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  • Presentation

S070: Therapeutic and Diagnostic Pearls : Medical Dermatology

Description

The speaker discusses their experience with 5-fluorouracil (5 FU) in treating actinic keratosis (AK) and its unexpected effects on patients with seborrheic dermatitis. They highlight that seborrheic dermatitis presents rapidly proliferating skin, which reacts negatively to 5 FU, leading to unnecessary irritation. To alleviate this, they recommend using ketoconazole 2% cream to treat seborrheic dermatitis before applying 5 FU, ensuring a more tolerable treatment experience for patients. The speaker also recounts a case of recurrent cellulitis in a patient with a past venectomy, noting that the procedure compromised lymphatic drainage and led to an immunocompromised area in the leg. They suggest treating such cases with Nyzarol cream to resolve fungal infections and prevent serious complications. Additionally, they explore the correlation between flat warts and tattoos, particularly observing that the majority of flat warts appeared within the black ink of tattoos due to localized immunosuppression from the tattoo pigments. The speaker encourages further exploration of nanoparticles in tattoo ink for potential therapeutic benefits, and shares findings from their practice to illustrate these phenomena.

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Conclusions

  • Topical 5-FU can exacerbate seborrheic dermatitis, causing unnecessary discomfort for patients.
  • Pre-treating the seborrheic dermatitis with ketoconazole 2% cream can reduce inflammation and improve patient satisfaction during 5-FU treatment.
  • In a study, patients with seborrheic dermatitis specifically experienced increased inflammation after 5-FU application compared to those without.
  • Recurrent lymphangitic cellulitis can occur in immunocompromised districts, such as the leg after venectomy, highlighting the importance of recognizing these at-risk areas.
  • Flat warts are more commonly found in tattooed skin, particularly in areas with black ink, suggesting a localized immunocompromised state due to the tattoo material.
  • The presence of nanoparticles in tattoo ink may suppress local immune responses, allowing viral infections like HPV to proliferate in those areas.
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