Aristizabal, Miguel

ABSTRACT Background Plasma cell mucositis (PCM) is a rare, chronic inflammatory condition of mucosal surfaces that is likely underdiagnosed and underreported, with limited data on its clinical characteristics, extracavitary involvement, and treatment outcomes. Objectives To characterize the clinical presentation, comorbidities, and treatment patterns of PCM in a cohort of patients from a tertiary care center. Methods We conducted a retrospective cohort study of histopathologically confirmed PCM cases diagnosed at a tertiary care center between 2004 and 2024. Cases were identified based on clinicopathologic correlation demonstrating a polyclonal plasma cell–rich infiltrate. Demographic data, clinical features, comorbidities, laboratory findings, and treatment outcomes were collected and analyzed descriptively. Results Ten patients were included, of whom 7 (70%) were aged ≥ 50 years and 6 (60%) were male. Genital involvement was observed in 6 patients (60%), whereas oral involvement occurred in 4 (40%). Symptom duration exceeded 2 years in 6 patients (60%). Concurrent malignancies were identified in 4 patients (40%), and autoimmune conditions in 2 (20%). Treatment responses were heterogeneous; topical corticosteroids were the most consistently effective therapy, while systemic immunosuppressive agents were required in 3 patients (30%) with variable outcomes. Patch testing identified contact allergens in 2 patients, with improvement following allergen avoidance. Conclusions PCM is a rare and often chronic condition with heterogeneous clinical manifestations and variable therapeutic responses. Genital involvement may be more common than previously recognized. Management remains challenging, highlighting the need for improved understanding of disease pathogenesis and development of more effective treatment strategies.

Abstract: Background: Extended patch testing beyond the standard series is commonly performed in patients with allergic contact dermatitis. This broader testing allows for more precise and complete allergen identification, ultimately leading to improved clinical outcomes. Objective: To report the Mayo Clinic Contact Dermatitis Group (MCCDG) patch testing results using a custom extended series from 2010 to 2023. Methods: A retrospective review of patch testing results using the MCCDG extended standard series at the Mayo Clinic was conducted. Data from 2010 to 2023 were analyzed. Results: Patch testing with the extended standard series was performed in 3,767 unique patients, with a total of 3834 extended standard patch tests administered (81.8% in women, 18.2% in men). The top 5 allergens eliciting positive reactions were gold (I) sodium thiosulfate (10.4%), benzisothiazolinone (10.4%), carmine (9.4%), thimerosal (9.3%), and hydroperoxides of linalool (8.8%). Conclusions: The extended standard series expands the diagnostic scope for patients in whom the standard series incompletely identifies relevant allergens. Preservatives and fragrances remain among the most common sensitizers, emphasizing the need for ongoing allergen surveillance, periodic review, and updates to patch test series to enhance diagnostic accuracy and patient care.

ABSTRACTBackgroundCellulite is a localized skin condition that affects many women, particularly after puberty. It results from a complex interplay of several factors that lead to the characteristic dimpled appearance of the skin. Cellulite may cause psychological stress and negatively impact quality of life. Additionally, body skin laxity may further exacerbate cosmetic concerns in these patients. Consequently, multiple therapeutic options, including topical treatments, have been explored to address both cellulite and skin laxity.ObjectivesTo review the pathophysiology of cellulite and skin laxity, as well as topical skincare options for their management.MethodsA literature search from 2000 to 2024 was conducted using the databases PubMed, EBSCOhost, Scopus, and Google Scholar, with the key terms “cellulite,” “cellulite management,” “cellulite topical treatment,” “skin sagging,” “skin laxity,” and “loose skin.” The search included clinical trials, observational studies, book chapters, and review articles in English and Spanish.ResultsThe pathophysiologic mechanisms underlying cellulite involve a combination of histological, hormonal, genetic, and lifestyle factors. Several topical agents, including retinoids and methylxanthines, have shown potential in improving the cosmetic appearance of cellulite and may contribute to localized fat reduction. Emerging botanical extracts hold promise as topical treatments for cellulite and skin tightening.ConclusionsCellulite and skin laxity are prevalent cosmetic concerns with multifactorial and complex pathophysiologic origins. Topical treatments for cellulite and skin tightening require further investigation. Although some studies have demonstrated positive outcomes with skincare products and topicals, robust evidence and studies with extended follow‐up are still lacking. Additional research is necessary to evaluate the long‐term efficacy of topical treatments as standalone therapies for cellulite and skin tightening.

