The Future of Dermatology

Summary In this episode of the Future of Dermatology Podcast, Dr. Faranak Kamangar and Dr. Errol Craig delve into the often-overlooked topic of scabies. They explore its historical context, transmission dynamics, and the psychological impact of the condition on patients. The conversation highlights the importance of understanding scabies as a community health issue, the challenges in diagnosis and treatment, and the need for new approaches in dermatology. Dr. Craig shares insights from his book, 'The Itch: Scabies', and discusses the future of scabies treatment, including potential new medications and diagnostic techniques. You can find Dr. Craig's book on Amazon: https://www.amazon.com/Itch-Scabies-Errol-Craig-ebook/dp/B0B15HYX84/ Takeaways - Scabies has a rich history that is often overlooked in medical education. - Transmission of scabies is primarily through close contact, not fomites. - The burden of scabies is significant, especially in tropical and developing regions. - Post-scobetic dermatitis is a common issue after treatment. - Community treatment is essential for effective scabies management. - Ivermectin and permethrin are commonly used treatments, but resistance is a concern. - Dermatoscopy is a valuable tool for diagnosing scabies. - The psychological impact of scabies on patients is profound and often irrational. - New diagnostic techniques and treatments for scabies are on the horizon. - Understanding the evolutionary fear of itch can help in patient care. Chapters 00:00 - Introduction to Dermatology and Scabies 01:25 - The Fascinating History of Scabies 04:53 - Understanding Transmission and Contagion 09:36 - The Burden of Scabies in Different Populations 12:02 - Diagnosis and Treatment Approaches 18:09 - Community Approach to Scabies Treatment 20:24 - The Evolutionary Fear of Itch 22:08 - Future Directions in Dermatology and Scabies Treatment

Summary In this episode of The Future of Dermatology Podcast, Dr. Faranak Kamangar interviews Dr. Jennifer Soung, a prominent dermatologist who shares her journey through academia, private practice, and her passion for clinical research. They discuss the importance of personal and professional development, the launch of the LEADderm conference aimed at empowering women in dermatology, and the need for diversity in leadership roles. Dr. Soung emphasizes the significance of mentorship and sponsorship in advancing careers, as well as the challenges of balancing work and family life. The conversation also touches on the future of dermatology, particularly in addressing the holistic health of patients with chronic skin conditions. Visit https://www.leadderm.org/ to learn more about the upcoming conference. Takeaways - Sharing stories inspires women to achieve great things. - Clinical research provides hope for patients with chronic conditions. - Mentorship and sponsorship are crucial for women's advancement. - Diversity in leadership roles is essential in dermatology. - Personal and professional development should be prioritized. - Work-life balance is about blending responsibilities, not perfection. - The skin reflects overall health and requires holistic care. - Conferences should address important issues in dermatology. - Women need support to navigate leadership challenges. - Collaboration and community are vital for success in dermatology. Chapters 00:00 - Introduction to the Future of Dermatology Podcast 01:39 - Dr. Jennifer Soung's Journey in Dermatology 05:52 - The Launch of LEADderm Conference 12:00 - Personal and Professional Development in Dermatology 20:59 - Navigating Leadership and Gender Dynamics 23:01 - Work-Life Balance and Career Paths 28:38 - Future Directions in Dermatology

Summary In this episode of the Future of Dermatology Podcast, we share a truncated replay of Dr. Daniel Klufas's session from the SF Derm 2024 Annual Conference on the management of Hydradenitis Suppurativa (HS) with a focus on the surgical technique of deroofing. This session covers the importance of medical optimization, patient selection, and the benefits of deroofing, including low recurrence rates and high patient satisfaction. Dr. Klufas emphasizes the need for thorough preoperative planning and the role of patient expectations in surgical outcomes. Takeaways - HS was long considered a purely surgical disease. - Recent strides in medical management can delay surgical intervention. - Deroofing is a critical procedure for managing HS. - Medical optimization is essential before considering surgery. - Patients should be well-informed about their treatment options. - Deroofing can be performed on solitary or regional lesions. - Patient satisfaction rates for deroofing are high. - Recurrence rates for deroofing are generally low. - Preoperative planning is crucial for successful outcomes. - Pain management post-deroofing is often less than expected. Chapters 00:00 - Introduction to the Future of Dermatology Podcast 01:00 - Understanding Hydradenitis Suppurativa (HS) and Surgical Management 03:14 - Medical Optimization and Patient Selection for Deroofing 05:01 - Deroofing Technique and Surgical Pearls 08:15 - Patient Satisfaction and Outcomes of Deroofing

Summary In this episode of the Future of Dermatology podcast, we hear from Dr. Akhil Wadhera, about the innovative use of lasers in treating Hidradenitis Suppurativa (HS), from his session at SF Derm Annual Meeting in 2024 . Dr. Wadhera highlights the significant impact of HS on patients' quality of life and explores the advantages of laser hair removal as a treatment option. He shares clinical evidence supporting the effectiveness of laser treatments and emphasizes the importance of integrating these technologies into dermatological practices for improved patient outcomes. Takeaways Lasers can significantly improve the management of HS. HS is a debilitating condition with a high financial burden. Laser hair removal is a viable treatment for HS. Patients report high satisfaction with laser treatments. Clinical studies show promising results for laser hair removal in HS. Integrating lasers into dermatology can enhance patient care. The mechanism of laser hair removal targets inflammation and hair follicles. Long-term treatment can lead to sustained improvements in HS. Collaboration among dermatologists is key to advancing treatment options. Continued research is essential for optimizing laser therapies. Chapters 00:00 - Introduction to the Future of Dermatology Podcast 01:16 - Exploring Lasers in Dermatology 02:46 - The Impact of Hidradenitis Suppurativa (HS) 04:48 - Mechanisms and Benefits of Laser Hair Removal 06:39 - Clinical Evidence and Patient Outcomes 09:26 - Conclusion and Future Directions in HS Treatment

Summary In this episode of the Future of Dermatology podcast, Dr. Faranak Kamangar interviews Dr. Natasha Atanaskova Mesinkovska MD PhD, a renowned dermatologist and researcher. They discuss Dr. Mesinkovska's journey in dermatology, her passion for hair research, the challenges of aging in dermatology, and the implications of chemical sunscreens on hair health. The conversation highlights the evolving landscape of dermatology, the importance of patient care, and the need for continued education in the field. In this conversation, the speakers delve into the evolving landscape of scalp care and its intersection with skincare trends, discussing the importance of scalp health and the various treatments available, including PRP and minoxidil. They also engage in a rapid-fire segment addressing treatment approaches for alopecia areata in different age groups, emphasizing the significance of addressing comorbidities and the potential of new treatments like JAK inhibitors. The discussion concludes with an exploration of exciting innovations in dermatology, including advancements in non-invasive imaging and AI technologies. Takeaways Dr. Mesinkovska emphasizes the importance of mentorship in medicine. The podcast aims to create a positive environment for dermatology professionals. Aging affects not just skin but also hair health. Chemical sunscreens may have adverse effects on hair conditions. The landscape of hair research is evolving with new treatment options. Dermatology interfaces with patients' psychological perceptions of aging. The importance of understanding the social aspects of dermatological conditions. Dr. Mesinkovska's journey reflects the American dream in medicine. The role of AI in enhancing dermatological practices is promising. Frontal fibrosing alopecia is a growing concern in dermatology. Scalp care is increasingly recognized as part of skincare. PRP treatments are popular for scalp rejuvenation. Regular hair washing is essential for scalp health. Preservatives in products serve important functions. Oils and ceramides are crucial for scalp hydration. Anti-dandruff shampoos can help maintain scalp balance. Atopy is a significant factor in alopecia in children. Minoxidil can help maintain hair density. New technologies in dermatology are promising. The future of dermatology is bright with innovative treatments. Chapters 00:00 - Introduction to the Future of Dermatology Podcast 02:06 - Meet Dr. Natasha Mesinkovska: A Dermatology Pioneer 05:15 - The Journey of a Dermatologist: Passion and Purpose 09:14 - The Evolving Landscape of Hair Research 12:36 - Aging and Its Impact on Dermatology 14:08 - Chemical Sunscreens and Their Effects on Hair Health 16:56 - Navigating Scalp Care and Skincare Trends 21:23 - Rapid Fire on Alopecia Areata Treatment 29:24 - Exciting Innovations in Dermatology

Summary In this episode of the Future of Dermatology podcast, we revisit the SF Derm 2024 Annual meeting and hear from Dr. Haley Naik, MD, as she discusses the management of Hidradenitis Suppurativa (HS). Dr. Naik covers the importance of controlling inflammation with medical therapies, the role of biologics in treatment, and the clinical pearls for using TNF inhibitors effectively. She emphasizes the need for early intervention to prevent permanent disfigurement and the importance of optimizing medical management before considering surgical options. Takeaways Using medical therapies to control inflammation is crucial. When to start a biologic is a common question. Preventing permanent disfigurement is a key goal. Adalimumab was the first FDA approved drug for HS. Real world goals include reducing pain and symptoms. Complete response means no pain and no new lesions. Infliximab is the best biologic for moderate to severe HS. Layering therapies is important for effective management. Optimizing medical management is essential before surgery. Chapters 00:00 - Introduction to the Future of Dermatology Podcast 01:03 - Managing Hidradenitis Suppurativa (HS) with Medical Therapies 04:35 - Understanding Biologics in HS Treatment 09:17 - Clinical Pearls for TNF Inhibitors in HS 11:35 - Optimizing HS Management Before Surgery

