Skin and Connective Tissue Diseases Commons^™

Convolutional Neural Networks For Predicting Skin Lesions Of Melanoma, Anuruddha Jayasekara Pathiranage

Regis University Student Publications (comprehensive collection)

Diagnosis of an unknown skin lesion is crucial to enable proper treatments. While curable with early diagnosis, only highly trained dermatologists are capable of accurately recognize melanoma skin lesions. Expert dermatologist classification for melanoma dermoscopic images is 65-66%. As expertise is in limited supply, systems that can automatically classify skin lesions as either benign or malignant melanoma are very useful as initial screening tools. Towards this goal, this study presents a convolutional neural network model, trained on features extracted from a highway convolutional neural network pretrained on dermoscopic images of skin lesions. This requires no lesion segmentation nor complex preprocessing. …

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

Physician Assistant Scholarly Project Papers

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 patients, …

Papuloerythroderma Of Ofuji: A First Case Report From Indonesia, Graciella Regina, Listya Paramita, Sunard Radiono, Yohanes Widodo Wirohadidjojo, William R. Faber

Journal of General - Procedural Dermatology and Venereology Indonesia

Papuloerythroderma (PE) is a rare skin disease which was first described by Ofuji et al. in 1984, with a typical sign that the lesions spare the large cutaneous folds, known as the deck chair sign. Due to its recent identification, this disease is still underrecognized and may lead to misdiagnosis. We reported the first case report of PE of Ofuji from Indonesia in which the diagnosis was delayed for two years. Besides the deck chair sign in the large cutaneous fold, we also found that the area between and above his eyebrows that was relatively spared in contrast to the …

Pulsed-Dye Laser Efficacy In The Treatment Of Psoriasis In Adult Patients: An Evidence-Based Case Report, Made Ananda Krisna, Hanny Nilasari

Journal of General - Procedural Dermatology and Venereology Indonesia

Psoriasis is a chronic inflammatory skin disease known to be highly responsive to phototherapy. Narrow-band UVB (NBUVB) phototherapy has been one of the standard treatments for its moderate to severe form. However, its lack of efficacy in treating stable psoriatic plaques on extremities has lead researchers to find alternative treatments, one of which is pulsed-dye laser (PDL). Laser has been known to be effective in treating vascular lesions; in psoriasis, elongation of rete ridge along with tortuous dermal capillaries are one of the first pathologies identified early in the disease progression. Several in vivo and preliminary studies have found the …

Occupational Skin Cancer And Precancerous Lesions, Fifinela Raissa, Githa Rahmayunita, Sri Linuwih Menaldi, Dewi Soemarko

Journal of General - Procedural Dermatology and Venereology Indonesia

Occupational skin cancer and precancerous lesions are skin disorders caused by exposure to chemical carcinogens such as polycyclic hydrocarbons and arsenic, or radiation, such as ultraviolet light and ionizing light in the workplace. Annual increase in skin cancer incidence is believed to be related to various factors such as frequent intense sunlight exposure (i.e. at work, recreational activities, and sun-tanning habit), ozone depletion, an increase in number of geriatric population, and an increase of public awareness in skin cancer. The most common occupational skin cancers are basal cell carcinoma, squamous cell carcinoma, and melanoma. Examples of occupational precancerous lesion of …

Vaginal Microbiota In Menopause, Martinus Martinus, Larisa Paramitha Wibawa, Evita Halim Effendi, Shannaz Nadia Yusharyahya, Hanny Nilasari, Wresti Indriatmi

Journal of General - Procedural Dermatology and Venereology Indonesia

The human vagina together with its resident, microbiota, comprise a dynamic ecosystem. Normal microbiota is dominated by Lactobacillus species, and pathogen microbiota such as Gardnerella species and Bacteroides species can occur due to decrease in Lactobacillus domination. Lactobacillus plays an essential role in keeping normal vaginal microbiota in balance. Vaginal microbiota adapts to pH change and hormonal value. Changes in the vaginal microbiota over a woman’s lifespan will influence the colonization of pathogenic microbes. They include changes in child, puberty, reproductive state, menopause, and postmenopause. Estrogen levels change will affect the colonization of pathogenic microbium, leading to genitourinary syndrome of …

Suspected Resistance Of Mdt-Mb In Multibacillary Leprosy Of Hansen's Disease: Two Case Reports, Yudo Irawan, Sri Linuwih Menaldi, Emmy Soedarmi Sd, Melani Marissa, Erika Zoulba

