Dermalogues Podcast

This season, host Dr. Kerri Purdy is taking a deep dive into complex medical dermatology, talking to leading dermatologists about how they diagnose and treat complex cases and conditions. Her first guest is onco-dermatologist Dr. Maxwell Sauder. They discuss cutaneous toxicities, filled with clinical pearls for all our residents who are listening. This episode was recorded in person at the CDA Annual Conference in Toronto.

Dr. Maxwell Sauder is an assistant professor and the onco-dermatology fellowship director at the University of Toronto. He is also an onco-dermatologist at Princess Margaret Cancer Centre; and he practices at the Toronto Dermatology Centre as the research director and director of the pigmented lesion clinic.

In this episode, Dr. Purdy and guest Dr. Lori Connors, a clinical immunologist and allergist with both academic and community-based practices, discuss three big areas: Chronic Spontaneous Urticaria, Type 2 Inflammatory Conditions, and some of the information or disinformation around food allergies and how it applies to eczema.

Dr. Lori Connors is an allergist and immunologist at Dalhousie University, where she is an Associate Professor in the Department of Medicine. She splits her time between community and academic practice and is very involved in resident education at Dalhousie. And she is the outgoing CPD Chair for the Canadian Society of Allergy and Immunology.

In this episode, host Dr. Kerri Purdy and guest Dr. Shojania dive into topics including psoriatic disease, scleroderma, and the lupus/germinomatous spectrum.

Dr. Shojania is a clinical professor at the University of British Columbia. He is also Chief of Rheumatology at Vancouver General Hospital and Medical Director of the Mary Pack Arthritis Program. He also works with dermatologist Dr. Sheila Au, in the Dermatology and RheumaTology, or DART clinic at St. Paul’s Hospital.

Our residents’ questions this episode come from Dr. Touraj Khosravi and Dr. Julia Mayba from UBC, and Dr. Anastasiya Muntyanu from the University of Toronto.

We’re thrilled to have Dr. Rachel Asiniwasis on the podcast, as we take a short break from our cross-specialty series. Dr. Asiniwasis joins us to discuss Indigenous health and dermatology. She is First Nations of Plains Cree and Saulteux descent, and a double board-certified dermatologist working on Treaty 4 territory in Regina, Saskatchewan. She also carries out in-person and telehealth dermatology clinics for remote, northern and First Nations communities across Saskatchewan. Host Dr. Kerri and Dr. Asiniwasis discuss best practices for working in these communities and with Indigenous Canadians, including an awareness of the ongoing impact of Residential Schools and systemic racism, and how regularly visiting and working in Indigenous communities can help overcome issues of trust and improve healthcare conditions in communities that are desperately underserved.

One of Canada’s leading dermatologists and hair loss experts, Dr. Jeff Donovan, joins Dr. Kerri Purdy for a fun, fascinating and in-depth conversation about hair as we kick off Season 3. The topics they dive into include: female androgenetic alopecia, why Dr Donovan isn’t a fan of hair pull tests, what is a normal amount of daily hair loss, what to do when patients bring in bags of hair, what to look for when using a dermatoscope, prescribing minoxidil, spironolactone, finasteride, reliability of patient photos, how to time a hair transplant in men and women and much more.

Many thanks to residents Dr. Danny Mansour from the University of British Columbia and Dr. Anastasiya Muntyanu from McGill University for sending in questions for this episode.

Dr. Jeff Donovan specializes in the diagnosis and management of common, uncommon and rare reasons for hair loss at his practice, Donovan Medical, in Whistler, BC and Vancouver. He is also the President of the Canadian Hair Loss Foundation, and a faculty member in the Dermatology department at the University of British Columbia.

One of Canada’s leading pediatric dermatologists, Dr. Michele Ramien, joins Dr. Kerri Purdy to share pearls from her career in this fun and fascinating conversation. What is the best approach to diagnosing and treating children with skin disorders? At what age do you begin engaging directly with children about their treatment and side-effects? How does the work-up for methotrexate in a child compare to that of an adult? How do you manage topical treatment for kids? What are the best pediatric derm reference sources for Residents?