Abstract Background Dermatological health-related quality of life (HRQoL) among solid organ transplant recipients (SOTRs) may be adversely affected by various factors, including skin cancer. However, there has been limited assessment of dermatological HRQoL in SOTRs. This study aimed to evaluate the impact of skin cancer on quality of life (QoL) in SOTRs and to compare HRQoL measures between SOTRs with and without skin cancer. Methods This cross-sectional study was conducted at the Mayo Clinic Florida from June 2023 to March 2024. Adult patients who underwent solid organ transplantation between June 1995 and December 2023 were assessed using the Dermatology Life Quality Index (DLQI) and Skindex-29 questionnaires. For SOTRs with keratinocyte carcinoma (KC), the Basal and Squamous Cell Carcinoma Quality of Life (BaSQoL) questionnaire was also administered. Results A total of 150 adult SOTRs were included, with 82 having developed post-transplant skin cancer, including melanoma and keratinocyte carcinomas (KC). SOTRs with skin cancer were older at first transplant (Median: 61.8 vs. 57.3 years, P = 0.0073) and had a higher proportion of males (76.8% vs. 55.9%, P = 0.0086). Fitzpatrick skin type III-VI was less prevalent (8.5% vs. 38.2%, P < 0.0001). The frequency of SCC and BCC was 92.7% and 41.5%, respectively. DLQI scores were higher in SOTRs with skin cancer, however, the difference was not statistically significant (P ≥ 0.065). SOTRs with skin cancer had higher total Skindex-29 scores (P = 0.012) and “emotion” subscale scores (P = 0.0049), indicating a negative impact on QoL. BaSQoL scores showed a moderate negative effect on QoL, with a higher number of KCs correlating with lower QoL (P < 0.05). Female gender had higher DLQI total score (P = 0.0042) and BaSQoL diagnosis and treatment (P = 0.031). Conclusions: SOTRs with skin cancer exhibited lower overall QoL, with a greater number of skin cancers linked to more pronounced negative impacts on QoL across all assessment instruments. Female gender was also associated with lower QoL scores. Recognizing the potential for reduced QoL in SOTRs is essential for developing tailored management strategies to support this population.

BACKGROUND While there has been improved gender representation in dermatology, there remains areas for improvement, especially in leadership positions. Studies have evaluated diversity in various dermatology subspecialties, but evaluation of gender diversity in cosmetic dermatology is lacking. OBJECTIVE To evaluate the temporal trends in gender diversity within the American Society for Dermatologic Surgery (ASDS) Cosmetic Dermatologic Surgery Fellowship Programs from 2013 to 2022. To discuss strategies for improvement. MATERIALS AND METHODS The ASDS Cosmetic Dermatologic Surgery Fellowship program directors and fellows were reviewed from 2013 to 2022. Gender was determined through online professional websites and biographies. The number and proportion of each gender was determined for each year, and the change over time was calculated. RESULTS The number of fellowship positions and program directors has increased from 2013 to 2022. Most of the fellows have been women. The average yearly rate of change for fellows is +1.67 and +0.67 for men and women. Most of the fellowship directors have been men. The average yearly rate of change is +1.56 and +0.44 for men and women. CONCLUSION Gender inequalities remain across leadership positions and further studies are necessary to better determine why these discrepancies exist and how to improve this inequality.

Abstract: Background: Allergic contact dermatitis is a common, pruritic, debilitating skin disease, affecting at least 20% of the population. Objective: To prospectively validate a computer vision algorithm across all Fitzpatrick skin types. Methods: Each participant was exposed to 10 allergens. The reference criterion was obtained 5 days after initial patch placement by a board-certified dermatologist. The algorithm processed photographs of the test site obtained on Day 5. Human performance in reading the photographs was also evaluated. Results: A total of 206 evaluable participants [mean age 39 years, 66% (136/206) female, and 47% with Fitzpatrick skin types IV–VI] completed testing. Forty-two percent (87/206) of participants experienced 1 or more allergic reaction resulting in a total of 132 allergic reactions. The model provided high discrimination (AUROC 0.86, 95% CI: 0.82–0.90) and specificity (93%, 95% CI: 92%–94%) but with lower sensitivity (58%, 95% CI: 49%–67%). Human performance interpreting the photographs ranged from providing similar performance to the algorithm to providing superior performance when combined across readers. There were no serious adverse events. Conclusions: The combination of a smartphone capture of patch testing sites with deep learning yielded high discrimination across a diverse sample.