Dermasphere Podcast (2025)

10/11/2025

Hey listeners! We are working on a Dermasphere-powered app for users to keep themselves up-to-date about dermatology in 15-25 minutes per day. 📱 We need a name! Which is your favorite? Comment the corresponding number below!

04/11/2025

Have you listened to the newest episode yet? 🎧In Episode 169, we discuss the following topics:

➡Sugar bugs and milk tongues - with special guest Dr. Joseph Lam! (learn more about him her: https://www.bcchr.ca/jlam)
➡Social determinants of health
➡Neuropathic pruritus
➡Conge***al syphilis

01/11/2025

Exciting news!!!! Dr. Tarbox was inducted into the American Dermatological Association this weekend. The ADA is the oldest and most prestigious, honorific society in the world of dermatology. It was established in 1876 and it spawned the AAD, the ABD, the ASDS and the ASDP. She was inducted by Dr. Bergfield. Join us in congratulating her on this amazing accomplishment! 🎉

28/10/2025

Hello friends & colleagues! I’m inviting you to participate in a FREE small-group, online social learning experience! It's about chronic spontaneous urticaria. It's free, accredited (earn 7.25 AMA CME/CE credits), brief, non-branded, valuable (current modules and patient cases), and flexible in time commitment. In addition to independently completing the short modules and cases, our cohort will meet online via Zoom for discussions to exchange insights: We meet once at the beginning and then several times throughout the year to review updates from major conferences!

Sign up here: https://aaaaicsu.gathered.com/invite/KQe1wPZbJY

23/10/2025

And now we have Michelle's Top Five! 👩‍⚕️

• Chemowraps with 5-FU can be particularly useful on AKs and SCCs of the lower legs for patients who are poor surgical candidates or have comorbidities leading to poor healing.
• Traditional treatment of AKs or SCCs on the lower legs often requires excision, followed by secondary intention healing or skin grafting, particularly in patients with poor circulation or limited wound-healing capacity.
• DSAP (disseminated superficial actinic porokeratosis) has been linked to mutations in the mevalonate kinase pathway in cholesterol synthesis. Individual lesions typically arise after a second hit, such as UV damage or local trauma, and chemowraps may be helpful in these cases.
• Imiquimod is a topical immune response modifier that acts via toll-like receptor 7, and to some extent TLR8, activating NF-κB and type I interferon pathways to stimulate local innate immunity against BCC, AKs, warts, and superficial malignancies.
• Women may display stronger local skin reactions to imiquimod than men, possibly because TLR7 is encoded on the X chromosome and may escape complete X-inactivation leading to higher baseline expression in females.

23/10/2025

It's time for Top Five's from Episode 168! First up, Luke! 👨‍⚕️ For new listeners, our Top Five segment consists of each doc's clinical pearls from the articles discussed in that episode 🤓

➡Cidofovir is a deoxycytidine monophosphate analogue that inhibits viral DNA synthesis and binds 35-40 x more avidly to viral vs. human DNA polymerases.
➡Intralesional cidofovir can be given for recalcitrant warts; IV formulation is commonly diluted for IL use (often ~15 mg/mL) and injected into lesions using serial puncture or cross-hatching techniques.
➡IL or topical cidofovir demonstrates ~50% response in case reports for common, plantar, periungual, flat, and ge***al warts. Response is often seen between 1-3 months.
➡Cidofovir can be used for acyclovir-resistant HSV because it does not require viral thymidine kinase activation unlike acyclovir/valacyclovir.
➡Cidofovir may have antineoplastic and antiproliferative effects, making it a potential option for HPV-induced SCCs, BCCs, HSIL, CIN, erythroplasia of Queyrat, lentigo maligna, and EBV-related nasopharyngeal carcinoma.

17/10/2025

A new episode dropped this week! Have you listened yet?

In this episode, we were joined again by Dr. Ian Myles (who last joined us in Episode 124!) to discuss topical steroid withdrawal. The other topics discussed were chemowraps and cidofovir in dermatology!

Listen wherever you get your podcasts (Apple Podcasts, Spotify, Amazon music, & more!) 🎧

16/10/2025

Now for Michelle's Top Five from Episode 167!

➡Scalp dysesthesia: potential causes include cervical spine disease, cranial nerve impingement, dermatomyositis, autoimmune or inflammatory alopecia, and occasionally delusional parasitosis.
➡Lichen sclerosus (LS) is a chronic inflammatory dermatosis that primarily affects the anoge***al region in postmenopausal women and prepubertal girls. Extrage***al LS occurs in ~15% of cases, often presenting with pruritus or treatment resistance.
➡A review of extrage***al LS showed topical corticosteroids were the most effective first-line therapy: ~80% complete response.
➡Patients with extrage***al LS should receive a full-skin and ge***al exam, as asymptomatic or unrecognized ge***al disease is common and may be mistaken for menopausal changes.
➡Sites of extrage***al LS: upper back > breasts > abdominal folds. Lesions appear as porcelain-white plaques with pruritus and color change. It is important to rule out morphea and overlapping presentations.

