Discover and read the best of Twitter Threads about #dermatology

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Happening now, all are welcome to tune in for this FREE half day session on advocacy in dermatology! #IDTAD22…
First up, the incredible Dr. Murad Alam, speaking about the nuts and bolts of #advocacy work in #dermatology
Next, Dr. Robert Brodell speaking about the importance of your purpose in developing yourself as an advocate.
Read 10 tweets
Varón de 32 años derivado por su MAP por Teledermatología por aparición de estas lesiones localizadas en espalda, flancos (imagen) y raíz de miembros superiores de 1 año de evolución Image
¿Cuál sería el siguiente paso a realizar?
Una sola imagen, sin historia clínica, no es nada (por poder ser, pudiera incluso no corresponder siquiera a nuestro paciente).
Así pues, lo citamos en consulta (RC: 4 ✅).
¿Cómo describiría la morfología del eritema?
Read 12 tweets
A #dermtwitter and #MedEd #tweetorial on...


This is an autoimmune blistering disorder that can be triggered by drugs!

Hey #medtwitter, what do you think is one of common culprits for causing this eruption?
You'd be correct if you said vancomycin!

Vanco triggers IgA to attack proteins in the hemidesmosome that holds epidermis to the basement membrane. That means this is a part of the PEMPHIGOID group.

So you get TENSE blisters with a NEGATIVE NIKOLSKY.
For the #dermatology residents who need to memorize this, remember that the antigen that is targeted is the 97 kDa portion of the extracellular domain found in BPAg2.

For everyone, remember this is part of the pemphigoiD (D for deep) group, hence the exam findings.
Read 10 tweets
I'll be adding short important points which would hopefully help in remembering certain concepts during #PLAB preparation, to this thread🧵every now and then as I take them out from my scattered notes. Feel free to comment your tips and tricks which would help others, as well 👇
Please don't take any of these as medical advice 😂🙏. Real life stuff is much more nuanced. These are just clinchers for the sake of the exam.
1. Drug contraindications...
-Avoid BAN drugs in Asthma (Beta blockers, aspirin, NSAIDS) &
-DAMN drugs in diarrhoea (Diuretics, ACEIs, Metformin, NSAIDs)
Read 60 tweets
#antivaxx efforts now even use #deepfake

to target #refugee, Black, religious minority communities

like measles outbreak in Minnesota in 2019: Wakefield was flown in TO spread #misinformation & #disinformation

Now: online fake accounts/fake identities vs #VaccinesWork
What has #healthcare been doing meanwhile?

#Medbikini: Teach (male Asian) med students to make fake accounts to cyberstalk trainees’ personal Facebook for: bikini
or “being political” or “religious” (#BLM)

➡️“model minority” pipeline for “shadow faculty” vs Blck @ayshakhoury
#Medbikini #research got flak for men vs women

BUT was ALSO fake acct #surveillance vs #BLM like drove out @ayshakhoury @uche_blackstock @nhannahjones

While academia has ignored #vaccineequity
➡️ongoing #pandemic & deaths in marginalized targeted by #antivaxx

Read 23 tweets
Join me for a quick #tweetorial/#medthread on:

Pearls for the #Dermatology Exam!

#MedEd #dermtwitter #medtwitter #medstudenttwitter #FOAMed

First a question - What do you think when someone asks for your help with a rash?
Regardless how you answered, I hope to teach you something today! Let's start!

"In #dermatology, we don't do an H+P, we do a P+H."

The exam is perhaps most important. You can use it to narrow down your ddx! Then, you use your history to further work toward the right dx.
"If there's scale, there probably is epidermal involvement."

Scale usually implies action in the epidermis. This doesn't rule out anything in the dermis or subcutis, but just that the pathology includes action up top.

Check out my #tweetorial on scale
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📢📢 The supplemental @ERASinfo application is open!

I shared details about the application in a prior thread. A few other points & tips for #Match2022 #medstudenttwitter whether you're applying in #dermatology #internalmedicine or #GenSurgMatch2022.

Applicants will be invited to complete the supplemental application once they save a participating program in any of the 3 specialties in MyERAS.

‼️ There is a 24 hour delay between saving a program and receiving the invite. So, get saving if you haven't yet!
The supplemental app is now optional for ALL participating programs in the 3 specialties. All ?? are also optional.

I recommend you complete it. Why? I (& many others) feel this can only help applicants by allowing you to highlight unique qualities & prefs. 3/
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1/ For about two weeks now I have been suffering from a disturbing skin problem. My left arm and the right side of my chest developed a redness, accompanied by pimples and itching. It's unbearable.
2/ The dermatologist I have consulted with glanced at it, and asked if I had ever suffered from skin asthma. I told her no. But that I'm very allergic to the change of seasons, and maybe that's a reaction to that.
3/ She nodded, prescribed me two ointments to apply twice a day, body lotion and therapeutic soap and sent me home.
I have been applying these creams and lotions for a week now. And I hate it. I have always hated the touch of cream on my skin.
Read 9 tweets
Great points by @jbcarmody on the new @ERASinfo secondary application tool. I'll add a few points & address some questions I've seen, particularly related to how the process will unfold in #dermatology for #Match2022. 1/
@jbcarmody @ERASinfo 1. Participation by individual programs is voluntary in #dermatology. We will encourage programs to participate but not mandate as a specialty.

