Skin and Connective Tissue Diseases Commons^™

Childhood-Onset Borderline Tuberculoid Leprosy With Reversal Reaction, Ramona D. Lubis, Mila Darmi, Rudi Chandra

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Leprosy is a chronic granulomatous infection caused by Mycobacterium lepraethat predominantly affects the skin and peripheral nerves. Leprosy among children is still common in endemic countries.

Case Illustration: A 12-year-old girl complained about a hypopigmented anesthetic patch on her face for 11 years, which became larger and spread slowly to her arms and legs. She had a history of close contact with her aunt, who was diagnosed with multibacillary leprosy. On slit-skin-smear test, acid-fast-bacilli (bacteriologic index +1) were found. She was diagnosed with multibacillary leprosy and treated with children’s multidrug therapy-multibacillary (MDT-MB) regimen. After 2 months of …

Noninvasive Diagnostic Modality For Skin Cancer, Remenda Siregar, Raja Nurhayati, Widyaningsih Oentari, Ari Karmila Sari

Journal of General - Procedural Dermatology & Venereology Indonesia

Histopathological examination is the gold standard for the diagnosis of nonmelanoma and melanoma skin cancer, but it is an invasive procedure that consumes time and requires large costs. The average cure rate for skin cancer is high with early detection and appropriate treatment. This is an article review that was made through findings from several scientific articles. There are several noninvasive imaging modality choices that can be used for screening at low cost, high quality, and faster result, which includes dermoscopy, optical coherence tomography, reflectance confocal microscopy, electrical impedance spectroscopy, multispectral imaging, and SIAscopy®. These imaging modalities can assist in …

Morphological Spectrum Of Vesiculobullous Skin Lesions: An Institutional Perspective, Javaria Ali, Sabeeh Islam, Syed Munqaad Ali, Syed Rafay Yaqeen, Anum Aslam, Qurat Ul Ain Khan, Umair Arshad Malik, Muhammad Irfan, Hanna Naqvi, Atif A. Hashmi

Section of Internal Medicine

Introduction: A vesiculobullous lesion of the skin encompasses a group of dermatological disorders with protean clinicopathological features. They usually occur as a part of the spectrum of various infectious, inflammatory, drug-induced, genetic, and autoimmune disorders. Therefore, accurate diagnosis of these lesions is essential for appropriate management and to reduce the associated morbidity and mortality. The conventional skin punch biopsy is the mainstay in the diagnosis of dermatological diseases, especially when combined with confirmatory tests, such as direct immunofluorescence (DIF). Our study evaluated the clinicopathological spectrum of vesiculobullous lesions.
Methods: We studied 150 cases of vesiculobullous lesions at the Department of …

Managing Pediatric Atopic Dermatitis In The Allergy Clinic: Use Of An Eczema Action Plan To Improve Caregiver Understanding And Self-Efficacy, A Pilot Study, Danielle Hubacek

Doctor of Nursing Practice Final Manuscripts

Eczema, or atopic dermatitis, is a complex and chronic condition that affects approximately 10% of children throughout the United States (Brown et al., 2018). The American Academy of Allergy Asthma & Immunology (AAAAI) (2017) estimates the average cost of eczema management for each patient is approximately $3,302 per year. The complex nature of atopic dermatitis indicates a need for individualized treatment plans. Research has shown that standardized patient teaching, written education materials, and Eczema Action Plans (EAP) reinforce patient teaching, parental understanding, and improve quality of life. This evidence-based practice (EBP) project introduces the use of a written Eczema Action …

Antibiotic Durations For Skin And Soft Tissue Infections In Pediatric Urgent Care Clinics, Megan Hamner

Research Days

Background: Skin and soft tissue infections (SSTIs) are the second most common diagnosis leading to pediatric antibiotic prescriptions in the outpatient setting after respiratory diagnoses. However, most antibiotic stewardship programs have mainly focused on the latter. Children seen in the ambulatory setting for SSTIs often receive >7 days of antibiotics, although current society guidelines recommend 5-7 days for most diagnoses.

Objectives/Goal: To determine the baseline percentage of patients receiving antibiotic prescriptions for >7 days for SSTIs in Children’s Mercy urgent care clinics (UCC)s and to evaluate factors that influence providers towards longer durations.

Methods/Design: We built a report that extracted …

Refining The Optimal First Treatment For Pediatric Breast Abscesses, Kayla B. Briggs

Research Days

Background: We previously reported treatment and outcomes of children with untreated, not spontaneously draining (UTND) breast abscesses. What has not been well defined however are those with previously treated, not spontaneously draining (PTND) pediatric breast abscesses. In general, a more conservative approach is favored in children with breast abscesses to avoid damage to the developing breast bud.

Objectives/Goal: We sought to determine if care at a pediatric tertiary referral center impacts disease persistence rate.

Methods/Design: Following IRB approval, patientstherapy.

