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

Jonny Hatch and Deven Curtis
  • 5.0 (4)
  • Medicine
  • Updated Weekly

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

Episodes

  1. 3h ago

    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

  2. Aug 31

    Ep 6. Atopic Dermatitis Pathophysiology, Clinical Features, Variants, and Biologics

    Send us Fan Mail Atopic Dermatitis High-Yield Review: Etymology, Diagnosis, Pathogenesis, Cytokines, Microbiome, Distribution, and Mimickers | The Derm Resident Email us: thedermresident.pod@gmail.com  Hosts Dr. Jonny Hatch and Dr. Deven Curtis review high-yield atopic dermatitis (AD), covering its 1923 “atopos” etymology, clinical definition, and the atopic march (AD/food allergy in infancy, asthma in childhood, allergic rhinoconjunctivitis in adolescence). They outline AAD diagnostic criteria: pruritus, classic age-specific morphology/distribution, and chronicity, plus intrinsic (IgE-associated) vs non–IgE AD. Pathogenesis is framed as barrier dysfunction, immune dysregulation, and microbiome alteration, highlighting filaggrin’s role, transepidermal water loss, increased skin pH, and unchecked kallikrein proteases; Netherton syndrome (SPINK5/LEKTI) is discussed. They review Th2→Th1 evolution, key cytokines (IL-4/13 targeted by dupilumab; IL-13-only agents; IL-31 “itch cytokine” and nemolizumab), Staph aureus colonization and impetiginization, age-based distribution patterns, site variants and stigmata (Denny-Morgan lines, white dermatographism, keratosis pilaris, ichthyosis vulgaris), complications (ocular disease, eczema herpeticum with IV acyclovir on boards), quality-of-life impact, biopsy rationale (spongiotic dermatitis, rule out mycosis fungoides), and common mimickers and differentials including seb derm, scabies, contact dermatitis, immunodeficiencies, hypereosinophilia causes, nummular dermatitis, SCC in situ, dyshidrotic eczema, and asteatotic eczema. 00:00 Welcome and Topic Setup 00:31 Atopic Derm Name Origin 01:59 What It Is and Atopic March 04:41 Diagnosis Criteria Essentials 06:13 IgE Types and Core Pathogenesis 08:32 Barrier Breakdown and Filaggrin 13:02 Proteases and Netherton Syndrome 15:11 TH2 to TH1 Cytokine Shift 18:09 Dupilumab IL4 IL13 Explained 21:24 IL31 The Itch Cytokine 23:57 Staph Aureus and Microbiome 27:10 Age Based Distribution Infants 27:53 Age Based Distribution 29:32 Site Specific Variants 31:18 Head Neck Dupixent 31:58 Atopic Stigmata Signs 34:24 Ichthyosis And KP 36:09 Ocular Complications 37:55 Eczema Herpeticum Urgency 40:07 Quality Of Life Burden 42:27 When To Biopsy 45:18 Mimickers And Immunodeficiency 49:31 Eosinophilia Differential 50:22 Rapid Fire Dermatitis 53:25 Episode Wrap Up

  3. Aug 24

    Ep 5: Rosacea, Granulomatous Rosacea, Solid Facial Edema, Periorificial Dermatitis, etc. with Anuj Kunadia, MD

    Send us Fan Mail Rosacea High-Yield Review: Subtypes, Triggers, Treatment Ladder, and Key Differentials (with Dr. Anuj Kunadia) | The Derm Resident Contact us at: thedermresident.pod@gmail.com DermatoGraphix Discount Code (not an affiliate link): DERMNERDS30 Link to Rosacea Sketches Dr. Jonny Hatch welcomes Dr. Anuj Kunadia, founder of DermatoGraphix, to review high-yield rosacea. They distinguish rosacea from acne by the absence of comedones and discuss subtypes: erythematotelangiectatic (erythema/telangiectasias, burning/stinging; often procedural treatment with PDL or IPL), papulopustular (topicals like azelaic acid, metronidazole, ivermectin; oral low-dose doxycycline; isotretinoin if refractory), phymatous (sebaceous hyperplasia/fibrosis; rhinophyma and other “phyma” sites; early isotretinoin vs surgical/laser debulking), and ocular (can precede skin findings; refer to ophthalmology and consider doxycycline). They cover pathogenesis including kallikrein-5/cathelicidin LL-37, Demodex association and ivermectin, common triggers, variants (granulomatous rosacea, rosacea fulminans, Morbihan disease), key differentials (seborrheic dermatitis, lupus), periorificial dermatitis management (stop steroids, pimecrolimus/doxycycline), and conclude with rapid-fire boards questions and an art-history rhinophyma example. 00:00 Welcome and Setup 00:19 Meet the Guest 00:44 Dermatographics Origin 01:52 Classic Rosacea Case 02:30 Rosacea Basics 03:08 Acne vs Rosacea 04:21 Rosacea Subtypes 04:49 ETR Features and Lasers 05:58 Pathogenesis and Demodex 08:55 Triggers and Photoprotection 11:46 Phymatous Rosacea 13:41 Ocular Rosacea Red Flags 15:15 Rare Rosacea Variants 19:34 Key Differentials 23:19 Treatment Ladder Overview 24:23 Topicals for Redness 26:19 Papulopustular Treatments 30:19 Procedures for Rhinophyma 31:03 Periorificial Dermatitis 34:29 Periorificial Treatment Plan 35:47 Rapid Fire Boards Quiz 41:01 Fun Fact and Wrap Up

