Vaiibhav Patel, MD, is a cardiologist at the Ohio State University Wexner Medical Center.

The Current Diagnostic and Treatment Landscape of Cardiac Sarcoidosis, With Vaiibhav Patel, MD

Cardiac sarcoidosis (CS) is among the hardest cardiovascular diseases to diagnose, primarily because it shares the majority of its symptoms with a long list of other conditions. Common presentations include high-grade conduction disease, left ventricular dysfunction, or ventricular arrhythmias.

“Sarcoidosis can present very clinically silently through just imaging findings, and it could present with patients coming in really sick, with ventricular arrhythmias and potentially even cardiogenic shock,” Vaiibhav Patel, MD, a cardiologist at the Ohio State University Wexner Medical Center, told 

 in an exclusive interview. “There are a lot of different cardiac diseases that can present that way, so I think it’s the job of the clinician to try to rule out everything else before you come to a diagnosis of cardiac sarcoidosis.”


Current clinical guidelines recommend diagnosis through a combination of multimodality imaging and multidisciplinary collaboration – not as a method of finding indicators of the condition, but to positively rule out alternative diagnoses. CS often presents with systemic involvement, which highlights the need for a thorough organ assessment.

The actual diagnosis process recommended involves a range of devices, including echocardiography, which may demonstrate reduced left ventricle ejection fraction or regional wall aneurysm, and ECG, which may show conduction delay, fragmented QRS complexes, and right or left bundle-branch block. However, the guidelines also warn of patients potentially presenting with normal ECG and normal echocardiography, which prompts the use of cardiac magnetic resonance and fluorine-18 fluorodeoxyglucose-positron emission tomography (PET).

In the event of continued uncertainty, clinicians are advised to proceed to endomyocardial biopsy, polymerase chain reaction, and immunohistochemistry – these procedures are considered the gold standard for sarcoidosis. However, studies have shown that treatment should still be initiated despite a negative biopsy result if abnormalities are detected via other diagnostic methods.

The guidelines state that treatment should be based on a risk-benefit ratio. If the disease is symptomatic, treatment should be initiated in patients with probable or definite CS. Those with possible or low-probability CS generally do not receive treatment given the uncertainty of diagnosis and unclear benefit for treatment. Additionally, given that the primary form of treatment is immunomodulation, the guidelines acknowledge an additional potential for harm.

Corticosteroids are first-line agents initiated at moderate to high doses and tapered according to imaging and clinical responses. Additional immunosuppression is administered in the case of incomplete response or steroid intolerance. Additionally, cardiologic management is recommended to reduce the risk of arrhythmias or heart failure. Patients at high risk may be administered an implantable cardioverter-defibrillator (ICD), although standard heart failure therapies are also assigned as indicated.

Despite these difficulties, the horizon for CS looks promising. Novel biologics like TNF-a inhibitors are currently in testing for refractory or steroid-resistant disease, targeting inflammatory pathways central to the formation of granuloma. Additionally, new biomarkers like circulating cytokines, imaging metrics, and emerging molecule markers, are allowing for real-time monitoring and therapeutic efficacy. However, the diagnostic challenge still remains at the forefront of the treatment process.

“In the past, we really thought of cardiac sarcoidosis as being a younger person’s disease. But I think the longer I’ve been doing this, the more I’ve been humbled by the fact that anyone can present with cardiac sarcoidosis,” Patel said. “And the caveat is that there are other things that can cause some of these presentations, and we need to rule those out first.”

Editors’ Note: Patel reports disclosures with Revamp Medical.

Cheng RK, Kittleson MM, Beavers CJ, et al. Diagnosis and management of cardiac sarcoidosis: A scientific statement from the American Heart Association. 

Kancerek J, Świerczek D, Baron W, Rojek M, Lewandowski P, Wojnicz R. Unmasking Cardiac Sarcoidosis: Integrating Multimodal Imaging with Histochemical and Ultrastructural Analysis. 

. 2026;27(7):2969. Published 2026 Mar 25. 

Videos

Patel provides an inside perspective on one of the most diagnostically challenging cardiovascular conditions.

News

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Clinical

clinical page is a resource for content on every specialty, disease, and topic available on our medical news site.

