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McKenzie S, Wang J, Mora Hurtado AC, Uppal P, Taylor SC, Elbuluk N. Cosmetic injectables in skin of color: A review of uses, safety, and effectiveness of neuromodulators and dermal fillers. J Cosmet Dermatol 2024; 23:2345-2360. [PMID: 38553836 DOI: 10.1111/jocd.16297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 01/20/2024] [Accepted: 03/12/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Skin of color (SOC) individuals represent a growing market for cosmetic injectables and can have different aesthetic goals and responses to treatment. OBJECTIVE A review of the uses, safety, and effectiveness of injectable neuromodulators and dermal fillers in SOC individuals. METHODS AND MATERIALS A search of the PubMed/MEDLINE database was conducted from August 1960 to December 2020. Studies that were included either had a focus on SOC (>20% SOC study participants) or dedicated article content commenting on the safety and/or efficacy of injectables in SOC participants. RESULTS Of the 503 publications identified, a total of 88 articles were selected for this review. Differences in aging and cultural factors can influence aesthetic goals amongst SOC populations. Available data suggests that botulinum toxin (BTX) and dermal fillers are safe and effective in SOC populations, with the largest amount of data existing for Asian populations. There remains a paucity of research on Black and Latinx populations. CONCLUSION BTX and dermal fillers are generally effective and well tolerated in SOC populations, particularly Asian populations for which the greatest amount of data exists. More high quality, randomized controlled trials in Black and Latinx populations are warranted.
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Syder NC, Omar D, McKenzie S, Brown-Korsah JB, Taylor SC, Elbuluk N. Gaps in medical education curricula on skin of color in medical school, residency, and beyond: Part 1. J Am Acad Dermatol 2023; 89:885-892. [PMID: 35390429 DOI: 10.1016/j.jaad.2022.03.053] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 11/20/2022]
Abstract
Various studies have revealed a disproportionately low representation of skin of color (SOC) dermatology in the medical education system of the United States. This disparity contributes to adverse experiences, missed and/or delayed diagnoses, and overall health inequities for individuals of color. The lack of sufficient SOC education begins at the medical school level and continues throughout residency, fellowship, and beyond formal training. This lack of education can be seen in the dearth of images of common and uncommon skin conditions in darker skin in widely used textbooks and educational resources as well as in the lack of formal training in SOC in many residency programs. Thus far, there have been valuable strides to make dermatologic education more inclusive of all skin colors, but there remains significant work to be done. With the population of the United States expected to continue to diversify and with the expectation that SOC will be a trait of over half of the population of the United States by 2050, it is important to strive for health equity by ensuring that comprehensive and inclusive medical training incorporates SOC. This paper will explore the issue of gaps in medical education in SOC dermatology at all levels and offer a strategic call to action to aid in rectifying this situation.
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Omar D, Syder N, Brown-Korsah JB, McKenzie S, Elbuluk N, Taylor S. Racial and ethnic disparities in clinical research and the dermatology workforce: Part 2. J Am Acad Dermatol 2023; 89:895-902. [PMID: 35390428 DOI: 10.1016/j.jaad.2022.03.052] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 11/20/2022]
Abstract
Although racial and ethnic demographics are shifting in this country, it is not reflected in the diversity of clinical trial research participants; science, technology, engineering, and mathematics pipeline programs; or the workforce in the field of dermatology. Barriers to recruitment of minority patients for research studies also exist for numerous reasons including lack of education of prospective subjects, lack of awareness of ongoing trials, and mistrust within the health care system. Gaps in the science, technology, engineering, and mathematics pipeline for racial and ethnic minorities, particularly Black, Hispanic/Latinx, and American Indian or Alaska Native, are due in large part to structural racism. Lack of exposure as well as lack of educational, mentorship, and research opportunities contribute to gaps in the dermatology workforce. Having a representative population in the dermatology workforce and in clinical research trial patients is essential for optimum patient care, excellence in the specialty, and knowledge of appropriate treatments for minority populations. This article will discuss knowledge gaps for increasing minority subjects who participate in clinical research trials and discuss mechanisms to engage this community in trial recruitment. Additionally, this article addresses lack of racial and ethnic diversity of the dermatology workforce and performance gaps in the recruitment of racial/ethnic minorities into dermatology.
