Era Caterina Murzaku

Diet in dermatology: Part II. Melanoma, chronic urticaria, and psoriasis

The roles of dietary factors in aggravating, preventing, or treating skin diseases are common questions encountered in dermatology practice. Part II of this two-part series reviews dietary modifications that can potentially be utilized in the management of melanoma, chronic urticaria, and psoriasis patients. Specifically, we examine the effect of alcohol consumption and supplementation with vitamins D and E, polyunsaturated fatty acids, selenium, green tea, resveratrol, and lycopene on melanoma risk. The relationships between chronic urticaria symptoms and dietary pseudoallergens, gluten, and vitamin D are analyzed. We explore weight loss, reduced alcohol consumption, and gluten avoidance as means of reducing psoriasis-associated morbidity, as well as the possible utility of supplementation with polyunsaturated fatty acids, folic acid, vitamin D, and antioxidants. With proper knowledge of the role of diet in these cutaneous disease processes, dermatologists can better answer patient inquiries and consider implementation of dietary modifications as adjuncts to other treatments and preventative measures.

Methods and rates of dermoscopy usage: A cross-sectional survey of US dermatologists stratified by years in practice

inadequate response to narrowband UVB, PUVA, topical corticosteroids, and topical tacrolimus. B, Left upper back. Significant perifollicular repigmentation seen 1 week following 2 sessions of intralesional triamcinolone acetonide injection spaced 2.5 months apart. C, Left upper back. Complete repigmentation seen 1 year later. This patient only had a total of 2 injection sessions of intralesional triamcinolone acetonide as stated in B. J AM ACAD DERMATOL VOLUME 71, NUMBER 2 Letters 393

Diet in dermatology

The roles of dietary factors in aggravating, preventing, or treating skin diseases are common questions encountered in dermatology practice. Part II of this two-part series reviews dietary modifications that can potentially be utilized in the management of melanoma, chronic urticaria, and psoriasis patients. Specifically, we examine the effect of alcohol consumption and supplementation with vitamins D and E, polyunsaturated fatty acids, selenium, green tea, resveratrol, and lycopene on melanoma risk. The relationships between chronic urticaria symptoms and dietary pseudoallergens, gluten, and vitamin D are analyzed. We explore weight loss, reduced alcohol consumption, and gluten avoidance as means of reducing psoriasis-associated morbidity, as well as the possible utility of supplementation with polyunsaturated fatty acids, folic acid, vitamin D, and antioxidants. With proper knowledge of the role of diet in these cutaneous disease processes, dermatologists can better answer patient inquiries and consider implementation of dietary modifications as adjuncts to other treatments and preventative measures.

Atypical pigmented acral lesion proven to be fungal using reflectance confocal microscopy

Rao Dermatology, New York; Rutgers Robert Wood Johnson edical School, Piscataway; and the Department of Dermatogy, Rutgers Robert Wood Johnson Medical School, Somerset. ing sources: None. ao is a consultant for Caliber Imaging and Diagnostics, Inc ochester, NY), the makers of confocal microscopes. The other thors have no conflicts of interest to declare. Reprint requests: Era Caterina Murzaku, Rutgers Robert Wood Johnson Medical School, 1 World’s Fair Dr, Somerset, NJ 08873. E-mail: murzakec@rwjms.rutgers.edu. J Am Acad Dermatol 2014;70:e77-9. 0190-9622/

Response to: “Evidence on pseudoallergen-free diet for chronic urticaria”

36.00 a 2013 by the American Academy of Dermatology, Inc. http://dx.doi.org/10.1016/j.jaad.2013.10.033

Continuing medical educationDiet in dermatology: Part II. Melanoma, chronic urticaria, and psoriasis

To the Editor: We thank Drs Yeung and Swerlick for their comments on our continuing medical education article ‘‘Diet in dermatology: Part II. Melanoma, chronic urticaria, and psoriasis.’’ We agree that the benefits of a pseudoallergen-free diet are controversial. Additionally, a pseudoallergen elimination diet may be of limited utility in the majority of chronic urticaria patients. Indeed, it is important to emphasize that a recent trial found sensitivity to pseudoallergens in less than 1% of a cohort of 100 patients with chronic urticaria. Prospective interventional studies have reported improvement of chronic urticaria symptoms in 28% to 73% of participants adopting a pseudoallergen-free diet. Doubleblind, placebo-controlled oral challenges with individual pseudoallergens, the current gold standard for diagnosing food allergy, yield reproducible urticaria symptoms following a pseudoallergen-free diet in only 1% to 19% of patients. We agree that while these studies do not confirm the efficacy of pseudoallergen elimination diets in improving chronic urticaria, they suggest that distinct pseudoallergens may trigger reproducible chronic urticaria symptoms in some patients. A summary statement from a recent systematic review from the American Academy of Allergy, Asthma, and Immunology concludes that the evidence supporting pseudoallergen-free diets in chronic urticaria is weak. Furthermore, adhering to a pseudoallergen-free diet may be burdensome and difficult for some patients. Given its low cost and relative safety, however, a pseudoallergen elimination diet can be considered in a small subset of chronic urticaria patients. Isolationofpseudoallergensdirectly

Diet in dermatology: Part I. Atopic dermatitis, acne, and nonmelanoma skin cancer

The roles of dietary factors in aggravating, preventing, or treating skin diseases are common questions encountered in dermatology practice. Part II of this two-part series reviews dietary modifications that can potentially be utilized in the management of melanoma, chronic urticaria, and psoriasis patients. Specifically, we examine the effect of alcohol consumption and supplementation with vitamins D and E, polyunsaturated fatty acids, selenium, green tea, resveratrol, and lycopene on melanoma risk. The relationships between chronic urticaria symptoms and dietary pseudoallergens, gluten, and vitamin D are analyzed. We explore weight loss, reduced alcohol consumption, and gluten avoidance as means of reducing psoriasis-associated morbidity, as well as the possible utility of supplementation with polyunsaturated fatty acids, folic acid, vitamin D, and antioxidants. With proper knowledge of the role of diet in these cutaneous disease processes, dermatologists can better answer patient inquiries and consider implementation of dietary modifications as adjuncts to other treatments and preventative measures.