Skin and Connective Tissue Diseases Commons^™

Necrotizing Fasciitis, Holly Herron

Nursing Student Class Projects (Formerly MSN)

Necrotizing fasciitis also known as necrotizing soft tissue infections (NSTIs) is a rare life-threatening infection that involves the skin and soft tissue. A rapid and accurate diagnosis of NSTIs must be identified by healthcare providers to diminish morbidity and mortality. NSTIs are characterized by progressive necrosis of subcutaneous tissue and fascia involving large areas of tissue (Lin, Chang, Lai, Lin, & Chen, 2013). Hippocrates (500 BC) described necrotizing fasciitis as “diffuse erysipelas caused by trivial accidents [where] flesh, sinews, and bones fell away in large quantities, [leading to] death in many cases” (Lancerotto, Tocco, Salmaso, Vindigni & Bassetto, 2012). In …

Steven-Johnson’S Syndrome/Toxic Epidermal Necrolysis, Lindsey Grant

Nursing Student Class Projects (Formerly MSN)

Steven-Johnson’s Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are both diseases mediated by hypersensitive immune reactions resulting in “full thickness epidermal necrosis” characterized by skin detachment. However, in SJS, there is only 10% skin surface area involvement whereas in TEN, over 30% of the skin becomes detached. TENS has a 50% mortality rate. (East-Innis & Thompson, 2013, p. 590) Why Chosen: SJS/TEN is a rare but extremely fatal disease. Initially, it is often mistaken as a simple allergic reaction to a new medication or environmental exposure because both cause truncal rashes and fevers. However, simple allergic reactions occur within days …

New Malignancies After Squamous Cell Carcinoma And Melanomas: A Population-Based Study From Norway, Trude E. Robsahm, Margaret R. Karagas, Judy R. Rees, Astri Syse

Dartmouth Scholarship

Skin cancer survivors experience an increased risk for subsequent malignancies but the associated risk factors are poorly understood. This study examined the risk of a new primary cancer following an initial skin cancer and assessed risk factors associated with second primary cancers.

Systematic Condition In A Ncaa-I Collegiate Soccer Player, Ashley D. Smith

Theses, Dissertations and Capstones

Objective: The purpose of this case study is to inform athletic trainers of a systematic disease not common in our patient population.

Background: The athlete, a twenty-one YO, 160 lb, 69 inch female NCAA-I collegiate soccer goalie presented with complaint of bilateral elbow and knee joint pain and stiffness along with tender red itchy bumps on the anterior aspect of her shins. The athlete had flu-like symptoms and a URI prior to this complaint. The athlete has a history of anemia, mononucleosis, and streptococcal.

Differential Diagnosis: Rheumatoid arthritis, lymphoma, HIV/aids, erythema nodosum, lupus, Lyme disease.

Treatment: The athlete sought out …

The Role Of Poly N Acetyl Glucosamine Nanofibers In Cutaneous Wound Healing, Amanda Haley Buff-Lindner

MUSC Theses and Dissertations

Treatment of cutaneous wounds with poly-N-acetyl-glucosamine nanofibers (pGlcNAc), a novel polysaccharide material derived from a marine diatom, results in increases in wound closure, antibacterial activities and innate immune responses. Treatment with nanofibers results in increased defensin, small antimicrobial peptides, expression both in vitro and in vivo. Induction of defensing expression results in bacterial clearance in a cutaneous wound model. We have also shown that Akt1 plays a central role in the regulation of these activities. We show that pGlcNAc treatment of cutaneous wounds in mice results in decreased scar sizes. Additionally, treatment of cutaneous wounds with pGlcNAc results in increased …

Is Arginine Oral Supplement Effective On Wound Healing In Adult Patients With Stage Ii, Iii And Iv Pressure Ulcers?, Camilla Chou

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not the addition of arginine protein supplementation is effective in wound healing of adult patients with stage II, III and IV pressure ulcers.