Journal of General - Procedural Dermatology and Venereology Indonesia

Resistance to multidrug therapy (MDT) is one of the complications in the treatment of Hansen’s disease/Morbus Hansen (MH). There are two types of resistancy, which are primary and secondary. MDT-multibacillary (MB) resistance must be suspected when no clinical improvement and the acid-fast bacilli (AFB) index is not reduced after 12 months of therapy. A 28-year-old woman with paresthesia on her face, arms and legs since 2.5 years ago, accompanied by thickening of the right posterior tibial nerve. The AFB examination showed a bacteriological index (BI) of 15/6 and morphological index (MI) of 0.50%. The second case, a 42-year-old man came …

Neural Leprosy: A Case Report, Alida Widiawaty, Emmy Soedarmi Sjamsoe-Daili, Taruli Olivia, Sri Linuwih Menaldi, Melani Marissa, Fitri Octaviana

Journal of General - Procedural Dermatology and Venereology Indonesia

Neural leprosy is characterized by neurological deficit without skin lesions, with a prevalence ranging from 1% to 17.7%. Diagnosis might be difficult and need a multidisciplinary approach. This is a case of axonal type motor and sensory polyradiculoneuropathy of the peripheral facial nerve. A 26-year-old woman was referred from the neurology clinic with facial paralysis, suspected as leprosy. Physical examinations were as follows: no skin lesions, left eye lagophthalmos, thickening of right lateral peroneal and bilateral posterior tibial nerves, sensory impairment, peripheral bilateral facial palsy, and wasting of bilateral distal small muscles of the hands, with normal autonomic function. Nerve …

Subcutaneous Mycosis At The Department Of Dermatology And Venereology Dr. Cipto Mangunkusumo National Hospital, Jakarta, 1989-2013, Sammy Yahya, Sandra Widaty, Eliza Miranda, Kusmarinah Bramono, Artini Wijayanti Islami

Journal of General - Procedural Dermatology and Venereology Indonesia

Introduction: Subcutaneous mycosis (SM) is a fungal infection involving dermis and subcutaneous tissue, which can disseminate slowly through systemic blood or lymphatic circulation. The subacute or chronic infection usually found in workers of rural tropical and subtropical area. SM occurs due to trauma along with other predisposing factors such as sex, genetic and occupation.

Aim: To identify the types of SM, its clinical findings, laboratory work-up and the treatment at the Dermatomycology Division, Department of Dermatology and Venereology dr. Cipto Mangunkusumo National Hospital between the year 1989 and 2013.

Method: This retrospective study collected data from medical …

Atopic Dermatitis In The Elderly, Yudo Irawan, Rahadi Rihatmadja, Lili Legiawati, Shannaz Nadia Yusharyahya, Sri Adi Sularsito

Journal of General - Procedural Dermatology and Venereology Indonesia

Atopic dermatitis (AD) is a recurrent skin inflammation accompanied by itching. The incidence of AD is increasing worldwide. AD, which persists until elderly or with an onset during elderly, is known as senile AD. It has different prevalence and clinical features from other AD stages. Senile atopic dermatitis affects males more than females, which is different from other stages of AD. Skin manifestation of senile AD is similar with the adult stage of Hanifin-Rajka criteria, but can be atypical. The typical feature of senile AD is eczematous dermatitis around a free-lesion fossa. Other common clinical manifestations are erythroderma and non- …

Failure To Use Routine Prevention Of Disability (Pod) Assessment Resulting In Permanent Disability, Erika Zoulba, Emmy Soedarmi Sjamsoe, Sri Linuwih Menaldi, Melani Marissa, Yudo Irawan

Journal of General - Procedural Dermatology and Venereology Indonesia

Disability is one of problems in leprosy or Morbus Hansen (MH), which can cause the patient loose his autonomy and may affect his social relationship with family and community. Disability occurs due to neurological inflammation that can manifest as silent neuritis (which develops without any pain). Silent neuritis can be recognized early with a routine prevention of disability (POD) assessment.

A 19-year-old male patient was referred from a District General Hospital with a history of numbness and stiffness of his 4th and 5th fingers of his left hand since 1 month before admittance. The patient was refered by Community Health …

Acquired Vulvar Lymphangioma: Report Of Two Cases, Indah Widyasari, Hafiza Fathan, Larisa Paramitha Wibawa, Herman Cipto, Adhimukti T. Sampurna, Sondang Pandjaitan Sirait

Journal of General - Procedural Dermatology and Venereology Indonesia

Vulvar lymphangioma is a rare case and often being misdiagnosed as genital wart. This acquired disorder manifests as dilatation of superficial lymph vessel due to obstruction. It is caused by urogenital infection and most often occurs following surgery and radiotherapy of cervical cancer. The diagnosis is established based on clinical and histopathological features. Treatment aimed to eliminate the cause of obstruction. This article reports two cases of vulvar lymphangioma found in our Hospital.

