The various ingredients and impurities that can be detected within tattoo inks have been associated with a myriad of dermatologic complications. Legislation regarding these antigenic substances ...varies widely around the world, with Europe serving as both the research and regulatory center on these intradermal formulations. Although industry is said to be moving away from metallic and metalloid pigments in exchange for organic or organometallic dyes, surveys of commercially available inks continue to detect these elements at concentrations considered unsafe for application into the dermis. In order to better assess the formulation and safety of tattoo ink, we present a systematic review and meta-analysis of studies quantifying restricted metals and metalloids in commercially available tattoo ink products. Among the papers selected, inconsistencies were noted in the degree of specificity by which ink products were identified and the elements sampled for. In addition, the analytical targets’ valency and/or solubility were not always considered in accordance with regulation criteria. Of note, chromium, by total content and that of its regulated +6 valency, exceeded its maximum allowed concentration in nearly every sample tested. Total copper content exceeded the limit for soluble copper in half of inks sampled. In descending order, concentrations of cadmium, barium, mercury, soluble copper, arsenic, zinc, antimony, and lead violated regulations in one-sixth or fewer of samples tested. Cobalt and tin levels never violated regulation. Overall, our findings indicate that unsafe levels of restricted elements continue to be detected across studies, warranting further investigation under a regulatory lens.
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•Most testing for metals and metalloids in tattoo inks has been performed in Europe.•Cr VI is undertested in tattoo inks yet projected to be hyper-prevalent.•Red and yellow tattoo inks lack specific metallic or metalloid markers.•Nickel and copper are markers for blue and green tattoo inks.
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that is clinically defined by lesions ranging from painful, deep seated nodules to abscesses, draining sinus tracts, and ...ultimately, irreversible fibrotic scars. While the etiology remains unclear, a number of mechanisms ranging from genetics to aberrations of the immune system have been proposed. In addition, HS has a number of associations and may occur in conjunction with several diseases that span a host of medical specialties. The estimated prevalence ranges are from 1% to 4%; however, a large degree of under‐reporting and misdiagnosis of this condition likely underestimates its true clinical significance. The debilitating consequences of missed diagnoses or improper management leads to severe pain and irreversible cutaneous manifestations (i.e., fistulae, sinus tracts, disfiguring scarring). HS has been found to significantly impair patients’ quality of life to a greater degree when compared with other skin conditions. Early recognition and treatment are critical for a favorable prognosis, and diagnostic delays may be related to variable presentations within numerous comorbidities. Here we provide an in‐depth, clinical‐based review of HS, highlighting the clinical presentation, pathophysiology, grading systems, epidemiology, and comorbidities, in hopes of shedding light on an often misunderstood disease and ultimately moving closer to a more conclusive understanding of its various presentations and association.
Updates on disorders in curly hair Geisler, Amaris N; Taye, Marta; Larrondo, Jorge ...
International journal of dermatology,
04/2024
Journal Article
Recenzirano
Hair disorders, including central centrifugal cicatricial alopecia (CCCA), traction alopecia (TA), and acquired trichorrhexis nodosa (ATN), commonly occur in individuals with curly textured hair. ...Curly textured hair in individuals of African descent has unique properties and can present diagnostic and therapeutic challenges. CCCA has been linked to uterine leiomyoma and type 2 diabetes mellitus, as well as fibroproliferation. TA often presents with a fringe sign and can arise from high-tension hairstyles presumed to be protective. Trichoscopy is useful in establishing a diagnosis; perifollicular halos are more commonly seen than perifollicular erythema or scale in CCCA. In TA, miniaturized follicles, hair casts, and "flambeau sign" can be seen. Hairstyling practices likely contribute to TA and ATN; however, the data are mixed on the role of chemical relaxers and heat styling in CCCA. Unique considerations in the presentation of frontal fibrosing alopecia in curly textured hair have also been published recently. This review provides a comprehensive, up-to-date summary of these disorders with an emphasis on their unique properties, as well as considerations in hair care for curly textured hair.
Traction alopecia is prevalent in patients of color. Its significance in clinical practice may be underemphasized due to the transient nature of the condition; however, it has the potential to become ...permanent and cause significant psychosocial distress. Understanding of afro-textured hair and cultural practices, as well as early recognition and treatment, provides an opportunity to prevent permanent traction alopecia and long-term sequelae.
