Skin in the Game

The legendary Dr. James Del Rosso (JDR) joins Skin in the Game to get under the surface of three hot topics in dermatology: hidradenitis suppurativa, ocular surface disease in atopic dermatitis, and emerging breakthroughs in the sebaceous gland. From evolving treatment strategies to practical clinical pearls, JDR brings his signature expertise and no-nonsense insights to help you stay ahead of the curve. Three topics, one legend, and plenty of pearls you won’t want to miss!

Skin in the Game delivers high-yield dermatology quick hits for busy clinicians.

Hosted by:
• Graham Litchman, DO, MS — Vivida Dermatology, Las Vegas, NV
• Diego Ruiz Dasilva, MD — Forefront Dermatology, Virginia Beach, VA

We read the research so you don’t have to.

For show notes and more information please visit our website at https://skininthegamepodcast.buzzsprout.com/

Disclaimer: This podcast is intended for educational purposes only and does not constitute medical advice. Views expressed are those of the hosts and do not necessarily reflect those of their employers or affiliated organizations.

What happens in Vegas doesn’t always stay in Vegas especially when it comes to dermatology!

Diego and Graham unpack the latest data, emerging therapies, and practice-changing insights from Fall Clinical 2026. From exciting breakthroughs to questionable hype, they separate what’s new from what actually matters in clinical practice - with a few hot takes along the way.

Skin in the Game delivers high-yield dermatology quick hits for busy clinicians.

Hosted by:
• Graham Litchman, DO, MS — Vivida Dermatology, Las Vegas, NV
• Diego Ruiz Dasilva, MD — Forefront Dermatology, Virginia Beach, VA

We read the research so you don’t have to.

For show notes and more information please visit our website at https://skininthegamepodcast.buzzsprout.com/

Disclaimer: This podcast is intended for educational purposes only and does not constitute medical advice. Views expressed are those of the hosts and do not necessarily reflect those of their employers or affiliated organizations.

You are what you itch! In this episode of Skin in the Game, we dive into the gut–skin connection and explore whether diet, probiotics, and nutritional supplements can actually improve atopic dermatitis. We separate science from hype, tackle common misconceptions, and discuss what the evidence really tells us about eating your way to better skin.

Skin in the Game delivers high-yield dermatology quick hits for busy clinicians.

Hosted by:
• Graham Litchman, DO, MS — Vivida Dermatology, Las Vegas, NV
• Diego Ruiz Dasilva, MD — Forefront Dermatology, Virginia Beach, VA

We read the research so you don’t have to.

For show notes and more information please visit our website at https://skininthegamepodcast.buzzsprout.com/

Disclaimer: This podcast is intended for educational purposes only and does not constitute medical advice. Views expressed are those of the hosts and do not necessarily reflect those of their employers or affiliated organizations.

What happens in Vegas doesn’t always stay in Vegas especially when it comes to dermatology!

Diego and Graham unpack the latest data, emerging therapies, and practice-changing insights from Fall Clinical 2026. From exciting breakthroughs to questionable hype, they separate what’s new from what actually matters in clinical practice - with a few hot takes along the way.

Skin in the Game delivers high-yield dermatology quick hits for busy clinicians.

Hosted by:
• Graham Litchman, DO, MS — Vivida Dermatology, Las Vegas, NV
• Diego Ruiz Dasilva, MD — Forefront Dermatology, Virginia Beach, VA

We read the research so you don’t have to.

For show notes and more information please visit our website at https://skininthegamepodcast.buzzsprout.com/

Disclaimer: This podcast is intended for educational purposes only and does not constitute medical advice. Views expressed are those of the hosts and do not necessarily reflect those of their employers or affiliated organizations.

Are we over-monitoring isotretinoin and overreacting to Dupixent safety signals? We unpack the evidence behind moving away from routine lab monitoring with isotretinoin, then tackle two of Dupixent’s most controversial reported adverse events: CTCL and vision loss. What’s a true safety signal, what’s association, and what should we actually tell our patients?

Skin in the Game delivers high-yield dermatology quick hits for busy clinicians.

Hosted by:
• Graham Litchman, DO, MS — Vivida Dermatology, Las Vegas, NV
• Diego Ruiz Dasilva, MD — Forefront Dermatology, Virginia Beach, VA

We read the research so you don’t have to.

