January 2019 Editorial Message

Dear Colleagues: 

Welcome to the January 2019 issue of The Journal of Clinical and Aesthetic Dermatology. 

We begin the issue with a study titled, “Halobetasol 0.01%/Tazarotene 0.045% Fixed-combination Lotion in the Treatment of Plaque Psoriasis: Sensitization and Irritation Potential.” In this article, Del Rosso et al evaluated the results from two studies that assessed the potential for skin irritation (Study A) and contact sensitization (Study B) of halobetasol 0.01%/tazarotene 0.045% (HP/TAZ) lotion. HP/TAZ lotion and vehicle were studied in 244 healthy volunteers for the potential to induce contact skin sensitization. An additional 21-day cumulative irritation study was performed in 40 healthy volunteers to compare HP/TAZ lotion, vehicle, tazarotene 0.05% (Tazorac®; Allergan, Dublin, Ireland) cream, and positive/negative controls. There was no evidence of contact sensitization, and a low level of irritation in the induction phase. In addition, HP/TAZ lotion was significantly less irritating than tazarotene cream.

Next, we present a review from Bebe et al titled, “Role, Extent, and Impact of Comorbidity on Prognosis and Survival in Advanced Metastatic Melanoma: A Review.” Here, the authors review the impact of comorbidities on the prognosis and survival outcomes of patients diagnosed with advanced metastatic melanoma (AMM). While their search initially yielded limited results, the authors decided to expand their search to include breast, colorectal, and prostate cancer. The authors found that most studies show a higher prevalence of comorbidity in association with more advanced cancer stage. Both treatment and survival of patients were influenced by age and the extent of comorbidity. Racial differences in survival were greatest for patients with no comorbidities and less evident at higher levels of comorbidity. The authors ultimately assert that limited information in the literature demonstrates the need for more research with respect to comorbidities and AMM. 

After this, Comeau et al present a case report of a 71-year-old man with a long-standing history of rosacea who presented with severe rhinophyma. The authors ultimately chose to treat the patient’s condition with fractionated carbon dioxide laser resurfacing, which yielded impressive results, excellent tolerability, and minimal downtime.

Next, we present a case report by Duncanson et al, who discuss the case of 47-year-old woman who presented to the emergency department with a 9.7cm×8.3cm melanoma on her foot, which impeded her ability to walk. The patient had been treating the fungating mass with black salve after seeking treatment from a homeopathic physician. The authors discuss the predicament created by easily accessed websites that promote products for medical use that that have not undergone controlled trials or been approved by the FDA.  

Next, in a case series by Olvera-Cortés and Pulido-Díaz, the authors discuss three cases of Morbihan’s disease, a condition characterized by the presence of chronic and persistent edema of the periorbital tissue, forehead, glabella, nose, and cheeks that can eventually lead to fibrotic induration. While a defined therapeutic approach has yet to be established for the treatment of Morbihan’s disease, the authors recount successful treatment of these three patients with long-term isotretinoin.  

Following this, in a case report by Sampson and Lewis, the authors discuss a case of medication-associated paronychia involving multiple toenails in a patient undergoing hepatitis C (HCV) therapy with ledipasvir/sofosbuvir. The patient was treated conservatively with topical mupirocin, clobetasol ointment, and acetic acid soaks, resulting in symptom improvement. This topical regimen was maintainined throughout the remaining weeks of the patient’s antiviral course, with complete symptom resolution occurring only after completion of his ledipasvir/sofosbuvir treatment.

Finally, in a review by Udompanich and Vachiramon titled, “Acquired Macular Pigmentation of Unknown Etiology,” the authors compare the clinical and histological features of ashy dermatosis (AD), erythema dyschromicum perstans (EDP), lichen planus pigmentosus (LPP), and idiopathic eruptive macular pigmentation (IEMP). According to the authors, these conditions comprise what has been termed acquired macular pigmentation of unknown etiology. The authors describe symptoms, characteristics, and treatment methods of these conditions. 

We hope you enjoy this issue of JCAD, and as always we welcome your feedback and submissions. 

James Q. Del Rosso, DO, FAOCDEditor-in-Chief, Clinical Dermatology

Wm. Philip Werschler, MD, FAAD, FAACSEditor-in-Chief, Aesthetic Dermatology

Seemal R. Desai, MD, FAAD— Associate Editor