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Clinical decision-making bias in darker skin types: a prospective survey study identifying diagnostic bias in decision to biopsy [Letter]

Krueger, Loren; Hijab, Eman; Latkowski, Jo-Ann; Elbuluk, Nada
PMID: 35388461
ISSN: 1365-4632
CID: 5232762

Seborrheic macular hypopigmentation: a case series proposing a new pigmentary disorder [Letter]

Krueger, L; Saizan, A L; Meehan, S A; Ezzedine, K; Hamzavi, I; Elbuluk, N
PMID: 34927764
ISSN: 1468-3083
CID: 5108712

Dermoscopy of acquired pigmentary disorders: a comprehensive review

Krueger, Loren; Saizan, Autumn; Stein, Jennifer A; Elbuluk, Nada
Dermoscopy has traditionally been used for the diagnosis of neoplasms and more recently in the evaluation of inflammatory conditions. Recent observational studies have suggested a role for dermoscopy in identifying and differentiating acquired pigmentary disorders. This comprehensive review will summarize the growing literature on the use of dermoscopy for pigmentary disorders. A literature review was performed on PubMed dating from inception to October 2020. The following pigmentary disorders were included in this study: melasma, solar lentigines, poikiloderma of Civatte, exogenous ochronosis, lichen planus pigmentosus, erythromelanosis follicularis faciei et colli, pigmented contact dermatitis, Riehl's melanosis, postinflammatory hyperpigmentation, erythema dyschromicum perstans, ashy dermatosis, confluent and reticulated papillomatosis, acanthosis nigricans, pityriasis versicolor, tinea versicolor, idiopathic guttate hypomelanosis, and vitiligo. Search terms used included each pigmentary disorder along with the terms "dermoscopy" or "dermatoscopy." Relevant case reports and case series were included. Many pigmentary disorders have unique and distinguishable features on dermoscopy. Given that these disorders can be clinically challenging for clinicians and emotionally distressing for patients, dermoscopy provides an additional, useful tool in the evaluation and assessment process.
PMID: 34235719
ISSN: 1365-4632
CID: 4933372

A quantitative analysis of research publications focused on the top chief complaints in skin of color patients

Montgomery, Simone N; Elbuluk, Nada
PMID: 32800869
ISSN: 1097-6787
CID: 4566412

A Multi-Centered Case-Control Study of Vitiligo Support Groups and Quality of Life

Smith, Zoë I; Wang, Jason F; Elbuluk, Nada; Huggins, Richard H; Birnbaum, Mathew R; Rzepecki, Alexandra; Bhatia, Bhavnit K; Kratschmer, Christina; McLellan, Beth; Kutner, Allison
BACKGROUND:There is limited research on the association between vitiligo support group membership and patient quality of life (QoL). OBJECTIVES/OBJECTIVE:To explore the association between support groups and QoL in those with vitiligo by evaluating and comparing the QoL of vitiligo support group members and non-support group members. METHODS:Support group members (n=135) and non-support group members (n=129) were recruited from the Global Vitiligo Foundation (GVF), and three academic medical centers respectively. Patients completed the Vitiligo-Specific Quality of Life (VitiQoL) instrument and a demographic survey. RESULTS:Mean VitiQoL scores for support group members were higher than non-support group members (48.6 ± 23.6 vs 33.0 ± 23.8; P-value < 0.0001), highlighting more negatively impacted QoL. Support group members were less likely to be undergoing treatment (27.4% vs 53.5%; P-value = <0.0001) and were more likely to report duration of vitiligo for >20 years (38.5% vs 19.4%; P-value = 0.0007). CONCLUSIONS:Vitiligo support group membership is associated with worse QoL. Individuals with vitiligo who have worse QoL, chronic, and/or untreated vitiligo may be more likely to seek out vitiligo support groups. Support group referral should be considered in the therapeutic management of vitiligo, particularly in patients whose QoL is more significantly impacted, who fail or are who are without access to treatment or have longstanding disease. J Drugs Dermatol. 2021;20(6):672-675. doi:10.36849/JDD.5706.
PMID: 34076392
ISSN: 1545-9616
CID: 4891582

Long term safety, tolerability, and efficacy of intracutaneous zolmitriptan (M207) in the acute treatment of migraine

