Dr. Ted Rosen highlights key points from his lecture Annual Dermatology Evidence Review with Practical Application at the 6th Annual Elevate Derm Alliance Conference at the JW Marriott Water Street in Tampa, Florida.

In this video

In this interview with Lisa Weiss, Dr. Rosen runs through a year's worth of practice-changing studies. He notes that virtual dermatology, which took off during COVID, is here to stay where it's "reasonable and medically feasible" — good for following facial acne, rosacea, or atopic dermatitis, but not for a full-body exam or evaluating a single pigmented lesion. He flags the FDA warning that prolonged use of cetirizine or levocetirizine can trigger severe itching on withdrawal, advising clinicians to be judicious and to taper or periodically stop rather than leave a patient "scratching from hell."

He also unpacks a large Swedish study linking hormone replacement therapy to increased basal cell, squamous cell, and melanoma risk (melanoma up over 30%) — not a reason to stop HRT, but a reason to lower the threshold to biopsy and encourage self-exams. He clarifies when to worry about pigmented lesions on the feet in skin of color, and reviews the latest evidence on isotretinoin dosing and lifestyle changes in HS.

  • Use teledermatology where it's medically feasible — follow-ups for facial acne, rosacea, or atopic dermatitis — but not for full-body exams or evaluating a single pigmented lesion.
  • Be judicious with cetirizine and levocetirizine given the FDA warning; taper gradually or stop periodically to avoid severe rebound pruritus.
  • In women on HRT, keep a lower index of suspicion, biopsy more readily, and encourage self-exams between visits — HRT raised risk of basal cell, squamous cell, and melanoma (melanoma over 30%).
  • On the soles in skin of color, physiologic melanotic macules cluster on the ball and heel and are benign; lesions concentrated on the arch are more often pathologic, including syphilis-related PIH.
  • Increasing the cumulative isotretinoin dose does not appear to reduce acne recurrence; most recurrences (around 20%) don't need retreatment or respond to simple therapies.
  • Lifestyle changes matter in HS — smoking aggravates it ("smokers' boils" in Europe) and weight loss reduces flare frequency and symptoms; frame it as helping, not shaming.