For show notes and more information please visit our website at https://skininthegamepodcast.buzzsprout.com/

Disclaimer: This podcast is intended for educational purposes only and does not constitute medical advice. Views expressed are those of the hosts and do not necessarily reflect those of their employers or affiliated organizations.

Can we skip the scalpel? We break down the latest evidence for nonsurgical treatment of keratinocyte carcinomas, including when these approaches make sense and where surgery still reigns supreme. Then, we revisit an old precaution: avoiding live vaccines in patients on Dupixent. Has the evidence finally changed the conversation?

Skin in the Game delivers high-yield dermatology quick hits for busy clinicians.

Hosted by:
• Graham Litchman, DO, MS — Vivida Dermatology, Las Vegas, NV
• Diego Ruiz Dasilva, MD — Forefront Dermatology, Virginia Beach, VA

We read the research so you don’t have to.

For show notes and more information please visit our website at https://skininthegamepodcast.buzzsprout.com/

Disclaimer: This podcast is intended for educational purposes only and does not constitute medical advice. Views expressed are those of the hosts and do not necessarily reflect those of their employers or affiliated organizations.

This week, we tackle two very different topics: the emerging evidence for upadacitinib in alopecia areata, and new data challenging the long-standing surgical dogma of keeping wounds dry after dermatologic surgery.

Skin in the Game delivers high-yield dermatology quick hits for busy clinicians.

Hosted by:
• Graham Litchman, DO, MS — Vivida Dermatology, Las Vegas, NV
• Diego Ruiz Dasilva, MD — Forefront Dermatology, Virginia Beach, VA

We read the research so you don’t have to.

For show notes and more information please visit our website at https://skininthegamepodcast.buzzsprout.com/

Disclaimer: This podcast is intended for educational purposes only and does not constitute medical advice. Views expressed are those of the hosts and do not necessarily reflect those of their employers or affiliated organizations.

Dermatitis flares are common but should we really accept them as inevitable?

Are they more closely linked to IL-31 blockade compared to the other MOAs used in AD treatment?

In this episode of Skin in the Game, we challenge the way we define, treat, and even think about flares, exploring what they tell us about disease control and whether it’s time to stop chasing flares and start preventing them.

Skin in the Game delivers high-yield dermatology quick hits for busy clinicians.

Hosted by:
• Graham Litchman, DO, MS — Vivida Dermatology, Las Vegas, NV
• Diego Ruiz Dasilva, MD — Forefront Dermatology, Virginia Beach, VA

We read the research so you don’t have to.

For show notes and more information please visit our website at https://skininthegamepodcast.buzzsprout.com/

Disclaimer: This podcast is intended for educational purposes only and does not constitute medical advice. Views expressed are those of the hosts and do not necessarily reflect those of their employers or affiliated organizations.

With new therapies rapidly expanding the CSU treatment landscape, which options actually come out on top? We unpack a recent meta-analysis comparing efficacy across treatments and discuss what the rankings mean for real-world treatment decisions.

Skin in the Game delivers high-yield dermatology quick hits for busy clinicians.

Hosted by:
• Graham Litchman, DO, MS — Vivida Dermatology, Las Vegas, NV
• Diego Ruiz Dasilva, MD — Forefront Dermatology, Virginia Beach, VA

We read the research so you don’t have to.

For show notes and more information please visit our website at https://skininthegamepodcast.buzzsprout.com/

Disclaimer: This podcast is intended for educational purposes only and does not constitute medical advice. Views expressed are those of the hosts and do not necessarily reflect those of their employers or affiliated organizations.

Biosimilars promise lower drug costs - but are patients actually saving? We unpack the surprising reality that despite lower prices, biosimilars can leave patients with higher out-of-pocket costs and discuss what this means for access and affordability in dermatology.

Skin in the Game delivers high-yield dermatology quick hits for busy clinicians.

Hosted by:
• Graham Litchman, DO, MS — Vivida Dermatology, Las Vegas, NV
• Diego Ruiz Dasilva, MD — Forefront Dermatology, Virginia Beach, VA

We read the research so you don’t have to.

