Skin of Colour Dermatoses Self-Learning Module: Assessing Student Comprehension.

BACKGROUND: Dermatology for diverse skin types is a globally growing area of medicine, but the inclusion of skin of color dermatology has not yet been formally included across all Canadian undergraduate medical education curricula. There is also a paucity of representation of diverse skin types in most medical textbooks, research, and clinical trials. OBJECTIVES: The main objective was to develop a concise, Skin of Colour Dermatoses Self-Learning Module (SOCSLM) that could be implemented at an undergraduate medical education level. The secondary objective was to analyze participant responses to improve and add to learning module content. METHODS: From March to May 2022, second-year medical students at the University of Ottawa completed pre- and post-SOCSLM questionnaires which were available in French and English through their online student learning portals. The pre-test consisted of five multiple choice questions relating to images of dermatoses seen in diverse skin types. The post-test repeated the same five questions, rearranged, with an additional five new ones, and responses were analyzed. RESULTS: Twenty-five participants completed the surveys, and twenty responses were included. Percent correct answers increased between pre- and post-test, 51% vs 87%. In the post-test, questions repeated from the pre-test had a mean score of 95% while the new post-test questions had a mean score of 80%. Interest in dermatology did not have an impact on correct response rates. CONCLUSIONS: Skin of color dermatology self-learning modules may be an effective way to integrate skin of color dermatology into undergraduate medical curricula.

Cutaneous sarcoidosis in eyebrows cosmetically pigmented with microblading method: A case report and review of the literature.

Microblading is a novel method of semi-permanent makeup, which has achieved popularity in the last few years. We present the case of a patient who developed cutaneous sarcoidosis after microblading of her eyebrows. A 45-year-old female presented with a 6-month history of pruritic erythematous granulomatous plaques on bilateral eyebrows corresponding to the site of microblading 1.5 years prior. A tissue biopsy was preformed which was consistent with cutaneous sarcoidosis. An extensive work-up including assessment by respirology, rheumatology, and ophthalmology did not reveal any evidence of systemic sarcoidosis. The patient was treated with intralesional triamcinolone injections and tacrolimus ointment twice daily, with complete resolution. To our knowledge, this is the first case of cutaneous sarcoidosis associated with microblading in the literature. Dermatologists should be aware of popular and novel cosmetic procedures and the potential complications that arise from these interventions.

Bullous vesicant-type reaction to docetaxel along the venous tract: A case report.

Docetaxel is an anti-neoplastic agent commonly used to treat major solid tumors. Common toxicities of docetaxel include neutropenia, alopecia, nausea and vomiting. While docetaxel is typically considered an irritant, we present the case report of a 54-year-old female with high-grade undifferentiated uterine sarcoma who experienced a standard infusion reaction during a docetaxel infusion, followed by an atypical, delayed vesicant-type reaction, without a clear extravasation history.

Management of congenital cutaneous candidiasis in a healthy term baby: A case report.

The management of congenital cutaneous candidiasis in a healthy term neonate of normal birth weight is unclear. Often, healthy term neonates undergo extensive evaluation followed by systemic treatment, which may not be clinically warranted. Here, we present a case of a healthy term neonate with congenital cutaneous candidiasis, whose work-up was minimally invasive and was successfully treated with one oral dose of antifungals and topical antifungals, as well as a review of the literature.

Treatment of Mycoplasma pneumoniae-Induced Rash and Mucositis With Cyclosporine [Formula: see text].

BACKGROUND: Mycoplasma pneumoniae-induced rash and mucositis (MIRM) is a relatively newly recognized clinical entity that typically presents with predominant mucositis accompanied by variable cutaneous involvement 7-9 days after the onset of prodromal symptoms. There are no evidence-based guidelines for treatment, and current standards of care may include supportive therapy, antibiotics, corticosteroids, and intravenous immunoglobulin . OBJECTIVE: This case series aims to describe the potential efficacy of cyclosporine A (CsA) in the treatment of MIRM. METHODS: The present case series details our use of CsA early in the course of MIRM in 3 pediatric patients. RESULTS: Rapid clinical resolution was observed following CsA therapy. CONCLUSIONS: We suggest that early initiation of CsA may be an effective therapeutic option for MIRM.

Sunscreen Application, Safety, and Sun Protection: The Evidence.

Recently in Canada, there has been an effort to create consistent messaging about sun safety as there is a lack of up-to-date evidence-based guidelines regarding sun-protection measures. This review aimed to provide updated, evidence-based recommendations on sunscreen application, safety, and sun protection regarding the following topics for which there is clinical uncertainty: physical barriers, sunscreen properties, sunscreen application, and risk-benefit analysis.

Treatment of Darier's disease with oral magnesium: a case report.

Darier's disease, an autosomal dominant genodermatosis, arises from a mutation in the ATP2A2 gene that codes for sarco/endoplasmic reticulum Ca2+-ATPase in the endoplasmic reticulum and is characterized by greasy keratotic papules commonly found in seborrheic regions. Conventional treatments, including topical corticosteroids, antibiotics, antifungals and retinoids, often have limited efficacy. The present article reports the novel use of oral magnesium chloride supplementation (300 mg daily) in the treatment of Darier disease. After 5 years of limited improvement using conventional therapies, significant improvements in neck lesions were observed within 1 month of starting oral magnesium chloride. This suggests that oral magnesium chloride may be an effective therapeutic option for Darier disease, although further in vitro and clinical trials are necessary to evaluate its clinical efficacy.

