Skin and Connective Tissue Diseases Commons^™

An Unusual Presentation Of Tapinarof-Induced Folliculitis, Ysabelle Martinez, Christian J. Scheufele, Christopher Wong, Stephen E. Weis

North Texas GME Research Forum 2024

Introduction: Tapinarof 1% cream is a novel non-steroidal topical medication recently FDA-approved for plaque psoriasis. Tapinarof’s non-steroidal mechanism allow for longer treatment periods without topical corticosteroid side effects e.g. skin atrophy, hypopigmentation, telangiectasias, and striae. Adverse events identified during pivotal trials may not be completely defined before widespread clinical use. This case reports a new presentation of folliculitis with tapinarof use. Case Presentation: A 25-year-old female with trisomy-21 presented for a rash on her left lower leg. The eruption began one year earlier. The eruption was not associated with pruritus, joint pain or nail changes. A clinical diagnosis of …

Retrospective Review Of Adverse Events After Treatment Of Non-Melanoma Skin Cancer With Image-Guided Superficial Radiation Therapy, Marshall Hall, Henry Lim, Jason Pham, Alyssa Forsyth, Wenqin Du

North Texas GME Research Forum 2024

No abstract provided.

Crusted Scabies: A Case Report, Marshall Hall, Philip Oh, Michael Carletti, Stephen E. Weis

North Texas GME Research Forum 2024

Introduction: Scabies is a parasitic dermatologic condition that often presents as an extremely pruritic rash. A rare and highly contagious variant of scabies is crusted scabies, formerly known as Norwegian scabies. Crusted scabies presents with hyperkeratotic papules and plaques, most commonly on the palms and soles. Due to the variety of presentations seen in scabies, it can be difficult to diagnose. Case presentation: Case 1: An 89-year-old male with a history of dementia, anxiety, and benign prostatic hyperplasia presented with a 2-month history of a generalized pruritic rash. He lived in a memory care center. The physical exam showed an …

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Steroid Atrophy, Marshall Hall, Ysabelle Martinez, Wenqin Du, Christian Scheufele, Christopher M. Wong

North Texas GME Research Forum 2024

Introduction: Topical steroids are commonly prescribed first-line medications for various inflammatory and autoimmune dermatologic conditions. Their widespread use raises the importance of proper use. Topical steroids have well-known side effects including skin atrophy, redness, striae, and telangiectasias. These side effects have not been well documented in patients of various skin tones. Primary care clinicians must recognize topical steroid side effects and their appearance in various skin tones. This paper will focus on representing skin atrophy, the most common steroid side effect, in a variety of Fitzpatrick skin types. Case Presentation: We present a series of images illustrating skin atrophy …

A Bullous Eruption In An 81-Year-Old Male, Garrett S. Furth, Christian J. Scheufele, Carlos S. Bahrami, Stephen E. Weis

North Texas GME Research Forum 2024

INTRODUCTION: When a patient presents with a blistering rash arriving at the diagnosis can seem overwhelming. Bullous Pemphigoid (BP) is the most common autoimmune blistering disease and tends to affect older individuals, with a mean age of presentation of eighty. It is caused by antibodies targeting the basement membrane zone, the structure between epidermis and dermis, specifically affecting the BP180 (Type-XVII collagen) and BP230 (a plakin) proteins. Antibody-antigen complexes lead to complement activation and destruction of these transmembrane proteins, causing separation of the epidermis and dermis, and formation of tense, subepidermal blisters and bullae. Identification of key clinical features and …

Eikenella Corrodens Orbital Cellulitis On A 2 Year Old Boy: A Case Report, Juan F. Bedoya, Ricardo Zegarra-Linares, Meena Dhir

South Atlantic Division GME Research Day 2024

No abstract provided.

Ulcerating Plaques Of The Lower Extremities Of A 23-Year-Old Female, Robyn O. Okereke, Christian J. Scheufele, Michael Carletti, Stephen E. Weis

North Texas GME Research Forum 2024

INTRODUCTION: What should come to mind when any physician sees dark red spots on the legs? If you answered vasculitis, then you are on the right track. Leukocytoclastic vasculitis (LCV) is defined as small vessel inflammation of the dermal capillaries and venules. The clinical hallmark finding of LCV is palpable purpura (raised, round, purple plaques) on the lower extremities. LCV is confirmed by histopathology showing neutrophilic infiltration in the walls of dermal vasculature. Though LCV is the most common cause of clinical vasculitis, the annual incidence of biopsy-proven LCV is approximately 30-45 per million individuals. LCV typically occurs in adults …

Geometric Favre-Racouchot Syndrome Following Image-Guided Superficial Radiation Therapy, Marshall Hall, Cecilia Nguyen, Christian Scheufele, Christopher M. Wong, Stephen E. Weis