STUDY DESIGN: Systematic review of three English language primary studies. One observation controlled study and two randomized controlled studies all published between 2010- 2012.

DATA SOURCES: Two double blind randomized controlled trials and one observational controlled trial comparing the efficacy of arginine supplementation in wound healing of adult patients with stage II, III and IV pressure ulcers. All research articles were …

Is Minoxidil Efficacious And Safe For The Treatment Of Androgenetic Alopecia (Aga) In Men, And If So, What Is The Optimal Strength And Means Of Delivery?, Anhthu P. Pickart

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not minoxidil is efficacious and safe for the treatment of androgenetic alopecia (AGA) in men, and if so, what is the optimal strength and means of delivery.

STUDY DESIGN: Review of three double-blind randomized controlled trials studying men (18-49 y/o) with androgenetic alopecia published in English from 2007-2009.

DATA SOURCES: Three articles of double-blind randomized controlled trials found via PubMed.

OUTCOMES MEASURED: Outcomes measured included the efficacy and safety of minoxidil as well as the optimal strength and means of delivery of the …

Is Glycolic Acid Safe And Effective In The Treatment Of Mild To Moderate Acne?, Brittany Stokes

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EMB review is to determine whether or not the use of glycolic acid is effective in the treatment of inflammatory and non-inflammatory acne.

STUDY DESIGN: The review of three randomized, double-blind, controlled trials all published in English language between the years of 2008-2010.

DATA SOURCES: Three randomized, double-blind, controlled trails comparing glycolic acid to a visually matched placebo or pharmaceutical therapy in improvement of acne. All articles were found using PubMed and EBSCO.

OUTCOMES MEASURED: The improvement of inflammatory and non-inflammatory acne and tolerance/ safety of the intervention. Efficacy was …

Is The Addition Of A Topical Agent To Narrowband Uvb Treatment More Effective In Treating Male And Female Adults With Psoriasis Than Narrowband Treatment Alone?, Colleen M. Wagner

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not the addition of a topical agent to narrowband UVB treatment is more effective in treating adults with psoriasis than narrowband UVB treatment alone.

STUDY DESIGN: Review of three English language primary randomized trials that were published between 2003 and 2012.

DATA SOURCES: A randomized left-right comparison, placebo controlled clinical trial, a randomized trial, and a randomized placebo controlled, blinded clinical trial each comparing the addition of a topical agent to narrowband UVB treatment to narrowband UVB treatment alone were found using PubMed and …

Is A Low Glycemic Index Diet An Effective Treatment Regimen For Acne Vulgaris In Adolescents And Young Adults Ages 15-30?, Gina C. Tomkus

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not a low glycemic index (Low GI) diet is an effective treatment for acne vulgaris in adolescents and young adults ages 15-30.

STUDY DESIGN: Systematic review of two randomized, double blind, placebo controlled clinical trial and one parallel clinical trial published in peer-reviewed journals.

DATA SOURCES: Two randomized double blind clinical trials and one parallel clinical trial published in 2007, 2012, and 2010 respectively. The sources studying the use of a low glycemic index diet as a therapeutic intervention for acne vulgaris were obtained …

In Vivo Bioluminescence Imaging To Evaluate Systemic And Topical Antibiotics Against Community-Acquired Methicillin-Resistant Staphylococcus Aureus-Infected Skin Wounds In Mice, Yi Guo, Romela Irene Ramos, John S. Cho, Niles P. Donegan, Ambrose L. Cheung, Lloyd S. Miller

Dartmouth Scholarship

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) frequently causes skin and soft tissue infections, including impetigo, cellulitis, folliculitis, and infected wounds and ulcers. Uncomplicated CA-MRSA skin infections are typically managed in an outpatient setting with oral and topical antibiotics and/or incision and drainage, whereas complicated skin infections often require hospitalization, intravenous antibiotics, and sometimes surgery. The aim of this study was to devel

