Dermasphere Podcast

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Dermasphere Podcast

Dermasphere is a podcast by dermatologists, for dermatologists, that delivers the latest dermatology research direct to your ears.

14/09/2026

Have you listened to Episode 191 yet? If not, here are Luke's Top Five!

• Framing risk matters, especially since many patients are visual learners. Showing 999 shaded figures next to one unshaded figure can communicate rare risks better than percentages alone; it’s also important to frame untreated disease as carrying its own risks.

• Difamilast (Adquey) is a new nonsteroidal topical PDE4 inhibitor approved in February 2026 for mild-to-moderate atopic dermatitis in patients ≥2 years old, joining roflumilast and crisaborole as nonsteroidal options.

• In a phase 3 trial, 364 Japanese patients aged 15-70 with moderate AD used difamilast 1% or vehicle twice daily for 4 weeks. IGA success was achieved in 38.5% with difamilast versus 12.6% with vehicle.

• Difamilast pricing remains difficult to pin down given its recent approval, but may be around $500 for a 30-g tube. Consider offering samples alongside other nonsteroidal topical options when available.

• Biopsying normal-looking skin is diagnostically useful in rabies (5-6mm punch from posterior neck with 10+ hair follicles), systemic amyloidosis (punch of abdominal fat pad 3-4cm from the umbilicus), lupus (4mm punch of sun-protected skin for lupus band testing), and small fiber neuropathy (3mm punch from the distal leg for nerve fiber density).

26/08/2026

Check out Highlights from our special guests in Episode 190!

Dr. Feldman's Top 3:
• The ostrich effect, similar to how cartoon ostriches bury their heads in the sand, people willingly ignore negative consequences for their choices.
• Patients sometimes psychologically cope with their disease by ignoring symptoms and poor outcomes.
• The ostrich phenomenon may be particularly notable in pediatric dermatology, where children may not want to go to the doctor, which is why clinics often use fun decorations and other strategies to make visits less intimidating.

Dr. Kristina Duffin's Highlights:
• This randomized clinical trial of 783 patients with plaque or guttate psoriasis showed home-based phototherapy was non-inferior to office-based phototherapy across all skin tones for physician and patient-reported outcomes and was associated with a lower burden of indirect costs to patients.
• This was a unique design in that the population was stratified across different skin tones and showed a striking difference.
• Found that home-based phototherapy was as effective as office-based phototherapy for plaque or guttate psoriasis in everyday clinical practice and had less burden to patients.

25/08/2026

And now for Dr. Johnson's Top Five from Episode 189!
➡There's a new PDE4 4 inhibitor topica called difamilast.
➡Infantile hemangiomas, even if just on the scalp, should still be treated with propranolol due to effects on hair growth. Systemic steroids can help ulcerated infantile hemangiomas heal faster.
➡Segmental vitiligo may not be permanent; attempt topicals and laser for all children, and potentially polypodium leucotomos for treatment in teens.
➡If you are starting a patient on an immunosuppressive, make sure everyone in the household is up to date on vaccines.
➡Delgocitinib seems to have better results in adolescents compared to adults for the treatment of chronic hand eczema.

Dr. Feldman's Top 3: on THE EASTERLIN PARADOX
• The Easterlin paradox is the concept that increases in income do not increase an individual's happiness beyond a certain level.
• The hedonic treadmill explains this: as income rises, people quickly adapt to new luxuries, raising their material expectations and leaving their overall happiness level unchanged.
• Based on this theory, despite the opportunities Americans have today, there is likely no major difference in happiness levels from the cavemen who originally lived here.

Dr. Amit Om and Derm 5:
• The Derm 5 is a free newsletter delivered every weekday at 6 AM to your email inbox that shares 5 summarized articles with a one-line clinical takeaway to keep dermatologists up to date with the most recent changes in dermatology literature.
https://thederm5.substack.com/

24/08/2026

Check out Dr. Tarbox's Top Five from Episode 189!

➡Put the leopard in the pen, Noonan = Leopard syndrome has been renamed to Noonan syndrome with multiple lentigines
➡Doctor Jacqueline Noonan was an American pediatric cardiologist born in 1928, who co-discovered hypoplastic left heart syndrome.
➡2026 JAAD article: Daily saturated saline immersion for plantar warts showed a 98.3% lesion clearance and 88.2% patient cure rate after 2 months, with no recurrence at 6 months.
➡The mean time for clearance using salt water immersion was 4.2 weeks, and the treatment process was well tolerated and self-limiting, where warts gradually fell off. Transient erythema was present in 14/17 patients and interdigital maceration in 52.9% of patients during treatment with salt water immersion. There were zero serious adverse events.
➡LL37 is a naturally occurring peptide that serves as a critical component of the human innate immune system. Low salt concentrations have been shown to inhibit LL37 and other antimicrobial peptides; hypothetically, the hypertonic saline can reverse this to increase the body's ability to fight off the HPV infected cells seen in plantar warts.