  4. Aug 17

    Ep 2: The Full Body Skin Exam

    Send us Fan Mail Full Body Skin Exam: Sequence, Missed Sites, and High-Yield Lesions for Skin Cancer Screening | The Derm Resident In episode two of The Derm Resident, hosts Dr. Jonny Hatch and Dr. Deven Curtis walk through a practical approach to the full body skin exam for skin cancer screening, emphasizing the importance of a consistent exam sequence, patient communication, and documenting spots of concern. They review commonly missed sites (scalp, behind ears, interdigital toe spaces, palms/soles, g******s) and note the need for chaperones for sensitive exams. The episode covers high-yield benign lesions (seborrheic keratoses, sebaceous hyperplasia, cherry angiomas, nevi subtypes and dermoscopy patterns, dermatofibromas, lichen planus-like/lichenoid keratosis, skin tags) and premalignant/malignant lesions (actinic keratoses, basal cell carcinoma, squamous cell carcinoma including keratoacanthoma, and melanoma types including subungual melanoma and Hutchinson sign). They close with biopsy pearls, follow-up intervals based on risk, and counseling on warning signs and daily sun protection. 00:00 Welcome and Disclaimer 00:35 Why Skin Exams Matter 00:49 Starting the Encounter 02:37 Building Your Exam Sequence 05:26 Commonly Missed Sites 08:07 Benign vs Malignant Overview 08:29 Seborrheic Keratoses 12:37 Leser Trelat and Boards Pearls 14:14 Sebaceous Hyperplasia 16:27 Cherry Angiomas 18:20 Nevi Types and Aging 23:23 Dermoscopy of Junctional Nevi 25:10 Intradermal Nevi Patterns 25:21 Intradermal Nevus Clues 26:31 Dermatofibroma Exam Pearls 28:41 Lichenoid Keratosis Explained 30:37 Skin Tags Basics 31:38 Actinic Keratosis Recognition 32:55 AK Treatment Options 35:23 Basal Cell Carcinoma Signs 37:46 Squamous Cell and KA Debate 42:27 Melanoma Types and ABCDE 44:55 Subungual Melanoma Hutchinson 47:51 Biopsy Depth and Technique 48:58 Follow Up and Sun Safety 52:01 Final Wrap and Takeaways

  5. Aug 17

    Ep 3: Acne Pathogenesis, Clinical Features, Variants, and Topical Management

    Send us Fan Mail Acne Boot Camp: Pathogenesis, Clinical Evaluation, Variants, Mimickers & First-Line Topicals | The Derm Resident Hosts Dr. Jonny Hatch and Dr. Deven Curtis introduce The Derm Resident and begin an acne “boot camp” covering high-yield basics for clinic and boards. They review acne’s etymology and outline the four pillars of pathogenesis: follicular hyperkeratinization (microcomedone formation), androgen-driven sebum production (DHT via 5-alpha reductase), Cutibacterium acnes colonization with inflammatory free fatty acids, and inflammation. They discuss clinical morphology and distribution, inflammatory vs noninflammatory lesions, PIH versus true scarring (ice pick, boxcar, rolling, and hypertrophic scars), and diet associations (skim milk, whey protein, high glycemic load, vitamin B12/energy drinks). The episode covers variants and special populations including adult female acne, neonatal/infantile/mid-childhood/pre-adolescent acne (with workup triggers), acne fulminans treatment with prednisone then low-dose isotretinoin, follicular occlusion tetrad, acne excoriée, drug-induced acne, acne mechanica/occupational acne/chloracne, and mimickers like rosacea and gram-negative folliculitis, then closes with topical treatment ladders and key agents (retinoids, benzoyl peroxide, clindamycin, azelaic acid, dapsone, clascoterone). 00:00 Welcome and Focus 00:45 Acne Name Origins 02:15 Acne Pathogenesis Overview 03:24 Hyperkeratinization Explained 04:38 Comedones and Sebum Words 05:59 Androgens and Sebum 07:55 C Acnes and Inflammation 10:00 Diet and Acne Evidence 12:46 Clinical Exam and Severity 14:23 PIH Versus True Scars 17:46 Adult Female Acne 20:06 Acne Fulminans Treatment 23:45 Fulminans Name and Tetrad 25:32 Follicular Occlusion Tetrad 26:54 Pilonidal Cyst Etymology 27:21 Acne Excoriée Explained 28:39 Pediatric Acne Types 32:57 Drug Induced Acne Clues 36:28 Mechanica Occupational Chloracne 39:06 Acne Mimickers Differential 41:27 Hyperandrogenism Lab Workup 44:28 Acne Treatment Ladder 49:56 Topicals Beyond Retinoids 52:33 Systemic Therapy Next Episode 53:03 Wrap Up And Goodbye

