A retrospective JAAD study aimed to evaluate the association between hormonal intrauterine devices (IUDs) and adverse dermatologic events. The study, which included 1,224 women, compared new instances of dermatologic conditions between those using hormonal (levonorgestrel) and non-hormonal copper IUDs. The results revealed significantly increased odds of acne vulgaris diagnosis (odds ratio, 2.5) in the year following implantation for women using levonorgestrel versus women with the non-hormonal copper IUD.
On the other hand, women with the hormonal IUD were less likely to be diagnosed with androgenic alopecia (odds ratio, 0.12), rosacea (odds ratio, 0.38), and hirsutism (odds ratio, 0.45). The authors conclude that understanding hormonal interplays associated with levonorgestrel may aid in the risk assessment of dermatologic complications and guide contraceptive choices.
DermWorld Insights and Inquiries: COVID-19 can nail you in so many ways
Much less reported are findings on the nails that may be related to COVID-19 infection. The first manifestation reported was the red half-moon nail sign that occurs two to 14 days after diagnosis of COVID infection. It appears as an asymptomatic transverse convex red band located at the distal margin of the lunula. Transverse leukonychia has also been reported in a hospitalized patient six weeks after developing symptoms. Other nail changes include Beau’s lines and onychomadesis, which typically occur one to three months after development of symptoms. Another late manifestation of nail findings reported is a heterogeneous red-white discoloration of the nail bed with distal onycholysis. Keep reading!
What does Europe’s tattoo ingredient ban mean for North America?
Authors of a JAAD article explore what European bans on some tattoo inks may mean for North America. On Jan. 4, 2022, the European Union restricted more than 4,000 ingredients in tattoo inks and implemented stricter labeling and safety information. Despite a higher prevalence of adult tattoos in the United States and Canada (31%), these countries do not have similar oversight.
Cutaneous and systemic tattoo-associated adverse events have been reported, including edema, purpura, cutaneous infections, and allergic/inflammatory reactions. Many tattoo ink ingredients, such as polycyclic aromatic hydrocarbons in black inks, have been linked to in vivo carcinogenic and irritant properties. At the federal level, tattoo ink is categorized as a cosmetic — with no inks specifically approved for skin injection and many unapproved for skin contact. The authors recommend that dermatologists be aware of tattoo-related adverse reactions and educate patients and policymakers on tattoo safety.
Lab testing for pediatric patients using isotretinoin
A study published in Pediatric Dermatology showed that after two months of isotretinoin treatment, pediatric patients with acne vulgaris experienced significant elevations in mean total cholesterol, triglycerides, and low-density lipoprotein — with a decrease in high-density lipoprotein, all of which remained within clinically normal levels.
Patients with baseline elevated triglyceride levels were initiated on isotretinoin with no significant changes observed in liver function tests. None of the patients with lipid or liver enzyme abnormalities had related clinical sequelae. The authors suggest that routine lab monitoring of pediatric patients on isotretinoin may not be warranted, and that testing based on individual risk factors may be more appropriate.
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