DE Cohen

New York University | NYU · Department of Dermatology

Purpose of Review Occupational hand dermatitis is a common work-related disorder of the skin. Prevention and management of this disease is critical to improving workers’ quality of life and for occupation-specific retention. Recent Findings This is a critical review of the current literature on occupational hand dermatitis. Occupational dermatitis...

Background: New evidence has emerged since the 2014 guidelines that further informs the management of AD with topical therapies. These guidelines update the 2014 recommendations for management of atopic dermatitis (AD) with topical therapies. Objective: To provide evidence-based recommendations related to management of AD in adults using topical...

These guidelines update the 2014 recommendations for management of atopic dermatitis in adults with topical therapies. A multidisciplinary workgroup employed best practices for guideline development, including a systematic review of the evidence and application of the Grading of Recommendations, Assessment, Development, and Evaluation approach for...

Irritant and allergic contact dermatitis from wound closure materials can occur in patients after surgical procedures. The resulting inflammation from contact dermatitis can compromise wound healing, mimic surgical site infections, and result in wound dehiscence. Components of wound closure material, such as antibiotic coatings, dyes, sterilizing c...

Background Studies found associations between atopic dermatitis (AD) and many comorbidities. Objective To appraise evidence of the association between AD and comorbidities among adults. Methods Our multidisciplinary work group conducted a systematic review of the association between AD and selected comorbidities. We applied the GRADE for prognosi...

Topical cosmetic medications, cosmeceuticals, and minimally invasive cosmetic procedures play an important role in dermatologic practice. Advances have led to a tremendous expansion in the repertoire of nonsurgical cosmetic treatments. Adverse skin reactions to cosmetics include irritant contact dermatitis, allergic contact dermatitis, phototoxic d...

Occupation contact dermatitis (CD) is a common inflammatory skin condition impacting every professional industry in the United States. It is associated with significant personal and professional distress, loss of revenue, and decreased productivity. Occupational CD is further subdivided into irritant CD and allergic CD. Frequently, workers may suff...

Background: Assessment of chronic hand eczema (CHE) is complex and warrants standardization. Objective: We sought to guide clinicians on the assessment of CHE. Methods: An electronic questionnaire regarding the diagnosis and assessment of CHE was completed by councilors (n=45) of the International Eczema Council, an international group of clin...

Netherton syndrome (NS) is an autosomal recessive disorder characterized by congenital ichthyosis, trichorrhexis invaginata, and severe atopy.¹ It presents in the neonatal period, and the ichthyosis develops into serpiginous plaques, bordered by a double-edged scale, termed ichthyosis linearis circumflexa. Hair shaft abnormalities present later in...

Atopic dermatitis (AD) and allergic contact dermatitis (ACD) are common T-cell-mediated inflammatory skin conditions that can share clinical presentations. The variable expression of ACD among patients with AD represents the shades of gray of the multifaceted relationship between the 2 disorders, where increased allergen permeation in compromised e...

The field of contact dermatitis is constantly evolving. Trends in irritant and allergic contact dermatitis are shaped by the introduction of new chemicals, revival of older allergens, industrial practices, and consumer behaviors. This article discusses the most noteworthy trends within the field, organized by allergen category, with particular atte...

Background: Allergic contact dermatitis is a challenging diagnostic problem in children. Although epicutaneous patch testing is the diagnostic standard for confirmation of contact sensitization, it is less used in children by dermatologists treating children, pediatric dermatologists, and pediatricians, when compared with adult practitioners. Obj...

Though screening for skin cancer is an essential practice in dermatology, limited data are published on dermatologists' total body skin examination (TBSE) behaviors. We surveyed 6500 dermatologists on their TBSE practices, including questions about less commonly examined body sites. We found varied TBSE practices among all dermatologists and discre...

Proximal subungual onychomycosis (PSO), which predominantly involves the nail plate from the proximal nail fold, is the rarest form of onychomycosis. Classically associated with an immunocompromised state, PSO is an uncommon diagnosis in individuals without immunodeficiency. We present a case of a healthy 51-year-old man, who presented with a three...

Background: While most of the attention regarding skin pigmentation has focused on the effects of ultraviolet radiation, the cutaneous effects of visible light (400 to 700nm) are rarely reported. Objective: The purpose of this study was to investigate the cutaneous pigmentary response to pure visible light irradiation, examine the difference in r...

