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A dermatologist’s guide to skincare from growing up to glowing up
Board-certified dermatologist (and mom) shares holiday shopping tips for teens and tweens. ROSEMONT, Ill. (Oct. 28, 2025) — As online skincare trends continue to capture the attention of tweens and teens (and major retailers roll out early holiday promotions), an AAD board-certified dermatologist offers guidance to help families cut through
Skin care for developing countries
Learn more about skin care for developing countries. The Academy offers grants to individuals and organizations to fund international volunteer and humanitarian projects under the SkinCare for Developing Countries program.
Career case study archives
Access the career case study archives of Dermatology World Directions in Residency. The archives are designed to help resident choose a subspecialty within dermatology. Read insider advice from dermatologists working in those subspecialties today.
If want to be a true leader, emulate the first president
I recently had a discussion with our departing chief resident as he was about to embark on his academic career at UCLA. He was looking for sage advice – I focused on the need to maintain enthusiasm, wonder, curiosity, and dedication to one’s patients, as we enter the turbulent seas
Is your margarita giving you a rash?
Dermatologist shines a light on the latest research in photocontact dermatitis SAN DIEGO (March 8, 2024) — Sun sensitivity and related skin conditions are often misunderstood. Foods, medications, and skincare products can trigger symptoms like itching, redness, blistering, or burning. One of the most common conditions is photocontact dermatitis, a
EHR use cases: Streamline operations and improve practice efficiency
Listen to Academy interviews with working dermatologists on how they use EHR templates to streamline operations and improve practice efficiency. Excerpts of each interview focus on particular areas of concern common to dermatologists, while the full interviews provide a wealth of practical advice.
Where can I find updated guidance on teledermatology?
Asked and Answered ... May 1, 2022 The Academy has recently launched an updated teledermatology toolkit for AAD members, including more in-depth information on: ... Starting teledermatology ... Workflow advice for small practices ... How to prepare staff for offering teledermatology ... Up-to-date coding and reimbursement information ... Advice on
Start the new year off with a fresh start (and skin)
Advice from a board-certified dermatologist on seeking cosmetic treatments ROSEMONT, Ill. (January 9, 2024) — With a rise in both public accessibility and visibility, cosmetic treatments are more popular than ever. Whether your New Year’s resolution is to improve your health or to look and feel your best, the most
How aligned are Redditor-driven recommendations with the current AAD acne guidelines?
Clinical Applications ... Dr. Schwarzenberger is the former physician editor of ... DermWorld . She interviews the author of a recent study each month. ... By Kathryn Schwarzenberger, MD, FAAD, October 1, 2024 In this month’s Clinical Applications column, DermWorld ... Physician Editor Kathryn Schwarzenberger, MD, FAAD, talks with Justin
Think that DIY acne trick is helping? Here’s what dermatologists want you to know
Board-certified dermatologist provides tips for clearer skin ahead of Acne Awareness Month ROSEMONT, Ill. (May 27, 2025) — Acne is one of the most common skin conditions, affecting nearly 85% of people at some point in their lives. With people increasingly turning to social media for skin care advice, at-home
Disaster strikes. Are you prepared?
Go to AAD Home ... Go to AAD Home ... Menu ... Experts offer advice on emergency preparedness planning. ... Experts offer advice on emergency preparedness planning. ... By Allison Evans, assistant managing editor “We went through hell after Hurricane Katrina. It was pandemonium. Talk about getting caught without any
We all know.
From the Editor ... Dr. Schwarzenberger is the former physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, FAAD, October 1, 2024 Ask any of us and we will confidently claim that no one knows more about skin, hair, and nails than a board-certified dermatologist. Unfortunately, social media offers an
From "slugging" to snail mucin
Dermatologists discuss popular social media trends impacting the skin. ... Feature ... By Emily Margosian, Assistant Editor, October 1, 2023 Social media and the skin have a long history together. For over 15 years, social media has been an ever-growing presence in nearly all facets of life: politics, commerce —
Five unsafe skin care trends to avoid
Advice from board-certified dermatologists to keep your skin healthy ROSEMONT, Ill. (Nov. 1, 2023) — Social media platforms are rife with skin care advice from a variety of sources, which can make it difficult to know how to approach the recommendations you find online. In recognition of National Healthy Skin
Start the presses!
Go to AAD Home ... Go to AAD Home ... Menu ... Experts offer advice on how to successfully manage media relations ... Experts offer advice on how to successfully manage media relations ... By Victoria Houghton, assistant managing editor When Anne Chapas, MD, arrived in New York City and
November
Issue ... November January February March April May June July August September October November December View digital flipbook In this issue ... From the Editor ... They are hot. What’s hot ... This month’s news from across the specialty Clinical Applications ... What can dermatologists do to advocate for expanded
Bad online review?
Go to AAD Home ... Go to AAD Home ... Menu ... Dermatology World explains why bad online reviews may not be so bad after all ... Dermatology World explains why bad online reviews may not be so bad after all ... By Ruth Carol, contributing writer Patients are increasingly
April
Issue ... April January February March April May June July August September October November December View digital flipbook In this issue ... From the Editor ... From the editor What's hot ... What's hot? Cracking the Code ... Coding and documentation clarity Acta Eruditorum ... Treating metastatic melanoma: Understanding a
June
Issue ... June January February March April May June July August View digital flipbook In this issue ... From the Editor ... Dermatology is bustin’ out all over What’s hot ... This month’s news from across the specialty DermWorld Insights and Inquiries ... A potential roadMAP for treating malignant atrophic
How can I safely run my practice and limit potential exposures during COVID-19?
Asked and Answered ... February 1, 2021 The AAD offers a step-by-step guide on running a dermatology practice during COVID-19, including advice on how to: ... Assess your community’s COVID-19 prevalence and operate at an appropriate capacity ... Clean and disinfect your practice ... Reorganize your practice to minimize patient
Does the Academy offer any PPE resources?
Asked and Answered ... January 1, 2021 Yes. The Academy’s Coronavirus Resource Center offers dermatology practices a wide variety of clinical guidance on COVID-19, including resources relating to PPE and medical supplies. These include: ... Advice for medical workers on how to protect their skin while using PPE ... Conservation
Cutaneous T-cell lymphoma
Old stains leaving new marks in dermatology Paraneoplastic Sarcoidosis? A Proposal to Revise and Rename the "Sarcoidosis-Lymphoma Syndrome" Brentuximab vedotin update and the #MeToo saga of the Reed-Sternberg cell Attending the masquerade ball with CTCL and alopecia areata ... All content found on Dermatology World Insights and Inquiries, including:
August
Issue ... August January February March April May June July August September October November December View digital flipbook In this issue ... From the Editor ... From the editor What's hot ... What's hot? Clinical Applications ... Guidelines for the management of hidradenitis suppurativa Feature ... Disaster strikes. Are you
Not what the doctor ordered?
Go to AAD Home ... Go to AAD Home ... Menu ... Pharmacists assume greater role in dermatology patient care ... Pharmacists assume greater role in dermatology patient care ... By Jan Bowers, contributing writer A critical member of the health care team, the pharmacist not only dispenses medication, but
What is being recommended to patients on social media?
Facts at your Fingertips ... By Emily Margosian, Assistant Editor, October 1, 2023 Social media is abundant with skin care advice. A recent ... JAAD cross-sectional analysis of acne treatments on YouTube found that up to 91% of teens report using social media to access health information. However, who is
Optimizing financial efficiency: Part 3
Experts offer advice on best practices for monitoring and auditing income. ... Feature ... By Megan Bennett, Staff Writer , July 1, 2026 The dermatologist sees their patient, finalizes their notes, closes the chart, and submits their claims. ... However, the revenue cycle is far from over. ... Careful consideration
Adapting with intention: Tips for joining an established practice
Answers in Practice ... By Emily Margosian, Senior Editor, July 1, 2025 DermWorld ... talks to Brittany Smirnov, DO, FAAD, about advice on assimilating to a new work culture when joining an established practice. DermWorld: Tell us about your practice. Brittany Smirnov, DO, FAAD ... Dr. Smirnov: I practice in
San Francisco dermatologist advances innovative treatment on FDA committee
American Academy of Dermatology honors Dr. Kenneth Katz as National "Patient Care Hero" ROSEMONT, Ill. (April 11, 2022) - San Francisco board-certified dermatologist Kenneth Katz, MD, MSc, MSCE, FAAD, was named an American Academy of Dermatology ... Patient Care Hero for his work leading a national advisory committee at the
Good advice?
Go to AAD Home ... Go to AAD Home ... Menu ... What is the USPSTF and what do its skin cancer counseling recommendations mean for the specialty and its patients? ... What is the USPSTF and what do its skin cancer counseling recommendations mean for the specialty and its
Caring for their own
DW Weekly spoke with Tufts University medical student Haya Raef, and Jennifer Tan, MD, dermatology faculty member at Massachusetts General Hospital about their efforts to create COVID-19 skin care and hygiene kits for individuals experiencing homelessness in the Boston and Portland, Maine area.
Full disclosure
From the Editor ... Dr. Schwarzenberger is the former physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, FAAD, June 1, 2023 Many of you know that I am married to an ob-gyn, so treating pregnant patients has always been easy for me. Even in the middle of the night,
Optimizing financial efficiency: Part 2
Experts offer advice on best practices for documentation and filing claims. ... Feature ... By Megan Bennett, Staff Writer, June 1, 2026 Proper documentation of a patient’s care during and after an appointment can make or break the chances of timely and appropriate reimbursement. ... "Overall, the issue isn’t just
iPLEDGE changes
Ask the Expert ... By Victoria Houghton, Managing Editor, July 1, 2023 DermWorld ... spoke to Stephanie Croney, JD, assistant director of regulatory policy for the American Academy of Dermatology Association (AADA), about the recent FDA advisory committee meeting on recommended changes to the iPLEDGE REMS program. DermWorld : Recently,
Pathways: Inclusivity in Dermatology to increase number of Black, Latino, and Indigenous physicians in dermatology
American Academy of Dermatology collaboration with Johnson & Johnson Consumer Health and the Janssen Pharmaceutical Companies of Johnson & Johnson will double representation in next 5 years. ROSEMONT, Ill. (March 23, 2022) — People of color often face unequal access to health care and experience poorer outcomes across the health
How to treat acne
Board-certified dermatologist offers skin care advice to help you get the best results from your acne treatment ROSEMONT, Ill. (November 17, 2022) — Acne is the most common skin condition in the United States, affecting up to 50 million Americans annually. As your body’s largest organ, it’s important to take
Who do you turn to?
From the President ... Dr. Cronin served as Academy president from March 2023 to March 2024. ... By Terrence A. Cronin Jr., MD, FAAD, June 1, 2023 Dr. Cronin speaking at the Plenary at the 2023 Annual Meeting in New Orleans. ... When you need financial advice where do you
Optimizing financial efficiency: Part 1
Experts offer advice on best practices to ensure financial health before the appointment begins. ... Feature ... By Megan Bennett, Staff Writer, May 1, 2026 When opening her private practice in 2022, Suzanne McGoey, MD, MPH, FAAD, also discovered the challenges of managing the business of medicine. ... "We do
From the editor
From the Editor ... Dr. Schwarzenberger is the former physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, March 1, 2019 Learning to say no. For some of us, this is one of the hardest things we do. However, it is a skill needed by those of us who chronically
Reimagining the Rolodex
Experts offer advice on how to build stronger patient and referral networks. ... Feature ... By Andrea Neirmeier, Contributing Writer, November 1, 2025 Before digital address books and smartphones, a full Rolodex on the corner of a desk symbolized a large professional network. Today, along with basic marketing, social media,
Malpractice insurance 101
Experts offer advice on navigating malpractice insurance policies. ... Feature ... By Andrea Niermeier, Contributing Writer, February 1, 2025 While medical malpractice suits first regularly appeared in the United States in the 1800s, the frequency of claims has only increased since the 1960s, with lawsuits relatively common today. Medical malpractice
A simple stripe or a red flag?
Experts share advice for the often-tricky triage of nail pigmentation. ... Feature ... By Heidi Splete, Contributing Writer, November 1, 2025 Lines or streaks on the nails are not uncommon, but deducing the cause of these discolorations is essential for separating benign melanonychia from nail unit melanoma (NUM). ... Melanonychia,
Misinformation puts over 16 million Americans at an increased risk for skin cancer
New data from the American Academy of Dermatology reveals misinformation drives adults to cut back or stop using sunscreen Survey data show influence of social media, misconceptions, and gaps in sun safety knowledge – especially among Gen Z Gen Z is flunking sun safety, with one-third scoring a D or
Avoid the opioid
Experts offer advice on effective pain management in dermatology. ... Feature ... By Heidi Splete, Contributing Writer, May 1, 2026 Many dermatoses and dermatologic procedures are painful, but consensus on pain management in dermatology is limited, and complicated not only by the individual and varied experience of pain, but also
Aiming to hit the target in cutaneous granulomatous diseases
DermWorld discusses the latest treatment strategies for granulomatous skin diseases, and clinical advice for how to manage patients in the absence of approved therapies. ... Feature ... By Heidi Splete, Contributing Writer, February 1, 2026 Approved treatments for granulomatous skin diseases are lacking, but a growing number of case series
International volunteerism resources
Browse AAD's international volunteer opportunities and resources. Part of the Academy's mission, as enacted through the Education and Volunteers Abroad Committee (EVAC), is to improve dermatologic care to those in underserved areas through education and service.
American Academy of Dermatology survey shows Gen Z adults at risk for skin cancer due to increasing rates of tanning and burning
Board-certified dermatologist urges sun protection to prevent skin cancer ROSEMONT, Ill. (May 14, 2024) — A new survey from the American Academy of Dermatology revealed that Generation Z adults, ages 18-26, are at risk for skin cancer due to increasing rates of tanning and burning. To encourage safe sun habits,
Academic leadership in dermatology: Heeding to advice from surgical chairs
It is irrelevant that the “good old days” of the omniscient chairs of hierarchical departments are a relic of the past. While I will acknowledge that life may have been simpler decades ago, perhaps it was not better (except for the chief!).
American Academy of Dermatology survey: half of Americans worry about skin aging, but many still skip sunscreen
Board-certified dermatologist encourages public to incorporate sun protection into daily skin care routine ROSEMONT, Ill. (May 6, 2025) — A recent American Academy of Dermatology survey of more than 1,000 U.S. adults found that half worry about premature skin aging and only half use sunscreen regularly, while nearly 1 in
New coding content offers expert advice
The Academy continues to add to its expansive list of its coding resources.
Free skin cancer screenings at a shelter for displaced and unhoused veterans
Stephanie Choi, a medical student at UMass Memorial Medical Center, sought to bring dermatology care to the underserved.
Beef tallow for eczema: Grade A prime or just another bum steer?
Dermatologists must take the bull by the horns and inform patients that beef tallow for eczema is far from being an optimal moisturizer.
Solo practice
Solo dermatology practice offers full autonomy and control for physicians who want to run and manage their own clinic. While this model presents challenges, especially in today’s environment of practice consolidation, it remains a viable and rewarding path for dermatologists who value flexibility, long-term patient relationships, and entrepreneurial freedom.
Your Dermatologist Knows media wins 2024
A key part of Your Dermatologist Knows is pitching stories to media outlets in hopes they’ll run news stories sharing information about the wide breadth of knowledge dermatologists have to their readership. We consider every new story published as a result of our pitches as a win, regardless of whether
What’s new and what can I expect from the 2025 Annual Meeting?
Asked and Answered ... December 1, 2024 Get ready to register for a magical experience in Orlando, Florida! ... 2025 AAD Annual Meeting attendees can expect some exciting new offerings alongside the top-tier education you expect from the AAD. ... What’s new ... Opening Ceremony, Friday, March 7 from 5:00
June 19, 2024
Derm World Weekly - A Publication of the American Academy of Dermatology | Association ... IN THIS ISSUE / June 19, 2024 ... Neuropsychiatric diagnoses after isotretinoin initiation in pediatric acne patients DermWorld Insights and Inquiries : Advances in pruritus therapeutics — It’s Greek to us Efficacy of treatment options
Albinism awareness gets a makeover
In Practice ... Victoria Williams, MD, is an assistant professor of clinical dermatology at the University of Pennsylvania. ... By Emily Margosian, assistant editor, May 1, 2019 "What really struck me was that there were no dermatologists on the ground there," recalls Victoria Williams, MD, assistant professor of clinical dermatology
The AAD and the international arena
From the President ... Dr. Tomecki served as Academy president from March 2021 to March 2022. ... By Kenneth Tomecki, MD, FAAD, October 1, 2021 The Academy is clearly a national organization, but it has appreciable international reach and influence in other countries. The Academy has more than 16,000 U.S.
