Monthly Archives: October 2015

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New exciting advance in Melanoma Treatment


The Food and Drug Administration has just approved a new drug (T-VEC) that uses a safe herpes virus in association with an immunologic attack on the malignant melanoma metastases. This is the first time  a combination of an “Oncolytic” (cancer melting) agent, in this case a modified virus and an immunologic substance (Granulocyte- Macrophage Colony Stimulating Factor) has been used.
In fact, the immunologic agent is secreted by the same virus that melts the tumor.
The drug is administered by injection directly into the skin metastases which gradually disappear. Remarkably, it has shown to also melt  internal metastases. The survival rate in cases of metastatic melanoma treated with this agent alone, is 54% at one year and 52% at 2 years.

SOURCE: U.S. Food and Drug Administration, news release, Oct. 27, 2015

3 post-Halloween dermatology woes and how to treat them

By Lisette Hilton – Dermatology Times
 The ghosts, ghouls and goblins might be gone, but the skin problems from costumes, makeup and accessories will likely fuel post-Halloween visits to dermatologists. We asked dermatologists to comment on what colleagues are likely to see this time of year and how best to treat those skin conditions.

Skin problem 1: Allergic fallout

Anyone can react to ingredients in Halloween makeup products, according to Arielle R. Nagler, M.D., instructor, department of dermatology, NYU Langone Medical Center, New York City.

“Reactions that are irritant in nature are faster in onset, while reactions that are allergic (type IV hypersensitivity) tend to be delayed, appearing between 24 to 96 hours after exposure,” Dr. Nagler says. “Patients who present with eczematous eruptions and pruritus after Halloween makeup should be evaluated for an irritant or allergic contact dermatitis and treated with topical steroids. If an allergic contact dermatitis is being considered, the patient can be referred for patch testing to identify the offending agent. It is particularly important to consider adhesives as culprits for reactions around eyes because these are common allergens and frequently used in attaching fake eyelashes. Other common culprits in facial cosmetics include preservatives such as methylisothiazolinone, metals such as nickel, propylene glycol and lanolin.”

Red dye is one of the main culprits for skin irritation, according to Elizabeth Tanzi, M.D., founder and director, Capital Laser and Skin Care, Chevy Chase, Md., and clinical professor of dermatology at the George Washington Medical Center.

“The classic signs for irritant or an allergic contact dermatitis can develop with pruritus and erythema, but I’ve even seen papular and vesicular reactions in the past that can be quite severe. Although a topical corticosteroid is all that’s needed in most cases, the most severe cases may require intramuscular corticosteroid as treatment,” Dr. Tanzi says.

Allergic or irritant contact dermatitis can also occur from fragrances, such as Balsam of Peru, or preservatives, including parabens, found in makeup, according to Julia Tzu, M.D., of Wall Street Dermatology in Manhattan, New York City.

“It presents as an itchy or irritated pink to pink scaly rash,” Dr. Tzu says. “Topical steroids can be used to treat both allergic and irritant contact dermatitis.”

Skin problem 2: The big breakout

Acne can be a problem when using heavy (especially oil-based) makeup on the skin, according to Dr. Tzu.

“To treat comedonal acne (which results from clogged pores and appear as blackheads and whiteheads), use a keratolytic agent, such as a topical retinoid,” Dr. Tzu says.

Dr. Nagler said that short courses of topical acne therapy, including benzoyl peroxide, salicylic acid, topical antibiotics or tretinoin can be used if patients do develop acne after applying Halloween makeup.

Dendy Engelman, M.D., a New York City-based dermatologist and Galderma consultant, said post-Halloween attempts at makeup removal can result in rosacea flares.

Skin problem 3: Scary infections

Dermatologists might encounter skin infections from sharing makeup, according to Dr. Nagler.

“Since makeup is often applied to and around mucosal surfaces there is significant risk of infection,” Dr. Nagler says. Sharing makeup can increase patients’ risk of catching [an] upper respiratory tract infection, herpes and even bacterial infections in open areas. Skin infections need to be evaluated on a case by case basis, but both viral causes such as herpes and bacterial causes must be considered.”

7 tips for educating patients about Halloween skin irritants

By Lisette HiltonDermatology Times

What’s more frightful than Halloween? What the makeup and costumes can do to children’s and adult’s skin. Dermatologists weigh in with their top tips to help patients avoid post-Halloween skin horrors.


