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Episode 73 Depression

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Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025

Outro Music: Path to Bright by Alex Grohl

Courtesy of Pixabay under Creative Commons non-commercial use.

Produced by: Todd Fredricks DO MSS

Edited by: Todd Fredricks DO MSS

Answers for Episode 72 Rosacea

QUESTION 1

A 44-year-old woman presents to an outpatient clinic for recurrent facial “flare-ups” for the past 18 months. She reports episodes triggered by exercise and hot beverages with a burning sensation across the cheeks. On examination, there are scattered inflammatory papules and pustules over the central face with visible telangiectasia. There is no persistent baseline erythema at today’s visit. She denies vision changes.

Which additional finding, if present, would be considered independently diagnostic of rosacea in the updated phenotype-basedclassification system?

C. Phymatous changes

QUESTION 2

A 39-year-old man is diagnosed with rosacea. He has moderate-to-severe disease (IGA 3) with both persistent facial erythema and numerous inflammatory papules/pustules. He requests a regimen that targets both redness and inflammatory lesions. His medical history is unremarkable. Based on evidence summarized in the article, which regimen best aligns with a randomized, double-blind, vehicle-controlled trial evaluating a combination approach for patients who have both erythema and inflammatory lesions?

B. Brimonidine 0.33% AM + ivermectin 1% PM

QUESTION 3

A 58-year-old patient presents with severe papulopustular rosacea (IGA 4) with extensive inflammatory lesions and frequent flushing. He has been adherent to topical therapy. He is started on topical ivermectin 1% cream, but he wants an evidence-based approach that improves the probability of clearing lesions more completely.

Which additional therapy is best supported by the phase IIIb/IV trial summarized in the article for improving outcomes in severe rosaceacompared with topical ivermectin alone?

D. Doxycycline 40 mg modified release

Paper for Next week:

Mishra, Aneesh K., and Anuj R. Varma. "A Comprehensive Review of the Generalized Anxiety Disorder." Cureus 15, no. 9 (September 28, 2023): e46115.

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