This month’s news from across the specialty
What’s hot ... August 1, 2023 In this monthly column, members of the ... DermWorld Editorial Advisory Workgroup identify exciting news from across the specialty. ... Craig Burkhart, MD, MS, MPH, FAAD SARMs is a growing and dangerous social media trend. ... The U.S. Food and Drug Administration (FDA)
Providing free skin cancer screenings and advice on sun safety and skin cancer prevention
Learn how AAD member Susan Boiko, MD, volunteered to screen patients during Skin Cancer Awareness Month.
Your Dermatologist Knows media wins 2026
A key part of Your Dermatologist Knows is pitching stories to media outlets in hopes they’ll run news stories sharing information about the wide breadth of knowledge dermatologists have to their readership. We consider every new story published as a result of our pitches as a win, regardless of whether
Eye-opening news about oxymetazoline
Read the April 27, 2022 DermWorld Insights and Inquiries on eye-opening news about oxymetazoline.
June 8, 2022
Derm World Weekly - A Publication of the American Academy of Dermatology | Association ... IN THIS ISSUE / June 8, 2022 ... The administrative burden of prescribing isotretinoin DermWorld Insights and Inquiries : Sweating over acquired idiopathic generalized anhidrosis AADA counters IPMG objections to iPLEDGE improvements Actinic keratosis guidelines
May 29
Learn more about May 29 at aad.org
IL-36 and generalized pustular psoriasis: L’chaim!
Read the March 9, 2022 DermWorld Insights and Inquiries on IL-36 and generalized pustular psoriasis.
Tarrying for tapinarof
Read the January 12, 2022 DermWorld Insights and Inquiries on tapinarof.
ChatGPT enters the chat
Dermatologists discuss the possibilities — and pitfalls — of ChatGPT in clinical practice. ... Feature ... By Emily Margosian, Assistant Editor, April 1, 2024 Design a webpage. Make a content strategy. Answer medical questions. Write an essay about trickle-down economics in the style of a Taylor Swift song. The possibilities
#DermTwitter @ a glance
Go to AAD Home ... Go to AAD Home ... Menu ... Dermatologists harness the twittersphere for clinical discussion, patient education, and more ... Dermatologists harness the twittersphere for clinical discussion, patient education, and more ... By Emily Margosian, assistant editor Among the now 321 million Twitter users currently on
Supplements and the skin
Are nutritional supplements aimed at skin care helpful, harmful, or simply a placebo for patients? ... Feature ... By Heidi Splete, Contributing Writer, July 1, 2023 Nutritional supplements appeal to many individuals as an alternative or additive treatment for skin and hair ailments, but evidence to support the effectiveness of
Cutaneous green and E-A-G-L-E-S!
Dermatologists will be seeing a lot of green in their offices the next two weeks, especially here in the Delaware Valley, in anticipation of Super Bowl LII in Minneapolis on February 4th, 2018.
AAD mentorship programs for early-career dermatologists
Explore the AAD’s mentorship and leadership programs for early-career dermatologists. Find flash mentoring, leadership training, and career resources.
A new spin
Go to AAD Home ... Go to AAD Home ... Menu ... Examining the theory behind the use of platelet rich plasma for dermatologic procedures ... Examining the theory behind the use of platelet rich plasma for dermatologic procedures ... By Victoria Houghton, assistant managing editor Professional football players, world-renowned
May
Issue ... May January February March April May June July August View digital flipbook In this issue ... From the Editor ... Easing the pain of dermatology What’s hot ... This month’s news from across the specialty DermWorld Insights and Inquiries ... Granular C3 dermatosis in granular detail Feature ...
Can posting about patients on social media get you into trouble?
Legally Speaking ... Daniel F. Shay, Esq. is a health care attorney at Alice G. Gosfield and Associates, P.C. ... By Daniel F. Shay, Esq., March 1, 2018 From the humble beginnings of now-nearly-forgotten sites such as Friendster and MySpace, long before the age of SnapChat and Instagram, social media
Refusal of medical treatment
Legally Speaking ... Clifford Warren Lober, MD, JD, presents legal dilemmas in dermatology every other month. He is a dermatologist in practice in Florida and a partner in the law firm Lober, Brown, and Lober. ... By Clifford Warren Lober, MD, October 1, 2019 Question: When can a patient refuse
I was scammed into registering for a fake meeting. How can I verify an Academy meeting is legitimate?
Asked and Answered ... April 1, 2020 Most meeting fraud can be avoided by verifying the authenticity of a registration site before providing any personal or financial information. ... Registration for official AAD/A meetings should only be done through the Academy’s website and the AAD’s legitimate registration and housing partner,
Meet the newest Your Dermatologist Knows correspondents
Answers in Practice ... By Matthew Walsh, Member Communications Specialist, March 1, 2025 DermWorld ... talks to Charlie Dunn, MD, FAAD, and Preetha Kamath, MD, FAAD, about the Academy’s Your Dermatologist Knows consumer positioning strategy and what they bring to their new roles as campaign correspondents. DermWorld: What made you
Strategic debt repayment: What young dermatologists should know
Money Matters ... Mandell is an attorney and author of more than a dozen books for doctors. He is a partner in the wealth management firm OJM Group (www.ojmgroup.com), where he can be reached at 877-656-4362 or mandell@ojmgroup.com. ... By David B. Mandell, JD, MBA and Myhanh Hoskin, CFP®, CWS®,
A nail-biting commentary
Read the Feb. 15, 2023 DermWorld Insights and Inquiries on nail biting.
Curbside consult or formal medical consultation?
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, D.C. ... By Megan La Suer, JD, MHA, and Rob Portman, JD, MPP, December 1, 2020 Every month, DermWorld ... covers legal issues in "Legally Speaking." This month’s authors
Patient preference in dermatologist attire: A lesson from “Annie”
The physician-patient relationship is predicated on trust and confidence. Impressions form rapidly and physician attire is an important component on how patients perceive their physician(s).
Leadership succession: Sunrise, sunset
Advancing to become a chair of dermatology, or any position of authority, can be daunting. The skills that promoted you may not provide the skills necessary for success. Take advantage of educational resources, mentors, and colleagues for their collective wisdom.
From the editor
From the Editor ... Dr. Schwarzenberger is the former physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, April 1, 2019 A lot has changed in medicine over the past 20 years. We have new diseases, new understanding of old diseases, and innumerable new medications with which to practice our
One less headache to worry about: Using Isotretinoin in patients with a history of pseudotumor cerebri
I have been prescribing isotretinoin since it was first introduced over thirty years ago, having encountered just a few patients with truly suspect pseudotumor cerebri (PTC).
Direct-to-consumer telemedicine websites: Caveat emptor, a prediction, and proposal
Two weeks ago, I experienced pain extending from my right groin to my buttock to the degree that I almost could not bear weight. I felt as though I was 90, and if anyone saw my gait, they would have reached that conclusion. If there were an app for my
Mea culpa: The truth about Grover Cleveland’s cancer!
I want to apologize to every resident that I taught over the years, misinforming them that Grover Cleveland did not have oral cancer, but rather necrotizing sialometaplasia.
Step 2: Learn the MIPS categories
Determining what you have to report depends on the MIPS categories and their various requirements. These tools and resources will help you learn more about the MIPS categories ahead of the next step, which gives guidance on how to meet the requirements.
Step 1: Check participation requirements
The first step of the Academy's 3-step MIPS guide enables dermatologists to determine whether they are exempt from MIPS reporting. Dermatologists who do not meet certain Medicare participation thresholds are not subject to MIPS reimbursement penalties, though they optionally participate to earn incentives.
Minimizing the risk of medical malpractice liability related to COVID-19 public health emergency
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, D.C. ... By Megan La Suer, JD, MHA, and Rob Portman, JD, MPP, August 1, 2020 Every month, Dermatology World ... covers legal issues in "Legally Speaking." This month’s
Vicarious liability
Legally Speaking ... Every month, DW covers legal issues in "Legally Speaking." Clifford Warren Lober, MD, JD, presents legal dilemmas in dermatology every other month. He is a dermatologist in practice in Florida and a partner in the law firm Lober, Brown, and Lober. ... By Clifford Warren Lober, MD,
Leading when you’re not the practice owner
Answers in Practice ... By Megan Bennett, Staff Writer, November 1, 2025 DermWorld ... talks to Sama Carley, MD, FAAD, chief of dermatologic surgery at Sharp Rees-Stealy in San Diego, about exhibiting leadership qualities even when you don’t lead the practice. DermWorld: Tell us about your practice. Dr. Carley: The
Dermatology World Insights and Inquiries
Learn more about Dermatology World Insights and Inquiries at aad.org
DW Insights and Inquiries archive
Learn more about DW Insights and Inquiries archive at aad.org
Scratching from A Hard Day’s Night? Meet the beetles!
One of my least favorite encounters in dermatology is telling patients that it looks like they have insect bites.
2026 exemption reweighting
See this more detailed information on how the various MIPS categories are reweighted if you gain an exemption from one or more categories in 2026.
2025 exemption reweighting
See this more detailed information on how the various MIPS categories are reweighted if you gain an exemption from one or more categories in 2025.
Dermatology Match Day: The ecstasy and the agony
In February, 1979, one month prior to matching in internal medicine at NYU/Bellevue Hospital, I took a dermatology elective under the tutelage of Dr. Michael Fisher at the Albert Einstein College of Medicine. What an epiphany – a fascinating discipline that matched my skill set! In March, I applied
How to meet two common wealth-planning goals using the same ‘medicine'
Money Matters ... Mandell is an attorney and author of more than a dozen books for doctors. He is a partner in the wealth management firm OJM Group (www.ojmgroup.com), where he can be reached at 877-656-4362 or mandell@ojmgroup.com. ... By David B. Mandell, JD, MBA, April 1, 2026 In working
Say it ain’t so: Dark chocolate exacerbates acne!
Diet and acne has always been controversial. When I was a child I heard that pizza and chocolate could lead to break-outs; over time that was relegated to be a myth (thank goodness).
Nails
Breaking the terbinafine laboratory habit for onychomycosis Biting my nails worrying about atypical presentations of nail unit melanomas Dyeing for a "new" topical agent for psoriasis? Think indigo Clawing to understand lichen nitidus Cutaneous green and E-A-G-L-E-S! Nailing the diagnosis of psoriatic arthritis ... All content found on Dermatology
Dermatologic surgery
Transplantation dermatology: Race matters Breaking up (with habits) is hard to do: The role of platelet transfusions when performing skin biopsies on profoundly thrombocytopenic patients Angiosarcomas and morbid obesity: An enormous problem Nom de plume: Affaire risquée A surgical pearl (in waiting) for the medical dermatologist Patients’ (mis)understanding of their
Fifty shades of black salve
Diet and acne has always been controversial. When I was a child I heard that pizza and chocolate could lead to break-outs; over time that was relegated to be a myth (thank goodness).
New Medicare cards
In Practice ... Rachna Chaudhari is the AAD's practice management manager. Her column offers tips in response to common member questions. ... By Rachna Chaudhari, MPH, director of practice management, April 2, 2018 ... The Centers for Medicare and Medicaid Services (CMS) recently announced that it would be changing your
The Academy has something for everyone
From the President ... Dr. Thiers served as Academy president from March 2020 to March 2021. ... By Bruce Thiers, MD, January 1, 2021 Welcome, 2021! January always brings the inevitable questions about New Year’s resolutions and change, so what’s in store for you this year? Are you considering retirement?
Leadership story by Kelly M. Cordoro, MD, FAAD
Leadership Development Steering Committee chair Kelly M. Cordoro, MD, FAAD is strengthening and expanding the programs and offerings of the Leadership Institute.
DW Insights and Inquiries archive
Learn more about DW Insights and Inquiries archive at aad.org
Acne/rosacea
Putting muscle into isotretinoin laboratory testing isn’t chopped liver! Stress2 + Hormones2 = Acne2 The rosy reality of coffee Why we do what we do Scarred by dogma: Revising recommendations for surgery and isotretinoin use A novel sebum inhibitor for acne vulgaris: A slick maneuver Got milk? Got acne? Low
Evolution of mentorship in medicine
Experts discuss a recent paradigm shift in the look and feel of mentorships. ... Feature ... By Ruth Carol, Contributing Writer, July 1, 2023 What are your core values? It’s not the typical question mentees would have been asked years ago but one they may be asked now as mentorships
2026 DW Insights and Inquiries archive
Explore past issues of DW Insights and Inquiries that were published in 2026.
April
Issue ... April January February March April May June July August September October November December View digital flipbook In this issue ... From the Editor ... From the editor Asked and Answered ... I have a job opening at my practice. Where can I post it? What's hot ... What's
Mastering dermatology
Patients expect their physicians to be clinical masters. Dermatology can never be mastered — the discipline is too dynamic and humbling. Regardless, we should all strive to master our field to the best of our ability.
Dermatitis
Parabens — A common allergen with lots of hype and no real harm Finding Joy in pediatric phototherapy Should dermatologists be anti-antihistamine for atopic dermatitis? Aha! The iodide paradox now makes sense! Dupilumab’s conjunctivitis conundrum Dupilumab: The first year The medical word to watch in 2018: Dysbiosis Hairdressers’ dermatologic odyssey:
February
Issue ... February January February March April May June July August View digital flipbook In this issue ... From the Editor ... All you need is love. What’s hot ... This month’s news from across the specialty DermWorld Insights and Inquiries ... Deeper thoughts about acne keloidalis nuchae Feature ...
Five myths about HIPAA
Legally Speaking ... Daniel F. Shay, Esq., is a health care attorney at Alice G. Gosfield and Associates, P.C. ... By Daniel F. Shay, Esq., November 1, 2022 DermWorld ... covers legal issues in "Legally Speaking." This month’s author, Daniel F. Shay, Esq. is a health care attorney at Alice
Holy dermatology, Batman!
Balance in practice ... By Emily Margosian, assistant editor, August 1, 2020 Each month, Dermatology World ... addresses issues "in practice" for dermatologists. This month, Philip Latham, MD, talks about his passion for Batman-inspired car remodels. "You can’t just go down and tell the guy at the auto store that
41’s gracious contribution to skin cancer awareness
The author reflects on pen pal relationship with George H.W. Bush.
Joining the “fold”: Squamous cell carcinoma complicating porokeratosis ptychotropica
I know the variants of porokeratoses and can recite them as though I am the very model of a modern major general — Mibelli, linear, punctate, palmoplantar, DSAP, superficial disseminated, immunosuppression-related, and porokeratosis ptychotropica (PP).
Physicians love to be recognized
From the Editor ... Dr. Schwarzenberger is the former physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, FAAD, April 1, 2023 Unless it is for the wrong reason. Our colleagues who have received the dreaded "outlier" letter from insurers almost certainly would agree. The growing trend for insurers to
Psoriasis
Finding Joy in pediatric phototherapy The newest frontier for biologics and psoriasis may be adherence Coughing up a new warning for ustekinumab Tofacitinib: A JAK inhibitor of all trades Psoriasin: Its other meaning and implications Asking Psoriasis Patients to Open Their Mouths and Say "Ahhh" Dyeing for a "new" topical
Understanding payer contracts
Although payer contracts differ, they share some key elements. Understanding common terms and concerning provisions can inform your review of payer contracts and help you look out for the best interests of your practice and patients.
February
Issue ... February January February March April May June July August September October November December View digital flipbook In this issue ... From the Editor ... It was simpler back then. What’s hot ... This month’s news from across the specialty Clinical Applications ... What can be done to reduce
Fighting for truth in advertising in Indiana
Ask the Expert ... By Victoria Houghton, Managing Editor, August 1, 2022 DermWorld ... spoke to Carrie Davis, MD, FAAD, former chair of the Government Affairs and Advocacy Committee at the Indiana Academy of Dermatology, about efforts with the American Academy of Dermatology Association (AADA) to advocate for truth in
Off-label but not off-limits
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, D.C. ... By Ben Tesdahl, JD, LL.M, Megan La Suer, JD, MHA, and Rob Portman, JD, MPP, June 1, 2021 Every month, DermWorld ... covers legal issues in "Legally
Dermatologic ergonomics: Straighten up and fly right
Ergonomic training should start with residency and continue throughout a career to avoid potentially serious musculoskeletal injury.
Loss and legacy: A tribute to Robert F. Duffy, MD
Moments such as these force us to stop, reflect, and prioritize what is important in life. Dr. Duffy enriched my life in so many ways. I want to honor him by asking you to spend a few moments reading the eulogy I delivered on May 22, 2025 — all of
Perianal dermatologic exams are looking up
Every dermatologist confronts how to ask a person to disrobe for a full body skin examination. Ultimately, I came up with the following line when asked what should be exposed: “The more of you I see, the better off you are – please get undressed to your level of comfort”.
It was simpler back then.
From the Editor ... Dr. Schwarzenberger is the former physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, FAAD, February 1, 2025 Skin care in my youth was not a big deal. We washed our face with soap or Noxzema, cleansed our pores with astringent-soaked cotton balls (Sea Breeze was
Neurofibromatosis type 1, juvenile xanthogranuloma, and leukemia: Wasting a good worry?
