IDCP 2022 - 2023 Cohort Updates

Skin Microbiome

This lecture will review the fundamentals of the bacteria, fungi, and viruses on the skin and the importance of their roles. We also discuss perturbations in the microbiome and the potential effects.

After completing this activity, participants will be able to:

1. Describe the functions of the cutaneous microbiome
2. Outline some of the deleterious effects of a disrupted microbiome
3. Identify some techniques, supplements, and approaches to maintaining and possibly improving the microbiome, as well as those that may harm it

Functional Medicine Testing: Stool Tests and OATs

While dermatological diseases such as eczema have complicated pathologies, there is abundant evidence that part of the underlying root cause of these conditions is connected to gut microbiome dysfunction. This course presents the latest published research on the gut/skin connection including commensal bacteria, pathogenic bacteria, fungal organisms, and intestinal hyperpermeability. It will also review how to use functional medicine tests, like stool tests and organic acid tests, to determine and treat the root cause of dermatological disease.

After completing this activity, participants will be able to:

1. List the basic components of a stool test and recognize which specific bacterial strains, markers, and patterns are most helpful for analyzing dermatological problems
2. List the basic components of an organic acid test and recognize which specific markers and patterns are most helpful for analyzing dermatological problems
3. Summarize research on the changes in the gut microbiome in patients with atopic dermatitis and psoriasis compared to healthy controls
4. Analyze research on how gut dysbiosis contributes to the pathophysiology of skin diseases

Update on AD Therapy

This session delves into both conventional as well as alternative and integrative therapies for AD.

After completing this activity, participants will be able to:

1. Describe the current guidelines for AD therapy
2. Outline some of the potential therapies that may fill in treatment gaps
3. Identify some of the pitfalls and limitations of these approaches

Atopic Dermatitis and Itch

This course will cover the role itch plays in atopic dermatitis and review appropriate initial approaches to alleviating itch.

After completing this activity, participants will be able to:

1. Describe the mechanism for itch in atopic dermatitis
2. List two important mediators of itch
3. Identify life style factors that help alleviate itch

The Microbiome in AD

We examine the relationship between the gut microbiome and skin health and review the literature on the similarities and differences between the microbiomes.

After completing this activity, participants will be able to:

1. Describe some of the roles of the microbiome in the gut and on the skin
2. Outline some of the potential connections between these disparate microbiomes
3. Identify some of the diagnostic and therapeutic potential of better understanding these systems

Botanicals and Supplements for AD

There is growing interest in the use of botanical and supplement based approaches for skin care. This session will review some of the emerging supplements and botanicals and discuss their evidence.

After completing this activity, participants will be able to:

1. Evaluate the mechanism of action and evidence for the use of L-histidine
2. Recall the probiotics that have evidence for use in atopic dermatitis
3. Describe how herbs and supplements can be incorporated into a treatment plan

TCM and AD

In this course, you will learn about the differences between TCM and western approaches to AD. How herbal medicines are formulated will be discussed along with what can be expected when working with a TCM practitioner through case review.

After completing this activity, participants will be able to:

1. Differentiate TCM from the Western Medicine approach to dermatological issues
2. Assess a basic understanding of how herbal ingredients and dosages are determined
3. Distinguish what patients can expect if they see a TCM practitioner

Acne: Therapeutics Update

This lecture will serve as a review of the novel therapeutics that have gained recent FDA approval for the treatment of acne and to assess the mechanisms of action that are involved.

After completing this activity, participants will be able to:

1. Recall the novel therapies for acne
2. Evaluate the evidence for the use of novel therapeutics
3. Diagram how current therapeutics affect the pathophysiology of acne

Acne: Microbiome (Gut and Skin)

This lecture will focus on how the microbiota of the skin and the gut are connected to acne. In particular, we will discuss how the microbiome of the skin shifts with the presence of acne and how short chain fatty acids levels are shifted in those with acne.

After completing this activity, participants will be able to:

1. Describe how the gut microbiome and skin microbiome are shifted in acne
2. Define gut-skin axis and review how blood levels of short chain fatty acids are altered in acne
3. Evaluate the evidence for the use of topical and oral probiotics for acne

Diet and Acne

This session will take a look at foods that contribute to acne and the mechanisms involved.

