Hair loss is common in women of color, and is associated with significant psychosocial complaints. Early clinical recognition and prompt initiation of intervention with medical treatment is critical to halt the disease process. In this article, we review the clinical presentations of nonscarring and scarring alopecias in women of color, use of dermoscopy for early recognition of the disease process, and medical, procedural, and surgical interventions. In conditions that result in scarring alopecia, such as late-stage traction, frontal fibrosing, or central centrifugal cicatricial alopecia, patients may benefit from procedural interventions, such as hair transplantation, platelet rich plasma injections, low-level laser therapy, or scalp therapy.

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Pembrolizumab is a humanized IgG4 isotype mAb that the targets and blocks the programmed cell death protein 1 receptor on lymphocytes. Its use in treating metastatic melanoma is associated with increased overall survival compared to other older immunotherapies. Several adverse effects have been noted including both systemic and cutaneous manifestations. As a relatively novel treatment option, many new cutaneous manifestations are still being observed, occurring at various times after initiation of therapy. Previously noted cutaneous adverse effects include sarcoid-like reactions, rash, and changes in preexisting lesions or scars. Here we present a case in which biopsy-proven morphea developed after completion of pembrolizumab therapy.

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Immunobiologics are used to treat patients with moderate to severe psoriasis and allow for continuous maintenance therapy for longer periods of time without the adverse effects seen with older systemic medications, such as methotrexate or cyclosporine. However, will patients stop responding to the drug if they discontinue and restart therapy? This review will examine four biologic agents currently used in the treatment of psoriasis – etanercept, adalimumab, infliximab, and ustekinumab — to determine whether patients can re-achieve comparable clinical response with intermittent therapy versus continuous therapy. While some data suggest that continuous immunologic therapy may lead to decreased efficacy over time, etanercept, adalimumab, and ustekinumab provide patients with durable response should a patient need to discontinue and reinitiate treatment. These findings may assist clinicians in selecting an appropriate agent should interruption of therapy be necessary.