Derm-it Trotter! Don't Swear About Skincare.

Joint pain with psoriasis is easy to brush off until it starts affecting your daily life. We sit down with Mark Lebwohl to break down the early warning signs of psoriatic arthritis, from nail pitting and heel pain to swollen “sausage” fingers and morning stiffness. We also explain how doctors diagnose it, why it is often mistaken for osteoarthritis, and why catching it early matters.
We also unpack the rapidly changing treatment landscape, including biologics that protect joints and improve skin disease, plus the major role inflammation and obesity play in worsening symptoms. If you have psoriasis and unexplained aches or swelling, this episode gives you a clear roadmap for what to watch for and what questions to ask next.

A biopsy is still the gold standard for diagnosing skin cancer, but it is far from perfect. From the AOCD meeting in Orlando, Dr. Laura Ferris, Chair of Dermatology at the University of North Carolina, joins us to break down how skin cancer detection is evolving and why tools like dermoscopy, mole mapping, and total body photography are changing the way dermatologists evaluate suspicious lesions.
We also explore the growing role of AI and FDA-cleared technologies like Nevisense and Dermasensor, plus the challenges of access to dermatology care, especially in rural communities. From smarter screening to reducing unnecessary biopsies, this episode looks at what the future of skin cancer detection could really look like.

Insurance denials are one of the most frustrating parts of modern healthcare, and in dermatology, they can delay medically necessary treatment for weeks or even months. Recorded live from the AOCD meeting in Florida, board-certified dermatologist Dr. Kristi Hawley joins us to explain what’s really happening behind prior authorizations, PBMs, formulary restrictions, and “peer-to-peer” reviews.
We talk about the real impact these delays have on patients living with eczema, psoriasis, and other inflammatory skin diseases, along with what patients can actually do to advocate for themselves. If you’ve ever been told your medication “isn’t covered,” this episode breaks down why and what happens next.

Squamous cell carcinoma is the skin cancer most people shrug off until it stops playing by the rules. From the AOCD meeting in Orlando, I sit down with board-certified dermatologist and Mohs surgeon Dr. Carlos Gomez Mead to talk about why cutaneous squamous cell carcinoma can be far more dangerous than its reputation and why, on a population level, it can lead to more deaths than melanoma.

We dig into what actually makes a squamous cell carcinoma “high risk” in real life: rapid growth, pain with pressure that can hint at perineural invasion, and high risk head and neck locations where lymphatic spread is a real concern. We also talk candidly about the shortcomings of common staging systems (NCCN, AJCC, and BWH) and why clinical judgment still matters when cancer behavior is unpredictable.

Then we get practical about gene expression profiling for squamous cell carcinoma, including DecisionDx-SCC (a 40-gene test run on the original biopsy tissue). Dr. Gomez Mead breaks down results in plain language: low, medium, and high risk, and how those categories can change what we do next, from imaging surveillance and oncology collaboration to when adjuvant radiation therapy may actually help. We also spend time on immunosuppressed patients, especially transplant recipients, and why proactive planning can be lifesaving.

If you care about skin cancer prevention, early detection, and smarter personalized treatment, hit subscribe, share this with a friend, and leave a review so more people can find the show.

Acne can feel mysterious until you zoom out and see the pattern: your skin is responding to signals from blood sugar, hormones, inflammation, stress, and even your environment. Dr. Shannon C. Trotter sits down with board-certified dermatologist Dr. Katie Varman of Shine Functional Dermatology to unpack what’s happening under the surface, and why treating acne is often about finding your biggest driver rather than hunting for a single “bad” ingredient. 

We dig into the science linking insulin to acne, including how frequent high-glycemic foods can activate growth pathways (including mTOR and insulin-like growth factor signaling) that increase oil production and pore-clogging skin buildup. We also talk dairy and why it can be a powerful trigger for some people, plus how a continuous glucose monitor (CGM) can help you personalize what actually spikes your blood sugar. If you’ve ever wondered why one person can eat pizza and be fine while another breaks out overnight, we explain the “threshold” concept and how to test changes without living on a permanent restriction plan. 

From there, we connect the dots on gut health and the gut microbiome, probiotics and postbiotics, and why processed foods can quietly undermine skin health. We also get real about stress and acne, breaking down the HPA axis, cortisol, and how your skin can behave like an endocrine organ. Finally, we cover endocrine disrupting chemicals like phthalates and BPA, why synthetic fragrance is a common exposure, and simple swaps that can reduce your load without panic. 

If you want clearer skin and a smarter acne routine, hit play, then subscribe, leave a review, and share the show with someone who needs a little skincare sanity.