Autoimmune diseases create a substantial burden of disease, and alopecia areata is among the more prevalent forms. Comorbidities are medical conditions that tend to occur together and may provide etiologic insights, suggest novel therapeutic strategies, and help patients and family members understand the risk of other health conditions. It is well established that having one autoimmune disease increases risk for others because of an underlying shared biology. Precision medicine initiatives are creating vast amounts of data that allow us to efficiently identify comorbidities. A survey across various datasets suggests that patients with autoimmune disease, and patients with alopecia areata in particular, may have comorbid neuropsychiatric and metabolic conditions.

Sixty-five percent of glucoside-allergic patients exhibited co-reactions to decyl and lauryl glucosides. Thus, neither glucoside is an adequate screen for allergy to the other. Given that these reactions are often relevant, clinicians should patch test with decyl, lauryl, and other alkyl glucosides in cases of suspected cosmetic allergy.

Knowledge about genetic drivers of disease increases the efficiency of interpreting patient DNA sequence and helps to identify and prioritize biological points of intervention. Discoveries of genes with single mutations exerting substantial phenotypic impact reliably provide new biological insight, although such approaches tend to generate knowledge that is disjointed from the complexity of biological systems governed by elaborate networks. Here we sought to facilitate diagnostic sequencing for hair disorders and assess the underlying biology by compiling an archive of 684 genes discovered in studies of monogenic disorders and identifying molecular annotations enriched by them. To demonstrate utility for this dataset, we performed two data driven analyses. First, we extracted and analyzed data implicating enriched signaling pathways and identified previously unrecognized contributions from Hippo signaling. Second, we performed hierarchical clustering on the entire dataset to investigate the underlying causal structure of hair disorders. We identified 35 gene clusters representing genetically derived biological modules that provide a foundation for the development of a new disease taxonomy grounded in biology, rather than clinical presentations alone. This Resource will be useful for diagnostic sequencing in patients with diseases affecting the hair follicle, improved characterization of hair follicle biology, and methods development in precision medicine.

Continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion (CSII) are the standard of care for type 1 diabetes (T1D). There is little reported on skin complications related to these devices. This study documents cutaneous reactions to CGM and CSII devices in children and young adults with T1D. 121 subjects (3-25 years) with T1D and CGM and/or CSII use were recruited over a 3-month period from the Naomi Berrie Diabetes Center at Columbia University Medical Center. A 5-question survey was completed for each subject detailing demographic data and device-related skin problems. 60% of subjects reported skin problems related to CGM and/or CSII use. Terms most frequently used to describe their reactions were red, itchy, painful, and rash. Subjects who used both CGM and CSII were more likely to report skin problems than those who used only CSII (OR [2.9]; p=0.015; 95% CI [1.2, 6.7]). There were no associations between skin problems and age, sex, or race/ethnicity. 22% of subjects with an adverse skin event discontinued use of their device due to their skin problem. 7% were evaluated by a dermatologist. 81% used a range of products to treat their symptoms, with variable perceived clinical effects. Skin complications related to CSII or CGM devices are common, and may lead to interruption or discontinuation of treatment. Future studies to elucidate the causes are needed. Table 1Supplemental Products Used By Patients: Effects on Skin ProblemsProduct categoryPatients using products in category (n)Patients reporting clinical improvement (%)Patients reporting no change (%)Patients reporting clinical worsening (%)Patients reporting discordant effects (%)Adhesive barrier wipe2726% (7/27)48% (13/27)11% (3/27)15% (4/27)Transparent film dressing2733% (9/27)48% (13/27)11% (3/27)7% (2/27)Topical steroid2277% (17/22)18% (4/22)0% (0/22)5% (1/22)Adhesive bandage1315% (2/13)54% (7/13)23% (3/13)8% (1/13)Hydrocolloid adhesive pad1369% (9/13)15% (2/13)15% (2/13)0% (0/13)Topical antibiotic1182% (9/11)18% (2/11)0% (0/11)0% (0/11)Adhesive remover1050% (5/10)40% (4/10)10% (1/10)0% (0/10) Disclosure R.K. Severin: None. R. Gandica: None. L.E. Levin: None. D.V. Belsito: None. M.C. Garzon: None. K.M. Williams: None.

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