Inaugural ElderDerm Conference Hosted by GW

The inaugural ElderDerm Conference was held June 6 in Washington, DC, hosted by the GW Department of Dermatology.

Co-Director Adam Friedman, MD, a Practical DermatologyÒ Editorial Board member, presented two talks: “Hair Loss in the Elderly: Considerations and Therapeutic Approaches” and “Current Concepts in the Pathogenesis, Recognition, and Management of Dermatoporosis.” Other speakers included Blair Allais, MD, FAAD; Colton Hood, MD; Mikhail Kogan, MD; Shawn Kwatra, MD; Vishal Patel, MD; Christina Prather, MD, FACP; and Karl Saardi, MD.

In “Hair Loss in the Elderly: Considerations and Therapeutic Approaches,” Dr. Friedman first discussed evaluation of the elderly patient with hair loss, including questions about the how the patient noticed it and any associated symptoms such as itching, scaling, redness, or pain. Dr. Friedman also covered medication-induced alopecia from anticoagulants, antiretroviral, anti-thyroid drugs, mood stabilizers, dopaminergic therapy for Parkinson’s disease, ACE inhibitors, allopurinol, and analgesics/anti-inflammatories; all drugs taken 4 months before the onset of hair loss should be considered, he said. Also covered were diagnosis and treatment approaches, including separate considerations for both men and women. Dr. Friedman discussed alopecia areata treatments ranging from corticosteroids to minoxidil 5%, methotrexate/CsA, oral non-sedating antihistamines, and oral JAK inhibitors, as well as treatments for other conditions.

In “Current Concepts in the Pathogenesis, Recognition, and Management of Dermatoporosis,” Dr. Friedman described key features of the condition: atrophic skin, solar purpura, and white pseudoscars. He also noted that skin lacerations and delayed healing are frequent features. While advancing age is the primary risk factor for dermatoporosis, Dr. Friedman listed several secondary factors: UVA/UVB, genetic susceptibility, topical corticosteroid use, systemic corticosteroid use, chronic renal failure, anticoagulant use, chronic obstructive pulmonary disease, epidermal growth factor receptor inhibitor use, and lack of exercise. Complications, he added, can include linear skin tears and lacerations, delayed wound healing, and deep dissecting hematosas; for post-menopausal women, dermatoporosis has been linked to osteoporosis and osteoporotic fractures. Prevention measures, he said, include sun protection, avoiding furniture with sharp edges, and emollients for epidermal barrier repair. Among various treatment options, Dr. Friedman suggested a combination of calcipotriene ointment qAM, tazarotene .045% lotion qHD, vitamin C 1000 mg BID, and citrus bioflavnoid complex 1000 mg qD.