Raman Spectroscopic Analysis Of Human Skin Tissue Sections Ex-Vivo: Evaluation Of The Effects Of Tissue Processing And Dewaxing, Syed Mehmood Ali, Franck Bonnier, Ali Tfayli, Helen Lambkin, Kathleen Flynn, Vincent Mcdonagh, Claragh Healy, Thomas Lee, Fiona Lyng, Hugh Byrne

Articles

Raman spectroscopy coupled with K-means clustering analysis (KMCA) is employed to elucidate the biochemical structure of human skin tissue sections, and the effects of tissue processing. Both hand and thigh sections of human cadavers were analysed in their unprocessed and formalin fixed paraffin processed (FFPP) and subsequently dewaxed forms. In unprocessed sections, KMCA reveals clear differentiation of the stratum corneum, intermediate underlying epithelium and dermal layers for sections from both anatomical sites. The stratum corneum is seen to be relatively rich in lipidic content; the spectrum of the subjacent layers is strongly influenced by the presence of melanin, while that …

Preventing Skin Cancer In Adolescent Girls Through Intervention With Their Mothers, Mary K. Baker

Electronic Theses and Dissertations

Indoor tanning (IT) before the age of 35 increases one’s risk for melanoma by 75%, and epidemiological data show a 6.1% annual increase in the incidence of melanomas in white women younger than age 44 in the US. Population-based studies reveal that 15% of adolescents and 8% to 14% of their primary caregivers have engaged in IT in the past year.

The compelling case for IT being a significant risk factor for melanoma, together with the high rates of IT in teen girls and their mothers, provided a strong rationale for conducting an antitanning intervention directed at mother-daughter dyads. This …

Characterization Of Differentiation And Prognostic Biomarkers On Cd8+ Tumor-Infiltrating Lymphocytes In Metastatic Melanoma, Richard C. Wu

Dissertations and Theses (Open Access)

CD8⁺ cytotoxic T lymphocytes (CTL) frequently infiltrate tumors, yet most melanoma patients fail to undergo tumor regression. We studied the differentiation of the CD8⁺ tumor-infiltrating lymphocytes (TIL) from 44 metastatic melanoma patients using known T-cell differentiation markers. We also compared CD8⁺ TIL against the T cells from matched melanoma patients’ peripheral blood. We discovered a novel subset of CD8⁺ TIL co-expressing early-differentiation markers, CD27, CD28, and a late/senescent CTL differentiation marker, CD57. This CD8⁺CD57⁺ TIL expressed a cytolytic enzyme, granzyme B (GB), yet did not express another cytolytic pore-forming molecule, perforin (Perf). In …

Skin Cancer - Education And Prevention: The Role Of Social Marketing, Tim Crowley

Theses

Skin cancer is the most common cancer in Ireland and worldwide. Skin cancer rates have been steadily rising in recent times. The high use of sunbeds in both Ireland and the UK is quite worrisome. Skin cancer is caused by over exposure to UV rays or through the use of sunbeds and as a result it is actually a highly preventable disease. It is estimated that 90-95% of all skin cancers are preventable. This thesis focuses on the use of social marketing in order to educate people on the dangers of skin cancer with the eventual aim of making recommendations …

Are Epidermal Barrier Defects Responsible For The Underlying Pathology Of Atopic Dermatitis?, Naomi Davis

The Science Journal of the Lander College of Arts and Sciences

Atopic dermatitis, often referred to as eczema, is a chronic inflammatory skin condition frequently seen in young children. It is a complex disease involving environmental factors, genetics and immune dysregulation. There is currently no cure with conflicting opinions from physicians regarding treatment and management. A clearer understanding of pathogenesis of atopic dermatitis can hopefully lead to new and improved treatment options for patients. Current evidence seems to support epidermal skin barrier defects as the cause of this disease. This paper seeks to investigate if this out-in hypothesis can be responsible as the sole pathogenesis of atopic dermatitis. To write this …

Is Dapsone Gel Safe And Effective For The Treatment Of Acne Vulgaris?, Amy Patel

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not dapsone gel is safe and effective for the treatment of acne vulgaris.