First case was a 43-year-old female with a history of surgery and radiation for cervical cancer 10 years ago presented with vesicular skin lesion in genital area, …

Atypical Mycobacterial Infection Resembles Sporotrichosis In Elderly Patient, Siti Nurani Fauziah, Lili Legiawati, Sri Adi Sularsito, Shannaz Nadia Yusharyahya, Rahadi Rihatmadja, Sondang P. Sirait, Fifi Mifta Huda, Indah Widyasari

Journal of General - Procedural Dermatology and Venereology Indonesia

Atypical mycobacterial (AM) infection is caused by Mycobacterium species other than M.tuberculosis. AM skin infection has clinical manifestations that resemble M. tuberculosis infection and deep fungal infection. Laboratory workup is necessary to confirm the diagnosis.

An 83-year old female came with a painful lump and swelling on her right lower extremity since three months before admission. Physical examination revealed a plaque consisting, of multiple erythematous and hyperpigmented papules and nodules, diffuse erythematous lesion, and shallow ulcers partially covered with pus and crust. Histopathological features showed tuberculoid granuloma. Direct test and periodic acid-Schiff (PAS) staining of the skin biopsy found no …

The Role Of Dermoscopy In Non-Pigmented Skin Disorders, Hafiza Fathan, Wresti Indriatmi, Rahadi Rihatmadja, Inge Ade Krisanti

Journal of General - Procedural Dermatology and Venereology Indonesia

The use of dermoscopy in non-pigmented skin disorders includes dermoscopy as a diagnostic tool for non- pigmented skin tumors, inflammatory diseases (inflammoscopy) and/or infectious disease (entomodermoscopy), lesions on nail fold and as a tool to monitor skin reaction as a response to treatment and/or side effect. The diagnosis becomes easier, faster and less expensive with dermoscopy without the need for invasive procedures. Knowledge on vascular pattern and its architectural arrangement; which is coupled with additional dermoscopic features, can aid clinicians to the diagnosis. Dermatoscopy can also predict, monitor and evaluate therapeutical response and/or side effect of skin disorders. Nonetheless, dermoscopy …

Poly (Adp) Ribose Polymerase Inhibitors For The Treatment Of Malignant Peripheral Nerve Sheath Tumor, Christine M. Kivlin

Dissertations and Theses (Open Access)

Malignant peripheral nerve sheath tumor (MPNST) is a rare subtype of soft tissue sarcoma. Surgical excision has remained the standard of care for this highly aggressive malignancy for over a decade. Conventional chemotherapy and radiotherapy have shown limited efficacy in MPNST; therefore, it is imperative that targeted treatment be identified to improve the outcome for MPNST patients. Poly (ADP) ribose polymerase (PARP) inhibitors were first reported over a decade ago to have substantial anti-tumorigenic effects in malignancies with defective DNA repair, specifically those with BRCA1/2 (breast cancer, early onset 1/2) mutations. Further evaluation of these inhibitors has shown multiple mechanisms …

Inadequate Sensitivity Of Laboratory Risk Indicator To Rule Out Necrotizing Fasciitis In The Emergency Department, Elizabeth Burner, Sean Henderson, Guenevere Burke, Jeffrey Nakashioya, Jerome R. Hoffman

Emergency Medicine Faculty Publications

Introduction: Necrotizing fasciitis (NF) is a life-threatening illness, particularly when surgical debridement is delayed. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score was developed to identify patients at higher risk for NF. Despite limited information in this regard, the LRINEC score is often used to "rule out" NF if negative. We describe the sensitivity of the LRINEC score in emergency department (ED) patients for the diagnosis of NF.

Methods: We conducted a chart review of ED patients in whom coding of hospital discharge diagnoses included NF. We employed standard methods to minimize bias. We used laboratory data to …

Pain In Photodynamic Therapy, Mircea Tampa, Maria Isabela Sârbu, Mădălina Irina Mitran, Cristina Iulia Mitran, Adrian Dumitru, Vasile Benea, Simona Roxana Georgescu

Journal of Mind and Medical Sciences

Photodynamic therapy is a modern treatment with applications in several medical specialties, which has been intensely studied in the last years. The main indications in dermatology are actinic keratosis, superficial basal cell carcinoma and Bowen's disease- common skin disorders in which photodynamic therapy proved its efficacy. At present, the use of photodynamic therapy for the treatment of other skin disorders is profoundly researched. Pain is the most common and redoubtable adverse effect of photodynamic therapy and it is the most important factor affecting the patient's adherence to treatment. The aim of this article is to look over the most recent …