2. Programs will decide whether the tool is required or optional for their applicants. 2/
What does this mean for you?

Because #dermatology applicants typically apply to >60 programs, unless you plan to apply to very few programs that happen to not be participating, you will very likely need to complete the new supplemental application. 3/
Read 24 tweets
Just out in @JAADjournals, interesting cohort study led by @ArielleNaglerMD evaluating whether there is an increased risk of suicidality among #acne patients treated with #isotretinoin. A quick thread 1/7
#dermtwitter #dermatology
The authors conducted a cohort study evaluating the rate of psychiatric disorders and suicidality among 3 cohorts: those with acne treated with isotretinoin, those treated with antibiotics only, and those in the general population. 2/7
After adjusting for age and sex, they found that those treated with isotretinoin had increased odds of a psychiatric disorder (e.g. depression) but decreased odds of suicidality compared to those treated with antibiotics and those in the general population. 3/7
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Let's spend some time on a #dermtwitter #tweetorial on all things....


Even though there are 8 herpesviruses that infect humans, I'm going to focus on HSV1 and HSV2 today.

#medtwitter #medstudenttwitter #meded #FOAMEd
You know how we say that everything could be sarcoid? Well, HSV-1/HSV-2 (which I'll refer to as herpes for this #thread) would be a close 2nd, ESPECIALLY on the inpatient service.

While HSV-1 is usually thought to be oral and HSV-2 genital, this certainly is NOT always true.
The class exam finding for herpes is the "dew drop on a rose petal." In clinical speak, that would be a vesicle on an erythematous base. But often we don't see the vesicle intact.

For ex, the photo above shows intact vesicles, whereas here, we just see the resultant crust.
Read 16 tweets
@R_J_Howes @SpringerNature It is a misnomer to assume the appellation of #AcneInversa is peculiar only to Germany.

#HidradenitisSuppurativa and #Dermatology may be associated with a short memory.
@R_J_Howes @SpringerNature Changing a bad disease name to another bad disease name is not good science. But you go right ahead and stand on the calcaneum of dwarves. #Dermatology #HidradenitisSuppurativa
Read 6 tweets
"A group of authors has found a way to crank up the number of papers on their resumes." #Dermatology #Bullshitology
2020 Sep. #Retraction: Five papers from Open Access Maced J Med Sci. Vol. 7 No. 18 (2019): Sep 30 (Global #Dermatology)…
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Let's kick off the new year with a #dermatology #tweetorial! I put together some tweets on


#MedEd #FOAMEd #medtwitter #dermtwitter #onctwitter

Let's start with a poll:

Among BOTH males and females in the US, how common is melanoma?
Melanoma is the 6th most common malignancy (that's tracked) for BOTH men & women. Basal cell carcinoma is actually the MOST common cancer in the US, but we don't track it.

While melanomas are 6th, in certain groups (eg: women age 25-30), it is the #1 cause of cancer death! Image
So melanoma is deadly, especially in certain age groups. But something peculiar is happening too. @AdeAdamson recently spoke at @MassGeneralNews about this interesting finding 👉 melanoma diagnosis is increasing, but melanoma death is decreasing.

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Lo que el #Año2020 nos dejo
1. Las 2 primeras vacunas ARNm de la historia, producidas en 🕛 récord, para prevenir formas sintomáticas de la infección por el #SARSCoV2.
a) @pfizer/ Biontech: BNT162b2 / 95% de efectividad
b) @moderna_tx: mRNA-1273 / 94.1% de efectividad
2. El #RECOVERY trial de la @UniofOxford y el #Solidarity trial de la @WHO q' demostraron el beneficio de usar dexametasona en pacientes hospitalizados con #COVID19 severo, y el NO beneficio de utilizar #hidroxicloroquina, cloroquina, interferon, lopinavir/ritonavir o azitromicin
3. Los 47 países del continente africano libres de #poliomelitis por el virus salvaje, según la @WHO 25/08/2020.
4. El fin de la epidemia de #Ébola en la república democrática del Congo, gracias a la única #vacuna vs el virus, llamada ERBEVO de @Merck.
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While we're all doom-scrolling through Twitter, I thought I could help provide some distraction for #medtwitter, #dermtwitter & #medstudenttwitter.

A #Derm101 #tweetorial on the #dermatology exam:


AKA: "How a dermatologist approaches a rash!"
So what exactly is a reaction pattern? It's an organizational way to think about rashes so that we can bucket them. There are FIVE main reaction patterns:

1) Papapulosquamous
2) Eczematous
3) Dermal
4) Vascular
5) Vesicobullous

Which reaction pattern was that last photo?👆
It's PAPULOSQUAMOUS! The name means it's papular (raised) with scale. The prototypical rash for these is psoriasis, which is that 1st photo! Notice how in darker skin, the erythema of psoriasis is harder to see!