Nahas, Stephanie J; Hindiyeh, Nada; Friedman, Deborah I; Elbuluk, Nada; Kellerman, Donald J; Foreman, Pamela K; Schmidt, Peter
OBJECTIVE:To determine the long-term safety and tolerability profile of M207 in the acute treatment of migraine. BACKGROUND:M207 is an investigational microneedle-based system for intracutaneous delivery of zolmitriptan for the treatment of migraine attacks. Following on the positive results of a Phase 2/3 placebo-controlled efficacy study (ZOTRIP), this study was designed to evaluate the safety of this novel product during repeated use for the treatment of migraine attacks. METHODS:In this 6-12 month open-label, multicenter observational study, participants used an eDiary to record headache symptoms and adverse events at specified intervals up to 48 h following treatment of a qualifying attack with M207 3.8 mg (intracutaneous zolmitriptan). Participants underwent clinical evaluations at specified intervals up to 12 months. RESULTS:Among 335 participants who treated ≥1 migraine attack, 257 completed 6 months and 127 completed 1 year of treatment. The most common reason for withdrawal from the study was a low frequency of reported attacks post randomization. Overall, 5963 migraine attacks were treated. Most participants (96%) experienced at least 1 adverse event, the vast majority of which concerned the application site, and > 95% of which were mild. Fifteen participants (4%) withdrew due to adverse events; 4 withdrew due to 7 application site reactions, 6 of which were mild. Participants achieved pain freedom in 2477/5617 (44%) of attacks, most bothersome symptom freedom in 3315/5330 (62%) of attacks, and pain relief 2 h post-dose in 4552/5617 (81%) of attacks. Sustained pain freedom 2-24 h was seen in 1761/4698 (38%) of attacks, and 2-48 h in 1534/4429 (35%) of attacks. CONCLUSIONS:The majority of participants experienced cutaneous adverse reactions such as application site erythema, swelling, and bleeding, and most reactions were scored as mild. These results are consistent with what was observed in the single migraine attack treatment ZOTRIP trial indicating that M207 is well tolerated in the setting of longer-term repeated use. Efficacy findings were also similar to those in the ZOTRIP trial. TRIAL REGISTRATION/BACKGROUND:Clinicaltrials.gov on September 13, 2017 ( NCT03282227 ).
PMCID:8127195
PMID: 34001002
ISSN: 1129-2377
CID: 4876802

A diverse nation calls for a diverse healthcare force

Saizan, Autumn L; Douglas, Annyella; Elbuluk, Nada; Taylor, Susan
PMCID:8102711
PMID: 33997735
ISSN: 2589-5370
CID: 4876612

Direct-to-consumer dermatology-related advertising differs in magazines targeted to women of color: A cross-sectional analysis of top-circulating consumer magazines

Wiznia, Lauren E; Wang, Jenny; Steuer, Alexa B; Elbuluk, Nada
Background/UNASSIGNED:Advertisements for dermatology-related products in consumer magazines serve as a potential source of health literacy, which varies by demographic group. Objective/UNASSIGNED:This study sought to examine differences in advertisements for dermatology-related products in the top U.S. consumer magazines targeted at women of color compared with three other demographic groups: teenagers, adult women, and adult men. Methods/UNASSIGNED:Dermatology advertisements in the most circulated U.S. consumer magazines targeting these four demographic groups were analyzed. Descriptive statistics were obtained. Simple logistic regressions were used to compare the product indications, language used, and the sex, age, ethnicity, and skin type of models between magazine categories. Limitations of this study included that certain magazines could not be included due to a lack of accessibility, and subjective assessments were made when necessary because not all data collected were explicitly stated. Results/UNASSIGNED:Significant differences exist in print media advertising for women of color in comparison with other demographic groups, including skin-of-color magazines having an increased number of darker-skin models, more advertisements related to products that target pigmentation, and differences in advertisement word choices. Conclusion/UNASSIGNED:The differences in print media advertising for women of color in comparison with other demographic groups may influence the dermatologic concerns of this population, including their dermatology-related knowledge base, grooming practices, beauty perceptions, and utilization of dermatology as a specialty.
PMCID:8072494
PMID: 33937491
ISSN: 2352-6475
CID: 4865932

The digital divide: how Covid-19's telemedicine expansion could exacerbate disparities [Letter]

Bakhtiar, Mina; Elbuluk, Nada; Lipoff, Jules B
PMCID:7365110
PMID: 32682890
ISSN: 1097-6787
CID: 4531842

Vitiligo and Melanoma-Associated Vitiligo: Understanding Their Similarities and Differences

Cohen, Brandon E; Manga, Prashiela; Lin, Krysta; Elbuluk, Nada
BACKGROUND:There has been a significant increase in the number and efficacy of therapies for advanced melanoma. Immunotherapies, such as anti-cytotoxic T-lymphocyte antigen-4 and programmed cell death-1 inhibitors, have improved the prognosis for patients with advanced melanoma. While spontaneous melanoma-associated vitiligo is a known phenomenon, the occurrence of melanoma-associated vitiligo following melanoma therapy is now recognized to associate with favorable outcomes. OBJECTIVE:The objective of this article is to provide a comprehensive literature review of melanoma-associated vitiligo and explore the insights these findings provide about the pathobiology of vitiligo and mechanisms underlying melanoma therapies. METHODS:PubMed and Science Direct databases were searched for studies pertaining to melanoma-associated vitiligo. The 36 studies reviewed included meta-analyses (n = 2), prospective cohort studies (n = 4), prospective observational studies (n = 3), retrospective studies (n = 12), case series (n = 2), and case reports (n = 13). RESULTS:The basic mechanisms underlying melanoma-associated vitiligo and vitiligo may be shared. Characterization of these mechanisms will identify new biomarkers and therapeutic targets for both melanoma and vitiligo. CONCLUSIONS:Co-opting the immune system to target tumor antigens highlights the potential overlap between anti-tumor immunity and autoimmunity. The development of vitiligo-like depigmentation in association with immunotherapy for melanoma may provide insights into both the immune response against melanoma as well as the pathogenesis of vitiligo.
PMID: 32468356
ISSN: 1179-1888
CID: 4451972