North Texas GME Research Forum 2024

Introduction: Favre-Racouchot Syndrome is a cutaneous disease characterized by nodules, cysts, and comedones located in sun-exposed areas of the face. It is most commonly found on the bilateral temporal and periorbital skin. Favre-Racouchot Syndrome is most associated with chronic sun exposure. It occurs more commonly in cigarette smokers. It has been rarely associated with radiation therapy. It has not been reported after image-guided superficial radiation therapy or in a geometric pattern. Case presentation: We present the first two recorded cases of Favre-Racouchot Syndrome occurring in the setting of image-guided superficial radiation therapy. Both patients presented with well-demarcated geometric plaques with …

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Tinea Corporis, Navya Peddireddy, Braden Van Alfen, Christian Scheufele, Marshall Hall, Christopher M. Wong

North Texas GME Research Forum 2024

Introduction: Tinea corporis, a superficial fungal skin infection, typically manifests as pruritic annular erythematous scaly plaques with central clearing. This condition can involve every body region. Here we present tinea corporis across various skin pigmentations. The goal of this presentation is to highlight distinctions and similarities in light, medium, and dark skin tones, using the Fitzpatrick scale for stratification of skin types. We hope this can aid primary care clinicians in early recognition of this common condition. Case Presentation: We present a series of cases illustrating the diverse manifestations of tinea corporis across different Fitzpatrick skin types. In Figure 2, …

Bilateral Corticosteroid Atrophy Mimicking Morphea En Coup De Sabre: A Case Report, Christopher M. Wong, Jade Pool, Rafael Do Valle, Cassandra Kenny, Dustin V. Wilkes

North Texas GME Research Forum 2024

Introduction: Corticosteroids affect numerous downstream cytokines to exert anti-inflammatory and immunosuppressive effects. Intralesional corticosteroid injection provides several advantages, including bypassing the stratum corneum to deliver a higher concentration of drug locally, while reducing systemic exposure. Intralesional corticosteroids are used in a variety of dermatologic conditions, and suboccipital steroid injection has been described as a novel treatment for cluster headaches. Case Presentation: A 52-year-old Caucasian female presented to the outpatient dermatologic clinic with indented skin lesions on the scalp and forehead for six weeks. The indentation started on her left frontal scalp and spread down gradually to her forehead and temple. …

Improving Lesion Diameter Reporting On Skin Biopsy Requisition Forms: A Quality Improvement Project, Christopher Wong, Christian Scheufele, Marshall Hall, Henry Lim, Daniel A. Nguyen

North Texas GME Research Forum 2024

Background: Skin biopsy requisition forms (SBRFs) are the primary communication tool between dermatologists and dermatopathologists. Diameters of biopsied skin lesions are frequently omitted on SBRFs. This quality improvement project aimed to increase the rate of reporting diameters of neoplasms on SBRFs from an academic dermatology outpatient clinic to greater than 65% within three years. Methods: The Plan-Do-Study-Act model was utilized. An initial audit was performed for SBRFs of biopsies obtained between July 1, 2021, and February 4, 2022 (“Cycle 1”). On February 4, 2022, the authors discussed societal guidelines for lesion diameter reporting on SBRFs (“Intervention A”). Cycle 2 prospectively …

Efficacious Antibiotic Treatment For Small Intestinal Bacterial Overgrowth And Refractory Gastroparesis Secondary To Scleroderma, Andrea Francis, Ellen Pepperell, Brandon Chong, Micheline Tantchou

Central & West Texas GME Research Day 2024

No abstract provided.

Cutaneous Leishmaniasis In The Setting Of Syphilis On The Us-Mx Border, Jourdan Harper, Enkhbileg Batbileg, Andrew Bush, Cesar Calianga, Hector Zepeda

Central & West Texas GME Research Day 2024

No abstract provided.

Stevens-Johnson Syndrome And Pemphigus Vulgaris: A Missed Connection, Amelia Mellor, Suresh Antony

Central & West Texas GME Research Day 2024

No abstract provided.

A Case Of Underlying Inflammation Mistaken For Ascites, Zuhaib Murtaza, Mattia Walter, Joseph Sammarco, Micheline Tantchou, Oscar Garcia

Central & West Texas GME Research Day 2024

No abstract provided.

In Tint Condition: Analysis Of Actice Ingredients In Popular Tinted Moisturizers And Facial Sunscreens, Nadia El-Hamdi, Peyton Harris, Sloan Long, Sheeva Shahinfar, Palak Parekh

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Unveiling The Complexities: A Case Report On Anti-Mda5 Amyopathic Dermatomyositis And Its Clinical Implications And Therapeutic Challenges, Ines Ramirez-Cibes, Dylan Little, Anna Buck, Lisa Gieseke

Continental, MidAmerica, & Mountain Divisions GME Research Day 2024

No abstract provided.

Cytochrome P450 Alterations In A Patient Treated With Guselkumab For Moderate-Severe Plaque Psoriasis, Michelle Militello, Sarah Ferrer-Bruker

South Atlantic Division GME Research Day 2024

No abstract provided.

A Rare Case Of Eggerthella Lenta In Lower Extremity Necrotizing Soft Tissue Infection: A Case Report, Natalia M. Raimundi Santos, Natalia C. Badillo Velez, Sandeep Rathod, Hassan Tahir Khokhar, Wendy M. Timirau, Naja Naddaf

South Atlantic Division GME Research Day 2024

No abstract provided.

