Dermatology Commons^™

Finding The Right Scope: Dermoscopy For Primary Care, Peggy Cyr, Elizabeth Seiverling

Maine Medical Center

Background

• Primary care physicians (PCPs) frequently address skin concerns and perform clinical skin examinations1

• For PCPs, the use of dermoscopy has been shown to increase the sensitivity for skin cancer diagnosis compared to unassisted examinations2,3

• Prior to this study, no formal consensus existed on the fundamental knowledge and skills that PCPs should have with respect to dermoscopy

Objectives

• To develop an expert opinion consensus statement on 2 proficiency standards for PCPs using dermoscopy

The 2-Methoxymethyl Modification Of P -Phenylenediamine Reduces The Sensitization Risk For Hairdressers To Hair Dyes-An Occupational Hand Exposure-Based Risk Assessment, Emanuele Marco Gargano, Brunhilde Blömeke, Anthony Gaspari, Carsten Goebel

Department of Dermatology and Cutaneous Biology Faculty Papers

Background: Allergic contact dermatitis involving the hands is a common occupational skin disease for hairdressers and the potent sensitizers p -phenylenediamine (PPD) and toluene-2,5-diamine (PTD) are associated with the development of occupational allergic contact dermatitis.

Objective: The aim of the study was to analyze whether the use of the moderate sensitizer 2-methoxymethyl-PPD (ME-PPD) in professional hair dyes is a suitable tool to reduce the occupational contact allergy risk for hairdressers.

Methods: Hand exposure of hairdressers (N = 11) to ME-PPD was analyzed under routine hair coloring conditions in commercial salons. By accounting for wet work and uneven hand exposure, the …

Impact Of Dermoscopy Training For Pcps On Nnb To Detect Melanoma, Madeline Prentiss, Kathryn Stevens, Henry Stoddard, Peggy Cyr, Laura Houk, Hadjh Ahrns, Elizabeth Seiverling

Maine Medical Center

The goal of this project was to analyze the impact of dermoscopy training on the number of melanocytic nevi needed to biopsy (NNB) to detect a melanoma in the primary care setting .

Pediatric Dermatology Econsult Program With Dermoscopy: Sub Analysis Of Infantile Hemangiomas, Peggy R. Cyr, Madeline Prentiss, Hadjh Ahrns, Abby Markham, Elizabeth V Seiverling

Maine Medical Center

Here we present an analysis of pediatric dermatology eConsults with emphasis on dermoscopy utilization and the impact on eConsult on infantile hemangiomas (IH) management.

Delayed Diagnosis Of Klippel-Trénaunay Syndrome In A 23-Year-Old African American Male, Daniel A. Nguyen, Pranav Patel, Stephen E. Weis

HCA Healthcare Journal of Medicine

Klippel-Trénaunay syndrome is a rare genetic disorder that typically presents as a triad of symptoms consisting of venous malformations (varicosities), capillary malformations (port-wine stain), and limb overgrowth. We followed a 23-year-old African American male with a past medical history of peripheral vascular disease, who was visiting the dermatology clinic for a persistent skin lesion on his thigh. During physical examinations, we noted a subtle port-wine stain on his right leg, right leg hypertrophy, and peripheral vascular disease. Skin findings were difficult to observe on his darker skin tone, Fitzpatrick skin type VI, which may have led to the delayed diagnosis …

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Cutaneous Abscesses, Christopher M. Wong, Christian J. Scheufele, Sandhya Bodapati, Daniel A. Nguyen, Ashleigh E. Hermann, Jean Elizze M. Charles, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Cutaneous abscesses are collections of pus resulting from skin and soft tissue bacterial infections. They clinically exhibit the four cardinal inflammatory signs of pain, warmth, swelling, and erythema. In patients with darkly pigmented skin, classically-associated erythema may be challenging to appreciate and can lead to missed or delayed diagnosis. We compare abscess presentations in different skin types. Recognition of varying presentations of cutaneous abscesses in diverse skin colors will help clinicians utilize additional clues to identify and diagnose this entity correctly.

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Inverse Psoriasis, Daniel A. Nguyen, Henry Lim, Christopher M. Wong, Christian J. Scheufele, Ashleigh E. Hermann, Jean Elizze M. Charles, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Inverse psoriasis is a clinical variant of psoriasis involving flexural or intertriginous areas of the body. Inverse psoriasis may be present in 3 to 36% of psoriasis patients. Lesions are clinically characterized as smooth, well-demarcated, erythematous plaques (raised, >1 cm) without the typical silvery scales of classic psoriasis. Differential diagnosis includes tinea infection, candidiasis, seborrheic dermatitis, or bacterial streptococcal infection. The clinical images in this review focus on identifying inverse psoriasis along the full spectrum of skin tones.

