Expert Treatment Tips You Don’t Want to Miss

Simple but effective treatment options can often be overlooked, but presenters from Winter Clinical Hawaii 2023 demonstrated with their quick tips how some simple solutions provide effective outcomes. In a 2-day series on the main island, Linda F. Stein Gold, MD; Mark Lebwohl, MD; Joslyn R. Sciacca Kirby, MD, MS, MEd; Matt L. Leavitt, DO; Daniel M. Siegel, MD, MS; Kenneth J. Tomecki, MD; and Clay J. Cockerell, MD, provided their top tips in a fast-paced panel discussion.

Tips from day 1:

• Linda F. Stein Gold: Keep treating acne even when just residual erythema remains to help prevent atrophic scars.
• Mark Lebwohl: Dermatologists tend to overlook and underutilize hedgehog inhibitors. Patients can go on and off 200mg of sonidegib and still have good response rates.
• Joslyn R. Sciacca Kirby: “Boil bubbles” in the background of a biopsy are a sign of superficial basal cell carcinoma.
• Matt L. Leavitt: Intralesional injections can help grow hair back and stop inflammation.
• Daniel M. Siegel: Clinicians are not billing photodynamic therapy correctly. Additionally, an ALA stick is a one-time use unit, while ALA gel has 200 units per tube.
• Kenneth J. Tomecki: In a recent study, 95,000 patients with psoriasis who received systemic therapy and received two systemic agents had a 60% increased risk of zoster.
• Clay J. Cockerell: Bullosisdiabeticorum may appear identical histologically to bullous pemphigoid in older patients.¹

Tips from day 2:

• Linda F. Stein Gold: Rhabdomyolysis is one of the major causes of acute renal failure. If you receive an elevated CPK test after evaluating for muscle injury, remember that the elevation of CPK levels has no good correlation with the severity of muscle damage and renal failure. Treat with supportive care of adequate hydration to prevent renal failure.
• Mark Lebwohl: There are multiple, effective treatment options available for prurigo nodularis to stop the itch, including dupilumab, nemolizumab, and difelikefalin.
• Joslyn R. Sciacca Kirby: Turmeric has beneficial properties such as protection from sun damage and wrinkling, as well as prevention of anti-inflammatory reactions in diseases of acne, psoriasis, and atopic dermatitis.
• Matt L. Leavitt: Trichoscopy is one of the most useful diagnostic tools when assessing alopecia areata. Trichoscopic findings are well conserved in respect to alopecia subtypes, and similar findings are observed regardless of race, gender, or age.
• Daniel M. Siegel: Use your nose to rule out potential diseases when first meeting a patient. You don’t realize how useful your sense of smell is in dermatology.
• Clay J. Cockerell: Some photodermatitis may appear as bright red erythema and have clinical inflammation, but no inflammation histologically. Clinicians are often in disbelief after seeing normal skin on the biopsy.
• Kenneth J. Tomecki: Pyoderma gangrenosum is often associated with inflammatory bowel disease, ulcerative colitis, and Crohn’s disease.²

For more expert opinions, visit our Winter Clinical Hawaii conference page.

References

1. Stein Gold L, Lebwohl M, Sciacca Kirby J, et al. 60 tips in 60 minutes: Day 1; Presented at the 2023 Winter Clinical Hawaii Dermatology Conference; January 13-18, 2023; Kohala Coast, Hawaii.
2. Stein Gold L, Lebwohl M, Sciacca Kirby J, et al. 60 tips in 60 minutes: Day 2; Presented at the 2023 Winter Clinical Hawaii Dermatology Conference; January 13-18, 2023; Kohala Coast, Hawaii.
3. Thumbnail image courtesy of Md Ayub Ali Khan. AdobeStock.