Proving Pyoderma, Diagnosis And Treatment Of Suspected Pyoderma Gangrenosum, Samuel Milam, Sean Gibbs

South Atlantic Division GME Research Day 2024

No abstract provided.

Evaluating The Effect Of Vitamin D Supplementation On Long Term Prednisone Dosage In Systemic Lupus Erythematosus, Ellen Yos, Mohamed Faris

South Atlantic Division GME Research Day 2024

No abstract provided.

Investigating The Link Between Vitamin D Levels And Glucocorticoid Usage In Systemic Lupus Erythematosus, Ellen Yos, Jayden Navarro, Mohamed Faris

South Atlantic Division GME Research Day 2024

No abstract provided.

Type Iv Ehlers-Danlos Syndrome And A Fragile Uterus, Alyssa M. Moffitt, Cullen D. Smith, Alicia Farris, William Osborne, Anthony Royek

South Atlantic Division GME Research Day 2024

No abstract provided.

Reactive Infectious Mucocutaneous Eruption Secondary To Mycoplasma Pneumoniae, Final Patel, Michael Bossak, Natalie Hogan

South Atlantic Division GME Research Day 2024

No abstract provided.

Facial Angiosarcoma Masquerading As Rosacea, Rachel Murray, Danielle Glinka, Juan Rosario-Collazo, Karthik Krishnamurthy

South Atlantic Division GME Research Day 2024

No abstract provided.

A Rare Case Of Epithelioid Hemangioendothelioma In A Teenager, Layal Antoury, Sarah Ferrer Bruker, Karthik Krishnamurthy

South Atlantic Division GME Research Day 2024

No abstract provided.

Presentations Of Tumor Recurrence Of Non-Melanoma Skin Cancer After Treatment With Low-Energy Superficial Radiation Therapy, Marshall Hall, Henry Lim, Christian Scheufele, Christopher M. Wong, Daniel A. Nguyen, Michael Carletti, Stephen Weis

North Texas GME Research Forum 2023

Background: Basal cell carcinoma and squamous cell carcinoma are the most common types of non-melanoma skin cancers.1 Superficial radiation therapy (SRT) is a treatment modality that utilizes low-energy x-rays to disrupt cell mitosis.2 While this technique has been used for over a century, it has recently gained favor in clinical practice.3,4 This method of treatment offers favorable outcomes and advantages for select patients. Although the incidence of cancer recurrence after superficial radiation therapy is low, relatively little is known regarding predictive patterns. The frequency and timing of cancer recurrence is not well defined using SRT delivered technology with an image-guided …

Retrospective Review Of Adverse Events Following Treatment Of Non-Melanoma Skin Cancer With Low-Energy Superficial Radiation Therapy, Marshall Hall, Henry Lim, Christian Scheufele, Christopher Wong, Daniel A. Nguyen, Michael Carletti, Stephen Weis

North Texas GME Research Forum 2023

Background: Basal cell carcinoma and squamous cell carcinoma are the most common types of non-melanoma skin cancer.1 Superficial radiation therapy (SRT) is a treatment modality that utilizes low-energy x-rays to disrupt cell mitosis directly and indirectly.2 This method of treatment offers advantages for select patients. While this technique has been utilized for over a century, it has recently begun to gain favor in clinical practice.1,3 Although SRT has shown favorable outcomes with a low risk of complications, it still poses a risk for adverse events.1,3,4 The frequency and severity of adverse events are not well-defined with SRT delivered technology with …

A Case Of Erythema Nodosum, Mahmood Ahmad, Sunitha Valayil

North Texas GME Research Forum 2023

Background: Erythema nodosum (EN) is characterized as a delayed hypersensitivity reaction to subcutaneous adipose tissue. This panniculitis process presents as erythematous, tender nodules and plaques most commonly located on the pretibial areas. EN may be idiopathic or may be caused by a number of factors such as infection, chronic systemic inflammatory processes, drugs or malignancy.

Case presentation: A 29-year-old male with no significant past medical history presented with a 2-week history of worsening bilateral lower extremity erythema, nodules and pain. This patient was initially seen in the emergency department after a 4-day history of his symptoms. At this time, he …

Lesion Size Inclusion On Dermatopathology Requisition Forms: A Quality Improvement Project, Christopher M. Wong, Henry Lim, Christian Scheufele, Daniel A. Nguyen, Ashleigh E. Hermann, Michael Carletti, Stephen Weis

North Texas GME Research Forum 2023

Introduction: Dermatopathology requisition forms (RFs) are a critical communication tool between dermatologists and dermatopathologists. Including detailed information on RFs improves the diagnostic accuracy of the consulting dermatopathologist. However, the diameter of the biopsied lesion is often omitted on RFs. This study aimed to increase the rate of reporting lesion diameters on RFs from an academic outpatient dermatology clinic to greater than 65% through education, reinforcement, and evaluation. Methods: This quality improvement project retrospectively and prospectively analyzed the inclusion rate of lesion diameters on dermatopathology RFs from a single institution. In Phase 1, data was collected from all skin biopsies performed …