Lack of an association between alopecia areata and visceral or hematopoietic cancers

To the Editor: Alopecia areata (AA) is a polygenic, patchy nonscarring hair loss that presents on the scalp and body that drastically affects patients' quality of life.1 The pathogenesis of AA remains elusive, though T-lymphocyte–mediated inflammation and various environmental stressors play a role. The association between AA and various autoimmune diseases has been explored in several studies.1 Recently, studies found lower rates of nonmelanoma skin cancers and a trend toward decreased melanoma among AA patients.

http://ift.tt/2ycgNXc

Recurrence of genital aphthosis in girls: A retrospective analysis

To the Editor: Genital aphthosis in girls is a rare, underrecognized condition characterized by genital ulceration after an acute systemic illness.1,2 The aphthae often are associated with severe dysuria and emotional distress in this young, adolescent population. We sought to identify disease recurrence by reviewing clinical records from January 1997 through August 2015. Institutional review board approval was obtained (IRB# 15-008638, December 2015).

http://ift.tt/2wNkqSg

Prevalence of pediatric alopecia areata among 572,617 dermatology patients

To the Editor: The authors initiated this retrospective analysis to evaluate the prevalence, age, and sex of pediatric patients with alopecia areata (AA) and the impact that pediatric AA has on a typical dermatology practice. Billing data from Leavitt Medical Associates of Florida, doing business under the name Advanced Dermatology and Cosmetic Surgery, was collected from offices throughout Florida and Ohio, and 572,617 dermatology patients were identified. The study population included 71,951 pediatric patients (1-17 years of age): 33,800 boys and 37,791 girls.

http://ift.tt/2ycwpdA

Spectrum of orocutaneous disease associations

The oral cavity and cutaneous organ systems share a close embryologic origin. Therefore, there are numerous dermatologic conditions presenting with concomitant oral findings of which the dermatologist must be aware. The second article in this continuing medical education series reviews inflammatory orocutaneous conditions and a number of genodermatoses. It is essential for dermatologists to be familiar with oral cavity manifestations associated with dermatologic diseases for prompt diagnosis, management, and appropriate referral to stomatology and dentistry.

http://ift.tt/2wMV5Yi

Onychophagia and onychotillomania can be effectively managed

To the Editor: We greatly appreciate the commentary by Lipner and Scher.1 We agree that our patients would benefit from prompt treatment to reduce shame and prevent irreversible nail damage. Herein, we present our clinical pearls using pharmacotherapy, stimulus control, habit-reversal training (HRT), and cognitive behavioral and aversion therapy. We often combine psychotherapies such as HRT and stimulus control. Six or more sessions are typically required. We have treated several cases of onychophagia and onychotillomania with N-acetylcysteine 1200-2400 mg/day.

http://ift.tt/2ybJvro

October iotaderma (#284)

http://ift.tt/2wNkem0

Comment on “Psychocutaneous disease: Clinical perspectives”

To the Editor: Kuhn et al1 are to be commended for writing this informative review on psychocutaneous disease. In this manuscript, they delineate common psychiatric conditions with skin manifestations including delusional, factitious, obsessive-compulsive, and eating disorders; psychogenic pruritus; cutaneous sensory (pain) syndromes; posttraumatic stress disorder; and sleep-wake disorders. They appropriately describe the important role fingernails play in removing organisms during delusional infestations and describe patients with factitious skin disorder creating well-demarcated geometric erosions.

http://ift.tt/2yb9kaY