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McKenzie S, Brown-Korsah JB, Syder NC, Omar D, Taylor SC, Elbuluk N. Variations in genetics, biology, and phenotype of cutaneous disorders in skin of color. Part II: Differences in clinical presentation and disparities in cutaneous disorders in skin of color. J Am Acad Dermatol 2022; 87:1261-1270. [PMID: 35817332 DOI: 10.1016/j.jaad.2022.03.067] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 11/20/2022]
Abstract
Skin of color (SOC) patients are projected to comprise the majority of the population by 2044, yet knowledge gaps in the clinical presentation and treatment of both common and uncommon dermatologic conditions in skin of color persist. Improved awareness of disparities that disproportionately impact SOC patients is necessary to address health inequity in the field of dermatology. The first part of this CME discussed structural, genetic, and immunophenotypic differences in SOC in common inflammatory disorders as well as cutaneous malignancies. The second part of this CME highlights clinical differences in the phenotypic presentation of the inflammatory disorders of atopic dermatitis, psoriasis, and hidradenitis suppurativa as well as the cutaneous malignancies of melanoma, basal cell carcinoma, and cutaneous T-cell lymphoma. Health disparities associated with each of these conditions are also discussed.
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Brown-Korsah JB, McKenzie S, Omar D, Syder NC, Elbuluk N, Taylor SC. Variations in genetics, biology, and phenotype of cutaneous disorders in skin of color - Part I: Genetic, biologic, and structural differences in skin of color. J Am Acad Dermatol 2022; 87:1239-1258. [PMID: 35809800 DOI: 10.1016/j.jaad.2022.06.1193] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 05/27/2022] [Accepted: 06/13/2022] [Indexed: 11/18/2022]
Abstract
Skin of color (SOC) populations include those who identify as Black/African, Hispanic/Latinx, Asian/Pacific Islander, American Indian/Native Alaskan, Indigenous Australian, Middle Eastern, biracial/multiracial, or non-White; this list is far from exhaustive and may vary between and within cultures. Recent genetic and immunological studies have suggested that cutaneous inflammatory disorders (atopic dermatitis, psoriasis, and hidradenitis suppurativa) and malignancies (melanoma, basal cell carcinoma, and cutaneous T-cell lymphoma) may have variations in their immunophenotype among SOC. Additionally, there is growing recognition of the substantial role social determinants of health play in driving health inequalities in SOC communities. It is critically important to understand that social determinants of health often play a larger role than biologic or genetic factors attributed to "race" in health care outcomes. Herein, we describe the structural, genetic, and immunological variations and the potential implications of these variations in populations with SOC. This article underscores the importance of increasing the number of large, robust genetic studies of cutaneous disorders in SOC to create more targeted, effective therapies for this often underserved and understudied population. Part II of this CME will highlight the clinical differences in the phenotypic presentation of and the health disparities associated with the aforementioned cutaneous disorders in SOC.
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Rutstein A, Baldini M, Morris N, Atherton J, McCormack L, Wong Y, Dashwood A, Wee Y, McKenzie S, Wang W, Hill J, Denman R, Ng K, Haqqani H. Embedding Genetic Counselling Into Cardiology Clinics: Case Studies From a Queensland Cardiology Genomics Service. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.04.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Bayat MK, Chan W, Javorsky G, Platts D, Dashwood A, Wong Y, Mulligan A, Tesar P, Prahbu A, Thomson B, Lavana J, McKenzie S. Acute Compartment Syndrome Following Heart Transplant. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Khorramshahi Bayat M, McKenzie S, Javorsky G, Wong Y, Platts D, Dashwood A, Lavana J, Thomson B, Chan W. Genetic Testing Could Assist in the Clinical Management in Patients Supported on Ventricular Assist Devices With Recovered Myocardial Function. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abdul Halim M, McKenzie S, Scalia G, Chan J. 272 2D Speckled Tracking Echocardiographic Diastolic Strain Analysis May Have the Potential Utility to Identify Pathological Left Ventricular (LV) ‘Hypertrophy’ Conditions. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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McKenzie S, Arzeno J, Lonowski S, Cheng CE, Hogeling M. Increased melanocytic nevi and lentigines in two patients with harlequin ichthyosis. Pediatr Dermatol 2020; 37:192-195. [PMID: 31765010 DOI: 10.1111/pde.14066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 11/02/2019] [Indexed: 11/30/2022]
Abstract
An increased number of melanocytic nevi and lentigines have been reported in patients with two types of autosomal recessive congenital ichthyosis (ARCI): lamellar ichthyosis and nonbullous congenital ichthyosiform erythroderma. These melanocytic lesions may have clinical and dermoscopic features of atypia, necessitating close surveillance. Here, we report two interesting cases of pediatric patients with harlequin ichthyosis (HI) who developed increased melanocytic nevi and lentigines. These cases are unique in that the patients presented at a younger age and one patient had a darker skin phototype than previously described in the literature.
