The Derm Resident: Boards Fodder and Clinical Pearls for Dermatology Residents

Jonny Hatch and Deven Curtis
  • 5.0 (8)
  • Medicine
  • Updated Weekly

High yield dermatology boards fodder and clinical pearls for derm residents, by derm residents.

  1. 2d ago

    Ep 14. Allergic Contact Dermatitis | Common Allergens, Patch Testing, and Treating of Acute Allergic Contact Dermatitis

    Send us Fan Mail Allergic Contact Dermatitis: Type IV Hypersensitivity, Patch Testing, and High-Yield Allergens | The Derm Resident Dr. Jonny Hatch and Dr. Deven Curtis review allergic contact dermatitis (ACD) as a type IV, T-cell–mediated delayed hypersensitivity, contrasting it with the more common irritant contact dermatitis (ICD), which is non-immunologic and can occur on first exposure. They outline sensitization (hapten-protein complex processed by Langerhans cells in lymph nodes) and elicitation on re-exposure with cytokine-driven spongiotic dermatitis, pruritus, and possible vesicles. Clinical clues include delayed onset in ACD, burning/stinging and rapid onset in ICD, and using distribution patterns (earlobes, periumbilical, eyelids, shoes, scalp). They explain patch testing logistics, grading, pitfalls (irritant reactions, angry back syndrome, false negatives), and ROAT. High-yield allergens include nickel, fragrance mixes/balsam of Peru, formaldehyde releasers, rubber accelerators, neomycin, cobalt, PPD, MI, acrylates, urushiol, textile dyes, and chromates in cement. Management emphasizes allergen avoidance aided by CAMP/SkinSafe and topical/systemic steroids for flares, noting rebound with short steroid courses. 00:00 Allergic Contact Dermatitis Overview 01:27 Allergy History Pearl 02:24 Irritant vs Allergic Dermatitis 05:54 Type Four Immunology Basics 07:10 Sensitization and Elicitation 12:00 Clinical Morphology and Timing 12:53 Distribution Pattern Clues 14:59 Patch Testing When and Why 17:33 Patch Testing How It Works 19:41 Reading Results and Pitfalls 22:47 High Yield Allergens List 34:34 Special Scenarios and Occupations 39:32 Treatment and Allergen Avoidance 43:43 Wrap Up and Resources This episode is sponsored by Mind the Skin, a patent-pending, steroid-free, patch system. Learn more at mindtheskinlabs.com. Use code TDRP26 at checkout for 20% off.

  2. Oct 19

    Ep 13. Hair Loss Bootcamp | Androgenetic Alopecia, Alopecia Areata, Telogen Effluvium, CCCA, LPP, FFA, Dissecting Cellulitis of the Scalp and MORE!

    Send us Fan Mail Alopecia Boot Camp: Scarring vs Non-Scarring, Key Patterns, Dermoscopy Pearls, and First-Line Management | The Derm Resident Contact: thedermresident.pod@gmail.com Hosts Dr. Jonny Hatch and Dr. Deven Curtis present an “alopecia boot camp” framework focused on first distinguishing scarring (cicatricial) from non-scarring alopecia by assessing follicular ostia with dermoscopy, emphasizing that scarring implies permanent loss and requires urgent treatment at the active edge for biopsy and intralesional therapy. They review non-scarring causes including androgenetic alopecia (DHT-driven miniaturization, anisotrichosis; Hamilton-Norwood/Ludwig scales; minoxidil, finasteride/dutasteride, spironolactone in women, PRP and transplant with donor dominance), alopecia areata (CD8 attack, exclamation point hairs, yellow/black dots; ILK and FDA-approved JAK inhibitors baricitinib and ritlecitinib; totalis/universalis/ophiasis), telogen effluvium (delayed shedding after stressors; hair pull test; consider TSH and iron studies/ferritin), traction alopecia (fringe sign; may become scarring), and trichotillomania (broken hairs of varying length). Scarring alopecias covered include LPP/FFA (perifollicular erythema and tubular scale; hydroxychloroquine/doxycycline and steroids), CCCA (central centrifugal pattern; biopsy active border; discuss styling factors and PADI3), and rapid-fire pearls for DLE (follicular plugging), folliculitis decalvans (tufting; clindamycin/rifampin), dissecting cellulitis (boggy nodules/sinus tracts; follicular occlusion tetrad), and acne keloidalis nuchae (posterior scalp/neck plaques; consider laser/excision). 00:00 Alopecia Boot Camp 00:52 Why Hair Loss Is Hard 01:24 Scarring Versus Nonscarring 03:28 Follicular Ostia Clues 05:38 Androgenetic Alopecia Basics 08:05 Treating Pattern Hair Loss 08:34 Minoxidil ICU Story 12:08 Counseling and Transplants 13:44 Alopecia Areata Recognition 17:04 Areata Workup and Treatment 18:30 Telogen Effluvium Shift 20:31 Postpartum Shedding Explained 20:54 Hair Pull Test Basics 21:50 When to Order Labs 23:37 Traction Alopecia Red Flags 26:21 Trichotillomania Patterns 27:42 LPP and FFA Scarring Clues 30:09 Treating LPP and FFA Early 31:33 CCCA Diagnosis and Biopsy 36:04 Rapid Fire Scarring Alopecias 40:19 Clinic Safety Takeaways 41:12 Boot Camp Wrap Up This episode is sponsored by Mind the Skin, a patent-pending, steroid-free, patch system. Learn more at mindtheskinlabs.com. Use code TDRP26 at checkout for 20% off.

