Telogen effluvium associated with COVID-19 infection.

Telogen effluvium (TE) is characterized by diffuse hair shedding 2-3 months after a stressor, and COVID-19 infection is potentially one such stressor. Those who were infected with the virus were under immense psychosocial and physiologic stress. We retrospectively reviewed electronic medical records of 552 patients who were evaluated by a Henry Ford Health System dermatologist between February 2020 and September 2020 and had a diagnosis of COVID-19 infection. Ten patients were identified with TE attributed to COVID-19 infection and described their presentations as a case series. For the ten patients selected, the mean age was 48.5 years old and 90% were female. Six of the patients were Black, one Middle Eastern, and three White. On average, the hair shedding began 50 days after the first symptom of COVID-19 infection. About 80% of these patients were treated with antibiotics, systemic corticosteroids, and/or hydroxychloroquine for their COVID-19 infection and 70% were hospitalized. The presentations of these patients suggest that COVID-19 infection may be a significant trigger of TE. TE caused by hydroxychloroquine, azithromycin or other medications cannot be ruled out, and the global pandemic itself is a source of psychosocial stress. Further studies will be needed to understand the long-term prevalence and prognosis of TE associated with COVID-19 infection.

A retrospective review of 93 cases of cellular dermatofibromas.

BACKGROUND: Cellular dermatofibromas (CDF) are an uncommon variant of benign fibrous histiocytomas with propensity to recur and rarely metastasize as well as demonstrate histologic similarities to more dangerous lesions. OBJECTIVES: The aim of this present study was to further describe the presentation and outcome of the cellular variant of benign fibrous histiocytomas so that it can be diagnosed and treated appropriately. METHODS: A retrospective chart review was performed on all patients seen in a single hospital system in Detroit, Michigan, from 2007 to 2017. CDF was confirmed by pathology. Baseline demographics, specialty service of diagnosis and treatment, treatment modality, and outcome were collected. RESULTS: Of the 93 qualifying patients, the average age at diagnosis was 42.65 years. The most common specialty service that diagnosed and treated patients was dermatology (38.71%). About 95.0% of CDF stained positive for Factor 13A (19/20), and 90.48% were CD34 negative (19/21). Of patients, 33.33% had recurrences of their CDF (9/27). Two patients had three or more recurrences. One patient's death was attributed to the CDF. CONCLUSION: CDF have a high local recurrence rate and similarities to more dangerous and malignant lesions. Patients with cellular dermatofibromas present to many subspecialty services for diagnosis and should be treated aggressively.

A Comparative Analysis of Electric and Radiofrequency Microneedling Devices on the Market.

Microneedling was first described in 1995 by Orentreich and Orentreich for the treatment of atrophic scars and wrinkles.1 The local injury induced by dermal penetration of microneedling causes release of growth factors such as transforming growth factor (TGF)-α, TGF-ß, and platelet-derived growth factor (PDGF). This stimulates collagen and elastin fiber production as well as capillary formation, ultimately leading to tissue remodeling.2.

Ertapenem - a potent treatment for clinical and quality of life improvement in patients with hidradenitis suppurativa.

BACKGROUND: A paucity of knowledge exists regarding the use of ertapenem in hidradenitis suppurativa. Our retrospective chart review and telephone interview aims to investigate the utility of intravenous ertapenem in severe, refractory hidradenitis suppurativa. METHODS: This retrospective chart review and telephone interview included patients with severe, refractory hidradenitis suppurativa treated with intravenous ertapenem between March 2013 and December 2016. Data were obtained from medical charts. During the telephone interview, patients were asked questions relating to satisfaction, quality of life changes, and disease state changes with ertapenem therapy. RESULTS: A total of 36 patients including 22 females and 14 males with Hurley stage II or III hidradenitis suppurativa were included. Thirty-five patients (97.2%), demonstrated improvements in hidradenitis suppurativa with ertapenem treatment. In total, 28 patients participated in our telephone interview. Twenty patients (71.4%) were very satisfied (n = 12) or satisfied (n = 8). Quality of life improved in 85.7% of patients (n = 24). CONCLUSION: Following ertapenem therapy, patients reported improvements in quality of life. This treatment appears promising as an adjunct to biologics or as a bridge to surgery in the treatment of severe, refractory hidradenitis suppurativa.

Photosensitive disorders of the skin with ocular involvement.

Patients with photosensitive disorders of the skin may present with ocular manifestations that are evident at birth or may be manifested later with progression of the disorder. Dermatologists should be able to recognize these and appropriately refer patients for further management. Ocular involvement associated with immunologically mediated photodermatoses, drug- and chemical-induced photosensitivity, photodermatoses associated with defective DNA repair/chromosome instability, and photoaggravated dermatoses are reviewed. Photodermatoses are commonly classified into four general groups: (1) immunologically mediated photodermatoses; (2) drug- and chemical-induced photosensitivity; (3) photodermatoses associated with defective DNA repair/chromosome instability; and (4) photoaggravated dermatoses. Photodermatoses in these groups with ocular involvement will be discussed. In addition, skin diseases associated with photophobia are also described.

A systematic review of treatments for hidradenitis suppurativa.

OBJECTIVES: To conduct a systematic review of the effectiveness of various modalities to treat hidradenitis suppurativa (HS) and to establish recommendations on its appropriate management. DATA SOURCES: MEDLINE, Cochrane, and PubMed databases. STUDY SELECTION: English-language prospective, retrospective, and case studies describing at least 4 patients with HS. DATA EXTRACTION: Data quality and validity were addressed by multiple reviewers using independent extraction. DATA SYNTHESIS: Studies were categorized as treatments using antibiotics, biological agents, laser surgery, excisional surgery, or miscellaneous modalities. Of 62 publications included in the review, 4 studies met criteria to be assigned the highest grade for quality of evidence. CONCLUSIONS: Shown to be effective treatments for HS were a clindamycin-rifampin combination regimen, a course of infliximab, monthly Nd:YAG laser sessions, and surgical excision and primary closure with a gentamicin sulfate-collagen sponge. Most therapies used to treat HS were supported by limited or weak scientific evidence. A treatment approach is presented based on the evidence and on clinical experience at the Follicular Disorders Clinic, Department of Dermatology, Henry Ford Hospital, Detroit, Michigan. This review emphasizes the need for large randomized controlled trials to evaluate treatment options for HS.