Summary In this episode of the Future of Dermatology Podcast, we hear from Dr. Maria Aleshin who spoke at the Annual SF Derm Society's 2024 Meeting. She presents on Hidradenitis Suppurativa (HS) and various non-biologic treatment strategies. Dr. Aleshin covers practical approaches to managing HS flare-ups, long-term management considerations, and the role of antibiotics in treatment. She emphasizes the importance of personalized care and the need for a multifaceted approach to effectively address this challenging skin condition. Takeaways The pathogenesis of HS is multifactorial, requiring a comprehensive treatment approach. Treatment stacking often involves combining medical, procedural, and lifestyle interventions. Topical therapies like chlorhexidine and benzoyl peroxide are commonly recommended, but alternatives exist. Systemic antibiotics are frequently used for managing HS flares. Hormonal therapies, including oral contraceptives and spironolactone, can be effective for female patients with HS. Metformin may be beneficial for patients with metabolic dysfunction associated with HS. Isotretinoin is not a first-line treatment for HS due to mixed results. Botulinum toxin can help reduce sweating and inflammation in HS patients. Combination antibiotic therapy, particularly clindamycin and rifampin, shows high efficacy but has relapse risks. Urtipenem is a powerful antibiotic reserved for severe HS cases as a bridge to surgery or biologics. Chapters 00:00 - Introduction to the Future of Dermatology Podcast 01:19 - Understanding Hidradenitis Suppurativa (HS) and Its Complexities 07:10 - Treatment Strategies for Managing HS Flare-Ups 10:21 - Long-Term Management of HS: Hormonal and Metabolic Considerations 13:20 - Antibiotic Therapies for Hidradenitis Suppurativa 17:22 - Severe HS Cases: Advanced Treatment Options and Considerations

Summary In this episode of the Future of Dermatology podcast, we hear from Dr. Leandra A. Barnes, who, during the SF Derm Society 2024 Annual Meeting, presented on the challenges and strategies in managing Hidradenitis Suppurativa (HS), a chronic inflammatory skin condition. She explores the barriers to care, the importance of optimizing clinic visits, building trust with patients, and effective treatment approaches. Dr. Barnes emphasizes the need for early intervention, patient empowerment, and the role of follow-up care in improving patient outcomes. Takeaways HS is a painful and disfiguring chronic inflammatory disease. There is a significant diagnostic delay of 7 to 10 years for HS. Barriers to care include cost, stigma, and lack of knowledge. Provider attitudes and health system characteristics impact patient care. Empathy and clear communication are crucial in patient visits. Preparation before patient visits can optimize care delivery. Early intervention is key to managing HS effectively. Patients prioritize treatment and flare management during visits. Support groups can empower patients between visits. Follow-up care is essential to prevent emergency room visits. Chapters 00:00 - Introduction to the Future of Dermatology Podcast 01:35 - Understanding Hidradenitis Suppurativa (HS) 05:02 - Optimizing the HS Clinic Visit 07:03 - Building Trust and Communication in Patient Visits 08:01 - Treatment Approaches for HS 10:52 - Follow-Up and Patient Empowerment

Summary In this conversation, Dr. Ilona Frieden and Dr. Vail Reese discuss the origin and significance of PHACE syndrome, a condition characterized by facial hemangiomas and neurological abnormalities. They share their experiences in identifying and naming the syndrome, the importance of collaboration in medical research, and the future of dermatology in understanding genetic conditions. The discussion highlights the role of dermatologists in recognizing and describing new syndromes, the impact of acronyms in medical education, and the ongoing research into the causes and implications of PHACE syndrome. To read Dr. Frieden and Dr. Reese's original article, visit: https://pubmed.ncbi.nlm.nih.gov/8607636/ Takeaways Dr. Frieden has over 35 years of experience in pediatric skincare. The origin of PHACE syndrome began with a unique patient case. Collaboration among dermatologists is crucial for medical advancements. Acronyms can aid in memorizing complex medical conditions. PHACE syndrome includes various components beyond hemangiomas. Research continues to explore the genetic basis of PHACE syndrome. Patient advocacy groups play a vital role in supporting affected families. Dermatology is evolving with advancements in genomics and technology. Understanding regional aspects of disease can lead to new insights. The future of dermatology is promising with ongoing research and discoveries. Chapters 00:00 - The Origin of PHACE Syndrome 07:37 - Understanding the Components of PHACE Syndrome 14:30 - The Significance of Acronyms in Medicine 20:00 - The Future of PHACE Syndrome and Dermatology

Summary In this episode of the Future of Dermatology podcast, Dr. Faranak Kamangar and Dr. Amit Pandya delve into the complexities of vitiligo, a pigmentary disorder. They discuss the importance of shared decision-making in patient care, the various treatment options available including systemic therapies and phototherapy, and the future of vitiligo treatment with emerging therapies like JAK inhibitors. Dr. Pandya emphasizes the need for personalized treatment plans based on patient preferences and the significance of monitoring progress through regular check-ups and photographs. The conversation highlights the exciting advancements in vitiligo treatment and the hope for better management strategies in the future. Takeaways Shared decision making is crucial in vitiligo treatment. Understanding the extent and location of lesions is key. Systemic therapies like dexamethasone are commonly used. Phototherapy is essential for managing vitiligo. Long-term management requires regular follow-ups and monitoring. Emerging JAK inhibitors show promise for future treatments. Patient goals should guide treatment decisions. Phototherapy can prevent new lesions from forming. New therapies aim to stimulate melanocyte repigmentation. The field of vitiligo treatment is rapidly evolving. Chapters 00:00 - Introduction to Dermatology and Vitiligo 01:30 - Understanding Patient Perspectives in Vitiligo Treatment 05:00 - Exploring Systemic Therapies for Vitiligo 09:52 - The Role of Phototherapy in Vitiligo Management 12:14 - Long-Term Management of Vitiligo Patients 14:42 - Future Directions in Vitiligo Treatment

Summary In this episode of The Future of Dermatology Podcast, Dr. Faranak Kamangar interviews James Kilgour, a dermatology resident at Stanford and the founder of KilgourMD. They discuss James's journey from the UK to California, his experiences in dermatology, and the innovative skincare line he developed for scalp health. The conversation delves into the importance of understanding the environmental factors affecting hair loss, the need for a skincare regimen for the scalp, and the future of treatments like PRP in dermatology. Takeaways James Kilgour's journey from the UK to Stanford highlights the importance of mentorship. The concept of treating the scalp like facial skin is revolutionary. Environmental factors play a significant role in hair loss. Patients often seek alternatives to traditional hair loss treatments like minoxidil. Regenerative medicine is becoming a focal point in dermatology. Understanding the microenvironment around hair follicles is crucial for treatment. Skincare products are essential for both cosmetic and health reasons. The need for a comprehensive approach to scalp health is unmet in current dermatology practices. PRP shows promise in hair restoration and scalp health. Innovation in dermatology is driven by patient needs and scientific research. Chapters 00:00 - Introduction to the Future of Dermatology Podcast 01:51 - James Kilgour's Journey in Dermatology 04:15 - The Birth of KilgourMD 07:56 - Understanding Scalp Health and Environment 10:14 - Innovative Approaches to Hair Loss Treatment 14:00 - The Future of Dermatology and PRP

Summary In this episode of the Future of Dermatology podcast, Dr. Faranak Kamangar speaks with Mitchell Hanson, a medical student and researcher, about the intersection of dermatology, sexual health, and public health. They discuss the importance of modernizing sexual health history taking, the impact of MPOX on sexual and gender minorities, and the role of trust in patient care. The conversation also highlights the significance of vaccination efforts and the integration of art and advocacy in dermatology. Mitchell shares his vision for the future of dermatology, emphasizing the need for effective communication and engagement with the public through media. Articles mentioned in this podcast: https://practicaldermatology.com/topics/feature/advancing-sexual-health-histories-in-dermatology-a-modernized-comprehensive-approach-for-diverse-populations/28864/ https://www.greaterthan.org/campaigns/mpox/ https://www.nejm.org/doi/full/10.1056/NEJMp2407068 Takeaways Dermatology has deep roots in public health and sexual health education. Building trust with patients is essential for effective care. Modernizing sexual health history taking is crucial for accurate diagnoses. MPOX has significant implications for sexual and gender minorities. Vaccination efforts are vital in controlling public health threats like MPOX. Art can serve as a powerful tool for advocacy in dermatology. Health equity must be prioritized in dermatological practices. Education is key to dispelling misinformation about vaccines. Engaging with media can enhance public understanding of dermatology. The future of dermatology lies in innovative ideas and community involvement. Chapters 00:00 - Introduction to Dermatology and Guest Background 02:48 - The Importance of Sexual Health in Dermatology 05:59 - Building Trust with Patients 09:08 - Modernizing Sexual Health History Taking 11:46 - Understanding MPOX and Its Impact 14:56 - Clinical Presentation and Diagnosis of MPOX 18:09 - Public Health Response and Vaccination Efforts 20:56 - Art and Advocacy in Dermatology 23:46 - Future of Dermatology and Media Engagement

