Skin and Connective Tissue Diseases Commons^™

Therapeutic Benefit Of Apremilast On Enthesitis And Dactylitis In Patients With Psoriatic Arthritis: A Pooled Analysis Of The Palace 1-3 Studies, Dafna D. Gladman, Arthur Kavanaugh, Juan J. Gomez-Reino, Jurgen Wollenhaupt, Maurizio Cutolo, Georg Schett, Eric Lespessailles, Benoit Guerette, Nikolay Delev, Lichen Teng, Christopher J. Edwards, Charles Birbara, Philip J. Mease

Open Access Articles

Objective: The Psoriatic Arthritis Long-term Assessment of Clinical Efficacy (PALACE) clinical trial programme findings demonstrated that apremilast, an oral phosphodiesterase 4 inhibitor, is effective for treating psoriatic arthritis (PsA). Enthesitis and dactylitis are difficult-to-treat features of PsA leading to disability and affecting quality of life. PALACE 1, 2 and 3 data were pooled to assess the efficacy of apremilast on enthesitis and dactylitis outcomes in patients with these conditions at baseline.

Methods: Patients with enthesitis (n=945) or dactylitis (n=633) at baseline were analysed after receiving double-blind treatment with placebo, apremilast 30 mg two times per day or apremilast ...

Fas Ligand Promotes An Inducible Tlr-Dependent Model Of Cutaneous Lupus-Like Inflammation, Purvi Mande, Bahar Zirak, Wei-Che Ko, Keyon Taravati, Karen L. Bride, Tia Bumpus Brodeur, April C. Deng, Karen A. Dresser, Zhaozhao Jiang, Rachel Ettinger, Katherine A. Fitzgerald, Michael D. Rosenblum, John E. Harris, Ann Marshak-Rothstein

University of Massachusetts Medical School Faculty Publications

Toll-like receptors TLR7 and TLR9 are both implicated in the activation of autoreactive B cells and other cell types associated with systemic lupus erythematosus (SLE) pathogenesis. However, Tlr9-/- autoimmune-prone strains paradoxically develop more severe disease. We have now leveraged the negative regulatory role of TLR9 to develop an inducible rapid-onset murine model of systemic autoimmunity that depends on T cell detection of a membrane-bound OVA fusion protein expressed by MHC class II+ cells, expression of TLR7, expression of the type I IFN receptor, and loss of expression of TLR9. These mice are distinguished by a high frequency of OVA-specific Tbet ...

Doacs Least Harmful For Patients With Calciphylaxis On Hemodialysis Needing Anticoagulation, Mona Fayad

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of King BJ, El-Azhary RA, Mcevoy MT, et al. Direct oral anticoagulant medications in calciphylaxis. International Journal of Dermatology. 30 August 2017;56(1):1065-1070. doi: 10.1111/ijd.13685

Inflammation And Immune Evasion Coexist In Treponema Pallidum-Infected Skin, Rodolfo Trujillo, Jorge Cervantes, Kelly L. Hawley, Adriana R. Cruz, Sankhiros Babapoor, Michael Murphy, Soheil S. Dadras, Juan C. Salazar

Biology Faculty Publications

Syphilis is a systemic, multistage, sexually transmitted infection caused by the highly invasive spirochetal bacterium, Treponema pallidum, subspecies pallidum. In the United States, the annual rate of primary and secondary syphilis (SS) between 2002 and 2016 has increased from 2.1 to 8.7 cases per 100,000.¹ Gestational and congenital syphilis cases have also increased in the last few years. There is no evidence of a change in T pallidum susceptibility to penicillin as an explanation for the significant increase in the number of syphilis cases in the United States. It is more likely that changes in risk-taking ...

Assistive Utensil: A Spork For Hand Tremors And Spatial Awareness, Ana Font Hernandez, Jacob Kabariti, Troy Taylor

Publications and Research

In this poster, we present a 3D printed solution for hand tremors and special awareness. Our spork is an assistive device designed and 3D printed for patients suffering from scleroderma, systemic sclerosis, Parkinson's, multiple sclerosis, drug withdrawal, etc. The scale-based handle will act as a counterweight to offset the contents on the other end and reduce shakiness. The larger grip allows an easy and comfortable hold. The product will be 3D printed for a customizable fit and at an affordable price. Lastly, the product will include a haptic feedback sensor to assist the visually impaired in locating food contents ...