After completing this activity, participants will be able to:

1. Explain the role dairy plays in acne
2. Describe how glycemic index/glycemic load impacts acne
3. List two botanicals that can interrupt acne pathways

Botanicals and Supplements for Acne

This lecture will review the evidence behind the use of botanicals and supplements in the treatment of acne.

After completing this activity, participants will be able to:

1. Evaluate the evidence for the use of topical supplements and botanicals in the treatment of acne
2. Review the evidence for the role of oral supplements and botanicals for acne vulgaris
3. Incorporate probiotics into an acne treatment plan

Psoriasis Therapeutics Update

Review allopathic treatment approaches to psoriasis

After completing this activity, participants will be able to:

1. Describe four factors to consider when developing a psoriasis treatment plan
2. List four topical treatment options for psoriasis
3. Categorize systemic treatment options for psoriasis

Rosacea: Therapeutics Update

This session will review emerging therapeutics for rosacea.

After completing this activity, participants will be able to:

1. Evaluate the evidence for novel therapeutics in rosacea
2. Assess the role of rifaximin in the treatment of SIBO in rosacea

Non-Scarring Hair Loss

This course provides an overview of the different types of scarring hair loss along with a summary of treatments.

After completing this activity, participants will be able to:

1. List common types of non-scaring hair loss
2. Identify botanical 5-alpha reductase inhibitors
3. Recognize two adaptogens that may be helpful in minimizing the physiologic stress response

(Hair Health) Practical Integration with Pharmaceuticals

This session will cover how to practically integrate multiple perspectives when addressing patients with hair health and hair loss related concerns. Three cases will be illustrated as examples.

After completing this activity, participants will be able to:

1. Break down hair health into its component pathophysiological subunits
2. Diagram an integrative approach to treating hair based conditions on a case based approach

Wrinkles: Diet and Oral Supplements

Dietary factors can impact collagen function and the development of wrinkles, which will be explored in this session.

After completing this activity, participants will be able to:

1. Discuss advanced glycation end products and how they are introduced into the body
2. Review an optimal anti wrinkle diet
3. List foods that contribute to increased photodamage and wrinkling

Dermatologic Care of the Transgender Patient

The role of the dermatologist in the care of the transgender individual is multifaceted. Hormones used for transitioning affect both hair and sebum, each with consequences from paucity to excess. Gender-confirming surgeries may have dermatologic pre- and post-operative interventions, and create sometimes-novel anatomy for disease presentation. Cosmetic procedures classically used for rejuvenation can be used to help create an appearance more congruent with an individual’s self-image. The objective of this presentation is therefore to explore these issues and the challenges the dermatologist may face when doing so in order to provide both medically sound and culturally competent care.

After completing this activity, participants will be able to:

1. Develop cultural competence in caring for transgender individuals
2. Describe the impact of exogenous hormones on the skin and hair
3. Recall aesthetic techniques for the purpose of gender affirmation

Integrative Medicine Legal Overview for Dermatologists (Roundtable)

This session will provide an overview of some of the legal, ethical, and business issues impacting the practice of Integrative Dermatology

After completing this activity, participants will be able to:

1. Review the different types of business model structures for integrative medical practices
2. Understand best practices and legal risks involved with integrative medical practices
3. Review the importance of staying within scope of practice

Liability Insurance Tips for Integrative Dermatologists (Roundtable)

This session will focus on insurance for developing a skin care line, selling products in office, and conducting research.

After completing this activity, participants will be able to:

1. Review what liability insurance is and the importance of having it
2. Recall the different types of liability insurance, including general, products, medical professional, research, and cyber liability
3. Identify the liability involved with consulting to a group vs one-on-one with patients

Direct To Patient Care: Foundations for A Successful Practice (Roundtable)

Direct to patient (DTP) care healthcare is a burgeoning category within the healthcare space. While this category continues to be defined, the principle that defines this category is empowering patients as consumers of healthcare. In our discussion we will review the major forces driving DTP care and opportunities for dermatologists to add value in this emerging space. We will also discuss specifics around setting up a direct care dermatology practice including choosing a niche, building a brand and tactical issues around practicing medicine outside of the third party payer system.

After completing this activity, participants will be able to:

1. Understand DTP care as an important emerging healthcare category
2. Identify areas where dermatologists can be leaders in the DTP category
3. Understand the basics of operating a DTP practice