Summary In this episode of the Future of Dermatology podcast, Dr. Zakia Rahman, MD, discusses the advancements in laser treatments for dermatological conditions, particularly focusing on acne scarring. The conversation covers the differences between ablative and non-ablative lasers, their applications, and the importance of understanding patient healing processes. The episode also highlights the success of the SF Derm 2024 meeting and encourages listeners to engage with the podcast community. Takeaways The SF Derm 2024 meeting was a significant event for dermatologists. Fractional lasers utilize surrounding normal skin for effective treatment. Acne scarring is prevalent, especially in certain ethnic groups. Active acne must be treated before addressing scarring. Non-ablative lasers can be effective for various skin types. Ablative lasers require careful consideration of downtime and healing. Skin healing varies significantly among patients. FDA clearance for lasers includes treatment for vascular lesions. Engagement with the audience is crucial for podcast growth. Medical advice should always come from a qualified doctor. Chapters 00:00 - Introduction to the Future of Dermatology Podcast 01:00 - Understanding Laser Treatments in Dermatology 04:13 - Addressing Acne Scarring and Treatment Modalities 07:05 - Ablative vs Non-Ablative Laser Treatments

Summary In this episode of the Future of Dermatology podcast, Dr. Faranak Kamangar welcomes back Dr. Nahid Vidal to discuss her experience at the ASDS Iron Surgeon Competition. They delve into the creative process behind Dr. Vidal's entertaining video presentation, the balance between professionalism and creativity in the medical field, and the joy of participating in such a unique event. Dr. Vidal shares insights on the importance of community and the positive impact of creativity in dermatology, as well as her reflections on the future of her career and the field. Watch Dr Nahid Vidal's epic music video here: https://youtu.be/5oYTc2YKa3M?si=qovWHj5clI5uOfEL Takeaways Dr. Vidal won the ASDS Iron Surgeon Competition, showcasing her skills and creativity. The competition combines surgical expertise with entertainment, making it unique in the dermatology field. Creativity in reconstructive surgery is essential and can enhance patient outcomes. Dr. Vidal's background in making music videos contributed to her success in the competition. The video presentation was a collaborative effort involving her family and colleagues. Balancing professionalism with creativity is a challenge for many physicians. The joy and camaraderie among colleagues were evident in the video and during the competition. Dr. Vidal aims to inspire others in the field through her creative endeavors. Participating in the competition was an honor and a fun experience for Dr. Vidal. The future of dermatology may benefit from more creative and entertaining approaches. Chapters 00:00 - Introduction to the Future of Dermatology Podcast 00:49 - The ASDS Iron Surgeon Competition 04:07 - Creative Process Behind the Competition Video 10:57 - Balancing Professionalism and Creativity 17:59 - The Day of the Competition 23:53 - Reflections on the Experience and Future Aspirations

Summary In this episode of The Future of Dermatology podcast, host Dr. Faranak Kamangar and, podcast producer Steph Cullen, discuss the behind-the-scenes workings of the podcast, the importance of nonprofit organizations, and the educational and mentorship roles within the field. They explore the impact of media on dermatology, the depth of the specialty beyond cosmetic procedures, and future topics for the podcast, including tattoos and their effects on skin health. Takeaways The Future of Dermatology Podcast aims to educate and inform about various dermatological topics. Nonprofits play a crucial role in enhancing community health and awareness in dermatology. Media production is essential for nonprofits to gain exposure and support. Education and mentorship are vital components of the dermatology community. The podcast has evolved to include virtual conferences and a wider audience. Dermatology encompasses much more than just cosmetic procedures like pimple popping. The passion of dermatologists for their field is evident in their discussions. Future podcast topics may include tattoos and their implications for skin health. The importance of community and collaboration in dermatology is emphasized. The podcast encourages participation and feedback from its audience. Chapters 00:00 - Introduction to the Future of Dermatology Podcast 01:52 - Behind the Scenes with Stephanie 07:58 - The Impact of Nonprofits in Dermatology 10:53 - Education and Mentorship in Dermatology 18:02 - The Role of Media in Dermatology 22:17 - Exploring the Depth of Dermatology 23:38 - Future Topics for the Podcast

Summary In this conversation, Dr. Faranak Kamangar and medical student, Payton Smith, delve into the complexities of chronic itch, discussing its prevalence, societal misunderstandings, and the evolution of treatment options. Payton shares his personal journey with chronic idiopathic pruritus, highlighting the emotional and physical toll of the condition. They explore the inadequacies of current treatment approaches, the importance of validating patients' experiences, and the promising future of biologics in dermatology. The discussion emphasizes the need for empathy in patient care and the challenges within the healthcare system that hinder access to effective treatments. Takeaways Chronic itch affects over 15% of the population. Itch is often misunderstood and dismissed in society. Pain management has more research and resources than itch. Chronic itch can be caused by various systemic diseases. Biologics are changing the landscape of itch treatment. Patients often feel isolated and misunderstood due to their condition. Early and aggressive treatment of itch is crucial. The healthcare system complicates access to itch treatments. Empathy and validation are essential in patient care. Research and advocacy for itch need to be prioritized. Chapters 00:00 - Introduction to Itch and Its Importance 02:50 - Understanding Chronic Itch 05:09 - The Pain vs. Itch Paradigm 11:09 - The Role of Biologics in Treating Itch 16:13 - Challenges in Accessing Treatments 18:34 - Societal Misunderstandings of Itch 24:59 - The Need for Early Intervention 26:54 - Future of Dermatology and Itch Treatments

Summary In this episode of The Future of Dermatology Podcast, Dr. Faranak Kamangar engages in a deep conversation with Dr. Kathy Fields about the evolving landscape of dermatology, the psychological impact of skin conditions, and the importance of mental health awareness. They reflect on the recent TEDx event, discuss the challenges posed by social media, and emphasize the need for female leadership in medicine. The conversation also touches on the future of dermatology with the rise of AI and the importance of building strong relationships with patients. Watch Dr. Field's full TEDx presentation: https://youtu.be/SbSa81utzJE?si=Ur4J-oRFVxdENMo5 Catch more TEDx presentations! Dr. Faranak Kamangar: https://youtu.be/XAcCahWkKiQ?si=KOw8eo9X-VmbrBC4 Dr. Julie Letsinger: https://youtu.be/BKpRZHp1u44?si=C1IybJtRiJFoZL-P Nora Engstrom: https://youtu.be/ZP64ZhULyBI?si=ewmVSApitKs7mURn Dr. Leah Millheiser: https://youtu.be/hvkHeb7_Q6w?si=LrCevtnksLrMhOg5 Melissa Bowdoin: https://youtu.be/SbSa81utzJE?si=Ur4J-oRFVxdENMo5 Takeaways The psychological impact of skin conditions is significant and often overlooked. Social media exacerbates mental health issues related to skin appearance. Female leadership in medicine is crucial for fostering inclusivity and support. AI is transforming diagnostics but cannot replace the human touch in patient care. Dermatology has evolved significantly over the past decades, offering more than just treatment for skin issues. Building relationships with patients is essential for effective care. Imposter syndrome is a common challenge for both men and women in medicine. Advocacy for mental health awareness is vital in dermatology. The importance of mentorship and finding advocates in your professional journey. The future of dermatology is bright, with opportunities for growth and innovation. Chapters 00:00 - Introduction to the Future of Dermatology Podcast 00:58 - Reflections on the TEDx Event 05:06 - The Impact of Social Media on Mental Health 07:03 - The Psychological Aspects of Dermatology 11:47 - Female Leadership in Medicine 16:06 - The Future of Dermatology and AI 20:01 - Building Relationships in Patient Care

Summary Dr. Faranak Kamangar and Sam Kamangar chat about the TEDx Sandhill Road Women event, highlighting the importance of storytelling, mentorship, and community support in empowering women. They discuss their experiences and insights on engaging the younger generation, the role of men in supporting women's empowerment, the significance of language in professional settings, and the challenges women face in health and legal access. This discussion emphasizes the need for continuous growth, collaboration, and the sharing of ideas to foster a supportive environment for future generations. Do you know someone who has a story to share? Let's connect! [email protected] They could be a guest on our next podcast or at our next TEDx event. Watch the full TEDx presentations! Dr. Faranak Kamangar: https://youtu.be/XAcCahWkKiQ?si=KOw8eo9X-VmbrBC4 Dr. Julie Letsinger: https://youtu.be/BKpRZHp1u44?si=C1IybJtRiJFoZL-P Nora Engstrom: https://youtu.be/ZP64ZhULyBI?si=ewmVSApitKs7mURn Dr. Leah Millheiser: https://youtu.be/hvkHeb7_Q6w?si=LrCevtnksLrMhOg5 Melissa Bowdoin: https://youtu.be/SbSa81utzJE?si=Ur4J-oRFVxdENMo5 Dr. Kathy Fields: https://youtu.be/SbSa81utzJE?si=Ur4J-oRFVxdENMo5 Takeaways The TEDx format is an effective way for professionals to share ideas. Storytelling plays a crucial role in shaping the next generation. - Engaging young people in discussions is essential for their development. Men's support is vital in women's empowerment initiatives. Language proficiency can significantly impact professional success. Access to legal resources is critical for personal and professional growth. Empowering young female leaders is essential for future progress. Navigating change requires personal growth and stepping out of comfort zones. Menopause should be openly discussed to educate and empower women. Collaboration and sharing ideas can lead to greater success. Chapters 00:00 - Introduction to the Future of Dermatology Podcast 00:52 - The Importance of Executive Presence 03:38 - Role Models and Storytelling in Women's Lives 05:30 - Engaging the Younger Generation 07:17 - The Power of Diverse Communities 09:10 - Men Supporting Women in Professional Spaces 11:05 - Breaking Taboos in Women's Health Discussions 12:21 - Recap of TEDx Talks 12:40 - AI and Language in Dermatology 16:09 - Dr Kathy Fields: A Dermatology Pioneer 19:12 - Nora Engstrom: Access to Law for Women 21:23 - Melissa Bowdoin: Empowering Future Leaders 25:16 - Dr. Julie Letsinger: Navigating Change 26:35 - Dr. Leah Millheiser: Menopause and Women's Health 29:22 - The Impact of Education and Experience 32:11 - The Importance of Teamwork and Support 34:29 - Encouraging the Next Generation 37:10 - Looking Ahead: Future TEDx Events

