Beneath the Surface
A Healio podcast hosted by Joel M. Gelfand, MD, discussing the latest news and hot topics in the field of dermatology.
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A deep dive into iPledge changes with John Barbieri, MD
09/03/2025
A deep dive into iPledge changes with John Barbieri, MD
In this episode, guest John Barbieri, MD, MBA, discusses the FDA’s 2023 proposed changes to the iPledge system and the impacts of clinical trials and treatments on patients with hormonal acne. • Intro 0:28 • John Barbieri, MD, MBA 0:42 • What does it mean to have a conditional recommendation, and why is this considered “controversial”? 1:50 • What are the reasons, such as limitations of use, that lead to a conditional recommendation? 2:48 • How would you implement these care guidelines into clinical practice? 3:53 • Why is a medication like minocycline in the conditional category relative to other medications? 5:55 • Tell us about some of the recent studies on spironolactone that have come out of the UK and France, and what we’ve learned from them. 7:10 • Did they monitor any lab tests during these studies? 9:57 • Can you tell us about the NIH-funded trial you are leading in the US? 10:36 • Who uses spironolactone? How do you start this drug? 11:38 • What is currently happening with iPledge? 13:04 • How will these changes work operationally? What kind of home pregnancy test is used for patients? 15:20 • When can clinicians expect these changes to iPledge to be implemented? 16:42 • Thank you, Dr. Barbieri. 17:15 John Barbieri, MD, MBA, is the director of the Advanced Acne Therapeutics Clinic at Brigham and Women’s Hospital in Boston. We’d love to hear from you! Send your comments/questions to Dr. Gelfand at . Follow Dr. Gelfand on . For more, be sure to visit the video blog on Healio.com. Disclosures: Gelfand and Barbieri report no relevant financial disclosures.
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The science behind vitiligo with John Harris, MD, PhD
08/06/2025
The science behind vitiligo with John Harris, MD, PhD
In this episode, guest John E. Harris, MD, PhD, discusses how vitiligo occurs and how dermatologists can navigate the vitiligo treatment landscape. • Intro 0:28 • John E. Harris, MD, PhD 0:41 • How does vitiligo occur, and what is the basic science behind it? 1:08 • Are there any known triggers of this condition in people who have genetic susceptibility to it? 3:19 • How does drug-induced vitiligo occur in people? 4:42 • When you see a patient with vitiligo, how do you approach the patient to establish a diagnosis? 6:03 • Given that this is an autoimmune disease, do you routinely screen vitiligo patients for things like their thyroid function and B12 levels? 9:54 • What about the pernicious anemia aspect of things? 10:36 • Tell us a little bit about the treatment landscape, and how you counsel patients. 12:26 • Who is a good candidate for these new treatment options, and what success rate do you quote over a period of time? 14:06 • When do you bring patients back in for follow-ups? 14:59 • How often are you administering combination therapy? 15:30 • Does narrow band UVB work synergistically with other therapies, or is it more of an added measure? 16:20 • How do you manage patients who have early extensive active vitiligo? 17:08 • If someone has facial vitiligo in a non-pigmented area, do you still treat that patient? 18:01 • Thank you, Dr. Harris. 19:09 John E. Harris, MD, PhD, is professor and chair of the Department of Dermatology and founding director of the Vitiligo Clinical Research Center, as well as the founding director of the Autoimmune Therapeutics Institute at UMass Chan Medical School. We’d love to hear from you! Send your comments/questions to Dr. Gelfand at . Follow Dr. Gelfand on . For more, be sure to visit the video blog on Healio.com. Disclosures: Gelfand reports no relevant financial disclosures. Harris reports having financial relationships with AbbVie, Aclaris Therapeutics, Admirx, Aldena Therapeutics, Almirall, AnaptysBio, Avita, BiologicsMD, Boston Pharma, Celgene, Cogen Therapeutics, Dermavant, Dermira, EMD Serono, Expert Institute, Frazier Management, Genzyme/Sanofi, Incyte, Janssen, LEO Pharma, Methuselah Health, NIRA Biosciences, Pandion, Pfizer, Rheos Medicines, Sonoma Biotherapeutics, Stiefel/GSK, Sun Pharmaceuticals, Temprian Therapeutics, TeVido BioDevices, 3rd Rock Ventures, TWi Biotech, Villaris Therapeutics and Vimela Therapeutics.