Cardiology

Cardiology condition center page is a comprehensive resource for clinical news and insights on cardiovascular and cardiometabolic diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for heart disease and cardiovascular events, as well as associated diabetes, renal failure, and more...

Nancy Reau, MD, is Professor of Internal Medicine, Richard B. Capps Chair of Hepatology, Associate Director of Solid Organ Transplantation, and Section Chief of Hepatology at Rush University Medical Center.

Kimberly Brown, MD, is division chief of gastroenterology and hepatology and the Associate Medical Director of the Henry Ford Hospital Transplant Institute at Henry Ford Hospital. She is also a Professor of Medicine at Wayne State University

Meena Bansal, MD, is director of the MASLD/MASH (NAFLD/NASH) Center of Excellence at Mount Sinai and System Chief, Division of Liver Diseases for the Mount Sinai Health System.

Liver Lineup: Updates & Unfiltered Insights

Liver Lineup: Closing the Gap in Women’s Liver Health

, hosts Nancy Reau, MD, and Kimberly Brown, MD, are joined by Meena Bansal, MD, to examine how liver disease uniquely affects women across the lifespan. While conditions like 

metabolic dysfunction-associated steatotic liver disease (MASLD)

 are often discussed in broad terms, the trio highlights how risk, progression, and outcomes can differ significantly based on sex and hormonal status.

From reproductive years through menopause and beyond, physiologic changes play a central role in shaping liver health, but these distinctions have historically been underrecognized in both research and clinical care.

0:00:00 – Welcome & women’s liver health framework

0:03:17 – Menopause, estrogen loss, and fibrosis risk

0:10:57 – PCOS, young women, and high‑risk metabolic phenotypes

0:13:54 – Pregnancy, MASH, and maternal-fetal outcomes

0:18:45 – Screening strategy, menopause as a pivot, and intervals

0:28:03 – Practical toolkit: FIB‑4, second‑line tests, and who to test

0:31:27 – Management, GLP‑1s, resmetirom, and key takeaways

Bansal frames MASLD through the lens of a woman’s life course, emphasizing that risk is not static but evolves from reproductive years through menopause and beyond. While premenopausal women may have some degree of protection against liver disease, this advantage diminishes with the loss of estrogen.

As Bansal explains, the postmenopausal transition is associated with increased visceral adiposity and heightened fibrogenic activity, contributing to a rise in MASLD prevalence and severity that begins to parallel, and in some cases exceed, that seen in men. These physiologic shifts mirror patterns observed in cardiovascular disease and underscore the need for more tailored approaches to screening and monitoring in women.

The discussion also underscores critical gaps in the evidence base, with much of the existing literature historically extrapolating findings from predominantly male populations or failing to account for hormonal status among women. As Brown notes, even when women are included in studies, they are rarely stratified by life stage, limiting the ability to draw meaningful conclusions about disease behavior in specific subgroups such as those with polycystic ovary syndrome (PCOS), during pregnancy, or after menopause.

Pregnancy represents another key inflection point. Women with MASLD face increased risks of adverse maternal outcomes, including gestational diabetes and preeclampsia, as well as potential downstream effects on fetal health. Emerging data suggesting epigenetic influences further reinforce the importance of early identification and management. However, therapeutic decision-making in this population remains challenging, particularly given contraindications for commonly used agents such as GLP-1 receptor agonists during pregnancy and the lack of robust safety data for newer therapies.

Across the discussion, Bansal and the hosts repeatedly emphasize the importance of proactive screening and patient advocacy. Tools such as the FIB-4 index offer accessible, scalable approaches to risk stratification, but clinicians must remain attentive to timing and frequency, particularly during periods of hormonal transition. The group also calls for greater collaboration with obstetrics and gynecology providers, who often serve as primary care touchpoints for women, to improve early detection and intervention.

Ultimately, this episode highlights a critical shift in hepatology: moving beyond a one-size-fits-all model toward a more nuanced understanding of how sex and gender influence liver disease. As Bansal notes, empowering women with knowledge about their risk and encouraging clinicians to recognize these distinctions will be essential to improving outcomes in MASLD and beyond.