Periostin Antisense Oligonucleotide Suppresses Bleomycin-Induced Formation Of A Lung Premetastatic Niche For Melanoma, Takashi Semba, Eiji Sugihara, Nagisa Kamoshita, Sayaka Ueno, Keitaro Fukuda, Masafumi Yoshino, Kazumasa Takao, Kazunori Yoshikawa, Kenji Izuhara, Yoshimi Arima, Makoto Suzuki, Hideyuki Saya

Open Access Articles

Metastasis is the leading cause of cancer death. A tumor-supportive microenvironment, or premetastatic niche, at potential secondary tumor sites plays an important role in metastasis, especially in tumor cell colonization. Although a fibrotic milieu is known to promote tumorigenesis and metastasis, the underlying molecular contributors to this effect have remained unclear. Here we show that periostin, a component of the extracellular matrix that functions in tissue remodeling, has a key role in formation of a fibrotic environment that promotes tumor metastatic colonization. We found that periostin was widely expressed in fibrotic lesions of mice with bleomycin-induced lung fibrosis, and that ...

Infections Not Fought: Antibiotic Resistance In Underserved Communities, Derek Lillestolen

Senior Honors Theses

In 1928, the profound effects of penicillin were discovered and antibiotic treatments became extremely popular. Broad-spectrum antibiotics, like tetracyclines, have been since branded as cure-all prescriptions and used profusely in the Western World and abroad. Due to ignorance of specific biochemical mechanisms and the misuse of antibiotics these drugs inadvertently allowed the rise in prevalence of antibiotic resistant strains of certain bacteria as the century progressed. Now, the specific genetic causes and mechanisms of antibiotic resistance are being understood, but the fight against antimicrobial resistance is far from over. In the United States, thousands of fatalities are caused annually by ...

Differential Diagnosis Of Pan-Uveitis: Behçet’S Disease, Peter Blosser, Remil Simon, Courtney Ridner

Appalachian Student Research Forum

This report describes the case of a 56-year-old man who presented with blurry vision, increased intraocular pressure, and conjunctival injection after posterior chamber intraocular lens implantation. Initially post-operative endophalmitis and foreign body inflammation were considered as differential diagnoses, but after further examination pan-uveitis was diagnosed. Uveitis is an ocular finding that may indicate several diseases, one of which is Behçet’s Disease. During the interview, the patient mentioned a history of apthous ulcers and genital ulcers which then lead to the clinical diagnosis of Behçet’s Disease. This report emphasizes that Behçet’s Disease is rare in Caucasians. Therefore, is ...

Androgenic Alopecia; The Risk–Benefit Ratio Of Finasteride, David L. Rowland, Ion G. Motofei, Ioana Păunică, Petrișor Banu, Mihaela F. Nistor, Stana Păunică, Vlad D. Constantin

Journal of Mind and Medical Sciences

Finasteride is currently approved and largely used as a therapeutic option for androgenetic alopecia. Apparently a safe drug and effective at the onset of its application, several concerns have since appeared over the years regarding the frequency and magnitude of finasteride adverse effects, which in some cases appear irreversible even after drug termination.

This paper discusses the use of finasteride for androgenic alopecia from two distinct perspectives. On the one hand, androgenic alopecia is a condition that especially affects a person’s self-image and esteem, aspects that are subjectively-constructed and thus relative and changeable. On the other hand, this condition ...

Studies Of Amino Acid Mutations In Drug Resistance Of The Smo Protein, Eunice Wintona

Student Research and Creative Activity Fair

Smoothened receptor (SMO) is a protein that in humans, is encoded by the SMO gene. A systemic mutation in its binding pocket helps predict the sensitivity of mutant proteins to different drugs. Known as a GPCR-like receptor, it is a component of the hedgehog signaling pathway; a pathway involved in body patterning and the regulation of adult stem cells. An uncontrolled or inappropriate activation of the Hedgehog pathway drives tumor progression in cancers and a number of birth defects. To achieve these goals, the molecular modeling software MOE was used to build small molecules and drug molecules like Vismodegib and ...