STUDY DESIGN: A review of three English language studies published in 2007. Includes two randomized, double-blind, controlled trials and one open label, noncomparative study. DATA SOURCES: Randomized, controlled trials comparing dapsone gel to vehicle gel control were found using PubMed and Cochrane database.

OUTCOMES MEASURED: Success on the Global Acne Assessment Score (GAAS) and reduction in acne lesion counts

RESULTS: The two randomized, controlled trials and the open-label noncomparative study …

Merkel Cell Carcinoma, Cynthia L. Bartus Md, Steven Oberlender Md, Phd, Christian W. Oram Do

Department of Medicine

No abstract provided.

Analysis Of The Effects And Current Treatments Of Laminin Deficiency, Joshua Mark Reynolds

Senior Honors Theses

Laminin (LM) is a network of proteins that functions as a connective framework of most cells in the body. It is composed of multiple different subunits and therefore has many different variations. It is a trimeric protein, meaning that it is composed primarily of ⍺, β, and γ chains. The differentiation of these subunits is what gives the different variants their functions. In addition, although LM is the primary molecule in scope, the network of other connective proteins involved in LM-associated diseases will also be covered in lesser detail because molecules like dystrophin, dystroglycan, collagen, and integrin are vital to …

Frequency And Clinical Variants Of Specific Dermatoses In Third Trimester Of Pregnancy: A Study From A Tertiary Care Centre, Sadra Masood, Dilawar Abbas Rizvi, Saadia Tabassum, Shaheen Akhtar, Rehan Uddin Alvi

Section of Internal Medicine

OBJECTIVE: To determine the frequency of patients with dermatoses in the third trimester of pregnancy and to identify various clinical types of dermatoses in the third trimester.

METHODS: The study was carried out at the Department of Dermatology and the Department of Gynaecology & Obstetrics, PNS Shifa Hospital, Karachi, from January 2 to July 1, 2008. Two hundred pregnant women in their third trimester were included in the study. The diagnosis was based on history, clinical examination and relevant investigations. Patients with physiological dermatoses and dermatoses which flare up during pregnancy were excluded. A comprehensive pro-forma was used to evaluate …

The Mechanical Behavior Of Mutant K14-R125p Keratin Bundles And Networks In Neb-1 Keratinocytes, Daniel R. Beriault, Oualid Haddad, John V. Mccuaig, Zachary J. Robinson, David Russell, E. Birgitte Lane, Douglas S. Fudge

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Epidermolysis bullosa simplex (EBS) is an inherited skin-blistering disease that is caused by dominant mutations in the genes for keratin K5 or K14 proteins. While the link between keratin mutations and keratinocyte fragility in EBS patients is clear, the exact biophysical mechanisms underlying cell fragility are not known. In this study, we tested the hypotheses that mutant K14-R125P filaments and/or networks in human keratinocytes are mechanically defective in their response to large-scale deformations. We found that mutant filaments and networks exhibit no obvious defects when subjected to large uniaxial strains and have no negative effects on the ability of human …

Is Acupuncture Effective In Reducing Itch Intensity And Wheal Size In Patients With Dermatologic Conditions?, Melanie Schwer

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether acupuncture is effective in reducing itch intensity and wheal size in patients with dermatologic conditions.

STUDY DESIGN: Review of all English language primary randomized controlled trials published after 1984

DATA SOURCES: Three randomized controlled trials were found using Pubmed database.

