In this episode of the Science of Skin Podcast, board-certified dermatologist Dr. Ted Lain sits down with world-renowned eczema and atopic dermatitis expert Dr. Peter Lio, founder of the Chicago Integrative Eczema Center, to unpack a game-changing shift in how dermatologists think about chronic inflammatory skin conditions.

If you're a dermatologist, skincare professional, or someone managing eczema, psoriasis, seborrheic dermatitis, or other steroid-responsive skin conditions — this episode is essential listening.

What you'll learn:

• Why topical corticosteroids, despite being effective, carry real risks with long-term use — including skin atrophy, growth suppression in children, HPA axis suppression, and the increasingly recognized phenomenon of topical steroid withdrawal (TSW)
• What PDE4 (phosphodiesterase 4) is, how it drives the inflammatory cascade in atopic dermatitis, and why targeting it is a "Goldilocks" approach to treatment
• The evolution of PDE4 inhibitor topical therapies, including roflumilast (Zoryve) — its origins as an oral COPD drug and its transformation into a highly effective topical for eczema, psoriasis, and seborrheic dermatitis
• The concept of "PDE4 inhibitor-responsive dermatoses" — a new framework introduced in Dr. Lio's JAAD publication that expands the clinical use of this drug class across a wide range of skin conditions, including rare and pediatric diseases with zero FDA-approved treatments
• The excellent safety profile of topical roflumilast, including what side effects to watch for and how to counsel patients
• Why dermatologists must continue championing innovation in topical therapies — not just biologics — to serve patients with mild-to-moderate disease

Featured guest: Dr. Peter Lio, MD — Clinical Assistant Professor of Dermatology and Pediatrics, Northwestern University; Founder, Chicago Integrative Eczema Center; Global speaker, researcher, and consultant in atopic dermatitis and inflammatory skin disease.

Sponsored by Arcutis Biotherapeutics, makers of roflumilast (Zoryve) topical foam and cream.

This episode was recorded ahead of the 2026 AAD Annual Meeting.

Link to Dr. Lio's JAAD publication on PDE4 inhibitor-responsive dermatoses.

DISCLAIMER: This podcast is not intended to provide diagnosis, treatment, or medical advice. Content provided in this podcast is for educational purposes only. Please consult with a physician regarding any health-related diagnosis or treatment

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