Jan 01
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Seborrheic Dermatitis in Skin of Color: Clinical Considerations

By | SOC Manuscripts | No Comments

Source: J Drugs Dermatol. 2019;18(1):24-27.

May Elgash BS, Ncoza Dlova MBChB FCDerm PhD, Temitayo Ogunleye MD, Susan C. Taylor MD

Skin of Color Update 2019 faculty Susan C. Taylor, MD and colleagues published a paper in the January 2019 issue of the Journal of Drugs in Dermatology on seborrheic dermatitis in skin of color.  Read the abstract below or login in to JDD for the full manuscript.

Abstract: Seborrheic dermatitis is a common, relapsing, inflammatory skin condition of unclear etiology. The Malassezia yeast genus are believed to play a role. Seborrheic dermatitis commonly affects areas of the skin with high sebum production, including the scalp, nasolabial folds, glabella, eyebrows, beard, ears, retroauricular skin, sternum, and other skin folds. Seborrheic dermatitis may present differently in individuals with skin of color. Darker-skinned individuals may present with scaly, hypopigmented macules and patches in typical areas of involvement. Arcuate or petal-like patches may be seen, specifically termed petaloid seborrheic dermatitis. Children of color often do not experience the classic “cradle cap” appearance of seborrheic dermatitis, and have erythema, flaking, and hypopigmentation of the affected areas and folds of skin. Seborrheic dermatitis tends to respond well to conventional treatments, although it tends to recur. Skin of color patients may require a modified treatment approach which takes into account differences in hair texture and hair washing frequency. This paper aims to highlight these differences to help reduce disparities in the management of seborrheic dermatitis in patients of color. To read the full manuscript with your JDD subscription, click here.

Nov 05
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Hair disorders skin of color update

Clinical Approach to Hair Loss in Pediatric Patients

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Physicians from throughout the Washington DC area recently convened at a hair disorders symposium, where distinguished experts in the field of hair disorders discussed the evaluation, work-up, and treatment of a wide variety of alopecias and scalp disorders. A treasure trove of clinical pearls was shared along the way, and the attendees learned a host of new strategies to apply to the management of hair loss, which is both widely prevalent and frequently undertreated.

This is an excerpt from a multi-part series on Next Steps in Dermatology that summarizes salient points from each of the lectures, as well as strategies that physicians can add to their alopecia armamentarium.

This post is devoted to Dr. Leslie Castelo-Soccio’s lecture, “Clinical approach to hair loss in pediatric patients.” Dr. Castelo-Soccio is a pediatric dermatologist as well as the Dermatology Section’s Director of Clinical Research at Children’s Hospital of Philadelphia. She is an expert in alopecia as well as genetic skin disease. Her lecture provided an incredibly useful roadmap for residents learning to navigate the following aspects of caring for the pediatric alopecia patient…

Read more.

Nov 01
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Clinical Evaluation of Safety and Efficacy of Fractional Radiofrequency Facial Treatment of Skin Type VI Patients

By | SOC Manuscripts | No Comments

Source: J Drugs Dermatol. 2018;17(11):1169-1172.

Eliot F. Battle Jr. MD and Sally Battle CNMT

We are excited to highlight a November 2018 published in the Journal of Drugs in Dermatology by our very own co-founder, Eliot F. Battle, MD.   The study was intended to evaluate the safety and efficacy of fractional RF technology for the treatment of patients with Fitzpatrick skin type VI. We recommend you read the abstract or login with your JDD subscription for the full manuscript here.

Oct 28
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Innovations in Skin of Color Dermatology Award Goes to Eliot Battle, MD

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Source: DermWire

Eliot Battle, MD has been awarded the Innovations in Skin of Color Dermatology Award. The award was presented by  The Journal of Drugs in Dermatology (JDD) at the Skin of Color Seminar Series (SOCSS) held May 5 and 6, 2018, in New York. The award recognizes individuals who have fostered innovation and improvement in dermatology through increased emphasis on skin of color education and research. Dr. Battle is a co-founder and co-chair of SOCSS.

