Discovering Black Soap: A Survey on the Attitudes and Practices of Black Soap Users.

OBJECTIVE: The purpose of this study was to discover the general attitudes and practices of black soap users with regard to amelioration of various dermatologic conditions. DESIGN: This was a prospective questionnaire-based study with a sample size of 100 black soap users. Setting: Outpatient dermatology clinics of Montefiore Medical Center and other Albert Einstein affiliated dermatology clinics in Bronx, New York. PARTICIPANTS: One hundred subjects who have used black soap were recruited. MEASUREMENTS: The participants evaluated and reported their attitudes and applications of black soap. Data on sociodemographic prevalence and user satisfactions of black soap were collected and analyzed. RESULTS: The age distribution of participants was uniform among the specified age categories: 1) 18 to 29 years; 2) 30 to 39 years, 3) 40 to 49 yesars, and 4) 50 years and older. The sex distribution favored women, comprising 74 percent of those surveyed. A significant number of participants were born in either Africa (23%) or the Caribbean (19%). Black soap usage was applied to mitigate many dermatologic conditions, including acne (23%), dark spots (20%), razor bumps (13%), eczema (7%), and fine lines (4%). The most popular usage was for overall skin care (70%). The vast majority of users found black soap helpful for their skin condition (51% very satisfied, and 40% somewhat satisfied). Conclusion: The survey results indicate widespread usage and satisfaction with black soap for reduction in symptoms of various dermatologic conditions. Further investigations are warranted to discover active ingredients present in black soap that may unveil future therapeutic options for various dermatologic conditions.

Diagnosis and management of cold urticaria.

Cold urticaria is a physical urticaria characterized by a localized or systemic eruption of papules upon exposure of the skin to cold air, liquids, and/or objects. In some cases, angioedema and anaphylaxis also may occur. The symptoms of cold urticaria can have a negative impact on patients' quality of life. Second-generation H1 antihistamines are the first line of treatment in cold urticaria; however, patients who are unresponsive to initial treatment with H1 antihistamines may require further management options. Avoidance of cold exposure is the most effective prophylactic measure. In mild to moderate cases, the primary goal of therapy is to improve the patient's quality of life. In more severe cases, treatment measures to protect the patient's airway, breathing, and circulation may be necessary. We report the case of a 23-year-old man with cold urticaria who was refractory to initial therapy with H1 antihistamines. A review of the literature also is provided.

Nonstandard and off-label therapies for psoriasis.

Although most psoriasis patients respond to standard therapies, many circumstances warrant the use of nonstandard or off-label treatments. For instance, patients with treatment-resistant psoriasis or those who have had multiple adverse effects to other therapies may be good candidates for off-label treatments. Similarly, patients with unusual and hard-to-treat forms of psoriasis such as pustular psoriasis and palmoplantar psoriasis or specific comorbidities may benefit from certain nonstandard therapies. Drugs that may be used as alternatives to standard therapies include mycophenolate mofetil, tacrolimus or pimecrolimus, isotretinoin, colchicine, sulfasalazine, paclitaxel, dapsone, azathioprine, and hydroxyurea. Other unconventional therapies include climatotherapy at the Dead Sea and grenz ray therapy.

Cushing syndrome from percutaneous absorption of 1% hydrocortisone ointment in Netherton syndrome.

Netherton syndrome is a congenital skin disease associated with decreased skin barrier function and increased percutaneous absorption. We report an 11-year-old boy with Netherton syndrome who developed Cushing syndrome after application of 1% hydrocortisone ointment to his entire body for more than 1 year. This presentation illustrates that even low-potency steroid ointments should be used with caution in Netherton syndrome and warns about the use of long-term topical medications with potential systemic side effects when used in large quantities in any chronic skin disease.

Lack of significant skeletal changes after long-term, low-dose retinoid therapy: case report and review of the literature.

BACKGROUND: Long-term systemic retinoid therapy has been associated with skeletal side effects. There have been reports of diffuse idiopathic skeletal hyperostosis (DISH) syndrome, calcification of ligaments, and osteoporosis, as well as premature fusion of epiphyses and modeling abnormalities of long bones, occurring in patients on chronic high-dose isotretinoin, etretinate, and acitretin therapy. Low-dose acitretin has been used for many years as monotherapy or in combination with other systemic therapies for psoriasis. Evidence to date suggests that the frequency of symptomatic bony effects is quite low in these patients. OBJECTIVE: To present the radiologic findings of a patient on long-term, low-dose acitretin and etretinate and to review the literature on the radiologic evidence of skeletal side effects during retinoid therapy. METHODS: Case report and literature search. RESULTS: A patient on low-dose acitretin had no significant radiologic abnormalities associated with retinoid use after 9 years of treatment. A review of the literature revealed conflicting reports on the incidence of radiologic abnormalities in patients on retinoid treatment. CONCLUSION: The evidence to date does not substantiate a clear link between radiologic skeletal abnormalities and long-term, low-dose acitretin or etretinate therapy.