Summary In this episode of the Future of Dermatology podcast, Dr. Faranak Kamangar discusses the intersection of artificial intelligence and dermatology with Pedram Abrari, a leading expert in AI and technology. They explore the complexities of integrating AI into medical practice, the potential benefits and challenges of large language models, and the importance of building trust between physicians and technology. The conversation highlights practical applications of AI in diagnostics, patient care, and administrative tasks, while addressing the historical mistrust of technology in medicine. The episode concludes with insights on the future of AI in healthcare and the necessity for physicians to adapt to these advancements. Pedram Abrari, CTO of Pramata, is a proven technology leader specialized in highly scalable cloud platforms. Entrepreneur who excels at assessing the strengths and weaknesses of technology, competitive analysis, tracking market trends and strategic technology planning. Experienced at building world-class engineering teams and fostering high productivity. Believes quality begins with the inception of the idea, sound design, and proper architecture. Works tirelessly to pave the way for engineering teams to overachieve. Takeaways AI is a game-changing technology that can enhance medical practice. The relationship between physicians and technology has historically been complicated. Large language models have the potential to mimic human intelligence. AI can help connect the dots in diagnosing rare diseases. Trust in AI will grow as its capabilities are proven over time. AI can significantly reduce administrative burdens in healthcare. The adoption of AI can improve patient care and outcomes. Physicians need to understand AI's strengths and weaknesses. AI will not replace doctors but will serve as an assistant. The future of healthcare will involve a collaborative approach between AI and medical professionals. Chapters 00:00 - Introduction to AI in Dermatology 02:52 - Understanding Large Language Models 06:13 - The Relationship Between Physicians and Technology 09:03 - AI's Role in Medical Diagnostics 11:52 - The Future of AI in Healthcare 15:07 - Technology Adoption and Trust Issues 17:58 - Practical Applications of AI in Dermatology 21:05 - Overcoming Challenges in Prior Authorization 23:49 - Conclusion and Future Perspectives

Summary From the 2024 SF Derm Society Annual Meeting, dermatologist, Dr. David Fiorentino discuss the significance of auto-antibodies in diagnosing dermatomyositis. He explores various phenotypes associated with the disease, emphasizing the importance of recognizing specific symptoms and patient presentations to improve diagnostic accuracy and patient outcomes. The conversation highlights the need for dermatologists to be aware of the complexities of dermatomyositis and the potential for severe complications if not diagnosed and treated promptly. Takeaways The six groups of DM specific antibodies are crucial for diagnosis. Understanding phenotypes can enhance diagnostic capabilities. NDA5 antibodies are linked to severe interstitial lung disease. Dermatomyositis can present without typical skin symptoms. Early intervention is critical for patients with NXP2 antibodies. Patients may present with atypical symptoms that require careful assessment. Auto-antibodies can guide treatment decisions in dermatology. Recognizing the signs of dermatomyositis can prevent severe outcomes. Collaboration among dermatologists is essential for patient care. Continuous education in dermatology is vital for improving patient outcomes. Chapters 00:00 - Introduction to the Future of Dermatology Podcast 00:58 - Understanding Auto-Antibodies in Dermatomyositis 03:13 - Diagnostic Approaches in Dermatomyositis 05:48 - Identifying Phenotypes in Dermatomyositis Patients 08:57 - Conclusion and Future Directions

Summary In this episode of the Future of Dermatology podcast, Dr. Farah Kamangar interviews Dr. Paradi Mirmirani, MD, a leading expert in hair disorders. They discuss the latest advancements in treating hair loss, particularly focusing on frontal fibrosing alopecia and scarring alopecia. Dr. Mirmirani shares her treatment algorithms, emphasizing the importance of removing triggers and using innovative therapies like oral minoxidil and JAK inhibitors. The conversation highlights the evolving landscape of dermatology and the exciting future of hair loss treatments. Dr. Mirmirani's paper that is spoken about in this podcast will be published on November 20th, 2024. Takeaways Dr. Mirmirani is a leading expert in hair disorders. Frontal fibrosing alopecia is increasingly common. Removing environmental triggers can significantly improve patient outcomes. Dutasteride is preferred over finasteride for treating FFA. Oral minoxidil is an effective treatment for hair loss. Dermatoscopy is essential for assessing hair loss conditions. New treatments for alopecia areata are now FDA-approved. Patient education is crucial for effective treatment. The landscape of hair loss treatments is rapidly evolving. Future research will focus on personalized treatment options for hair disorders. Chapters 00:00 - Introduction to Dermatology and Dr. Mirmirani's Expertise 02:09 - Frontal Fibrosing Alopecia: Treatment Approaches 10:24 - Innovative Therapies for Scarring Alopecia 18:46 - Future of Hair Loss Treatments and Research

Summary Dr. Mehdi Rashighi, MD, discusses groundbreaking research in dermatology focusing on autoimmune skin diseases. The conversation delves into multiomics research, the role of interferons in skin diseases, and the impact of UV exposure on conditions like cutaneous lupus and dermatomyositis. The episode highlights the importance of understanding cytokine signatures and the potential for new treatments targeting specific immune cells. Takeaways The SFDerm 2024 meeting showcased significant advancements in dermatology. Multiomics research is crucial for understanding autoimmune skin diseases. Type one interferon plays a key role in cutaneous lupus and dermatomyositis. Cytokine signatures can help identify new treatment targets. Plasmacytoid dendritic cells are important in the pathogenesis of lupus. UV exposure can exacerbate skin diseases like lupus and dermatomyositis. Clinical trials are exploring monoclonal antibodies against interferons. Understanding photosensitivity is vital for managing lupus patients. Research is ongoing to better understand the immune response in skin diseases. Chapters 00:00 - Introduction to the Future of Dermatology Podcast 00:56 - Exploring Multiomics in Dermatology Research 02:53 - Understanding Interferon Signatures in Skin Diseases 05:58 - Photosensitivity in Cutaneous Lupus and Dermatomyositis

Summary In this episode of The Future of Dermatology Podcast, Dr. Faranak Kamangar discusses hyperhidrosis, a common condition characterized by excessive sweating. The conversation covers the causes, prevalence, and various treatment options available, including topical treatments, botulinum toxin injections, oral medications, and advanced technologies like ionophoresis and miradry. Dr. Kamangar emphasizes the importance of patient education and setting realistic expectations for treatment outcomes. Takeaways Hyperhidrosis is often diagnosed by patients before seeing a doctor. The condition can be debilitating and affects various aspects of life. Most cases of hyperhidrosis are primary, with few secondary causes. Topical antiperspirants are the first line of treatment. Setting expectations is crucial for patient satisfaction with treatments. Botulinum toxin is effective but can be painful for patients. Oral medications can be used but have contraindications. Ionophoresis is a viable option for some patients. Emerging technologies like microneedling for botulinum toxin show promise. Patient education is key to managing hyperhidrosis effectively. Chapters 00:00 - Introduction to Hyperhidrosis 02:45 - Understanding Hyperhidrosis: Causes and Prevalence 06:00 - First-Line Treatments for Hyperhidrosis 09:13 - Advanced Treatment Options: Botulinum Toxin and Microneedling 11:51 - Oral Medications and Ionophoresis 15:06 - Injectable Treatments and Patient Management 17:47 - Emerging Technologies and Future Directions in Treatment

Summary From the 2024 Annual SF Dermatology Society sessions, Dr. Iltefat Hamzavi shares insights on vitiligo, its psychosocial impacts, and the pathophysiology behind the condition. The session emphasizes the need for effective treatment strategies and the importance of patient well-being in managing skin conditions. Takeaways Dermatology is a community-focused specialty. The VASI score is crucial for assessing vitiligo severity. Vitiligo has a significant psychosocial impact on patients. Younger patients with vitiligo show higher rates of depression. Effective treatment of vitiligo requires time and patience. Counseling patients is essential for successful treatment outcomes. The face is the most responsive area for vitiligo treatment. Oxidative stress plays a key role in vitiligo pathophysiology. A multi-faceted approach is necessary for treating vitiligo. Future dermatology meetings will continue to address these important topics. Chapters 00:00 - Introduction to the Dermatology Podcast 01:58 - The Importance of Community in Dermatology 03:25 - Understanding the Impact of Vitiligo 06:45 - Pathophysiology and Treatment of Vitiligo 10:09 - Conclusion and Future Directions in Dermatology

Summary This The Future of Dermatology Podcast focuses on recent advancements in the treatment of vitiligo, particularly highlighting the role of Afamelanotide in clinical trials. Dr. Kamangar includes insights from the SF Derm 2024 Annual Meeting, the mechanisms of vitiligo, and the potential of Afamelanotide to aid in repigmentation without affecting the immune system. Clinical trial results and patient outcomes are also discussed, emphasizing the importance of this treatment for patients with darker skin types. Takeaways Vitiligo treatments have traditionally focused on the immune system. Afamelanotide aims to boost repigmentation without immune suppression. The study is a phase three trial comparing Afamelanotide with narrowband UVB. Initial results show promise for Fitzpatrick skin types four to six. The treatment is suitable for adolescents and adults aged 12 and up. Photos from trials indicate significant repigmentation in patients. - Afamelanotide has a good safety profile based on previous treatments. The drug is being studied for its broader dermatological applications. - There are concerns about unregulated versions of Afamelanotide in the market. Awareness of Afamelanotide is crucial for dermatologists. Chapters 00:00 - Introduction to the Future of Dermatology Podcast 01:20 - Exploring Vitiligo Treatments and Research 03:10 - Afamelanotide: A New Hope for Repigmentation 05:37 - Clinical Results and Implications of Afamelanotide

