#232 Skinternship: Scalp & Face with Helena Pasieka MD
The Curbsiders Internal Medicine Podcast
Facial Rash Differentials: Acne vs. Rosacea
This chapter examines the differential diagnosis of facial rashes, focusing on conditions like psoriasis, acne, and rosacea. The speakers present a clinical case that highlights the complex similarities between acne and rosacea, particularly in their manifestations and underlying pathophysiology. They also discuss effective treatment strategies for both conditions while addressing the challenges of diagnosis in diverse skin tones.
Dive deep into common dermatological conditions of the scalp and face including alopecia, seborrheic dermatitis, rosacea, acne, and even the scourge of health professionals, ‘maskne’! We are joined by our Kashlak Chief of Dermatology and resident Skinternist Dr. Helena Pasieka (of @MedStarWHC). After listening to this episode, your dermatology knowledge will be head and shoulders above the rest!
Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).
Note: The full slide deck with images for this episode is not available at this time. We will post it to this show notes page as soon as we clear the image rights.
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Credits
- Written and Produced by: Beth Garbitelli, Matthew Watto MD, FACP,
- Cover Art and Infographic by: Beth Garbitelli
- Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli
- Editor: Cyrus Askin MD (written materials); Clair Morgan of nodderly.com
- Guest: Helena Pasieka MD, MS
Sponsors
Provider Solutions & Development
Provider Solutions & Development is a community of experts dedicated to offering guidance and career coaching to physicians and clinicians throughout their entire career journey. With exclusive access to hundreds of opportunities across the nation, reach out today to begin the search for your perfect practice: www.psdrecruit.org/curbsiders.
VCU Health CE
The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. Note: A free VCU Health CloudCME account is required in order to seek credit.
Time Stamps
- Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders.
- Sponsor - VCU Health Continuing Education
- 00:30 Intro, disclaimer, guest bio
- 04:35 Guest one-liner, Picks of the Week*: Hamilton and Alexander Hamilton by Ron Chernow, Ultra-Gooey Stovetop Mac and Cheese Recipe, The Food Lab: Better Home Cooking Through Science by J. Kenji Lopez-Alt
- Sponsor - Provider Solutions & Development www.psdrecruit.org/curbsiders
- 08:30 Case 1: Alopecia
- 12:05 Assessing scalp for inflammatory changes and follicular drop-out
- 13:10 Central Centrifugal Cicatricial Alopecia (CCCA)
- 14:00 Alopecia/hair loss non-scarring subtypes
- 25:00 Alopecia Treatments
- 28:55 Case 2: Psoriasis vs. Seborrheic Dermatitis
- 31:45 Looking for psoriatic plaques
- 32:11 Seborrheic dermatitis hallmarks
- 35:19 Treatment for Seborrheic Dermatitis
- 42:10 Case 3: Rosacea vs. Acne
- 50:40 Differentiating rosacea rash from SLE
- 52:40 Rosacea management & treatment
- 55:00 Identifying rosacea in Black skin
- 56:50 Acne management & treatment
- 59:10 Retinoid dermatitis
- 1:00:30 Maskne
- 1:02:29 Antibiotics for acne
- 1:03:38 Retinoids and pregnancy
- 1:04:09 Doxycycline for rosacea
- 1:06:15 Take home points
- Sponsor - VCU Health Continuing Education
Links*
- Hamilton and Alexander Hamilton by Ron Chernow,
- Serious Eats/The Food Lab's Ultra-Gooey Stovetop Mac and Cheese Recipe (Beth’s Cheese Blend: 8oz American cheese, 8 oz Fontina, 8 oz cheddar- not Seriously Sharp!! Also, you may be able to get away with not using 1.5lb of cheese, mix in and see how it goes, feel free to DM @VermontKitchen on Instagram for cooking guidance)
- The Food Lab: Better Home Cooking Through Science by J. Kenji Lopez-Alt
- Mineral sunscreens: suggestions include Neutrogena Sensitive Skin Sunscreen or Elta MD UV Physical Broad-Spectrum Tinted Facial Sunscreen (Formulations with Zinc Oxide only tend to be very heavy and will not blend well in all skin tones)
- Brown Skin Matters on Twitter and Instagram
- Skin of Color Society
- American Academy of Dermatology
- Society for Dermatology Hospitalists
- Black Skin Directory Learning Journal
- Mind the Gap (2020) by Malone Mukwende
- Ethnic Dermatology: Principles and Practice (2013)
- Skin of Color: A Practical Guide to Dermatologic Diagnosis and Treatment (2012)
- An Atlas of African Dermatology (2001)
*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.
Goals
Listeners will appropriately recognize, diagnose and treat common dermatological complaints of the scalp and face seen in the primary care clinic.
Learning objectives
After listening to this episode listeners will...
- Recognize and treat common skin complaints of the scalp and face in primary care.
- Become familiar with the basic therapeutic arsenal to treat scalp and face complaints in primary care.
- Be able to differentiate non-scarring versus scarring hair loss on physical exam.
- Comprehend nuances in total body presentations of psoriasis as a means to differentiate from seborrheic dermatitis.
- Review when referral to dermatology for hair loss or skin changes of the face/scalp is necessary.
- Recognize the extreme lack of diversity in dermatology and disparities in outcomes for various diagnoses.
Disclosures
Dr. Pasieka reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.
CitationPasieka HB, Williams PN, Watto MF, Garbitelli EC. “#232 Skinternship: Scalp & Face”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date September 14, 2020.
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