Stinging Nettle: The Bad, The Good, The Unknown, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Stinging nettle (Urtica dioica) is native to most of the United States. It has a characteristic description and distribution in the environment. Physical contact with numerous tiny needlelike hairs present on leaves and stems of this plant may result in a contact urticarial dermatitis due to chemical and mechanical irritation triggered by skin penetration of the hairs. The manifestations are self-limited in humans and may be treated by washing the skin, topical preparations and oral antihistamines. Explanation of the natural history of these encounters to the patient is helpful in reducing the sometimes significant anxiety. Preparations and extracts …

Phage Therapy As A Mrsa Treatment, Miriam Sussman

The Science Journal of the Lander College of Arts and Sciences

This paper seeks to review how previous research on bacteriophage therapy can be utilized to improve the treatment of MRSA infections. Due to the growing phenomenon of antibiotic resistance, scientists are looking to utilize the natural antibacterial qualities of bacterial viruses called phages to fight MRSA infections. In order to improve the therapeutic methods of combatting MRSA, one must first understand the mechanics of how phages infect bacterial cells and lyse them with their proteins. The narrow host range of bacteriophages causes the infection of only the pathogenic bacteria and maintains the state of the normal flora. Research suggests that …

Treatment Options For Skin And Soft Tissue Infections Caused By Methicillin-Resistant Staphylococcus Aureus, Renee Weinberg

The Science Journal of the Lander College of Arts and Sciences

Staphylococcus aureus is a pathogen responsible for common skin infections, such as impetigo, cellulitis, folliculitis, and abscess and it is the most common cause for skin and soft tissue infections (SSTI). Humans are carriers of this microorganism and are responsible for facilitating its spread around the world. Over time it has developed resistance to multiple antibiotics, such as penicillin and methicillin, which has made S. aureus a persistent problem in the healthcare world today. Its methicillin resistance has given it the more commonly known name methicillin-resistant S. aureus (MRSA). MRSA was initially discovered solely in the healthcare environment and thus …

Is Narrowband Uvb Phototherapy In Combination With Nonsteroidal Topical Medications More Effective At Repigmentation Of Vitiligo Lesions When Compared To Narrowband Uvb Therapy Alone In Healthy Men And Women Between The Ages Of 11 And 69?, Cassandra Baier

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not narrowband UVB (NB-UVB) phototherapy in combination with nonsteroidal topical medications is more effective at repigmentation of vitiligo lesions when compared to NB-UVB therapy alone in healthy men and women between the ages of 11 and 69.

STUDY DESIGN: Review of three peer-reviewed randomized controlled trials written in English, two of which were published in 2014, and one in 2011.

DATA SOURCES: Studies were selected based on the method of study, the randomized- control structure of the studies, and the relevance to the clinical question, and all …

Medical Interns', Residents' And Attending Physicians' Attitudes Towards Integrative Medicine And Recommended Treatments For Patients With Psoriasis, Jennifer L. Pacyon

PCOM Psychology Dissertations

Background: Psoriasis is a multifactorial disease that effect approximately 7.5 million Americans. There are a variety of traditional treatments for psoriasis (e.g. topical medications, biologics) that for many, are effective in combating the disease. However, traditional treatments often have aversive side effects and may not be appropriate for every patient (e.g. pregnant women). Additionally, the efficacy of these medications are variable leaving some looking for adjunctive treatment options. There is increasing evidence to support the use of adjunctive treatments for psoriatic patients (e.g. psychotherapy, mindfulness). However, research is variable in regards to medical professionals’ attitudes towards integrative medicine (IM) as …

Lavender Oil: The New Sleep Aid, Audrey Nichols

University Honors Program

The purpose of this research paper is to discuss and evaluate the benefits of lavender oil within the general population and hospitalized patients. Specifically, this paper will look at aromatherapy use with lavender oil within the hospitalized population and it’s ability to better sleep quality within these patients. Sleep is a major factor in the boies ability to heal, and the hope of this research is to determine whether lavender oil would be an effective option for patients struggling with sleep disturbances during their hospital stay. In order to evaluate the effectiveness of lavender oil, previously conducted research articles and …

Basal Cell Carcinoma—A Preventable Disease, Jamie Weaver

Nursing Student Class Projects (Formerly MSN)

Basal cell carcinoma (BCC) is a nonmelanoma skin cancer. According to the Skin Cancer Foundation, “BCC is the most frequently occurring form of all skin cancers. More than one out of every three new cancers is a skin cancer, and the vast majority are BCC’s” (www.skincancer.org). Exposure to ultraviolet (UV) rays is one of the main risk factors in developing a BCC. People with a lighter skin tone are at a higher risk of developing a BCC than those with a darker skin tone.

