Derms on Drugs

Some studies make you rethink everything. Others… not so much. This week, it’s a classic Derms on Drugs 6-pack that sorts through what’s actually useful, what’s overhyped, and what might quietly change how you practice. Can Castle testing spare sentinel node biopsies—or not yet? And why U.S. derms (and Patton) disagree with Europe on BP guidance. Plus more!

The Derms on Drugs get schooled on Hidradenitis Suppurativa by Dr. Chris Sayed from the University of North Carolina.  This will be one of the most practically useful sessions you've ever heard as we go way beyond the basics - we go way beyond basics like the biologics that don't work all that well.
We'll get into a bunch of questions you probably haven't hear discussed with HS before:
- What's the window of opportunity in HS and how do you keep it open?
- Is there any such thing as mild HS?
- What antibiotics actually work for HS and how do you use them?
- Do ancillary treatments like spironolactone, metronidazole and oral roflumilast actually move the needle in a meaningful way?
- If you're going to learn one surgical technique to really help your HS patients which procedure should you pick and how should you learn it?
- What will be the likely role of JAK Inhibitors in HS?
- Is it actually possible to get patients with long term, scarring severe HS better?

Melanoma, extramammary paget's and a prostate cancer drug walk into a bar... well, it may sound like a joke, but this week's episode is no laughing matter!  Join the Derms on Drugs as we get into some deep topics:
New data on Castle Gene Expression Profiling for thin melanomas - does it finally answer the age old question question:  To send or not to send?
Did you know that as we get older, our lymphatics get leaky and it is actually pretty important when it comes to melanoma?
Extramammary Paget's Disease (EMPD) is a bad actor - when you see it, what should you do about it? Wide local excision vs Mohs vs Mohs plus radiation?
You know Dr. Patton's a nerd.  But this week is off the charts.  You'll learn more about pathological staining of EMPD that you ever wanted.
Bicaludamide?  Better than spironolactone for female pattern hair loss?  What do you need to know to start prescribing it?
Pruritus in renal failure patients is the WORST, turns out that medications can be a big driving factor and stopping them might be all you need to do.

Matt, Laura, and Tim are joined by Dr. Lauren Graham (UAB) for a deep dive into cutaneous connective tissue disease. They cover the latest in lupus treatment — including the game-changing anifrolumab and its emerging sub-Q formulation — plus dermatomyositis workup, malignancy screening, the buzz around brepocitinib, and whether roflumilast deserves a spot as first-line therapy.

The Derms on Drugs are back it, answering the burning questions you didn't know you had.  This week's hot topics:
Aviclear laser new data just dropped. Realistic alternative to Accutane or just another device that sits in the corner and gathers dust?
Does mycophenolate actually do anything in pemphigus?
More data about Dupixent, CTCL and cancer.  Does it help, hurt or it's a wash?
What happens if you get scabies while you're on Dupixent?  Turns out Zirwas has been wrong about this for years.
Who is at risk for hyperkalemia on spironolactone and is it bad enough that we should care?
Our goal in early hidradenitis is to prevent progression to scarring - what factors that predict who is likely to progress and what can prevent it?
There's a new side effect to worry about with JAK inhibitors and we promise you won't forget about it.
Finally, what do you say when a patient says "What would you do?"