Treatment for central centrifugal cicatricial alopecia-Delphi consensus recommendations.

BACKGROUND: There is no established standard of care for treating central centrifugal cicatricial alopecia (CCCA), and treatment approaches vary widely. OBJECTIVE: To develop consensus statements regarding the use of various pharmacological therapies in treating adults with CCCA. METHODS: We invited 27 dermatologists with expertise in hair and scalp disorders to participate in a 3-round modified Delphi study between January and March 2023. Statements met strong consensus if 75% of respondents agreed or disagreed. Statements met moderate consensus if 55% or more but less than 75% agreed or disagreed. RESULTS: In round 1, 5 of 33 (15.2%) statements met strong consensus, followed by 9 of 28 (32.1%) in round 2. After the final round 3 meeting, strong consensus was reached for 20 of 70 (28.6%) overall statements. Two statements achieved moderate consensus. LIMITATIONS: This study included only English-speaking, US-based dermatologists and did not consider nonpharmacological therapies. CONCLUSION: Despite varying opinions among dermatologists, consensus was reached for several statements to help clinicians manage CCCA. We also highlight areas that lack expert consensus with the goal of advancing research and therapeutic options for CCCA.

Representation of Racially Minoritized Patients on Dermatology Private Practice Websites.

Images on the homepages of private practice dermatology websites often do not reflect the racial diversity of the metropolitan area in which each practice is located. A Google Maps scraper (Apify) was used to identify websites for private practices in 27 United States metropolitan areas selected from the 2020 U.S. Census list of 100 largest areas where non-white individuals makeup more than 50% of the population. Homepages from the top ten websites listed by the search engine were analyzed for images, use of non-English language, and mention of "Skin of Color" or "Ethnic Skin." One hundred seventeen websites were included. Two mentioned "Skin of Color" or "Ethnic Skin"; seven mentioned a non-English language. A significantly lower percentage of non-white-presenting patients (p < 0.001) and providers (p < 0.001) were pictured on the selected dermatology websites than reported in the Census. These findings suggest that the images on the homepages of private practice dermatology websites were not reflective of the racial diversity of the metropolitan area in which each practice is located. Private practice dermatologists should be mindful of how their services are represented online, as it may dissuade potential minoritized patients from seeking dermatologic care.

Herpetic Pseudotumor of the Nostril: A Report of Facial Herpes Vegetans in a Patient With Chronic Lymphocytic Leukemia.

Cutaneous herpes simplex virus (HSV) infections characteristically present with a vesicular eruption on an erythematous base that is easily recognized and diagnosed. Immunocompromised patients, such as those with HIV/AIDS or malignancy, may develop atypical verrucous lesions, necrotic ulcers, and/or erosive vegetative plaques. The most common location for these atypical lesions is the anogenital region. Few facial lesions have been reported in the literature. We report a case of a rapidly growing vegetative lesion on the nose of a 63-year-old male with chronic lymphocytic leukemia. A skin biopsy and immunostaining confirmed a diagnosis of herpes simplex. The patient was successfully treated with IV acyclovir. Infection is the main cause of mortality among patients with chronic lymphocytic leukemia (CLL), and reactivation of herpes is common. Occasionally, HSV may present in an unusual manner and/or location, creating a diagnostic dilemma that can potentially delay diagnosis and treatment. The present report highlights the importance of considering atypical presentations of HSV in immunosuppressed patients, regardless of lesion location, as early detection and treatment are especially critical in this population.

Commonly used hair oils in the Black community: a narrative review in their use to treat androgenetic alopecia.

Alopecia, the loss of hair on the scalp and/or body, experienced by millions of people worldwide, can be a very debilitating condition. Specifically, androgenetic alopecia (AGA), commonly known as male or female pattern baldness, is the most common form of hair loss. In the African diaspora, oils have traditionally been used to promote hair growth and recently, the application of hair oils to the scalp for the treatment of alopecia has become increasingly popular. With the recent surge of hair oil usage in the Black community, more research is needed to determine the efficacy of hair oils, as most studies have primarily used mice subjects. This article reviews the existing literature to better understand the use of hair oils in the treatment of androgenetic alopecia. Specifically, we investigate the popular carrier oils, castor oil, and pumpkin oil as well as the essential oils, lavender, peppermint, rosemary, and tea tree oil.

Osimertinib and Ramucirumab Induced Pyogenic Granulomas: A Possible Synergistic Effect of Dual Oncologic Therapy.

Pyogenic granulomas represent benign vascular tumors that can present on the skin and mucous membranes. Multiple etiologic agents have been implicated in the pathogenesis including several systemic medications. Two notable oncologic therapies, epidermal growth factor receptor inhibitors and vascular endothelial growth factor receptor inhibitors, have each been associated with drug-induced pyogenic granulomas. We report a novel case report of dual therapy, medication-induced pyogenic granulomas. This likely represents a synergistic relationship between an epidermal growth factor receptor inhibitor, osimertinib, and a vascular endothelial growth factor receptor inhibitor, ramucirumab.