Worry comes with the territory of Neurofibromatosis Type I (NF-1). It often starts with the anxiety of determining if a child has enough criteria to confirm the diagnosis.
A burning question: Should patients receive the zoster vaccine after an episode of shingles?
The question as to whether a patient should receive the vaccine after having had herpes zoster (HZ) has been asked since the initial release of the vaccine. There has been remarkably little data to help guide the clinician.
Private equity ownership
Private equity (PE) and venture capital (VC) groups have increasingly invested in dermatology practices, attracted by the specialty’s fragmentation, growth potential, and multiple revenue streams. These firms acquire independent practices, consolidate them into larger groups, and apply skilled management to improve efficiency and profitability.
Read all about it: Dermatology's media impact
Facts at your Fingertips ... By Emily Margosian, assistant editor, April 1, 2019 There’s nothing fake about this news: In 2018, the Academy generated nearly 9 billion media impressions in print and online. Despite the unpredictability of the current media landscape, the specialty’s public impact has remained stable with a
Hair
Slivers of skin may diagnose silver hair syndromes Laboratory testing for syphilitic alopecia: Time to renew old habits? Adjusting the screen door: Developing a rational approach to assessing for thyroid disease in patients with alopecia areata Hairdressers’ dermatologic odyssey: From dye to death prevention Alopecia areata incognita in Cronkhite-Canada syndrome
July
Issue ... July January February March April May June July August View digital flipbook In this issue ... From the Editor ... Keeping a cool head in July What’s hot ... This month’s news from across the specialty DermWorld Insights and Inquiries ... Human papillomavirus 42: Putting a finger on
I have a job opening at my practice. Where can I post it?
Asked and Answered ... April 1, 2019 You have options! ... AAD members can post job openings at their practice either: ... Online through AADCareerCompass at ... www.healthecareers.com/aad/search-jobs , hosted through Health eCareers, an AAD Preferred Provider. ... OR In print and online through the classifieds section of ... Dermatology
Your Dermatologist Knows secures traditional media wins
Since its launch in October 2022, the AAD’s Your Dermatologist Knows consumer positioning strategy has garnered major print, TV, and online media successes. As of Aug. 30, 2025, Your Dermatologist Knows-related efforts by the Academy have resulted in over 8,100 media placements in news outlets with a reach of 100,000
Building relationships and building leadership
Read the inspiring story of how networking helped AAD member Benedict Wu, DO, PhD.
American Academy of Dermatology Website Terms of Use
The American Academy of Dermatology's Terms of Use outlines the rules, specifications, and requirements for the use of it's website.
Step 3: Small and large practice reporting options
See the various reporting options for small and large practices for MIPS.
Step 3: Small and large practice reporting options
See the various reporting options for small and large practices for MIPS 2024.
Atrophic tinea versicolor: More than a mirage?
On occasion I would examine a patient with tinea versicolor and wonder if the finely scaly patches were atrophic. Somehow, I figured (possibly mistakenly) that it was more of an optical illusion than genuine atrophy.
Ongoing best practices for HIPAA
Legally Speaking ... Daniel F. Shay, Esq., is a health care attorney at Alice G. Gosfield and Associates, P.C. ... By Daniel F. Shay, Esq., March 1, 2024 DermWorld covers legal issues in "Legally Speaking." This month’s author, Daniel F. Shay, Esq. is a health care attorney at Alice G.
Digital strategy for dermatologists
Answers in Practice ... By Emily Margosian, Assistant Editor, May 1, 2024 DermWorld ... talks to Lindsey Zubritsky, MD, FAAD, from Premier Dermatology and Skin Cancer Center in Ocean Springs, Mississippi, about tips for building a digital strategy and online presence. Lindsey Zubritsky, MD, FAAD ... DermWorld: Tell us about
Hair repigmentation in frontal fibrosing alopecia
One of the major joys of practicing dermatology is that I’m stumped by something every day. Today an 81 year-old woman complained of months of hair loss along the frontal scalp with some loss of eyebrow hair. She had alopecia, follicular prominence, and the “lonely hair” sign. A classic case
Recommended mentoring topics
Discover common topics explored in mentorship relationships and helpful tips for navigating them, including work/life balance, career advancement, and managing conflict.
Are you part of our AAD Clinical Community?
Launched earlier this year, your new online AAD Clinical Community is living up to its name and growing into a large, vibrant community! This new member benefit provides AAD members a moderated space to collaborate on clinical cases, advance medical skills and knowledge, and participate in a forum to educate
Medical Ego Inflation and a Lesson from Mom
Last week my 95-year-old mother literally returned from the deceased. In classic Hollywood motif, my cousin Elysa, who was at her bedside when she was moribund, was pleading for me to desperately get to there, demanding that the attending do something, as he was asking her about her DNR status.
To concierge or not concierge, that is the question
After very long days of difficult patients (diagnostically, therapeutically, and otherwise), insurance denials, prior authorizations, business decisions, MACRA, et cetera, I think of the milkman Tevye from “Fiddler on the Roof”, finally sitting down, and singing “If I Were a Rich Man”. I’ll even spring for a few Powerball lottery
February 15, 2023
Derm World Weekly - A Publication of the American Academy of Dermatology | Association ... IN THIS ISSUE / Feb. 15, 2023 ... AADA addresses lidocaine shortage with manufacturers DermWorld Insights and Inquiries : A nail-biting commentary Risk of rebound psoriasis flare from systemic corticosteroids DermWorld Young Physician Focus :
Journal of Investigative Dermatology
Cutting giant congenital nevi down to size molecularly I never wanted chaperones — until now An acne vaccine to make patients happy CAMPers? The rosy reality of coffee Aha! The iodide paradox now makes sense! A future therapeutic Harlequin Romance? A string of (clinical) pearls about drug-induced linear IgA disease
I'm retiring and want to sell my practice. Does the Academy have any resources to help?
Asked and Answered ... July 1, 2019 Yes! We offer the following resources to assist AAD members who are considering closing their practices: ... ... The AADA’s Practice Management Center breaks down: ... How to value your practice, with a detailed explanation of how to calculate EBITDA (Earnings Before
Will PD-1 inhibitors be msed for Mastocytosis?
The authors evaluated 16 specimens from 12 patients with mastocytosis, using immunohistochemical stains for PD-L1, CD-117, and mast cell tryptase on all specimens.
Coding Resource Center
Access the Coding Resource Center to find Academy coding tools and resources. Find information on E/M codes, ICD-10 codes, modifiers, audits, coding guides, and more.
Surviving and thriving after a natural disaster
Answers in Practice ... By Emily Margosian, Assistant Editor, September 1, 2023 DermWorld ... talks to Mary Lupo, MD, FAAD, from the Lupo Center for Aesthetic and General Dermatology in New Orleans, about how to prepare your practice for a natural disaster. Mary Lupo, MD, FAAD ... DermWorld: Tell us
Challenging patient scenarios
Answers in Practice ... By Emily Margosian, Assistant Editor, January 1, 2023 DermWorld ... talks to Melissa Mauskar, MD, FAAD, associate professor of dermatology and obstetrics and gynecology at UT Southwestern Medical Center, about how to approach difficult conversations with patients. DermWorld: Tell us about your practice. Melissa Mauskar, MD,
Race, equity, and the impact of COVID-19 on African Americans
Dermatology World Weekly talked to Sacharitha Bowers, MD, vice chair of the Diversity, Inclusion, Community Engagement and Equity (DICE) Council for the Department of Internal Medicine at Southern Illinois University School of Medicine, about the barriers to care that contribute to the staggering COVID-19 statistics plaguing the African American
Maximizing your retirement wealth
Money Matters ... David B. Snyder, JD, CLU ... ® ... , is an attorney, author, and financial advisor at the wealth management firm OJM Group. He covers financial issues for dermatologists in this quarterly ... Dermatology World column. ... By David B. Synder, JD, CLU, December 3, 2018 For
Optimizing your patient portal
Answers in Practice ... By Emily Margosian, Assistant Editor, July 1, 2022 DermWorld ... talks to Laura Houk, MD, FAAD, from MaineHealth Medical Group in Portland, Maine, about her tips on how to effectively manage your patient portal. DermWorld: Tell us about your practice. Dr. Houk: I work at MaineHealth
Streamlining the claim denial process in your practice
Claim denials are a reality for every dermatology practice. It is wise to be proactive and understand what you need to do when you receive a claim denial. Streamlining your claim denial process requires understanding the meaning behind each denial on the explanation of benefits (EOB) and the appropriate action
Employment-related legal considerations during COVID-19: Part II
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, D.C. ... By Megan La Suer, JD, MHA, Rob Portman, JD, MPP, and Ben Tesdahl, JD, June 1, 2020 Every month, Dermatology World ... covers legal issues in "Legally
Frozen sections to diagnose epidermolytic ichthyosis: Very cool!
Is there anything more daunting than being called to the neonatal unit confronted by a desquamating, peeling, neonate? The differential diagnosis is broad, ranging from Staphylococcal Scalded Skin Syndrome (SSSS), Toxic Epidermal Necrolysis (TEN), Epdermolysis Bullosa, Bullous Congenital Ichthyosiform Erythroderma (Epidermolytic Hyperkeratosis, Epidermolytic Ichthyosis), Ichthyosis Bullosa of Siemens, Congenital Candidiasis,
Mee too: More than just arsenic
Mee’s lines is the eponym for linear leukonychia, presenting as transverse white bands of the nail plate. It is due to interrupted growth of the nail matrix, resulting in parakeratosis of the nail plate.
Happy 4th of July from DI&I
George Washington contracted smallpox when he was 19 years old. Although he nearly succumbed to the disease, he survived with pockmark scars and life-long immunity. (1) He and other founders recognized the severity of smallpox and its threat to their independence and took all measures at their disposal to
Forever young with chocolate
Recently we discussed how dark chocolate can exacerbate acne. How many times have you heard a patient complain that it’s just not fair – they’re getting wrinkles and are still breaking out? Here is some good news!
British Journal of Dermatology
The pachydermoperiostosis prostaglandin paradigm Tofacitinib: A JAK inhibitor of all trades Focusing attention on X-linked ichthyosis We’ve gotta recognize GATA2 deficiency Sirolumus’s merit for the Kasabach-Merritt phenomenon Aha! The iodide paradox now makes sense! Changing perceptions of pediatric mastocytosis A string of (clinical) pearls about drug-induced linear IgA disease Dupilumab’s
Happy Father’s Day
It is ironic that the founding father of the American Academy of Dermatology, Howard Fox, was a bachelor with no children. He was undoubtedly influenced by his father, the beloved and internationally known dermatologist, George Henry Fox. We are their legacy, and on this Father’s Day, I would like to
Plantar melanoma and mechanical stress
Acral lentiginous melanoma (ALM) involves the palms, soles, and nail beds. It is the most common type of melanoma in patients of African or Asian descent. Delays in diagnosis result in more advanced disease at the time of diagnosis.
Skin cancer/ melanoma
Cutting giant congenital nevi down to size molecularly Calcipotriene and 5-fluorouracil: Dermatology’s new dynamic duo? Rejecting preconceived notions of squamous cell carcinomas in patients experiencing transplant rejections Biting my nails worrying about atypical presentations of nail unit melanomas 41’s gracious contribution to skin cancer awareness Dermatopathology reports about basal cell
Leadership story by Maria Teresa García-Romero, MD, MPH, IFAAD
Learn how AAD member Maria Teresa García-Romero, MD, MPH, IFAAD had her professional life changed through the Academic Dermatology Leadership Program.
Impact Report — Vol 5, Issue 3
Your Academy continues to protect and advance our specialty where it matters most. We advocated for fair payment, defended against inappropriate step therapy protocols, raised the visibility of dermatology, expanded CME access, and strengthened our member community.
The meaning of community
Former camper Kaitlyn Wannall, now 18, loved her time at Camp Discovery.
Smarter not harder
In Practice ... Dr. Gardner serves as assistant professor of medicine and dermatology at the University of Washington School of Medicine and works in the dermatology clinic at UW Medical Center Roosevelt and the Seattle Cancer Care Alliance. ... By Victoria Houghton, managing editor, March 1, 2019 Dermatology World talks
The anti-markup rule applied to dermatology
Legally Speaking ... Daniel F. Shay, Esq., is a health care attorney at Alice G. Gosfield and Associates, P.C. ... By Daniel F. Shay, Esq., December 1, 2025 Every month, DermWorld ... covers legal issues in "Legally Speaking." This month’s author Daniel F. Shay, Esq., is a health care attorney
Beneficiary inducements: What's permissible?
Legally Speaking ... Alice G. Gosfield, Esq. is a health care attorney at Alice G. Gosfield and Associates, P.C. ... By Alice G. Gosfield, Esq., November 1, 2018 The anti-kickback statute with its criminal and civil penalties, fines, and exclusion options is incredibly broad. It implicates a wide range of
Does the No Surprises Act affect dermatologists?
Legally Speaking ... By Allyn Rosenberger, JD, MPH, and Robert M. Portman, JD, MPP, May 1, 2023 Every month, ... DermWorld covers legal issues in ... "Legally Speaking." This month’s authors are health care attorneys with Powers Pyles Sutter & Verville in Washington, D.C. Portman is also general counsel for
July 4
Learn more about July 4 at aad.org
Diagnosing and managing delusional parasitosis
Acta Eruditorum ... Dr. Schwarzenberger is the former physician editor of ... DermWorld . She interviews the author of a recent study each month. ... By Kathryn Schwarzenberger, MD, April 1, 2019 In this month’s Acta Eruditorum column, Physician Editor Kathryn Schwarzenberger, MD, talks with Dirk M. Elston, MD, about
Future shock of teledermatology
Most respondents reported no concern about the safety of an e-visit compared with that of an office visit. When given a choice of cost of an e-visit [from $25 to $200] 40 (38.1%) respondents were unwilling to pay any amount out pocket for an e-visit, and 64 (61%) were willing
Psoriasiform eruptions during Kawasaki disease (KD): A prognosis that lets the good times roll
Psoriasiform skin changes have been rarely described in the literature in both acute (1-4 weeks) and convalescent phases (4-12 weeks) of KD.
Changing a long-standing habit
Topical corticosteroid has no influence has no influence on inflammation or efficacy after ingenol mebutate treatment of grade I to III actinic keratosis (AK).
Diagnosing pyoderma gangrenosum? Consider cocaine/levamisole as a potential culprit!
The authors presented 8 patients with PG following exposure to levamisole-contaminated cocaine. All patients had lower extremity involvement, and 6 also had PG on the upper extremities. Retiform purpura was only observed in 3 patients. Most had elevated titers for p-ANCA and antiphospholipid antibodies. Histologic examination was predominantly neutrophilic, consistent
Neutrophil-rich subcutaneous fat necrosis of the newborn: Sometimes a cigar is just a cigar!
Recently, I was consulted to the neonatal ICU to evaluate a newborn with red, indurated, fluctuant plaques on the back. I had no doubt that this was a classical case of subcutaneous fat necrosis of the newborn (SCFN). A biopsy demonstrated a neutrophilic panniculitis without crystals – a tissue gram
Pediatric dermatology
Finding Joy in pediatric phototherapy Congenital Juvenile Xanthogranulomas: Born To Be Wild (But Ultimately Mild) Sophie’s choice: Assessing atypical Spitz tumors in the molecular era The real jigsaw puzzle of the Brooke-Spiegler Syndrome: Translating the molecular biology to therapy Sirolumus’s merit for the Kasabach-Merritt phenomenon A future therapeutic Harlequin Romance?
Pityriasis rubra pilaris: Check a TSH!
There are myriad ways to mine the data from the review of 100 cases of PRP by Ross et al, however, one key finding will change the way I will assess these patients – 20% were hypothyroid! (1)
Another mastocytosis surprise: IgM on DIF in bullous mastocytosis
If I read my horoscope this week, it would no doubt say “Beware of any preconceived notions in your patients with mastocytosis.” Now that I have expanded my horizons about TMEP, I also need to reconsider the notion that ruling out an autoimmune blistering disease versus bullous cutaneous mastocytosis is straightforward,
A trend I cannot endorse
A patient with a morbilliform eruption was assessed at our clinic. My resident evaluated him first before presenting the case to me.
DWI&I holiday greeting 2020: Eyeing dermatology’s future
Read the December 18, 2019 DWII on dermatology's future, with a holiday greeting to all.
Mentorship helps the dermatologic career
Read the story of AAD member Mariam Mafee, MD, FAAD, who loved her time in the Academic Dermatology Leadership Program.
Allopurinol-induced adverse reactions: More than genetics
There are certain drugs that confer a high risk of severe cutaneous adverse reactions (SCAR) ranging from morbilliform drug eruptions, DRESS, Stevens-Johnson, to Toxic Epidermal Necrolysis. You know the usual suspects – anticonvulsive agents, sulfa drugs, other anti-infective agents, and antidepressants. Allopurinol is a frequent culprit.
