Speakers: Dr. Jacob Beer
Dr. Jacob Beer: Hi, Hi everyone. My name is Dr Jacob Beer. I'm currently a dermatology resident passionate about improving patient care in particular patients with darker skin.
What is your most recent article in the JDD about?
Dr. Jacob Beer: I'm excited to discuss with you our most recent paper, "Scarring and Dyschromia in Fitzpatrick Types IV through VI: A Review of Dermatologic Treatment Protocols." It's really a thorough discussion of scarring and pigmentary complications in darker skinned patients. We discussed the management pearls for clinicians including first line treatment protocols, experimental recommendations based on the available literature, and the author's recommendations for management. I really worked with an incredible team throughout this project and hope you enjoy our discussion.
What excites you about this topic?
Dr. Jacob Beer: I'm excited about the ways that we as clinicians and we as dermatologists can improve patient outcomes in patient care and ultimately our patients lives. These wound healing disorders have a profound impact on the lives of our patients and it can lead to depression, anxiety, and just patients becoming incredibly self conscious about these complications. So this review really provides a series of recommendations to help ameliorate these complications and hopefully improve the lives of our patients.
What is the key take away from your article?
Dr. Jacob Beer: For patients with darker skin, the main complications and wound healing include scarring, which includes hypertrophic scarring and keloid formation as well as dyschromias or pigment abnormalities, and those include hyperpigmentation or hypopigmentation. With respect to scarring, prevention is really key and this can usually be done by ascertaining a really thorough patient history. Once the hypertrophic scar keloid forms, the proposed management is really done on a case by case basis. Some of the recommendations from the authors are silicone sheeting, pressure dressings, intralesional steroids and the authors in particular, caution against the use of cryotherapy. For patients undergoing surgical revisions, the authors recommend triple keloid therapy with silicone sheeting, post surgical steroids and pulsed dye laser, but with caution. For dyschromia, there's hyperpigmentation and hypopigmentation. For hyperpigmentation, the emphasis on management is really sun protection, sun protection, sun protection. Studies have shown that sunscreens are usually under prescribed in patients with darker skin. Aside from that, some of the first line recommendations are hydroquinone, tretinoin, and topical steroids. For a hypopigmentation, this is typically due to scarring or inflammation and the first line treatment is topical steroids or topical calcineurin inhibitors. Topical JAK inhibitors have also proven to be efficacious as well, and these can be offered with light therapy.
How can your findings influence future research on the topic?
Dr. Jacob Beer: Our findings help to establish the current treatments for these complications as well as to incorporate experimental therapies into considerations for treatment. We also provide comprehensive tables for interventions, effectiveness, and possible complications for these disorders. And we look forward to continuing to update these recommendations for management. Thank you for listening.
