Women's Health in Dermatology

• Hidradenitis Suppurativa: strong correlation with Metabolic Syndrome, Obesity thus Metformin can be considered as adjunctive therapy. Dose intensification with Adalimumab to 80mg weekly can be helpful for pts who initially improved with standard Adalimumab but have diminishing response. Care of HS patients should include screening for comorbidities such as IBD, Inflammatory arthritis.

• Pregnant/Lactating patients: If using biologics throughout entire pregnancy, infant immunization scheduled should be delayed by 6 months. Polymorphic eruption of pregnancy- key clues starts in striae, SPARES umbilicus, more common to occur in first pregnancy, third trimester; vs Pemphigus Gestationis which STARTS around and involves umbilicus; 1st generation antihistamines (diphenhydramine) are preferred in pregnant patients.

• Vulvar bx techniques: prior to biopsying vulvar dermatoses- the patient should be off topical steroids for 2-4 weeks prior to biopsy. Biopsy technique: Use the suture, lift, and snip technique. Take bite with suture, lift skin and snip with curved iris scissors