Background: Complete removal of individual dysplastic nevi (DN) is often accomplished by a second surgical procedure after the initial biopsy. The choice to perform the second procedure is strongly influenced by histopathologic margin status of the initial biopsy specimen. Objective: To evaluate the clinical and histopathologic outcomes of in to...

Discovered by Marie and Pierre Curie, the radioactive element radium became one of the first wonder drugs. Known for its alluring luminescence, the benefits of radium were touted both commercially as an additive in toothpaste, cosmetics, and even tonic water, as well as medically. The first published reports of radium therapy in dermatology describ...

p>BACKGROUND: While most of the attention regarding skin pigmentation has focused on the effects on ultraviolet radiation, the cutaneous effects of visible light (400 to 700nm) are rarely reported. In this report, we describe a case of painful erythema and induration that resulted from direct irradiation of UV-naïve skin with visible LED light in a...

Hair has always played an important role in the history of mankind. Egyptian hieroglyphics are testimony of the paramount importance of hair for this ancient civilization, not only because of the visual effect, but also because of the erotic symbolism connected with hair. For the ancient Romans hair was not only a question of fashion but was used a...

We report a 51-year-old female with a 3-year history of recalcitrant annular elastolytic giant cell granuloma (AEGCG) who was effectively treated with the anti-tumor necrosis factor (TNF)-alpha antibody, adalimumab. Her disease was refractory to topical glucocorticoids, intralesional glucocorticoids, narrow-band ultraviolet light (UV)-B phototherap...

Gyrate erythema, which also is known as erythema annulare centrifugum (EAC), is a reactive dermatitis that is thought to occur in response to an underlying trigger. The superficial form is characterized by the typical, centrifugally-expanding, annular, erythematous patches or plaques with a distinct trailing scale. The deep form also is a centrifug...

Keratolysis exfoliativa (KE) is a palmoplantar eruption of air-filled bullae on an erythematous base, which results in lamellar peeling with hallmark superficial collarettes of scale. It is distinct from other diseases of volar skin, such as dyshidrosis, contact dermatitis, tinea, epidermolysis bullosa, and acral skin peeling. We present a 55-year-...

Chronic actinic dermatitis (CAD) is a photosensitivity disorder that is characterized by a persistent eczematous eruption in sunexposed sites. The hallmark of CAD is a reduced minimal erythema dose (MED) to ultraviolet B (UVB), ultraviolet A (UVA), and/or to visible light, which makes phototesting the essential diagnostic investigation. The uncommo...

This case report describes the successful treatment of acrodermatitis continua of Hallopeau with ustekinumab as monotherapy.Acrodermatitis continua of Hallopeau (ACH), a rare pustular eruption affecting the distal digits, was successfully treated with ustekinumab as monotherapy.Article InformationCorresponding Author: David E. Cohen, MD, The Ronald...

Hypersensitivity reactions can occur in response to topical agents. Adverse reactions can include irritant contact dermatitis and allergic contact dermatitis. Patch testing is a reliable method for determining the etiology of adverse reactions to topical products. Treatment of hypersensitivity reactions involves prompt recognition with identificati...

Oral allergy syndrome (OAS) or pollen-food allergy syndrome (PFS) is a hypersensitivity reaction to plant-based foods, manifesting most commonly with pruritus of the lips, tongue, and mouth. Unlike simple food allergy, OAS requires prior sensitization to a cross-reacting inhalant allergen rather than direct sensitization to a specific food protein....

Netherton syndrome is a rare, autosomal recessive disorder that is characterized by congenital ichthyosis, trichorrhexis invaginata, and atopic diathesis. Ichthyosis presents at birth with erythroderma and subsequently evolves into ichthyosis linearis circumflexa; hair shaft abnormalities tend to present later. The disorder is caused by loss-of-fun...

Pruritus is a major symptom of skin disease. The quest to identify a valid and reliable method to assess this important symptom has led to the development of a myriad of measurement tools. Some clinical trials using subjective measurements of itch intensity have reported itch intensity levels in psoriasis that are close to severity levels found in...