Editors’ note: Relevant disclosures for 

 include AbbVie, Gilead, Salix, Arbutus, and VIR. Relevant disclosures for 

 include Mallinckrodt Pharmaceuticals, Gilead, Salix, Intercept, Ipsen, and Madrigal. Relevant disclosures for 

 include Boeheringer-Ingelheim, Boston Pharma, Fibronostics, GSK, Madrigal, Merck, NOVO Nordisk, and The Kinetix Group.

DiStefano JK. NAFLD and NASH in Postmenopausal Women: Implications for Diagnosis and Treatment. Endocrinology. 2020;161(10):bqaa134. doi:10.1210/endocr/bqaa134

Sarkar M, Kushner T. Metabolic dysfunction-associated steatotic liver disease and pregnancy. J Clin Invest. 2025;135(10):e186426. Published 2025 May 15. doi:10.1172/JCI186426

Mass General Brigham. Patients Who Discontinued GLP-1s Had More Weight Gain, Complications During Pregnancy. November 24, 2025. Accessed April 16, 2026. 

https://www.massgeneralbrigham.org/en/about/newsroom/press-releases/pregnancy-effects-from-discontinued-glp-1-use

Podcasts

Hosts are joined by Meena Bansal, MD, to discuss long-standing research gaps and what clinicians need to understand about sex-specific drivers of liver disease today.

Hepatology

MASH / MASLD

The HCPLive MASH & MASLD page is a comprehensive resource for clinical news and insights on metabolic dysfunction-associated steatotic liver disease and steatohepatitis. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for fatty liver disease, steatohepatitis, and more.

podcasts page features a feed of medical news and interview podcast series, including DocTalk, Lungcast, Derm Discussions, and Heart Trials.

Introducing Liver Lineup: Updates & Unfiltered Insights — an exciting new podcast delivering timely, candid perspectives on the most pressing topics in the fast-moving world of hepatology. Created by Nancy Reau, MD, and Kimberly Brown, MD, and hosted by HCPLive, this series dives into the cutting edge of liver disease research, clinical care, and real-world practice.

Strategic Alliance Partnership

James Murrough, MD, PhD, from the Icahn School of Medicine at Mount Sinai.

 Kv7 Channel Modulator Shows Promise for Anhedonia in MDD, With James Murrough, MD

A phase 2 randomized trial evaluating the Kv7 potassium channel opener azetukalner in 

 with anhedonia showed encouraging signals across secondary and exploratory measures, according to findings presented at ADAA 2026. James Murrough, MD, from the Icahn School of Medicine at Mount Sinai, 

discussed the results in an interview with 

 highlighting preliminary antidepressant effects and a favorable tolerability profile.

The double-blind, placebo-controlled study enrolled 60 participants with MDD and anhedonia in a current depressive episode. Individuals were randomized 1:1 to receive azetukalner 20 mg once daily or placebo for 8 weeks. The primary endpoint evaluated changes in bilateral ventral striatum activity during a reward-processing task using functional MRI. Secondary outcomes included changes in depressive symptoms and anhedonia measured by the Montgomery-Åsberg Depression Rating Scale (MADRS) and Snaith-Hamilton Pleasure Scale (SHAPS).

The trial did not demonstrate a significant difference between groups for the primary neuroimaging endpoint. However, Murrough noted that clinical symptom measures numerically favored azetukalner, and the magnitude of symptom improvement fell between a 2 – 4 difference on the MADRS.

“Although it didn't meet statistical significance, it's in the range that we would expect of drugs that have established antidepressant efficacy, so that was encouraging,” Murrough said.

Additional exploratory endpoints, including multiple assessments of anhedonia and clinician-rated global improvement, also trended in favor of azetukalner.

Safety and tolerability findings were favorable overall. Known class-related adverse effects associated with antiseizure medications were observed, including sedation, confusion, and occasional perceptual disturbances such as visual illusions. These events were generally transient, occurred primarily at night when dosing occurred, and did not typically lead to discontinuation. He noted that the cognitive or perceptual changes, although not severe enough to lead to discontinuation, need to be monitored in future trials.

Murrough emphasized that while the results remain preliminary, they contribute to growing interest in targeting reward circuitry and anhedonia in depression. Future research will focus on larger trials to clarify efficacy and further characterize safety.

“Our data from this trial encourages the further pursuit of this target, but we can't say a lot more beyond that,” Murough said. “We need more research.”

