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Sessions

The Skin Lightening Dilemma: A Candid Conversation with the Experts

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This article features a recap of the Skin Lightening Panel 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 experts, Drs. Eliot Battle, Seemal Desai and Valerie Callender.

Each panelist started with a PowerPoint presentation on skin lightening, followed by a panel discussion. Rather than reporting on the session chronologically, I have divided the session into key points. Under each key point, I have indicated each faculty member’s contributions and opinions on the topic.  *Clinical pearls* from this session are bolded, underlined and marked with asterisks.

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2018 Scientific Poster Abstracts from Skin of Color Update

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A selection of scientific poster abstracts from Skin of Color Seminar Series 2018 (now known as Skin of Color Update.) Thank you to our poster presentations and faculty. 


 

Cutaneous Crohn’s Disease of the Vulva in an Elderly African American Patient

Authors: Leah Wells, MS & David Kent, MD

We present a case of a 79-year-old African American female with painful vulvar ulcers of several years duration. She presented to an OB-GYN and was tested for syphilis, lymphoproliferative granulomatosis, herpes, TB, and fungal infection. Once these etiologies were ruled out, she was referred to dermatology where the knife-like lesions prompted suspicion for cutaneous Crohn’s disease. However, the patient had not been previously diagnosed with Crohn’s and had no gastrointestinal symptoms of the disease. Biopsy revealed non-caseating granulomas, confirming a probable diagnosis of vulvar Crohn’s. The patient was initially treated with oral steroids, and her lesions showed improvement after one month of therapy. Due to the severity of her case, infliximab was recently added to her regimen to further promote healing.
Less than 200 cases of vulvar Crohn’s disease have been reported in the literature. The mean age of onset is 35, making our patient’s advanced age uncommon. Vulvar Crohn’s is often difficult to diagnose, due to the multitude of differential diagnoses for genital ulcers. Further, a significant amount of patients with vulvar Crohn’s disease will not exhibit any gastrointestinal symptoms and vulvar Crohn’s will be the initial manifestation of underlying disease. As a result, many patients suffer from the disease for many years before it is recognized as cutaneous Crohn’s. A biopsy is necessary to achieve definite diagnosis.
Treatment recommendations for vulvar Crohn’s have not been well-established. However, initial treatment often includes metronidazole, steroids, and/or immunosuppressants. Recent case-reports have shown success in treating severe, or refractory, vulvar Crohn’s with infliximab.  Read More

Seemal Desai Melasma Skin of Color Update

Melasma and PIH – Disorders of Hyperpigmentation

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During his talk at the 2018 Skin of Color Seminar Series (now known as the Skin of Color Update), Dr. Seemal Desai discussed the treatment of melasma with a particular emphasis on new and emerging therapies. Dr. Bridget Kaufman, onsite correspondent for the meeting, shares highlights directly from the talk.  *Clinical pearls* from this session are bolded, underlined, and marked with asterisks.

Dr. Desai started by stressing the importance of having an honest and upfront conversation with your melasma patients about realistic expectations for treatment. *You must emphasize to patients that this is a chronic condition and set their expectations accordingly.*While improvement with treatment is likely, there will always be underlying pigmentary changes even despite treatment. Patients must understand from the beginning that they cannot be cured of this condition.

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Excerpt provided with permission. Originally published by Next Steps in Dermatology. All rights reserved.
Skin of Color Update CCCA

Pearls from Primary Cicatricial Alopecias in Black Women

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Hair Apparent: A Multi-Part Series on Hair Disorders – Part II

Dermatology residents from throughout the Washington DC area recently convened at a recent 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. Attend Skin of Color Update in to learn more or continuing reading below.

This post is the second of a multi-part series that summarizes salient points from each of the lectures, as well as strategies that residents can add to their alopecia armamentarium.

 

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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.

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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.

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Excerpt provided with permission. Originally published by Next Steps in Dermatology. All rights reserved.

Staying Ahead of the Game in Skin of Color Dermatologic Care

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The optimal treatments for skin of color patients seeking dermatologic care are constantly changing. Keeping up to date with the latest advances in the field, both medical and aesthetic, can prove to be difficult and overwhelm even the most brilliant dermatologist. With a growing recognition that constant training and direct access to skin of color thought leaders is necessary to be at the forefront of trending evidence-based research, leading experts in the field are joining forces to ensure skin of color patients receive the care they need. Among these experts are Dr. Andrew Alexis and Dr. Eliot Battle, co-chairs of the Skin of Color Seminar Series, the largest CE event dedicated to patients with skin types III – VI. With an unparalleled agenda and an esteemed faculty of KOL’s, this is probably THE event all dermatologists wanting to stay up to date on all skin of color medical and aesthetic advances must attend.

Always a highlight of the Skin of Color Seminar Series, attendees have the rare opportunity to ask their most pressing questions to the world’s top skin of color dermatology experts.

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Treating Scalp Psoriasis in Women of African Descent

By | Sessions, Skin of Color Update Agenda | No Comments

Dr. Andrew Alexis is the Chair of the Department of Dermatology at Mount Sinai St. Luke’s and Mount Sinai Roosevelt. He is also Associate Professor of Dermatology at the Icahn School of Medicine at Mount Sinai. Dr. Alexis is the Co-Chair of the Skin of Color Seminar Series in New York City. During the 2017 conference he provided practical pearls and treatment outlines for skin of color patients with scalp psoriasis.

