Mar 31
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Retinoids and Azelaic Acid to Treat Acne and Hyperpigmentation in Skin of Color

By SOC Manuscripts

There are increasing data describing the use of retinoid and azelaic acid use in skin of color for the treatment of both acne and the subsequent postinflammatory hyperpigmentation. Historically, some dermatologists have been hesitant to use retinoids in skin of color because of perceived hypersensitivity in this patient population. However, recent data support the use of retinoids and azelaic acid in skin of color as both safe and beneficial.

Tretinoin, tazarotene, and adapalene (ADA), have been successfully used to treat acne. These treatments are reviewed and their effectiveness in hyperpigmentation is discussed.

  1. Tazarotene for Postinflammatory Hyperpigmentation
    In a blinded, vehicle-controlled trial, 74 acne patients from darker racial ethnic groups (Fitzpatrick skin types IV to VI) were treated with once-daily application of tazarotene 0.1% cream.  Results showed significant reductions in overall post-inflammatory hyperpigmentation and dryness, erythema, burning, and peeling were mild in both patient groups studied.
  2. Adapalene for Acne in African American Patients An analysis of 5 trials were conducted assessing adapalene gel 0.1% for the efficacy of reduces acne lesions in African American patients.  Results showed adapalene 0.1% gel significantly reduced a greater number of inflammatory lesions among African American patients with Fitzpatrick skin types IV through VI. Adapalene may have better efficacy for inflammatory lesions in African Americans than in Caucasians and is a good choice for patients with skin of color.
  3. Adapalene for Postinflammatory Hyperpigmentation
  4. Adapalene/Benzoyl Peroxide and Tolerability in Skin of Color
  5. Benzoyl Peroxide/Clindamycin Plus Retinoid
  6. Clindamycin and Retinoid for Acne in Darker-Skinned Patients
  7. Azelaic Acid

To see the results of the remaining retinoids and azelaic acid, please read the free full-text at JDDOnline.com.

The full-text review article is available for free from the Journal of Drugs in Dermatology . The article was written by Heather C. Woolery-Lloyd MD, Jonette Keri MD, and Stefan Doig MD from the Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL.

Mar 30
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Join Dermatology Leadership Discussion of COVID-19

By COVID-19 Resources

Join Dermatology Leadership Discussion of COVID-19

Skin of Color Update and JDD invite you to attend a webinar panel to provide discussion, guidance, and leadership for dermatologists and dermatology practices during the global coronavirus pandemic.

Over the course of the 2 hours, 8 different thought leaders will join the conversation, discussing questions that are on the mind of many dermatologists in the country. Click here to register.

MODERATOR
Joel L. Cohen, MD (Director, About Skin Dermatology & Associate Clinical Professor, University of California at Irvine)

AGENDA
6:00-7:00PM
Neal Bhatia, MD (Vice President-elect of the AAD & Director of Clinical Dermatology, Therapeutics Clinical Research)
Adam Friedman, MD (Professor and Interim Chair of Dermatology, GW School of Medicine & Health Sciences)
William D. Humphries (President, Ortho Dermatologics)
Mark Kaufman, MD (Associate Clinical Professor, Icahn School of Medicine at Mount Sinai)

7:00-8:00PM
Sue Ellen Cox, MD (Founder, Aesthetic Solutions)
Kavita Mariwalla, MD (Founder, Mariwalla Dermatology)
Carrie Strom (Senior Vice President, US Medical Aesthetics at Allergan)

ARCHIVED RECORDING
This webinar will be archived for on demand viewing on JDDonline.com by end of day Friday April 3rd.
Mar 17
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STATEMENT ABOUT COVID-19, CORONAVIRUS ACTION

By COVID-19 Resources
Sanovaworks Cares logo

NEW YORK (Mar. 13, 2020) – A Note from Shelley Tanner, SanovaWorks CEO/President

First and foremost, in light of the rapidly evolving global COVID-19 situation, we hope that you and your family are safe and healthy. We send companywide thoughts and prayers to the individuals, families, and other groups who have been impacted by this situation, and hope that things will improve very soon.

While many things are uncertain surrounding this virus, as an organization, SanovaWorks believes in taking action early. We are dedicated to providing the best care and support we can to all our employees and business partners.