Tip 1: Test before applying

Elizabeth Tanzi, M.D., founder and director, Capital Laser and Skin Care, and clinical professor of dermatology at the George Washington Medical Center, recommends that patients do a skin test on the neck or forearm to see if a product they plan to put all over their faces and even their bodies will cause an aller

“Halloween makeup is notorious for containing irritating dyes and chemicals, so be very careful about what you use. Also, some of these products come from China where lead has been an issue, so as a parent, I would think twice about applying inexpensive Halloween makeup to large areas on children,” Dr. Tanzi says. “The best bet is to find professional theater makeup, if an elaborate face painting job is required, for the costume. It’s more expensive, but at least the likelihood of irritation or toxicity is decreased.”

Tip 2: Unclogging what’s clogged

S. Manjula Jegasothy, M.D. founder of the Miami Skin Institute and clinical associate professor of dermatology, University of Miami Miller School of Medicine, Miami. Fla., says Halloween parties can result in long exposures to costume makeup paste and gels.

“These can cause clogging of the pores and [acne] eruptions. These issues are best treated with OTC salicylic acid cleansers and spot treatments, or benzoyl peroxide spot treatments,” Dr. Jegasothy says.

Dermatologists should let their patients know that they should make appointments to address skin issues that persist for more than a week after costume-makeup application.

Tip 4: Costume dangers

Halloween costumes can be allergies waiting to happen, Dr. Prystowsky says.

“Keep latex allergies in mind as well for masks, prosthetics and other accessories. If your patients plan to reuse old clothes that have been sitting in their attic, you may want to suggest they give them a heavy clean. Dust and mites can cause allergic reactions if the clothes aren’t carefully cleaned,” Dr. Prystowsky said. “Storing clothes in suboptimal conditions could also expose them to mold. Many costumes have metal pieces, like buttons, crowns, jewelry or shields. Tell your patients to make sure these pieces don’t contain nickel.”

Julia Tzu, M.D., of Wall Street Dermatology in Manhattan, New York City, said she recommends patients wear looser, well aerated costumes to avoid skin issues.

According to Dr. Tzu, 100% cotton fabric is gentlest on the skin.

Tip 5: Where not to buy makeup

Suggest your patients avoid buying their Halloween makeup from the dollar store type retailers or Halloween pop-up shops, according to Jessica J. Krant, M.D., M.P.H., a New York City-based dermatologist surgeon.

“Most of this makeup is poorly regulated and often sells only once per year, so some of it may be pretty old. Since it is not well regulated, it may not contain quality preservatives that are meant to prevent bacterial buildup, increasing the risk for infections,” Dr. Krant says.

Tip 6: Take it off… as soon as possible

Dermatologists should recommend their patients remove all Halloween makeup before going to bed, according to Dallas, Texas, dermatologist Kristel Polder, M.D.

“… thicker foundations can clog pores and contribute to acne,” Dr. Polder says.

She also tells patients to rinse off body paint or sprays with gentle soap and water to avoid irritating the skin and to apply a mild hydrocortisone cream immediately after removing anything that itches or burns.

Tip 7: Accessory hazards

Certain mainstays of Halloween costumes can be particularly hazardous to the skin, according to dermatologist and cosmetic surgeon Joel Schlessinger, M.D., A few examples: the red dye in a petroleum base in fake blood can wreak havoc on the skin. Patients can try, instead, to make their own blood look-alike with corn syrup, flour and food coloring, according to Dr. Schlessinger, who is president of

“Certain false nails are more harmful than others. The chemicals used to apply acrylic nails, for example, include resins and formaldehyde, which are known to cause cancer. Over time, these chemicals can also damage the nail matrix, causing the entire nail to fall off,” Dr. Schlessinger wrote in a recent blog. “Glue-on nails pose less of a threat to your nail health, as long as you remove them properly. However, these are still hard on your natural nail and not recommended. It’s better to paint your nails with regular nail polish.”

Los Angeles-based dermatologist Tsippora Shainhouse, M.D., clinical instructor of pediatric dermatology at the University of Southern California, says that, while fake eyelashes can make a costume a pop, eyelash glues (especially cheap ones) can cause severe contact dermatitis.

“Even reputable brands contain potential contact allergens, such as formaldehyde, cyanoacrylates, latex and rosins,” Dr. Shainhouse says.

She recommends patients test patch the adhesive on their inner arm before applying the lashes to eyes.

Other tips: be careful the glue does not drip beyond the edge of the false lash strip, and keep in mind that tape strips on fake moustaches, sideburns and beards can cause a contact dermatitis. Patients should consider wearing wigs and strap-on beards with elastic ties, according to Shainhouse.