  3. Oct 12

    Ep 12. Hidradenitis Suppurativa Bootcamp: Risk Factors, Clinical Features, and Management

    Send us Fan Mail Hidradenitis Suppurativa (HS) Boot Camp: Diagnosis, Hurley Staging, Treatment Ladder & Surgical Options | The Derm Resident Contact: thedermresident.pod@gmail.com Dr. Jonny Hatch and Dr. Deven Curtis deliver a clinic-focused boot camp on hidradenitis suppurativa (HS), noting the misnomer (not a sweat-gland disease) and reviewing typical intertriginous involvement with painful nodules/abscesses and the pathognomonic double-ended open comedone. They discuss delayed diagnosis, stigma, family history, modifiable factors (smoking and obesity), and flare triggers (menses, friction, sweating, heat, diet). Hurley staging is outlined (I boils only; II recurrent abscesses with sinus tracts/scars; III diffuse interconnected tracts) with emphasis that severity and inflammation may not perfectly match stage. They highlight disease burden (pain, depression screening; associations with Crohn disease, PCOS, metabolic syndrome), exam pearls, and a treatment ladder: topicals (clindamycin with BPO), oral antibiotics (doxycycline, clinda/rifampin; rescue options), hormonal therapy, biologics (adalimumab, infliximab, IL-17 agents), and procedures (I&D, punch deroofing, deroofing, wide excision, reconstruction), plus counseling that HS is chronic, not due to hygiene, and requires ongoing support. 00:00 HS Boot Camp Intro 00:30 Name Origins and Misnomer 02:06 Classic Presentation and Diagnosis 05:04 Risk Factors and Flare Triggers 07:09 Hurley Staging Basics 11:12 Disease Burden and Comorbidities 13:13 Topicals and Lifestyle First Line 15:20 Oral Antibiotics and Escalation 16:58 Hormonal Therapy Pearls 20:00 Biologics for Moderate Severe HS 24:20 Surgical Options and Deroofing 29:38 Patient Counseling and Wrap Up This episode is sponsored by Mind the Skin, a patent-pending, steroid-free, patch system. Learn more at mindtheskinlabs.com. Use code TDRP26 at checkout for 20% off.

