Skin and Connective Tissue Diseases Commons^™

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 ...

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.

Integrative Cancer Immunogenomic Analysis Of Serial Melanoma Biopsies Reveals Correlates Of Response And Resistance To Sequential Ctla-4 And Pd-1 Blockade Treatment, Whijae Roh

UT GSBS Dissertations and Theses (Open Access)

Melanoma is the most malignant form of skin cancer. The five-year survival rate for metastatic melanoma is 19.9%. Although targeted therapy of BRAF and MEK inhibitors were developed for melanoma, resistance to therapy is inevitable. Immune checkpoint blockade, which reverses the suppression of the immune system, on the other hand, has shown a durable response in 20-30% of patients with metastatic melanoma. However, more predictive and robust biomarkers of response to this therapy are still needed, and resistance mechanisms remain incompletely understood. To address this, we examined a cohort of metastatic melanoma patients treated with sequential checkpoint blockade against ...

Impact Of Tocilizumab Monotherapy On Clinical And Patient-Reported Quality-Of-Life Outcomes In Patients With Rheumatoid Arthritis, Leslie R. Harrold, Ani John, George W. Reed, Tmirah Haselkorn, Chitra Karki, Youfu Li, Jennie Best, Steve Zlotnick, Joel M. Kremer, Jeffrey D. Greenberg

Open Access Articles

INTRODUCTION: Tocilizumab (TCZ) monotherapy has been proven as an effective treatment for rheumatoid arthritis (RA) in clinical trials. However, there are limited data available regarding the effectiveness of TCZ monotherapy in real-world clinical settings in the United States. The objective of this study was to evaluate the impact of TCZ monotherapy on disease activity and patient-reported outcomes (PROs) in a US-based observational cohort of patients with RA seen in routine clinical practice.

METHODS: Eligible patients had active RA, no prior use of TCZ, and initiated TCZ as monotherapy. Changes in disease activity and PROs were assessed 1 year after TCZ ...

Dermatologist And Patient Preferences In Choosing Treatments For Moderate To Severe Psoriasis, Matthew Alcusky, Seina Lee, Gordon Lau, Gretchen R. Chiu, Nandini Hadker, Aparna Deshpande, Stephen Fleming, Nicola Vance, Steve Fakharzadeh

Open Access Articles

INTRODUCTION: The objective of the study was to determine the relative importance (RI) of treatment attributes psoriasis patients and physicians consider when choosing between biologic therapies based on psoriasis severity.

METHODS: A discrete choice experiment (DCE) weighting preference for eight sets of hypothetical treatments for moderate or severe psoriasis was conducted. DCE hypothetical treatments were defined and varied on combinations of efficacy, safety, and dosing attributes [frequency/setting/route of administration (ROA)].

RESULTS: When assuming moderate psoriasis in the patient DCE, ROA (RI 29%) and efficacy (RI 27%) drive treatment choices. When assuming severe disease in the DCE, patients preferred ...

Dermatomyositis, Sandi Watts

ASA Multidisciplinary Research Symposium

Dermatomyositis is a rare disease which affects the skin and muscles. This disease can manifest in children or not present until one is older. Since this disease is so rare, most individuals who are diagnosed with it will have a team of physicians who work together to help treat the patient.

Acute Bacterial Cellulitis: Emergency Department Management, Aetiological Epidemiology And Clinical Risk Factors For Antibiotic Treatment Failure, Michael Quirke

MD theses

This thesis consists of 6 work-packages (WPs) that describe the Emergency Department (ED) management of cellulitis; it’s aetiological epidemiology, and risk factors for antibiotic treatment failure.

In order to provide a context for this thesis, I performed a scientometric analysis of research output related to skin and soft tissue infections (SSTIs) between 1945 and 2014. Overall, research output was low but increased as a result of the community associated methicillin-resistant Staphylococcus aureus (CA-MRSA) epidemic in North American settings.

My observational research work began with two studies describing the ED incidence of cellulitis, antibiotic prescribing practices and physician adherence to ...

Suppression Of Systemic Autoimmunity By The Innate Immune Adaptor Sting, Shrutie Sharma, Allison M. Campbell, Jennie Chan, Stefan A. Schattgen, Gregory M. Orlowski, Ribhu Nayar, Annie H. Huyler, Kerstin Nundel, Chandra Mohan, Leslie J. Berg, Mark J. Shlomchik, Ann Marshak-Rothstein, Katherine A. Fitzgerald

Katherine A. Fitzgerald

Cytosolic DNA-sensing pathways that signal via Stimulator of interferon genes (STING) mediate immunity to pathogens and also promote autoimmune pathology in DNaseII- and DNaseIII-deficient mice. In contrast, we report here that STING potently suppresses inflammation in a model of systemic lupus erythematosus (SLE). Lymphoid hypertrophy, autoantibody production, serum cytokine levels, and other indicators of immune activation were markedly increased in STING-deficient autoimmune-prone mice compared with STING-sufficient littermates. As a result, STING-deficient autoimmune-prone mice had significantly shorter lifespans than controls. Importantly, Toll-like receptor (TLR)-dependent systemic inflammation during 2,6,10,14-tetramethylpentadecane (TMPD)-mediated peritonitis was similarly aggravated in STING-deficient mice ...