Leaders in medicine – Part 2
DermWorld talks to dermatologists in leadership roles in the house of medicine. ... Feature ... By Matthew Walsh, Member Communications Specialist, June 1, 2023 This is the second part of a series of interviews in which ... DermWorld spoke with nine board-certified dermatologists who serve or have served in important
#DermTok
TikTok as a tool to engage with public health and promote dermatologic expertise ... Feature ... By Emily Margosian, Assistant Editor, May 1, 2022 For a fleeting moment, there were few questions more pressing than, "Is it a Bones Day?" ... Last fall, Noodle, a 13-year-old pug, shot to stardom
How to participate in AAD’s DataDerm™ clinical data registry
Legally Speaking ... By Allyn Rosenberger, JD, MPH, Ben Tesdahl, JD, LL.M, and Robert M. Portman, JD, MPP, September 1, 2023 Every month, ... DermWorld covers legal issues in "Legally Speaking." This month’s authors are health care attorneys with Allyn Rosenberger, JD, MPH, Ben Tesdahl, JD, LL.M, and Robert M.
Hand-wringing over the histology of mechanic’s hands and other cutaneous manifestations of dermatomyositis
Of all the cutaneous manifestations of dermatomyositis (DM) – the heliotrope rash, Gottron’s papules, Gottron’s sign, shawl sign, holster sign, flagellate erythema, photosensitivity, poikiloderma, periungual erythema, periungual telangiectasis, Samitz sign, pruritic erythema of the scalp, and panniculitis – none has perplexed me more than mechanic’s hands (MH).
Voriconazole prophylaxis mandates cutaneous prophylaxis – and communication
The utilization of allogeneic hematopoietic stem cell transplantation (HSCT) has been increasing dramatically. According to the Health Resources and Services Administration, 92,784 procedures were performed between 2010 and 2014.
Selectivity and the choice of beta-blockers for infantile hemangiomas
Has there ever been a more radical change in therapy following a serendipitous discovery than the use of propranolol for infantile hemangiomas (IHs)? Since the landmark report of Léauté-Labrèze in 2008 (1), propranolol has rapidly become the first-line treatment for IHs; nearly 800 papers detailing its use have been
Terra Firma-Forme Dermatosis
Terra firma-forme dermatosis is diagnosed by a simple alcohol wipe. Recognition of this disorder may ease fears and embarrassment and avoid unnecessary diagnostic tests.
AccessDerm: Serving the underserved
Learn more about AccessDerm: Serving the underserved at aad.org
Payer contracts redux
Legally Speaking ... By Alice G. Gosfield, Esq., December 1, 2023 DermWorld ... covers legal issues in "Legally Speaking." This month’s author, Alice G. Gosfield, Esq. is a health care attorney at Alice G. Gosfield and Associates, P.C. Alice G. Gosfield, Esq ... In 2016, I wrote an ... article
Move over Lues: Graft-versus-host disease is the new mimicker king
I have always been intrigued by graft-versus-host disease (GVH). I first learned of the disorder in my college immunology course when it was referred to as a cause of “runting syndrome” in mice.
Thoughts and prayers ad infinitum
How many times do we have to hear our leaders offer the “thoughts and prayers” homily until it becomes devoid of meaning?
Thinking of discontinuing the PD-1 inhibitor because of a lichenoid eruption? Don’t do it!
Immune checkpoint inhibitors have been the proverbial “game changers” in oncology, and offer hope (and a chance of survival) where none existed just a few years ago.
New pitfalls in the diagnosis of Kaposi sarcoma
Human Herpes Virus-8 (HHV-8)is the common denominator in all forms of Kaposi sarcoma (KS) – classic, endemic, post-transplant/immunosuppressive, and epidemic/HIV. Virtually all cases will demonstrate HHV-8 by immunohistochemistry in all types.
Eruptive nevi: Trying to connect the dots
Eruptive nevi are striking – they may appear after a variety of disorders, including Stevens-Johnson/toxic epidermal necrolysis, primary blistering diseases, trauma, immunosuppression (from disease or iatrogenically-induced), PUVA therapy, or idiopathically. There are also several reports in the literature for eruptive Spitz nevi and blue nevi.
Toxicity of topical timolol for infantile hemangiomas in preterm infants: Size matters
I have been using topical timolol (0.5% gel) for the past few years for infants with infantile hemangiomas (IH) with reasonable success, but I am always nervous about prescribing it, as data on the degree of topical absorption remains to be defined.
Nanotechnology for topical cyclosporine: Not a small matter
Taken at face value, the study by Kumar et al, demonstrating the efficacy of topical cyclosporine for psoriasis, utilizing liposomal nanocarriers (lipogel), might elicit a shrug, because in this randomized study, at 14 weeks, complete clearance of psoriasis was observed in 41% of treated sites with cyclosporine in lipogel
Primary sclerosing cholangitis associated with pyostomatitis vegetans and pyodermatitis vegetans: A potentially bilious situation
Inflammatory bowel disease may be associated with multiple cutaneous manifestations including pyoderma gangrenosum (PG), erythema nodosum, or directly by fistulae or “metastatic” Crohn disease.
Improving insomnia by increasing the diagnostic accuracy of desmoplastic melanomas
Desmoplastic melanomas (DM) may only represent up to 4% of melanomas, however, they are responsible for 50% my insomniac nights. It is easy to lose sleep worrying if that the slightly indurated lesion that I reassured the patient was a “scar”, or the spindle cell lesion I diagnosed histologically as
A heartfelt thank you note to my psoriasis research colleagues
I first met Casey (not his real name) when he was a child, referred to me for awful psoriasis. He was always upbeat and resilient, but clearly the disease adversely affected his life and that of his family.
Cimetidine offers a ray of sunshine for patients With erythropoietic protoporphyria
Only once in a great while an article makes me want to break into my happy dance – the report of 3 pediatric cases of erythropoietic protoporhyria (EPP) by Tu et al had that effect. Recently, I ran a post on EPP where I discussed the new findings of EPP
A surgical pearl (in waiting) for the medical dermatologist
I admit it – the surgical aspect of my practice is rudimentary. Honestly, any non-cosmetic procedure that takes me more than 5 minutes gets referred. It’s amazing how I can make a living with shave biopsies, tangential excisions, electrodesiccation and curettage, and cryosurgery. Putting in a suture is an
I’ll have a necrobiotic xanthogranuloma to go – with mustard!
Mechlorethamine has been used for decades to treat cutaneous T cell lymphoma. Rodriguez et al utilized 0.01% topical nitrogen mustard to treat a 60+ year-old man with biopsy-proven NXG with paraproteinemia (IgG-κ), without myeloma.
Low dose isotretinoin for recalcitrant rosacea: I pledge to use it sporadically
While rosacea can usually be reasonably managed with a combination of topical agents (metronidazole, azelaic acid, ivermectin, sulfacetamide, brimonidine), oral antibiotics (the tetracycline family), vascular lasers, intense pulsed light and surgery (for phymatous disease), some cases are recalcitrant to standard therapy.
Board of Directors
Learn about the Academy's Board of Directors. This page lists all the current Board of Directors, along with incoming members. It also includes board minutes and a link to email the board.
Noncompete clauses
Noncompete clauses are contractual agreements that prohibit physicians from engaging in the practice of medicine within a defined geographic area and time period after leaving a job. To be enforceable, the noncompete must be reasonable in scope and duration.
Opening doors and paying it forward
Read about AAD member John Zampella, MD, FAAD, and his experience participating in the AAD’s Leadership Institute programs.
Learning about proton pump inhibitor-induced dermatologic adverse reactions is ulcerogenic
How many of your patients are on protein pump inhibitors (PPI) such as Nexium [esomeprazole], Prevacid [lansoprazole], or Prilosec [omeprazole] for GERD? Let me rephrase the question. How many of your patients are NOT on PPI’s?
AccessDerm: Serving the underserved
In Practice ... Dr. Simpson serves in the Department of Dermatology at University of Pennsylvania. ... By Dean Monti, managing editor, special publications, September 2, 2019 Dermatology World speaks with Cory Simpson, MD, PhD, about why he uses AccessDerm — the Academy's volunteer teledermatology platform — how it works, and
Recent health care enforcement trends and risk areas for physicians and their practices
Legally Speaking ... Alexandra Volpe, JD, and John Kelly, JD, are health care attorneys with Barnes & Thornburg LLP. ... By Alexandra Volpe, JD, and John Kelly, JD, September 1, 2025 DermWorld ... covers legal issues in "Legally Speaking." This month’s authors are health care attorneys with Barnes & Thornburg
The physician view of employment agreements
Legally Speaking ... Daniel F. Shay, Esq., is a health care attorney at Alice G. Gosfield and Associates, P.C. ... By Daniel F. Shay, Esq. , July 1, 2023 DermWorld ... covers legal issues in "Legally Speaking." This month’s author, Daniel F. Shay, Esq. is a health care attorney at
Fake news, predatory journals, case reports, biostatistics, and other journalistic musings
We live in an era of information excess delivered by print, digital devices, webcasts, podcasts, and tweets. Time for reflection is minimal. One of the major precipitants of physician burnout is the endless electronically documenting data, which has replaced speaking to and examining patients, and most importantly thinking about their
Long-term care planning
Money Matters ... David B. Snyder, JD, CLU ... ® ... , is an attorney, author, and financial advisor at the wealth management firm OJM Group. He covers financial issues for dermatologists in this quarterly ... Dermatology World column. ... By David B. Snyder, JD, CLU, March 1, 2019 What
Using trusts to shield assets from potential liability
Money Matters ... David B. Snyder, JD, CLU ... ® ... , is an attorney, author, and financial advisor at the wealth management firm OJM Group. He covers financial issues for dermatologists in this quarterly ... Dermatology World column. ... By David B. Snyder, JD, CLU, September 3, 2018 Given
Reflectance confocal microscopy, driverless cars, and Uber: The future of dermatopathology
In a matter of days, you will be able to use Uber to hail a driverless car to your destination in Pittsburgh. During these trials, initially there will be a human monitor (1). You know where this is going – within a decade you will arrive in style without anyone
A point to make about punctate, pigmented, and verrucous papillomatosis
What is your mental image of the Gougerot-Carteaud (GC) syndrome? I equate it with confluent and reticulated papillomatosis, presenting on the trunk with hyperpigmented minimally raised plaques. The KOH examination is negative and there is a quick, characteristic response to antibiotics such as minocycline.
A revelation: Drug-induced pseudoglucagonoma syndrome
Although only having diagnosed the glucagonoma syndrome (GS) once, I have always been fascinated by necrolytic migratory erythema (NME), and conditions that mimic NME, the so-called pseudoglucagonoma syndrome (PGS).
Iododerma from contrast material or Sweet syndrome?
Take a look at “Images in Clinical Medicine” in the June 23rd issue of the New England Journal of Medicine. The authors present the case of a 57 year-old man who presented with a 12 hour history of hematuria.
Holiday Greeting 2022
Read the Dec. 21, 2022 DermWorld Insights and Inquiries holiday greeting.
PASI 100 and the perfection paradox
I am not a psychiatrist, but over the years I have concluded that my patients’ happiness is more supratentorial than epidermal.
“Black dot” alopecia areata
This week I had a 35 year old man present with a one month history of a round patch of alopecia. He was told by his PMD that he had tinea and was started on oral terbinafine (which he had been on for 5 days when he first came to
Multinucleated keratinocytes: A real histologic finding in factitial dermatoses
Patients presenting with factitial dermatoses are challenging on every level, and proving the diagnosis may be very difficult because of patient (or parental) denial of the situation. Recently, there have been a few reports of a histologic finding that may help confirm the diagnosis – multinucleated keratinocytes (MKs, also known
Following up on “A Trend I Cannot Endorse”
Read the September 22, 2021 DermWorld Insights and Inquiries on Following up on “A Trend I Cannot Endorse.”
Erythropoietic protoporhyria in an adult: Something I usually don’t think about!
I examined a 53 year-old woman this morning with a mild facial eruption that at best was slightly erythematous and papular.
A Trumpian analysis of infliximab-induced follicular mucinosis: Something’s going on here
Williams et al presented two cases of biopsy-proven facial follicular mucinosis (FM), apparently induced by infliximab, with a normal tissue CD4/CD8 ratio of 2/1 and the presence of CD7, thereby ruling out CTCL. The first case was a 23 year-old man with Crohn disease; the other patient was a 16
About DermWorld Insights and Inquiries
Learn more about DermWorld Insights and Inquiries, including the mission statement, our editor’s bio, and the members of the Editorial Board.
DWI&I Holiday Greeting 2021
Read the December 22, 2021 DermWorld Insights and Inquiries, offering you holiday greetings to conclude 2021.
The AAD Clinical Community
The Academy is excited to introduce its online Clinical Community, a forum for dermatologists to discuss clinical issues and more. The forum is secure, organized, and moderated. It is also free to members of the Academy.
Meeting with your member of Congress: A guide for dermatologists
You can meet with your elected officials or their staff in their local district office or the office where you practice. This guide provides essential tips to ensure a smooth, productive visit that can build an impactful relationship.
Mind the gap
Read the March 16, 2022 DermWorld Insights and Inquiries on the pros and cons of taking a gap year before dermatology residency.
Voluntary repayments and false claims liability
Legally Speaking ... Daniel F. Shay, Esq., is a health care attorney at Alice G. Gosfield and Associates, P.C. ... By Daniel F. Shay, Esq., March 1, 2026 Every month, DermWorld ... covers legal issues in "Legally Speaking." This month’s author Daniel F. Shay, Esq., is a health care attorney
Business associate agreements 101
Legally Speaking ... Daniel F. Shay, Esq., is a health care attorney at Alice G. Gosfield and Associates, P.C. ... By Daniel F. Shay, Esq., July 1, 2021 Every month, DermWorld ... covers legal issues in "Legally Speaking." This month’s author is a health care attorney at Alice G. Gosfield
Primer on payer contract issues
Answers in Practice ... By Lou Terranova, Associate Director, Practice and Payment Policy, and Teresa Salaway, Senior Manager, Practice and Payment Policy, October 1, 2024 Each month, DermWorld ... tackles issues "in practice" for dermatologists. This month, AADA regulatory and payment policy staff highlight critical elements of payer contracts for
Keeping current with Medicare enrollment
Legally Speaking ... Daniel F. Shay, Esq., is a health care attorney at Alice G. Gosfield and Associates, P.C. ... By Daniel F. Shay, Esq., December 1, 2024 DermWorld ... covers legal issues in "Legally Speaking." This month’s author, Daniel F. Shay, Esq. is a health care attorney at Alice
Life insurance 102: Five success factors when using permanent life insurance
Money Matters ... David B. Snyder, JD, CLU ... ® ... , is an attorney, author, and financial advisor at the wealth management firm OJM Group. He covers financial issues for dermatologists in this quarterly ... Dermatology World column. ... By David B. Snyder, JD, CLU, September 2, 2019 In
Tax reform: What you need to know
Money Matters ... Jason P. Wainscott, JD, is an attorney, author, and general manager of the financial planning firm OJM Group. ... By Jason P. Wainscott, JD, March 1, 2018 Every dermatologist needs to know 2017 saw widespread changes to the federal tax code. There are many cuts and additional
FTC proposed rule on non-compete clauses: What are the implications for dermatologists?
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, D.C. ... By Natalie Lorenz, JD, Ben Tesdahl, JD, and Robert M. Portman, JD, MPP, January 1, 2024 Every month, DermWorld ... covers legal issues in "Legally Speaking." This
Danazol for telomerase disorders: Prolonging the end — For chromosomes (yes), for dyskeratosis congenita (perhaps)
Telomeres are located at the ends of chromosomes; they are repaired by telomerases. Shortening of telomeres leads to cell senescence, apoptosis, and chromosome instability.
Why we do what we do
The relentless drumbeat of dictates, regulations, prior authorizations, audits, and social media reviews is taking its toll on physicians’ psyche. Combined with downward reimbursement, narrow insurance networks, pressure to be increasingly productive, and far too many clicks on the electronic medical record, it is not surprising many physicians have questioned
Pineapple and cicatricial pemphigoid: A need to dole out more studies
The benefits of pineapples have been touted in folk medicine for years. Increasing knowledge of its active ingredient bromelain has lead to a therapeutic pineapple renaissance.
Being aware of the “Chik” sign in the current arbovirus renaissance
As the world focuses its attention on the Zika virus, with its profound complications of microcephaly in neonates and Guillain-Barré in adults, we cannot ignore other arboviruses that may cause devastating illness – Dengue Fever and Chikungunya Fever.
The brave new world of melanoma gene expression markers
Epidermolysis bullosa nevi (EBN) are clinically alarming lesions that may display “pseudomelanoma” features histologically. Changes within these lesions may be disconcerting, necessitating repeated biopsies. Any advances to predict biologic behavior would be welcome.
