Beneath the Surface

Diagnosing, treating complex wounds with Robert Kirsner, MD, PhD

In this episode, guest Robert Kirsner, MD, PhD, discusses clinical approaches to diagnosing chronic wounds, advancements and methods for treating them. · Intro 0:28 · Robert Kirsner, MD, PhD 0:35 · From a public health perspective, how big of a problem are chronic wounds? 0:59 · What is your clinical approach to define and evaluate chronic wounds? 2:06 · What imaging do you order for patients with lower extremity wounds? 4:58 · What advancements are we seeing in wound healing? 6:46 · What are some of the differential diagnoses that can generate chronic wounds in patients? 8:25 · Can you describe your technique for biopsy? 9:37 · Are there situations where you should avoid biopsy? 10:27 · Does a diagnosis of exclusion such as pyoderma gangrenosum (PG) need to be biopsied? 11:30 · Are retinoids like acitretin commonly used? 11:39 · What is your approach to patients with PG? 12:30 · Are there other immune targets that you're excited about for PG? 14:28 · Thanks for listening. 15:29 Robert Kirsner, MD, PhD, is chairman and professor in the department of dermatology and cutaneous surgery at University of Miami Miller School of Medicine, director of the University of Miami Hospital and Clinics Wound Center and a past vice president of the American Academy of Dermatology. We'd love to hear from you! Send your comments/questions to Dr. Gelfand at podcasts@healio.com [podcasts@healio.com]. Follow Dr. Gelfand on LinkedIn [https://www.linkedin.com/in/drjoelgelfand/]. Dr. Kirsner can be reached at rkirsner@med.miami.edu [rkirsner@med.miami.edu]. For more, be sure to visit the Beneath the Surface [https://www.healio.com/news/dermatology/blogs-and-columns/beneath-the-surface] video blog on Healio.com. Disclosures: Gelfand is Chief Medical Editor of Healio Dermatology. Kirsner reports receiving advisory board or consultant fees from AbbVie, BPGbio, Kerecis, Leo Pharma, Organogenesis, Smith & Nephew and Urgo and grant or research support from Boehringer Ingelheim and MediWound. References: · Pyoderma gangrenosum. https://my.clevelandclinic.org/health/diseases/17825-pyoderma-gangrenosum-pg [https://my.clevelandclinic.org/health/diseases/17825-pyoderma-gangrenosum-pg]. Updated May 13, 2022. Accessed Feb. 25, 2026.

Diagnosing, treating and managing hidradenitis suppurativa with Lauren Orenstein, MD

In this episode, guest Lauren Orenstein, MD, MSc, discusses the challenge of diagnosing hidradenitis suppurativa, the range of therapies and pain management for patients. · Intro 0:28 · Lauren Orenstein, MD, MSc 0:37 · What is HS, and how is it diagnosed? 0:57 · Is there a differential diagnosis? 2:11 · Who develops HS, and why does it develop? 3:16 · Are there biological explanations for this patient distribution in the US? 3:54 · Are there any underlying genetic or environmental factors contributing to the prevalence of HS by race in the US? 4:50 · How much of an impact do hormones have on diagnosis? 5:37 · What role does age play in diagnosis? 6:45 · Tell us about your approach to this disease. 9:30 · Are retinoids like acitretin commonly used? 11:39 · How do you choose which biologic therapy to use for management of HS? 12:25 · Are there striking differences in findings between different biologics? 14:50 · Can you explain what deroofing is and when a patient should undergo this procedure? 15:25 · How do you do this procedure clinically in your practice? 19:17 · How do you manage the pain aspect of HS? 20:31 · Do people have rebounds coming off prednisone? 23:57 · What about patients with chronic pain? 24:46 · Thanks for listening. 28:11 Lauren Orenstein, MD, MSc, is an assistant professor in the department of dermatology at Emory University and staff physician at Grady Memorial Hospital. We'd love to hear from you! Send your comments/questions to Dr. Gelfand at podcasts@healio.com [podcasts@healio.com]. Follow Dr. Gelfand on LinkedIn [https://www.linkedin.com/in/drjoelgelfand/]. Dr. Orenstein can be reached at lauren.orenstein@emory.edu [lauren.orenstein@emory.edu]. For more, be sure to visit the Beneath the Surface [https://www.healio.com/news/dermatology/blogs-and-columns/beneath-the-surface] video blog on Healio.com. Disclosures: Gelfand is Chief Medical Editor of Healio Dermatology. Orenstein reports financial relationships with Incyte, Novartis, Pfizer and UCB Pharma and is a member of the board of directors for the HS Foundation.

