The Derm Resident: Boards Fodder and Clinical Pearls for Dermatology Residents – Détails, épisodes et analyse

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The Derm Resident: Boards Fodder and Clinical Pearls for Dermatology Residents

Jonny Hatch and Deven Curtis

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Fréquence : 1 épisode/5j. Total Éps: 14

High yield dermatology boards fodder and clinical pearls for derm residents, by derm residents.

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Données mises à jour le 27/10/2026

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Ep 14. Allergic Contact Dermatitis | Common Allergens, Patch Testing, and Treating of Acute Allergic Contact Dermatitis

lundi 26 octobre 2026 • Durée 45:32

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Allergic Contact Dermatitis: Type IV Hypersensitivity, Patch Testing, and High-Yield Allergens | The Derm Resident

Dr. Jonny Hatch and Dr. Deven Curtis review allergic contact dermatitis (ACD) as a type IV, T-cell–mediated delayed hypersensitivity, contrasting it with the more common irritant contact dermatitis (ICD), which is non-immunologic and can occur on first exposure. They outline sensitization (hapten-protein complex processed by Langerhans cells in lymph nodes) and elicitation on re-exposure with cytokine-driven spongiotic dermatitis, pruritus, and possible vesicles. Clinical clues include delayed onset in ACD, burning/stinging and rapid onset in ICD, and using distribution patterns (earlobes, periumbilical, eyelids, shoes, scalp). They explain patch testing logistics, grading, pitfalls (irritant reactions, angry back syndrome, false negatives), and ROAT. High-yield allergens include nickel, fragrance mixes/balsam of Peru, formaldehyde releasers, rubber accelerators, neomycin, cobalt, PPD, MI, acrylates, urushiol, textile dyes, and chromates in cement. Management emphasizes allergen avoidance aided by CAMP/SkinSafe and topical/systemic steroids for flares, noting rebound with short steroid courses.

00:00 Allergic Contact Dermatitis Overview
01:27 Allergy History Pearl
02:24 Irritant vs Allergic Dermatitis
05:54 Type Four Immunology Basics
07:10 Sensitization and Elicitation
12:00 Clinical Morphology and Timing
12:53 Distribution Pattern Clues
14:59 Patch Testing When and Why
17:33 Patch Testing How It Works
19:41 Reading Results and Pitfalls
22:47 High Yield Allergens List
34:34 Special Scenarios and Occupations
39:32 Treatment and Allergen Avoidance
43:43 Wrap Up and Resources

This episode is sponsored by Mind the Skin, a patent-pending, steroid-free, patch system. Learn more at mindtheskinlabs.com. Use code TDRP26 at checkout for 20% off.

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Ep 13. Hair Loss Bootcamp | Androgenetic Alopecia, Alopecia Areata, Telogen Effluvium, CCCA, LPP, FFA, Dissecting Cellulitis of the Scalp and MORE!

lundi 19 octobre 2026 • Durée 42:23

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Alopecia Boot Camp: Scarring vs Non-Scarring, Key Patterns, Dermoscopy Pearls, and First-Line Management | The Derm Resident

Contact: thedermresident.pod@gmail.com

Hosts Dr. Jonny Hatch and Dr. Deven Curtis present an “alopecia boot camp” framework focused on first distinguishing scarring (cicatricial) from non-scarring alopecia by assessing follicular ostia with dermoscopy, emphasizing that scarring implies permanent loss and requires urgent treatment at the active edge for biopsy and intralesional therapy. They review non-scarring causes including androgenetic alopecia (DHT-driven miniaturization, anisotrichosis; Hamilton-Norwood/Ludwig scales; minoxidil, finasteride/dutasteride, spironolactone in women, PRP and transplant with donor dominance), alopecia areata (CD8 attack, exclamation point hairs, yellow/black dots; ILK and FDA-approved JAK inhibitors baricitinib and ritlecitinib; totalis/universalis/ophiasis), telogen effluvium (delayed shedding after stressors; hair pull test; consider TSH and iron studies/ferritin), traction alopecia (fringe sign; may become scarring), and trichotillomania (broken hairs of varying length). Scarring alopecias covered include LPP/FFA (perifollicular erythema and tubular scale; hydroxychloroquine/doxycycline and steroids), CCCA (central centrifugal pattern; biopsy active border; discuss styling factors and PADI3), and rapid-fire pearls for DLE (follicular plugging), folliculitis decalvans (tufting; clindamycin/rifampin), dissecting cellulitis (boggy nodules/sinus tracts; follicular occlusion tetrad), and acne keloidalis nuchae (posterior scalp/neck plaques; consider laser/excision).