Purpuric dermatitis herpetiformis: Itching to know why
Last week my partner, Justin Green MD, asked for my opinion about a man with biopsy-proven dermatitis herpetiformis (neutrophilic abscesses and granular IgA deposition) with negative serologic studies for anti-endomysial antibodies (tissue transglutaminase). He had classical lesions on his elbows (grouped vesicles) but the lower extremity lesions were purpuric.
Rheumatoid vasculitis? Rule-out methotrexate-associated EBV
Rheumatoid vasculitis (RV) is a serious complication of rheumatoid arthritis (RA) causing high morbidity and mortality, despite aggressive immunosuppressive treatment.
2022: Best of DermWorld Insights and Inquiries
December 29, 2022 We know how much you enjoy Dr. Heymann and the editorial board’s weekly analyses of dermatologic literature, so we’ve created a list of the top 10 most popular issues in 2022 — starting with the most popular issue of the year. ... 1. Coming full circle (almost)
Interfering with interferon Gamma: The mechanisms behind acquired resistance to PD-1 inhibitors for melanoma
Astounding major advances in targeted therapies for melanoma, most notably by PD-1 blockade, have given hope and life to patients with metastatic melanoma. Approximately 30 % of advanced melanoma patients experience tumor responses from checkpoint blockade monotherapy, with better clinical responses seen with the combination of anti-PD-1 and anti-CTLA-4 antibodies.
Pseudomolluscoid papules: A more accurate description than pseudoverrucous papules
When patients ask me how I made their diagnosis so quickly, I politely tell them that if any particular lesion takes more than 25 milliseconds to diagnose, they really do have a problem.
Going retro: Reactivation of incontinentia pigmenti
The concept of reactivating incontinentia pigmenti (IP) has always fascinated me – I have only encountered cases in my readings. Of course you will recall the vesicular, verrucous, hyperpigmented, and hypopigmented (atrophic) phases of this X-linked dominant disease.
Acquired acrodermatitis enteropathica from “total” parenteral nutrition: Still crazy after all these years
During my dermatology elective under the tutelage of Michael Fisher, MD (former Chief of Dermatology at the Albert Einstein College of Medicine), we saw a patient with Crohn disease who had acral bullae. The case was baffling for everyone, except for Dr. Fisher. With one glance he knew that the
Got milk? Got acne?
I loved to drink milk as a kid – I would guzzle it. I was on the chunky side, so my mother encouraged me to have skim milk to cut down on the calories. I never really cared for it, but she did the shopping. As a teenager I also
An incisive approach to chronic paronychia: The square flap technique
I cannot begin to guess how many patients I have seen with chronic paronychia (CP) since I started my residency 36 years ago. I know precisely how many patients I have referred for surgical correction of CP – zero! The reason for that is that I never thought about this
Holiday wishes, Darwin, and dermatology
Dermatology (and dermatologists) has existed from the inception of skin, far preceding the remedies noted in the Ebers papyrus,dating to 1500 BC.
DWI&I Holiday Greeting 2020
Read the December 23, 2020 DermWorld Insights and Inquiries with a personal holiday address from Dr. Warren Heymann.
On the front lines during COVID-19
Dermatology World Weekly talks with Linda Stein Gold, MD, recently chosen as the AAD’s next vice president-elect and the current division head of dermatology at the Henry Ford Health System, about how dermatologists have stepped in during the COVID-19 crisis.
2019 DW Insights and Inquiries archive
Explore past issues of DW Insights and Inquiries that were published in 2019.
DWI&I Holiday Greeting 2025
On behalf of the editors and staff of DWI&I, I wish you and your loved ones a healthy, safe, and peaceful 2025 and beyond.
Best of DermWorld Insights and Inquiries
We’ve created a list of the top 10 most popular issues in 2023 — starting with the most popular issue of the year.
Legal considerations when using artificial intelligence in practice
Legally Speaking ... Daniel F. Shay, Esq. is a health care attorney at Alice G. Gosfield and Associates, P.C. ... By Daniel F. Shay, Esq, March 1, 2025 DermWorld ... covers legal issues in "Legally Speaking." This month’s author, Daniel F. Shay, Esq. is a health care attorney at Alice
HIPAA for dermatology practices
Legally Speaking ... Jane Sitorius, JD, is a health care attorney with Barnes & Thornburg LLP in Washington, D.C. ... By Jane Sitorius, JD, January 1, 2026 Every month, DermWorld ... covers legal issues in "Legally Speaking." This month’s author Jane Sitorius, JD, is a health care attorney with Barnes
Der(mom)atology: Navigating parenthood as a physician
Answers in Practice ... By Emily Margosian, Assistant Editor , November 1, 2023 DermWorld ... talks to Asmaa Chaudhry, MD, FAAD, from Stone Ridge Dermatology in Aldie, Virginia, about her tips for balancing two demanding jobs — physician and parent. Asmaa Chaudhry, MD, FAAD ... DermWorld : Tell us about
Quality fraud: What’s that?
Legally Speaking ... Alice G. Gosfield, Esq. is a health care attorney at Alice G. Gosfield and Associates, P.C. ... By Alice G. Gosfield, Esq., July 1, 2024 Every month , DermWorld ... covers legal issues in "Legally Speaking." This month’s author is a health care attorney at Alice G.
Wound care practices draw increased enforcement and regulatory focus
Legally Speaking ... Erin Steele, JD is a health care attorney with Barnes & Thornburg LLP in Washington, D.C. ... By Erin Steele, JD, May 1, 2026 Every month, DermWorld ... covers legal issues in "Legally Speaking." This month’s author is a health care attorney with Barnes & Thornburg LLP
The billing company relationship: A most significant ‘other’
Legally Speaking ... Alice G. Gosfield, Esq. is a health care attorney at Alice G. Gosfield and Associates, P.C. ... By Alice G. Gosfield, Esq., July 1, 2025 Every month, DermWorld ... covers legal issues in "Legally Speaking." This month’s author is a health care attorney at Alice G. Gosfield
Incident to: Old wine in modern bottles
Legally Speaking ... Alice G. Gosfield, Esq. is a health care attorney at Alice G. Gosfield and Associates, P.C. ... By Alice G. Gosfield, Esq., March 1, 2021 Every month, DermWorld ... covers legal issues in "Legally Speaking." This month’s author, Alice G. Gosfield, Esq., is a health care attorney
Implications of the Corporate Transparency Act for physicians
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, D.C. ... By Allyn Rosenberger, JD, MPH, Jason Qu, JD, and Rob Portman, JD, MPP, April 1, 2024 Every month, DermWorld ... covers legal issues in "Legally Speaking." This
COVID-19 impact on employed dermatologists: Part 1
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, D.C. ... By Ben Tesdahl, JD, Megan La Suer, JD, MHA, and Rob Portman, JD, MPP, September 1, 2020 Every month, Dermatology World ... covers legal issues in "Legally
Modifier madness
Cracking the Code ... Dr. Miller, who is in private practice in Yorba Linda, California, represents the American Academy of Dermatology on the AMA-CPT Advisory Committee. ... By Alexander Miller, MD, April 1, 2019 Test your knowledge: Modifier madness ... Take the quiz to see if you're up to date.
What dermatologists need to know about workplace disability accommodations under the ADA
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, D.C. ... By Jason Qu, JD, and Robert M. Portman, JD, MPP, January 1, 2025 Every month, DermWorld ... covers legal issues in "Legally Speaking." This month’s authors are
Granulomatous slack skin: More than one type of mimicry
Read the November 18, 2020 DermWorld Insights and Inquiries on granulomatous slack skin.
Lipschütz ulcers: Not only for women
Read the March 24, 2021 DermWorld Insights and Inquiries on Lipschütz ulcers.
A cold abscess remains a cold case: Multiple neonatal staphylococcal cold abscesses of the large folds
Healthy neonates presenting with cold abscesses in skin folds and growing methicillin-sensitive Staphylococcus aureus on culture may have “Multiple Neonatal Staphylococcal Cold Abscesses of the Large Folds.” With appropriate treatment, this benign disorder will not have any untoward sequelae.
Protect your ability to practice
Money Matters ... David B. Snyder, JD, CLU ... ® ... , is an attorney, author, and financial advisor at the wealth management firm OJM Group. He covers financial issues for dermatologists in this quarterly ... Dermatology World column. ... By David B. Snyder, JD, CLU, June 3, 2019 For
What dermatology practices need to know about laws protecting pregnant and lactating employees
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, D.C. ... By Ben Tesdahl, JD, LLM, Jason Qu, JD, and Rob Portman, JD, MPP, September 1, 2024 Every month , DermWorld ... covers legal issues in "Legally Speaking."
Intralesional triamcinolone for hidradenitis suppurativa and thoughts on confirmation bias
Anyone who has treated the scourge of hidradenitis suppurativa (HS) has probably injected inflamed nodules and cysts with triamcinolone (TAC) successfully, resulting in very grateful patients.
PDT for erosive pustular dermatitis of the scalp: Seeing the light (but reaching a different conclusion)
Erosive Pustular Dermatitis of the Scalp (EPDS) is a relative common condition, typically seen on the actinically damaged scalps of the elderly men. Lesions characteristically present as hyperkeratotic, crusted erosions with varying degrees of pustulation. Lesions may become secondarily infected.
A plasma cell dyscrasia fable: AESOP and POEMS presenting concurrently
There is a moral to every fable. In this commentary, it is that VEGF (vascular endothelial growth factor) may have multiple cutaneous manifestations, even in the same patient.
Home at last
My mother has talked of her demise for years, but usually in the context of challenging medical dogma in her will to live – having surgeries (cervical spine repair, ostomy reversal) and procedures performed that were considered too risky for the aged – “It’s all about quality of life. I’d
Systemic amyloidosis presenting as nail dystrophy (and inducing onychophagia in the reviewer)
I admit it – I am plagued with onychophagia (nail biting). It is a life-long habit, and now that I’m 61, I presume that this foible will remain with me to the end. It is worse with anxiety – after reviewing the following articles, I’m down to the hyponychium!
Waiting for Wong
The Wong variant of dermatomyositis was originally described by O’Leary during the Eisenhower administration (1953) and named for Wong during Nixon’s tenure (1969). I have been involved with dermatology since Carter’s term in office (1979). Since that time (Reagan, Bush, Clinton, Bush, Obama) I have yet to see a case
Paraneoplastic syndromes (PNS) associated with merkel cell carcinoma are analogous to small cell cung Cancer: A comparison to other lung cancers
Merkel cell carcinomas (MCC) are neuroendocrine tumors associated with the Merkel cell carcinoma polyomavirus in greater than 80% of tumors (1). Small cell lung cancer, another neuroendocrine tumor, is associated with paraneoplastic syndromes (PNS) in up to 20% of cases, notably the syndrome of inappropriate antidiuretic hormone (SIADH) and Lambert-Eaton
This year, the ADA celebrates its 30th anniversary
From the Editor ... Dr. Schwarzenberger is the former physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, October 1, 2020 Not the dental ADA, or even the dermatologic one. The Americans with Disabilities Act ADA. This landmark piece of legislation sought to ensure that Americans living with a disability
Stiff skin syndrome: Hard in many ways
Stiff skin syndrome (SSS) is a noninflammatory, fibrosing condition of the skin and fascia, often affecting the limb girdle region, notably the buttock and thighs, resulting in a lordotic posture.
Clinician-educator or a clinician who educates?
Ever since my first exposure to dermatology as medical student at the Albert Einstein College of Medicine, I was mesmerized by the enthusiasm of the dermatology faculty, lead by Dr. Michael Fisher. He was a teacher par excellence; I cannot overestimate the influence he had on my future path.
A sweeter approach to treating scleroderma?
We’re like licorice. Not everybody likes licorice, but the people who like licorice really like licorice – Jerry Garcia. Patients with scleroderma may learn to love licorice.
Getting a toehold on subungual tumors: Aneurysmal bone cysts join the club
Subungual tumors make me nervous. I realize that most are benign (subungual exostosis, osteochondroma, onycholemmal cyst, glomus tumor, pyogenic granuloma, wart, fibroma, acral fibromyxoma), however subungual malignant lesions (squamous cell carcinoma, keratoacanthoma, melanoma) occur. A delayed diagnosis can result in a profoundly adverse outcome.
Make no bones about it: Primary cutaneous ewing sarcoma is for real
Recently my partner biopsied a verrucous papule from the face of a young boy, without being confident of his clinical impression. Histologically, I knew I was looking at a malignant lesion, but could not identify it.
Short duration cyclosporine may undress DRESS
DRESS (Drug Rash with Eosinophilia and Systemic Symptoms) is a severe drug-induced hypersensitivity syndrome (DIHS) that may affect adults and children.
Joining the bullae pulpit: PD-1 inhibitors
As the use of immune checkpoint inhibitors has increased, so have the number of severe immunotherapy-related adverse events (irAEs). Although discontinuation of therapy may result in resolution of these untoward reactions, long-term sequelae and death have been reported. In a recently published systematic review encompassing 191publications reporting on 251 cases,
Spot on! Lentigines in resolved psoriatic plaques
Having treated psoriatic patients throughout my career, there have been innumerable occasions where patients were concerned about pigmentary changes following successful treatment of the plaques. I have usually reassured them that these are postinflammatory pigmentary alterations that should abate with time. Recently, however, there have been a spate of articles
Doxycycline as prophylaxis for EGFR-induced folliculitis: Is a pound of cure worth an ounce of prevention?
Epidermal Growth Factor Inhibitors (EGFRI) may cause acneiform eruptions that characteristically appear within a few weeks of their administration. These appear in greater than 50% of cases treated with EGFRI and in up to 100% of those cases treated with cetuximab.
Tofacitinib for dermatomyositis: A potential belle of the ball?
JAK1/3 signaling participates in the pathogenesis of inflammatory disorders while JAK1/2 signaling plays a role in the development of several malignancies including leukemias, lymphomas, and myeloproliferative neoplasms. Tofacitinib (Xeljans) is a pan-JAK inhibitor that is approved by the FDA for the treatment of rheumatoid arthritis and ruxolitinib (Jakafi) is a
You like tomato, I like tomahto, you soak with steroids, I use them dry…
I have been a firm believer in the “Soak and Smear” approach to treating recalcitrant dermatoses, including atopic dermatitis, as detailed by Gutman et al, more than a decade ago.
Journal of Cutaneous Pathology
Eosinophilic dermatosis of hematologic malignancy: Reality bites Oy, another "Oid" to worry about: Cryptococcoid lesions Biting my nails worrying about atypical presentations of nail unit melanomas Deep penetrating thoughts about deep penetrating nevi Sophie’s choice: Assessing atypical Spitz tumors in the molecular era Develop a nose for suspecting angiosarcoma Granulomatous
Out with the old and in with the new!
From the President ... Dr. Hruza served as Academy president from March 2019 to March 2020. ... By George Hruza, MD, MBA, January 1, 2020 Happy New Year! I trust that everyone has their New Year’s resolutions in order. Whether they be resolving to tackle your burnout or contribute more
Advocacy Update Aug 19, 2025
The AADA met with Cigna to review its (E/M) Coding and Accuracy policy, which is set to target physicians who frequently report Level 4 and 5 codes starting Oct. 1.
Leaders in medicine – Part 1
DermWorld talks to dermatologists in leadership roles in the house of medicine. ... Feature ... By Matthew Walsh, Member Communications Specialist, May 1, 2023 The American Academy of Dermatology is one of hundreds of medical associations in the U.S., each offering opportunities for doctors to assume important leadership positions. Engaged
Atrophic tinea versicolor: Knowledge about its pathogenesis is hypertrophying
In the entry “Atrophic Tinea Versicolor: More Than a Mirage” (April 22, 2016), I learned that the atrophic appearance of some cases of tinea versicolor is not just an optical illusion.
Generalized multinucleate cell angiohistiocytomas and thoughts on diagnostic first impressions
I became aware of multinucleate cell angiohistiocytomas (MCA) when I learned of an article published by friends who reported the first cases in the United States.
Truth in advertising in Georgia
Ask the Expert ... February 1, 2024 DermWorld ... interviews Alexander Gross, MD, FAAD, chair of the Academy State PolicyCommittee, about his efforts in advocating for a truth in advertising bill in Georgia. DermWorld : In a win for Georgia dermatologists, the entire medical community in Georgia, as well as
They are hot.
From the Editor ... Dr. Schwarzenberger is the former physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, FAAD, November 1, 2025 It is hard to think of another class of drugs that has generated such excitement from the general public as the GLP-1 agonists. While originally designed (and still
The risk of melanoma in adults with giant pigmented nevi
Giant pigmented nevi (GPN, defined in reference 1 as greater than 20 cm in an adult) are among the most challenging lesions from so many perspectives. When diagnosed in childhood, questions from parents regarding the risk of melanoma, approach to monitoring, managing, and addressing the psychologic aspects of the lesion
Topical minocycline for acne: A good Idea?
