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Going Virtual With Dermatology Education

Going Virtual With Dermatology Education

The final stretch of the 2020 event calendar is upon dermatology, and a number of great virtual conferences are slated to take place during the final quarter of the year. Since the beginning of the pandemic where there was a sudden change in presentation formats, meetings and conferences have hit their stride with digital proceedings. Page 17 (see below) highlights two presentations from recent digital conferences from this past September—San Diego Dermatology Symposium and Skin of Color Update.

As meetings are scheduled, moved, or shared online, The Dermatologist will share that information across our social media platforms (Facebook, Twitter, Instagram, LinkedIn) and on our website, the-dermatologist.com.


OCTOBER

Society of Dermatology Physician Assistant 2020 Digital
https://sdpadigital.org/
Thursday, October 29, to Saturday, October 31

Dermatology physician assistants across the United States can now participate in the SDPA’s innovative three-dimensional virtual conference. The weekend-long event features on-demand presentations, live chat networking opportunities, and an interactive industry exhibit hall. Presentations include “Ocular Dermatology” by Douglas DiRuggiero, DMSc, MHS, PA-C; “Cutaneous Lupus and Dermatomyositis” by Elizabeth Brezinski Wallace, MD; and “Billing and Coding in Dermatology” by Alex Flamm, MD.

DECEMBER

Revolutionizing Atopic Dermatitis Virtual Conference
https://revolutionizingad.com/
Sunday, December 13, to Monday, December 14

Led by conference chair Jonathan Silverberg, MD, PhD, MPH, the third RAD conference brings together several leaders at the forefront of research and treatment of atopic dermatitis. The tentative schedule includes eight mini-symposia featuring discussions on atopic comorbidities, measuring symptoms, clinically relevant epidemiology, allergic contact dermatitis and patch testing, and more. In addition, attendees can submit their poster abstracts until November 11, 2020; all accepted abstracts will be published in the British Journal of Dermatology.

JANUARY

Symposium for Inflammatory Skin Disease
https://www.dermrefoundation.org/symposium-for-inflammatory-skin-disease.html
Friday, January 8, to Sunday, January 10

Jashin J. Wu, MD, and colleagues bring years of world-renowned expertise on inflammatory skin diseases such as psoriasis, atopic dermatitis, acne, hidradenitis suppurativa, vitiligo, and more to the inaugural Symposium for Inflammatory Skin Disease. In addition to insights into dermatologic disease, Dr Wu will present attendees with critical information regarding in tax planning, insurance, retirement accounts, living trusts, and stock investing, topics rarely discussed in medical education meetings.

MARCH

American Academy of Dermatology Annual Meeting
https://www.aad.org/member/meetings/am2021
Friday, March 19, to Tuesday March 23

The 2021 AAD Annual Meeting is currently slated to take place in San Francisco, CA, in mid-March. With the uncertainty surrounding the COVID-19 pandemic and its potential impact on travel, the AAD has announced they are also making preparations for some elements of the meeting to be virtual. Registration opens in December 2020.

Note: This is not meant to be an exhaustive list. If you attend a great conference or meeting and want to share it with your peers, please send your recommendation to dermeditor@hmpglobal.com


SDDS: The Connection Between Alopecia Areata and Atopic Dermatitis

At the inaugural San Diego Dermatology Symposium, Natasha Mesinkovska, MD, covered a number of nonscarring alopecia topics, focusing on three key areas: alopecia areata (AA), scalp allergies, and tips from her clinic.1 “But one of the most interesting things that has really come out is the connection between areata and atopic dermatitis,” she said.

Historically, she noted, AA is considered a type 1 inflammatory disease, whereas atopic dermatitis (AD) is a type 2 inflammatory disease. However, AA is known to have many atopic comorbidities, including rhinitis, asthma, and atopic eczema. She noted that the literature has shown higher odds ratios for AA and atopic comorbidities. In addition, mast cells and eosinophils are found even in infiltrates around the hair bulbs as well as lymphocytes.

Dr Mesinkovska also pointed out that AA commonly follows a seasonal exacerbation pattern, with the autumn months seeing more cases vs the spring for children and adults. Interestingly, she pointed to studies by Putterman and Castelo-Soccio2 and Kim et al3 that demonstrated a seasonal severity fluctuation in AD.

“This brings in a potential role for antihistamines for alopecia areata control,” explained Dr Mesinkovska. She stated that she regularly uses antihistamines in her patients who are cyclic shedders or who have seasonal allergies, even as prophylaxis. She identified 11 manuscripts on antihistamine use in AA, noting that the most published antihistimine therapy is fexofenadine in several case reports. Also included in the literature are ebastine, cimetidine, and hydroxyzine.

Another treatment with some clinical optimism is dupilumab. Citing 10 published cases, Dr Mesinkovska noted that 50% of the literature showed improvement in AA, with 50% demonstrating new onset alopecia. She clarified that the new onset alopecia tends to be somewhat different on histology with more atrophic sebaceous glands.

Dr Mesinkovska recommended starting the patient with alopecia and eczema on dupilumab and evaluating their results after a 3-month period. n

References
1. Mesinkovska N. Non-scarring alopecia. Presented at:  San Diego Dermatology Symposium; September 11-13, 2020; virtual.
2. Putterman E, Castelo-Soccio L. Seasonal patterns in alopecia areata, totalis, and universalis. J Am Acad Dermatol. 2018;79(5):974-975. doi:10.1016/j.jaad.2018.06.029
3. Kim M, Kim YM, Lee JY, et al. Seasonal variation and monthly patterns of skin symptoms in Korean children with atopic eczema/dermatitis syndrome. Allergy Asthma Proc. 2017;38(4):294-299. doi:10.2500/aap.2017.38.4055


SOC Update: Alternative Treatment for Hair Loss With Dr Aguh

qr codeHair loss is challenging for patients but can be particularly difficult when it is refractory to standard therapies. Patients may require off-label and/or alternative treatment options in order to experience improvements in their condition. At the Skin of Color Update, Crystal Aguh, MD, discussed alternative therapies for various types of hair loss. The Dermatologist asked Dr Aguh to share some of her insights on alternative therapies for hair loss.

“One form of hair loss that is nonscarring but can be difficult to treat is androgenetic alopecia, or female-pattern hair loss,” said Dr Aguh. “This is the one exception on the list, because this form of hair loss tends to be more challenging to treat in women compared with men.” She described oral minoxidil as a potential alternative therapy for this type of hair loss. When this blood pressure therapy is used at low doses, it has been shown to effectively regrow hair. In particular, it can be a great option for patients who do not have the enzyme in their scalp to activate the standard therapy topical minoxidil.

For certain scarring alopecias, such as lichen planopilaris and frontal fibrosing alopecia, it is important to control inflammation. Dr Aguh explained that for patients with unresponsive scarring alopecias, she uses low-dose naltrexone. This drug has anti-inflammatory effects and can be beneficial for patients with refractory inflammation with itching and burning sensations. In addition, she also may use a compounded cleanser formulation of tacrolimus. While topical tacrolimus is considered a standard therapy, a higher strength, compounded cleanser can be more effective for visible inflammation.

In central centrifugal cicatricial alopecia, Dr Aguh said she typically uses a cream formulation of metformin. “While oral metformin is a well-known first-line therapy for diabetes, topical forms have been shown to reduce scarring in murine models,” she said. “Some patients have not only seen stabilization of their disease but also have been fortunate enough to see some regrowth.” n

Reference
Aguh C. Hair & scalp disorders in SOC: alternative treatment options. Presented at: Skin of Color Update; September 13, 2020; virtual.

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