Here's a whole #tweetorial I made:
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Dear #NEISvoid/twitter, I am VINDICATED (&, uh, still hyper on steroids, FWIW). Awesome Sleep/RespDoc is of the educated &firm opinion (upon reviewing my hospital discharge summary, lung function test results...which the hospital still hadn’t passed on yet as of this morning? 🙄)
...that I have NOT suddenly & completely coincidentally managed to develop asthma for the first time in my life at the tender age of 39 (although he thinks it does sound like a bronchospasm cough, which is literally how I was describing it when it first started happening.
Nor do I seem to have any kind of lung problem, nor a recent past upper/lower resp tract infection). Although apparently he hadn’t received the results of either of the sputum culture tests from the hosp. I’m assuming they were boringly negative or I’d have heard by now, though.)
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Time for another #morphology #Derm101 series #tweetorial on the skin exam. Today, we'll cover:


How the location a rash occupies on the body might help us with the differential diagnosis!

#FOAMEd #MedEd #medtwitter #dermtwitter #medstudenttwitter #dermatology
An important point to start:
Distribution is LEAST important in the skin exam. Primary & secondary lesions, configuration & scale are all better in informing our DDx.

I tell my learners that if confused about a rash, pretend it's elsewhere on the body & see if that helps.
Also - throughout this #tweetorial, I will try to display skin disease in lighter & darker skinned patients side by side. Remember in darker skin, erythema is harder to see, so I hope this highlights the point!

A question: In tweet 1, what distribution is shown in the photo:
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Stretch mark- the thick lines we dread to find on our skin. Unlike acne, this is one condition that very few people will escape having; males and females are almost equally affected.

So what causes a stretch mark?

#Dermatology Image
A stretch mark is a type of scar that develops when our skin stretches or shrinks quickly. During this rapid stretching/shrinking of skin, some components of the skin called collagen and elastin rupture and as the skin heals, it can form a stretch mark
Stretch marks are likely to develop in puberty (from growing rapidly), pregnancy, after rapid weight loss or gain, or when weight training and you have rapid muscle growth (now you know why weight lifters get them).
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I've been having trouble getting my residency research project published. Since I don't feel like arguing with reviewer #2 anymore, I figured I'd just tweet it! More people will probably see my work this way anyway ...

#dermtwitter #dermatology

1st, thanks to @HeidiJacobe for all of her help with this project.

And for an abstract in twitter form:

tl;dr ➡️ there's a lot of bogus derm content on twitter, but the most popular misinformation often isn't addressed by the @AADskin's tweets or online patient info articles.
When I first got into #medtwitter as an MS4, there weren't a lot of derms on here (which has thankfully changed!)

I did, however, notice a lot of tweets like this one:
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OK team, #tweetorial #3 in our #Derm101 series on the #dermatology exam. Today, let's discuss:


How primary lesions are grouped or shaped. Read on to learn more!

#dermtwitter #medtwitter #medstudentwitter #meded #FOAMEd pc:@dermnetnz @BrwnSkinMatters
Since this is the 3rd installment in the #Derm101 series, remember that if you haven't already, you might want to check out the first two #tweetorials on skin morphology.

Primary Lesion:

Secondary Lesion:
I think of configuration as how the primary lesion might be shaped or grouped. So this would include rashes that are:

Target/Targetoid (kind of)

What configuration was the rash in tweet #1?
Read 20 tweets
As promised, here's the second installment of my #Derm101 series on the #dermatology physical exam and #morphology. A #tweetorial on:


#MedEd #FOAMEd #dermtwitter #medtwitter #medstudenttwitter pc:@dermnetnz
First off, if you haven't gone through the primary lesion #tweetorial yet, it's a good idea to start there. Here's the link:

As review, these are the different primary lesions👇
Secondary lesions are the changes that affect the primary lesion.

Say what? If a papule is scaly, the SCALE is the secondary lesion. If a plaque is crusty, the CRUST is the secondary lesion.

A question: What was the secondary lesion seen in the pic from the 1st tweet?
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“Dermatologists don’t save lives.”

This was a recent comment made by a non-dermatologist about our field. I beg to differ.

As an academic dermatologist, I specialize in the treatment of difficult skin cancers, esp when they cannot be treated by straightforward surgeries. 1/
This pt had undergone a kidney transplant for polycystic kidney disease and was on anti-rejection immunosuppressive meds. He then developed a deep 3.1 mm melanoma on his scalp (+BRAF mutation), underwent excision and complete lymph node neck dissection after a positive SLN. 2/
He could not tolerate an oral BRAF inhibitor due to severe hand-foot skin reaction. 3/
Read 10 tweets

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