Summary From the 2024 Annual SF Dermatology Society sessions, Dr. Amit Pandya discusses the complexities of vitiligo, a common skin disorder affecting millions worldwide. He explores the importance of understanding patient perspectives, the pathogenesis of vitiligo, and the latest treatment approaches. This talk emphasizes the need for personalized patient care and the significance of early intervention for better outcomes. The session concludes with a call for increased awareness and education in dermatology. Takeaways Vitiligo affects about 1% of Americans and 70 million people worldwide. Patients with vitiligo often feel abandoned due to a lack of specialized care. The peak age of onset for vitiligo is during young adulthood, which can be particularly stressful. Understanding the pathogenesis of vitiligo is crucial for effective treatment. The treatment of vitiligo requires patience and realistic expectations from patients. Photographs are essential for monitoring treatment progress in vitiligo patients. Public education is needed to encourage early treatment for vitiligo. Dermascopy can help assess the prognosis of vitiligo patients. Shared decision-making is vital in managing treatment options for patients. Every patient's experience with vitiligo is unique and should be approached individually. Chapters 00:00 - Introduction to the Future of Dermatology Podcast 00:58 - The Importance of Vitiligo Awareness 02:53 - Understanding Vitiligo: Patient Perspectives 06:07 - Pathogenesis of Vitiligo 08:55 - Treatment Approaches for Vitiligo 11:50 - Prognosis and Patient Management 15:10 - Conclusion and Future Directions

Summary In this episode, medical students Chandler Johnson and Payton Smith share their experiences navigating the residency application process in dermatology. They discuss the challenges of applying for away rotations, the importance of preparation and research, and strategies for making a positive impression during rotations. The conversation emphasizes the significance of building relationships within the medical team, active participation in procedures, and the necessity of self-care and authenticity throughout the demanding journey of medical education. Takeaways The residency application process is highly competitive, especially in dermatology. Away rotations are crucial for gaining exposure and making connections. - Researching programs and reaching out to past students can ease anxiety. Preparation for rotations includes studying relevant material beforehand. Building relationships with all team members is essential for success. Active participation in procedures can help you stand out. Self-care is vital to avoid burnout during medical training. Authenticity is key; be yourself during rotations. Networking is important; introduce yourself to everyone. The timeline for interviews and applications can be overwhelming, focus on one step at a time. Chapters 00:00 - Introduction to the Journey of Dermatology Residency 03:03 - Navigating the ERAS Application Process 05:52 - Choosing and Preparing for Away Rotations 09:05 - Tips for Success During Away Rotations 11:56 - Building Relationships and Networking 15:08 - Active Participation in Procedures 18:12 - The Future: Interviews and Match Day Preparation 21:09 - Self-Care and Maintaining Authenticity

Summary Dr. Paradi Mirmirani shares insights on hair loss, particularly alopecia areata, and discusses the importance of miniaturization in hair disorders. This exclusive session from SF Derm 2024 delves into the role of environmental factors in scarring alopecia and offers practical tips for dermatologists to improve patient outcomes. Want to learn more? You'll have to join us for next year's SF Derm Society Conference in June of 2025! Takeaways Hair loss updates are crucial for effective patient care. Miniaturization is a key factor in diagnosing hair loss. Low dose oral minoxidil is effective for various hair disorders. Environmental factors may contribute to scarring alopecia. Avoiding fragrances can significantly improve scalp health. Monitoring for side effects of minoxidil is essential. Collaboration among experts can enhance treatment protocols. Understanding patient history is vital for effective treatment. Education on hair disorders is important for dermatology practitioners. Chapters 00:00 - Introduction to the Future of Dermatology Podcast 01:54 - Hair Loss Updates and Practical Tips 04:36 - Understanding Miniaturization in Hair Loss 10:55 - Exploring Scarring Alopecia and Environmental Factors

Summary In this episode of the Future of Dermatology Podcast, Dr. Faranak Kamangar discusses the complexities of acne treatment, focusing on the psychological impact of acne on patients and the importance of effective topical therapies. The conversation covers the latest guidelines for acne treatment, the efficacy of various topical agents including benzoyl peroxide and retinoids, and explores advanced treatment options such as isotretinoin and laser therapy. The episode emphasizes the need for patient compliance and the role of alternative treatments in managing acne effectively. Takeaways Acne topicals are important for improving patients' quality of life. The AED guidelines recommend benzoyl peroxide, topical retinoids, and topical antibiotics as preferred treatments. Combining multiple topical therapies and limiting systemic antibiotic use are good practice statements. Topical therapies are not highly effective, but their efficacy improves when combined. Other treatments like Clascoterone cream and isotretinoin target sebum reduction and sebaceous gland apoptosis. The 1726 nanometer laser shows promise as a treatment option. Azelaic acid, salicylic acid, and other topicals are effective and popular among patients. Compliance is crucial in acne treatment. Chapters 00:00 - Introduction to Acne and Its Impact 03:06 - Topical Therapies for Acne Treatment 06:07 - Understanding Benzoyl Peroxide and Its Efficacy 08:47 - Exploring Advanced Treatments and Mechanisms 12:01 - Alternative Topical Treatments and Patient Compliance

Summary Dr. Mary Alice Mina, a Harvard-trained dermatologist, discusses her transition from clinical medicine to providing education on social media and hosting The Skin Real, a podcast on skin health. She emphasizes the importance of providing accurate and reliable information in the skincare industry, which is often filled with misinformation and gimmicks. Dr. Mina also highlights the shift towards a more holistic and proactive approach to skincare, focusing on preventative measures and overall health. She discusses the advancements in regenerative medicine, such as exosomes and stem cell therapy, and the potential they hold for the future of dermatology. Additionally, she emphasizes the importance of sun protection and the need to educate people about the different types of skin cancers and their potential risks. Takeaways Transitioning from clinical medicine to teaching on social media and hosting a podcast allows dermatologists to provide accurate and reliable information to a wider audience. A holistic and proactive approach to skincare, focusing on preventative measures and overall health, is becoming more popular. Advancements in regenerative medicine, such as exosomes and stem cell therapy, show promise for the future of dermatology. Educating people about the importance of sun protection and the different types of skin cancers is crucial in preventing and treating these conditions. Chapters 00:00 - Introduction and Background of Dr. Mary Alice Mina 02:24 - Transitioning from Clinical Medicine to Teaching on Social Media 05:15 - Embracing a Pro-Aging and Holistic Approach to Skincare 15:45 - Exploring Emerging Technologies in Dermatology 19:28 - The Importance of Sun Protection in Preventing Skin Cancers 24:57 - Educating People about Different Types of Skin Cancers 31:47 - Advice for Residents and the Future of Dermatology

Summary Shawn Thomas shares his journey as a psoriasis patient and co-founder of Solay. He describes his initial symptoms and the progression of his psoriasis, leading to his diagnosis in 2018. Shawn discusses the emotional impact of being diagnosed with an incurable disease and the challenges of managing psoriasis on a daily basis. He emphasizes the importance of sharing his diagnosis and finding support from others who also have psoriasis. Shawn explores various treatment options he tried, including topical corticosteroids and natural remedies, before discovering the Goeckerman therapy. He shares his experience of self-administering the therapy using over-the-counter coal tar and UVB light. Learn more about Solay at: https://solayhealth.com/ Takeaways Psoriasis is an incurable disease that can have a significant emotional impact on patients. Sharing the diagnosis and finding support from others with psoriasis can help patients feel less alone. Exploring different treatment options, including natural remedies and innovative therapies like Goeckerman therapy, can be beneficial. Self-administering treatments like coal tar and UVB light may be an alternative for patients who cannot access specialized clinics. Goeckerman therapy can be an effective and safe treatment for psoriasis, but it is often inaccessible due to limited availability and barriers such as time and cost. Soleil, a telemedicine platform co-founded by Shawn Thomas, aims to make Goeckerman therapy more accessible by providing patients with the necessary equipment and physician oversight. Innovations in healthcare access and delivery, such as value-based care models and telehealth, are needed to ensure that effective treatments are affordable and available to all patients. Building trust and strong patient-provider relationships are crucial in improving treatment adherence and outcomes. The future of dermatology and healthcare should focus on both treatment innovations and innovations in access to care. Chapters 00:00 - Introduction and Guest Introduction 02:19 - Diagnosis and Challenges of Psoriasis 12:18 - Discovering Goeckerman Therapy 19:06 - Personal Experience with Goeckerman Therapy 27:24 - Innovations in Access to Dermatological Care 35:03 -The Future of Dermatology and Healthcare 40:16 - Conclusion and Closing Remarks