  4. Oct 5

    Ep 11. Psoriasis Part 2: Psoriatic Arthritis, Topicals, Systemics, Biologics, and More

    Send us Fan Mail Psoriasis Part 2: Differentials, Psoriatic Arthritis Screening, and the Psoriasis Treatment Ladder | The Derm Resident Contact: thedermresident.pod@gmail.com Hosts Dr. Jonny Hatch and Dr. Deven Curtis continue psoriasis with a focus on chronic plaque differentials, psoriatic arthritis, and a practical treatment ladder. They review mimickers including seborrheic dermatitis and lichen simplex chronicus (including “sebo-psoriasis”), mycosis fungoides prompting biopsy when plaques are treatment-resistant or atrophic, hypertrophic lichen planus on shins, and guttate-pattern differentials such as pityriasis rosea, pityriasis lichenoides chronica, and secondary syphilis. They emphasize screening for psoriatic arthritis (about one-third of patients; HLA-B27 association) using joint/back pain history, nail findings, and dactylitis, with rheumatology referral when appropriate. Treatments covered include topical steroids by site, calcipotriene, tazarotene, roflumilast foam, tapinarof, phototherapy (narrowband UVB preferred over PUVA), and systemic therapies (methotrexate with folate, cyclosporine, apremilast, acitretin) plus biologics (TNF, IL-17, IL-23, ustekinumab) and deucravacitinib, along with biologic prescreening (TB, hepatitis, CBC/CMP, vaccine counseling) and psoriasis comorbidity risks. 00:00 Show Intro and Disclaimer 00:29 Plaque Psoriasis Differentials 02:21 Guttate Mimickers 03:25 Screening for Psoriatic Arthritis 04:53 Topical Treatment Basics 06:32 Nonsteroid Topicals and New Agents 08:13 Phototherapy UVB and PUVA 10:45 Systemics Methotrexate Deep Dive 13:45 Cyclosporine and Oral Options 18:11 Biologics TNF Alpha Inhibitors 22:41 IL-17 Inhibitors Key Pearls 25:47 IL-23 and IL-12/23 Therapies 28:23 Deucravacitinib and Biologic Workup 30:46 Psoriasis as Systemic Disease 31:32 Closing Pearls and Wrap Up This episode is sponsored by Mind the Skin, a patent-pending, steroid-free, patch system. Learn more at mindtheskinlabs.com. Use code TDRP26 at checkout for 20% off.

  5. Sep 28

    Ep 10. Psoriasis Part 1: Pathophysiology, Clinical Features, and Variants

    Send us Fan Mail Psoriasis High-Yield Review (Part 1): Epidemiology, Immunopathogenesis, Triggers, and Clinical Variants | The Derm Resident Hosts Dr. Jonny Hatch and Dr. Deven Curtis review psoriasis for residents, covering historical confusion with leprosy, prevalence (about 2% worldwide; higher in the US/Canada), bimodal onset (20–30 and 50–60), and systemic burden including psoriatic arthritis and comorbid metabolic, cardiovascular, and mood disease. They discuss genetics (notably HLA-Cw6 at PSORS1) and modern immunopathogenesis centered on the IL-23/Th17/IL-17 axis, including keratinocyte–immune “vicious cycle,” neutrophilic histology (Munro microabscesses, spongiform pustules of Kogoj), and TNF’s broad role. The episode reviews disease memory, Koebner phenomenon, triggers (strep, stress, HIV, hypocalcemia, pregnancy, key medications), lifestyle associations, classic plaque features and signs (Auspitz, Woronoff), PASI scoring, and variants including guttate, erythrodermic, and pustular psoriasis (IL36RN/DITRA; spesolimab), plus scalp, inverse, nail, and rare mucosal involvement.  Contact: thedermresident.pod@gmail.com 00:00 Show Intro and Disclaimer 00:36 Psoriasis History Origins 02:06 Epidemiology and Onset 03:23 Systemic Burden Comorbidities 04:22 Genetics and HLA CW6 06:38 Modern Immune Model 08:43 Trigger to T Cell Cascade 12:02 Th17 Cytokines and Plaques 15:08 IL 23 Th17 Axis Explained 18:20 Histology Neutrophils and TNF 20:48 Disease Memory and Koebner 22:36 Triggers Infections Drugs Lifestyle 27:19 Plaque Psoriasis Clinical Exam 30:10 PASI Score Made Simple 32:37 Guttate and Erythrodermic Types 35:40 Pustular Variants and Genetics 40:11 Special Sites Nails Mucosa 42:14 Wrap Up and Part Two This episode is sponsored by Mind the Skin, a patent-pending, steroid-free, patch system. Learn more at mindtheskinlabs.com. Use code TDRP26 at checkout for 20% off.