23/08/2026

Have you caught up on the newest Dermasphere Episodes?

In Episode 189, we discussed "The Easterlin Paradox" with Dr. Feldman, More ways to reach the dermatologically curious with Dr. Om, Highlights from the SPD, and saltwater for warts.

In Episode 190, we discussed "The Ostrich Effect" with Dr. Feldman, Home phototherapy with Dr. Kristina Duffin, and featured a clipshow from Episodes 181-190!

Listen wherever you get your podcasts. 🎧

17/08/2026

Another Team Dermasphere citing in the wild 🥰 Dr. Tarbox got to meet team member Karen in person at the Hair Health Summit in Chicago this weekend!

27/07/2026

Have you listened to the newest episodes yet? 186 and 187 are good ones! Check out the topics we discussed: 🎧

➡Active surveillance for AKs?
➡Microfragmented autologous fat for wound healing after foot amputation
➡Why do residents choose specific subspecialties?
➡Sulfites: 2024 allergen of the year!

➡Toxic erythema of chemotherapy
➡Fatigue with biologics, with Jake Loose, PA-S
➡Juxta-clavicular beaded lines
➡Managing facial hyperpigmentation

What was something new that you learned?

25/07/2026

And now for Michelle's Top 5 from Episode 186!

➡5-alpha reductase inhibitors show a statistically significant but small association with sexual dysfunction, with a 3% AR and 1.51 OR in a TriNetX retrospective cohort of nearly 60,000 patients. Critically, when six key comorbidities (HTN, obesity, mood disorders, anxiety, diabetes, and ni****ne dependence) were excluded, the AR fell to 0.43% and was no longer significant.
➡Of the 5-alpha reductase inhibitors studied, only finasteride 5mg/day showed a significant risk increase for sexual dysfunction; finasteride 1mg/day and dutasteride did not, which is reassuring for dermatologists prescribing the standard 1mg dose for androgenetic alopecia.
➡The nocebo effect is a major confounder in 5-alpha reductase inhibitor counseling: a 2007 study found that patients warned about possible sexual side effects reported them 43.6% of the time versus only 15.3% in those not warned, a 3-fold difference based purely on how consent was framed.
➡Oral isotretinoin at 20mg/day showed striking results for acquired dermal macular hyperpigmentation, improving pigmentation in 100% of Riehl's melanosis patients and 90% of lichen planus pigmentosus patients across a 121-patient multi-institutional study.
➡Predictors of better response to oral isotretinoin for acquired dermal macular hyperpigmentation include localized lesions, disease duration under 5 years, darker Fitzpatrick skin types (3-6), and a cumulative dose over 3,600mg.

23/07/2026

Luke got to meet Team Dermasphere member Hiral Patel in person at the Society for Pediatric Dermatology meeting in Minneapolis!

18/07/2026

Have you listened to Episode 186 yet? 🎧 Here are Luke & Ian's top takeaways:

• ACD to glucose devices affects ~3% of users, with onset from weeks to years after first use. Removing the device usually resolves the reaction within a week, though irritant contact dermatitis can appear identical and is likely even more common.
• Patch testing for device ACD is challenging because manufacturers don't disclose ingredients. Test with a baseline, acrylate, and plastics/glues series plus a piece of the device itself, and always read at day 7, which is commonly missed.
• Isobornyl acrylate (IBOA) is the most common allergen in glucose devices and should be tested at 0.3%, not the commercially available 0.1%—an important cause of false-negative patch tests.
• Treatment options are limited and largely based on case reports: topical steroid sprays, barrier films (Cavilon), and physical barriers (Tegaderm) have shown mixed results. Switching devices is possible but difficult because ingredient lists change frequently.
• Manufacturers should disclose complete ingredient lists for medical devices to improve identification and management of these reactions.

• VOCs are an important, underrecognized environmental trigger for AD. Standard HEPA purifiers remove particles but not VOCs. Choose purifiers that specifically capture VOCs, and avoid those using "chemical reactions," which may indicate ozone production.
• A low-cost DIY option—a box fan in a window with a furnace filter taped to the front—can dramatically reduce indoor VOCs at a fraction of the cost of commercial purifiers. Replace filters every few months.
• Moisturizer packaging matters: tubs require added antimicrobials that may disrupt the skin microbiome. Some products, including Aquaphor, selectively suppressed commensal organisms while allowing *Staph aureus* to thrive. Squeeze tubes or pumps are preferred, and Vaseline Advanced Healing was noted to be more microbiome-friendly.

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