Radiation Recall Dermatitis With Bruton Tyrosine Kinase Inhibitor Therapy.

This case report describes a woman in her 70s with a history of breast cancer and chronic lymphocytic leukemia who presented with a painful rash of the bilateral chest extending onto the flanks.

Dermatology's role in the fight against human trafficking: A report from the AAD Ad Hoc Task Force and call to action.

While the majority of American Academy of Dermatology members have some broad awareness of human trafficking, most are not aware of it in their communities or of the skin signs that could prompt identification of those being exploited, and have requested educational resources to assist patients affected by trafficking. The American Academy of Dermatology Ad Hoc Task Force on Dermatologic Resources for the Intervention and Prevention of Human Trafficking has been working to develop relevant resources, including an online toolkit on the American Academy of Dermatology website: https://www.aad.org/member/clinical-quality/clinical-care/human-trafficking.

The Burden of Air Pollution on Skin Health: a Brief Report and Call to Action.

INTRODUCTION: Air pollution in North America has intensified due to wildfires in recent years. In 2023, the wildfires in the Canadian province of Quebec caused a southward spread of pollutants, negatively affecting air quality and thereby aggravating certain health conditions in northeastern USA. This study examines the impact of air pollution on atopic dermatitis (AD) and skin health and how wildfires can exacerbate the burden of disease. METHODS: Carbon monoxide levels measured by the U.S. Environmental Protection Agency (EPA) in the Boston region during the months following the Canadian wildfires of 2023 were collected from the U.S. EPA Outdoor Air Quality webpage. Patient records on dermatology clinic visits for dermatitis and eczema at the Mass General Brigham (MGB) hospital system, 300 miles from the wildfires, were examined, and the data compared with data from the corresponding months in 2019-2022 for historical control. No individual patient data were collected. RESULTS: A notable rise and atypical summer peak in carbon monoxide (CO) levels in the Boston region during 2023 correlated with a spike in AD, dermatitis, and eczema-related dermatology clinic visits within the MGB hospital system, as compared with the prior 4 years. CONCLUSION: The synchronized atypical peaks of CO levels and AD-related visits during the summer of 2023 highlight the potential impact of acute air pollution events such as wildfires on air quality and the consequences for skin health. Air pollution, exacerbated by wildfires, can damage the skin through the smoke and chemicals utilized for extinguishing fires, which contain multiple potential allergens and irritants to the skin, such as CO, particulate matter (PM2.5), and ammonium phosphates, triggering airway and skin inflammation and flares of AD. This issue disproportionately affects vulnerable populations, including low-income communities and the geriatric and pediatric populations. Healthcare professionals and government agencies must work together to improve air quality and purification policies and initiatives to lower the burden of skin disease, especially for vulnerable communities.

Lower Extremity Salvage in the Setting of Bullous Pemphigoid Exacerbation: A Case Report.

Bullous pemphigoid is an autoimmune blistering disease where patients suffer from painful bullae, often covering large portions of the skin and requiring management with immune-suppression. Our case report of recurring bullous pemphigoid illustrates the importance of considering immunosuppressive perioperative management in patients with a history of autoimmune blistering even when the disease has been quiescent for some time. With multidisciplinary care and immune suppressive therapies in the perioperative period, a free flap complicated by recurrent bullous pemphigoid can be salvaged.

The art of prevention: COVID-19 vaccine preparedness for the dermatologist.

As COVID-19 vaccinations begin, dermatologists must be aware of the cutaneous adverse events reported in the clinical trials, including injection site and hypersensitivity reactions, and emerging evidence of dermal filler injection reactions after vaccination. The filler reaction may represent the development of a delayed-type hypersensitivity in the setting of another immunologic trigger (i.e., the vaccine). After conducting a literature review of similar reactions, their pathophysiology, and management, we present a set of timely clinical considerations for counseling, prevention, and management of possible cutaneous sequelae of the COVID-19 vaccine. We encourage documentation of vaccine-related reactions to aid the safety data collection in the Vaccine Adverse Event Reporting System and the American Academy of Dermatology COVID-19 Registry.

Geranyl and neryl triazole bisphosphonates as inhibitors of geranylgeranyl diphosphate synthase.

When inhibitors of enzymes that utilize isoprenoid pyrophosphates are based on the natural substrates, a significant challenge can be to achieve selective inhibition of a specific enzyme. One element in the design process is the stereochemistry of the isoprenoid olefins. We recently reported preparation of a series of isoprenoid triazoles as potential inhibitors of geranylgeranyl transferase II but these compounds were obtained as a mixture of olefin isomers. We now have accomplished the stereoselective synthesis of these triazoles through the use of epoxy azides for the cycloaddition reaction followed by regeneration of the desired olefin. Both geranyl and neryl derivatives have been prepared as single olefin isomers through parallel reaction sequences. The products were assayed against multiple enzymes as well as in cell culture studies and surprisingly a Z-olefin isomer was found to be a potent and selective inhibitor of geranylgeranyl diphosphate synthase.