Episode 118: Latent Tuberculosis in Dermatology - A 2025 SF Derm Session | The Future of Dermatology Podcast

Summary In this truncated replay from the 2025 SF Derm Annual Conference, Dr. David Cotter discusses the implications of latent tuberculosis in dermatology, particularly in psoriasis treatment. He highlights the prevalence of latent TB, risk factors, and the importance of targeted screening. This session also addresses the mental health challenges faced by psoriasis patients and evaluates the safety of new treatments, emphasizing the need for careful monitoring and patient support. Takeaways - The prevalence of latent TB infection in the U.S. is 5%. - Healthcare workers have a higher risk of latent TB. - Patients on TNF inhibitors are significantly more likely to develop active TB. - Screening for latent TB should be targeted to high-risk patients. - Annual TB screening is not necessary for most psoriasis patients on IL-17 and IL-23 inhibitors. - The cost of screening for latent TB can be substantial. - Patients with psoriasis have higher rates of suicidal ideation and behavior. - Effective psoriasis treatment can improve mental health outcomes. - The event rate for suicide in clinical trials is very low. - Monitoring for mental health issues is crucial in psoriasis treatment. Chapters 00:00 - Understanding Latent Tuberculosis in Dermatology 08:40 - Mental Health and Psoriasis: A Critical Connection