Marcella R. Aquino, MD, FACAAI: Don’t Make a Rash Dx

“During the Hot Topics and Practical Pearls in Dermatology” session at the American College of Allergy, Asthma and Immunology (ACAAI) 2023 Annual Scientific Meeting, Marcella R. Aquino, MD, FACAAI, tackled rashes that mimic allergic skin conditions to assist clinicians in the differential diagnosis.¹ Aquino is a staff allergist/immunologist at Rhode Island Hospital and its Hasbro Children’s Hospital in Rhode Island in the department of pediatrics, division of allergy and immunology. She is also an associate professor of pediatrics and clinician educator at The Warren Alpert Medical School of Brown University.

“If you listen to the lecture, you'll see that some of the disease states are repeated,” she told Dermatology Times. Aquino added she took a regional approach to sharing clinical pearls and insights to tackle the types of rashes and mimics that clinicians might face, starting at one part of the body and moving along. She reviewed presentation and epidemiological issues to keep in mind when considering diagnoses.

For instance, Aquino explained that although hand dermatitis affects 2% to 10% of the general population, it actually constitutes 20% to 35% of all & constitutes 20–35% of all skin diseases of the hands. Interestingly, she noted that the mean onset is the third decade of life. When considering hand dermatitis, clinicians should also think about allergic and atopicdermatitis (eg, irritant, allergic, or atopic dermatitis; dyshidrotic eczema), psoriasis, infections (eg, fungal, viral, and scabies), and lichen planus.  Frequent hand washing, the use of latex gloves, atopic dermatitis diagnosis, filaggrin null mutations, and female sex are risk factors for developing hand dermatitis and should be considered during the differential diagnosis.

Some conditions she is comfortable addressing on her own, but she also appreciates collaborating with dermatologists. “If I have any concern that it's psoriasis, I will refer to dermatology. I may start something on my own—like a topical,” she told Dermatology Times. “But for more advanced therapeutics like biologics, I will refer to dermatology.”

Aquino is also part of the 2022 – 2023 Officers and Board of Regents for ACAAI. During the conference she also shared tips on conducting a punch biopsy and assisted with the hands on training as part of the advanced patch testing and interpretation.

Reference

1. Aquino MR. Rashes That Mimic Allergic Skin Conditions. Presented at the American College of Allergy, Asthma and Immunology 2023 Annual Scientific Meeting. November 9-13, 2023; Anaheim, CA.