Dermatology Pearls from Winter Dermatology Conference 2018

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This past week I attended the 2018 Winter Dermatology Conference in Maui, and it was such a great experience, filled with tons of dermatology pearls! I competed as part of the Rising Derm Stars research competition, in which 20 residents from around the country were invited to give presentations on their research. Aside from giving me an opportunity to share my research, the program also paired me up with a mentor, Dr. Shane Chapman (Chair of Dermatology at Dartmouth), who met with me and my co-mentee and gave us great life and career advice. As many of you may have seen on my instagram stories, I learned so much pearls that I’m going to start using right away in clinic. I wanted to summarize some of these points for you here; to see my commentary and explanations, check out my IG story highlight under “Maui Derm.”

Winter Clinical Dermatology Rising Derm Stars presentation

Presenting on my research about acne and hormonal anti-androgen acne therapy

Winter Clinical Dermatology Conference 2018

With my mentor Dr. Chapman, head of Dartmouth Dermatology, and my co-mentee Ryan

Winter Clinical Dermatology 2018

With one of our attendings, Dr. Jennifer Stein, melanoma and dermoscopy expert

 Without further ado, here’s some cool pearls I learned!

Pearls about Allergic Contact Dermatitis

  • If you have a patient with recalcitrant cheilitis, not improving with topical steroids and antifungals, think about allergic contact dermatitis! Maybe they are having an allergic reaction to a product they are still using. Think: lip balms, toothpastes, nail polishes, and cosmetics
  • Great toothpastes to try for sensitive individuals: Cleure, VMV, Jack & Jill flavor free pastes
  • For kids: Tom’s toddler propylene glycol-free toothpaste
  • For people with allergies to orange, red, and blue dye: use white cotton or silk clothing only and see if that improves the rashes

Acne Pearls

  • Benzoyl peroxide wash DOES NOT WORK WELL because you’re immediately washing it off! The product needs short contact on the skin; put on 5 minutes prior to shower and then wash off.
  • New antibiotic coming out: Sarecycline (less photosensitivity and GI upset!)
  • Isotretinoin: check lipid panel and hepatic panels at week 8 and if normal, no more checks. If abnormal, keep checking.
    • Triglycerides: what makes us nervous? High = 200 – 499 mg/dL; very high = > 500 (risk for pancreatitis).
    • Acute pancreatitis associated with TG > 1000 mg/dL; to reduce risk, you should reduce Isotretinoin to below 500 mg/dL. Drug holiday if > 500 mg/dL.

 Psoriasis Pearls:

  • Stelara is now approved for kids/teens; if their weight is < 60 kg, they get adult dosing. If less than that, then they get dosed at 0.75 mg/kg
  • Humira: now approved for nail psoriasis
  • Certolizumab: TNF alpha blocker; soon to be approved for skin

Hyperpigmentation Pearls

  • Superficial peeling agents (salicylic acid and glycolic acid) can work well
  • Discontinue topical retinoids 1 week prior to an in-office chemical peel, and make sure patients are not doing anything abrasive at home either, like using a Clarisonic brush prior to the peel

Miscellaneous Pearls

  • L-carnitine 1000 to 1500 mg nightly can help to reduce the side effect of muscle cramping in patients on Vismodegib
  • Serlopitant: new medication coming out for ITCHING! *this can’t come out soon enough; I have so many itchy patients!*
  • First time I heard about eryfotona actinica, a sunscreen containing photolyase (DNA repair enzyme) in liposomes
  • Tranexamic acid for melasma: dosing is at 250 mg twice a day, but carefully screen patients because of increased risk of blood clots
  • As an alternative to Efudex alone, use Efuex plus Dovonex twice a day for 4 days to treat actinic keratoses (I’ve done this! Works a lot faster than Efudex alone). If you’re interested in this, the original paper is here
    • Main conclusion: “Four-day application of calcipotriol plus 5-FU versus Vaseline plus 5-FU led to an 87.8% versus 26.3% mean reduction in the number of actinic keratoses in participants (P < 0.0001).”
I’ll be publishing another post shortly – a Maui travel guide!

6 Comments on Dermatology Pearls from Winter Dermatology Conference 2018

  1. Farrah
    January 23, 2018 at 2:52 pm (1 month ago)

    Congrats on being part of the Rising Derm Stars research competition, and how cool that the conference was in Hawai’i! *-*

    Thanks so much for all these clinical pearls! We definitely get skin complaints at our office, and sometimes their insurance won’t cover enough for them to be able to see a specialist, so these will definitely be helpful for me to keep in mind! :]

    Reply
    • Joyce
      January 24, 2018 at 9:08 pm (1 month ago)

      Hi Farrah, so glad that these were helpful! Hope you can use some of these tips in your practice :)

      Reply
  2. Shann Eileen
    January 24, 2018 at 2:28 pm (1 month ago)

    Wow, looks like you learned a lot there! Maui is probably one of the best places to have a conference, isn’t it. My dad is actually attending a conference there soon and taking my mom, lucky!

    Shann Eileen | http://www.shanneileen.com

    Reply
    • Joyce
      January 24, 2018 at 9:10 pm (1 month ago)

      Hi Shann, your parents are going to have such a great time! You should try to join too :) I will be publishing my Maui travel guide tomorrow so hopefully that’ll be useful for your parents too!

      Reply
  3. Joy
    January 24, 2018 at 8:45 pm (1 month ago)

    This is SO helpful! Thank you so much. I didn’t get to go to Maui derm this year, so glad you shared these pearls.

    Reply
    • Joyce
      January 24, 2018 at 9:10 pm (1 month ago)

      Hi Joy, thanks for stopping by and leaving a comment! I learned so much at Maui; what a fantastic conference! Hope to be back next year.

      Reply

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