Background
Several bruise reduction methods have been suggested to decrease postprocedure ecchymoses. Comparing the effectiveness of common bruise reduction therapies provides better evidence of the ...efficacy of bruise reduction techniques.
Objective
To compare the effectiveness of cold compresses, hydrogen peroxide, over‐the‐counter bruise serum, and pulsed dye laser (PDL) in minimizing the time required for bruise resolution.
Methods
Seventeen patients aged 22 to 51 (mean 28) with Fitzpatrick skin types I to IV underwent bruise induction with a PDL to produce five 2‐ by 2‐cm zones of bruising on the lower abdomen. Excluding the control, bruises were randomly treated using a cold compress, bruise serum, 3% hydrogen peroxide–soaked gauze, or PDL. Subjects and two blinded physician evaluators evaluated bruise severity and graded it on a visual analog scale on days 0, 3, and 7.
Results
Treatment did not result in statistically significantly shorter bruise resolution time than in controls. PDL‐treated bruises took a statistically significantly longer time to resolve than controls.
Conclusion
Our study showed no significant difference in cold compress, hydrogen peroxide, and over‐the‐counter serum in reducing time to bruise resolution. PDL therapy resulted in greater bruise severity scores and increased time to bruise resolution when used soon after bruise induction.
Introduction: Lipedematous scalp (LS) is a rare condition characterized by thickened adipose tissue in the subcutaneous layer of the scalp resulting in a soft, spongy, or thick consistency of the ...scalp. When associated with hair loss, this condition is called lipedematous alopecia (LA). Various imaging modalities have been used to diagnose LS and LA along with histopathology. Case Presentation: We present 2 cases of LS: a 56-year-old female with a 1-year history of hair thinning, pain, and tenderness at the vertex scalp and a 60-year-old female with a 5-year history of lichen planopilaris presenting with a 1-year history of itching and soreness on the crown of her head. Ultrasound (US) was used for diagnosis, treatment response surveillance, routine clinical examination, and symptom assessment. Follow-up US revealed no improvement in scalp thickness in either case despite symptom improvement and visual improvement in hair growth. Discussion/Conclusion: US has been reported as a helpful tool in the diagnosis of LS; however, treatment response was better approximated by hair growth and symptom alleviation. We found that once the diagnosis with made with US, clinical monitoring is adequate as symptom improvement and hair growth may not correlate with a change in scalp thickness.
Background
Hidradenitis suppurativa (HS) is a debilitating chronic inflammatory skin condition that typically requires consistent care. Contributory factors to why patients with HS miss their clinic ...appointments have not been investigated.
Objectives
This article seeks to characterise reasons that HS patients do not keep their appointments and identify strategies to minimise no‐show rates and improve delivery of care to HS patients.
Methods
An anonymous survey was distributed to online HS support groups.
Results
Of the 254 respondents, 18.9% reported ever missing an appointment for HS. Common reasons for missing an appointment include: patient was experiencing an HS flare (72.9%), prior poor experience with a healthcare provider (54.2%) or healthcare staff member (37.5%), embarrassment of condition (41.7%), and distrust that the appointment would help with management of HS (39.6%). Respondents who were non‐White, who were disabled, or who had lower socioeconomic status were more likely to have missed an appointment (p < 0.05).
Conclusions
This study highlights areas where dermatologists may help improve appointment attendance, including encouraging patients to seek care during flares and striving to optimise the patient experience.
Alopecia is one of the most common reasons for a dermatology visit among Black patients. Patients with concomitant afro‐textured hair and scarring alopecias are often subjected to delays in diagnosis ...and treatment. Race‐discordant physicians may find the examination of scarring alopecias in ethnic hair to be daunting. Herein we present a standardized approach to evaluating the hair and scalp in afro‐textured alopecia patients in the hopes of providing a framework and guide for the proper clinical assessment of these patients. This guide focuses on common scarring alopecias specific to this ethnic population including traction alopecia, central centrifugal alopecia, frontal fibrosing alopecia and lichen planopilaris.
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