The emerging role of GLP-1s in inflammatory diseases

In this episode, guests Fatima Stanford, MD, MPH, and Philip Mease, MD, discuss the role of GLP-1s in inflammatory diseases, determining who and how these medications should be prescribed and more. · Intro 0:28 · Fatima C. Stanford, MD, MPH, MPA, MBA, MACP, FAAP, FAHA, FAMWA, FTOS, and Philip J. Mease, MD 0:37 · Fatima, from your expert perspective, how did we get here with GLP-1 usage, and where is the field going? 1:12 · Have these medications reached their maximum benefit for patients or are we going to see GLP-1 agonists improve? 2:30 · Philip, as a rheumatologist, can you tell us how you think about GLP-1 medications and obesity in general when approaching a rheumatic patient? 4:09 · Fatima, what are the best ways to approach the subject of obesity with patients? 7:46 · Philip, when do you broach the topic of how GLP-1s will impact patients with rheumatic disease? 11:09 · Which rheumatic diseases are most amenable to being improved by weight loss, GLP-1 agonism or a combination of both? 14:27 · Where do you see GLP-1s role in improving inflammatory diseases? 16:29 · Philip, what is your take on rheumatologists prescribing these medications directly? 18:43 · Fatima, what should those who are not experts in GLP-1 usage know about how prescribe these medications and help patients be successful on them? 21:23 · Are there serious side effects we need to worry about? 24:57 · Are there things you check before starting someone on a GLP-1 medication, or monitor while they are on one? 26:24 · Discussion on advisements on when to be NPO in preparation for surgery while taking these medications. 28:00 · Final thoughts: Where do you see the future going in this field of medicine? 29:46 · Thanks for listening. 32:39 Fatima C. Stanford, MD, MPH, MPA, MBA, MACP, FAAP, FAHA, FAMWA, FTOS, is an obesity medicine physician scientist at Massachusetts General Hospital and Harvard Medical School. Philip J. Mease, MD, is director of rheumatology research at Swedish Medical Center/Providence St. Joseph Health and a clinical professor at the University of Washington School of Medicine in Seattle. We'd love to hear from you! Send your comments/questions to Dr. Gelfand at podcasts@healio.com [podcasts@healio.com]. Follow Dr. Gelfand on LinkedIn [https://www.linkedin.com/in/drjoelgelfand/]. For more, be sure to visit the Beneath the Surface [https://www.healio.com/news/dermatology/blogs-and-columns/beneath-the-surface] video blog on Healio.com. Disclosures: Gelfand is Chief Medical Editor of Healio Dermatology. Mease reports receiving research grants, consultant fees and/or speaker honoraria from AbbVie, Amgen, AstraZeneca, Bristol Myers Squibb, Century, Cullinan, Eli Lilly, Immagene, Janssen, Moonlake Pharma, Novartis, Pfizer, Spyre, Takeda and UCB. Stanford reports consulting for Boehringer Ingelheim, Currax, Eli Lilly, Gelesis, Novo Nordisk, Pfizer and Rhythm Pharmaceuticals and serving on advisory boards for Eli Lilly and Novo Nordisk.

How to recognize and diagnose measles with Amy Paller, MD

In this episode, guest Amy S. Paller, MD, MS, discusses warning signs of measles, protocols physicians should take and more. · Intro 0:28 · Amy S. Paller, MD, MS 0:38 · Can you give us your perspective as a clinician on what the presentation of measles is, and what clinicians should think about this? 1:49 · How would you diagnose measles? 4:43 · How long is the quarantine period for those who have been exposed to a case of measles? 6:13 · Gelfand and Paller on measles exposure and vaccination status. 7:30 · What is the treatment for measles? 8:34 · Gelfand and Paller on newborns' vulnerability to this disease. 10:07 · How much is temporary immune amnesia going to be a problem for people who experience more susceptibility after being diagnosed with measles? 12:28 · Thanks for listening. 13:20 Amy S. Paller, MD, MS, is the Walter J. Hamlin professor and chair of dermatology and professor of pediatrics and director of the Skin Biology and Diseases Resource-based Center at Northwestern University's Feinberg School of Medicine. We'd love to hear from you! Send your comments/questions to Dr. Gelfand at podcasts@healio.com [podcasts@healio.com]. Follow Dr. Gelfand on LinkedIn [https://www.linkedin.com/in/drjoelgelfand/]. For more, be sure to visit the Beneath the Surface [https://www.healio.com/news/dermatology/blogs-and-columns/beneath-the-surface] video blog on Healio.com. Disclosures: Gelfand is Chief Medical Editor of Healio Dermatology. Paller reports having investigator roles with AbbVie, BioMendics, Dermavant, Eli Lilly, Incyte, Johnson & Johnson Innovative Medicine, Regeneron and UCB; consulting roles with Abeona, Arcutis, BioCryst, Boehringer-Ingelheim, Castle Creek, Chiesi, Dermavant, Johnson & Johnson Innovative Medicine, Krystal, LEO Pharma, Lilly, L'Oreal, MoonLake Immunotherapeutics, Pelthos, Quoin, Regeneron and Sanofi; and data safety monitoring board roles with AbbVie, Abeona, BioCryst, Daiichi, Sankyo and Galderma.

Navigating the rapidly changing world of dermatology with Susan Taylor, MD, FAAD

In this episode, guest and AAD president, Susan C Taylor, MD, FAAD, discusses keeping up with dermatologic innovations, advocacy in the field and more. • Intro 0:28 • Susan C Taylor, MD, FAAD 0:34 • How can dermatologists get involved with the AAD? 1:03 • What is the path forward for dermatologists as we adapt to this rapidly changing world of new employment models, technologies and AI? […] What is the AAD doing to help people navigate these changes? 3:22 • Gelfand and Taylor discuss the AAD's Late-Breaking Research Program. 5:57 • What initially got you into the field of dermatology? 6:45 • What is it like when you go to Washington DC to meet with representatives? What is their perception of dermatology as a field, and how do you help them understand the importance of what we do? 10:35 • Thanks for listening. 13:02 Susan C Taylor, MD, FAAD, is president of the American Academy of Dermatology. We'd love to hear from you! Send your comments/questions to Dr. Gelfand at podcasts@healio.com [podcasts@healio.com]. Follow Dr. Gelfand on LinkedIn [https://www.linkedin.com/in/drjoelgelfand/]. For more, be sure to visit the Beneath the Surface [https://www.healio.com/news/dermatology/blogs-and-columns/beneath-the-surface] video blog on Healio.com. Disclosures: Gelfand is Chief Medical Editor of Healio Dermatology. Taylor is president of the AAD.