Keratosis pilaris and keratosis pilaris-like eruptions have been reported in association with RAF inhibitors sorafenib and vemurafenib. We describe herein what is to our knowledge the first reported case of new onset keratosis pilaris after discontinuation of EGFR inhibitor erlotinib. A 60 year-old female with stage IV lung cancer was treated with...

The cutaneous ulcer in a patient with a history of international travel poses a vexing diagnostic dilemma for the clinician. While Streptococcus and Staphylococcus are common causes of cutaneous ecthyma, the necrotizing ulcer can have a vast differential diagnosis including ulcerating zoonoses. Copyright © 2014. Published by Elsevier Ltd.

Atopic dermatitis is a common, chronic inflammatory dermatosis that can affect all age groups. This evidence-based guideline addresses important clinical questions that arise in its management. In this final section, treatments for flare prevention and adjunctive and complementary therapies and approaches are reviewed. Suggestions on use are given...

Background: Clinical photography enhances medical care, research, and teaching. Empirical data are needed to guide best practices regarding dermatologic photography. Objective: To investigate patient opinion about clinical photography and identify demographic factors that influence these opinions. Methods and materials: Four hundred patients r...

Corticosteroids are commonly used for a variety of dermatologic and systemic conditions due to their strong anti-inflammatory and immunosuppressive properties. Hypersensitivity reactions to corticosteroids are generally rare, but are not uncommon in high-risk patient populations such as those chronically treated with steroids.1 Allergic contact der...

Rosacea fulminans, previously known as pyoderma faciale, is a rare disease occurring almost exclusively in young women characterized by the sudden eruption of coalescing papules and pustules, and large cystic nodules limited to the face. Patients generally respond well to standard therapy consisting of systemic isotretinoin in combination with topi...

Atopic dermatitis is a chronic, pruritic inflammatory dermatosis that affects up to 25% of children and 2% to 3% of adults. This guideline addresses important clinical questions that arise in atopic dermatitis management and care, providing recommendations based on the available evidence. In this third of 4 sections, treatment of atopic dermatitis...

Atopic dermatitis is a common and chronic, pruritic inflammatory skin condition that can affect all age groups. This evidence-based guideline addresses important clinical questions that arise in its management. In this second of 4 sections, treatment of atopic dermatitis with nonpharmacologic interventions and pharmacologic topical therapies are re...

Chronic actinic dermatitis is a photosensitivity disorder with scant epidemiologic data. Case series in Europe have previously shown that improvement or resolution of chronic actinic dermatitis occurs over time in most patients. However, the natural history of chronic actinic dermatitis in patients in the United States has not been studied. To stud...

We present a 67-year-old man with an ulcerated, indurated plaque on the right mid back with a presumed diagnosis of morphea that was complicated by an allergic contact dermatitis. Further clinical and histopathologic data elucidated the diagnosis of fluoroscopy-induced radiation dermatitis. We present a brief review of the common locations, clinica...

Atopic dermatitis (AD) is a chronic, pruritic, inflammatory dermatosis that affects up to 25% of children and 2% to 3% of adults. This guideline addresses important clinical questions that arise in the management and care of AD, providing updated and expanded recommendations based on the available evidence. In this first of 4 sections, methods for...

Background: There is no known association between the development of keratoacanthomas and prurigo nodules. Objective: We report a case series of 7 patients with a long-standing history of actinic damage, pruritus, and prurigo nodularis who developed widespread keratoacanthomas within the same affected area. Methods: This was a retrospective ca...

Fentichlor elicits high rates of positive photopatch test reactions despite its currently unknown clinical relevance. The aims of this study were to provide a comprehensive review of fentichlor, to investigate the characteristics of patients with photosensitivity to fentichlor, and to explore the current uses of fentichlor. A review of photopatch t...

Our study identified the most common diagnoses in patients with a history of photosensitivity or with a photodistributed eruption and normal minimal erythema dose (MED) responses. We retrospectively reviewed the diagnoses and phototest results of 319 patients who were phototested at the New York University Photomedicine Section of the Charles C. Ha...

Introduction Traditional clinical trials in psoriasis exclude a significant proportion of patients with complex disease and comorbidities. A consensus panel of 14 experts in the field of psoriasis was formed to conduct a Delphi method exercise to identify difficult-to-treat psoriasis clinical scenarios and to rank treatment approaches. Methods The...