  6. Sep 21

    Ep 9. Generalized Pruritus, JAK Inhibitors, and Other Itch Treatments with Diego Ruiz Dasilva, MD

    Send us Fan Mail Chronic Pruritus Workup & Treatment Pearls (CPUO, Neuropathic Itch, Nemolizumab, JAKs) | The Derm Resident Contact: thedermresident.pod@gmail.com Dr. Jonny Hatch hosts Dr. Diego Da Silva, a chronic pruritus expert and host of Skin In the Game, to discuss a practical approach to itch. They outline an initial framework based on distribution (localized vs generalized), time course (with shorter duration and older age raising concern for malignancy), and morphology (primary lesions vs excoriations only). For localized itch without rash, they emphasize neuropathic etiologies (notalgia paresthetica, brachioradial pruritus, meralgia, dysesthesias), consider spine wear-and-tear, and discuss PT plus gabapentinoids and other neuromodulators. For generalized pruritus without rash, they review ROS for constitutional symptoms, recommend considering biopsy of “normal” itchy skin (e.g., CTCL, sarcoid), and suggest labs (CBC, CMP, TSH, A1C, SPEP/IFE, ferritin, vitamin D), chest X-ray, and BP testing/DIF. Treatment pearls include skincare, phototherapy, atopic-directed therapies (dupilumab, nemolizumab), JAK inhibitor counseling (noting shingles risk and “JAKne”), and empiric ivermectin for possible scabies; off-label options include low-dose naltrexone, dronabinol, and intranasal butorphanol, plus advice for residents to develop a niche and “declare” expertise. 00:00 Show Introduction 00:59 Why Itch Matters 01:26 Finding a Niche 04:44 First Steps in Pruritus 07:00 Localized Itch Workup 09:02 Neuropathic Itch Treatments 11:32 Generalized Itch Workup 14:32 Labs Imaging and Biopsy 17:54 Treating CPUO Like Atopy 21:49 Choosing First Biologic 22:27 Nemolizumab Itch Breakthrough 23:58 JAK Inhibitors Safety Reality 26:08 Managing Shingles And Jackne 28:05 Treating Jackne Options 28:54 Derms As Real Doctors 30:54 Low Dose Naltrexone Role 32:15 Scabies And Empiric Ivermectin 33:09 Off Label Itch Rescue Meds 35:42 Advice And Podcast Wrap Up This episode is sponsored by Mind the Skin, a patent-pending, steroid-free, patch system. Learn more at mindtheskinlabs.com. Use code TDRP26 at checkout for 20% off.

  7. Sep 14

    Ep 8. Atopic Dermatitis Management with Dr. Peter Lio Part 2 | Eczema Herpeticum/Kaposi’s Varicelliform Eruption, Infection Management, and the Atopic March

    Send us Fan Mail Atopic Dermatitis Cases & Board Pearls: Eczema Herpeticum/Kaposi’s Varicelliform Eruption, Infection Management, and the Atopic March | The Derm Resident Host dermatology resident Jonny Hatch and Dr. Peter Leo finish an atopic dermatitis episode with cases and board-focused pearls. They review recognition and urgent management of eczema herpeticum (crusted, punched-out lesions), emphasizing HSV PCR/culture, considering bacterial coinfection, empiric antivirals (valacyclovir/acyclovir) and when IV acyclovir/hospitalization is warranted, plus Tzanck smear and biopsy findings (three Ms). They discuss Kaposi’s varicelliform eruption etiologies including eczema coxsackium (supportive care, possible empiric antiviral while ruling out HSV, and onychomadesis) and a life-threatening eczema vaccinatum story. They cover the atopic march, transcutaneous sensitization, LEAP study implications, and why most eczema doesn’t improve with dietary restriction. Practical guidance includes treating impetiginized AD with drying compresses and topical mupirocin, limited oral antibiotics, updated views on bleach baths, bathing frequency, topical steroid potency by vehicle, dupilumab-associated conjunctivitis theories, IL-31-mediated itch, TSLP signaling, site-specific steroid absorption, and why JAK1 selectivity matters. 00:00 Podcast Intro 00:19 Eczema Herpeticum Case 02:04 Testing and Swabs 03:09 Empiric Treatment Plan 04:05 When to Hospitalize 05:27 Tzanck Smear Basics 06:53 Eczema Coxsackium Overview 07:33 Kaposi Varicelliform Story 10:21 Differentiating Coxsackium 11:32 Atopic March Explained 13:56 Diet and Food Allergy Myths 18:13 Bacterial Superinfection Case 20:11 Topicals and Tea Compresses 21:13 Bleach Baths Reality Check 22:01 Topicals Over Orals 23:50 Bleach Baths and Bathing 27:23 Eczema Herpeticum Drill 28:20 Steroid Potency Vehicles 29:11 Dupilumab Eye Effects 31:22 Itch Pathways Explained 32:22 Eczema Coxsackium Care 34:58 Atopic March TSLP 36:42 Steroid Absorption Sites 37:30 Genital Itch Strategy 39:49 JAK STAT6 and Future 41:41 Wrap Up and Thanks This episode is sponsored by Mind the Skin, a patent-pending, steroid-free, patch system. Learn more at mindtheskinlabs.com. Use code TDRP26 at checkout for 20% off.