“Dr. Battle’s tireless support and advocacy has been instrumental in starting the industry wide shift towards dermatology education that is inclusive of all skin types,” said Shelley Tanner, CEO and president of SanovaWorks, which produces the JDD and SOCSS. ”Dr. Battle received the award for his commitment to safe, accessible, and cutting-edge dermatology care for patients of all ethnicities and for being a champion for this cause.”

Read more. 

Oct 01
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Epidemiology of Skin Diseases in a Diverse Patient Population

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Source: J Drugs Dermatol. 2018;17(10):1032-1036

Jewell V. Gaulding MD, Daniel Gutierrez MD, Bhavnit K. Bhatia MD, Xiaoxia Han PhD, Richard Krajenta BS, Christine Neslund-Dudas PhD, Henry W. Lim MD, Ellen N. Pritchett MD MPH

Abstract
BACKGROUND: Epidemiologic studies of patients who present to dermatology clinics are necessary to identify the needs of patients. OBJECTIVE: To quantify and compare diagnoses according to race, ethnicity, and socioeconomic status (SES) at 6 general dermatology clinics from January 2013 to December 2016. METHODS: A retrospective cohort of new patients was established using an electronic medical record database. Primary diagnoses and diagnostic codes were recorded. Geocoding was utilized to obtain SES. RESULTS: There were 65969 new patient visits. Racial and ethnic demographics were obtained with the overall top 3 conditions being eczema or dermatitis, benign skin neoplasm, and adnexal disease. In blacks, however, follicular disorders were the third most common condition seen. The most frequently encountered diagnoses at the clinics with the highest and lowest SES were benign skin neoplasm and eczema or dermatitis, respectively.

Read more. 

Sep 28
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Skin of Color Seminar Series roundup

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Source: Dermatology Times

Eliot F. Battle, Jr., MD

The most discussed topic and most controversial session (in a good way) at this year’s Skin of Color Seminar Series in New York City was the panel discussion on the increasing trend of total body skin lightening and the ethical and health concerns that shadow it.

I started the panel discussion by outlining the medical and ethical concerns facing dermatologists regarding patients who are seeking treatments for total body lightening. I was followed by comments and a slide presentation from Dr. Valerie Callender, some practical advice by Dr. Seemal Desai ― who is considered one of the leading experts on skin pigmentation, and the conference’s co-founder and skin of color expert, Dr. Andrew Alexis who shared pearls of wisdom on the subject.

Read more. 

Sep 10
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Acanthosis-Nigricans-Mimicking-Melasma-boost-768x578

Acanthosis Nigricans Mimicking Melasma

By | Skin of Color Update Agenda | No Comments

Case Report and Pearls for Accurate Diagnosis – An Interview with the Author

During the 2018 Skin of Color Seminar Series (now the Skin of Color Update), approximately twenty posters could be seen hanging in the poster viewing area.  Each of these posters highlights novel and exciting research in skin of color. In one such poster, Dr. Monica Huynh and colleagues presented a case of acanthosis nigricans mimicking melasma.

Case Report

The patient was a 45-year-old female with a pertinent past medical history of diabetes mellitus type 2. They presented with discoloration of the cheeks for several years.  She had been treated previously with hydroquinone 4% with minimal improvement. Physical examination revealed brown-gray hyperpigmented, velvety, lichenified plaques on the lateral zygoma and hollow of the cheeks bilaterally as well as on the posterior neck.  Given the patient’s clinical presentation and past medical history of diabetes mellitus, a diagnosis of acanthosis nigricans was made. The dermatology team initiated treatment with salicylic acid cleanser twice daily, hydroquinone 4% cream twice daily, and tretinoin 0.025% cream nightly. After 8 weeks, the patient was switched to triple combination cream with improvement in facial hyperpigmentation. Due to facial dryness, the cleansing regimen was changed to salicylic acid cleanser in the morning and mandelic acid cleanser plus toner in the evening.

Read more.