For show notes and more information please visit our website at https://skininthegamepodcast.buzzsprout.com/

Disclaimer: This podcast is intended for educational purposes only and does not constitute medical advice. Views expressed are those of the hosts and do not necessarily reflect those of their employers or affiliated organizations.

Radiographic progression in psoriatic arthritis isn’t always as straightforward as the headline results suggest. We discuss David Oberlin’s recent JAAD paper examining IL-23 inhibitor trials, why trial design matters when interpreting structural outcomes, and what dermatologists should understand when treating patients with PsA.

Skin in the Game delivers high-yield dermatology quick hits for busy clinicians.

Hosted by:
• Graham Litchman, DO, MS — Vivida Dermatology, Las Vegas, NV
• Diego Ruiz Dasilva, MD — Forefront Dermatology, Virginia Beach, VA

We read the research so you don’t have to.

For show notes and more information please visit our website at https://skininthegamepodcast.buzzsprout.com/

Disclaimer: This podcast is intended for educational purposes only and does not constitute medical advice. Views expressed are those of the hosts and do not necessarily reflect those of their employers or affiliated organizations.

Few topics in dermatology generate more debate than the management of dysplastic nevi. Should every positive margin be re-excised? Does the degree of atypia matter? And what does the evidence actually tell us about melanoma risk?

In this episode of Skin in the Game, Drs. Diego Ruiz Dasilva and Graham Litchman dive into one of the most common—and controversial—decisions in everyday dermatology. They separate long-held dogma from current evidence and share a practical, patient-centered approach to managing dysplastic nevi.

Whether you’re a resident, practicing dermatologist, or dermatology PA/NP, this episode will help you navigate one of the grayest areas in skin cancer management with greater confidence and evidence-based clarity.

Skin in the Game delivers high-yield dermatology quick hits for busy clinicians.

Hosted by:
• Graham Litchman, DO, MS — Vivida Dermatology, Las Vegas, NV
• Diego Ruiz Dasilva, MD — Forefront Dermatology, Virginia Beach, VA

We read the research so you don’t have to.

For show notes and more information please visit our website at https://skininthegamepodcast.buzzsprout.com/

Disclaimer: This podcast is intended for educational purposes only and does not constitute medical advice. Views expressed are those of the hosts and do not necessarily reflect those of their employers or affiliated organizations.

Tofacitinib was the first oral JAK inhibitor to transform the treatment of inflammatory disease but after the ORAL Surveillance trial, its boxed warning reshaped how many clinicians viewed the entire class.

Now, everything is changing again.

With generic tofacitinib becoming dramatically less expensive, clinicians are asking whether it’s time to take another look. In this episode of Skin in the Game, Drs. Diego Ruiz Dasilva and Graham Litchman unpack the history of tofacitinib, what the boxed warning actually means, how to interpret the available safety data, and where the drug may still have an important role in dermatology.

Whether you’re excited about the affordability of generic JAK inhibitors or remain cautious because of the boxed warning, this episode explores the evidence behind the headlines.

Skin in the Game delivers high-yield dermatology quick hits for busy clinicians.

Hosted by:
• Graham Litchman, DO, MS — Vivida Dermatology, Las Vegas, NV
• Diego Ruiz Dasilva, MD — Forefront Dermatology, Virginia Beach, VA

We read the research so you don’t have to.

For show notes and more information please visit our website at https://skininthegamepodcast.buzzsprout.com/

Disclaimer: This podcast is intended for educational purposes only and does not constitute medical advice. Views expressed are those of the hosts and do not necessarily reflect those of their employers or affiliated organizations.

With more treatment options than ever, choosing the right therapy for psoriasis isn’t always straightforward. In this episode of Skin in the Game, we break down the latest JAMA Dermatology meta-analysis comparing systemic treatments for plaque psoriasis. We discuss which therapies rise to the top, the strengths and limitations of network meta-analyses, and what these findings mean for real-world clinical practice.

Join us for a practical, evidence-based discussion with actionable takeaways for busy clinicians.

Skin in the Game delivers high-yield dermatology quick hits for busy clinicians.

Hosted by:
• Graham Litchman, DO, MS — Vivida Dermatology, Las Vegas, NV
• Diego Ruiz Dasilva, MD — Forefront Dermatology, Virginia Beach, VA

We read the research so you don’t have to.