Concerns about the safety of minocycline have been increasing over the past two decades, with rare, serious adverse immunologic reactions including DRESS syndrome, pneumonitis, nephritis, autoimmune hepatitis, and a lupus-like syndrome.
Do not take a pass on the PAS stain
My threshold for obtaining a Periodic acid-Schiff (PAS) on inflammatory lesions rivals the opinion of most Americans’ opinion of tomorrow’s election as reported in the New York Times – very low.
Reflections on vacation and terrorism impacting continuing medical education
This commentary was composed over the Atlantic Ocean, returning from a cruise sponsored by the Alabama Dermatology Society. For anyone who has toured Europe, it is easy to relate to the “If it’s Tuesday, it’s Belgium” effect.
Prognosticating folliculotropic mycosis fungoides: Everything old is new again
I was dermatology resident in 1980 learning about mycosis fungoides when the late Peter Allen was in his glory singing “Everything Old is New Again”. The universe of cutaneous T cell lymphoma was simultaneously more confusing (how would you differentiate poikiloderma atrophicans vasculare from xanthoerythrodermia perstans?) and easier (there were
An association of rosacea with risk of glioma? More research please!
A nationwide cohort study of the Danish population of all citizens older than 18 over a 14-year period (1997-2011), encompassing 5,484,910 people was performed: 21,118 had glioma and 68,372 had rosacea.
Increasing evidence for the use of topical timolol for pyogenic granulomas
There are multiple approaches to treating pyogenic granulomas (PGs). If possible, I usually perform a shave biopsy and electrodesiccate the base of the lesion.
The congenital perineal groove: Defective recognition of a dermal defect
It has been nearly half a century since Stephens first detailed the perineal groove (PG) as a congenital malformation consisting of three features.
Topical crisaborole ointment for atopic dermatitis: Hoping for a painless introduction
Any dermatologist who treats atopic dermatitis (AD) must be eagerly awaiting the introduction of 2% Crisaborole ointment. This is equally true for patients (and their parents!) who are steroid-phobic and uncomfortable with the black box warning for calcineurin inhibitors (despite our reassurances).
InCYSTing on searching for explosives
I have enjoyed medical writing and editing since publishing my first article in 1983 when I wrote about a penile Fibroepithelioma of Pinkus (my medical school roommate’s father was the patient).
Getting a leg up on squamous cell carcinomas of the teratoacanthoma type
I thought it was my imagination, but apparently not – there is distinct subset of patients, mostly mature women, with squamous cell carcinomas (SCC) of the keratoacanthoma type (KA) usually presenting on the anterior distal lower extremities.
A 2019 resolution: Talk more, Tweet less
Learn more about A 2019 resolution: Talk more, Tweet less at aad.org
Glomus tumors point a finger at neurofibromatosis
The correct diagnosis of the JAMA Dermatology Clinicopathological Correlation of a glomus tumor presenting as longitudinal erythronychia was straightforward – I was fascinated by this comment in the discussion: “The presence of multiple glomus tumors in the digits should raise suspicion for neurofibromatosis type I” (1).
2021 DW Insights and Inquiries archive
Explore past issues of DW Insights and Inquiries that were published in 2021.
2021: Best of DermWorld Insights and Inquiries
Read a "best of" collection of DermWorld Insights and Inquiries from 2021.
2022 DW Insights and Inquiries archive
Explore past issues of DW Insights and Inquiries that were published in 2022.
Best of DermWorld Insights and Inquiries
We know how much you enjoy Dr. Heymann and the editorial board’s weekly analyses of dermatologic literature, so we’ve created a list of the top 10 most popular issues in 2024 — starting with the most popular issue of the year.
August 22
Learn more about August 22 at aad.org
2020 DW Insights and Inquiries archive
Explore past issues of DW Insights and Inquiries that were published in 2020.
Cut it out!
From the Editor ... Dr. Schwarzenberger is the former physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, FAAD, May 1, 2025 For most of us, our first instinct after diagnosing a melanoma is to cut it out quickly and definitively. For thin melanomas, this response is still usually appropriate;
From the editor
From the Editor ... Dr. Schwarzenberger is the former physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, November 1, 2018 November is a perfect month to give thanks. It’s also a good time for personal reflection. As physicians, we have many privileges and, hopefully, much to be thankful for.
The telltale plastic bag of flakes
From the Editor ... Dr. Schwarzenberger is the former physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, April 1, 2020 For many of us, that baggie is the start of a really bad day, because while we all recognize delusions of parasitosis, few of us are completely comfortable treating
FTC narrowly passes final rule prohibiting non-compete clauses
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, D.C. ... By Natalie Lorenz, JD, Ben Tesdahl, JD, LLM, and Robert M. Portman, JD, MPP, June 1, 2024 Every month , DermWorld ... covers legal issues in "Legally
Intellectual property issues for dermatology practices
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, D.C. ... By Ben Tesdahl, JD, LL.M, Fernando Montoya, JD, and Robert M. Portman, JD, MPP, January 1, 2023 DermWorld ... covers legal issues in "Legally Speaking." This month’s
COVID-19 impact on employed dermatologists: Part 2
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, D.C. ... By Ben Tesdahl, JD, Megan La Suer, JD, MHA, and Rob Portman, JD, MPP, October 1, 2020 Every month, DermWorld ... covers legal issues in "Legally Speaking."
Tips for avoiding fraud and abuse liability – Part I
Legally Speaking ... By Christina A. Hughes, JD, MPH, Megan La Suer, JD, MHA, and Robert M. Portman, JD, MPP, January 1, 2022 Every month, DermWorld ... covers legal issues in "Legally Speaking." This month’s authors are health care attorneys with Powers Pyles Sutter & Verville in Washington, D.C. Portman
Life insurance 101: Options and considerations
Money Matters ... David B. Snyder, JD, CLU ... ® ... , is an attorney, author, and financial advisor at the wealth management firm OJM Group. He covers financial issues for dermatologists in this quarterly ... Dermatology World column. ... By David B. Snyder, JD, CLU, September 2, 2019 Life
Tips for avoiding fraud and abuse liability – Part II
Legally Speaking ... By Christina A. Hughes, JD, MPH, Megan La Suer, JD, MHA, and Robert M. Portman, JD, MPP, February 1, 2022 Every month, DermWorld ... covers legal issues in "Legally Speaking." This month’s authors are health care attorneys with Powers Pyles Sutter & Verville in Washington, D.C. Portman
Immediate pathology report release to patients – Is the 21st Century CURES Act worse than the disease?
Read the August 25, 2021 DermWorld Insights and Inquiries on the 21st Century CURES Act and patient access.
June 28, 2023
Derm World Weekly - A Publication of the American Academy of Dermatology | Association ... IN THIS ISSUE/ June 28, 2023 ... A beneficial botanical extract for actinic keratosis? DermWorld Insights and Inquiries : Dermatologic ergonomics — Straighten up and fly right FDA approves alopecia areata treatment in adults and
Information blocking rules for physicians and other health care providers
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, D.C. ... By Allyn Rosenberger, JD, MPH, Jason Qu, JD, and Rob Portman, JD, MPP, August 1, 2024 Every month , DermWorld ... covers legal issues in "Legally Speaking."
Moving on to snail mucin…
From the Editor ... Dr. Schwarzenberger is the former physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, FAAD, October 1, 2023 Last month, we explored the subject of allergic contact dermatitis to cosmetic ingredients. It appears that we may have missed some potential allergens, including snail mucin. While reports
A big, fat lie
The statistics on obesity are staggering. According to the CDC, the percent of adults aged 20 and over with obesity is 39.8% (2015-2016).
Oral tranexamic acid to treat melasma: Are you bloody kidding me?
Tranexamic acid (TA) is a synthetic derivative of lysine utilized as an antifibrinolytic agent to prevent bleeding (for dental surgery in patients with hemophilia, post-cardiac bypass surgery patients, or in women with menorrhagia) and as a treatment option for hereditary angioedema.
Any month is a good month to give thanks.
From the Editor ... Dr. Schwarzenberger is the former physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, FAAD, November 1, 2024 However, there is something special about November — other than the obvious day of Thanksgiving — that encourages me to think about the good things in my life.
It is finally a beautiful day!
From the Editor ... Dr. Schwarzenberger is the former physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, May 1, 2021 I don’t know about you, but I feel like we are nearing the end of an 18-month winter…I guess spring is good for that, and this May, in particular,
Idiopathic facial aseptic granuloma — Have we met?
I’m racking my brain wondering if I have ever seen a case of idiopathic facial aseptic granuloma (IFAG)– I know that I never made the diagnosis because I had never heard the term until I read the first reference. I surmise that I have seen and misdiagnosed it as an
Diagnosing atypical hand, foot, and mouth disease by routine microscopy
Hand, foot, and mouth (HFM) disease is childhood exanthem usually caused by Coxsackie A16; enterovirus 71 has been implicated in cases of HFM complicated by encephalitis, flaccid paralysis, myocarditis and pulmonary edema. Coxsackie A6 has recently been associated with severe, atypical episodes of HFM in children and adults.
Differentiating lichen planopilaris from chronic cutaneous lupus may be as easy as 1,2,3 (actually CD123)
My last dermatopathology case of the week was that of a woman with scarring alopecia, which was clearly well advanced. Hardly any follicles remained, and on one section there was a small follicular unit with a peri-infundibular mononuclear infiltrate and slight vacuolar alteration of the follicular epithelium. I signed the
The neutrophil-to-lymphocyte ratio in cancer: Beauty in simplicity
The world was stunned and saddened on January 28th, 1986 when the Space Shuttle Challenger exploded. Six months later, during the meeting of the Rogers Commission analyzing the disaster, the famed physicist Richard Feynman demonstrated how O-rings lost their resilience. By placing the sample material in ice water, he proved
Preventing hair loss in breast cancer patients is very cool
The loss of my late aunt Millie to breast cancer was devastating; it was even harder to bear after learning that she was aware of the advancing breast tumors, but so afraid of chemotherapy that she delayed treatment until the cancer was too advanced. I do not know if it
Dupilumab and the dawn of the biologic era for atopic dermatitis
I have a list of patients with severe, recalcitrant atopic dermatitis (AD) eagerly awaiting the release of dupilumab. I first became aware of this biologic from the article by Beck et al, who noted that dupilumab, a fully humanized monoclonal antibody that blocks IL-4 and IL-13, previously reported to be
I don’t know JAK — but I will! Ruxolitinib improving chilblain lupus erythematosus
The JAK inhibitors are among the current darlings of treating autoimmune diseases. Recent articles about tofacitinib for vitiligo (1) and alopecia areata (2) have been reported in the lay press with considerable fanfare.
Scratching under the surface: The Temple Itch Center experience
Nothing raises more questions than the development of a database. Nothing needs a database more than the study of chronic pruritus. Mollanazar et al reviewed their data from the Temple Itch Center in Philadelphia, encompassing 920 visits by 597 patients, in the first year of the center’s existence.
Topical amelioration of neuropathic pain and pruritus leading to painful consequences
Increasingly, compounded amitriptyline and ketamine have been utilized for the management of neuropathic pain and pruritus. A review of PubMed reveals its utility in erythomelalgia and diverse neuropathic disorders (peripheral neuropathy, radiation-induced neuropathy, chemotherapy-induced neuropathy, post-herpetic neuralgia, proctodynia, and pain associated with hidradenitis suppurativa).
Write this down if your patient has multiple PENS: Look further
Papular Epidermal Nevus with Skyline Basal Cell Layer (PENS) was first described by Torrelo et al. They detailed 5 infants with solitary or multiple 1 to 7 mm congenital keratotic papules.
2023 DW Insights and Inquiries archive
Explore past issues of DW Insights and Inquiries that were published in 2023.
Fooled again: Misdiagnosing cutaneous follicle center lymphoma
Learn more about Fooled again: Misdiagnosing cutaneous follicle center lymphoma at aad.org
Hidradenitis suppurativa and socioeconomic status: Food for thought (and benefit)
We see many patients with hidradenitis suppurativa (HS), especially in our Camden practice. I am certainly not surprised by the well-documented comorbidities of obesity and smoking, which may play a role in the pathogenesis of the disease.
Rapalogs for vascular lesions: Caveat mTOR
Rapalogs are drugs that inhibit the mTOR pathway and include sirolimus (rapamycin), temsirolimus, everolimus, and deforolimus. All are immunosuppressive and have antineoplastic/antiproliferative effects.
The prescience of Bernie Ackerman: The road from “pseudoleukemia cutis” to “intralymphatic proliferation of T-cell lymphoid blasts (IPTCLBs)”
Hand, foot, and mouth (HFM) disease is childhood exanthem usually caused by Coxsackie A16; enterovirus 71 has been implicated in cases of HFM complicated by encephalitis, flaccid paralysis, myocarditis and pulmonary edema. Coxsackie A6 has recently been associated with severe, atypical episodes of HFM in children and adults.
Telangiectasia macularis eruptiva perstans revisited
I have always struggled with the diagnosis of telangiectasia macularis eruptive perstans (TMEP). Aside from taking the first 6 months of my residency to remember how to say it, I have never been confident of securing the diagnosis. It would always enter the differential diagnosis when telangiectasias were observed, especially
Vulvar hidradenoma papilliferum and mammary-like gnogenital glands: The whole story
I had always assumed that hidradenoma papilliferum (HP), which characteristically appears in the vulvar region, was derived from apocrine glands. Until I read the article by El-Khoury et al (1) I had never even heard of mammary-like anogenital glands (MLAGs).
Atopic dermatitis: Up in smoke!
The etiology of atopic dermatitis (AD) is multifactorial, with genetic mutations of the filaggrin mutations affecting barrier function, immunodysregulation of the TH2 pathway, and environmental triggers being of primary importance. AD has long been associated with autoimmune diseases such as vitiligo and alopecia areata.
Best of DermWorld Insights and Inquiries
We know how much you enjoy Dr. Heymann and the editorial board’s weekly analyses of dermatologic literature, so we’ve created a list of the top 10 most popular issues in 2025 — starting with the most popular issue of the year.
DWI&I Holiday Greeting 2023
For me, this year will be a time for prayer instead. I am not naïve in expecting miracles overnight. I hope that rancor can be replaced by civil discourse and respect for others. Only then can we work toward a more peaceful world.
2024 DW Insights and Inquiries archive
Explore past issues of DW Insights and Inquiries that were published in 2024.
How do we get dermatologic care to those who need it?
From the Editor ... Dr. Schwarzenberger is the former physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, FAAD, June 1, 2022 Many potential barriers that limit access to our services — financial, geographic, and social issues — all come into play, often combining into the perfect storm. Reviewing this
Where there’s smoke, there’s fire…
From the Editor ... Dr. Schwarzenberger is the former physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, FAAD, June 1, 2025 And now dermatologists have a new concern to watch for regarding smoke: skin cancer. Epidemiologic studies have linked environmental exposure to chemicals in smoke with exacerbations of skin
From the editor
From the Editor ... Dr. Schwarzenberger is the former physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, April 2, 2018 I hope you enjoyed the AAD Annual Meeting in San Diego. I certainly did. I came home yet again feeling renewed, returning to the clinic armed with new knowledge
From the editor
From the Editor ... Dr. Schwarzenberger is the former physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, August 1, 2019 August is already upon us. I never quite understand where the summer goes. It seems like the flowers begin blooming and, suddenly, the leaves already start to change colors.
More payers implementing evaluation and management code level reviews
Several insurance payers are expanding pre-payment claim reviews for higher-level evaluation and management (E/M) services. These reviews often target level 4 and 5 visits and may result in downcoding. UnitedHealthcare’s Smart Edit and Elevance Health’s (formerly Anthem) E/M Leveling program have been in place for several years. Now, additional
Flimflammers.
From the Editor ... Dr. Schwarzenberger is the former physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, FAAD, March 1, 2025 My new favorite word for 2025. As much as I would love to take credit for this perfect word, I must thank our esteemed ... DermWorld Editorial Advisor
Itch
From the Editor ... Dr. Schwarzenberger is the former physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, FAAD, April 1, 2022 That final frontier that torments us almost as much as it does our patients. I have always considered itch to be one of the worst conditions that our
The importance of getting involved
From the President ... Dr. Alam is the Academy’s current president. ... By Murad Alam, MD, FAAD, April 1, 2026 Dear members, ... I would like to begin by thanking you for trusting me to serve as your president. We have important work to do this year, and I am
Who knew?
From the Editor ... Dr. Schwarzenberger is the former physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, FAAD, November 1, 2023 When it comes to skin health, we all know that a board-certified dermatologist knows best. In years past, we were comfortable being known and respected for our expertise.
Becoming whipped up over flagellate dermatoses
The literature on flagellate dermatoses has been whipped into frenzy.