00:00 Alopecia Boot Camp
00:52 Why Hair Loss Is Hard
01:24 Scarring Versus Nonscarring
03:28 Follicular Ostia Clues
05:38 Androgenetic Alopecia Basics
08:05 Treating Pattern Hair Loss
08:34 Minoxidil ICU Story
12:08 Counseling and Transplants
13:44 Alopecia Areata Recognition
17:04 Areata Workup and Treatment
18:30 Telogen Effluvium Shift
20:31 Postpartum Shedding Explained
20:54 Hair Pull Test Basics21:50 When to Order Labs23:37 Traction Alopecia Red Flags26:21 Trichotillomania Patterns27:42 LPP and FFA Scarring Clues30:09 Treating LPP and FFA Early31:33 CCCA Diagnosis and Biopsy36:04 Rapid Fire Scarring Alopecias40:19 Clinic Safety Takeaways41:12 Boot Camp Wrap Up

Ep 12. Hidradenitis Suppurativa Bootcamp: Risk Factors, Clinical Features, and Management

lundi 12 octobre 2026 • Durée 34:10

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Hidradenitis Suppurativa (HS) Boot Camp: Diagnosis, Hurley Staging, Treatment Ladder & Surgical Options | The Derm Resident

Contact: thedermresident.pod@gmail.com

Dr. Jonny Hatch and Dr. Deven Curtis deliver a clinic-focused boot camp on hidradenitis suppurativa (HS), noting the misnomer (not a sweat-gland disease) and reviewing typical intertriginous involvement with painful nodules/abscesses and the pathognomonic double-ended open comedone. They discuss delayed diagnosis, stigma, family history, modifiable factors (smoking and obesity), and flare triggers (menses, friction, sweating, heat, diet). Hurley staging is outlined (I boils only; II recurrent abscesses with sinus tracts/scars; III diffuse interconnected tracts) with emphasis that severity and inflammation may not perfectly match stage. They highlight disease burden (pain, depression screening; associations with Crohn disease, PCOS, metabolic syndrome), exam pearls, and a treatment ladder: topicals (clindamycin with BPO), oral antibiotics (doxycycline, clinda/rifampin; rescue options), hormonal therapy, biologics (adalimumab, infliximab, IL-17 agents), and procedures (I&D, punch deroofing, deroofing, wide excision, reconstruction), plus counseling that HS is chronic, not due to hygiene, and requires ongoing support.

00:00 HS Boot Camp Intro
00:30 Name Origins and Misnomer
02:06 Classic Presentation and Diagnosis
05:04 Risk Factors and Flare Triggers
07:09 Hurley Staging Basics
11:12 Disease Burden and Comorbidities
13:13 Topicals and Lifestyle First Line
15:20 Oral Antibiotics and Escalation
16:58 Hormonal Therapy Pearls
20:00 Biologics for Moderate Severe HS
24:20 Surgical Options and Deroofing
29:38 Patient Counseling and Wrap Up

This episode is sponsored by Mind the Skin, a patent-pending, steroid-free, patch system. Learn more at mindtheskinlabs.com. Use code TDRP26 at checkout for 20% off.

Ep 11. Psoriasis Part 2: Psoriatic Arthritis, Topicals, Systemics, Biologics, and More

lundi 5 octobre 2026 • Durée 35:33

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Psoriasis Part 2: Differentials, Psoriatic Arthritis Screening, and the Psoriasis Treatment Ladder | The Derm Resident

