Skin and Connective Tissue Diseases Commons^™

The Clinical Definition And Characterization Of Field Of Cancerization In Patients With Actinic Keratoses, Stuti Prajapati, Christina Kontzias, Mallory Zaino, Steven Feldman

Rowan-Virtua Research Day

Introduction: Chronic UV radiation affects the entire area of skin exposed, leading to visible actinic keratoses (AK) and subclinical changes in the surrounding skin. AKs are hyperkeratotic lesions, with a 0.025-16% risk of transforming into squamous cell carcinoma (SCC).1 Cellular atypia around AKs is the field of cancerization (FOC). Topical AK therapies can treat the FOC, while destructive treatments address visible lesions. FDA-approved products may be approved for field sizes up to 25 cm2.1,2

Objective: To characterize the FOC and assess the correlation between the FOC and number of AKs.

Methods: 100 patients with AKs were recruited. FOC was defined …

Barriers To Dermatological Care In Patients Who Received Extensive Mohs Surgery - An In-Depth Qualitative Analysis, Stuti Prajapati, Mallory Zaino, Christina Kontzias, Laura Doerfler, Steven R. Feldman

Rowan-Virtua Research Day

Background: Dermatological care needs to be accessible for the elderly, but they face prominent challenges contributing to delays in diagnosis and treatment. Prolonged management of may lead to widespread cutaneous malignancies, necessitating extensive Mohs surgery.

Objective: To identify areas for early intervention in the geriatric population who have undergone extensive Mohs surgery.

Methods: We performed a qualitative study on 10 patients 65 years and older (68-91) from Atrium Health Wake Forest Baptist dermatology clinics between December 2022 and February 2023, who had extensive Mohs surgery (3 or more layers removed).

Results: Three major areas for potential intervention for cutaneous carcinoma …

Case Report: Facial Mask-Induced Acne ("Maskne"), Gabriel Meister, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

A 42 year old male health care worker presented with complaints of severe mask related acne vulgaris predominately to the cheeks, chin and nose Here we present the case of a N95 and surgical facial mask use has been a requirement for many occupations during the Covid-19 pandemic. Patient states their current position requires use of an N95 respirator to be worn throughout their shift which can range from 9-14 hours, 6 days per week. Extended daily use of such masks may lead to changes in the skin which can induce irritation and precipitate infection.

Case Report: Nosocomial Digital Eczema From Surface Cleansing Bleach, James Espinosa, Umar Sannoh, Alan Lucerna

Rowan-Virtua Research Day

We report the case of a healthcare provider who developed hand eczema, predominantly on the first digit and thumb of the right hand, in association with contact with the surface of a desk and mouse pad at work. The eczema abated on days off and was exacerbated within hours of work. The diagnosis was made of hand eczema from surface cleaning bleach. It was noted that several other healthcare providers had developed similar symptoms. The patient's eczema was confirmed by a dermatologist and was successfully treated with topical triamcinolone and emollient cream to the affected areas. Prevention by adhesive strip …

Ureterocutaneous Fistula In Setting Of Recurrent Gluteal Abscesses: A Case Report, Catherine Alapatt, Young Son, Benjamin Fink, Brian Thomas, Sean Coulson, Shawon Akanda, Jacob Thatcher, Thomas Mueller

Rowan-Virtua Research Day

Ureteral fistulas are a rare occurrence that can arise from iatrogenic trauma, radiation, malignancy, and inflammation. Treatment options of urinary tract fistulas are handled on a case-by-case basis and can necessitate a surgical approach. We present the case of an 85-year-old patient with a ureterocutaneous fistula where conservative management with PCN is a viable alternative to surgical intervention.

Case Report And Brief Review: A Case Of Erythema Ab Igne Due To A Space Heater, Adam Kandil, James Espinosa, Alan Lucerna, James Lee, Robin Lahr

Rowan-Virtua Research Day

A 35 year old male presented to the Emergency Department (ED) with a rash of his left lateral lower leg of a 2 months duration. The patient had been using an electric space heater and the affected area was the closest part of his body to the heater. A diagnosis of erythema ab igne was made. Here we discuss erythema ab igne in reference to the medical history of the diagnosis, pathophysiology, modern causative heat sources such as laptop computers and treatment.

Dorsal Wrist Impingement Syndrome Pain After Ganglion Cyst Removal – A Case Report, Sidharth Sahni, Joseph Fares, Natty Jumreornvong, Arpun Shah, Mariam Zakhary

Rowan-Virtua Research Day

A ganglion cyst is a benign fluid-filled sac that develops idiopathically on the dorsal aspect of the wrist by the joint capsule or tendon sheath. It is diagnosed clinically, with MRI and ultrasound used for confirmation. Treatment includes immobilization, aspiration, hydrossection, steroid or hyaluronidase injection, and surgery. Although uncommon, Dorsal Ganglion Cysts (DGC) can lead to Dorsal Wrist Impingement (DWI) syndrome. This syndrome is caused by a thickening of the wrist capsule from overuse, injury, or repetitive procedures. This thickness leads to capsule pinching commonly by the extensor carpi radialis brevis (ECRB) tendon during wrist extension and tenderness by the …

An Unusual Ed Case: Spontaneous Necrotizing Fasciitis Presenting As Hypoxic Pneumonia, Chetna Thawani, Kishan Patel

Rowan-Virtua Research Day

We present a case of necrotizing fasciitis initially presenting as septic hypoxic pneumonia, and discuss imaging modalities and diagnostic evaluation. Necrotizing soft tissue infection (NSTI) is a rapidly progressive surgical emergency with a mortality rate of 30%. In approximately 80% of cases, it is introduced through a break in the skin. It can also occur after any invasive procedure or surgery. It is most commonly associated with skin flora including staph and strep, though polymicrobial infections are most common. It usually presents with signs of systemic infection, including fever, chills, sepsis, altered mental status - and signs of cutaneous involvement …

New Onset Lichen Planus And Back Pain Leading To Discovery Of A Peri Aortic Abscess, Monica Diep, Wayne Tamaska, Philip Carhart, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Back pain is a common chief complaint in the emergency department. With the differential ranging from musculoskeletal pain to cauda equina, there are a plethora of diagnoses. Differentiating between benign back pain and back pain that warrants further evaluation and even possible emergent surgical intervention is often a challenge in the acute setting. In this case report, a strange combination of all new symptoms including lichen planus, fevers, chills and atraumatic back pain lead to the eerie and very unexpected diagnosis of a peri-aortic abscess.

Racial Differences In Perceived Risk And Sunscreen Usage, Rebecca Fliorent, Alicia Podwojniak, Lianne Adolphe, Katharine Milani

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Background Although White individuals have higher incidence of melanoma, clinical outcomes are worse among patients with skin of color. This disparity arises from delayed diagnoses and treatment that are largely due to clinical and sociodemographic factors. Investigating this discrepancy is crucial to decrease melanoma-related mortality rates in minority communities. A survey was used to investigate the presence of racial disparities in perceived sun exposure risks and behaviors. Methods A survey consisting of 16 questions was deployed via social media to assess skin health knowledge. Over 350 responses were recorded, and the extracted data were analyzed using statistical software. Results Of …