Summary Dr. Arianne Shadi Kourosh, Director of Community Health Department of Dermatology at Massachusetts General Hospital, discusses her work on dermatologic resources for the intervention and prevention of human trafficking. She shares how she first became aware of the issue through her pro bono tattoo removal program for young people leaving gangs. Dr. Kourosh explains the three major categories of skin signs of trafficking: infection/infestations, injury/scarring, and imagery/tattoos. She emphasizes the importance of trauma-informed care and building trust with patients. Dr. Kourosh also highlights the resources available, including the AAD's online toolkit, an online registry of skin signs of trafficking, and the upcoming smartphone app called SSTEAR. Helpful links: AAD trafficking toolkit: https://www.aad.org/member/clinical-quality/clinical-care/human-trafficking Registry of the Skin Signs of Trafficking: Redcap.link/trafficking Volunteer - contact [email protected] https://humantraffickinghotline.org/en Takeaways Human trafficking is a prevalent issue that can affect individuals in our own communities. Dermatologists can play a crucial role in identifying and assisting trafficking survivors through the recognition of skin signs. The three major categories of skin signs of trafficking are infection/infestations, injury/scarring, and imagery/tattoos. Trauma-informed care and building trust with patients are essential in providing effective care. Resources such as the AAD's online toolkit, an online registry of skin signs of trafficking, and the upcoming smartphone app called STEER are available to healthcare providers. Chapters 00:00 - Introduction and Background 01:30 - Discovering the Issue of Human Trafficking 03:54 - Skin Signs of Trafficking 09:56 - Recognizing the Prevalence in Our Communities 12:48 - The Three I's: Infection, Injury, and Imagery 19:15 - Trauma-Informed Care and Building Rapport 22:04 - Resources for Healthcare Providers 26:14 - Collaboration and Partnerships

Summary In this episode, Dr. Fara Kamangar and personal trainer Danny Estrella discuss the importance of building muscle for functional longevity and overall health. They debunk myths about weightlifting making women bulky and emphasize the need for proper nutrition and strength training to optimize body composition. They also highlight the connection between muscle mass and basal metabolic rate, emphasizing the importance of maintaining muscle as we age. The conversation concludes with a discussion about the future of fitness and the potential for collaboration between health professionals and personal trainers. Takeaways Building muscle is important for functional longevity and overall health. Proper nutrition and strength training are essential for optimizing body composition. Maintaining muscle mass is crucial for a higher basal metabolic rate and efficient calorie burning. The fear of getting bulky from weightlifting is a misconception; it takes time and dedication to build significant muscle mass. Collaboration between health professionals and personal trainers can lead to better overall health outcomes. Chapters 00:00 - Introduction and Importance of Building Muscle 05:03 - Debunking Myths About Weightlifting 10:11 - The Role of Nutrition and Stimuli 14:57 - Addressing the Fear of Getting Bulky 20:09 - The Impact of Body Composition and Muscle Mass 25:12 - Bridging the Gap Between Health Professionals and Personal Trainers

Summary Dr. Andrew Weinstein, MD, MPH, and board-certified dermatologist, discusses the challenges of physician reimbursements in the healthcare industry. He highlights the unsustainable environment that physicians face, with increasing costs and decreasing reimbursements. Dr. Weinstein explains the physician fee schedule and how it has led to a decline in payments for medical services. He emphasizes the need for physicians to unite and advocate for appropriate reimbursement to ensure the future of medicine. Dr. Weinstein proposes the formation of a single-issue alliance and the importance of messaging and lobbying to bring about change. Contact Dr. Weinstein at [email protected] or American Academy of Dermatology Association at [email protected] Takeaways Physicians face an unsustainable environment with increasing costs and decreasing reimbursements. The physician fee schedule, established in 1992, determines reimbursement based on the resources utilized in delivering medical services. Physicians need to unite and advocate for appropriate reimbursement to ensure the future of medicine. A single-issue alliance can be formed to address the challenges of physician reimbursements and amplify the message to Congress. Messaging and lobbying efforts are crucial in bringing about change and securing an inflation-based adjustment to the reimbursement system. Chapters 00:00 - Introduction to the Future of Dermatology podcast 01:15 - Dr. Andrew Weinstein's background and expertise 02:07 - The challenge of physician reimbursements in the healthcare industry 08:36 - The need for physicians to unite and advocate for appropriate reimbursement 19:30 - The power of a single issue alliance in addressing physician reimbursements 23:45 - The importance of changing the path and uniting all specialties 29:24 - Excitement for the future of dermatology and the role of AI 39:56 - Conclusion and call to action

Summary In this episode, Dr. Faranak Kamangar answers questions from medical students about various dermatology topics. The students ask about red light therapy, preventative Botox, collagen supplements, homemade sunscreen, and the use of antimicrobial products for acne. Dr. Kamangar provides insights and advice on each topic, discussing the efficacy and safety of these practices. They also various topics related to dermatology, including the microbiome, summer-related rashes, skincare regimens, and burn care tips. Dr. Kamangar emphasizes the importance of maintaining a healthy skin barrier and using non-comedogenic products. She also provides tips for managing eczema and rosacea during the summer months. She advises on preventing arthropod bites and treating superficial burns. Takeaways Red light therapy has proven efficacy for its anti-inflammatory and antimicrobial effects. Preventative Botox can be effective in delaying the formation of wrinkles, but it should be done in conjunction with maintaining collagen through a healthy lifestyle. Collagen supplements can be beneficial for collagen production, but they should be seen as a supplement to a healthy lifestyle rather than a magic solution. Homemade sunscreen is not recommended as it is difficult to replicate the accuracy and effectiveness of commercially available sunscreens. Antimicrobial products like Hibiclens can be useful for treating acne and other skin conditions, but their impact on the skin microbiome should be considered. It is important to strike a balance between using antimicrobial products and preserving a healthy skin microbiome. Maintaining a healthy skin barrier is crucial for overall skin health. Using non-comedogenic products can help prevent acne and other skin issues. During the summer, it's important to protect the skin from the sun and heat. Vigilance is key in preventing arthropod bites, such as ticks and leeches. For superficial burns, cooling the skin and using barrier creams can aid in healing. Chapters 00:00 - Introduction of New Medical Students 07:23 - Exploring the Benefits and Limitations of Red Light Therapy 11:01 - The Role of Preventative Botox in Delaying the Signs of Aging 14:08 - Collagen Supplements: A Supplement to a Healthy Lifestyle 18:06 - The Risks of Homemade Sunscreen 21:06 - Harnessing the Power of the Microbiome for Treating Body Acne 22:23 - Antimicrobial Products and the Skin Microbiome 25:38 - Common Summer-Related Skin Issues 29:33 - Managing Skin Conditions in the Summer 31:48 - Tips for a Summer Skincare Regimen 38:24 - Preventing Arthropod Bites 41:00 - Home Burn Care

Summary Dr. Forum Patel, a board-certified dermatologist, discusses various cosmetic procedures and treatments, including the use of Ozempic and other GLP-1 drugs for weight loss. She explains the phenomenon known as 'Ozempic face,' which refers to the specific facial changes that occur with rapid weight loss. Dr. Patel also highlights the importance of collagen rebuilding and volume restoration in addressing these changes. She mentions the use of Sculptra, a filler that stimulates collagen production, and discusses the role of lasers and skin tightening devices in enhancing collagen and elastic tissue. The conversation emphasizes the need for individualized treatment and the importance of starting preventative measures early. In this conversation, Dr. Forum Patel and Dr. Faranak Kamangar discuss the importance of a longitudinal relationship between patients and dermatologists for achieving the best cosmetic outcomes. They emphasize the need for a personalized approach and gradual progress in cosmetic treatments. They also discuss the usage of Sculptra, a collagen-building treatment, and the importance of maintenance and a well-balanced diet for optimal results. They touch on the future of dermatology, including the potential impact of AI technology in streamlining consultations and providing customized recommendations. Takeaways Ozempic and other GLP-1 drugs can cause rapid weight loss, leading to specific facial changes known as 'Ozempic face.' Collagen rebuilding and volume restoration are important in addressing the facial changes associated with rapid weight loss. Sculptra, a filler that stimulates collagen production, can be used to restore volume in the face. Lasers and skin tightening devices can enhance collagen and elastic tissue, improving the overall appearance of the skin. Individualized treatment is crucial in achieving natural and aesthetically pleasing results. Starting preventative measures, such as collagen rebuilding, early can help maintain a youthful appearance. A longitudinal relationship between patients and dermatologists is crucial for achieving the best cosmetic outcomes. Cosmetic treatments should be approached gradually and with a personalized plan. Sculptra is a collagen-building treatment that can address areas of fat loss in the face. Maintenance and regular follow-ups are necessary to maintain the results of cosmetic treatments. A well-balanced diet is important for collagen synthesis and optimal skin health. The future of dermatology may involve the use of AI technology to streamline consultations and provide customized recommendations.