Dr. Alexis recommends selecting a treatment regimen that is compatible with the patient’s hair care practices including less frequent hair washing in women of African descent (typically once per week to once every other week). Daily hair washing, especially with most prescription shampoos, is often associated with increased hair dryness and breakage. In addition, it is also very time consuming for most women of African descent due to common styling practices.

Suggested Regimen for African-American Females:

  • Once weekly washing with prescription shampoo. This may be increased to two times a week depending on the severity and patient preferences
  • Continue with usual conditioner
  • Once weekly topical fluocinolone acetonide in peanut oil vehicle applied to the scalp for 6-8 hours overnight prior to washing or several times per week without washing
  • Once to twice daily application of POTENT topical steroid in vehicle that is compatible with hair care practices and hair texture (e.g. lotion, emollient foam, oil > gel, solution, ethanolic foam) Ask the patient for vehicle preferences
  • Alternative: calcipotriene and betamethasone dipropionate topical suspension daily

Attendees at the Skin of Color Seminar Series May 5-6 in NYC will have the opportunity to dig deeper into psoriasis treatment in skin of color patients as Dr. Alexis gives his latest updates, pearls and therapeutic insights and also personally answers attendees’ most pressing questions.

 

 

Parameters for Success – Treating Skin of Color Patients with Dr. Eliot Battle

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Dr. Battle is CEO and founder of Washington, DC’s renowned Cultura Cosmetic Dermatology and Laser Center, a ground-breaking medical practice merging dermatology, laser surgery, plastic surgery, and spa therapy. His office is always filled with physicians seeking advance training and patients from all over the world who seek out his expertise. His 3 year pioneering research at Harvard helped to invent the new generation of non-invasive “color blind” cosmetic lasers opening up the field to patients of all cultures, regardless of skin of color or ethnicity. He is one of the most sought out teachers and lecturers in the field of cosmetic laser therapy.

Dr. Battle is the Co-Chair of the Skin of Color Seminar Series, May 5-6, 2018 in New York City. During the 2017 event, he shared his top parameters for success in treating skin of color patients with lasers and devices.

Parameters for Success – Treating Skin of Color Patients

  • Use the Correct Laser or Device
    • Choose the Appropriate Wavelength
    • Stay within Safe Parameters
    • Use Aggressive Skin Cooling
  • Become an Expert
  • Choose only treatments with proven success including:
    • Hair Removal
    • Pigment Improvement
    • Texture Improvement
    • Skin Tightening
    • Body Contouring
  • Do No Harm – Treat Conservatively
    • “Don’t rely on most parameters supplied by the laser manufacturers.  Treat more conservatively and minimize erythema or edema.”
  • Stay Under the Erythema & Edema Threshold
    • “When treating patients with skin of color, stay under the erythema threshold. Longer wavelengths, lower fluences, longer pulse durations, maximize cooling. Skin Cooling – Thermal  side effects happens when the epidermis heats up > 45 degrees. Treat all Skin of Color patients at max. of 1 hertz.”
  • Manage Patient Expectations 

Dr. Battle will share insights into his extensive laser knowledge at SOCSS 2018 where he will present the latest research, practical pearls and techniques during in-depth sessions including:

  • Live Laser and Device Demonstrations
  • Updates on New Technologies for Treating Aesthetic Concerns in Skin of Color
  • Ten Easy Steps to Improving Patient Experiences and Your Happiness
  • Minimizing Laser Complications in Skin of Color Patients
  • The Masters Share: Aesthetic Treatments Pearls in Skin of Color Patients  – Panel Discussion

Practical Pearls for Dermatology in Skin of Color Patients

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The Skin of Color Seminar Series (SOCSS) is the largest CE event dedicated to trending evidence-based research and new practical pearls for treating skin types III – VI. Each year, esteemed faculty provide attendees with fresh, practical pearls that are immediately useful in their practice.

In 2017, co-chairs Eliot Battle, MD and Andrew Alexis, MD gave their insight on everything from PIH to Lasers and everything in between.

3 Practical Pearls from Dr. Eliot Battle:

  1. Don’t rely on most parameters supplied by the laser manufacturers.  Treat more conservatively. Minimize erythema or edema.
  2. Inconsistent laser treatments on skin of color include: Vascular Lasers,  IPL (on Skin Type V & VI) and Resurfacing Lasers (on Skin Type V & VI).
  3. When treating patient with skin of color, stay under the erythema threshold. Longer wavelengths, lower fluences, longer pulse durations, maximize cooling. Skin Cooling – Thermal side effects happens when the epidermis heats up > 45 degrees. Treat all Skin of Color patients at max. of 1 hertz.

3 Practical Pearls from Dr. Andrew Alexis:

  1. Ethnicity does not predict skin color.
  2. Given that PIH can occur as a sequela of acne itself, or as a complication of treatment, treatment regimens must not only be aggressive enough to reduce inflammation and other pathogenic factors, but also well tolerated so that irritation is avoided.
  3. Daily hair washing, especially with most prescription shampoos, is often associated with increased hair dryness and breakage; it is also very time consuming for most women of African descent due to common styling practices.