Cosmetic procedures carry inherent risks of adverse events. Though rarely reported, transient and permanent alopecia are potential complications of these procedures. We report the case of a 35-year-old woman who developed pain and patches of nonscarring alopecia with erythema and edema following aesthetic application of poly-L-lactic acid (PLLA) on the face and along the frontal hairline. Trichoscopy and histopathologic analysis confirmed the diagnosis. Dermatologists should be aware of the potential for embolization and retinal ischemia following the use of PLLA. Moreover, trichoscopy combined with histopathologic analysis should be encouraged to improve early recognition and proper management of this rare adverse event.

The American Contact Dermatitis Society (ACDS) selected sulfites as the 2024 Allergen of the Year. These common and potentially allergenic ingredients are used as preservatives and antioxidants in a variety of foods, beverages, medications, and personal care products. In this article, we review common sources of sulfite exposure, clinical manifestations of allergic contact dermatitis (ACD) to sulfites, and patch testing considerations for this emerging allergen.

Despite having an overall lower lifetime risk for skin cancer, Latine/Hispanic individuals experience increased morbidity and mortality in skin cancer outcomes compared to non-Hispanic White individuals. The reasons for these disparate outcomes are multifactorial, but challenges in early skin cancer detection, limited awareness of risks, and inequitable access to care and/or treatment among this patient population likely are contributory. In this article, we review cutaneous malignancies in the Latine/Hispanic population and explore factors that impact overall prognosis, including unique clinical features, inadequate health coverage, medical mistrust, language barriers, differing cultural perspectives, and inadequate research. We aim to provide a pivotal foundation for development of effective strategies to advance skin cancer education and awareness and promote equity in skin cancer treatment among this population.

More than 30 million Americans lack access to affordable health care, and many seek medical services such as dermatologic care at free clinics. In this study, we analyzed the dermatology patient populations at the Birmingham Free Clinic (BFC) and the University of Pittsburgh Medical Center (UPMC), both in Pittsburgh, Pennsylvania. A retrospective chart review of 76 BFC dermatology patients and a time-matched sample of 322 UPMC dermatology patients was performed for the period from January 2020 to May 2022. Dermatologic care at both clinics can be improved by strengthening communication with patients with limited English proficiency (LEP), providing skin care education, and offering social and scheduling services such as transportation, insurance assistance, and triage.

Identifying an optimal treatment method for verruca vulgaris can be a frustrating challenge for clinicians. We describe the use of a pinto bean pressure wrap to induce ischemic change in digital warts. This novel technique provides a low-cost, low-risk, and nearly pain-free home-based treatment option with response rates similar to those of other commonly employed methods.

Current evidence indicates that obesity may initiate psoriasis or worsen existing disease. Various factors contribute to the development of obesity, including eating disorders (EDs). The aim of this study was to screen for and identify factors associated with EDs in patients with psoriasis and their impact on the development of obesity in this population. Demographic information including body mass index (BMI), Eating Attitude Test (EAT-26), Dermatology Life Quality Index (DLQI), Attitude Scale for Healthy Nutrition (ASHN), and Depression Anxiety Stress Scale 21 (DASS-21) scores were statistically analyzed for 82 participants with psoriasis at a tertiary dermatology clinic. It is important to manage obesity and other comorbidities of psoriasis in addition to treating its cutaneous manifestations, which may require a biopsychosocial approach.

Hookworm infection represents a major global disease burden, in terms of both morbidity and economic impact, and there has been a resurgence of hookworms in developed nations where these parasites were once thought to be eradicated. Hookworms can infest humans or other mammals as their primary hosts depending on the species. The 2 most common species that seek human hosts-Necator americanus and Ancylostoma duodenale-enter the body through the epidermis, and hookworm infection may manifest as a pruritic and papular inflammatory reaction know as ground itch. Once they penetrate blood vessels, the hookworms localize in the lungs where they produce an eosinophilic pneumonitis, then they are swallowed with sputum and localize in the gastrointestinal tract in their adult form, with resulting symptoms of iron deficiency. Zoonotic hookworms such as Ancylostoma caninum, Ancylostoma braziliense, and Uncinaria stenocephala can infest pets such as dogs and cats but also can erroneously penetrate the skin when a human comes into contact with soil contaminated with larval hookworms. In such instances, the hookworms cannot traverse the basal layer of the epidermis and remain confined to the stratum spinosum, a condition known as cutaneous larva migrans (CLM).

Inpatient consultative dermatologists play a critical role in the care of hospitalized patients with skin disease. Our review of the 2023-2024 dermatology literature identified several areas of active investigation relevant to inpatient dermatology. In this article, we highlight advances in the understanding of severe cutaneous adverse drug reactions, diagnosis and prevention of skin and soft tissue infections, and management of autoimmune blistering diseases (AIBDs).

The western pygmy rattlesnake (Sistrurus miliarius streckeri) belongs to the Crotalidae family (also known as pit vipers). The western pygmy rattlesnake is native to Missouri, Arkansas, Oklahoma, Kentucky, and Tennessee. Although it is a small snake, envenomation often results in hospitalization and tissue necrosis. Medical stabilization and local wound care are critical to avoid late sequalae. We present the case of a 56-year-old man who was bitten on the right third digit. He required treatment with Crotalidae polyvalent immune fab antivenom and hospitalization, followed by 6 weeks of local wound care.

The National Psoriasis Foundation (NPF) treatment targets aim to achieve 1% or lower body surface area (BSA) affected after 3 months of treatment. European psoriasis treatment guidelines aim to achieve similar goals based on improvements in Psoriasis Area and Severity Index (PASI) scores. We performed pooled analyses of the PSOARING phase 3 program, which evaluated treat-to-target outcomes for patients treated with tapinarof cream 1% once daily (QD) for up to 52 weeks. Our analyses included 915 patients from PSOARING 1 and PSOARING 2 who had Physician Global Assessment (PGA) scores of 2 or higher before undergoing treatment with tapinarof, including those who received the vehicle in PSOARING 1 and PSOARING 2 and then tapinarof in PSOARING 3. The treatment targets we analyzed included the proportion of patients achieving an absolute BSA of 1% or lower or an absolute total PASI score of 3 or lower. In total, 40% of patients achieved the stringent NPF target of BSA of 1% or lower within 3 months, and 61% achieved a BSA of 1% or lower at any time (median, ~4 months). Furthermore, 75%, 67%, and 50% achieved PASI scores of 3, 2, and 1 or lower, respectively, at any time (median, ~2-6 months). Our results indicated that a high percentage of patients with mild to severe psoriasis can achieve and exceed ambitious treatment targets when treated with topical tapinarof monotherapy for up to 1 year.

Community outreach is an important aspect of residency training. Skin cancer screenings, free clinics, and teledermatology are a few ways in which dermatology residents may take leadership roles and get involved in their local communities. These opportunities not only provide invaluable education for residents, they also deliver specialty care to communities that may otherwise encounter considerable difficulty accessing dermatologic care.