Faculty Bibliography

Pregnancy dermatoses are inflammatory skin disorders that occur during pregnancy or immediately postpartum. This heterogenous group of disorders includes pemphigoid gestationis, polymorphic eruption of pregnancy, intrahepatic cholestasis of pregnancy, atopic eruption of pregnancy, and pustular psoriasis of pregnancy. In this article, we provide a comprehensive literature review of each condition focusing on nomenclature, epidemiology, pathogenesis, clinical presentation, diagnosis, differential diagnosis, maternal risk, fetal risk, and treatment. We aim to increase awareness and help clinicians recognize, diagnose, and manage these unique conditions.

B-cell chronic lymphocytic leukemia (CLL) is the most prevalent leukemia in the United States, and its diagnosis can have many dermatologic implications. For one, the cutaneous manifestations of CLL include several entities, most notably leukemia cutis, eosinophilic dermatosis of hematologic malignancy, and a heightened risk of skin infections. Additionally, CLL patients are at an increased risk of secondary malignancies, most commonly of the skin. Furthermore, a number of commonly utilized treatments for CLL have cutaneous implications which should be considered in the interdisciplinary management of CLL patients. In this review, we will provide an update on the diverse cutaneous manifestations of CLL and CLL-directed therapies in order to help guide dermatologic management of this increasingly prevalent patient population.

Dental dams are a barrier method of protection, which may help prevent the spread of sexually transmitted infections during oral-vaginal or oral-anal sex. Despite their relative simplicity of use, data on dental dams are limited and patients infrequently utilize this method of barrier protection because of the lack of awareness, perceived barriers to procurement and accessibility, and unfamiliarity on the part of health educators. Nevertheless, increased knowledge of dental dams may be beneficial especially in high-risk populations, where sexually transmitted infections are more common and remain a significant cause for morbidity. This article aims to increase awareness and knowledge of dental dams, as well as provide an informational guide on their procurement and use that may be helpful to dermatologists when counseling patients.

As of January 2021, there are more than 3.8 million women in the United States with a history of breast cancer. The current standard of care for breast cancer involves surgical resection, radiation therapy, adjuvant endocrine therapy, and/or adjuvant chemotherapy. Aromatase inhibitors (AIs) are the gold standard for endocrine therapy in postmenopausal women. Dermatologic adverse events (dAEs) associated with AIs are rare but have been reported in the literature. Commonly reported dAEs include unspecified rash, pruritus, alopecia, vulvovaginal atrophy, vasculitis, and autoimmune/connective tissue disorders. Appropriate preventative strategies and careful management considerations have the potential to optimize the comprehensive care of patients with cancer and improve quality of life. Furthermore, prevention of dAEs can lead to a reduction in cancer treatment interruptions and discontinuations. Herein, we characterize dAEs of AIs and discuss preventative management to reduce the incidence of AI therapy interruption.

Background: Aromatase inhibitors (AIs) are the mainstay of adjuvant endocrine therapy in the management of estrogen receptor-positive breast cancer in postmenopausal women. Dermatology-related adverse events (AEs) (including the skin, hair, nails, and mucosal surfaces) associated with AIs are rare but have been reported in the literature. However, to date, no systematic reviews have been performed to analyze the characteristics of patients and types of dermatology-related AEs developed as a result of AI use.
Method(s): A comprehensive electronic literature research of published articles was conducted in the following databases: MEDLINE (Ovid), Scopus (Elsevier), Cochrane (Wiley), and Web of Science (Clarivate Analytics). Controlled vocabulary, MeSH, subject headings, and keywords were used with the search strategy. Two independent reviewers examined the titles and abstracts of all articles. The search identified 322 articles for title and abstract review. Review articles, other systematic reviews, and studies where AIs were used in combination with other treatments were excluded. Forty-nine articles met inclusion criteria.
Result(s): Our study analyzed AI usage in 5296 patients. The median age of patients on AI therapy was 64. The most commonly used AI was anastrozole (39%) followed by letrozole (36%) and exemestane (17%). Onset of dermatology-related AEs ranged from 2 days to 9 months. Commonly reported side effects included unspecified rash, pruritis, alopecia, vaginal dryness, dermatitis, and various autoimmune and connective tissue disease reactions.
Conclusion(s): While dermatology-related AEs are rare after AI use, our study shows that there may be a considerable proportion of patients experiencing dermatology-related AEs.
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Vulvar dermatology represents a challenge for many providers. Given that the vulva is both a gynecologic and dermatologic organ, patients with cutaneous lesions involving the vulva may present to primary care, gynecology, or dermatology. Particularly within dermatology, the vulva remains understudied, which can lead to anxiety among providers regarding appropriate next steps in the diagnosis and management of vulvar lesions. Thus, the purpose of this review is to highlight commonly encountered anatomic variants and benign neoplasms of the vulva, distinguish them from key pathologic mimickers, and provide guidance to practicing dermatologists on what may constitute normal vulvar variations.