Dr. Michele Ramien is clinical associate professor of dermatology at the University of Calgary. She practices in general and pediatric dermatology. She is the vice-chair of the Camp Liberté Society, a camp for children with skin disorders. And she’s the Chair of the Pediatric Dermatology Research Alliance and the vice-president of the Canadian Dermatology Association.

This episode our Derm Resident Questions come from Dr. Lydia Ouchene of McGill University and Dr. Rory Sutherland of the University of British Columbia.

Dr. Mark Kirchhof joins host, Dr. Kerri Purdy for this lively and informative conversation about how best to diagnose and treat hidradenitis suppurativa (HS), a chronic, systemic condition where an overactive immune system contributes to inflammation below the surface of the skin.

Our Resident questions this episode come from Dr. Krystina Cleminson, at Dalhousie University and Dr. Panteha Eshtiaghi of the University of Toronto.

Dr. Mark Kirchhof is the Division Head of Dermatology in the Faculty of Medicine at the University of Ottawa and The Ottawa Hospital. He has a PhD in Immunology from the University of Western Ontario.

Dr. Geeta Yadav joins host Dr. Kerri Purdy for this fun and informative discussion on the lessons she learned in opening her successful practice, Skin Science Dermatology, in Toronto. The questions they get into include; the reasons for going into practice, choosing to do it alone versus with a group, the advantages of first doing an elective or being an associate in a practice, how to choose your space, why getting your staff hires right is so critical, buying equipment and supplies, billing, record keeping and much more.

Our Resident questions this episode are from Dr. Meryem Safoine at l’Université de Montréal and Dr. Francois Lagace at McGill University in Montréal.

Dr. Yadav is the founder of Skin Science Dermatology in Toronto. She also lectures at the University of Toronto and is a Fellow of the Royal College of Physicians and Surgeons and the American Academy of Dermatology.

Dr. Julia Carroll of Compass Dermatology in Toronto joins host Dr. Kerri Purdy for this fun and interesting episode on opening and managing an aesthetics practice. Among the questions they dive into include how to incorporate aesthetics into a practice, how to choose what aspects of aesthetics to focus on and what courses, references or books Dr. Carroll recommends to learn more about aesthetics beyond what is offered in dermatology programs. Dr. Carroll also gives advice on social media and media appearances, based on her own extensive experience on television, radio and podcasts.

Our Dermatology residents’ questions in this episode come from Dr. Marcus Tan from the University of Ottawa and Dr. Niko MacLellan from the University of Toronto.

Dr. Carroll is the founder of Compass dermatology in Toronto, where she’s built a reputation for her ethical and natural approach to beauty. She is also a Fellow of the Royal College of Physicians and Surgeons and an active member of the Canadian Dermatology Association. And she is on staff at the University of Toronto Medical School.

In recognition of Sun Awareness Month, in this special edition episode of the Dermalogues podcast, host Dr. Kerri Purdy talks to the National Chair of the CDA Sun Awareness Working Group, Dr. Sunil Kalia, about early detection, prevention, general sun awareness, and what the CDA has planned for the month. And because it’s a special episode, we’ll be mixing things up a bit by taking questions from both Derm Residents and the general public.

Dr. Sunil Kalia is an associate professor of dermatology at the University of British Columbia and National Chair of the CDA Sun Awareness Working Group.

On our first episode back, Dr Kerri Purdy dives into two related topics, Phototherapy and PDT (photodynamic therapy) with Dr Vincent Richer of the University of British Columbia medical school and Pacific Derm in Vancouver.

They discuss when to prescribe PDT or Phototherapy, the importance of prepping the patient for what they are getting into, why tanning beds and home sunlamps are not a good alternative to in clinic treatment and why PDT remains an important tool in the dermatologists tool box even with new and effective drug options.

On this episode we take two dermatology resident questions, from Mimi Tran of the University of British Columbia and Annie Liu of the University of Toronto.

In a rare face-to-face Dermalogues episode, Dr. Kerri Purdy travels to Darmouth, Nova Scotia to interview one of her mentors, Dr Mary Lou Baxter, about vulvar dermatology.