We have the extremely good fortune to be functioning already as a virtual company and because of this we hope to be able to provide support and resources to our entire network who might not have the experience we have. Please check our blog for our tips and recommendations for transitioning to and being successful in a remote work environment:https://sanovaworks.com/2020/03/11/top-immediate-needs-of-remote-employees/

In addition to this, in order to protect our teams and others, until further notice, we have issued a complete restriction on all business-related travel. While the CDC has not placed restrictions on domestic travel, they have recently posted travel warnings on their website: https://www.cdc.gov/coronavirus/2019-ncov/travelers/travel-in-the-us.html?mod=article_inline

The CDC also provide general recommendations that we should all be following to prevent the spread of this disease:https://www.cdc.gov/coronavirus/2019-ncov/about/prevention.html

We will be working diligently as teams to connect with many of you so that we can share some very interesting ways to accomplish our results in this new, virtual environment. We have many years of experience transitioning traditional programs to digital programs, and launching successful virtual programs. Because we are already positioned as a remote company that produces virtual programs, we hope that we are able to support your own initiatives and bridge the gap this global situation has caused.

And last but not least, with a shout out to Jim Collins who introduced me to the Stockdale Paradox in his book Good To Great, we all need to look squarely at the facts, but have confidence that together we will prevail, as we balance realism with optimism.

 

Together.

Shelley and the entire SanovaWorks Team

Mar 06
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What’s New In Treatments for Hair Loss with Amy McMichael, MD at the ODAC Dermatology Conference

By Uncategorized

During the 2020 ODAC Dermatology, Aesthetic and Surgical Conference, Dr. Amy McMichael, Professor and Chair of Dermatology at the Wake Forest University School of Medicine, sat down with Next Steps in Derm to share important updates regarding treatments on the horizon for the most common forms of hair loss. Dr. McMichael will be presenting at Skin of Color Update 2020 with lectures including Hair & Scalp Disorders in SOC: Diagnostic Approaches and Hot Topics & Controversies in Photoprotection: Making sense of it all.

Click here to view the full Skin of Color Update agenda.

Read More…..

Feb 11
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Skin of Color Update audience

Skin of Color Update 2020, Largest CE Event Dedicated to Treatment of Skin Types III – VI, Announces Program and Faculty

By Uncategorized

Skin of Color Update 2020 is the largest CE event dedicated to trending evidence-based research and new practical pearls for treating skin types III – VI. The 2020 event will be held September 12 – 13 at a new location, the Sheraton Times Square in New York City.

Skin of Color Update uses a didactic, case-based approach through lectures, hands-on-training and live demonstrations. Sessions will address medical, surgical and cosmetic dermatology. A few sessions this year include:

  • “Conventional and New Treatment Options for Keloids (including LADD) – Expert Panel” with Maritza Perez, MD and Jared Jagdeo, MD
  • “Laser Staples & The New Players: Brand Loyalty Aside, This is What the Experts Want You to Know- Panel Conversation” with Eliot Battle, MD, Maritza Perez, MD and Andrew Alexis, MD
  • “Clinical Pearls for Kids, Tweens and Teens with Skin of Color” with Candrice Heath, MD
  • “Hot Topics & Controversies in Photoprotection: Making Sense of it All” with Amy McMichael, MD
  • “Hair & Scalp Disorders in SOC: Conventional Treatment Approaches” with Susan Taylor, MD
  • “Dermatologic Concerns, Diseases, and Treatments Unique to Asian Skin” with Hye Jin Chung, MD, MMS
  • “Consensus and Misconceptions Regarding the Aesthetic Skin of Color Patient: A Conversation with the Experts” with Andrew Alexis, MD and Maritza Perez, MD
  • “Keys to Connecting with Skin of Color Patients on Social Media” with Candrice Heath, MD
  • “New and Emerging Treatments in Vitiligo“

The full agenda can be viewed at skinofcolorupdate.com/agenda

The conference will also offer an exhibit hall featuring companies showcasing the latest innovations in dermatology. A poster session will also be available and up to 13 AMA PRA Category 1™ credit(s) can be earned. Registration is available at skinofcolorupdate.com.

Jan 28
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Lymphomatoid Papulosis JDD Skin of Color

Black Patients with Lymphomatoid Papulosis

By Case Reports, SOC Manuscripts

Lymphomatoid papulosis (LyP) is a CD30+ T-cell lymphoproliferative disorder (LPD) presenting as a recurrent eruption of papules and nodules which resolve spontaneously. CD30+ LPD prevalence in African American (AA)/Black patients is lower compared to White patients. CD30+ LPD has been recently reported to have worse outcomes in AA patients compared to White patients.