Botanicals With Dermatologic Properties Derived From First Nations Healing: Part 2-Plants and Algae.

INTRODUCTION: Plants and algae have played a central role in the treatment of skin conditions in both traditional First Nations healing and in modern dermatology. The objective of this study was to examine the evidence supporting the dermatological use of seaweed, witch hazel, bearberry, and mayapple. METHODS: Four plants and algae used in traditional First Nations treatments of skin disease were selected based on expert recommendations. Several databases were searched to identify relevant citations without language restrictions. RESULTS: Seaweed has potential clinical use in the treatment of acne and wrinkles and may be incorporated into biofunctional textiles. Witch hazel is an effective and well-tolerated treatment of inflammation and diaper dermatitis. Bearberry leaves contain arbutin, a skin-lightening agent that is an alternative for the treatment of hyperpigmentation. Mayapple contains podophyllotoxin, a treatment for condyloma accuminata, molluscum contagiosum, and recalcitrant palmoplantar warts. DISCUSSION: Common plants and algae are replete with bioactive agents that may have beneficial effects on the skin. Further research will open the door to new and innovative products in the future. Limitations of this study include that the scope of our study is limited to 4 plants and algae, a small sample of the breadth of plants used by First Nations for dermatological treatments.

Botanicals With Dermatologic Properties Derived From First Nations Healing: Part 1-Trees.

INTRODUCTION: First Nations people have a long history of working with medicinal plants used to treat skin diseases. The purpose was to assess the dermatologic therapeutic potential of western red cedar, white spruce, birch, balsam poplar, and black spruce. METHODS: Based on expert recommendations, 5 trees were selected that were used in First Nations medicine for cutaneous healing and have potential and/or current application to dermatology today. We searched several databases up to June 12, 2014. RESULTS: Western red cedar's known active principal compound, ß-thujaplicin, has been studied in atopic dermatitis. White spruce's known active principal compound, 7-hydroxymatairesinol, has anti-inflammatory activity, while phase II clinical trials have been completed on a birch bark emulsion for the treatment of actinic keratoses, epidermolysis bullosa, and the healing of split thickness graft donor sites. Balsam poplar has been used clinically as an anti-aging remedy. Black spruce bark contains higher amounts of the anti-oxidant trans-resveratrol than red wine. DISCUSSION: North American traditional medicine has identified important botanical agents that are potentially relevant to both cosmetic and medical dermatology. This study is limited by the lack of good quality evidence contributing to the review. The article is limited to 5 trees, a fraction of those used by First Nations with dermatological properties.

Hair pull test: Evidence-based update and revision of guidelines.

BACKGROUND: The hair pull test lacks validation and has unclear pretest guidelines. OBJECTIVE: We sought to quantify normal hair pull test values and elucidate the effect of pretest hair washing and brushing. The impact of hair texture and lifestyle was also examined. METHODS: Participants (n = 181) completed a questionnaire recording demographics, medications, and hair health/history. A single hair pull test (scalp vertex) was performed. RESULTS: The mean number of hairs removed per pull was 0.44 (SD 0.75). There was no significant difference in the mean number of hairs removed regardless of when participants washed (P = .20) or brushed (P = .25) their hair. Hair pull test values were similar between Caucasian-, Asian-, and Afro-textured hair. There was no significant difference in hair pull values between participants taking medications affecting hair loss and participants not taking these medications (P = .33). Tight hairstyles did not influence hair pull test values. LIMITATIONS: Participant hair washing and brushing could not be controlled during the study, but this information was documented and analyzed. CONCLUSION: Normal values for the hair pull test should be reduced to 2 hairs or fewer (97.2% of participants). The current 5-day restriction on pretest hair washing can be reduced and brushing be made permissible.

The association of indoor tanning and melanoma in adults: systematic review and meta-analysis.

BACKGROUND: Tanning beds are associated with increased risk of melanoma. OBJECTIVE: We sought to update the evidence of the association of melanoma and indoor tanning focusing on frequency of use and exposure to newer tanning beds. METHODS: We searched Scopus, MEDLINE, and Cumulative Index to Nursing and Allied Health Literature on August 14, 2013. We included all observational studies that included patients with melanoma who had indoor tanned. Odds ratios (OR) with 95% confidence intervals (CI) were extracted and combined using generic inverse variance methods assuming a random effects model. RESULTS: In all, 31 studies were included with data available on 14,956 melanoma cases and 233,106 controls. Compared with never using, the OR for melanoma associated with ever using indoor tanning beds was 1.16 (95% CI 1.05-1.28). Similar findings were identified in recent studies with enrollment occurring in the year 2000 onward (OR 1.22, 95% CI 1.03-1.45) and in subjects attending more than 10 tanning sessions (OR 1.34, 95% CI 1.05-1.71). LIMITATIONS: The quality of evidence contributing to review results ranges from poor to mediocre. CONCLUSION: Using tanning beds is associated with a subsequent melanoma diagnosis. Exposure from more than 10 tanning sessions is most strongly associated and there was no statistically significant difference in this association before and after 2000, suggesting that newer tanning technology is not safer than older models.