In their discussion the two cover everything from; the art of carrying out a thorough vulvar examination that is also comfortable for the patient; what the popular products are now that may be causing vulvar allergies and itch; when you might biopsy for genital lichens sclerosus; why estrogen based topical products are often so effective for post-menopausal patients… and be sure to stay to the end to hear #MaryLouSays, Dr Baxters five key pearls of vulvar dermatology wisdom.

Dr Baxter is an Assistant Professor at Dalhousie University and co-manages the Vulvar Dermatology Clinic in Halifax.

Dermatology Resident Questions on this episode are from Suzel Fournier at Laval University and Fatmah AlZahrani at the University of Alberta.

Dr Raed Alhusayen joins Dr Kerri Purdy to talk over an important and complicated area of Dermatology, Cutaneous Lymphoma.

Topics covered include: What clinical clues to look for in making a diagnosis of cutaneous lymphoma and specifically mycosis fungoides. Tips on when to biopsy, how often and the best techniques. Other investigations to consider in diagnosis and treatment. How to break the news to a patient. And the best treatments to use. And worthy of such a complicated topic, this episode features a Dermalogues record number of Resident Questions including:
Danny Mansour from the University of British Columbia, Naomi Labonté-Truong of L’Université de Montréal, Matthew Hughes of the University of Calgary and Misha Zarbafian of the University of British Columbia.

Dr Raed Alhusayen is an assistant professor at the University of Toronto and an associate scientist at Sunnybrook Research Institute. He runs a full-time medical dermatology practice with a focus on cutaneous lymphoma, hidradenitis suppurativa, and autoimmune bullous disorders. Dr. Alhusayen is the president of the Canadian HS foundation.

UBC’s Dr Jan Dutz joins Dr Kerri Purdy for a fascinating deep dive into the intersecting worlds of Dermatology and Rheumatology in this latest episode of Dermalogues. Topics covered include the best approach to the undifferentiated autoimmune-rheumatology patient, best tips on how to interpret auto-antibodies, treating cutaneous calcinosis in a dermatomyositis patient, what to do with a positive ANA result in a patient with a low likelihood for an autoimmune disease and much more.

Dermatolofy Resident questions in this episode come from Krystina Cleminson of Dalhousie University and Robert Bobotsis and Mathew Nicolas of the University of Toronto.

Dr Jan Dutz is a Dermatolgist and Rheumatologist. He is a Professor and Head of the Department of Dermatology and Skin Science at the University of British Columbia. He is also a Senior Scientist with the British Columbia Children’s Hospital Research Institute.

Neonatal dermatology, treating newborn infants under the age of one month, can be one of the greatest challenges facing a dermatologist. How do you treat a patient that is so small, helpless and unable to express the pain, or other effects of the the skin issues that are presenting. For this interview, Kerri Purdy is happy to be joined by someone with deep knowledge and expertise in both neonatal and dermatological care. Dr. Marrisa Joseph teaches pediatrics and dermatology at the University of Toronto and is the Director of the Ricky Kanee Schachter Dermatology Centre at Women’s College Hospital. And this episode also turns out to be a reunion! Kerri and Marissa were classmates at Dalhousie medical school, back in the day.

This summer, a swarm of Gypsy Moths have been stripping leaves from the forests of central Canada, stretching from southern Ontario into western Quebec. The mass infestation, which occurs ever twelve to fourteen years, has also produced an outbreak of rashes, Gypsy Moth Dermatitis, caused by contact with the insect.

In this fascinating and entertaining Editor’s Choice Edition of the podcast, Dr Kirk Barber, Editor-in-Chief of the Journal of Cutaneous Medicine and Surgery, talks to two experts on the Gypsy Moth phenomenon and the dermatitis it produces: Dr Melinda Gooderham, is Medical Director at the SKiN Centre for Dermatology in Peterborough, Ontario and an Assistant Professor at Queen’s University. And Professor David Beresford, teaches biology in the environmental studies program at Trent University, where he specializes in pest management.