In addition to Michelle's Top Five, we wanted to include Dr. Shreya Sreekantaswamy's Top 3!

1️⃣-methionine is an essential amino acid obtained solely through diet, vital for protein synthesis, liver function, and antioxidant activity.
2️⃣Possible mechanisms for L-methionine in wart therapy include oxidation of intracellular methionine, increasing protein susceptibility to proteolytic degradation, or altering keratin composition and its precursors.
3️⃣In a retrospective review of 29 patients treated with Versulisin verulise methionine for verrucae vulgaris, 56% achieved complete or near-complete resolution, while 44% did not respond. All patients with verrucae plana failed treatment.

15/10/2025

Check out Luke's Top Five from Episode 167!

➡In a study evaluating neck stretches for treatment of scalp dysesthesia, 4 of 16 patients achieved complete resolution, 10 partial improvement, and 2 had no benefit. Despite 24% adherence of participants, mean itch severity (VAS) improved from 6.4 to 2.4.
➡A multicenter review of 203 pediatric androgenetic alopecia cases found a mean onset age of presentation of 13 yo, highlighting that early-onset AGA is not uncommon and often managed with topical minoxidil as first-line therapy.
➡Androgenetic alopecia eventually affects approximately 80% of men and 40% of women; 20–30% of females with PCOS also experience androgen-related hair loss.
➡In adults, androgenetic alopecia presenting before age 35 has been associated with increased risk of early-onset cardiovascular disease, insulin resistance, and metabolic syndrome.
➡In women with suspected hormonal abnormalities contributing to acne, mid-cycle total testosterone and DHEA-S are appropriate initial screening tests.

We also loved this quote from Dr. Steve Feldman: “If we can keep in mind that our worst days are better than the best days of most of the people who have ever lived, perhaps we can force our conscious minds to see past the hedonic treadmill and find continuous joy in the lives we lead.”

05/10/2025

If you haven't listened to the newest episode yet, here are the topics we discussed!

-Dr. Feldman joined yet again to discuss the next chapter of his book - The Hedonic Treadmill
-Dr. Sreekantaswamy joined us to discuss L-methionine for warts!
-We also reviewed literature about neck stretches for scalp dysesthesia, extrage***al lichen sclerosus, and pediatric androgenetic alopecia.

What was your favorite part of this episode?

28/09/2025

And now for Michelle's !

1. Pediatric atopic dermatitis carries a significant neuropsychiatric burden with common behavioral comorbidities and frequent sleep disruption. This impact remains underrecognized and undertreated.

2. A retrospective analysis found dupilumab reduced neuropsychiatric risk in pediatric atopic dermatitis: overall 44% risk reduction (RR 0.56); behavioral disorders reduced by 38% (RR 0.62); anxiety disorders by 33% (RR 0.67); and learning disabilities by 59% (RR 0.41).

3. Dupilumab may reduce neuroinflammation through IL-4 and IL-13 blockade as their receptors are present in the brain. This may improve neuropsychiatric, sleep, and behavioral symptoms, possibly also stabilizing the blood–brain barrier by reducing systemic inflammation.

4. Dermatofibromas are benign fibrohistiocytic dermal tumors, typically presenting as hyperpigmented nodules or papules. Solitary lesions are incidental, but multiple (>5) should prompt evaluation for systemic associations (lupus erythematosus, immunosuppression, HIV...).

5. Histopathology of DF: Benign fibroblastic proliferation in the dermis with storiform architecture, collagen trapping, and Factor XIIIa positivity.

We also wanted to incude some key takeaways from Dr. Feldman's guest segment!
➡Belief bias: Anecdotes that align with what people already believe can be especially persuasive, while logical arguments that conflict with those beliefs are often discounted.

➡Clinical relevance: We should remain mindful of belief bias in both our patients and ourselves, using careful language that respects perspectives and helps preserve patient autonomy.

28/09/2025

If you haven't listened to Episode 166 yet, here are Luke's !

1. Belief bias explains why a compelling story, especially one with a believable conclusion, sometimes sways people more than data. Narratives can influence decision-making even when objective evidence is available.

2. Infantile hemangiomas with suboptimal response to standard propranolol were often segmental, located in the head/neck, and had deep or mixed components.

3. The incidence of IH is about 1.64 per 100 person years with an increasing trend over the last three decades. 12% of these infantile hemangiomas are high risk and require treatment consideration.

4. First-line dosing for IH is propranolol 2 mg/kg/day, often BID. It works 95% of the time.

5. Plausible mechanisms for propranolol’s effect include vasoconstriction, inhibition of angiogenesis, induction of endothelial cell apoptosis, increased pericyte contractility, and modulation of adipogenesis/hemangioma stem cell differentiation.

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