2019 AAD Meeting
The AAD Annual meeting is among my favourite meeting. It’s a wonderful opportunity to catch up with colleagues across the globe and an opportunity to get caught up what’s happening both in an outside of te hair world. I’m always pleasantly surprised at how fast various aspects of dermatology are progressing.
I particularly enjoyed leading a session last Friday afternoon at the American Academy of Dermatology Meeting Friday in Washington, DC. I guided attendees through a series of high yield self-assessment questions in the field of hair loss - and explained answers to these questions. Attendees had the opportunity to answer some pretty difficult questions in the areas of pathology, scalp dermoscopy, diagnosis, treatment and side effects.
There were several highlights of the session. I reviewed with attendees the link between male balding and an increased risk of skin cancer, prostate cancer and metabolic syndrome. We reviewed that isotretinoin was the most effective treatment for dissecting cellulitis as well as for the facial papules of frontal fibrosing alopecia. We reviewed the value of the scalp biopsy in giving an accurate assessment of terminal to vellus ratios, as well as the density of sebaceous glands. We discussed the benefit of oral minoxidil in the treatment of chronic telogen effluvium and reviewed the role of topical minoxidil in endocrine therapy induced alopecia (ETIA). We discussed the dose dependent side effects of tofacitinib including hyperlipidema, elevated creatine, infection risks, shingles, and possibly pulmonary embolism. We reviewed that newer proposed pathology of the facial papules in FFA as being secondary to destruction of elastic tissue that in turn causes dilation of sebaceous glands and dilated sebaceous ducts. We reviewed the pathology of CCCA and how loss of sebaceous glands might not in fact be such an early step in CCCA (as it is thought to be for scarring alopecias like LPP). We reviewed together the important clinical pearl that bilateral loss of the sideburns in males and eyebrow loss in peri menopausal females is highly suggestive of a diagnosis of FFA. I even challenged participants with questions about the best methods of managing tooth discolouration from iron supplementation in children! (... brushing with baking soda does the trick).
Congratulations to all attendees for their hard work answering some pretty tough questions!
Dr. Jeff Donovan is a Canadian and US board certified dermatologist specializing exclusively in hair loss. To schedule a consultation, please call the Whistler office at 604.283.1887