Patients are often sent for patch testing to rule out allergic contact dermatitis, but it is a clinical conundrum of what to do when they are on systemic agents. The clinical question is, should the systemic agents be held for 4-5 half-lives and then patch tested to ensure there is no blunting of the immune system? The reality is that in this population without systemic treatments, patients are seldom clear enough to patch test. Their backs are covered in dermatitis and testing runs the risk of eliciting an uninterpretable “angry back”. The other consideration is patients’ strong preference to ..read more

Dermatologists routinely treat acne with the objective of preventing acne scarring. Once control of acne has been achieved, our patients are often keen to improve textural skin changes such as atrophic acne scars. We often equate the management of atrophic acne scars with the need to reach for high-tech devices such as resurfacing lasers or radiofrequency-microneedling. While these modalities can play a pivotal role in resurfacing the skin, low-tech treatments can also be used in monotherapy or combination treatment to improve specific types of acne scars. In this article, we discuss the CROSS ..read more

The 49th annual Society of Pediatric Dermatology (SPD) meeting was a tremendous success, attracting over 650 attendees, the highest number ever recorded. The 3-day conference featured a wide range of new developments and tips and tricks from experts in the field.   ..read more

Dermatologists play a vital role in the early detection, prevention and effective management of skin cancer in patients with a prior history of the disease. Regular monitoring and timely interventions greatly enhance the overall prognosis and quality of life for patients with skin cancer. Dermatologists possess the requisite expertise to accurately diagnose and oversee the management of cutaneous skin cancers.  Skin cancer screening via total body skin exam (TBSE) is often considered one of the safest, easiest, and most cost-effective tests in medicine. Despite dermatologists’ ability to ..read more

Neurofibromatosis type 1 (NF1) is an autosomal dominant tumour suppressor syndrome associated with benign and malignant tumours, predominantly affecting the skin and nervous system. NF1, the most prevalent neurocutaneous syndrome, and the focus of this review, has a frequency of ~ 1/1,900-1/3,500 people worldwide. Disease manifestations can present at birth and emerge with age, negatively impacting multiple clinical domains and imparting a profound impact on a patient’s quality of life and life expectancy. Given its progressive nature and marked clinical variability, NF1 warrants a multidiscip ..read more

The use of biosimilars is becoming standard practice for Canadian dermatologists. However, most of these clinicians most likely graduated prior to their adoption of biosimilars and, as a result, are likely to have minimal to no experience with biosimilars. Considering this limited prior experience, it can be challenging to gain a full understanding of how one biosimilar differentiates from another. The objective of this paper is to educate clinicians so that they are well‑informed on how to select the appropriate biosimilar for the patient at hand. This literature review and summary will revie ..read more

Hand eczema is an inflammatory skin disease that often has a chronic course. Chronic hand eczema (CHE) is defined as eczema on the hands with a disease duration of longer than three months or two or more relapses per year. During the COVID-19 pandemic, hand eczema gained attention due to the increased risk of developing particularly irritant contact dermatitis in the context of a change in hand hygiene habits and frequency of hand washing. This has once more highlighted how important skin protection continues to be for prevention of the disease. Beyond this, new and updated guidelines are avai ..read more

Oral lichen planus (OLP) is an inflammatory disorder of the oral mucosa with a prevalence of 0.5% to 2.2% among adults. Disease onset tends to occur between the ages of 30 to 60 years and is observed more frequently among females than males. In contrast to the cutaneous lesions of lichen planus, OLP is often chronic and patients are plagued with relapses and remissions. OLP also often causes substantial morbidity, as it is considered to be a precancerous lesion owing to its associations with oral squamous cell carcinoma. Rates at which OLP undergoes malignant transformation ..read more

Keloids are fibroproliferative growths resulting from dysregulated healing following tissue injury with the subsequent deposition of excessive and disorganized collagen (Figure 1). Prolonged chronic inflammation in the reticular dermis in particular during healing, is thought to precede the development of keloids. Experimental studies have demonstrated an increased release of growth factors, cytokines, and multiple immune cells. The inflammatory cells secrete factors implicated in chronic inflammation, fibrosis and itch, among many others.  Keloids demonstrate an autosomal domin ..read more

Androgenetic alopecia (AGA) is a commondermatologic condition that can cause a significant amount of distress for some patients. Dihydrotestosterone (DHT), an endogenous hormone, plays a major role in this form of hair loss, causing scalp hairs to undergo miniaturization and reducing the amount of time they spend in the anagen growth phase. Dutasteride is one of several treatment options for AGA. It works by inhibiting 5-α reductase (5-aR) types I and II, ultimately reducing the levels of DHT in the scalp. This can be contrasted to another 5-aR inhibitor, finasteride, which only inhibits the 5 ..read more