A relevant disclosure for Murrough includes Janssen Scientific Affairs, LLC

Part 1 of the interview with Murrough can be watched here: 

Kv7 Channel Modulator Azetukalner May Improve Anhedonia, With James Murrough, MD, PhD

Fremont R, Neukam P, Govindarajulu U, et al. A Randomized, Controlled Trial Of The Novel Kv7 Channel Opener Azetukalner In Individuals With Major Depressive Disorder And Anhedonia. Poster presented at the 2026 Anxiety and Depression Association of America (ADAA) 2026 meeting in Chicago from April 9 – 11.

Murrough discusses ADAA 2026 findings evaluating azetukalner in MDD with anhedonia; exploratory outcomes suggest potential benefit despite nonsignificant primary endpoints.

Psychiatry

Psychiatry condition center page is a comprehensive resource for clinical news and insights on mental illnesses. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for depression, schizophrenia, bipolar disorder, anxiety, and more.

Major Depressive Disorder

Major Depressive Disorder condition center page, resources on the topics of medical news and expert insight into depression can be found. Content includes articles, interviews, videos, podcasts, and breaking news on MDD research, treatment, and drug development.

Kv7 Channel Modulator Shows Promise for Anhedonia in MDD, With James Murrough, MD

Can Gene Editing Be A 'Functional Cure' For Sickle Cell Disease?

may come in the form of an experimental one-time gene editing cell therapy, renizgamglogene autogedtemcel (reni-cel), according to findings published in the 

Reni-cel is designed to modify a patient’s own blood-forming stem cells to correct the mutation responsible for sickle cell disease, increasing fetal hemoglobin levels to prevent red blood cells from forming into sickle-shaped cells, and improving overall hemoglobin levels to reduce complications from the disease.

nephrology team spoke with the lead author and chair of the Pediatric Hematology – Oncology & Blood and Bone Marrow Transplant Division at Cleveland Clinic Children’s, Rabi Hanna, MD, for his perspective on the results from the RUBY trial.

What Are We Missing In Sickle Cell Disease Treatment?

Previous gaps in the common treatment options for sickle cell disease include limited donor availability and the possibility of graft-versus-host disease.

“Gene therapy is autologous, so every patient can essentially donate to themselves. And because it is autologous, you don’t usually have graft rejection or graft-versus-host disease, so no immunosuppression is required.”

data on burnout rates in physicians who treat sickle cell disease at 60%

, partially attributed to structural barriers in patient care.

Gene Editing Sickle Cell Disease With Reni-cel

In the phase 1-2 multicenter open-label, single-group study, study investigators evaluated reni-cel, an investigational clustered regularly interspaced short palindromic repeats (CRISPR)–Cas12a gene-edited autologous hematopoietic stem-cell therapy.

“Reni-cel is a novel therapy and represents a different approach. It is still autologous, but the gene-editing technique differs from previously approved therapies in two key ways. First, it uses Cas12a instead of Cas9, which offers greater specificity,” explained Hanna.

“The more important distinction is that it mimics a natural process. Approved gene therapies typically target BCL11A binding, whereas this approach targets the HBG1 and HBG2 promoters—similar to what occurs in individuals with sickle cell disease who remain asymptomatic due to persistently elevated fetal hemoglobin. We examined the underlying mutation in those individuals and aimed to replicate it. That is the rationale behind this study: to evaluate the safety and efficacy of this approach.”

Patients were treated with a single infusion of renicel after myeloblative conditioning with busulfan, a high-dose chemotherapy regimen used before allogeneic stem cell transplantation (HCT) to eliminate cancer cells and suppress the immune system.

The trial included 28 patients with severe sickle cell disease who were 12 to 50 years of age with ≥2 severe vasco-oclusive events per year in the previous 2 years.

According to the results, among 27 patients who had neutrophil and platelet engraftment by the data-cutoff date, neutrophil engraftment, the process where transplanted stem cells begin producing new, healthy blood cells in a patient's bone marrow. occurred after a median of 23 days (range, 14 to 29). Additionally, platelet engraftment, the process where newly transplanted stem cells begin producing platelets, signaling recovery in hematopoietic stem cell transplants, occurred after a median of 25 days (range, 17 to 51).