For show notes and more information please visit our website at https://skininthegamepodcast.buzzsprout.com/

Disclaimer: This podcast is intended for educational purposes only and does not constitute medical advice. Views expressed are those of the hosts and do not necessarily reflect those of their employers or affiliated organizations.

For decades, systemic therapy selection in atopic dermatitis has largely relied on clinical judgment and trial-and-error. The prospective IDENTITY study by Silverberg and colleagues challenges that paradigm.

In this episode of Skin in the Game, we unpack the landmark JAAD study evaluating a 487-gene expression profile designed to identify the dominant inflammatory pathway in individual patients and guide systemic treatment selection. We discuss how the test works, review the study design and key efficacy outcomes, explore its strengths and limitations, and debate whether molecular phenotyping is ready for everyday clinical practice.

Most importantly, we discuss what this means for real-world dermatologists: Which patients might benefit? How could this change treatment sequencing? And are we entering the era of precision medicine for atopic dermatitis?

Join us as we separate the hype from the evidence and discuss whether IDENTITY represents the future of personalized AD care.

Skin in the Game delivers high-yield dermatology quick hits for busy clinicians.

Hosted by:
• Graham Litchman, DO, MS — Vivida Dermatology, Las Vegas, NV
• Diego Ruiz Dasilva, MD — Forefront Dermatology, Virginia Beach, VA

We read the research so you don’t have to.

For show notes and more information please visit our website at https://skininthegamepodcast.buzzsprout.com/

Disclaimer: This podcast is intended for educational purposes only and does not constitute medical advice. Views expressed are those of the hosts and do not necessarily reflect those of their employers or affiliated organizations.

Few topics in dermatology spark more debate than the sexual side effects of oral finasteride. In this episode of Skin in the Game, we break down the latest evidence comparing finasteride and dutasteride, including a new pharmacovigilance analysis, and discuss what these data can—and can’t—tell us about real-world risk.

We explore the strengths and limitations of adverse event databases, the role of reporting bias and the nocebo effect, and how to counsel patients using the best available evidence. Finally, we discuss whether dutasteride truly differs from finasteride and what these findings mean for everyday clinical practice.

Join us as we separate myth from evidence and provide practical, evidence-based takeaways for clinicians treating patients with androgenetic alopecia.

Skin in the Game delivers high-yield dermatology quick hits for busy clinicians.

Hosted by:
• Graham Litchman, DO, MS — Vivida Dermatology, Las Vegas, NV
• Diego Ruiz Dasilva, MD — Forefront Dermatology, Virginia Beach, VA

We read the research so you don’t have to.

For show notes and more information please visit our website at https://skininthegamepodcast.buzzsprout.com/

Disclaimer: This podcast is intended for educational purposes only and does not constitute medical advice. Views expressed are those of the hosts and do not necessarily reflect those of their employers or affiliated organizations.

Welcome to Skin in the Game, a dermatology podcast delivering high-yield clinical pearls for busy clinicians. Hosted by dermatologists Graham Litchman and Diego Ruiz Dasilva: we break down the latest research and translate it into practical insights you can use immediately in clinic.

In our inaugural episode, we explain the philosophy behind the podcast and discuss the paper “Assessing Risk Amid Uncertainty Inside and Outside the Dermatology Clinic” by Vanderweil et al. Together, we explore how physicians perceive risk, why rare adverse events often loom larger than common disease burdens, and how framing uncertainty can influence patient care.

Sponsored by ReachRx: Instant answers to clinical questions. Save time, stay updated, and ensure accuracy with the search engine built for medicine—free for clinicians.

Skin in the Game delivers high-yield dermatology quick hits for busy clinicians.

Hosted by:
• Graham Litchman, DO, MS — Vivida Dermatology, Las Vegas, NV
• Diego Ruiz Dasilva, MD — Forefront Dermatology, Virginia Beach, VA

We read the research so you don’t have to.

For show notes and more information please visit our website at https://skininthegamepodcast.buzzsprout.com/

Disclaimer: This podcast is intended for educational purposes only and does not constitute medical advice. Views expressed are those of the hosts and do not necessarily reflect those of their employers or affiliated organizations.