  8. Sep 7

    Ep 7. Atopic Dermatitis Management with Peter Lio, MD Part 1

    Send us Fan Mail Atopic Dermatitis Treatment Ladder: Moisturizers, Topical Steroids, Nonsteroidals, Biologics, and JAK Inhibitors (with Dr. Peter Lio) | The Derm Resident Contact: thedermresident.pod@gmail.com. Host dermatology resident Jonny Hatch interviews Dr. Peter Lio about atopic dermatitis treatment, emphasizing moisturizers (prescriptive product guidance, National Eczema Association Seal of Acceptance, ointments/petrolatum for stinging) and topical corticosteroid selection by potency, vehicle, and body site, with counseling on rare but important adverse effects and steroid stewardship. They distinguish tachyphylaxis from topical steroid withdrawal, noting evolving recognition and potential mechanistic clues. The episode reviews nonsteroidal topicals (tacrolimus/pimecrolimus counseling, black box warning context, stinging mitigation, crisaborole limitations, roflumilast benefits/rare diarrhea, topical ruxolitinib efficacy and boxed warning counseling), then escalates to systemic therapy with phototherapy, biologics (dupilumab, tralokinumab, lebrikizumab, nemolizumab), and oral JAK inhibitors (upadacitinib, abrocitinib) including risks and lab monitoring. They also discuss limited roles for antihistamines, the Dr. Aron regimen compound, and phage-lysin anti-staph products, and preview part two.  00:00 Welcome and Guest Intro 00:51 Moisturizers as Foundation 02:45 Choosing Eczema Safe Products 05:27 Ointments for Sensitive Skin 07:07 Topical Steroid Ladder Basics 08:43 Potency Picks and Stewardship 11:18 Monitoring Steroid Side Effects 12:45 Eyelids and Steroid Sparing 14:19 Tachyphylaxis vs TSW 17:23 Steroid Mechanism of Action 18:51 Calcineurin Inhibitors Counseling 22:42 Eucrisa and PDE4 Reality Check 24:07 Roflumilast Practical Use 25:59 Topical JAK Inhibitor Opzelura 28:43 Placebo and Adherence 29:14 When to Escalate Care 29:41 Biologics Treatment Targets 31:57 ADCT Control Scoring 32:45 Insurance Documentation Tips 33:24 Dupilumab Side Effects 34:15 Managing Eye Symptoms 36:13 Head and Neck Flares 37:37 Switching Biologics Strategy 39:32 Nemolizumab Itch Control 40:00 Oral JAK Inhibitors Overview 41:45 Black Box Risk Counseling 44:36 Lab Monitoring Schedule 46:13 Antihistamines Reality Check 47:51 Aaron Regimen Compound 51:53 Bacteriophage Spray Future 53:42 Closing and Next Steps This episode is sponsored by Mind the Skin, a patent-pending, steroid-free, patch system. Learn more at mindtheskinlabs.com. Use code TDRP26 at checkout for 20% off.

See All (14)

Ratings & Reviews

5
out of 5
8 Ratings

About

High yield dermatology boards fodder and clinical pearls for derm residents, by derm residents.

Information

You Might Also Like