Sep 03
0
Hair Loss Callendar

Understanding Hair Loss in Skin of Color Patients

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These are clinical pearls from SOCSS 2018 on hair loss in skin of color patients by Valerie Callender, MD

At the Skin of Color Seminar Series 2018 (now Skin of Color Update), Dr. Valerie Callender focused on how structural differences in afrocentric hair and cultural haircare practices contribute to the high prevalence of alopecia in African American women in particular.

*Clinical pearls* from this session are bolded, underlined, and marked with asterisks.

Dr. Callender started her lecture with an introduction to alopecia – one of the most common dermatologic concerns of African American patients. Given that healthy hair is considered to be a sign of beauty, youth, and attractiveness, alopecia has a huge negative impact on the quality-of-life of affected individuals. The psychological comorbidity of hair loss makes it essential that physicians understand the etiology, diagnosis, and treatment of common causes of scarring and non-scarring alopecia. *It is important to note that patients can present with BOTH scarring and non-scarring alopecia, and both must be considered during the work-up*.

Read more.

Aug 18
0
Ask a mentor Amy McMichael

Ask a Mentor Q&A Recap – Dr. Amy McMichael

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We had the opportunity to ask a mentor,  Dr. Amy McMichael, chair and professor of dermatology at Wake Forest University Health Sciences and Skin of Color Update faculty, questions about establishing a career in academics, finding a mentor, and better serving patients of color.  See all of her insightful answers below.

Q1: I previously attended the Skin of Color Seminar Series (now Skin of Color Update) and while sitting in the audience, I noticed that many of attendees appeared to be white physicians. Do you think there’s a representation problem in Dermatology, and could it be impacting our patients?

However, we know from other research in the house of medicine that Dermatology is second only to Orthopedics in having the worst representation of African Americans. Also identified as a major problem is the poor pipeline of under-represented minorities in college, medical school, and ultimately, in residency. We all have lots of work to do in terms of mentoring at every level to get the pipeline full of appropriate candidates.

In addition to this, we need to all be thoughtful about looking at residency applicants who may not be traditional, but who would make resilient and excellent dermatologists.

Q2: Most dermatologists (at least most of the ones I know) seem to think they don’t need special training for treating patients of color and can’t seem to acknowledge that a gap in training exists. As a dermatologist of color, I find it personally frustrating. Do you find this to be true among your peers?  If so, how do you address this with them?

Read more.

Aug 04
0
Psoriasis Skin of Color Alexis

Psoriasis in Skin of Color: Are there differences in Presentation and Treatment?

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While previously thought to be a rare diagnosis in non-white racial ethnic groups, more recent data has shown that psoriasis in patients with skin of color is much more common than was once thought. Dr. Andrew Alexis spoke during the Skin of Color Seminar Series (now Skin of Color Update) in New York City on May 5th, 2018 on this condition and on the important differences in clinical characteristics, diagnosis, and treatment of psoriasis in skin of color.

Beginning with the diagnosis of psoriasis in skin of color, it is important to be aware that the classic red plaque typically seen in Caucasian skin may appear more violaceous or even red-brown in our skin of color patients.  This can be confusing with the similar appearing, but histologically unique entity, lichen planus. Pay close attention to the distribution of the plaques—extensor surfaces and asymptomatic will favor psoriasis whereas flexural and pruritic may favor lichen planus. Other conditions that may be more common in our skin of color patients such as sarcoidosis or hypertrophic discoid lupus also need to be considered.

Once a diagnosis of psoriasis is established, it is important to understand the intricacies of treating the psoriasis in skin of color patients. For example, when treating psoriasis of the scalp, it is important to select practices and treatments that are compatible with the patients’ hair care regimen and hair texture. It is critical to determine how frequently patients are washing their hair and how feasible it is for patients to use a daily solution or medication on the scalp. One potential option shown to have clinical benefit is a mixture of calcipotriene and betamethasone dipropionate in a castor oil vehicle.

Read more.