At month 6, among 18 patients with at least 6 months of available data, the mean (±SD) total hemoglobin level (9.8±1.7 g per deciliter at baseline) had increased to 13.8±1.9 g per deciliter, and the mean percentage of fetal hemoglobin (2.5±2.5% at baseline) had increased to 48.1±3.2%. Both of these measures remained stable.

In terms of pain crisis, 1 patient had 2 severe vaso-occlusive events after infusion. Overall, the adverse events were consistent with those that occur after myeloablative busulfan-based conditioning and autologous hematopoietic stem-cell transplantation.

Stay up to date with the rest of our conversation with Hanna to learn more about the significance of the reduction in pain crisis for patients with sickle cell disease. 

Editor’s Note: Hanna reports relevant disclosures with Chiesi USA, Inc., Swedish Orphan Biovitrum AB (Sobi), and Vertex Pharmaceuticals Incorporated. 

Hanna R, Frangoul H, Pineiro L, et al. CRISPR-Cas12a Gene Editing of 

 Promoters to Treat Sickle Cell Disease. 

Popat UR, Pasvolsky O, Bassett Jr. R, et al. Myeloablative fractionated busulfan for allogeneic stem cell transplant in older patients or patients with comorbidities. 

https://doi.org/10.1182/bloodadvances.2023010850

Hanna, MD, shares results from reni-cel, a one-time gene editing therapy for patients with sickle cell disease. 

Hematology

Sickle Cell

Sickle Cell condition center page, resources on the topics of medical news and expert insight into sickle cell disease can be found. Content includes articles, interviews, videos, podcasts, and breaking news on sickle cell research, treatment, and drug development.

Vinod E. Nambudiri, MD, MBA, MPH, is affiliated with Brigham and Women's Hospital and specializes in Dermatology and Internal Medicine.

How the AAD Clinical Image Collection Can Help Dermatologists, With Vinod Nambudiri, MD, MBA, MPH

2026 American Academy of Dermatology (AAD) Annual Meeting

 brought forward a timely and clinically relevant discussion with Vinod Nambudiri, MD, MBA, MPH, of Brigham and Women’s Hospital, centered on advancing dermatologic care for diverse patient populations. The conversation highlighted both the progress made and the ongoing gaps in addressing conditions that disproportionately affect individuals with skin of color, with a particular emphasis on health equity, access to care, and emerging therapeutic strategies.

A central theme of Nambudiri’s discussion was the importance of recognizing how dermatologic diseases can present differently across skin tones, and how these variations can contribute to delayed diagnosis or misdiagnosis. The speakers emphasized that improving clinician education remains critical, particularly in ensuring that providers are trained to identify subtle or atypical presentations in darker skin types. This gap in training continues to be a barrier to optimal care and underscores the need for more inclusive educational resources and clinical imagery.

The conversation also explored the psychosocial burden of dermatologic conditions in patients with skin of color, noting that visible skin diseases often carry significant stigma. This burden can be further compounded by cultural perceptions, societal pressures, and disparities in access to specialized care. As such, Nambudiri stressed the importance of culturally competent care and shared decision-making, ensuring that treatment plans align with patient preferences, expectations, and lived experiences.

Emerging therapies and innovations were another focal point, particularly in the context of conditions such as pigmentary disorders, inflammatory diseases, and hair disorders that are more prevalent or uniquely impactful in these populations. While new treatments are expanding the therapeutic landscape, the discussion underscored that clinical trial diversity remains insufficient. Increasing representation of patients with skin of color in research was identified as essential for generating data that are both generalizable and clinically meaningful.

In addition to therapeutic advancements, Nambudiri highlighted the role of community engagement and advocacy in driving change. Efforts to improve outreach, patient education, and trust in the healthcare system were noted as key components in addressing longstanding disparities. The integration of patient voices into both research and clinical practice was also emphasized as a means of ensuring more equitable and effective care delivery.

Overall, the discussion reflected a growing momentum within dermatology to prioritize inclusivity and equity. While meaningful strides have been made, the speakers acknowledged that sustained efforts are needed across education, research, and clinical practice to fully address disparities and improve outcomes for patients with skin of color.

Editor’s note: This summary was developed with the help of AI tools.