Summary Dr. Reed Berger, MD, PNS, an obesity medicine physician, discusses the use of GLP agonists and bariatric surgery in treating obesity. She explains the different types of GLP agonists and their approved uses for obesity and weight loss. Dr. Berger also discusses the efficacy and side effects of these medications, as well as the importance of protein in the diet for weight loss. She emphasizes the need for patients to receive proper nutrition and exercise guidance, and highlights the role of vitamins and supplements in supporting weight loss. In this conversation, Dr. Reed Berger discusses the use of GLP agonists in weight loss and the management of obesity. He explains that GLP agonists can be used after bariatric surgery to help patients maintain weight loss. The timing of starting GLP agonists after surgery depends on the individual patient. Dr. Berger also discusses the phenomenon of 'Ozempic face' and the potential causes behind it. He mentions that weight loss medications like phentermine and combination medications like Contrave can still be used in conjunction with GLP agonists. He also highlights the challenges of prior authorizations and medication shortages in the field of obesity medicine. Takeaways GLP agonists, such as Ozempic and Wegovy, are approved for weight loss and can help patients feel full and think about food less. Protein is important for weight loss as it is thermogenic and helps maintain lean body mass. Exercise is crucial for maintaining weight loss and increasing basal metabolic rate. Vitamins and supplements, such as multivitamins, vitamin D, and vitamin B12, may be recommended to support weight loss. Proper nutrition and exercise guidance are essential for patients starting GLP agonists or undergoing bariatric surgery. GLP agonists can be used after bariatric surgery to help patients maintain weight loss. The timing of starting GLP agonists after surgery depends on the individual patient. Weight loss medications like phentermine and combination medications like Contrave can still be used in conjunction with GLP agonists. Prior authorizations and medication shortages are challenges in the field of obesity medicine. Chapters 00:00 - Introduction and Overview 02:15 - Dr. Berger's Clinic and Focus 04:29 - Benefits of Telemedicine for Weight Management 05:22 - Different GLP Agonists and Their Uses 09:08 - Efficacy and Mechanisms of GLP Agonists 10:18 - Effects on Hunger Sensation and Gastric Emptying 13:01 - Nutrition Recommendations for GLP Agonist Patients 15:14 - Incorporating Exercise into Weight Management 18:29 - Supplementation and Vitamins for Weight Loss Patients 19:53 - Using GLP Agonists After Bariatric Surgery 21:17 - The 'Ozempic Face' and Potential Mechanisms 24:26 - Treatment of the 'Ozempic Face' 26:50 - Challenges of Prior Authorizations and Medication Shortages 29:26 - Other Medications in Weight Management 35:26 - The Future of Obesity Medicine

Summary The conversation revolves around the experiences of three medical students, Chandler Johnson, Payton Smith, and Kathryn Haran, who traveled to Kenya to collaborate with UCSF Dermatology and MTRH Dermatology. They discuss their role in sharing knowledge, establishing partnerships, and enhancing dermatology care and research. The discussion also touches on the future of global health, mentorship, and the impact of the trip on their careers. Takeaways Collaborative efforts in global health involve sharing knowledge and resources to enhance dermatology care and research. Global health initiatives don't necessarily require international travel and can have a profound impact locally. Mentorship and cultural humility play a significant role in global health endeavors and future career aspirations. The use of social media and technology can be leveraged to promote dermatology care and education in resource-limited communities. The impact of mentorship and the multiplier effect of training mentees in global health initiatives are essential for sustainable advancement in skin health. Visit Living Room International at https://linktr.ee/livingroominternational and on Instagram at @livingroominternational Visit Glo Derm at: gloderm.org Chapters 00:00 - Introduction and Overview of the Trip 01:15 - Collaboration between UCSF Dermatology and MTRH 02:21 - Activities and Focus Areas in Kenya 04:10 - Partnership with Living Room Hospital 05:36 - Continuing Collaboration and Access to Care 08:57 - Personal Motivations for Global Health Work 09:54 - Getting Involved in Global Health 14:47 - Balancing Work and Exploration 28:21 - Excitement for the Future of Global Health

Summary Dr. Vail Reese, a dermatologist, discusses the intersection of dermatology and media, particularly movies. He categorizes skin conditions in films into three main groups: skin conditions associated with evil characters, skin conditions that actors actually have, and skin conditions of heroic or sympathetic characters. Dr. Reese explores the reasons behind the association of skin conditions with evil characters and the impact of these portrayals on societal perceptions of skin conditions. He also highlights the importance of using examples of celebrities with skin conditions to reassure patients and normalize these conditions. Dr. Reese emphasizes the need for empathy and understanding when treating patients with skin conditions. Visit Dr. Reese's website, Skinema, at https://www.skinema.com/ Takeaways Skin conditions in movies are often associated with evil characters, creating a stigma around these conditions. Celebrities who openly discuss their skin conditions can help normalize and reassure patients. The portrayal of skin conditions in media can impact societal perceptions and contribute to bullying and harassment. Dermatologists should prioritize empathy and understanding when treating patients with skin conditions. Chapters 00:00 - Introduction and Background 02:47 - Skin Conditions and Evil Characters in Movies 09:23 - Celebrities as Role Models 15:02 - Exciting Breakthroughs in Dermatology

Summary Dr. Nahid Vidal discusses the innovative work being done in the field of dermatology, specifically in the areas of AI and digital health. She highlights the use of AI in diagnosing tumor, basal cell carcinoma, and the potential for AI to assist in identifying high-risk features during Mohs surgery. Dr. Vidal also discusses the advancements in skin imaging devices and the use of microscopy in dermatology. She emphasizes the importance of collaboration between physicians and engineers in developing these technologies and the need for improved communication and efficiency in medical practice. Takeaways AI can be used to diagnose tumor, basal cell carcinoma, with high accuracy AI can assist in identifying high-risk features during Mohs surgery Advancements in skin imaging devices and microscopy have the potential to revolutionize dermatology Collaboration between physicians and engineers is crucial in developing AI and digital health solutions - Improved communication and efficiency in medical practice can be achieved through technology Chapters 00:00 - Introduction and Overview 02:13 - AI Models for Tumor Diagnosis 06:05 - Identifying High-Risk Features in Mohs Surgery 15:10 - The Potential of Skin Imaging Devices 16:38 - Revolutionizing Dermatology with Microscopy

Summary Todd Bello, founder of the Facebook group, Overcoming Psoriasis, shares his journey as a psoriasis patient and the impact it had on his life. He discusses the challenges he faced, including the lack of information and treatment options available at the time of his diagnosis. Todd emphasizes the importance of finding a board-certified dermatologist and joining support groups like the National Psoriasis Foundation. He also highlights the advancements in psoriasis treatment over the past 30 years, particularly the development of biologics. Todd mentions the potential for genetic testing and personalized medicine in the future. He concludes by discussing the role of his patient networking group in providing support and accurate information to psoriasis patients worldwide. Takeaways Finding a board-certified dermatologist and joining support groups like the National Psoriasis Foundation are crucial for psoriasis patients. Advancements in psoriasis treatment, particularly the development of biologics, have significantly improved outcomes for patients. Genetic testing and personalized medicine hold promise for the future of psoriasis treatment. Patient networking groups play a vital role in providing support and accurate information to psoriasis patients worldwide. If you suffer from psoriasis: Help Us Understand More About Sleep and Psoriasis Are you interested in helping researchers understand how psoriasis and sleep are related? Please consider taking our paid online survey. Recruiting both individuals with and without psoriasis. https://redcap.ucsf.edu/surveys/?s=RLFR379LNL4RFTTF Help Us Understand About Menopause and Psoriasis Are you interested in helping researchers understand how psoriasis and menopause are related? Please consider taking our paid online survey. Recruiting post-menopausal women with psoriasis. https://redcap.ucsf.edu/surveys/?s=JYTNX3XKDC84J3DX Chapters 00:00 - Introduction and Overview 05:17 - The Impact of Psoriasis on a Patient's Life and Career 11:22 - Advancements in Psoriasis Treatment: The Role of Biologics 25:00 - Addressing Hesitancy Towards Biologics 26:20 - The Future of Psoriasis Research and Treatment

Summary Dr. Serena Elmariah, an expert in the nervous system, immune system, and skin, discusses the forefront of research on itch and neurosensory disorders. The research is focused on understanding the sensory aspects of the skin, as well as the neuroimmune and neuroepithelial connections. Aging skin and its association with itch is also explored, with factors such as epithelial dysfunction, immunosenescence, polypharmacy, and the aging nervous system contributing to itch. The importance of neuroprotection and overall health in maintaining skin health is emphasized. The conversation also touches on cryolipolysis and the potential benefits of cold exposure for the skin. Takeaways Research is focused on understanding the sensory aspects of the skin and the neuroimmune and neuroepithelial connections. Aging skin is associated with itch, with factors such as epithelial dysfunction, immunosenescence, polypharmacy, and the aging nervous system contributing to itch. Neuroprotection and overall health play a role in maintaining skin health. Cold exposure may have potential benefits for the skin. Chapters 00:00 - Introduction and Background of Dr. Serena Elmariah 01:16 - Research on Itch and the Nervous System 06:07 - The Potential of Neuroprotective Measures 12:49 - Exploring Cryolipolysis and Cold Exposure 26:48 - Exciting Advancements in Dermatology Research

Summary: Dr. Daniel Butler, a board-certified dermatologist and assistant dean of student affairs at the University of Arizona College of Medicine, discusses his research on aging skin and inflammatory diseases. He explores how aging independently becomes a risk factor for certain skin diseases and how age can affect access to medications. Dr. Butler emphasizes the need to understand the unique challenges and presentations of skin diseases in older adults. He also discusses the importance of dermatologists having a presence on social media to engage with patients and provide credible information. Takeaways: Aging independently becomes a risk factor for certain skin diseases and can affect how these diseases manifest in older adults. Access to medications can be more challenging for older adults, and age can be a modifiable risk factor in healthcare delivery. Dermatologists need to understand the unique challenges and presentations of skin diseases in older adults and avoid making assumptions based on age. Having a presence on social media allows dermatologists to engage with patients, provide credible information, and bridge the gap between academic knowledge and what is available on social media. The future of dermatology includes targeted therapies for various skin diseases and equipping the next generation of dermatologists with the skills to change lives. Chapters: 00:00 - Introduction and Background of Dr. Daniel Butler 02:01 - Research on Aging Skin and Inflammatory Diseases 06:16 - Understanding the Mechanisms of Aging Skin 10:54 - The Role of Dermatologists on Social Media 15:23 - Should Academic Physicians be on Social Media? 29:15 - The Future of Dermatology: Targeted Therapies and Next Generation Dermatologists