Contact: thedermresident.pod@gmail.com

Hosts Dr. Jonny Hatch and Dr. Deven Curtis continue psoriasis with a focus on chronic plaque differentials, psoriatic arthritis, and a practical treatment ladder. They review mimickers including seborrheic dermatitis and lichen simplex chronicus (including “sebo-psoriasis”), mycosis fungoides prompting biopsy when plaques are treatment-resistant or atrophic, hypertrophic lichen planus on shins, and guttate-pattern differentials such as pityriasis rosea, pityriasis lichenoides chronica, and secondary syphilis. They emphasize screening for psoriatic arthritis (about one-third of patients; HLA-B27 association) using joint/back pain history, nail findings, and dactylitis, with rheumatology referral when appropriate. Treatments covered include topical steroids by site, calcipotriene, tazarotene, roflumilast foam, tapinarof, phototherapy (narrowband UVB preferred over PUVA), and systemic therapies (methotrexate with folate, cyclosporine, apremilast, acitretin) plus biologics (TNF, IL-17, IL-23, ustekinumab) and deucravacitinib, along with biologic prescreening (TB, hepatitis, CBC/CMP, vaccine counseling) and psoriasis comorbidity risks.

00:00 Show Intro and Disclaimer
00:29 Plaque Psoriasis Differentials
02:21 Guttate Mimickers
03:25 Screening for Psoriatic Arthritis
04:53 Topical Treatment Basics
06:32 Nonsteroid Topicals and New Agents
08:13 Phototherapy UVB and PUVA
10:45 Systemics Methotrexate Deep Dive
13:45 Cyclosporine and Oral Options
18:11 Biologics TNF Alpha Inhibitors
22:41 IL-17 Inhibitors Key Pearls
25:47 IL-23 and IL-12/23 Therapies
28:23 Deucravacitinib and Biologic Workup
30:46 Psoriasis as Systemic Disease
31:32 Closing Pearls and Wrap Up

This episode is sponsored by Mind the Skin, a patent-pending, steroid-free, patch system. Learn more at . Use code TDRP26 at checkout for 20% off.

Ep 10. Psoriasis Part 1: Pathophysiology, Clinical Features, and Variants

lundi 28 septembre 2026 • Durée 43:59

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Psoriasis High-Yield Review (Part 1): Epidemiology, Immunopathogenesis, Triggers, and Clinical Variants | The Derm Resident

Hosts Dr. Jonny Hatch and Dr. Deven Curtis review psoriasis for residents, covering historical confusion with leprosy, prevalence (about 2% worldwide; higher in the US/Canada), bimodal onset (20–30 and 50–60), and systemic burden including psoriatic arthritis and comorbid metabolic, cardiovascular, and mood disease. They discuss genetics (notably HLA-Cw6 at PSORS1) and modern immunopathogenesis centered on the IL-23/Th17/IL-17 axis, including keratinocyte–immune “vicious cycle,” neutrophilic histology (Munro microabscesses, spongiform pustules of Kogoj), and TNF’s broad role. The episode reviews disease memory, Koebner phenomenon, triggers (strep, stress, HIV, hypocalcemia, pregnancy, key medications), lifestyle associations, classic plaque features and signs (Auspitz, Woronoff), PASI scoring, and variants including guttate, erythrodermic, and pustular psoriasis (IL36RN/DITRA; spesolimab), plus scalp, inverse, nail, and rare mucosal involvement.

Contact: thedermresident.pod@gmail.com

00:00 Show Intro and Disclaimer
00:36 Psoriasis History Origins
02:06 Epidemiology and Onset
03:23 Systemic Burden Comorbidities
04:22 Genetics and HLA CW6
06:38 Modern Immune Model
08:43 Trigger to T Cell Cascade
12:02 Th17 Cytokines and Plaques
15:08 IL 23 Th17 Axis Explained
18:20 Histology Neutrophils and TNF
20:48 Disease Memory and Koebner
22:36 Triggers Infections Drugs Lifestyle
27:19 Plaque Psoriasis Clinical Exam
30:10 PASI Score Made Simple
32:37 Guttate and Erythrodermic Types
35:40 Pustular Variants and Genetics
40:11 Special Sites Nails Mucosa
42:14 Wrap Up and Part Two

This episode is sponsored by Mind the Skin, a patent-pending, steroid-free, patch system. Learn more at . Use code TDRP26 at checkout for 20% off.