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Exploring sodium’s effect on dermatologic disease with Katrina Abuabara, MD
07/02/2025
Exploring sodium’s effect on dermatologic disease with Katrina Abuabara, MD
In this episode, guest Katrina Abuabara, MD, discusses the possible role of sodium in dermatologic diseases and how dermatologists can make recommendations for patients’ sodium intake. • Intro 0:29 • Katrina Abuabara, MD, MA, MSCE 0:41 • What made you think about the question behind your paper on ? 1:08 • How do you measure sodium in the skin? 2:49 • In which dermatologic diseases are abnormal sodium in the skin playing a significant role? 3:36 • Is there any evidence that changing salt intake can improve someone’s eczema or psoriasis? 5:23 • For dermatologists interested in this area, are there simple ways to recommend a low-salt diet? 6:09 • Thank you, Dr. Abuabara. 7:24 Katrina Abuabara, MD, MA, MSCE, is an associate professor of dermatology at University of California, San Francisco. We’d love to hear from you! Send your comments/questions to Dr. Gelfand at . Follow Dr. Gelfand on . Abuabara can be reached via . For more, be sure to visit the video blog on Healio.com. Disclosures: Gelfand reports no relevant financial disclosures. Abuabara reports receiving research funding to her institution from Pfizer and Cosmetique Internacional/La Roche Posay and consulting fees from Target RWE, Sanofi, Nektar and Amgen.
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Addressing JAK inhibitor safety in alopecia with Brett King, MD, PhD
06/04/2025
Addressing JAK inhibitor safety in alopecia with Brett King, MD, PhD
In this episode, guest Brett King, MD, PhD, discusses the efficacy of Janus kinase (JAK) inhibitors for the treatment of alopecia areata and conversations with patients surrounding medical pauses. • Intro 0:29 • Brett King, MD, PhD 0:41 • When a patient comes to the office with alopecia areata and want to go on a JAK inhibitor, how do you counsel them about their likelihood for significant hair regrowth? 1:35 • Is your estimate of roughly fifty percent rate from data, or from your own experiences with patients? 6:03 • How do you explain boxed warnings to patients using or thinking about using JAK inhibitors? 8:29 • Gelfand and King on the challenges presented by the current data on alopecia areata patients using JAK inhibitors. 12:02 • Is it true that patients experience hair loss quickly after going off JAK inhibitors? 12:49 • How do you manage these challenges in real-world clinical practice? 13:40 • With JAK, how do you deal with the issue of non-follow-up patients? 17:42 • Thank you, Dr. King. 19:55 Brett King, MD, PhD, is an associate professor of dermatology at Yale School of Medicine. We’d love to hear from you! Send your comments/questions to Dr. Gelfand at . Follow Dr. Gelfand on . King can be reached on X and on . For more, be sure to visit the video blog on Healio.com. Disclosures: Gelfand reports no relevant financial disclosures. King reports having financial relationships with AbbVie, AltruBio Inc, Almirall, Amgen, AnaptysBio, Apogee Therapeutics, Arena Pharmaceuticals, Aslan Pharmaceuticals, BiologicsMD, Bristol Meyers Squibb, Concert Pharmaceuticals, Eli Lilly, Equillium, Horizon Therapeutics, Eli Lilly and Company, Incyte, Janssen Pharmaceuticals, LEO Pharma, Merck, Otsuka/Visterra, Pfizer, Q32 Bio, Regeneron, Sanofi Genzyme, Sun Pharma, Takeda, TWi Biotechnology and Ventyx Biosciences.
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How to embrace AI responsibly with Roxana Daneshjou, MD, PhD
05/07/2025
How to embrace AI responsibly with Roxana Daneshjou, MD, PhD
In this episode, guest Roxana Daneshjou, MD, PhD, discusses the role of artificial intelligence in dermatology practice, and the future of AI models in medicine. • Intro 0:29 • Roxana Daneshjou, MD, PhD 0:45 • What is artificial intelligence? 1:10 • What led to this largely academic endeavor becoming deployable? 2:36 • How is AI being deployed in health care today? 5:36 • What is currently deployable about AI in the dermatology space? 7:56 • How long do you think it will be before dermatologists are using AI in their typical practice? 12:23 • Gelfand and Daneshjou on the dangers of AI models in health care. 17:06 • How much of a concern is diversity in clinical practice when it comes to AI and how do we navigate this as clinicians? 20:28 • Can you predict how long it will take for patients to come into a physician’s office with an AI-generated diagnosis and treatment plan? 23:18 • Thank you, Dr. Daneshjou. 26:35 Roxana Daneshjou, MD, PhD, is an assistant professor of biomedical data science and dermatology at Standford University. We’d love to hear from you! Send your comments/questions to Dr. Gelfand at Follow Dr. Gelfand on . Daneshjou can be found @RoxanaDaneshjou on X and on Instagram. For more, be sure to revisit the video blog on Healio.com. Disclosures: Gelfand reports no relevant financial disclosures. Daneshjou reports having stock options from Revea and MDalgorithms; receiving personal fees from Pfizer, Frazier Healthcare Partners and L'Oreal outside the submitted work; having a patent pending for 17/937 714; and serving as a member of American Academy of Dermatology Augmented Intelligence Committee.
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