A sticky mess-Are moisturizers overused in dermatitis care?

Microbial dysbiosis is increasingly understood to influence allergic sensitization and skin barrier defects in dermatitis. Occlusion, such as from moisturizers, fosters microbial dysbiosis, and increases itch in many patients with dermatitis. Nevertheless, use of moisturizers in dermatitis remains part of dermatologic guidelines.

Psychological Distress in the Era of Psychological Safety.

There has been a growing disconnect between learners and educators within medical education. As the landscape of medical education has been altered post-pandemic and cultural shifts favor "safe spaces," we sought to explore the tension that exists between a sense of safety and the discomfort inherent within the learning process. Through separate focus groups conducted with trainees and faculty, a common theme emerged: a sense of vulnerability.

Is Food-Triggered Atopic Dermatitis a Form of Systemic Contact Dermatitis?

Food allergy in atopic dermatitis is mediated by complex immune interactions between genetics, diet, environment, and the microbiome. When contact between inflamed skin and food antigens occurs, contact hypersensitivity can develop. Consequently, systemic contact dermatitis (SCD) can occur after ingestion of allergenic foods or food additives in the setting of a Th2 response with CLA-positive T cells, triggering dermatitis where skin resident memory lymphocytes reside.

Stasis Dermatitis: An Overview of Its Clinical Presentation, Pathogenesis, and Management.

Stasis dermatitis is a chronic inflammatory skin disease of the lower extremities. It typically occurs in older individuals and is the cutaneous manifestation of venous hypertension caused by venous reflux. Such retrograde venous blood flow is the result of incompetent venous valves, valve destruction, or venous obstruction.

Cutaneous dysbiosis may amplify barrier dysfunction in patients with atopic dermatitis.

Atopic dermatitis (AD) is associated with cutaneous dysbiosis, barrier defects, and immune dysregulation, but the interplay between these factors needs further study. Early-onset barrier dysfunction may facilitate an innate immune response to commensal organisms and, consequently, the development of allergic sensitization. We aimed to compare the cutaneous microbiome in patients with active dermatitis with and without a history of childhood flexural dermatitis (atopic dermatitis).

Design and implementation of a health systems science curriculum at a large teaching hospital.

Background: Physicians must increasingly lead change for improvement in the value of health care for individuals and populations. Leadership, stewardship, and population health competencies are not explicitly part of the Accreditation Council for Graduate Medical Education (ACGME) requirements and are best appreciated in the context of Health Systems Science (HSS). HSS education is best approached at the institutional level, yet almost all graduate medical education (GME) curriculum is at the program level.

Art of prevention: Allergic sensitization through damaged skin: Atopic, occupational, and stasis dermatitis.

The prevention of allergic contact dermatitis hinges on maintaining the integrity of the skin barrier and responding appropriately when it is disturbed. Although intact skin is subject to sensitization via highly irritating allergens, such as poison ivy, acutely inflamed and chronically inflamed skin is subject to sensitization to allergens without inherent irritant potential. In the chronically inflamed state of atopic dermatitis, sensitization to proteins, such as food, also carries a risk for systemic contact dermatitis via ingestion of the allergen.

American Contact Dermatitis Society Core Allergen Series: 2020 Update.

The American Contact Dermatitis Society Core Allergen series was introduced in 2013 and updated in 2017. Changes in our recommended allergens are again necessary, taking into account data from the American Contact Dermatitis Society's Contact Allergen Management Program top 100 allergens from 2018. For the updated series, we removed methyldibromoglutaronitrile and added new haptens: Lyral, Limonene, Linalool, carmine, benzyl salicylate, disperse yellow 3, jasmine, peppermint, pramoxine, shellac, and lauryl polyglucose (glucosides).

Allergic Contact Sensitization in Healthy Skin Differs from Sensitization in Chronic Dermatitis: Atopic, Occupational Wet Work, and Stasis Dermatitis.

The duration of cutaneous inflammation preceding sensitization influences the resulting allergic response; the innate immune system instructs the adaptive immune response. Potent allergens that function as their own irritant cause classic T helper cell type 1 skewed dermatitis. Examples include poison ivy, epoxy resin, and methylchloroisothiazolinone.

Clinical Psoriasiform Dermatitis Following Dupilumab Use for Autoeczematization Secondary to Chronic Stasis Dermatitis.

T helper 2 (Th2) and T helper 1 (Th1) mediated immune processes lie on a spectrum. Autoeczematization secondary to chronic stasis dermatitis may fall on the Th2 side of the spectrum due to skin stretch and chronic barrier dysfunction, supporting a primary Th2 response to self-antigen. In our patient, we posited that dupilumab would benefit autoeczematization secondary to chronic stasis dermatitis given its efficacy in atopic dermatitis, a Th2-mediated immune process.

Relative Prevalence of Contact Allergens in North America in 2018.

Background: The American Contact Dermatitis Society Contact Allergen Management Program (CAMP) database was developed to provide patients with safe alternative products free of selected contact allergens. However, the CAMP database also records valuable information including the frequency of contact allergen searches for patients.

Objectives: The aim of the study was to determine the relative prevalence of contact allergens in North America.

Atopy patch tests may identify patients at risk for systemic contact dermatitis.

Background: A subset of patients with positive patch tests demonstrates systemic contact dermatitis (SCD) upon ingestion or inhalation of the allergen. Concern has been raised about the use of patch tests for protein allergens (APTs) to detect SCD in atopic dermatitis (AD) patients.

Methods: We present atopy patch test (APT) data for 97 people.

Scalp Dermatitis in Patients Sensitized to Components of Hair Products.

Background: Allergic contact dermatitis is an inflammatory condition that less commonly presents with scalp involvement. Recently, T regulatory cells have been documented to be residents of hair follicles, illuminating why contact allergens are less likely to elicit dermatitis in the scalp.

Objective: The aims of the study were to determine the prevalence of scalp symptoms, with and without other affected areas, in patients presenting for evaluation of allergic contact dermatitis and to determine the allergens most likely to be associated with scalp dermatitis.

Alternatives for Allergens in the 2018 American Contact Dermatitis Society Core Series: Report by the American Contact Alternatives Group.

The most successful treatment for contact allergy is allergen avoidance. Patient improvement ultimately relies on identification of safe alternative products, which can be used by the patient. "Safe" personal care product options can typically be found using ingredient database programs.