Expanding indications of the excimer laser for disorders of hypopigmentation: Equivocally seeing the light
The excimer laser is a reasonably effective modality for treating vitiligo. Other disorders of hypopigmentation, such as a nevus depigmentosus (ND), or post-inflammatory hypopigmentation (PIH) secondary to lichen striatus (LS) may be distressing to patients (or their parents). Is the excimer laser a viable option for these patients?
I’m tired
From the Editor ... Dr. Schwarzenberger is the former physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, June 1, 2020 I hear that a lot these days. COVID-19 blew up the world as we knew it and the process has been, among other things, exhausting. Almost overnight we turned
March is a strange month
From the Editor ... Dr. Schwarzenberger is the former physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, March 1, 2021 Other than the AAD Annual meeting (sadly, canceled for the second year, courtesy of the ongoing COVID-19 pandemic), there’s usually not much to look forward to in March. Sure,
It’s always the gluten
From the Editor ... Dr. Schwarzenberger is the former physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, November 1, 2020 Gluten is to dermatitis as brown recluse spider bites are to ulcers. Often blamed, but rarely the cause. I run a contact dermatitis clinic, and without fail, at least
Here’s looking at you, KID
Keratitis, ichthyosis, and deafness (KID) syndrome is a rare genodermatosis associated with mutations in the GJB2 gene, which encodes connexin 26. Abnormalities of this gap junction protein presumably affects epithelial differentiation, resulting in myriad clinical features.
Treating acrodermatitis continua of hallopeau in 2018? Try guselkumab!
Acrodermatitis continua of Hallopeau (ACH) is a disorder well known to dermatologists, but absolutely mysterious to everyone else. It is now considered a localized form of pustular psoriasis of the digits that may be accompanied by onychodystrophy and osteolysis.
My core incompetencies
It is time for our semiannual ritual – the meeting of our Clinical Competency Committee (CCC). Our dermatology program is small, having twice as many faculty members as residents, so everyone serves on the committee. The process has changed dramatically from the time I was our program director (which ended
Perspectives on peristomal pyoderma gangrenosum
Peristomal pyoderma gangrenosum (PPG) is a challenging problem, both physically and emotionally. The diagnosis may be delayed, often being mistaken for an irritant dermatitis or an infection.
Multiple café au lait spots in fair skinned children without evidence of neurofibromatosis type 1: Don’t SPRE(A)D the word – yet
Café au lait spots (CALS) are extraordinarily common; six or more lesions (at least 0.5 cm prior to puberty or 1.5 cm post puberty) are considered one of the criteria for diagnosing neurofibromatosis type I (NF1), and are also seen in a variety of other syndromes.
The “rope” sign is knot pathognomonic: Autoimmunity ties the etiologies together
The “rope” sign is a dramatic finding presenting as a linear to curvilinear cords (“cordonifom”) on the lateral chest. It was originally described as an uncommon, but specific feature of Interstitial Granulomatous Dermatitis with Arthritis (IGDA), and has been considered pathognomonic for that disorder. That perspective is no longer tenable.
Stepping back from the abyss: A kinder, gentler variant of calciphylaxis
My reaction to the diagnosis of calciphylaxis is Pavlovian – I automatically think about an end-stage renal insufficiency patient with an abysmal prognosis. Increasingly there are reports of nonuremic forms of the disease, where the prognosis may not be as bleak (*although clinically very significant).
A watershed discovery for potential treatment of pseudoxanthoma elasticum
We had the honor of presenting a family with pseudoxanthoma elasticum (PXE) at the Cooper Medical School of Rowan University session of the Philadelphia Dermatological Society on February 24th, 2017. The proband was referred to confirm the diagnosis of PXE prior to her coronary artery bypass graft surgery.
The darkness of lichen planus pigmentosus
Darkness defines lichen planus pigmentosus (LPP) – lesional morphology, the patient’s mood about their appearance, and our ability to understand or treat it. Both patient and physician are literally in the dark.
Patients’ (mis)understanding of their skin cancer diagnosis
Occasionally a patient’s misunderstanding of their dermatologic diagnosis can elicit a smile. How can you not chuckle when someone says that they suffer from “hanky-panky” (lichen planus) or that they have been plagued with acme since high school? In cases of skin cancer, the consequences of inaccuracy may not be
AAD's guidance on resources related to workplace violence
Read Academy guidance and access resources related to workplace violence. Learn about source for education on prevention and response. Review OSHA requirements and best practices for keeping clinicians, staff, and patients safe.
2025 DW Insights and Inquiries archive
Explore past issues of DW Insights and Inquiries that were published in 2025.
Administrative burden: How the AAD can help you
The Academy offers a variety resources to help alleviate your administrative burden. We give you the tools you need for appeals and other administrative processes, so you can get back to patient care.
Cash-only practice
A cash-only practice is a patient self-pay model where dermatologic services are provided without billing insurance. Patients pay directly at the time of service, streamlining practice operations and enhancing autonomy for the physician. Similarly, a concierge practice is one where the patient pays an annual membership fee.
Joint venture practice
A joint venture is a collaborative business arrangement where two or more practices come together as shareholders in a new entity or contract to achieve mutual goals. Unlike a full merger, each party retains its own legal identity while sharing profits, risks, and operations to appear as a unified entity
The profound dermatological manifestations of COVID-19
Read the March 18, 2020 DermWorld Insights and Inquiries on COVID-19.
Does your dermatology practice comply with the Family and Medical Leave Act?
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, D.C. ... By Jeremy Lewin, JD, Ben Tesdahl, JD, LL.M, and Robert M. Portman, JD, MPP, September 1, 2022 DermWorld ... covers legal issues in Legally Speaking. This month’s
ADA issues for dermatology practice websites
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, D.C. ... By Ben Tesdahl, JD, LLM, and Rob Portman, JD, MPP, May 1, 2024 Every month, DermWorld ... covers legal issues in "Legally Speaking." This month’s authors are
Reopening the dermatologic surgery office in the COVID-19 era
Read the May 20, 2020 DermWorld Insights & Inquiries article on reopening dermatology offices in the COVID-19 era.
Can we chat?
Read the March 29, 2023 DermWorld Insights and Inquiries on new chatbot AI technologies.
Insult to injury: COVID-19-associated mucormycosis
Read the June 9, 2021 DermWorld Insights and Inquiries on COVID-19-associated mucormycosis.
Malignant syphilis: History in the making
Malignant syphilis has been increasingly reported in both immunocompromised and immunocompetent patients. Dermatologists should consider this diagnosis when encountering patients with an acute onset of well-defined necrotic ulcers that may be associated with rupioid crusts.
Anti-kickback implications for company-sponsored speaker programs
Legally Speaking ... Robert M. Portman, JD, MPP, is a health care attorney with Powers Pyles Sutter & Verville, in Washington, D.C. ... By Megan La Suer, JD, MHA, and Rob Portman, JD, MPP, February 1, 2021 Every month, DermWorld ... covers legal issues in "Legally Speaking." This month’s authors
Out of bounds
How to protect against the unauthorized practice of dermatology and false advertising by non-physicians. ... Feature ... By Ben Tesdahl, JD, LLM, and Jason Qu, JD, Contributing Writers, April 1, 2025 Dermatologists face increasing competition from non-physicians offering various types of skin care services. Provided that such services do not
Demonstrating the value of dermatologic care to state legislators
Ask the Expert ... By Victoria Houghton, Managing Editor, April 1, 2022 DermWorld ... spoke to Victoria Pasko, assistant director of State Policy for the American Academy of Dermatology Association (AADA), about the Academy’s participation in the National Conference of State Legislatures. DermWorld: The AADA recently participated in the National
Welcome to Dermatology World Insights and Inquiries
Learn more about Welcome to Dermatology World Insights and Inquiries at aad.org
Herpes zoster, immunosuppression, and vaccination: Far from a blistering pace
I had long promised myself that I would get Zostavax when I turned 60. Now 61, I am actively procrastinating – I decided to wait for a new VZV subunit zoster vaccine that consists of recombinant VZV glycoprotein E and a liposome-based ASO1B adjuvant system.
Could wart immunotherapy open a therapeutic window for congenital nevi at risk for melanoma?
Two of the most vexing problems pediatric dermatologists face is treating recalcitrant warts and managing large congenital nevi.
Hallelujah! A negative comorbidity study: Putting comorbidities in perspective
Upon reading the title “Assessment of the risk of cardiovascular disease in patients with rosacea”, I was braced for yet another reason why we should invest in cardiac nuclear scans in our dermatology office instead of a new laser.
Maximizing knowledge about infantile hemangioma with minimal or arrested growth
Knowledge about hemangiomas is proliferating at a rate the compares with the first few days of an infantile hemangioma (IH) itself. Over the past decade a “new” lesion is coming into focus – the infantile hemangioma with minimal or arrested growth (IH-MAG).
Covfefe and the art of the diagnostic deal
I don’t know what’s more frightening — making diagnoses on autopilot or being genuinely stumped and having to think like a first-year resident.
How dry I am: The white scale sign of xerosis
When winter approaches my skin dries out. Fortunately, it doesn’t bother me at all. For others, especially in the elderly, xerosis be a predisposing factor for asteototic eczema, nummular dermatitis or dyshidrotic eczema.
Are you at risk for pityriasis rubra type V? It’s in the cards!
In a recent post advising to tread lightly before prescribing secukinumab for pityriasis rubra pilaris (PRP), I suggested that the Griffiths classification of PRP be expanded from types I –VI to include type VII (paraneoplastic) and type VIII (Sézary syndrome presenting as PRP). In my opinion, of all the types,
Taking biologics to heart
Comorbidities related to psoriasis have dominated the dermatologic literature for more than a decade since Joel Gelfand published his seminal paper.
Sirolimus for microcystic lymphatic malformations: Caviar for frog spawn
Recently, our understanding of lymphatic malformations (LMs) has vastly expanded. Genetic advances have focused on the PI3K/AKT/mTOR pathway allowing the use of mTOR inhibitors for those lesions involved in this pathway.
Top 3 administrative burdens in dermatology and how to tackle them!
Answers in Practice ... By Faiza Wasif and Swapna Pachauri, AADA Practice Management, December 1, 2021 Each month, DermWorld ... tackles issues "in practice" for dermatologists. This month, practice management staff offer tips on managing the top three administrative burdens. A successful dermatology office is established not only on optimal
From the editor
From the Editor ... Dr. Schwarzenberger is the former physician editor of ... DermWorld. By Kathryn Schwarzenberger, MD, March 1, 2018 Change is a recurring theme in this month’s ... Dermatology World . Change seems to be a given these days; perhaps it always was, but it’s hard to imagine
A novel sebum inhibitor for acne vulgaris: A slick maneuver
What a pleasure it is to think about a novel treatment for acne! Honestly, have you gotten excited learning that the “same old, same old” is now available in a cloth or foam?
Koebnerization in Henoch-Schönlein purpura: How does it line up with prognosis?
Heinrich Koebner is eponymically known for having first described the phenomenon of developing an existing dermatosis in previously normal skin following external or internal trauma. The prototype of the Koebner phenomenon, (aka isomorphic response) is observed in psoriasis, although it has been described in many dermatoses, including leukocytoclastic vasculitis.
Eyeing the use of cryotherapy for eyebrow alopecia areata
I am always looking for alternatives to injecting eyebrow alopecia areata with triamcinolone acetonide (TAC).
Cannabinoids may elevate therapy for connective tissue diseases to a higher level
Medical “reefer madness” is taking hold in the United States with approximately 10% of cannabis users utilizing it for diverse medical conditions, including dermatologic disorders such as pruritus and atopic dermatitis. To date, at least 28 states allow for the use of medical cannabis. (1)
Getting within a hair’s breadth of understanding prurigo pigmentosa
Prurigo pigmentosa (PP) is an uncommon dermatosis consisting of a network of erythematous, pruritic papules evolving into reticulated hyperpigmentation with a specific predilection for the trunk. It seen mostly in young adults, mostly in women.
Tofacitinib for adolescent alopecia areata: Balancing the risk-benefit ratio
There has been acute interest in utilizing Janus kinase (JAK) inhibitors for alopecia areata (AA). Does the media’s fervor touting tofactinib’s success translate into a rational decision to prescribe it for young patients?
The real jigsaw puzzle of the Brooke-Spiegler Syndrome: Translating the molecular biology to therapy
Residents jump for joy when they see the characteristic “jigsaw puzzle” appearance of cylindromas under the microscope. Histopathology, however, takes us only so far.
Vitiligo and melanoma: New thoughts on an old observation
I was fortunate that as a resident and fellow I had marvelous attending physicians who would offer their pearls of wisdom. As it is impossible to study every dictum, I would (usually) accept these viewpoints as “facts” and incorporate them into practice. An example is performing a full skin examination
Dermatomyositis oddities: Could one be responsible for the other?
So much about dermatomyositis (DM) has intrigued me since medical school. Over the years, I have probably read more about this disease than any other malady. I am always amazed how I much more there is to learn.
Thyroid hormone, mitochondria, photoaging and April 7, 2017
On April 7, 1997 I filed a patent entitled “Method for the treatment of dry skin”, utilizing topical thyroid hormone. The publication date of the patent US5951989 was September 14, 1999. The expiration date is April 7, 2017.
Aleppo to Zika: 2016’s anxieties may lead to 2017’s dermatoses
If you accept the theory that anxiety leads to stress, which, in turn, aggravates dermatoses, then 2016 has been a banner year for potential stressors.
Bringing pigmented lupus to light
Lettie (not her real name) was an elderly, charming, courtly, soft-spoken African-American woman whose facial skin was getting progressively darker. Only after I drew routine laboratory studies and found marked thrombocytopenia, did I entertain the diagnosis of lupus, which was subsequently confirmed by biopsy and serologies.
Incretin-based therapy for diabetes and dermatology: Promise and peril
In a given day, how many of your patients are diabetic? According to the American Diabetes Association, in 2015, 9.4% of the US population (30.3 million) were diabetic; 29 million of this group had type 2 diabetes.
The heartrending aspects of incontinentia pigmenti
Incontinentia pigmenti (IP, aka Bloch-Sulzberger syndrome) provides lessons in genetics, immunology, and neuroectodermal development. Frankly, I have never given much (if any) thought about its cardiovascular manifestations. Albeit rare, they are part of the spectrum of IP.
Of every possible solution for elastosis perforans serpiginosa, fractional carbon dioxide laser may be the best
My initial attraction to dermatology, which still offers great appeal, is the challenge and joy of differential diagnosis and clinical-pathologic correlation. I learned quickly, however, that patients don’t want to be interesting – they want a specific diagnosis for one reason only – to get the right treatment, preferably curative.
Melanoma risk in patients with melaoncortin-1 receptor independent of ultraviolet radiation: Is there a way not to be burned by your genome?
I admit that my concept of Type I skin red-headed patients getting melanoma was simple: They have a polymorphism(s) of the melanocortin-1 receptor (MC1R), pheomelanin, ultraviolet exposure, DNA damage, increased reactive oxygen species, and voila: melanoma! While conceptually elegant, this is apparently only a partial truth.
Desquamative gingivitis: Sinking your teeth in miagnosis and management
Patients presenting with desquamative gingivitis (DG) are typically some of the most frustrated, aggravated patients I encounter. Frequently, they have not been adequately evaluated, are in pain, and are desperate for help.
Treating psoriatic patients with associated inflammatory bowel disease: A personal bias
My late brother Andrew succumbed to complications of Crohn disease (CD) at age 29. His brief, but valiant life was punctuated by multiple hospitalizations, surgeries, remissions, and exacerbations.
Vitamin C as treatment of basal cell carcinoma: Is it fruitful?
For those of us who learned that taking mega dose vitamin C for the common cold, as advocated by the late Nobel Laureate Linus Pauling, was truly something to sneeze at, I always approach studies lauding the effects of nutrient-based therapies with a mega dose of skepticism.
Rituximab therapy for recalcitrant dermatitis herpetiformis: A gut feeling
Recently I “accidentally” diagnosed a severely pruritic man with dermatitis herpetiformis (DH). He had seen leading authorities for his life-altering pruritic dermatosis, that clinically and histologically was an eczematous eruption.
Labor Day thoughts on increasing dermatologist burnout
A recent Mayo Clinic study noted that between 2011 and 2014, dermatologists had the largest increase in burnout of any specialty (from 32% to 57%), listed as seventh in satisfaction with work-life balance. Just a few years earlier, dermatology was second, following preventive/occupational/environmental medicine (1).
Of strife and SDRIFE
A conceivable Yelp review: I was so uncomfortable with a nasty rash on my butt, armpits and groin – I called a dermatologist who was recommended to me by my mother-in-law. I was so upset with that doctor – I waited for an hour and a half! When he finally
Ubiquitous ubiquitination
While perusing the Journal of Investigative Dermatology, I was intrigued by the theory that a variant of epidermolysis bullosa simplex (EBS) may be due to “dysregulation of autoubiquitination” caused by mutations in KLHL24 (Kelch-like family member 24).