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McKenzie S, Vecerek N, Kang Y, Knowles B, Hogeling M. A neonatal pustule:Langerhans cell histiocytosis. Dermatol Online J 2019; 25:13030/qt6hr0w31v. [PMID: 31553864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 09/09/2019] [Indexed: 06/10/2023] Open
Abstract
Langerhans cell histiocytosis (LCH) is a rare, clinically heterogeneous disease that most commonly occurs in pediatric populations. Congenital self-limited LCH is a benign variant of LCH. It most commonly presents as a diffuse eruption and reports of single lesion cases are infrequent in the literature. Even in the case of congenital self-limited LCH, there is potential for future multisystem relapse, making long-term follow-up important. We present a case of single lesion self-limited LCH in a full-term male infant with interesting morphology. Physical examination revealed a painless, 6 millimeter, well-demarcated, papule encircled by erythema with central hemorrhage. An infectious workup was negative and a punch biopsy was obtained, which showed a dermal infiltrate of histiocytes consistent with a diagnosis of LCH. The lesion healed without intervention within three weeks. Our case highlights the need for dermatologists to consider LCH in the differential diagnosis for lesions of varying morphology in children, as proper identification is necessary to monitor for multisystem recurrence.
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McKenzie S, Zang P, Blackcloud P, Cohen B, Truong A, Worswick S, Arzeno J. Case series of cutaneous mucormycosis in the setting of Herpesviridae infection. Br J Dermatol 2019; 181:373-374. [PMID: 30633321 DOI: 10.1111/bjd.17631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Dashwood A, Chui F, Laher S, Vale C, Chan W, McKenzie S, Wong Y. Hypophosphataemia is Common After Intravenous Ferric Carboxymaltose Infusion Among Patients with Symptomatic Heart Failure. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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McKenzie S, Vecerek N, Kang Y, Knowles B, Hogeling M. A neonatal pustule:Langerhans cell histiocytosis. Dermatol Online J 2019. [DOI: 10.5070/d3258045129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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White D, Gurung S, Zhao D, Tabler T, McDaniel C, Styles D, McKenzie S, Farnell Y, Farnell M. Foam or spray application of agricultural chemicals to clean and disinfect layer cages. J APPL POULTRY RES 2018. [DOI: 10.3382/japr/pfx069] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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White D, Gurung S, Zhao D, Farnell Y, Byrd J, McKenzie S, Styles D, Farnell M. Evaluation of layer cage cleaning and disinfection regimens. J APPL POULTRY RES 2018. [DOI: 10.3382/japr/pfx056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Vale C, Gan J, McKenzie S, Wong Y, Rheault H, Laher S, Dashwood A. Early Real-World Experience of Tolerability and Titration Rates of Angiotensin-Receptor-Neprilysin Inhibitor. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Dashwood A, Laher S, Menon N, Thomson B, Prabhu A, Tesar P, Ziegenfuss M, Smith I, Javorsky G, Platts D, McKenzie S, Chan W, Bancroft J, Maddicks-Law J, Wong Y. Validation of EUROMACS-RHF (European Registry for Patients with Mechanical Circulatory Support Right-Sided Heart Failure) Score in Predicting Early Right Heart Failure Following Left Ventricular Assist Device Insertion in an Australian Single-Centre Cohort. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Dashwood A, Laher S, Wang C, Prabhu A, Tesar P, Ziegenfuss M, Wong Y, Javorsky G, Smith I, Platts D, Chan W, McKenzie S, Bancroft J, Maddicks-Law J, Thomson B. Single-Centre Experience of Durable Bi-Ventricular Support with HeartWare Continuous Flow, Centrifugal Ventricular Assist Devices (HeartWare BiVADs). Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lau K, Bancroft J, McKenzie S, Javorsky G, Chan W, Wong Y, Thomson B, Prabhu A, Fraser J, Platts D. Explant of Heartware Biventricular Assist Devices Following Myocardial Recovery After Peripartum Cardiomyopathy. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rheault H, Gan J, McKenzie S, Wong Y. Combining Forces: Nurse Practitioner and Clinical Pharmacist Led Heart Failure Clinic and its Impact on Titration Rates and Hospital Readmission. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Mengel C, McKenzie S. An Unusual Cause of Cardiac Arrest. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Kelly R, Walsh J, Paratz J, Yerkovich S, McKenzie S, Morris N. Quadriceps Strength Predicts Estimates of Physical Activity Post-Heart Transplantation. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Halim MA, Goodman A, Corpus R, McKenzie S. The Demographics and Natural History of Rheumatic Heart Disease: A Look into Indigenous Cardiac Outreach Programme Cohort after Nearly a Decade of Service. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Halim MA, Halim MA, Halim DA, Goodman A, Corpus R, McKenzie S. Characteristics of Lipid Profiles in Indigenous Cardiac Outreach Program Cohort in Rural and Remote Communities in Queensland: A Snapshot After 10 years of Service. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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