Nambudiri discusses the AAD Clinical Image Collection, launched in January 2025 to address the lack of diverse representation in dermatology education.


Dermatology

The HCPLive dermatology page is a resource for medical news and expert insights on skin disease. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for dermatologic conditions, and more.

Conference

 conference coverage page features articles, videos, and expert-led live coverage from major medical meetings throughout the year.

Abigail Brooks is an assistant managing editor for 

She joined MJH Life Sciences in August 2023 shortly after graduating from Monmouth University where she earned her BA in Communication with a concentration in Public Relations/Journalism and later an MA in Interactive Digital Media. She enjoys traveling, running, and reading books. She can be reached at abrooks@mjhlifesciences.com.

Articles

Experts discuss diagnostic challenges, variable presentations, and strategies to improve outcomes in Wilson disease.

From Diagnosis to Management: Addressing Gaps in Wilson Disease Care

Ryan Livingston joined the MJH Life Sciences team in March of 2025, shortly after graduating from TCNJ with a bachelor’s degree in English. He enjoys creative writing, reading, and scuba diving. He can be reached at rlivingston@mjhlifesciences.com.

Results from the largest and longest trial of orforglipron to date have displayed the drug’s efficacy in reducing all-cause cardiovascular death and MACE incidence.

Breaking News

Endocrinology

The HCPLive endocrinology page is a comprehensive resource for clinical news and insights on endocrine system conditions. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for diabetes, hormonal disease, and more.

Type 2 Diabetes

ACHIEVE-4: Orforglipron Non-Inferior to Insulin Glargine for Cardiovascular Protection in T2D

Learn how subtle liver enzyme changes and age-specific movement symptoms signal Wilson disease, plus the latest on newborn screening and tests.

Video Series

Early Clinical Signs and the Evolution of Diagnosis in Wilson Disease

Psoriasis care shifts beyond skin: treat-to-target goals, heart risk reduction, and new oral TYK2 pills with strong safety data.

Zasocitinib in Plaque Psoriasis from the LATITUDE Trials

Clinicians across specialties spot red flags, refer early to GI, and follow guidelines to improve diagnosis and management.

Who Diagnoses EPI? Defining Roles Across the Care Team

Wilson disease mimics tremor, dystonia, Parkinsonism or psychosis; watch for subtle liver signs and screen early to avoid delay.

Understanding Pathophysiology and Copper Transport in Wilson Disease

Discover how oral TYK2 inhibitors deliver targeted psoriasis control with strong safety data and biologic-like clearance, including insights on deucravacitinib and zasocitinib.

The Role of TYK2 Inhibitors in Modern Psoriasis Care

Why EPI stays missed: barriers to enzyme therapy, targeted fecal elastase testing, and preventing malnutrition, bone loss, and QoL decline.

EPI Unmet Needs: Barriers to Diagnosis and Long-Term Consequences

Martina J. Porter, MD, is a dermatologist at Beth Israel Deaconess Medical Center.

Extension data through week 54 reveal deepening responses with povorcitinib in moderate-to-severe HS.


Hidradenitis Suppurativa

Hidradenitis Suppurativa condition center page, audiences can find a variety of coverage mediums for medical news and updates, including articles, video interviews, podcasts, and breaking news on dermatology research, treatment, and drug development.

Povorcitinib Efficacy Holds in Biologic-Experienced HS, With Martina Porter, MD

Thierry Passeron, MD, PhD, is a professor and chair of the Department of Dermatology at the Université Côte d'Azur in Nice, France.

This Q&A interview highlights several takeaways from the data on upadacitinib in patients with non-segmental vitiligo (NSV).

Vitiligo

Vitiligo condition center page is a comprehensive resource for clinical news and insights on the dermatologic condition. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for the affected skin of vitiligo patients.

Latest News

The Current Diagnostic and Treatment Landscape of Cardiac Sarcoidosis, With Vaiibhav Patel, MD

Liver Lineup: Closing the Gap in Women’s Liver Health

Kv7 Channel Modulator Shows Promise for Anhedonia in MDD, With James Murrough, MD

Can Gene Editing Be A 'Functional Cure' For Sickle Cell Disease?

How the AAD Clinical Image Collection Can Help Dermatologists, With Vinod Nambudiri, MD, MBA, MPH