The Global Burden Of Scabies: A Cross-Sectional Analysis From The Global Burden Of Disease Study 2015., Chante Karimkhani, Danny V Colombara, Aaron M Drucker, Scott A Norton, Roderick Hay, Daniel Engelman, Andrew Steer, Margot Whitfeld, Mohsen Naghavi, Robert P Dellavalle

Dermatology Faculty Publications

Background

Numerous population-based studies have documented high prevalence of scabies in overcrowded settings, particularly among children and in tropical regions. We provide an estimate of the global burden of scabies using data from the Global Burden of Disease (GBD) Study 2015.

Methods

We identified scabies epidemiological data sources from an extensive literature search and hospital insurance data and analysed data sources with a Bayesian meta-regression modelling tool, DisMod-MR 2·1, to yield prevalence estimates. We combined prevalence estimates with a disability weight, measuring disfigurement, itch, and pain caused by scabies, to produce years lived with disability (YLDs). With an assumed ...

Multiple Fixed Drug Eruption To Minocycline At Sites Of Healed Burn And Zoster: An Interesting Case Of Locus Minoris Resistentiae, Renata Dalla Costa, Connie Yihan Yang, Molly Stout, Daniela Kroshinsky, Arianne Shadi Kourosh

Open Access Articles

We report a case of minocycline-induced FDE (fixed drug eruption) localized to sites of a previous burn and zoster.

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

Open Access Articles

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 ...

Teens, Tweets, And Tanning Beds: Rethinking The Use Of Social Media For Skin Cancer Prevention, Ashley E. Falzone, Claire D. Brindis, Mary-Margaret Chren, Alexandra Junn, Sherry L. Pagoto, Mackenzie Wehner, Eleni Linos

Open Access Articles

The incidence of skin cancer is rising in the U.S., and melanoma, the deadliest form, is increasing disproportionately among young white women. Indoor tanning is a modifiable risk factor for all skin cancers and continues to be used at the highest rates in young white women. Adolescents and young adults report personal appearance-based reasons for using indoor tanning. Previous research has explored the influences on tanning bed use, including individual factors as well as relationships with peers, family, schools, media influences, legislation, and societal beauty norms. Adolescents and young adults also have high rates of social media usage, and ...

Scleroderma, Erika Lawson

Master of Science in Nursing (MSN) Student Scholarship

Scleroderma, also known as sclerosis, is an autoimmune disease causing fibrosis in connective tissues. Symptoms include: skin tightening, stiffness and swelling of fingers, weight loss, fatigue, and musculoskeletal pain. Limited scleroderma, also known as CREST syndrome, includes calcinosis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia. This presentation is to help increase knowledge of scleroderma pathophysiology and nursing implications that will help medical staff better care for those affected.

Creating The First Indoor Tan-Free Skin Smart College Campus, Jessica S. Mounessa, Sherry L. Pagoto, Katie Baker, John Antonishak, Robert P. Dellavalle

Sherry L. Pagoto

Given the prevalence and risk associated with indoor tanning among college students, university campuses constitute a prime target for skin cancer prevention. This report identifies the successes and challenges faced in promoting a campus-wide tan-free policy through the National Council on Skin Cancer Prevention (NCSCP) Indoor Tan-Free Skin Smart Campus Initiative. Beginning in February 2016, we communicated with university faculty or staff members who have participated in skin cancer prevention via education, clinical care, or research at 20 universities regarding the steps to adopt the tan-free policy. One campus, East Tennessee State University (ETSU), successfully fulfilled all criteria and implemented ...

Noonan Syndrome With Loose Anagen Hair Associated With Trichorrhexis Nodosa And Trichoptilosis, Jennifer L. Kane, Kristen Berrebi, Riley Mclean, Stephanie Petkiewicz, Beverly N. Hay, Madelena Martin, Karen Wiss

Pediatric Publications and Presentations

We report a case of Noonan syndrome with loose anagen hair (NS/LAH), a rare variant of Noonan syndrome, with associated trichorrhexis nodosa and trichoptilosis. The SHOC2 mutation may be responsible for these additional hair shaft defects, revealing the importance of microscopic examination of hairs in these patients.

Fungal Infections From Human And Animal Contact, Dennis J. Baumgardner

Dennis J. Baumgardner. MD

Fungal infections in humans resulting from human or animal contact are relatively uncommon, but they include a significant proportion of dermatophyte infections. Some of the most commonly encountered diseases of the integument are dermatomycoses. Human or animal contact may be the source of all types of tinea infections, occasional candidal infections, and some other types of superficial or deep fungal infections. This narrative review focuses on the epidemiology, clinical features, diagnosis and treatment of anthropophilic dermatophyte infections primarily found in North America. Other human-acquired and zoonotic fungal infections also are discussed in brief.

Identification And Phenotypic Plasticity Of Metastatic Cells In A Mouse Model Of Melanoma, Xiaoshuang Li

FIU Electronic Theses and Dissertations

Melanoma is the deadliest form of skin cancer due to its high propensity to metastasize and resistance to current therapies. We have created a spontaneous mouse model of metastatic melanoma (Dct-Grm1/K5-Edn3) where metastasis to the lungs is 80% penetrant. The primary tumors of these mice present cellular heterogeneity with cells at varying levels of differentiation. The main goal of this study was to determine the metastatic potential of the primary tumor resident Tyrosinase positive cells and evaluate the dynamic phenotypic changes as those cells move from the primary tumors to the sites of metastasis. To accomplish this aim I ...