Derms and Conditions

• Poster Power: A Review of Selected Highlights from WCH25

  In this episode of Derms and Conditions, host Dr James Q. Del Rosso returns from the 2025 Winter Clinical Dermatology Conference – Miami® with a deep dive into some of the standout posters presented at the meeting. Dr Del Rosso begins the review with new insights on topical clascoterone 1% cream and its impact on the skin barrier, tolerability, and sebum reduction. He explores recent studies showing that clascoterone does not compromise the permeability barrier or increase transepidermal water loss—key considerations for its use alongside other acne treatments like benzoyl peroxide and topical retinoids. The analysis shifts to a comparative study on a triple combination acne therapy featuring clindamycin 1.2%, adapalene 0.15%, and benzoyl peroxide 3.1%, which demonstrated superior efficacy over dual-combination formulations. Dr Del Rosso breaks down early activity data, inflammatory and non-inflammatory lesion reductions, and how polymeric emulsion technology enhances both efficacy and tolerability. He also highlights new data on topical ruflomilast for atopic dermatitis in younger patients (ages 2-5) and explores the recent FDA approval of tapinarof 1% cream for atopic dermatitis down to age two. Posters on itch and sleep improvements in pediatric patients, as well as efficacy in skin of color, provide valuable clinical insights. Tune in for this rapid-fire breakdown of key posters, packed with data-driven takeaways to enhance your dermatology practice.

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• Highlights from Winter Clinical Hawaii 2025: Recorded Live on The Big Island

  In this special live episode of Derms and Conditions, recorded at the 2025 Winter Clinical Dermatology Conference - Hawaii®, host Dr James Q. Del Rosso welcomes Dr April Armstrong, chief of dermatology at UCLA, and Dr David Cohen, dermatologist at NYU Langone, to break down the key takeaways from this year’s meeting.   The discussion kicks off with chronic hand eczema, a condition that can be difficult to diagnose and treat due to its multiple causes. Dr Cohen highlights emerging data on new treatment options, including dupilumab, topical JAK inhibitors like ruxolitinib, and upcoming therapies like delgocitinib. They explore whether these newer therapies could be effective across different causes of hand eczema, even when an allergen isn’t clearly identified.   Dr Armstrong then shifts the conversation to the next frontier in psoriasis treatment, including new oral therapies that are pushing efficacy to higher levels. They discuss IL-23 receptor antagonists, IL-17 inhibitors, and TNF inhibitors in development, as well as 5-year safety and efficacy data for deucravacitinib, which shows no long-term need for routine monitoring. The group also tackles the evolving treatment landscape for hidradenitis suppurativa (HS), where combination therapy is emerging as a key strategy. Dr Armstrong shares insights into guidance from the HS Foundation and the potential of pairing JAK inhibitors with IL-17 or TNF inhibitors for refractory cases.   They wrap up with practical pearls from the conference, including extended terbinafine treatment durations for fungal infections, pediatric biologic use around live vaccines, and the latest treatment options for molluscum contagiosum.   Tune in to this information-packed episode for expert insights and clinical updates straight from Winter Clinical 2025!

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• "Don't Sweat It" You Say? With Once A Day, There Is A Way!

  In this episode of Derms and Conditions, host James Q. Del Rosso, DO, welcomes Lawrence Green, MD, clinical professor at George Washington University and practicing dermatologist, to discuss the evolving landscape of hyperhidrosis and the latest FDA-approved therapy, sofpironium bromide gel. Dr Green highlights that an estimated 16 million people in the US experience clinical hyperhidrosis, with axillary hyperhidrosis being the most frequently reported. However, a significant challenge is patient reluctance to discuss symptoms, often due to embarrassment or frustration with ineffective or irritating treatments. Dr Green suggests raising awareness through social media, office signage, and intake forms to help identify more patients needing care. The discussion then shifts to treatment options, including botulinum toxin, devices such as the Brella SweatControl Patch and the energy-based miraDry, and pharmacologic therapies.  They explore anticholinergic treatments in depth, explaining how sofpironium bromide gel differs from traditional glycopyrrolate wipes. While glycopyrrolate wipes can be messy, highly saturated, and prone to causing systemic absorption from contact with the hands, sofpironium bromide gel is applied via an applicator in a metered dose, reducing unintended exposure and improving application precision. Unlike glycopyrrolate, which affects muscarinic M1 receptors found throughout the body, sofpironium targets muscarinic M3 receptors, which are more specific to sweat glands, reducing the likelihood of systemic side effects. They next review clinical trial methodologies for hyperhidrosis, including the Hyperhidrosis Disease Severity Measure and gravimetric sweat production assessments, noting that they favor patient-reported outcomes over objective sweat measurements, as perceived symptom relief is the most important assessment for this condition. Tune in to the full episode to hear expert insights on identifying and treating hyperhidrosis with new and emerging therapies that improve both efficacy and the patient experience.

