribed therapies without substitution and the importance of providing specific skin care recommendations to minimize irritation and improve outcomes. A key focus of the conversation is topical clascoterone, a first-in-class androgen receptor inhibitor that targets the androgen-sebum pathway and reduces sebum production progressively over time. They emphasize the benefit of initiating it early and setting appropriate expectations with patients, as its therapeutic effects build over 2 to 3+ months. Both clinicians advocate pairing clascoterone from the outset with a combination of topical agents that addresses other pathophysiologic cascades in acne to provide early visible improvement while supporting longer-term disease control. Other agents, such as benzoyl peroxide, topical retinoids, and clindamycin, are available in combination topical formulations to allow for ease of use, including a triple-combination topical gel.    They also discuss strategies for simplifying complex regimens, especially for younger patients, and review admixture data supporting compatibility between clascoterone and other topical agents. Tune in to the episode for practical pearls on designing combination topical regimens, setting realistic expectations with patients, and applying these strategies to optimize acne management. Disclaimer: This podcast is not intended to provide diagnosis, treatment, or medical advice. Content provided in this podcast is for educational purposes only. Please consult with a physician regarding any health-related diagnosis or treatment.

    26 min
  6. Attention to Lupus is Long Overdue! Better Understanding of Disease Leads to Better Therapies

    19 MAR

    Attention to Lupus is Long Overdue! Better Understanding of Disease Leads to Better Therapies

    In this episode of Derms and Conditions, host James Q. Del Rosso, DO, welcomes Joseph Merola, MD, for a clinically focused discussion on updates in cutaneous lupus erythematosus (CLE). Long considered an area with limited therapeutic progress, CLE is gaining renewed attention as advances in disease biology and immunopathogenesis begin to inform new therapeutic approaches. They begin by discussing the importance of early recognition, particularly for scarring forms such as discoid lupus erythematosus, where permanent damage often drives diagnosis rather than earlier inflammatory changes. To help clinicians recognize disease activity sooner, Dr Merola shares a practical mnemonic (PASTE) highlighting features including follicular plugging, atrophy, scarring, telangiectasia, and erythema. They next discuss the clinical nuances of subacute cutaneous lupus erythematosus, including the need to evaluate for drug-induced disease. Medications such as hydrochlorothiazide and over-the-counter proton pump inhibitors may act as triggers and require careful medication history review. They next review current and emerging treatment strategies. While first-line therapy remains centered on antimalarials such as hydroxychloroquine, attention is increasingly turning toward targeted therapies approved for other immune-mediated diseases. For example, anifrolumab, which inhibits type I interferon signaling and is approved for systemic lupus, has demonstrated activity in cutaneous lupus and is being evaluated in dedicated trials. Similarly, the TYK2 inhibitor deucravacitinib, approved for psoriasis and psoriatic arthritis, has shown signals of efficacy for lupus-associated skin disease in early studies. They then discuss investigational therapies being developed specifically for lupus pathways. Among these is litifilimab, a monoclonal antibody targeting plasmacytoid dendritic cells to reduce type I interferon signaling. With fast-track designation and emerging clinical data, litifilimab highlights ongoing efforts to develop therapies directed at key immunologic drivers of both cutaneous and systemic lupus. Tune in to the full episode to hear diagnostic pearls for recognizing CLE earlier, strategies for identifying drug-induced disease, and perspectives on emerging therapies under investigation for cutaneous lupus.

    32 min
  7. Modern Training Of Future Dermatologists: Maintaining Core Fundamentals In A Rapidly Changing Educational Landscape

    12 MAR

    Modern Training Of Future Dermatologists: Maintaining Core Fundamentals In A Rapidly Changing Educational Landscape

    In this episode of Derms and Conditions, host James Q. Del Rosso, DO, welcomes Michelle Tarbox, MD, for a candid discussion about the realities of leading a dermatology department and training the next generation of dermatologists. Dr Tarbox reflects on the vision she brought to her role as department chair and the principles that guide her approach to residency education. Central to that philosophy is cultivating enthusiastic, lifelong learners. While a strong grounding in foundational dermatology, including historical therapies, is essential, she emphasizes that residents must also be fluent in emerging therapies and evolving evidence. She highlights the value of conferences, podcasts, and other modern educational resources that help clinicians remain current while connecting learning to real-world practice. The conversation also explores the growing influence of artificial intelligence (AI) in medicine. Dr Tarbox notes that AI tools are becoming increasingly accessible and may support educational development and information gathering. However, she cautions that technology should complement, not replace, clinical judgment. Both clinicians agree that medical students and residents must learn to critically evaluate AI-generated content, verify references, and take responsibility for the work they sign their names to. She shares practical strategies for mentoring trainees in this area, including careful citation review and clear expectations around responsible AI use. Finally, she reflects on the leadership lessons she has learned since becoming chair, including the importance of communication, collaborative decision-making, and balancing ambitious ideas with institutional realities. Tune into the episode to hear Dr Tarbox share insights on dermatology leadership, residency education, responsible use of emerging technologies, and the behind-the-scenes decisions that shape the training of future dermatologists.

    23 min
  8. Challenging Recycled Dogma: Fine-Tuning Accuracy to Improve Patient Care

    5 MAR

    Challenging Recycled Dogma: Fine-Tuning Accuracy to Improve Patient Care

    In this episode of Derms and Conditions, host James Q. Del Rosso, DO, welcomes David Seiter, FNP-C, for a wide-ranging discussion on challenging dermatologic dogma and integrating emerging evidence into clinical decision-making. They begin with Seiter sharing his approach to reviewing new literature, encouraging clinicians to look beyond mainstream dermatology journals to cross-disciplinary publications to help reshape long-held assumptions. Using lichen planus as an example, he revisits the entrenched association between diffuse lichen planus and hepatitis C. While many clinicians routinely test for hepatitis C in these patients, new data suggest the association is uncommon. More compelling, however, is the emerging link between persistent, widespread lichen planus and underlying malignancy. Seiter outlines how he thoughtfully screens for red flags and gaps in preventive care without alarming patients prematurely, reinforcing the importance of looking beyond a single lab test. The conversation then shifts to acanthosis nigricans, where traditional teaching centers on hyperglycemia and diabetes risk. Seiter explains why acanthosis nigricans is more accurately viewed as a marker of hyperinsulinemia rather than elevated A1c. He discusses incorporating HOMA-IR calculations to identify early insulin resistance, particularly in adolescents whose A1C may remain normal for years. Both clinicians stress that a “normal” A1C should not prematurely reassure patients when cutaneous markers signal metabolic risk. Additional topics include reconsidering intralesional triamcinolone as the default therapy for keloids, with discussion of emerging data on intralesional insulin as a potentially lower–adverse event alternative, and a pragmatic conversation about JAK inhibitor safety. Comparing adverse event data across agents, they emphasize individualized risk assessment, careful monitoring, and shared decision-making over reflexive fear of boxed warnings. Tune into the episode to explore how questioning assumptions, broadening your literature review, and contextualizing risk can sharpen your clinical reasoning and elevate patient care in everyday dermatology practice.

    35 min
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Hear from the leading dermatologists and experts as they discuss the hottest topics in dermatology. Tune in for clinical practice tips and treatment pearls you can implement quickly and efficiently into your busy practices!

Information

  • Creator
    Dermsquared
  • Years Active
    2021 - 2026
  • Episodes
    154
  • Rating
    Clean
  • Copyright
    © 2025 Dermsquared
  • Show Website
    Derms and Conditions

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