Results: In all, 114 patients met inclusion criteria, 96 in the UTND group and 18 in the PTND group (Figure 1). …

Rare Variant Of Porokeratosis: A Case Report, Nardin Awad

Stratford Campus Research Day

There are 5 clinically distinct variants of porokeratosis, including classic porokeratosis of Mibelli, disseminated superficial (actinic) porokeratosis, linear porokeratosis, punctate porokeratosis, and porokeratosis palmaris et plantaris disseminate. Porokeratosis ptychotropica (PP) is the sixth, lesser-known variant of the spectrum. PP is characterized by verrucous plaques, often resembling psoriasis plaques, that affect the buttocks, most commonly the gluteal cleft, and can also involve the extremities, most commonly the lower legs and feet. Due to its characteristic verrucous appearance, designations such as verrucous or hyperkeratotic porokeratosis are occasionally used. Besides its predilection for specific locations, PP also has a significant predilection for men …

Keeping Primary Care Providers Informed About Detecting Skin Cancer In Young Adults, Riley J. Spears

Evidence-Based Practice Project Reports

Skin cancer is a common, life-threatening disease that affects anyone, regardless of age or skin color (American Cancer Society [ACS], 2020). The incidence of melanoma is on the rise for young adults, with an estimated 2,400 new cases for individuals aged 15 to 29 (ACS, 2020). Although skin cancer is highly preventable, clinical guidelines are inconsistent regarding skin cancer screening. The purpose of this evidence-based practice (EBP) project was to determine if the implementation of the INternet curriculum FOR Melanoma Early Detection (INFORMED) program would improve primary care providers’ (PCPs’) confidence about skin cancer and the number of completed and …

Using Deep Learning To Automate The Diagnosis Of Skin Melanoma, Akhil Reddy Alasandagutti

Honors Theses

Machine learning and image processing techniques have been widely implemented in the field of medicine to help accurately diagnose a multitude of medical conditions. The automated diagnosis of skin melanoma is one such instance. However, a majority of the successful machine learning models that have been implemented in the past have used deep learning approaches where only raw image data has been utilized to train machine learning models, such as neural networks. While they have been quite effective at predicting the condition of these lesions, they lack key information about the images, such as clinical data, and features that medical …

Impact Of Acne On Quality Of Life In Young Pakistani Adults And Its Relationship With Severity: A Multicenter Study, Shaheen Naveed, Sadia Masood, Atiya Rahman, Safia Awan, Saadia Tabassum

Department of Medicine

Objectives: The current study aimed to determine the effect of acne vulgaris on quality of life of young adults and to assess the correlation between acne severity and impairment of quality of life (QOLI).
Methods: In this multi-center cross-sectional study, 163 young adults with acne vulgaris were assessed for severity and quality of life impairment between December 2016 and May 2017 at three tertiary care hospitals. Cardiff Acne Disability Index (CADI) was used to assess the quality of life while the severity of acne measured by Global Acne Grading System (GAGS). Data were collected on standardized forms, with CADI, GAGS …

Tuberculoid Leprosy Masquerading As Erythema Induratum, Manuel Britto, Danish M. Siddiq, Michael Morgan, Anthony Dedea, Utpal Patel

HCA Healthcare Journal of Medicine

Introduction

Erythema Induratum (EI) is a relatively rare dermatologic disorder affecting subcutaneous fat tissue, which is often associated with Mycobacterium tuberculosis. This report details the presentation, diagnosis and management in a 70-year-old female who presented with a painful erythematous annular rash at the clinic. The rash was later diagnosed as EI associated with Mycobacterium leprae, one rarely seen in literature.

Discussion

EI is a rare form of panniculitis that typically presents as a recurrent grouping of tender nodules and plaques on the posterior aspect of the lower legs. Although EI is considered idiopathic in most cases, it can be associated …

022— Examining P27 Expression And Quiescence In Clobetasol-Exposed Umscv-4 Vulvar Cancer Cells, Nina Mustico, Vincent Scalcione, Jani E. Lewis

GREAT Day

Vulvar cancer is rare, mostly afflicting women aged 60 and older [1]. The cancer is often preceded by a common vulvar rash, lichen sclerosus, that is usually treated with the ultra-potent corticosteroid, clobetasol propionate. This treatment may, in turn, be associated with vulvar carcinogenesis. Our previous findings suggest that clobetasol is causing UMSCV-4 vulvar carcinoma cells to enter a state of quiescence. Quiescence is temporary removal from the cell cycle and can be thought of as a dormant state in which cells are not actively dividing [2]. There is growing evidence suggesting that quiescence may play a role in allowing …

Prevalence Of Clinical Spectrum Of Cutaneous Adverse Drug Reactions In Patients Presenting At A Tertiary Care Hospital In Pakistan, Ayesha Hina 2nd, Sadia Masood, Sajjad Jamil, Saadia Tabassum, Palwasha Jalil, Unzela Ghulam

Section of Internal Medicine

Introduction: Cutaneous adverse drug reactions (CADRs) are the most common adverse drug reactions reported in the literature. CADRs have resulted in disabling infirmities during hospitalization and complications following outdoor drug therapy. The pattern of CADRs and the responsible drugs usually changes with the introduction of newer drugs and evolving clinical practices. Moreover, several international studies showed variable prevalence, emphasizing the need for local data in light of different socioeconomic and demographic practices. Therefore, the purpose of this study is to evaluate the prevalence of adverse cutaneous drug reactions and identify the clinical spectrum and any potential risk factors.
Methodology: The …