Summary In this episode, Dr. Faranak Kamangar and Katie Haran, UCSF med student, explores the relationship between vitiligo and retinal detachment, the implications for treatment, and the potential risks associated with certain medications. It also delves into the similarities between the eyes and skin, the impact of melanin on ocular health, and the need for extensive health monitoring for individuals with vitiligo. The discussion raises questions about the future of dermatology and the importance of understanding the mechanisms of vitiligo and its associated ocular pathologies. Takeaways: The relationship between vitiligo and retinal detachment raises questions about the need for more aggressive treatment and extensive health monitoring for individuals with vitiligo. The use of Afamelanotide for genetic diseases, weight loss, and skin tanning is not recommended due to potential risks and lack of regulation. - The conversation highlights the similarities between the eyes and skin, particularly in relation to melanin and its impact on ocular health. The discussion prompts consideration of the future of dermatology, the need for a deeper understanding of vitiligo mechanisms, and the implications for ocular pathologies associated with melanin-related conditions. Chapters: 00:00 - Introduction to the Future of Dermatology Podcast 01:22 - The Link Between Vitiligo and Retinal Detachment 05:25 - Understanding Vitiligo and Oculocutaneous Albinism 09:05 - The Mechanisms of Vitiligo and Ocular Pathologies 25:45 - Melanin: Uncovering the Similarities Between Eyes and Skin 26:22 - The Future of Dermatology: Understanding Vitiligo Mechanisms and Ocular Pathologies

Summary In this episode, Dr. Farah Kamangar is joined by Payton Smith, a third-year medical student, and Dr. Mitch Davis, who recently matched into a dermatology residency program. The conversation delves into the dermatology application process, the challenges, and the experiences of medical students and residents. It also explores the importance of mentorship, the impact of failure, and the future of dermatology in terms of targeted therapies and AI. The guests share their personal journeys, challenges, and the value of perseverance in pursuing a career in dermatology. Takeaways The dermatology application process is challenging and requires perseverance and dedication. Mentorship and networking play a crucial role in navigating the application process and building a successful career in dermatology. The impact of failure and the importance of not fearing it, but rather using it as a learning experience and a stepping stone to success. The future of dermatology holds promise with the development of targeted therapies and the potential role of AI in diagnosis and treatment. Personal experiences and challenges shared by medical students and residents highlight the value of resilience and determination in pursuing a career in dermatology.

Summary: Dr. Clark Otley discusses the importance of physician involvement in the development of devices and technology in dermatology. He shares his experiences in innovation and business development at Mayo Clinic, highlighting the process of bringing ideas from ideation to market. Dr. Otley also introduces the Mayo Clinic Platform, a digital innovation platform that aims to assist entrepreneurs and innovators in the field of digital healthcare technology. He emphasizes the potential of AI in dermatology and the importance of physicians being at the forefront of technological advancements. Takeaways: Physicians should be actively involved in the development of devices and technology in dermatology to ensure they meet the needs of clinicians and patients. The process of bringing an idea from ideation to market involves ideation, prototyping, testing, FDA approval, and developing a business model. The Mayo Clinic Platform is a digital innovation platform that connects innovators and entrepreneurs in digital healthcare technology with the tools, data, and expertise they need. AI has the potential to revolutionize dermatology by improving diagnostics, prognostics, and therapeutics, and optimizing practice management. Physicians can prevent burnout and find fulfillment by engaging in innovation and staying at the forefront of technological advancements in dermatology. Chapters 00:00 - Introduction and Background of Dr. Clark Otley 04:15 - The Process of Bringing Ideas from Ideation to Market 09:54 - The Mayo Clinic Platform for Digital Healthcare Innovation 13:45 - The Potential of AI in Dermatology

Summary Dr. Raja Sivamani, MD, MS (Bioengineering), AP, discusses his transition from academia to private practice and the importance of integrative medicine in dermatology. He shares his experience in running a clinical trials unit and the benefits of seeing Medi-Cal patients. Dr. Raja Sivamani also talks about Learn Skin, an online platform for dermatology education, and the future of dermatology, including the role of AI and the need for an open mind. Takeaways Transitioning from academia to private practice can provide more freedom and opportunities for innovation. Integrative medicine, including nutrition and lifestyle approaches, is an important aspect of dermatology. Running a clinical trials unit can be efficient and impactful, especially when combined with a successful practice. Learn Skin is an online platform that offers dermatology education with an integrative spin. The future of dermatology involves embracing AI and collaborating with other healthcare professionals. Continuing education and keeping an open mind are essential for staying up-to-date in the field. Chapters 00:00 - Introduction and Background 03:19 - Transitioning from Academia to Private Practice 06:08 - The Benefits of Private Practice 09:23 - Considerations for Starting a Private Practice 13:38 - Running a Clinical Trials Unit 21:56 - The Future of Dermatology

Summary Janelle Ball, the CEO and founder of BC Educators, discusses the importance of having a dedicated biologic coordinator in dermatology offices to streamline the prior authorization process for specialty medications. She emphasizes the need for proper documentation and education to ensure patients have access to the medications they need. BC Educators offers virtual coordinators and training to support offices in this role. Janelle also highlights the challenges of navigating insurance requirements and the importance of collaboration and networking among coordinators. She sees the future of dermatology involving more biologics and specialty medications, making the role of the biologic coordinator even more crucial. Takeaways: Having a dedicated biologic coordinator in dermatology offices can streamline the prior authorization process for specialty medications. Proper documentation and education are essential for ensuring patients have access to the medications they need. BC Educators offers virtual coordinators and training to support offices in the role of the biologic coordinator. Collaboration and networking among coordinators can help navigate insurance requirements and share best practices. The future of dermatology will likely involve more biologics and specialty medications, making the role of the biologic coordinator even more crucial. Chapters 00:00 Introduction and Background 06:45 Streamlining Workflow in Dermatology Offices 12:47 The Role of the Biologic Coordinator 23:20 The Future of Dermatology

Summary Dr. Farah Kamangar interviews Dr. Whitney Tolpinrud, the Medical Director at Curology, a personalized skincare service. They discuss the journey that led Dr. Tolpinrud to her current position and the inefficiencies of traditional clinical practice. They also explore the founding of Curology and its mission to provide accessible and personalized dermatological care through telemedicine. Dr. Tolpinrud shares her experience as the Medical Director and the various aspects of her role, including product development, marketing, and clinical research. They discuss the future of dermatology, emphasizing the importance of personalized medicine and the integration of technology, such as AI, into medical practice. Takeaways Traditional clinical practice can be inefficient and limit the number of patients that can be seen. Telemedicine offers a more scalable and accessible solution. Curology is a personalized skincare service that provides telemedicine consultations and customized prescription treatments. The company was founded by a dermatologist and focuses on treating conditions like acne through a telemedicine platform. Dr. Tolpinrud serves as the Medical Director at Curology and is involved in product development, marketing, clinical research, and maintaining high medical standards. The future of dermatology involves personalized medicine, utilizing individual bio data and genetics, as well as the integration of technology, such as AI, into medical practice. Chapters 00:00 - Introduction and Background 05:07 - Curology: Personalized Skincare through Telemedicine 11:35 - The Future of Dermatology: Personalized Medicine and Technology

Summary Dr. Tina Bhutani shares her journey to becoming a dermatologist and the challenges she faced along the way. She emphasizes the importance of being proactive in interviews and marketing oneself effectively. Dr. Bhutani also discusses the rewards and challenges of working in an academic setting, including the bureaucracy and administrative burdens. She highlights the significance of clinical trials and her interest in studying lifestyle modifications and their impact on skin disease. However, she acknowledges the difficulty of getting funding for these types of studies. In this conversation, she discusses her busy life as a dermatologist and the importance of patient-centered research and accessible clinical trials. Dr. Bhutani and Dr. Fara also talk about Dr. Bhutani's book that she co-authored on the use of biologics in psoriasis treatment. The conversation covers various chapters of the book, including laboratory monitoring, TNF-alpha inhibitors, IL-17 class of biologics, combination therapies, biologic agents for pediatric psoriasis, special site psoriasis, comparing biologic agents, long-term registry data, biologic agents in special populations, and adherence to biologic therapy. Dr. Fara and Dr. Bhutani emphasize the importance of individualizing treatment and having open conversations with patients about their preferences and needs. Takeaways Be proactive in interviews and market yourself effectively Working in an academic setting has rewards and challenges Clinical trials are important for providing access to treatments Studying lifestyle modifications and their impact on skin disease is valuable Obtaining funding for non-traditional studies can be challenging Patient-centered research and accessible clinical trials are important for improving dermatology treatments Dr. Bhutani's book on the use of biologics in psoriasis treatment provides practical guidance and evidence-based recommendations TNF-alpha inhibitors are still valuable in psoriatic arthritis treatment IL-17 class of biologics work quickly and are effective for tough-to-treat areas Combination therapies can be beneficial for patients who have already tried monotherapy Treating special site psoriasis is important for improving quality of life and preventing comorbidities Comparing biologic agents is challenging due to individual patient factors and access issues Long-term registry data provides reassurance about the safety and efficacy of biologic agents Special populations, such as pregnant women and the elderly, require careful consideration in biologic therapy Adherence to biologic therapy is crucial, and treatment should be tailored to individual patient preferences and needs Chapters 00:00 Introduction and Background 08:39 Navigating the Challenges of an Academic Setting 29:27 The Value of TNF-alpha Inhibitors in Psoriatic Arthritis 36:04 Comparing Biologic Agents: Challenges and Considerations