  6. Aug 17

    Ep 4. Acne Management with Dr. John Barbieri, MD

    Send us Fan Mail Acne & Rosacea Pearls with Dr. John Barbieri: Diagnosis, Antibiotics, Isotretinoin Dosing, and Pregnancy-Safe Options | The Derm Resident In this “Meet the Expert” episode of The Derm Resident, Dr. Jonny Hatch talks with acne and rosacea expert Dr. John Barbieri about practical, early-resident approaches to acne and common mimickers, emphasizing comedones as a key differentiator and reviewing clues for periorificial dermatitis, rosacea, and pityrosporum folliculitis. They discuss why “jawline acne” is not a strong predictor of PCOS/PMOS and why signs like irregular menses, hirsutism, and acanthosis nigricans are more informative. Dr. Barbieri outlines systemic treatment decision-making, favoring spironolactone over long-term antibiotics in many patients, and reviews antibiotic choices and resistance concerns. The conversation then covers isotretinoin timing, dosing to clinical endpoints, adjuncts to reduce flaring and side effects (loratadine, omega-3, L-carnitine), counseling on growth and mood risk, pregnancy-safe acne options, benzoyl peroxide/benzene concerns, rosacea redness treatment (oxymetazoline), and common trainee mistakes. 00:00 Welcome and Guest Intro 00:42 Acne Exam Basics 01:08 Acne Mimickers 02:36 History and PCOS Clues 03:30 Jawline and Hormones 05:26 Systemic Treatment Choices 07:01 Low Dose Doxy Debate 08:59 Antibiotics as Bridge 10:59 Which Antibiotic to Pick 13:35 Starting Isotretinoin (Accutane) 15:46 Dosing and Endpoints 17:32 Cumulative Dose Myths 19:17 Higher Daily Dosing 20:12 Antihistamine Add On 21:09 Omega 3 For Dryness 22:25 L Carnitine For Soreness 23:42 Growth Stunting Myth 24:33 Mood And Suicide Risk 27:02 Acne In Pregnancy 28:09 Topical Combo Strategies 29:23 Benzoyl Peroxide and Benzene 30:41 Resident Mistakes And Rosacea 33:18 Rosacea Phenotype Approach 34:52 Advice For New Residents 35:30 Final Thanks And Wrap

  7. Aug 17

    Ep 1: Intro to Dermatology | Framework and Morphology

    Send us Fan Mail Dermatology Morphology Basics: Building Differentials & Primary vs Secondary Lesions | The Derm Resident Hosts Dr. Jonny Hatch and Dr. Deven Curtis introduce The Derm Resident and outline the podcast’s goal of reviewing dermatologic diseases by pathogenesis, clinical features, workup, and management to help with clinic and boards. They discuss an approach to building differentials using a “tree” framework (neoplastic vs inflammatory, then infectious vs noninfectious) and emphasize that morphology is the core language of dermatology, sometimes outweighing patient history. The episode reviews key primary lesions—macule vs patch, papule vs plaque, nodules, wheals, vesicles vs bullae, and pustules—and explains why precise word choice matters. They then cover secondary changes including scale vs crust, fissures, excoriations, erosions vs ulcerations, atrophy, and lichenification, and end by stressing the importance of palpation in lesion assessment. 00:00 Welcome to the Podcast 00:52 How to Build a Differential 02:38 Disease Buckets and Pathogenesis 05:56 Morphology Is King 08:43 Primary Lesions Basics 11:54 Nodules and Wheals 14:49 Blisters and Pustules 19:52 Secondary Lesions Explained 21:06 Scale vs Crust and Micaceous 24:10 Breaks in the Skin 27:46 Atrophy and Lichenification 30:10 Palpation Pearls 32:17 Wrap Up and Next Episode

  • 7 Episodes

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

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