Dr Kerri Purdy speaks with Dr Laurie Parsons, a dermatologist and wound care expert in Edmonton. They discuss some of the strengths dermatologists bring to the field of wound care. And they answer resident questions such as:

• Approach to dressings in general (broad categories and when to use them)
• What dressings are best to prevent scars or improve cosmetic outcome?
• When should wound care be referred to a vascular surgeon? To a nursing service? Or when is it best for a dermatologist to manage?
• How soon can you expect wounds to heal in simple and moderately complex cases?
• What to do when you’ve tried everything you can think of, and the wound is not healing?

As always, the discussion goes beyond these specific questions and offers residents a wide-ranging look at this critical aspect of patient care.

Dr Kerri Purdy speaks with Dr Vincent Richer, a dermatologist and expert in lasers and phototherapy in Vancouver, BC. They briefly discuss just how cool lasers are and then get down to practical considerations such as how to determine which laser treatment to use for a specific condition. For example, what setting to use for vascular lesions vs melanocytic lesions and other finer considerations for finessing laser selection. Dr Richer and Dr Purdy also discuss the resources residents can use and approaches they can take to gain a better understanding of how to make effective clinical decisions on the use of lasers and phototherapy.

Dr Kerri Purdy speaks with Dr Perry Grewal, a dermatologist involved in clinical trials in Edmonton Alberta. They cover when to start and when to stop biologics and address specific questions from dermatology residents such as:

• How long do I have to wait before initiating a biologic in a patient with latent TB
• Should I hold a biologic for surgery?
• How do you start a biologic in a woman who wants to get pregnant, is pregnant, or is breastfeeding?

This episode offers an excellent opportunity for residents to hear from an expert who is frequently an invited speaker on biologics at conferences. In a nutshell, this episode is a perfect example of what this podcast series is all about!

Dr Kerri Purdy speaks with Dr Sam Hanna. Dr Hanna, a dermatologist practising both medical and cosmetic dermatology in Toronto, Ontario. Dr Hanna has a particular interest in Botox and injectable fillers for aesthetic improvement and is involved in research trials. They discuss the need for dermatologists to inject themselves into the increasingly crowded field of cosmetics. Dermatologists have unique expertise to ensure cosmetic injections are appropriate, safe and effective. As well, Dr Hanna offers some advice to residents on how to manage the stigma around aesthetic dermatology. He also answers some practical questions like:

How to assess the ageing face and how to prioritise different treatment options that yield the most noticeable aesthetic result?

Dr Kerri Purdy speaks with Dr Sandy Skotnicki the founding director of the Bay Dermatology Centre and an Assistant Professor at the University of Toronto, Department of Medicine in the Divisions of Dermatology and Occupational and Environmental Health.

Dr Skotnicki is also the author “Beyond Soap: The Real Truth About What You Are Doing to Your Skin and How to Fix It for a Beautiful, Healthy Glow.” She is a renowned expert in contact dermatitis. On this episode Dr Skotnicki tells residents what they need to know about:

• Patch testing
• Product labelling (and mis-labelling)
• The value of AAD conferences for residents
• Food allergens
• Top 5 hot allergens
• Preparing for the college exams
• Sunscreen reactions
• Her best contact dermatitis case ever

And of course, resident questions:

• When should a community dermatologist who does patch testing refer to a tertiary institution with more sophisticated testing?
• How to counsel a patient on cross reactants?

Dr Kerri Purdy speaks with Dr Melanie Pratt, a world-renowned expert on contact dermatitis. This is part two of our look at the Sherlock Holmes world of contact dermatitis. Treating this mysterious condition requires clinicians to trade their lab coats for detective caps as they hunt around for clues and search for allergens and irritants in fragrances, products and even furniture.

As you will hear, the process of discovering the culprit behind contact dermatitis is often far from elementary. In this episode, Drs Purdy and Pratt explore some of the most common irritants and allergens found in products.

They take a close look at specific problem areas, like eyelids, lips, scalp and hands.

And they review why patch tests are a critical tool for all dermatologists.