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Plaque Psoriasis, Ashleigh E. Hermann, Daniel A. Nguyen, Christopher M. Wong, Christian J. Scheufele, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Recent studies estimate that more than 8 million Americans have psoriasis. The prevalence of psoriasis in African Americans is 1.5% compared to 3.6% of Caucasians. Psoriasis is likely to be underdiagnosed among African Americans and other individuals with darker pigmented skin due to variations in clinical presentation in addition to disease distribution and severity. We present images of psoriasis vulgaris in a variety of Fitzpatrick skin types. Differences in the biology of skin pigmentation may explain the clinical masking of erythema in darker-skinned individuals. Recognition of this important difference will help clinicians utilize additional clues to identify and diagnose this …

Presentations Of Cutaneous Disease In Various Skin Pigmentations: An Introduction, Christian J. Scheufele, Delfin Weis, Stephen E. Weis

HCA Healthcare Journal of Medicine

Dermatological disease has historically been dependent on photography as a primary modality for education. Previously, photographs used for medical education were representative of the regional patient populations at that time; however, they have not proportionally reflected the rapidly changing demographics in the United States. Education on the diagnosis of cutaneous disease has, therefore, primarily relied on photographs of lighter skin tones. There is a need for a better representation of darker skin tones in dermatologic medical education. This article introduces a clinical series that highlights dermatological diseases in various skin pigmentations, which are commonly seen in the primary care office. …

Cutaneous Manifestation Of Thyroid Carcinoma In A 64-Year-Old Filipino Woman: A Case Report, Andrean Linata, Benedicto Dl Carpio, Eileen Regalado-Morales

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Cutaneous metastasis is a rare phenomenon of thyroid carcinoma. Several mechanisms regarding cutaneous metastasis from internal malignancies have been proposed. Various treatment options are available, including surgical procedures, radioiodine therapy, thyroid hormone therapy, and other possible therapies. The prognosis of thyroid carcinoma with cutaneous manifestation is poor.
Case Illustration: We presented a case of 64-year-old female patient with previously diagnosed thyroid carcinoma admitted with enlarged and tender nodules on the right side of the anterior neck. No surgical intervention was done and patient was treated with chemotherapy using doxorubicin 80 mg as the agent of choice. Levothyroxine …

Bacterial Sensitivity Pattern To Antibiotics In Acne Vulgaris At Universitas Sumatera Utara Hospital Medan, Indonesia In 2019, Lovena Sari, Nelva Karmila Jusuf, Imam Budi Putra

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: The association between psoriasis and metabolic syndrome is appealing as the two may share a similar cross-linking systemic inflammation process. The inflammation processes occurring in obesity and psoriasis may aggravate one another. This raised the question of whether a low-calorie diet would possibly reverse the aforementioned process. This study aims to determine whether calorie restriction reduces psoriasis area and severity index (PASI) in obese patients with moderate-to-severe psoriasis receiving conventional treatment compared to no calorie restriction.
Methods: We searched Pubmed/Pubmed Central, ScienceDirect, Cochrane library, EBSCOhost, and Scopus databases using keywords derived from our clinical question. The inclusion …

The Vaginal Microbiota, Indah Kencana, Satya Wydya Yenny

Journal of General - Procedural Dermatology & Venereology Indonesia

The vagina is an ecosystem consisting of various species of microorganisms (microbiota) that play important role in maintaining vaginal health. The vaginal ecosystem includes a variety of species classified into aerobic and anaerobic microorganisms which are vaginal microbiota (VMB). In the vagina of a healthy woman, 70% of normal microbiota is dominated by the Lactobacillus species. Lactobacillus is a Gram-positive, anaerobic bacterium, and belongs to the group of lactic acid bacteria (LAB). LAB produces lactic acid which plays a role in maintaining vaginal acidity at pH

Allergen Profile Of Facial Acd To Cosmetics Among Patients At Tertiary Referral Hospital In Yogyakarta, Alessandro Alfieri, Niken Indrastuti, Sri Awalia Febriana, Satiti Retno Pudjiati, Fajar Waskito

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Cosmetics are a part of life for most of the population and may cause allergic contact dermatitis (ACD), especially on the face, as the primary exposure of cosmetics is on the face area.
Methods: This research was conducted retrospectively using secondary data. The research subjects and demographic data were taken from the registered list of patients at Dermatology and Venereology Outpatient Clinic Dr. Sardjito General Hospital with a clinical picture of facial ACD due to cosmetics. Patch tests were carried out from January 2017 to December 2020.
Results: From three years period, 26 patients were diagnosed …

The Relationship Between Increased Body Mass Index With Transepidermal Water Loss: A Comparative Study, Muhammad Yurizar Yudhistira, Arie Kusumawardani, Suci Widhiati, Nurachmat Mulianto

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Obesity affect significant populations on all ages. The relationship between obesity and metabolic diseases is known but a dermatological link is rarely explained. Transepidermal water loss (TEWL) is one of the measurement tools used to define the skin’s barrier function by measuring the amount of water that evaporates through the skin in aspecific amount of time. Although several studies on TEWL are available but discussion about the correlation between TEWL and body mass index (BMI) is still limited. This study aims to evaluate the correlation between TEWL and BMI.
Methods: This research is a single-center study with …