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  25:47
• How to Streamline Study Data to Improve Selection of Therapy for Patients

  In this episode of Derms and Conditions, host James Del Rosso, DO, welcomes Ron Vender, MD, Associate Clinical Professor of Dermatology at McMaster University, to discuss practical strategies for psoriasis treatment and the management of chronic hand dermatitis. They begin with Dr Vender sharing his 90/70/40 rule, a numeric approach to evaluating biologic efficacy in psoriasis. He explains that across biologic agents, PASI75 responses typically reach 90%, PASI90 responses reach 70%, and PASI100 responses about 40%, providing a useful benchmark for evaluating treatment success. With many biologics showing similar efficacy and strong safety profiles, this method can help guide selection. They also discuss how comorbidities impact biologic choices, with Dr Vender noting he avoids TNF inhibitors in patients with multiple sclerosis, latent tuberculosis, malignancy, or hepatitis, though they remain a preferred option for women of childbearing potential. He advises caution when using IL-17 inhibitors in patients with a history of inflammatory bowel disease. While tuberculosis screening remains routine, he questions its necessity for anti-IL-17 and IL-23 inhibitors, given their lack of association with latent TB reactivation. The discussion then moves to chronic hand dermatitis, with Dr Vender stressing thorough history-taking, including identifying occupational exposures, and diagnostic testing, including patch testing and scrapings. He highlights alitretinoin, an oral retinoid specifically approved for chronic hand dermatitis, as an effective and well-tolerated treatment option. They conclude with a discussion on protective measures for chronic hand dermatitis, including hypoallergenic gloves, cotton liners, and emollient barrier creams. Tune in to the full episode to hear expert insights on optimizing psoriasis treatment and managing chronic hand dermatitis in clinical practice.

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  25:15
• Dermatology & Social Media: Tips on Engaging with Accuracy and Integrity

  In this episode of Derms and Conditions, James Del Rosso, DO, welcomes Dustin Portela, DO, a private practice dermatologist in Boise, ID, and well-known social media presence, to discuss the challenges and responsibilities of dermatologists engaging online while maintaining professional integrity. Dr Portela shares how he unintentionally became an influencer, initially using social media to market his new practice without a budget. His following grew as he provided accurate, engaging, and evidence-based dermatologic education, evolving into a broader platform for both patients and clinicians. They discuss combatting misinformation, as much of the skin care advice online comes from nonmedical sources. Dr Portela emphasizes that his goal is to provide science-backed, accessible information, mirroring the guidance he offers in the clinic. He recommends the AAD website, DermNet, and YouTube’s certified health professionals as trusted resources and uses AI tools like ChatGPT to simplify patient education, though he stresses the importance of reviewing content for accuracy before sharing. They also address legal considerations, with Dr Portela advising dermatologists to avoid direct medical advice online and instead keep recommendations general and educational. He cautions that malpractice policies typically do not cover social media activity, making it crucial to understand liability risks. Finally, they discuss brand partnerships, with Dr Portela emphasizing authenticity and trust. He only endorses products he has personally used and recommended in practice, ensuring his audience receives honest, unbiased information. Tune in to the full episode for insights on navigating social media responsibly, protecting credibility, and effectively leveraging online platforms for dermatologic education.

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