A case report published inContact Dermatitis reveals what may be the first known case of acute lichenoid allergic contact dermatitis leading to cicatricial alopecia from hair dyes that contain PPD. A 30-year-old woman who dyed her hair every two to three months presented with violaceous pigmentation of the scalp, adjacent forehead, and superolateral portions of the ears with patchy, scarred hair loss of the scalp and forehead.
The last application of hair dye was six months before presentation and led to itchy, oozing plaques on the scalp, forehead, and ears. A biopsy showed cicatricial (lichenoid) alopecia with pigmentation. Patch testing was notable for a very strong reaction to paraphenylenediamine (PPD) 1% pet. The diagnosis was allergic contact dermatitis resulting from the hair dye.
Are you a rash whisperer? Patch test. Identify allergens. Avoid them. If only if was that simple. Read more inDermWorld.
The above image is used with permission from DermNet NZ.
DermWorld Insights and Inquiries: Coming full circle (almost) — Low dose oral minoxidil for alopecia
I presume that virtually every dermatologist reading this commentary has recommended topical minoxidil for their patients with androgenetic alopecia and other alopecias. The thought of using oral minoxidil for alopecia never crossed my mind. Recently, there have been multiple studies exploring the use of low-dose oral minoxidil (< 5mg daily) for treating many forms of alopecia, with the goal of gaining hair while keeping adverse reactions at bay. Keep reading!
FDA approves atopic dermatitis biologic
The U.S. FDA recently approved tralokinumab-ldrm (Adbry™) for the treatment of moderate-to-severe atopic dermatitis (AD) in adults 18 years or older whose disease is not well controlled with topical prescription therapies or when those therapies are not advisable. Tralokinumab binds to and inhibits IL-13, a key driver of AD signs and symptoms.
In all three pivotal trials, 300 mg of tralokinumab every other week alone or with topical corticosteroids as needed met the primary endpoints at week 16 as measured by an Investigator Global Assessment score of clear or almost clear skin and/or at least a 75% improvement in the Eczema Area and Severity Index score, and the secondary endpoint of reduction of weekly average Worst Daily Pruritus NRS of ≥4 points on the 11-point itch NRS.
Tralokinumab will be available in a 150 mg/mL prefilled syringe for subcutaneous injection with an initial dose of 600 mg followed by 300 mg every other week. The treatment is expected to be available by February 2022.
Risk factors for positive surgical margins after excision of MCC
According to a JAAD research letter, among 7,609 patients with Merkel cell carcinoma (MCC) undergoing surgical excision, 6.8% of patients had positive surgical margins. Factors associated with positive surgical margins included older age, higher comorbidities, immunosuppression, and tumor size less than 2 cm. Tumor location not on the head/neck and excision margin of less than 1 cm were associated with lower odds of positive margins. Margin positivity was associated with worse overall survival, even in patients treated with adjuvant radiotherapy.
Life-changing advances and a multidisciplinary approach give new hope to patients with MCC. Read more inDermWorld.
Academy Advisory Board invites members to submit policy resolutions
The Academy’s Advisory Board invites all Academy members as well as state, local, and specialty dermatology groups to submit proposed AAD/A policy resolutions on issues of interest or concern. The Advisory Board convenes every year at the AAD Annual Meeting to deliberate on issues of importance to individual practitioners and propose new policies to the Academy’s Board of Directors for consideration.
If there is an issue of interest and/or concern, now is your opportunity to submit a resolution. If passed by the Advisory Board, it will go directly to the AAD/A Board of Directors. To get started on a resolution, determine who your state or local dermatology society’s Advisory Board Representative is by using the state society directory, and work with them to draft a policy resolution. The resolution should ask for the Academy to take specific action relating to advocacy or a general Academy policy.
Submit resolutions to Cierra Martin at cmartin@aad.orgby Feb. 7. The author or Advisory Board representative of the resolution must be present during the Reference Committee Hearing on Friday, March 25 at 2 p.m. (ET) to introduce and discuss the resolution. Even if you do not submit a resolution, the Academy strongly encourages all members to attend the Reference Committee Hearing to hear the debate on the proposed resolutions. The full Advisory Board will vote on the resolutions at the General Business Meeting on Sunday, March 27 at 2 p.m. (ET).
Visit the Advisory Board website and view the resolution template under "Related resources." In order to submit a resolution, your Disclosure of Outside Interests (DOI) statement must be updated.
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