We’re excited to announce our latest Pod of Inquiry episode featuring Dr. Tracey Vlahovic, a renowned podiatrist specializing in dermatology and professor discussing psoriasis and other skin conditions.
In this episode, Dr. Vlahovic shares her expertise on:
- The latest developments in psoriasis treatment
- Common misconceptions about skin health
- How lifestyle factors impact dermatological conditions
- Emerging technologies in dermatology
Dr. Vlahovic offers practical advice for managing psoriasis and maintaining healthy skin. Whether you’re dealing with skin issues or simply curious about dermatology, this episode provides valuable insights.
The episode is available now on all major podcast platforms. Don’t miss this opportunity to learn from one of the leading voices in dermatology!
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Show Notes from this episode
Dr. Vlahovic is a Professor at the Samuel Merritt University College of Podiatric Medicine in Oakland, CA. She is also a member of the Faculty of Podiatric Medicine of the Royal College of Physicians and Surgeons (Glasgow).
Dr. Vlahovic graduated from Yale University with a BS in Molecular Biophysics and Biochemistry and received her medical degree from Temple University School of Podiatric Medicine. After finishing her surgical residency at St Luke’s University Health Network in Allentown, PA, she was the first podiatrist in the US to complete a fellowship in podiatric dermatology under the supervision of Stephen Schleicher, MD.
She is board certified in foot surgery by the American Board of Podiatric Surgery and in podiatric medicine by the American Board of Podiatric Medicine. Dr. Vlahovic has authored several articles in peer-reviewed journals and has been involved in multiple clinical research trials for various dermatological therapies and devices.
She is the author of Skin Disease of the Lower Extremities: A Photographic Guide (HMP Communications), Onychomycosis: An Illustrated Guide to Diagnosis and Treatment along with Antonella Tosti and Roberto Arenas (Springer), and Atlas of Lower Extremity Skin Conditions with Dr Schleicher (Springer).
Summary
- Dermatology with a podiatrist and expert in the field. 0:00
- Dr. Tracy Vlahovic shares expertise on pediatric dermatology and skin health.
- Discussion covers latest developments in treating psoriasis and practical tips for managing foot-related skin issues.
- Dr. Vlahovic, a podiatrist, shares their journey to becoming an educator in dermatology, sparked by a rotation during residency.
- Dr. Vlahovic’s passion for dermatology grew unexpectedly during their rotation, leading them to pursue a fellowship and become an educator.
- Dermatology diagnosis challenges and nomenclature. 5:34
- Dermatologists are detectives, analyzing patient interactions and medical history to diagnose and treat conditions.
- In peripheral neuropathy, doctors gather evidence to identify causes, but sometimes treat symptoms empirically due to lack of knowledge.
- Dr. Vlahovic shares their passion for nomenclature, emphasizing its importance in communication, medicine, and law.
- Dr. Vlahovic explains how "porokeratosis" evolved into "porokeratosis plantaris discreta," highlighting the complexities of medical terminology.
- Keratosis and its potential to become squamous cell carcinoma. 9:59
- Dr. Vlahovic emphasizes importance of accurate nomenclature in dermatology to prevent misdiagnosis and potential legal issues.
- Punctate hyperkeratosis in feet may be difficult to distinguish from true poor keratosis without histological analysis.
- Dr. Vlahovic discusses potential link between mechanical lesions and warts.
- Treating various skin conditions, including punctate keratosis, psoriasis, and warts. 16:15
- Dr. Vlahovic discusses treatment options for punctate keratosis, considering mechanical factors such as weight bearing and pain level.
- She suggests offloading and treating lesions mechanically, rather than treating them as warts.
- Dr. Vlahovic uses adapalene gel and laser for wart treatment, but avoids cryoablation due to ineffectiveness and discomfort.
- They discuss treating psoriasis on the feet, using a stepwise approach with topicals, systemics, and phototherapy.
- Skin lesions, psoriasis, and its impact on daily life. 23:17
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- Dr. Barrett highlights the importance of considering skin lesions as impairments, rather than just cosmetic issues.
- Patients with psoriasis on their feet may experience significant impairment, missing work and impacting their daily activities.
- A detective approach to diagnosis involves asking patients about other areas of their body where they have skin lesions, and considering the possibility of underlying conditions like psoriasis.
- Psoriasis and psoriatic arthritis, including prevalence and pathophysiology. 28:45
- Dr. Vlahovic discusses the possibility of fungal infections being an environmental trigger for psoriasis.
- She notes that nail psoriasis can appear similar to onychomycosis and may coexist with fungal infections.
- Dr. Vlahovic estimates that 75% of psoriatic patients have plantar psoriasis without any skin manifestations elsewhere.
- Dr. Vlahovic believes that 10% of psoriatic patients only exhibit nail changes and isolated skin patches, with no joint involvement.
- She explains the complex pathophysiology of psoriasis, which affects the whole body, not just the skin and joints.
- The inflammatory cascade in psoriasis can increase the risk of cardiac events, depression, and other manifestations throughout the body.
- Gut health and microbiome's impact on skin conditions like psoriasis. 36:58
- Dr. Barrett and Dr. Vlahovic discuss the interconnectedness of human physiology and the impact of diet on various health conditions, including psoriasis and Alzheimer's disease.
- They also discuss the role of gut microbiome in influencing skin health and the potential benefits of adopting a non-inflammatory diet for improving skin conditions.
- Dr. Vlahovic believes gut and skin microbiomes play a role in skin diseases, and treating the underlying imbalances can help manage symptoms.
- Dr. Vlahovic prioritizes systemic treatment for severe cases, including cytokine panels and stress reduction strategies, to address the root causes of psoriasis and other skin conditions.
- Psoriasis, stress, and the impact of contact dermatitis on psoriatic disease. 42:24
- They discuss how breathwork and meditation can reduce inflammation.
- Biofeedback training in diabetic wound care improves outcomes.
- Dr. Vlahovic cautions against using duct tape on patients with dermatitis or psoriasis, as it can exacerbate the conditions.
- The term "porokeratosis" is often misused in podiatry, and its actual definition is not well understood.
- Podiatry and nail diseases with a passionate expert. 49:22
- Dr. Vlahovic discusses the importance of interdisciplinary collaboration in medicine, citing examples from her experience as a podiatrist.
- Dr. Vlahovic plans to launch a website and write more books on lower extremity dermatology and mycosis, making her knowledge more accessible to professionals and laypeople alike.