 

Excerpt provided with permission. Originally published by Next Steps in Dermatology. All rights reserved.
Jul 25
0
Keloids skin of color update Baldwin

Updates on the Prevention and Management of Keloids

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This article features a recap of Dr. Hilary Baldwin’s talk on the etiology, risk factors, and treatment of keloids at the 2018 Skin of Color Seminar Series, now known as the Skin of Color Update. Dr. Bridget Kaufman, onsite correspondent for the meeting, shares highlights directly from the talk. Dr. Baldwin focused on earlobe keloids in particular, which may present with several different morphologies: anterior button, posterior button, wraparound, dumbbell, and lobular. *Clinical pearls* from this session are bolded, underlined and marked with asterisks.

Dr. Baldwin started by discussing why some patients develop keloids and others do not. Based on a study of 220 patients at Kings County Hospital, there appears to be no difference in rate of cartilage piercing, metal sensitivity, types of earrings worn, piercing method, hormonal influences, or age at piercing between keloid formers and non-keloid formers.  In the keloid former group, 12.8% of patients developed keloids at the first piercing, and the risk of keloid formation dramatically increased at each piercing thereafter (70.2% risk for 2nd piercing).

Important Points:

– *Ear pierces on babies have a 0% risk of keloids*

– *Piercings done pre-menarche have a significantly lower risk of keloids than those performed post-menarche*

– *First pierces rarely keloid*

– *The chances of subsequent pierce keloiding in a keloid former is at least 20% or higher*

Read more.

Jul 05
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Poster Interview: Socioeconomic and Geographic Barriers to Dermatology Care in Urban and Rural U.S. Populations

By | Skin of Color Update Agenda | No Comments

Brianna Olamiju, Next Steps Correspondent, interviewed Toral S. Vaidya, Medical Student at the University of Cincinnati College of Medicine, to dig deeper on her research study titled “Socioeconomic and Geographic Barriers to Dermatology Care in Urban and Rural U.S. Populations” recently published in theJournal of the American Academy of Dermatology and presented at the Skin of Color Seminar Series (now Skin of Color Update) in May 2018.

Read more.

Jul 02
0

Avoid Antibiotics for Acne Treatment When Possible

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Source: Dermatology Times

Years ago antibiotics were used to treat acne because it was thought that the condition was an infectious disease, says Dr. Hilary Baldwin of the Rutgers Robert Wood Johnson Medical School in New Jersey. However, it is now realized that while Propionibacterium (P) acnes is implicated in the pathophysiology of the condition by producing an inflammatory cascade, acne is not the result of a bacterial infection because all adults have P. acnes in follicles and the severity of acne does not correlate with P. acnes counts.

Read more. 

Jul 01
0
Skin of Color Perez skin Cancer

Skin Cancer Detection and Treatments in Latino Patients

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During the 2018 Skin of Color Seminar Series (now the Skin of Color Update), Dr. Maritza Perez, one of the foremost leaders in skin of color dermatology, took attendees inside the world of the U.S. Hispanic population shedding light on the sociological diversity, cultural lifestyle hazards, and the healthcare disparities that increases their risk of deadly melanomas. Many Hispanics believe erroneously that they are less likely to get skin cancer, a dangerous preconception shared with many physicians who believe that this population is invulnerable to skin cancer, resulting in a delay in diagnosis and an unnecessary higher mortality rate.

Next Steps correspondent, Brianna Olamiju, reports back on Dr. Perez’s lecture and shares high- yield information all dermatologists should know.

 

Read more.

Jun 04
0

Aging through the Decades

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Source: Dermatology Times

Dermatologists have always known that different ethnic skin types age at different rates, but until now there hasn’t been clear evidence that these phenotypic differences have a pathophysiologic and histologic basis. Maritza Perez, M.D., Icahn School of Medicine at Mount Sinai, New York, presented new research illustrating the aging process across the decades and how it differs between ethnic skin types. Read more.

References:

“The Evaluation of the Aging Process Across Ethnic Variations,” Maritza Perez, M.D. Skin of Colour Seminar Series. 5-6 May, New York. May 5, 2018