Introduction Clinicians may be confronted with difficult-to-treat psoriasis cases for which there are scant data to rely upon for guidance. To assist in managing such patients, who are typically excluded from clinical trials, a consensus panel of 14 experts in the field of psoriasis was formed to conduct a Delphi method exercise. Methods The exerc...

Purpura annularis telangiectoides of Majocchi (PATM) is a clinical variant of pigmented purpuric dermatoses. It is characterized by asymptomatic or mildly pruritic, erythematous, annular patches that vary in size. The patches exhibit central clearing and peripheral cayenne pepper petechiae. It classically occurs on the lower legs but may be more ge...

We present a case of cutaneous sarcoidosis in a 77-year-old woman without systemic disease, who presented with two subtypes of lesions: erythematous and hyperpigmented macules on the arms and anterior upper legs and erythematous, hyperkeratotic nodules, some crateriform, on the lower legs and feet. Whereas cutaneous sarcoidosis is present in up to...

Morbihan disease, which consists of solid facial edema, is a rare complication of rosacea, a common cutaneous disorder in middle-aged individuals. The characteristic features of Morbihan disease are its chronic course, typical clinical picture, lack of specific laboratory and histopathologic findings, and refractoriness to therapeutic measures. Sin...

Background Morbihan disease (MD) is characterized by persistent erythema and solid edema of the upper two-thirds of the face. It is generally regarded as a late-stage complication of rosacea, although its etiology is poorly understood. The standard therapeutic management includes systemic anti-inflammatory medications; however, the clinical respons...

The pathophysiology of rosacea has undergone renewed interest over the past decade, with a large body of evidence supporting the role of an abnormal innate immune response in rosacea. Many mechanisms interact with the cutaneous innate immune system that may be operative. A variety of potential triggers stimulate this immune detection system which i...

Actinic keratosis (AK) constitutes the initial epidermal lesion in a disease continuum that may potentially progress to invasive squamous cell carcinoma (SCC). A number of treatment options are available to clear lesions and thus reduce the risk for progression to SCC. Field-directed therapies are primarily used to clear multiple AKs and subclinica...

: Vaccines are composed of immunogens, preservatives, adjuvants, antibiotics, and manufacturing by-products. Components of vaccines may rarely elicit adverse reactions in susceptible individuals, thus raising concerns regarding vaccine safety. In this report, we add to the medical literature 3 cases of cutaneous delayed-type hypersensitivity to the...

Actinic keratosis (AK) constitutes the initial epidermal lesion in a disease continuum that may progress to invasive squamous cell carcinoma (SCC). A number of treatment options are available to clear lesions, and thus reduce the risk for progression. Field-directed approaches are primarily used to clear multiple AKs and subclinical lesions. Curren...

We described self-reported skin rash 2 to 3 and 5 to 6 years after 9/11 and examined its association with exposures to 9/11 dust/debris. We analyzed a longitudinal study of New York City World Trade Center Health Registry participants who resided or worked in Lower Manhattan or worked in rescue/recovery in two surveys (W1 and W2). Among 42,025 part...

Over the past 25 years both the quality and quantity of pharmaceutical and biopharmaceutical research has changed. Formerly rigidly separated research efforts in academic institutions and the biopharmaceutical industry have become increasingly transparent to one another. Industry has in some cases scaled down its internal research efforts, while en...

Skin diseases including dermatitis constitute ≈ 30% of all occupational illnesses, with a high incidence in the printing industry. An outbreak of contact dermatitis among employees at an ink ribbon manufacturing plant was investigated by scientists from the National Institute for Occupational Safety and Health (NIOSH). Employees in the process area...

Epidermal growth factor receptor (EGFR) inhibitors are widely used medications in the treatment of cancers. To review the cutaneous adverse events related to EGFR inhibitors. A retrospective chart review of all cases referred for the management of cutaneous adverse events after the initiation of EGFR inhibitor therapy between the years of 2006 and...

On a daily basis, pool cleaners handle a variety of chemicals that are potentially hazardous to the skin. The aquatic environment with which the pool cleaner comes into contact aids in the transmission of infectious agents and potential contact allergens and irritants. In addition, ultraviolet radiation and genotoxic substances generated as disinfe...

