Hair loss in women of color represents a unique diagnostic challenge that requires a
systematic approach. In women of color, clinical examination of the hair and scalp is most
helpful when performed first and used to guide subsequent history-taking to arrive at a
clinical assessment. The most common hair problems in women of color are hair breakage,
traction alopecia, and central centrifugal cicatricial alopecia. A careful detailed clinical
examination and history will guide the clinician to appropriate counseling and management.
It is important to recognize that a patient may have more than one of these 3 diagnoses and
each requires separate attention. Traction alopecia is completely preventable with appropriate
education of the public and medical establishment.
Semin Cutan Med Surg 28:109-114 © 2009 Elsevier Inc. All rights reserved.
Melanoma is a highly aggressive skin cancer with an increasing incidence. Melanoma in situ is an early, non-invasive form in which the tumor is confined to the epidermis. Treatment of melanoma in situ is challenging due to the frequent subclinical microscopic spread and to the presentation on the head and neck in cosmetically sensitive areas with chronic sun damage. Optimizing tumor eradication is imperative to reduce the potential progression into invasive disease and metastasis, all while maintaining cosmesis. Multiple treatment regimens have been implemented for managing difficult melanoma in situ tumors. We provide a thorough review of surgical, and non-surgical, management of melanoma in situ which can pose therapeutic dilemmas due to size, anatomic location, and subclinical spread.
Semin Cutan Med Surg 29:258-263 © 2010 Elsevier Inc. All rights reserved.
Photodynamic therapy is a relatively new and rapidly evolving therapeutic option in dermatology.
Initially used for the treatment of actinic damage and nonmelanotic skin cancer,
more recent work indicates efficacy in the treatment of a wide range of conditions, such as
acne, infectious processes, cutaneous T-cell lymphoma, and photorejuvenation, among
others. This article provides a comprehensive review of applications and outcomes that use
topical photodynamic therapy in the treatment of dermatologic disease.
Semin Cutan Med Surg 27:52-62 © 2008 Elsevier Inc. All rights reserved.
The United States has become progressively more multicultural, with the ethnic population
growing at record rates. The US Census Bureau projects that, by the year 2056, greater
than 50% of the US population will be of non-Caucasian descent. Ethnic patients have
different cosmetic concerns and natural features that are unique. The cosmetic concerns of
ethnic patients also differ as the result of differences in skin pathophysiology, mechanisms
of aging, and unique anatomic structure. There is no longer a single standard of beauty. We
must now adapt to the more diverse population and understand how to accommodate the
diversity of beauty in the United States. Ethnic patients do not necessarily want a Westernized
look because what constitutes beauty is determined by racial, cultural, and environmental
influences. We as leaders in skin care must understand these differences and
adapt our practices accordingly. This article will focus on the differences in aging in
different ethnic populations and highlight procedures unique to skin of color.
Semin Cutan Med Surg 28:115-129 © 2009 Elsevier Inc. All rights reserved.
Fractional resurfacing is a new laser treatment modality that creates numerous microscopic
thermal injury zones of controlled width, depth, and density that are surrounded
by a reservoir of spared epidermal and dermal tissue, allowing for rapid repair of
laser-induced thermal injury. This unique modality, if implemented with proper laserdelivery
systems, enables high-energy treatments while minimizing risks. In this article,
we review the various fractional laser devices, including the new fractional ablative
devices, as well as the results of studies on the clinical efficacy of fractional photothermolysis.
This technology offers patients significant clinical improvement in photodamage,
melasma, and scarring with modest treatment-related downtime and minimal
risk of complications.
Semin Cutan Med Surg 27:63-71 © 2008 Elsevier Inc. All rights reserved.