Ep 9. Generalized Pruritus, JAK Inhibitors, and Other Itch Treatments with Diego Ruiz Dasilva, MD

lundi 21 septembre 2026 • Durée 40:08

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Chronic Pruritus Workup & Treatment Pearls (CPUO, Neuropathic Itch, Nemolizumab, JAKs) | The Derm Resident

Contact: thedermresident.pod@gmail.com

Dr. Jonny Hatch hosts Dr. Diego Da Silva, a chronic pruritus expert and host of Skin In the Game, to discuss a practical approach to itch. They outline an initial framework based on distribution (localized vs generalized), time course (with shorter duration and older age raising concern for malignancy), and morphology (primary lesions vs excoriations only). For localized itch without rash, they emphasize neuropathic etiologies (notalgia paresthetica, brachioradial pruritus, meralgia, dysesthesias), consider spine wear-and-tear, and discuss PT plus gabapentinoids and other neuromodulators. For generalized pruritus without rash, they review ROS for constitutional symptoms, recommend considering biopsy of “normal” itchy skin (e.g., CTCL, sarcoid), and suggest labs (CBC, CMP, TSH, A1C, SPEP/IFE, ferritin, vitamin D), chest X-ray, and BP testing/DIF. Treatment pearls include skincare, phototherapy, atopic-directed therapies (dupilumab, nemolizumab), JAK inhibitor counseling (noting shingles risk and “JAKne”), and empiric ivermectin for possible scabies; off-label options include low-dose naltrexone, dronabinol, and intranasal butorphanol, plus advice for residents to develop a niche and “declare” expertise.

00:00 Show Introduction
00:59 Why Itch Matters
01:26 Finding a Niche
04:44 First Steps in Pruritus
07:00 Localized Itch Workup
09:02 Neuropathic Itch Treatments
11:32 Generalized Itch Workup
14:32 Labs Imaging and Biopsy
17:54 Treating CPUO Like Atopy
21:49 Choosing First Biologic
22:27 Nemolizumab Itch Breakthrough
23:58 JAK Inhibitors Safety Reality
26:08 Managing Shingles And Jackne
28:05 Treating Jackne Options
28:54 Derms As Real Doctors
30:54 Low Dose Naltrexone Role
32:15 Scabies And Empiric Ivermectin33:09 Off Label Itch Rescue Meds35:42 Advice And Podcast Wrap Up

Ep 8. Atopic Dermatitis Management with Dr. Peter Lio Part 2 | Eczema Herpeticum/Kaposi’s Varicelliform Eruption, Infection Management, and the Atopic March

lundi 14 septembre 2026 • Durée 44:31

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Atopic Dermatitis Cases & Board Pearls: Eczema Herpeticum/Kaposi’s Varicelliform Eruption, Infection Management, and the Atopic March | The Derm Resident

Host dermatology resident Jonny Hatch and Dr. Peter Leo finish an atopic dermatitis episode with cases and board-focused pearls. They review recognition and urgent management of eczema herpeticum (crusted, punched-out lesions), emphasizing HSV PCR/culture, considering bacterial coinfection, empiric antivirals (valacyclovir/acyclovir) and when IV acyclovir/hospitalization is warranted, plus Tzanck smear and biopsy findings (three Ms). They discuss Kaposi’s varicelliform eruption etiologies including eczema coxsackium (supportive care, possible empiric antiviral while ruling out HSV, and onychomadesis) and a life-threatening eczema vaccinatum story. They cover the atopic march, transcutaneous sensitization, LEAP study implications, and why most eczema doesn’t improve with dietary restriction. Practical guidance includes treating impetiginized AD with drying compresses and topical mupirocin, limited oral antibiotics, updated views on bleach baths, bathing frequency, topical steroid potency by vehicle, dupilumab-associated conjunctivitis theories, IL-31-mediated itch, TSLP signaling, site-specific steroid absorption, and why JAK1 selectivity matters.

00:00 Podcast Intro
00:19 Eczema Herpeticum Case
02:04 Testing and Swabs
03:09 Empiric Treatment Plan
04:05 When to Hospitalize
05:27 Tzanck Smear Basics
06:53 Eczema Coxsackium Overview
07:33 Kaposi Varicelliform Story
10:21 Differentiating Coxsackium
11:32 Atopic March Explained
13:56 Diet and Food Allergy Myths
18:13 Bacterial Superinfection Case
20:11 Topicals and Tea Compresses
21:13 Bleach Baths Reality Check
22:01 Topicals Over Orals
23:50 Bleach Baths and Bathing
27:23 Eczema Herpeticum Drill
28:20 Steroid Potency Vehicles
29:11 Dupilumab Eye Effects
31:22 Itch Pathways Explained
32:22 Eczema Coxsackium Care34:58 Atopic March TSLP36:42 Steroid Absorption Sites37:30 Genital Itch Strategy39:49 JAK STAT6 and Future41:41 Wrap Up and Thanks