Cluster-Randomized Trial Of A Behavioral Intervention To Incorporate A Treat-To-Target Approach To Care Of Us Patients With Rheumatoid Arthritis, Leslie R. Harrold, George W. Reed, Ani John, Christine J. Barr, Kevin Soe, Robert P. Magner, Katherine C. Saunders, Eric M. Ruderman, Tmirah Haselkorn, Jeffrey D. Greenberg, Allan Gibofsky, J. Timothy Harrington, Joel M. Kremer

Open Access Articles

OBJECTIVE: To assess the feasibility and efficacy of implementing a treat-to-target approach versus usual care in a US-based cohort of rheumatoid arthritis patients.

METHODS: In this behavioral intervention trial, rheumatology practices were cluster-randomized to provide treat-to-target care or usual care. Eligible patients with moderate/high disease activity (Clinical Disease Activity Index [CDAI] score > 10) were followed for 12 months. Both treat-to-target and usual care patients were seen every 3 months. Treat-to-target providers were to have monthly visits with treatment acceleration at a minimum of every 3 months in patients with CDAI score > 10; additional visits and treatment acceleration were at ...

The Conundrum Of Indeterminate Quantiferon-Tb Gold Results Before Anti-Tumor Necrosis Factor Initiation, Shahrad Hakimian, Yevgeniy Popov, Abbas Rupawala, Karen I. Salomon-Escoto, Steven Hatch, Randall Pellish

Open Access Articles

Background: Tumor necrosis factor alpha (TNFalpha) is a key cytokine in both the pathogenesis of inflammatory bowel disease (IBD) and rheumatoid arthritis (RA) and the host defense against tuberculosis (TB). Consequently, anti-TNFalpha medications result in an increased risk of latent TB infection (LTBI) reactivation. Here, we sought to evaluate the factors affecting the results of QuantiFERON-TB Gold In-Tube (QFT-GIT) assay as a screening tool for LTBI.

Methods: We conducted an observational, retrospective study in patients with IBD and RA who underwent LTBI screening using QFT-GIT at UMass Memorial Medical Center between 2008 and 2016 prior to initiation of anti-TNF medications ...

Metastatic Extramammary Paget's Disease: Pathogenesis And Novel Therapeutic Approach, Keitaro Fukuda, Takeru Funakoshi

Open Access Articles

Extramammary Paget's disease (EMPD) is a rare, slow-growing, cutaneous adenocarcinoma that usually originates in the anogenital area and axillae outside the mammary glands. EMPD mostly progresses slowly and is often diagnosed as carcinoma in situ; however, upon becoming invasive, it promptly and frequently metastasizes to regional lymph nodes, leading to subsequent distant metastasis. To date, several chemotherapy regimens have been used to treat metastatic EMPD; however, they present limited effect and patients with distant metastasis exhibit a poor prognosis. Recently, basic and translational investigative research has elucidated factors and molecular mechanisms underlying the promotion of metastasis, which can lead ...

Assessment Of Temperature And Ultraviolet Radiation Effects On Sunburn At An Inland U.S. Beach: A Cohort Study, Jason W. Marion, Jiyoung Lee, James Rosenblum, Timothy J. Buckley

EKU Faculty and Staff Scholarship

Background

Increases in outdoor temperature may lead to increases in sunburn, outdoor exposure, and skin cancer in human populations.

Objective

This study aimed to quantify sunburn incidence and risk for Ohio beachgoers exposed to varying outdoor conditions.

Methods

Sunburn incidence data were obtained through a prospective cohort study at East Fork Lake (Cincinnati, Ohio, USA). Recruitment occurred over 26 weekend days. Beach interviews and follow-up telephone interviews obtained exposure and health information. New sunburns were self-reported 8–9 days post-enrollment. Survey data were paired with ultraviolet radiation (UVR) index and temperature data for statistical analysis.

Results

Among 947 beachgoers, new ...