A retrospective chart review identified eight AA patients with LyP. Authors Shamir Geller MD, Sarah J. Noor MD, and Patricia L. Myskowski MD describe their experience with these eight patients and review the literature on similar cases.

To view a synopsis of the case published in the Journal of Drugs in Dermatology, visit Next Steps in Derm. Log in to JDDOnline.com for full access of the manuscript.

Racial Differences in Incidence

Major racial differences in incidence among cutaneous lymphoma subtypes have been reported. AA/Blacks have statistically higher incidence ratios of CTCL and MF than other races and a trend towards lower incidence of CD30+ LPD was found in a national US database, which included 31 AAs with CD30+ LPD. A more recent study of another database included 153 AA patients with CD30+ LPD who had a significantly shorter overall survival compared to Caucasians after adjusting for patient disease characteristics, socioeconomic factors and types of treatment.

Discussion

The case series and three additional case reports suggest an indolent disease course of LyP in AA/Black patients. There are several possible explanations for the previous findings on poor survival in AA patients with CD30+ LPD.

  1. These results might be due to inclusion of ALCL and borderline cases with poorer prognosis compared to LyP.
  2. Another possibility is that patients with more aggressive CTCL variants (eg, transformed tumor-stage MF) might have been misdiagnosed or miscoded as CD30+ LPD.
  3. Results support previous reports on an earlier-onset of disease seen in AA/Black patients with LyP5 as well as with other CTCL subtypes, such as MF.  The self-healing crops of papules and nodules can be easily misdiagnosed as other malignant or inflammatory skin conditions (eg, arthropod bites).
  4. The diagnosis of early-stage patch stage MF may be more difficult in Black skin where erythema is less pronounced compared to lighter skin types.

Treatment Approaches

The case series highlights the need for additional studies before clinical recommendation can be made regarding prognosis and treatment in different race groups. Careful physical examination should be performed in Black patients who are diagnosed with LyP and no known history of MF. Once the diagnosis of LyP is made, several treatment approaches are possible.

  1. Noninterventional (“wait-and-see”) strategy is a legitimate approach, especially in patients with a limited number of lesions.
  2. Topical and skin-directed therapies (including topical steroids and phototherapy), and low-dose methotrexate are the best documented therapies for LyP.
  3. There is currently no curative therapy for LyP though the efficacy and safety of brentuximab vedotin, an antibody- drug conjugate directed against CD30, has recently been assessed for the treatment of LyP in 12 patients, including 2 AAs. Brentuximab vedotin was reported to be effective in treating LyP and has been suggested as a possible therapy in severe and refractory cases. Further studies are ongoing to optimize its dosing and to minimize adverse events.

In conclusion, a diagnosis of LyP should be considered in Black patients who present with recurring eruption of papules or nodules that resolve spontaneously. Patients with LyP should be carefully examined for concurrent or later development of MF. Although an indolent course may be expected in Black patients, residual hyperpigmentation and scars following resolution of the LyP lesions are common in this population, highlighting the need for better treatments of this disorder in the Black population.

The Journal of Drugs in Dermatology is available complimentary to US dermatologists, US dermatology residents and US dermatology NP/PA. Create an account on JDDonline.com and access over 15 years of PubMed/MEDLINE archived content.

Dec 09
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Rosacea in Skin of Color

Rosacea in Skin of Color

By Medical Dermatology, Sessions

What is Rosacea? 

Rosacea is a common chronic inflammatory skin disease that primarily impacts the face, and includes papules, pustules, erythema, telangiectasias, perilesional redness, phymatous changes, and even eye involvement. Symptoms may vary among different patients and even vary over time in an individual patient. Central facial redness affects many adults and can be an indicator of the chronic inflammatory disease rosacea. Rosacea is a clinical diagnosis based on the patient’s history, physical examination, and exclusion of other disorders.

Rosacea is often under-diagnosed, particularly in individuals with skin of color. As a result, Skin of Color Update held a lecture on the topic at the most recent event.

Rosacea: Nuances in Clinical Presentation and Treatment 

At Skin of Color Update 2019, Dr. Fran Cook-Bolden aimed to catch us all up to speed in how to recognize rosacea in more richly pigmented skin. Her lecture on Rosacea: Nuances in Clinical Presentation and Treatment was brimming with practical tips on how to identify the often subtle and overlooked ways that rosacea can manifest in skin of color.  The following is an excerpt of an article by Kimberly Huerth, MD published on Next Steps in Derm.

