David G. Cotter

Allergic contact dermatitis (ACD) is an increasingly common condition among athletes due to repeated exposure to sport-specific equipment, environmental allergens, and topical products. Sweating and repetitive cutaneous trauma facilitate allergen penetration. Rubber accelerators, metals, textile dyes, adhesives, synthetic resins, and topical medications represent the principal allergen categories implicated in sports-related ACD. This narrative review synthesizes the current literature on the epidemiology, pathophysiology, allergen profiles, and sport-specific exposure patterns of ACD in athletes, while outlining the essential principles of clinical recognition and targeted allergen avoidance.

Background: Patients with skin lesions suspicious for skin cancer or atypical melanocytic nevi of uncertain malignant potential often present to dermatologists, who may have variable dermoscopy triage clinical experience. Objective: To evaluate the clinical utility of a digital dermoscopy image-based artificial intelligence algorithm (DDI-AI device) on the diagnosis and management of skin cancers by dermatologists. Methods: Thirty-six United States board-certified dermatologists evaluated 50 clinical images and 50 digital dermoscopy images of the same skin lesions (25 malignant and 25 benign), first without and then with knowledge of the DDI-AI device output. Participants indicated whether they thought the lesion was likely benign (unremarkable) or malignant (suspicious). Results: The management sensitivity of dermatologists using the DDI-AI device was 91.1%, compared to 84.3% with DDI, and 70.0% with clinical images. The management specificity was 71.0%, compared to 68.4% and 64.9%, respectively. The diagnostic sensitivity of dermatologists using the DDI-AI device was 86.1%, compared to 78.8% with DDI, and 63.4% with clinical images. Diagnostic specificity using the DDI-AI device increased to 80.7%, compared to 75.9% and 73.6%, respectively. Conclusion: The use of the DDI-AI device may quickly, safely, and effectively improve dermoscopy performance, skin cancer diagnosis, and management when used by dermatologists, independent of training and experience.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), commonly prescribed for type 2 diabetes and obesity, have demonstrated potential anti-inflammatory and immunomodulatory effects that may be beneficial in chronic inflammatory skin conditions such as psoriasis and hidradenitis suppurativa (HS). A systematic review of the literature was conducted, focusing on prospective studies, case reports, and systematic reviews that evaluated the impact of GLP-1 RAs on these diseases. In psoriasis, GLP-1 RAs, particularly liraglutide, have been associated with improvements in the Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI), especially among patients with T2D. Reported benefits include enhanced glycemic control, weight reduction, and decreased levels of inflammatory markers, suggesting that GLP-1 RAs may modulate immune pathways and proinflammatory cytokine activity involved in the pathogenesis of psoriasis. Similarly, in HS, GLP-1 RAs such as liraglutide and semaglutide have shown promising results, including decreased lesion severity, improved quality of life, and reduced systemic inflammation. Weight loss induced by these agents may also contribute to symptom improvement by reducing mechanical stress in intertriginous areas and mitigating inflammatory responses associated with HS. Although preliminary evidence suggests that GLP-1 RAs may play a role in managing psoriasis and HS through both metabolic and immunologic mechanisms, current data are limited to early-phase studies and case reports. Further large-scale randomized controlled trials, some of which are ongoing, with diverse study populations are necessary to better understand their efficacy, safety, and long-term impact in the treatment of these chronic inflammatory skin conditions.

A "blueberry muffin rash," typically attributed to congenital toxoplasmosis, rubella, cytomegalovirus, and herpes simplex virus (TORCH) infections, is a rare and underreported cutaneous manifestation of serious underlying pathology, including hematologic malignancies. We report a case of congenital acute myeloid leukemia (AML) in a full-term newborn who presented at day-of-life 0 with multiple blue to purple macules, patches, and indurated papulonodules and plaques on the trunk and extremities consistent with a "blueberry muffin rash". Notably, the rash was transient and spontaneously resolved within 24 hours of life, making it easy to overlook, potentially delaying life-saving treatment. This case reinforces the need for a full diagnostic workup and high clinical suspicion for leukemia in neonates presenting with a "blueberry muffin rash."

Atopic dermatitis (AD) is the most common chronic inflammatory skin condition and typically presents with pruritus, xerosis, eczematous lesions, and lichenification. Treatment options vary depending on severity; however, core management involves trigger avoidance, daily skin care, and anti-inflammatory therapies. Dupilumab, a monoclonal antibody that blocks interleukin-4 (IL-4) receptor α, is approved for the treatment of moderate-to-severe AD in patients aged 6 months or older. While this approval represents a significant advancement in AD therapy, the full extent of its side effect profile continues to emerge. Herein, we report two cases of refractory AD in which dupilumab therapy was limited by conjunctivitis and paradoxical worsening of cutaneous symptoms. We present these cases to describe the presentation, clinical progression, and management of dupilumab-associated adverse reactions in AD treatment, thereby contributing to a deeper understanding of its side effect profile. Notably, these cases demonstrate the successful use of nemolizumab as a therapeutic alternative in the setting of dupilumab intolerance.

Recent years have witnessed significant growth in aging research due to groundbreaking discoveries in gerotherapeutics and an ever-increasing interest in longevity. Such advances beg the question, what if the physical and functional declines we associate with aging were no longer inevitable, but instead treatable through the next frontier of medical innovation? In this article, we explore the broader social and ethical implications of advancing healthspan and mitigating age-related decline. We also highlight dermatology’s unique role as a catalyst of aging research, serving as a model for integrating aesthetic and functional innovations. Finally, we discuss the curious role and the ethical challenges of the aesthetic dermatology industry in the healthspan debate.