Impact Of Rituximab On Patient-Reported Outcomes In Patients With Rheumatoid Arthritis From The Us Corrona Registry, Leslie R. Harrold, Ani John, Jennie Best, Steve Zlotnick, Chitra Karki, Youfu Li, Jeffrey D. Greenberg, Joel M. Kremer

Leslie R. Harrold

To evaluate the impact of rituximab on patient-reported outcomes (PROs) in a US-based observational cohort of patients with rheumatoid arthritis (RA). Patients with active RA, prior exposure to > /=1 tumor necrosis factor inhibitor (TNFi) and who newly initiated rituximab were identified. Changes in PROs were assessed 1 year after rituximab initiation. PRO measures included Clinical Disease Activity Index (CDAI); patient global disease activity, pain and fatigue (visual analog score; 0-100); morning stiffness (hours); modified Health Assessment Questionnaire (mHAQ; 0-3); and EuroQoL EQ-5D. Of the 667 patients who newly initiated rituximab, baseline PRO and clinical measures indicated that patients were substantially ...

A Case Of Eosinophilic Annular Erythema As A Presenting Sign For Autoimmune Hepatitis, Olabola Awosika, Kristin Totoraitis, Misty Eleryan, Monica Rengifo-Pardo, Alison Ehrlich

Dermatology Faculty Publications

Eosinophilic annular erythema (EAE) is a relatively new entity, clinically presenting as a figurate erythema. The cause of EAE remains obscure, but it has been associated with several chronic conditions and malignancies. We describe an unusual case of EAE developing before the onset of autoimmune hepatitis.

Profile Of Dupilumab And Its Potential In The Treatment Of Inadequately Controlled Moderate-To-Severe Atopic Dermatitis., Olabola Awosika, Lori Kim, Momina Mazhar, Monica Rengifo-Pardo, Alison Ehrlich

Dermatology Faculty Publications

Atopic dermatitis (AD) is a common inflammatory skin disorder that manifests as eczematous lesions, often associated with allergic rhinitis and asthma. Historically, moderate-to-severe disease has been managed with systemic immunosuppression, such as oral corticosteroids, which result in relapse and limiting side effects. Due to recent advancements in the identification of interleukin (IL)-4 and IL-13 as key mediators in AD, new biological agents have been developed for treatment. Dupilumab is a recently approved monoclonal antibody that targets the alpha subunit of the IL-4 receptor and, thus, downregulates activity of IL-4 and IL-13. This review discusses the profile of dupilumab and ...

Halting Progression Of Stasis Dermatitis: Community Perspectives And Strategies For Prevention, Allison B. Robbins

Family Medicine Clerkship Student Projects

Complications of stasis dermatitis including venous ulcers, osteomyelitis, and cellulitis all significantly increase morbidity and mortality of disease. Progression beyond stasis dermatitis and avoidance of the aforementioned complications are preventable with patient education and adherence to basic therapies including compression stockings and lifestyle modification. Therefore the goals of this project were to: assess the community’s understanding of stasis dermatitis and their awareness of its complications; use this information to help healthcare providers tailor their preventative health counseling accordingly; and provide education for patients on stasis dermatitis, its complications, and therapies/behavioral changes to prevent disease progression.

Effects Of Pak Kinase Inhibition On Emergence Of Vemurafenib Resistance In Melanoma, Brooke Jennings

University of Iowa Honors Theses

Melanoma is considered the most dangerous form of skin cancer, and the number of cases of melanoma per year has doubled in 30 years. Mutations in the B-RAF gene account for approximately 50% of genetic driver mutations in skin melanoma. Patients with B-RAF mutant melanoma are typically treated with a chemotherapy drug called vemurafenib. However, patients can stop responding to this treatment in as little as six months. The main purpose of this study was to determine if inhibiting PAK, a kinase-signaling molecule, in combination with vemurafenib could prevent the treatment-resistance in melanoma. PAK signaling plays an important role in ...

Treatment Options For Hidradenitis Suppurativa: Efficacy, Risks, Benefits, Katherine A. Hennager

Physician Assistant Scholarly Project Posters

Hidradenitis suppurativa is a chronic, recurrent follicular occlusion disease with painful, sometimes debilitating, cutaneous draining lesions and subcutaneous abscesses (DynaMed Plus, 2016). Hidradenitis suppurativa is understood to be a multifactorial disease that is hard to treat in some patients, especially those with a severe form of the disease. For this project, the efficacy of adalimumab for hidradenitis suppurativa was assessed and whether it is more beneficial than traditional treatments used. Adalimumab is a TNF-alpha inhibitor which belongs to the biologic DMARDs drug class. Kimball et al. (2012) found that at week 16 of their trial 3.9% of the placebo ...