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MALIGNANT MELANOMA

Less than 30% of melanoma develops from existing moles

ATOPIC DERMATITIS

Contact dermatitis is more likely to develop in patients with atopic dermatitis; an allergic or irritating contactant should be considered when acute weeping lesions are present.

LICHEN SIMPLEX CHRONICUS (CIRCUMSCRIBED NEURODERMATITIS)

Dupilumab is a new medication for generalized disease in lichen simplex chronicus or prurigo nodularis, its related condition.

PITYRIASIS ROSEA

Guttate and plaque psoriasis are important diagnostic considerations, and biopsy can help differentiate these from pityriasis rosea.

Oral acyclovir may improve the appearance of the rash.

SEBORRHEIC DERMATITIS

Seborrheic dermatitis is associated with inflammation due to Malassezia species.

CUTANEOUS LUPUS ERYTHEMATOSUS

Patients with cutaneous lupus erythematosus should be examined and tested annually (with a complete blood count and urinalysis) to screen for early signs of systemic involvement.

MISCELLANEOUS SCALING DERMATOSES

Fluorouracil cream is the most effective topical agent for field treatment of actinic keratosis. Imiquimod, ingenol mebutate, and photodynamic therapy are also effective.

CONTACT DERMATITIS

Some allergens will transmit through latex gloves.

ACNE VULGARIS

It may take 3 months or more for truncal acne to resolve with oral antibiotic treatment.

Side effects from isotretinoin that are almost universal are cheilitis, dry skin, and photosensitivity.

ROSACEA

Most treatments target the papulopustular and cystic components. Only certain topical medications (brimonidine and oxymetazoline) and laser benefit erythema, with laser treatment having longer term benefit.

REACTIVE ERYTHEMAS

Ligelizumab is effective for chronic urticaria in early clinical trials.

Etanercept is emerging as a promising therapy for Stevens- Johnson syndrome/toxic epidermal necrolysis and is now the treatment of choice in some centers.

PIGMENTARY DISORDERS

Topical or systemic JAK inhibitors (tofacitinib, ruxolitinib) may be effective in some patients with recalcitrant vitiligo, although response to therapy is not the rule.

ALOPECIA

Platelet rich plasma is an emerging therapy in androgenetic alopecia in women.

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