Combined Use Of Cross Tca And Modified Subcision With Prp Administration For Acne Scars, Ahmad Fiqri, Moerbono Mochtar, Dendy Zulfikar

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Acne vulgaris is a skin disease that can cause permanent scarring. Various therapeutic options are available to treat atrophic scars, but combination therapy is still the best choice according to different types of scars in a single patient. Chemical reconstruction of skin scars (CROSS) trichloroacetic acid (TCA), modified subcutaneous incisionless (subcision), and platelet-rich plasma (PRP) can be used as a combination therapy to treat acne scars.
Case Illustration: A 25-year-old man complained of acne scars on both sides of his face. Dermatologic findings were blackheads, icepick, boxcar, and rolling scars. Clinically he had moderate to severe acne …

Recent Progress In Immunotherapy For Skin Cancer, Fadhli Aulia Mughni, Rinadewi Astriningrum, Aida Sd Hoemardani, Kusmarinah Bramono, Adhimukti T. Sampurna, Agassi Suseno Sutarjo

Journal of General - Procedural Dermatology & Venereology Indonesia

Skin cancer is a global health concern due to its growing incidence and high mortality rate. The most common therapeutic modalities in skin cancer include surgery, radiotherapy, and chemotherapy. However, those therapies do not specifically target cancer cells and may damage healthy tissues. Cancer induces immune response by releasing soluble antigens and danger signals caused by tumor cellular stress or death, while the immune system continuously monitor and control malignant proliferation through cancer immunoediting. Therefore, targeting this mechanism is a promising approach to manage cancer, especially those unresponsive to conventional therapies. Immunotherapy is a specific therapy that manipulates the immune …

Comparison Between Oral Pentoxifylline + Corticosteroid Andoral Corticosteroid Alone For Severe Erythema Nodosum Leprosum, Martinus Martinus, Rahadi Rihatmadja, Sri Linuwih Menaldi

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Severe erythema nodosum leprosum (ENL) is common but difficult to treat. Long term use of systemic corticosteroid causes side effects. This study compares the use of a combination of pentoxifylline + oral corticosteroids with a single oral corticosteroid in leprosy patients with severe ENL reactions. Parameters measured include skin RSA score, systemic RSA, total corticosteroid dose, resolution time of skin lesions, improvement of pain VAS and treatment side effects.
Methods: 29 subjects with severe ENL reactions are allocated randomly into two groups which receive oral pentoxifylline + methylprednisolone, and oral placebo + methylprednisolone for 12 weeks. The …

Microneedling And Platelet-Rich Plasma (Prp) Treatment For Mixed Melasma, Puteri Wulandari, Nelva Karmila Jusuf, Khairina Nasution

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Melasma, or chloasma, is an acquired pigmentary disorder caused by increased melanin in the epidermal and dermal layers, characterized by brown or gray patches on the face and neck. There are many treatment options available; however, the difficulties in treating melasma are frequent recalcitrants, high recurrence rate, irregularity in treatment, and the tendency of the patients to self-medicate.
Case Ilustration: We report a case of mixed melasma treated by microneedling and topical PRP administration. Thirteen weeks following the therapy, the patient showed a favorable response brighter skin and substantial disappearance of brown patches.
Discussion: Studies assessing …

Advance Trends In Targeting Homology-Directed Repair For Accurate Gene Editing: An Inclusive Review Of Small Molecules And Modified Crispr-Cas9 Systems, Forough Shams, Hadi Bayat, Omid Mohammadian, Somayeh Mahboudi, Hassan Vahidnezhad, Mohsen Soosanabadi, Azam Rahimpour

Jefferson Institute of Molecular Medicine Papers and Presentations

Introduction: Clustered regularly interspaced short palindromic repeat and its associated protein (CRISPR-Cas)-based technologies generate targeted modifications in host genome by inducing site-specific double-strand breaks (DSBs) that can serve as a substrate for homology-directed repair (HDR) in both in vitro and in vivo models. HDR pathway could enhance incorporation of exogenous DNA templates into the CRISPR-Cas9-mediated DSB site. Owing to low rate of HDR pathway, the efficiency of accurate genome editing is diminished. Enhancing the efficiency of HDR can provide fast, easy, and accurate technologies based on CRISPR-Cas9 technologies. Methods: The current study presents an overview of attempts conducted on the …

Biowill - Characterising Willow Bark Bio-Actives For Skin Therapies, Arnold Marisa

ORBioM (Open Research BioSciences Meeting)

Willow bark is considered as a disposable by-product when processing willow for biomass. Willow (Salix) is known to contain high value bioactive compounds which include salicin and its derivatives, and other phytochemicals of interest such as polyphenols and flavonoids. The plant is historically known as the primary source of salicylates to which the well-known drug aspirin is derived from. The work forms part of the Interreg project BioWILL, which is focused on integrated “Zero Waste” biorefinery utilising all fractions of willow feedstock for the production of biochemicals and renewable energy. This project aims to investigate the crude and …