Because rosacea can have a nuanced presentation in skin of color (SOC), with erythema and telangiectasias that may be difficult to discern in the setting of increased background pigmentation, it was incorrectly assumed for a long time to simply not be there. The reality is that the prevalence of rosacea in SOC is not well characterized but is likely underestimated.1Dermatologists who see a large number of SOC patients, however, will tell you that rosacea is by no means rare in this population. And I am one of these dermatologists—at my Howard University clinic, where I see predominantly black and Hispanic patients, I see several of cases of rosacea every week.

And because a diagnosis not considered is a diagnosis not made, there is often unnecessary progression of rosacea in SOC patients that results from delayed and/or inaccurate diagnosis, which in turn engenders inappropriate or inadequate treatment. As a consequence, this can lead to morbidity in the form of disfiguring, occasionally irreversible cutaneous findings, as well as intense and chronic emotional distress.

Pearls

  • Look for the nuanced clinical findings!!
  • Fixed centrofacial erythema may appear more reddish/violet
  • A patient complains of “acne,” but has no comedones. Additionally, papules and pustules are superimposed on an erythematous background. Inflammatory papules may also appear on the chest and back.
  • Telangiectasias can be difficult to appreciate with the naked eye in FST V – VI, so use your dermatoscope to help you find them
  • Check for scleral injection, which may be a sign of ocular rosacea. Be aware that the onset of ocular findings may proceed cutaneous ones.
  • Phymatous rosacea is a giveaway!
  • Facial edema of the upper 2/3 of the face in a patient who has complained of longstanding rosacea symptoms may represent progression to Morbihan disease. Case in point (quite literally)—a poster that I presented at the Skin of Color Update highlighted a case of Morbihan disease in a black man who had reported symptoms of rosacea to his non-dermatology providers for 16 YEARS before he came to see me and received a correct diagnosis. To learn more about this case, and Morbihan disease, check out Dr. Lola Adekunle’s interview on Next Steps in Derm.
  • Pertinent negatives are just as important as pertinent positives. Know that post-inflammatory hyperpigmentation (PIH) is ALMOST NEVER directly related to rosacea, unless the disease is very chronic and severe OR if the patient has been injured their skin in some way while trying to self-treat disease manifestations (picking at lesions, using harsh topical therapies)

For more rosacea pearls and AHA moments, visit the article on Next Steps in Derm.

Purchase lectures like this one:

Skin of Color Update On Demand Video

Dec 04
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Skin of Color Update Skin Lightening

Skin Lightening in Skin of Color: What You Need to Know

By Media Coverage

The following is an excerpt from Next Steps in Dermatology based on a Pearl Grimes, MD lecture at Skin of Color Update 2019.

The topic of skin lightening can be very controversial, but the reality is that there is a large market for skin lightening and learning to treat patients in the safest way is the priority. At the 2019 Skin of Color Update, a lecture on skin lightening included panelists: Dr. Eliot Battle, Dr. Pearl Grimes, and Dr. Cheryl Burgess and featured their approaches to skin lightening.

  1. Skin lightening is still very common.
  2. Hydroquinone is still the gold standard.
  3. New therapies are on the horizon.
  4. More research needs to be done on glutathione.

Check out the full article on Next Steps in Derm for a more in-depth look.

Dec 04
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Hispanic Skin Cancer Prevention

Hispanic Tattoo Artists and Skin Cancer Prevention

By Uncategorized

Hispanic Tattoo Artists Could Provide Skin Cancer Prevention via Aftercare Instructions and Social Media according to The Journal of Drugs in Dermatology (JDD).

Skin cancer, melanoma and non-melanoma, has increased recently in the Hispanic population.  When diagnosed with melanoma, the overall prognosis is generally worse for Hispanics and it presents at a later stage.

According to the authors, Cristian D. Gonzalez MD et al, the purpose of this study was to explore Hispanic tattoo artists’ skin cancer knowledge, sun safety recommendations, and their willingness to implement primary and secondary skin cancer prevention in their daily work routines.

Interesting to note, all Hispanic tattoo artists used some form of social media, 100% used Facebook and Instagram. Tattoo artists reported that a majority of their clients followed them on Facebook after their tattoo.

Ninety percent of Hispanic tattoo artists felt emotionally invested in their clients. None of the tattoo artists currently recommended sun protection involving the client’s whole body, all of the artists agreed they could influence skin cancer safety in young adults by providing full-body sun protection in their aftercare instruction on social media in English and in Spanish.

To read more of this article, head to JDDonline.com.

 

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