Reflections on “Being Mortal” by Atul Gawande
I was given this best-selling book as a holiday gift last winter. I wanted to read it, but somehow it was easier to deny my fears about aging by ignoring the text. With increasing rapidity, I am losing patients that I have known for decades, and I’m getting used to
Can oral ivermectin cure pediatric periorificial dermatitis? It mite!
Ask any child when how long it is until their next birthday and they can usually give you a precise answer. If I’m treating a child with periorificial dermatitis (POD, also granulomatous POD or perioral dermatitis), I can’t wait until they turn 8, so I can prescribe doxycycline.
Ustekinumab: A topic for atopics?
If you’re like me, you have a cadre of patients with severe atopic dermatitis (AD) patients who are counting the minutes for the release of dupilimab (a human monoclonal antibody against interleukin-4 receptor alpha, that inhibits signaling of interleukin-4 and interleukin-13, type 2 cytokines that may be important drivers of
Red genitals: New roads to recovery
I searched PubMed for Quality of Life (QoL) studies on the Red Scrotum Syndrome (RSS) and Red Vulva Syndrome (RVS); I found no such manuscripts. On a practical level, none are needed – every person I have encountered with either condition has been in misery due to any combination of
Pubic hair grooming: Less means more
It is essential for dermatologists to comprehend current mores that affect our patients’ health. Understanding the trend toward increased genital hair grooming in men and women can help us instruct patients on how to avoid injuries related to hair removal.
Adherence to acne treatments: Flipped sides of the coin for physicians and patients
It takes a motivated, dedicated patient to adhere to their prescribed acne regimen. According to Moradi Tuchayi et al, primary nonadherence occurs when the medication is not even started.
Keeping abreast of the expanding literature of implant-associated Anaplastic Large Cell Lymphoma (ALCL)
Silicone gel implants were removed from the US market in 1992 because of health concerns, only to be reintroduced in 2006, with the provision for increased surveillance of health outcomes. I was under the (apparently mistaken) impression that the FDA put the brouhaha of a potential association of silicone
Sézary syndrome and Shakespeare: What’s in a name?
O Sézary, Sézary! Wherefore art thou Sézary? Deny thy erythema and refuse thy name Or, if thou wilt not, but sworn by biome, And you’ll no longer be a syndrome. Dermatologists have contended with entities such as zoster sine herpete and aleukemic leukemia cutis, but now reports of Sézary syndrome (SS) without erythroderma challenge
The retiring type?
“Tell me, Dr. Heymann, when do you plan to retire?” Patients seem to ask me that every day. My usual response: “Why do you ask, do I look that bad?” “No, you look pretty good for your age.” (According to my rabbi, there are three stages of life – youth, middle age, and
Blasé about the acronym BLAISE (Blaschko Linear Acquired Inflammatory Skin Eruptions)
I always enjoy rendering the diagnosis of lichen striatus – parents are concerned, the rash is benign, and usually resolves within months. The only downer is trying to answer the inevitable question of “Why did my child get this?” and I morph from the sagacious physician to a dunce,
No need for panic with MANIC
As a medical student, I would panic over embryology of the neck. I never quite understood the development and anomalies of branchial arches or the migration of the thyroid anlage from the foramen cecum; yet I knew that as a clinician, it would be important to comprehend the differential diagnosis
Becker’s nevus: Mutations that shoulder responsibility
It is fascinating to review original articles. In 1949, Becker described two young men, aged 17 and 24, respectively, with “blotchy” brown pigmentation with dark hairs, on the shoulder region, first noting their lesions in their early to mid teens. Both patients had their lesions follow an intense sunburn, allowing
The autumn of a career
I have always been haunted by Ervin Drake’s lyrics of “It Was a Very Good Year”, as sung by Frank Sinatra, since I first heard them as a ten-year-old boy listening to WMCA on my transistor radio. The journey of a man’s romances from his teenage through senior years resonated
An acne vaccine to make patients happy CAMPers?
When walking back to my office after receiving my flu shot, I thought about how wonderful it be to have a preventive therapy for common dermatologic disorders such as acne. That may not be so far-fetched.
Laboratory testing for syphilitic alopecia: Time to renew old habits?
I’m not sure how this happened. I used to check several laboratory studies in patients presenting with alopecia, including a rapid plasma reagin (RPR) for syphilis (in addition to a CBC, TSH, iron binding studies, ANA and vitamin D; testosterone and DHEAS would also be obtained if there was a
Mucho de Mucha-Habermann
As we approach interview season for our residency program, I try to think of some questions I haven’t asked before. I usually do not discuss dermatologic disorders per se, as I am more concerned about the interviewee as a person knowing how they would mesh in our division.
“Brain fog” and mastocytosis: In patients and me
When following patients with mastocytosis – whether classical urticaria pigmentosa in children or adult mastocytosis – I usually ask a directed review of systems, focusing on flushing, palpitations, and gastrointestinal symptoms.
Pediatric melanoma: A wolf in sheep’s clothing
Despite its rarity, the incidence of pediatric melanoma (PM) has been increasing. Every practicing dermatologist, past or present, has been humbled or fooled by the clinical appearance of melanomas, examples being amelanotic or desmoplastic variants.
Secukinumab for pityriasis rubra pilaris: Tread lightly
Every dermatology resident preparing for their board examination can rattle off Griffiths’ classification of pityriasis rubra pilaris (PRP) – Type I (Classical Adult), Type II (Atypical Adult), Type III (Classic Juvenile), Type IV (Circumscribed Juvenile), and Type V (Atypical Juvenile). Type VI, associated with HIV infection was subsequently added to
Aha! The iodide paradox now makes sense!
In the pre-direct immunofluorescence days of yore (before my time in dermatology), the exacerbation of dermatitis herpetiformis (DH) by oral or topical iodides could be used as a diagnostic tool.
Mindfulness for the patient and the dermatologist
While meditation has been present for millennia, the concept of mindfulness has recently come into vogue. Conceptually, mindfulness aims to have a person focus their attention on the present moment by developing coping strategies, such as meditation or deep breathing.
Intestinal obstruction of justice raises a question for dermatology residency applicants: Are you a real doctor?
“Are you a real doctor?” Every dermatologist has been asked this question.
Taking psoriasis by the throat
Once the transient satisfaction of explaining the association of streptococcal infections with psoriasis (guttate, vulgaris, or pustulosis palmaris et plantaris) passes, the reality of treatment must be addressed. Of course we’ll prescribe the usual regimens – topical steroids, phototherapy, retinoids, biologics, etc., but targeting the streptococcal trigger should be considered.
December 4, 2024
Derm World Weekly - A Publication of the American Academy of Dermatology | Association ... IN THIS ISSUE / December 4, 2024 ... What’s the best treatment for squamous cell carcinoma in situ? DermWorld Insights and Inquiries : Darier disease is rough clinically and therapeutically. MEK inhibition may offer a
What features in psoriasis patients indicate that the patient is at high risk of developing psoriatic arthritis?
Clinical Applications ... Dr. Abate is a member of the ... DermWorld Editorial Advisory Workgroup. ... By Mallory Abate, MD, FAAD, December 1, 2023 In this month’s Clinical Applications column, DermWorld ... Editorial Advisory Workgroup member Mallory Abate, MD, FAAD, talks with Luigi Naldi, MD, about his JAAD ... paper,
Understanding medical decision making
Understand the role of medical decision making in selecting the proper E/M code. Three components go into correctly coding the levels of evaluation and management (E/M) services. Medical Decision Making (MDM) is one of them.
Academic medical center practice
An academic dermatology position is based within a university or teaching hospital. Physicians in this setting typically divide their time between patient care, teaching, research, and administrative duties.
Getting started resources
Find resources to help you get started with teledermatology. These include downloadable checklists for your to consult, along with online education offered by the Academy that can help you understand teledermatology.
Accountable care organization (ACO)
ACO dermatology involves practicing within an Accountable Care Organization, a health care model that prioritizes quality, efficiency, and outcomes over volume. Dermatologists in ACO settings participate in value-based care contracts, where reimbursement is tied to patient outcomes, cost savings, and quality metrics rather than the number of procedures performed.
Group practice without walls (GPWW)
A group practice without walls (GPWW) is a collaborative model where independent dermatology practices operate under a shared tax ID number, combining financial and administrative operations while maintaining clinical autonomy. Unlike full mergers or acquisitions, GPWWs allow dermatologists to keep their separate office locations and patient relationships, while benefiting from
Independent practice association (IPA)
An independent practice association (IPA) allows dermatologists to retain their independent practice status while joining a separate entity that negotiates payer contracts on behalf of its members. This model offers a way to preserve autonomy while gaining access to better reimbursement rates, shared administrative services, and collective negotiating power.
Merged practice
A practice merger involves combining your dermatology practice with one or more other practices to expand your geographic reach, diversify services, and gain access to greater financial resources. This model offers opportunities for economies of scale, improved operational efficiency, and stronger negotiating power with payers.
Teledermatology practice
Dermatologists use telemedicine to evaluate and treat patients remotely, expanding access for those in rural or underserved areas. Teledermatology provides greater scheduling flexibility, supports efficient triage, convenient follow-ups, and enables collaboration with distant colleagues.
Midsize group practice (6-15 practitioners)
Group practices consist of multiple dermatologists working together within a shared business structure. These can be independent partnerships, large integrated groups, or practices owned by private equity.
Virtual credit card payments
Virtual credit card (VCC) payments are made by insurance companies issuing single-use credit card numbers to physicians. VCCs offer enhanced security but often incur higher fees. Health care organizations can choose between these options based on their preferences, balancing security and costs in managing their financial transactions.
Advocacy Update March 31, 2026
The AADA urged the FDA to reconsider its withdrawal of the proposed indoor sunlamp regulation and finalize restrictions on youth access.
Advocacy Update May 5, 2026
In response to advocacy by the AADA and other specialty societies, UnitedHealth Care will delay any adverse payment decisions related to Medicare Advantage referral requirements starting on May 1.
Here comes summer (and sunscreen conversations)!
Read the April 29, 2020 DermWorld Insights and Inquiries on suncreen.
Focusing attention on X-linked ichthyosis
This commentary focuses on some new literature about XLI that demands our attention.
Trial balloons of gene expression profiles of calloon cell melanoma predict the future
The site of balloons is joyous; however, I am always nervous blowing them up, because of a nagging fear that they would explode in my face. Similarly, the histologic site of balloon nevus cells may bring a smile, but is tempered by the concern that the lesion could be a
A potentially life-threatening association of autoimmune blistering disease we bloody well need to be aware of: Acquired hemophilia A
I have been treating patients with autoimmune bullous disorders for nearly four decades. The diseases’ vagaries and associations always astound me.
Dermatomyositis takes your breath away!
The dermatopulmonary syndrome (DPS) is a newly recognized subset of dermatomyositis (DM) associated with anti-MDA5 (melanoma differentiation-associated gene 5) antibodies. The hallmarks are palmar papules, cutaneous ulceration, a high risk of severe interstitial lung disease (ILD), a low risk of myositis, and a low risk of malignancy.
Debunking the myth of the aggressive nature of acantholytic squamous cell carcinomas
For years, I have taught my residents that acantholytic squamous cell carcinomas (aSCCs, aka “pseudoglandular” SCCs) were more aggressive than typical SCCs. Two recent studies suggest otherwise. In medicine (and life) there should be no room for “post-truths” – we need facts to confirm or refute long-standing assumptions.
The appeal of molecular medicine for the peeling skin syndrome
This may not be the most appropriate dermatologic admission, but as a child, I really enjoyed peeling away my post-sunburn desquamation. What joy ensued when it came off with glistening new skin underneath! Of course, I’m from the “now we know better” generation – this should never happen in 2018
Melanoma: A family affair
It has now been 5 years since I was diagnosed with melanoma. Six years ago, my wife Ronnie found a tick on my back; when she noted a lesion in the same region a year later, I remember asking her “What did you find, another tick?” No, it was melanoma
Platelet rich plasma: Good for whatever ails you?
Okay, okay, I admit it. The first time I ever heard of injecting autologous platelet rich plasma (PRP) for pattern alopecia, my suspicion was that it was being sold by the proverbial snake-oil salesman. I did my utmost to ignore it, but increasingly its use is being reported, and patients
Scratching below the surface for the etiology of lichen amyloidosis — no sweat?
We have all confronted patients with maddeningly pruritic, recalcitrant cases of lichen amyloidosis (LA). Establishing the diagnosis is easier than treating the disorder; understanding its pathogenesis is even more confounding.
The rosy reality of coffee
I have never discouraged caffeine in rosacea patients, because of a brilliant study by Jonathan Wilkin that I read early in my residency.
What is the role of sentinel lymph node biopsy for primary cSCC of the head and neck?
Clinical Applications ... Dr. Schwarzenberger is the former physician editor of ... DermWorld . She interviews the author of a recent study each month. ... By Kathryn Schwarzenberger, MD, FAAD, September 1, 2022 In this month’s Clinical Applications column, Physician Editor Kathryn Schwarzenberger, MD, FAAD, talks with Christian L. Baum,
The concept of atrophoderma of pasini and pierini as morphea may be falling off a cliff
Diagnosing Atrophoderma of Pasini and Pierini (APP) is reasonably straightforward – it usually presents in adolescents and young adults, more often in females, with sharply defined, single or multiple round to oval, hyperpigmented, depressed lesions with a “cliff-drop” border. Unusual presentations may include congenital lesions (1) or with a Blaschkoid
Does your dermatopathologist recommend treatment suggestions for melanocytic lesions? My two cents (and sense)
The question raised by the title is important for patient care and medicolegal concerns. The format of my commentary will differ from the usual. I have copied the abstract from the article by Lee et al (1) – my comments will appear underlined in italics within the abstract itself. (You
Slivers of skin may diagnose silver hair syndromes
Simple tests may help distinguish the rare silver hair syndromes (SHS): Chediak-Higashi (CHS) and Griscelli (GS).
Taking the challenge: Social media, adolescents, and the skin
Learn more about Taking the challenge: Social media, adolescents, and the skin at aad.org
Diagnosing infectious diseases in 2028: Let the good times roll
You may be overwhelmed by the “omics” – genomics, epigenomics, transcriptomics, proteomics, metabolomics, with good reason. “Big Data” are changing the diagnostic landscape in infectious diseases and oncology at breakneck speed. Warning: By the time this is posted, it may be obsolete!
Collodion babies and endocrine disorders: Another concern
Collodion baby (CB) describes an infant who is born with a cellophane-like, or parchment-like “membrane” resembling collodion. CB is not a specific diagnosis, but rather a phenotype seen in several forms of ichthyosis.
Proliferating tests for proliferative nodules of congenital melanocytic nevi
Proliferative nodules (PN) arising in congenital melanocytic nevi (CMN) require differentiation from melanoma. These are disconcerting, if not frightening, lesions to contend with. Do new techniques help in differential process?
Countering corticophobia
Topical corticosteroid phobia (TCP, aka “corticosteroid phobia”, “corticophobia”) describes exaggerated concerns, fears, worries, anxiety, doubts, reservations, reluctance or skepticism regarding corticosteroid use in patients, their caregivers, or health care professionals
Charlottesville, Anzio beachhead, eponyms, and Roger Maris
I never anticipated the need to write this commentary on our vacation to celebrate our 35th anniversary. We had long planned visiting Anzio, where my late father-in-law, Louis Schnur, fought valiantly on the beachhead in the army artillery unit.
Can steroids extinguish the fire of erythromelalgia?
The burning sensation of erythromelalgia is matched by a burning desire to help these patients. According to Tang et al: “This rare and debilitating disorder was first reported and named “erythromelalgia” according to its main symptoms (erythros-red, melos-limbs, algos-pain) by Mitchel in 1878.
A dermatologic riddle: How is IgG4-related ophthalmic disease parliamentary?
IgG4-related disease (IgG4-RD) is a chronic fibro-inflammatory disorder that potentially affects virtually every organ system. It characteristically affects middle-aged men, although for lesions of the head and neck, there is an equal gender distribution.
Ruth Heymann (1921-2018): A son’s reflection
Any life spanning from Warren Harding’s Teapot Dome Scandal to the Trumpian-Russian mishegas warrants reflection and celebration. Our first president, George Washington, understood that life’s trajectory is rooted in its first decades – for mom that included the Depression and World War II – the most challenging times of the
DI&I encore: Better than a back scratcher?
The potential toxicity of the combination of topical ketamine/amitriptyline/lidocaine (TKAL) was discussed in a recent entry detailing the encephalopathic findings in an octogenarian Parkinsonian man with atopic dermatitis who was treated with the compound.
APACHE no more
This commentary is about being DC (Dermatologically Correct), not PC (Politically Correct as in the Washington Redskins controversy). The time to retire the acronym APACHE (Acral Pseudolymphomatous Angiokeratoma of Children) is overdue.