Acne Vulgaris, Yejun Oh

Campus Research Day

Acne vulgaris is a common chronic skin disease where sebaceous glands that are inflamed or infected occur in the skin. It is well known as red pimples on the face and a lot of teenagers suffer from it. There are several factors that cause acne vulgaris such as excess oil production, hair follicles clogged by oil and dead skin cells, bacteria, and inflammation. There are some foods that can cause acne easily, recommending people to avoid. To give examples, those are fast foods, greasy foods, dairy products, and so on.

Use Of Prame Immunostaining To Distinguish Melanoma In Situ From Lentigo Senilis, Hailey Olds, Sarah Utz, Darius Mehregan

Medical Student Research Symposium

PRAME (PReferentially expressed Antigen in MElanoma) is an antigen that is expressed by malignant cells in melanoma, as well as other cancers such as breast carcinoma, renal cell carcinoma, and leukemia. PRAME immunohistochemistry has proved effective in identifying malignant melanocytes in melanoma lesions, but it is unclear if it may be used to distinguish melanoma from benign melanocytic conditions, such as lentigo senilis. In particular, melanoma in situ may be confused with lentigo senilis clinically and histologically, thus PRAME immunostaining is potentially useful for differentiating these two lesions. We evaluated 31 samples of lentigo senilis, 26 of melanoma in situ, …

Dermatology Technique: Mohs Micrographic Surgery, Michelle J. Volis

Mako: NSU Undergraduate Student Journal

This paper aims to educate the readers about a novel surgery approach that is becoming popular among dermatologists. This technique, Mohs surgery, is implemented in order to treat malignant skin cancer types. This paper incorporates the history of Mohs micrographic surgery, the advantages and disadvantages of the procedure, and alternatives to this approach. The main advantage is healthy tissue preservation while disadvantages include holes in fragmented tissue margins and tissue orientation complications.

Land-Based Exercise Versus Hydrotherapy In Osteoarthritis, Alyson Rivers

Capstone Showcase

Introduction: Osteoarthritis is the most common form of arthritis. It results in joint pain, stiffness, reduced mobility, and decreased quality of life. While NSAIDs are the cornerstone of treatment, exercise is one of the safest and least expensive treatments. Exercise can be completed on land or in water. Hydrotherapy is hypothesized to produce more beneficial outcomes compared to land-based exercise.

Methods: The database, PubMed, was used to acquire articles that compare hydrotherapy to land-based therapy in individuals with large-joint OA. Outcomes of interest included pain relief, joint mobility, and quality of life.

Results: Based collectively on four articles, there was …

Assessment Of The Clinical Validity Of Ctdna Analysis For Melanoma Management, Anda-Gabriela Marsavela

Theses: Doctorates and Masters

Metastatic melanoma is responsible for almost 80% of all skin cancer-related deaths and the incidence of people affected continues to rise worldwide. The emergence of targeted therapy and immune-checkpoint inhibitors has improved the clinical management of melanoma, but durable survival benefit is only seen in a minority of patients. The use of these very expensive systemic therapies on all appropriate patients also poses a high economic burden on health systems across numerous countries. Currently, surveillance for treatment failure is not optimal. Thus, reliable and accurate biomarkers of patient disease status are urgently required.

Circulating tumour DNA (ctDNA) analysis has emerged …

Unravelling The Potential Applications Of Extracellular Vesicles For The Clinical Management Of Melanoma Patients, Michael Edward Clark

Theses: Doctorates and Masters

Metastatic melanoma is the third most common cancer in Australia with global incidence increasing. After decades without effective systemic treatments for advanced melanoma, the advent of targeted and immune therapies has substantially improved patient survival. While this is encouraging, further research is needed as the majority of patients treated with targeted therapy ultimately develop drug resistance. Immunotherapy can achieve durable responses in many patients however, not all patients respond to current single or a combination of immune checkpoint inhibitors. Considering the cost and potential toxicities to patients being treated with these therapies, there is an urgent need to develop biomarkers …

Cutaneous Malignant Melanoma: A Synthesis On Updated Guidelines For The Primary Care Perspective, Seetha Venkateswaran, Nicholas D'Angelo

HCA Healthcare Journal of Medicine

Cutaneous malignant melanoma (CMM) is a condition wherein malignant cells form in the melanocytic cells. CMM is a potentially lethal form of skin cancer, commonly found in sun-exposed areas of the body. There are multiple risk factors for disease development, such as genetic mutation and UV radiation among others. Diagnosis and staging is important in determining disease morbidity and mortality. The United States Preventive Services Task Force (USPSTF) and the American Academy of Dermatology (AAD) have their respective guidelines and consensus on diagnosis, staging and treatment. It is imperative to delineate and educate primary care physicians on CMM, as they …