Ep 7. Atopic Dermatitis Management with Peter Lio, MD Part 1

lundi 7 septembre 2026 • Durée 55:24

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Atopic Dermatitis Treatment Ladder: Moisturizers, Topical Steroids, Nonsteroidals, Biologics, and JAK Inhibitors (with Dr. Peter Lio) | The Derm Resident

Contact: thedermresident.pod@gmail.com.

Host dermatology resident Jonny Hatch interviews Dr. Peter Lio about atopic dermatitis treatment, emphasizing moisturizers (prescriptive product guidance, National Eczema Association Seal of Acceptance, ointments/petrolatum for stinging) and topical corticosteroid selection by potency, vehicle, and body site, with counseling on rare but important adverse effects and steroid stewardship. They distinguish tachyphylaxis from topical steroid withdrawal, noting evolving recognition and potential mechanistic clues. The episode reviews nonsteroidal topicals (tacrolimus/pimecrolimus counseling, black box warning context, stinging mitigation, crisaborole limitations, roflumilast benefits/rare diarrhea, topical ruxolitinib efficacy and boxed warning counseling), then escalates to systemic therapy with phototherapy, biologics (dupilumab, tralokinumab, lebrikizumab, nemolizumab), and oral JAK inhibitors (upadacitinib, abrocitinib) including risks and lab monitoring. They also discuss limited roles for antihistamines, the Dr. Aron regimen compound, and phage-lysin anti-staph products, and preview part two.

00:00 Welcome and Guest Intro
00:51 Moisturizers as Foundation
02:45 Choosing Eczema Safe Products
05:27 Ointments for Sensitive Skin
07:07 Topical Steroid Ladder Basics
08:43 Potency Picks and Stewardship
11:18 Monitoring Steroid Side Effects
12:45 Eyelids and Steroid Sparing
14:19 Tachyphylaxis vs TSW
17:23 Steroid Mechanism of Action
18:51 Calcineurin Inhibitors Counseling
22:42 Eucrisa and PDE4 Reality Check
24:07 Roflumilast Practical Use
25:59 Topical JAK Inhibitor Opzelura
28:43 Placebo and Adherence
29:14 When to Escalate Care
29:41 Biologics Treatment Targets
31:57 ADCT Control Scoring32:45 Insurance Documentation Tips33:24 Dupilumab Side Effects34:15 Managing Eye Symptoms36:13 Head and Neck Flares37:37 Switching Biologics Strategy39:32 Nemolizumab Itch Control40:00 Oral JAK Inhibitors Overview41:45 Black Box Risk Counseling44:36 Lab Monitoring Schedule46:13 Antihistamines Reality Check47:51 Aaron Regimen Compound51:53 Bacteriophage Spray Future53:42 Closing and Next Steps

Ep 6. Atopic Dermatitis Pathophysiology, Clinical Features, Variants, and Biologics

lundi 31 août 2026 • Durée 55:10

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Atopic Dermatitis High-Yield Review: Etymology, Diagnosis, Pathogenesis, Cytokines, Microbiome, Distribution, and Mimickers | The Derm Resident

Email us: thedermresident.pod@gmail.com

Hosts Dr. Jonny Hatch and Dr. Deven Curtis review high-yield atopic dermatitis (AD), covering its 1923 “atopos” etymology, clinical definition, and the atopic march (AD/food allergy in infancy, asthma in childhood, allergic rhinoconjunctivitis in adolescence). They outline AAD diagnostic criteria: pruritus, classic age-specific morphology/distribution, and chronicity, plus intrinsic (IgE-associated) vs non–IgE AD. Pathogenesis is framed as barrier dysfunction, immune dysregulation, and microbiome alteration, highlighting filaggrin’s role, transepidermal water loss, increased skin pH, and unchecked kallikrein proteases; Netherton syndrome (SPINK5/LEKTI) is discussed. They review Th2→Th1 evolution, key cytokines (IL-4/13 targeted by dupilumab; IL-13-only agents; IL-31 “itch cytokine” and nemolizumab), Staph aureus colonization and impetiginization, age-based distribution patterns, site variants and stigmata (Denny-Morgan lines, white dermatographism, keratosis pilaris, ichthyosis vulgaris), complications (ocular disease, eczema herpeticum with IV acyclovir on boards), quality-of-life impact, biopsy rationale (spongiotic dermatitis, rule out mycosis fungoides), and common mimickers and differentials including seb derm, scabies, contact dermatitis, immunodeficiencies, hypereosinophilia causes, nummular dermatitis, SCC in situ, dyshidrotic eczema, and asteatotic eczema.

