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Hair and scalp at skin of color

Hair and Scalp Disorders at the 2019 Skin of Color Update

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Heather Woolery-Lloyd, MD lectured on hair and scalp disorders at Skin of Color Update 2019.  Kimberly Huerth, MD, M Ed, provided top tips and salient pearls from the lecture in the Next Steps in Derm article.  Missed this lecture? Purchase it on-demand

Treatment Strategies for Hair and Scalp Disorders: Biotin & Beyond

By: Kimberly Huerth, MD, M Ed

A full head of hair. This is how I came away from Dr. Heather Woolery-Lloyd’s lecture on hair and scalp disorders at the 2019 Skin of Color Update. There were many aspects of her talk that challenged me to rethink how I approach the management of hair loss in my patients. In this post we will cover biotin’s role in treating alopecia, and important considerations in the treatment of central centrifugal cicatricial alopecia (CCCA)—two topics that Dr. Woolery-Lloyd took a deep dive into during her lecture.

So I have a potentially hair raising confession to make…I might start recommending biotin again to my alopecia patients! I have previously written about the use of biotin in the treatment hair loss, the gist of it being—don’t. The don’t is because most individuals are not biotin deficient, there are potential risks associated with supplementation (such as effects on the results of thyroid function and troponin testing), and scientific data supporting the use of biotin to promote hair growth are weak unless there is a proven biotin deficiency. But Dr. Woolery-Lloyd discussed the results of a recent study out of Switzerland that lead me to question whether I might want to rethink my previous stance on biotin—Bad hair day for me!

Biotin is a coenzyme that plays a role in protein synthesis, including the production of keratin (which explains its contribution to healthy nail and hair growth). Primary and secondary biotin deficiencies are both considered very rare. Secondary biotin deficiency is thought to be rare because our intestinal flora produce more than our daily requirement. However, there are certain risk factors that may predispose an individual to a secondary biotin deficiency, including gastrointestinal disease, certain medications (isotretinoin, antibiotics, anti-epileptics), smoking, alcoholism, advanced age, extreme athleticism, pregnancy, and lactation. Moreover, serum biotin levels can demonstrate daily fluctuations of up to 100%, which is important to keep in mind when trying to identify which patients have suboptimal or deficient levels of biotin.

Let’s examine this study with a fine toothed comb. Read more on NextStepsinDerm.com 

Skin of Color Update On Demand Video

Andrew Alexis atopic dermatitis skin of color lecture

Treating Atopic Dermatitis in Patients With Skin of Color

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The Dermatologist recently featured an interview with Dr. Andrew Alexis, Skin of Color Update co-founder and co-chair, regarding his lecture on challenges and pearls of treating atopic dermatitis (AD) inpatients with skin of color.

Associate Editor, Melissa Weiss posed the following questions:

  • What are some of the challenges for diagnosing AD in patients with skin of color?
  • What are your recommendations for clinically assessing AD in patients with skin of color?
  • What are your recommendations and treatment considerations for AD?
  • Do you discuss options for a patient who want to treat AD-associated pigmentary changes?
  • Are there any other key takeaways you would like dermatologists to leave our audience with?

 

Visit The Dermatologist to read Dr. Alexis’s answers and more.

Missed Skin of Color Update 2019? Purchase this lecture and more on-demand.

Skin of Color Update On Demand Video

Skin Lightening at Skin of Color Update Eliot Battle

Skin Lightening in Skin of Color Remains Charged Topic

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We recently hosted an expert panel discussion on the topic of skin lightening in skin of color at the 2019 Skin of Color Update.  Skin of Color Update co-chair and co-founder, Eliot F. Battle, MD took an informal audience poll and the results will surprise you.

“How many of you think total body skin whitening is wrong?” Dr. Battle asked the audience for a show of hands.  The majority of the audience raised their hand.

“How many think breast augmentation is wrong?” he asked. “How many think changing your hair color is wrong? Before we cast judgment, let’s think a little about how our patients feel.”

Should physicians provide total body skin whitening for cosmetic purposes or should skin lightening be provided only for clinical indications, like melasma?

Dr. Pearl Grimes and Dr. Cheryl Burgess weighed in on this charged topic to provide compelling commentary.  Read their insights and more here. Coverage provided by MDedge |Dermatology.

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Skin of Color Update On Demand Video

 

Skin of Color Update Co-Chair Dr. Eliot Battle Shares Insights into 2019 Faculty and Topics

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Skin of Color Update Co-Chair, Dr. Eliot Battle, discusses the elite faculty lineup and topics planned this year including hair loss, keloids, rosacea, acne, lasers, aesthetic treatments, skin cancer, medical dermatology, melasma, hyperpigmentation, vitiligo, inflammatory diseases and much, much more!

Skin of Color Update 2019 (previously Skin of Color Seminar Series) is the largest CE event dedicated to trending evidence-based research and new practical pearls for treating skin types III – VI. Attendees leave with critical annual updates and fresh practical pearls in skin of color dermatology.

Join us this year in New York City, September 7-8, 2019! Register today at https://skinofcolorupdate.com/registration-hotel-2019/

Co-Chair Dr. Alexis Shares the Exciting 2019 Program Highlights

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Skin of Color Update 2019 (previously Skin of Color Seminar Series) is the largest CE event dedicated to trending evidence-based research and new practical pearls for treating skin types III – VI. Attendees leave with critical annual updates and fresh practical pearls in skin of color dermatology. Earn CE in New York City with direct access to elite experts and an experience unmatched by any other event in dermatology.

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 (post inflammatory hyperpigmentation PIH) 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.

Dr. Desai then addressed the large vasodilatation/vascular component of melasma. Although the predominant feature of melasma is the hyperpigmented patch, a pink hue becomes apparent after treatment of the brown pigment. Historically, the redness was thought to be a side effect of Modified Kligman’s Formula, but more recent research suggests that this due to an inherent expression of vascular markers in melasma lesions. This vascular component can be treated with low fluence pulsed dye laser; oral tranexamic acid has also been helpful in Dr. Desai’s practice.

Dr. Desai then addressed the relationship between thyroid disease and melasma. There are a few studies showing thyroid disease in patients with recalcitrant melasma. *If, after optimal treatment, a patient does not improve within 3-6 months, you may want to get a free T4 and TSH to screen for thyroid disease.*

So now onto the treatment of melasma! Given that triple combination cream (TCC) is the gold standard therapy for melasma, it makes sense that Dr. Desai started with a discussion of research on this product. A randomized controlled trial of TCC in Southeast and East Asian patients with melasma found that, after 8 weeks of treatment, *TCC was superior to monotherapy with hydroquinone, although it was associated with more adverse effects.* Dr. Desai has found this to be true in his practice and, therefore, he rarely prescribes hydroquinone alone. The retinoid and steroid in TCC help with desquamation and exhibit anti-inflammatory properties that counter the upregulation of prostaglandins and tyrosinase in melasma.

For more pearls like this – register for Skin of Color Update in NYC now before it is sold out.

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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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