The majority of cases of wood-related skin diseases occur in occupational settings. Several materials are known causes of contact dermatitis in cabinet makers: raw-wood components (bark, sapwood, or heartwood), living organisms (lichens, liverworts, insects), or chemicals (fungicides, preservatives, fire retardants). Contact with wood may cause a s...

Participation in ice-skating sports, particularly figure skating, ice hockey and speed skating, has increased in recent years. Competitive athletes in these sports experience a range of dermatological injuries related to mechanical factors: exposure to cold temperatures, infectious agents and inflammation. Part I of this two part review discussed t...

The development of topical drug delivery systems has recently gained significant interest due to the ease of administration and lesser risks of systemic toxicity. The development of these new technologies utilizes the properties of the structure and function of the skin. The stratum corneum plays the largest role in affecting drug permeation, as th...

Figure skaters, ice-hockey players and speed skaters experience a range of dermatologic conditions and tissue-related injuries on account of mechanical trauma, infectious pathogens, inflammatory processes and environmental factors related to these competitive pursuits. Sports medicine practitioners, family physicians, dermatologists and coaches sho...

Chronic actinic dermatitis (CAD) is a rare photosensitivity disorder with scant epidemiologic data. To evaluate demographic data and results of photopatch and patch tests over a 25-year period. Retrospective chart review of patients with CAD from 1993 to 2009. Forty patients had a mean age of 57.8 years, and 27 (67.5%) were men. Twelve patients (30...

Purpose: Mortalities due to skin cancer are escalating, but early detection via skin examinations can be beneficial. To date, dermatologists have not been isolated as a high-risk population for developing skin cancer, although some evidence suggests that they are a high-risk group. Therefore, the specific aims of this study were to measure the fre...

Ultraviolet filters are the most common topical photoallergens. Although currently not available on the US market, methylene bis-benzotriazolyl tetramethylbutylphenol (referred to as bisoctrizole on product labels) represents a new class of UV filters that have both organic and inorganic properties and are widely available in different preparations...

Figure skaters, ice-hockey players and speed skaters experience a range of dermatologic conditions and tissue-related injuries on account of mechanical trauma, infectious pathogens, inflammatory processes and environmental factors related to these competitive pursuits. Sports medicine practitioners, family physicians, dermatologists and coaches sho...

Author Contributions:Study concept and design: Warycha, Kopf, Cohen, and Polsky. Acquisition of data: Terushkin, Warycha, and Levy. Analysis and interpretation of data: Terushkin, Warycha, Kopf, Cohen, and Polsky. Drafting of the manuscript: Terushkin and Warycha. Critical revision of the manuscript for important intellectual content: Terushkin, Wa...

Retrospective chart reviews are periodically needed to update allergen series to detect changes in photoallergic contact dermatitis (PACD) over time. We sought to evaluate photopatch test results during a 13-year period and extend the observations to 20 years. A retrospective chart review was conducted in patients who were photopatch tested. In all...

Clinical trials for systemic psoriasis therapy typically enroll healthy patients and exclude patients with cardiovascular disease, latent tuberculosis, liver disease, histories of malignancies, viral infections, children, and pregnant or breast-feeding women. Physicians often require guidance for optimum management of severe psoriasis in patients t...

The "gold standard" for diagnosing allergic contact dermatitis is patch testing. Previous studies have not adequately addressed the validity and usefulness of the North American Contact Dermatitis Group (NACDG) Standard 65-allergen series alone as a screening tool in the evaluation of contact dermatitis. The purpose of this study is to examine the...

A 79-year-old woman presented with a history of peeling of the palms and soles that began in young adulthood, with exacerbation after exposure to water. Her mother, 2 sisters, and a female maternal cousin have similar symptoms. Physical examination showed scale and hyperlinearity of the palms. Brief exposure to water initiated the development of 1-...

A 71-year-old man presented with a six-year history of a pruritic, erythematous, blistering eruption of the face, chest, and arms. Clinical findings, histopathologic features, and phototests were consistent with a diagnosis of chronic actinic dermatitis. The patient also had contact allergy and photocontact allergy to multiple allergens. A discussi...