00:00 Welcome and Topic Setup
00:31 Atopic Derm Name Origin
01:59 What It Is and Atopic March
04:41 Diagnosis Criteria Essentials
06:13 IgE Types and Core Pathogenesis
08:32 Barrier Breakdown and Filaggrin
13:02 Proteases and Netherton Syndrome
15:11 TH2 to TH1 Cytokine Shift
18:09 Dupilumab IL4 IL13 Explained
21:24 IL31 The Itch Cytokine
23:57 Staph Aureus and Microbiome
27:10 Age Based Distribution Infants27:53 Age Based Distribution29:32 Site Specific Variants31:18 Head Neck Dupixent31:58 Atopic Stigmata Signs34:24 Ichthyosis And KP36:09 Ocular Complications37:55 Eczema Herpeticum Urgency40:07 Quality Of Life Burden42:27 When To Biopsy45:18 Mimickers And Immunodeficiency49:31 Eosinophilia Differential50:22 Rapid Fire Dermatitis53:25 Episode Wrap Up

Ep 5: Rosacea, Granulomatous Rosacea, Solid Facial Edema, Periorificial Dermatitis, etc. with Anuj Kunadia, MD

lundi 24 août 2026 • Durée 43:48

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Rosacea High-Yield Review: Subtypes, Triggers, Treatment Ladder, and Key Differentials (with Dr. Anuj Kunadia) | The Derm Resident

DermatoGraphix Discount Code (not an affiliate link): DERMNERDS30

Link to Rosacea Sketches

Dr. Jonny Hatch welcomes Dr. Anuj Kunadia, founder of DermatoGraphix, to review high-yield rosacea. They distinguish rosacea from acne by the absence of comedones and discuss subtypes: erythematotelangiectatic (erythema/telangiectasias, burning/stinging; often procedural treatment with PDL or IPL), papulopustular (topicals like azelaic acid, metronidazole, ivermectin; oral low-dose doxycycline; isotretinoin if refractory), phymatous (sebaceous hyperplasia/fibrosis; rhinophyma and other “phyma” sites; early isotretinoin vs surgical/laser debulking), and ocular (can precede skin findings; refer to ophthalmology and consider doxycycline). They cover pathogenesis including kallikrein-5/cathelicidin LL-37, Demodex association and ivermectin, common triggers, variants (granulomatous rosacea, rosacea fulminans, Morbihan disease), key differentials (seborrheic dermatitis, lupus), periorificial dermatitis management (stop steroids, pimecrolimus/doxycycline), and conclude with rapid-fire boards questions and an art-history rhinophyma example.

00:00 Welcome and Setup
00:19 Meet the Guest
00:44 Dermatographics Origin
01:52 Classic Rosacea Case
02:30 Rosacea Basics
03:08 Acne vs Rosacea
04:21 Rosacea Subtypes
04:49 ETR Features and Lasers
05:58 Pathogenesis and Demodex
08:55 Triggers and Photoprotection
11:46 Phymatous Rosacea
13:41 Ocular Rosacea Red Flags
15:15 Rare Rosacea Variants
19:34 Key Differentials
23:19 Treatment Ladder Overview24:23 Topicals for Redness26:19 Papulopustular Treatments30:19 Procedures for Rhinophyma31:03 Periorificial Dermatitis34:29 Periorificial Treatment Plan35:47 Rapid Fire Boards Quiz41:01 Fun Fact and Wrap Up

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The Derm Resident: Boards Fodder and Clinical Pearls for Dermatology Residents – Détails, épisodes et analyse

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