Gout, Lorrie Listebarger

Nursing Student Class Projects (Formerly MSN)

Gout is a syndrome caused by an inflammatory response creating an over production of uric acid increasing uric acid levels in the blood and body fluids. Gout is defined as a disorder resulting from tissue deposition of MSU crystals (in joints, bursae, bone, and certain other soft tissues, such as ligaments, tendons and occasionally, skin) and/or crystallization of uric acid within the renal collecting system (tubules and renal pelvis) that typically occurs in acid urine” (Terkeltaub & Edwards, 2013, p. 20). Gout is among the oldest diseases affecting approximately 3.9% of adults in America (Terkeltaub & Edwards, 2013, p. xv). …

Dermatitis Herpetiformis, Rachel Wolf

Nursing Student Class Projects (Formerly MSN)

The main sign that accompanies DH is the eruption of intensely pruritic papulovesical lesions that typically present bilaterally on the elbows, knees, buttocks, neck, and scalp (Criado et al., 2012). They may appear on the upper back, abdomen, groin, and face as well. The lesions are small blisters that resemble those that are caused by the herpes simplex virus. By the time a patient seeks evaluation by a care provider, the lesions have often been scratched so much as to cause erosions, excoriation, and or crusted papules (Junkins-Hopkins, 2010). The surrounding area may have erythema and or urticarial plaques. Patients …

Functional Analysis Of The Molluscum Contagiosum Virus Mc160 Death Effector Domain-Containing Protein Rxdl Motif, Sarah Weber

Seton Hall University Dissertations and Theses (ETDs)

The Molluscum contagiosum virus (MCV) is a member of the Poxviridae family that causes benign skin lesions. MCV lesions persist on average for 8-12 months in otherwise healthy individuals. MCV lesions are characterized by reduced inflammation. The persistence and reduction of inflammation at the site of MCV lesions have been attributed to MCV immune evasion genes. MCV encodes two death effector domain (DED) containing proteins, MC159 and MC160. DEDs are found in cellular proteins such as FADD and procaspase-8. These cellular proteins are involved in several innate immune responses such as apoptosis and activation of interferon (IFN). Presumably, MC159 and …

Is Benzoyl Peroxide And Clindamycin Effective Combination Treatment For Progressive Macular Hypomelanosis In Adults?, Samantha Colosi

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not there is efficacy with combination treatment benzoyl peroxide and clindamycin for progressive macular hypomelanosis in adults.

Study Design: A review of three English language studies. One published in 2006 and two in 2011. Includes two RCT’s and one randomized left-right comparison study.

Data Sources: Researched articles via PubMed and Cochrane database. All articles were published in peer-reviewed journals. Two randomized, controlled trials and one randomized left-right comparison study were used.

Outcomes Measured: The outcomes measured by: subjective patient ratings based on photographs before and after treatment …

Is Prophylactic Oxybutynin Safe And Effective In Reducing The Severity Of Palmar Hyperhidrosis In Adults?, Kristin K. Amicone

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine “Is prophylactic oxybutynin safe and effective in reducing the severity of palmar hyperhidrosis in adults?”

STUDY DESIGN: This review is based on two randomized controlled trials (RCTs) and one non-randomized crossover study published in 2008, 2011, and 2012. The studies compared the safety and efficacy of oxybutynin in reducing the severity of palmar hyperhidrosis.

DATA SOURCES: All articles used were published in English, in peer-reviewed journals, and found using PubMed, Ebscohost, and Cochrane Review databases.

OUTCOMES MEASURED: For all studies, the safety and effectiveness of oxybutynin on palmer hyperhidrosis …

Is A Once Daily Topical Application Of Fixed-Dose Combination Gel Containing Adapalene 0.1%-Benzoyl Peroxide (Bpo) 2.5%(Adapalene-Bpo) Effective At Treating Mild To Moderate Acne?, Kelly A. Weitzel

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not a once daily topical application of fixed-dose combination gel containing adapalene 0.1%-benzoyl peroxide (BPO) 2.5% (adapalene-BPO) is effective at treating mild to moderate acne.

STUDY DESIGN: Three multi-center double blind randomized control studies published in the English language between 2007-2013.

STUDY SOURCES: Three peer-reviewed RCTS were found using Pubmed. These studies compared the same fixed-dose combination gel adapalene-BPO against placebo vehicles. Two studies also compared to additional groups receiving monotherapies.

OUTCOMES MEASURED: Outcomes measured were improvement of participant’s acne according to the Investigator’s Global Assessment of …