OUTCOMES MEASURED: The three trials measured various outcomes: Visual Analog Scale (VAS); Eppendorf Itch Questionnaire; Cumulative Itch Index; Perimeter of wheal and flare size before, during, & after acupuncture; Psoriasis Area and Severity Index (PASI)

RESULTS: Belgrade et al. found statistically significant improvement in itch intensity and flare …

Is Ceftobiprole A Safe And Effective Treatment For Skin And Skin Structure Infections?, Laura Thompson

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether or not ceftobiprole is a safe and effective treatment for complicated skin and skin structure infections

STUDY DESIGN: Review of all English language primary randomized controlled trials from 1996-2010

DATA SOURCES: Three randomized controlled trials were found using Pubmed and Cochrane databases

OUTCOMES MEASURES: Skin or skin-structure infection cure with ceftobiprole intervention and adverse effects of this new pharmaceutical. Cure or failure to cure skin infection was determined based on both clinical and microbiological assessment. Adverse events were measured based on patient reports, clinician reports, labs, and vital sign …

Defining The Role Of Nras In Melanoma Maintenance, Sravya T. Challa, Sheri L. Holmen

Undergraduate Research Opportunities Program (UROP)

The incidence of melanoma has increased 600 percent over the last four decades; it is the most rapidly increasing malignancy among young people in the United States and is currently the leading cause of cancer death in women aged 25- 29. If detected early, the disease is easily treated; however, once the disease has metastasized it is largely refractory to conventional therapies and is associated with a high mortality rate. The development of cancer from a pre-malignant primary tumor to a metastatic cancer that develops at secondary sites is a multi-step process, thought to require many genetic and epigenetic events …

Juvenile Dermatomyositis, Sidra Ishaque, Shakeel Ahmed, Rehan Ali, Khurram Minhas

Section of Internal Medicine

Juvenile dermatomyositis (JDM) is an important subtype of dermatomyositis characterized by inflammation of muscle, skin and gastrointestinal tract. A 14-year-old girl, with a history of fever, joint pain, easy fatigability and a rash since the age of 3 years is described. Physical examination, laboratory evaluation, electromyography (EMG) and muscle biopsy were suggestive of a chronic inflammatory process involving the muscles, most likely dermatomyositis. The report highlights the importance of a muscle biopsy as the gold standard for diagnosing dermatomyositis.

Antivirulence Potential Of Tr-700 And Clindamycin On Clinical Isolates Of Staphylococcus Aureus Producing Phenol-Soluble Modulins, Jason Yamaki, Timothy Synold, Annie Wong-Beringer

Pharmacy Faculty Articles and Research

Staphylococcus aureus strains (n = 50) causing complicated skin and skin structure infections produced various levels of phenol-soluble modulin alpha-type (PSMα) peptides; some produced more than twice that produced by the control strain (LAC USA300). TR-700 (oxazolidinone) and clindamycin strongly inhibited PSM production at one-half the MIC but exhibited weak to modest induction at one-fourth and one-eighth the MICs, primarily in low producers. Adequate dosing of these agents is emphasized to minimize the potential for paradoxical induction of virulence.

New Perspectives On Melanoma: The Role Of Pax3, Sandra Medic

Theses: Doctorates and Masters

Background: Cutaneous melanoma is an aggressive form of skin cancer, arising in cutaneous melanocytes. The transcription factor PAX3 is critical for the proper development of neural crest lineages including melanocytes. Melanocytic cells show continued PAX3 expression from melanoblast formation in the neural crest to their differentiation into melanocytes. While many studies clarify the importance of PAX3 in embryonic development of melanocytes, less well understood, and more perplexing, is the continued PAX3 expression in adult skin melanocytes. By contrast PAX3 is frequently found in melanomas and naevi, and its expression correlates with melanoma staging. In this study we explore the multiple …

Is Topical 1% Pimecrolimus Cream An Effective Treatment For Rosacea?, Lauren Sloan

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether or not topical 1% pimecrolimus cream is an effective treatment for rosacea.

Is Alitretinoin (9-Cis-Retinoic Acid) Safe And Effective For Use In Hand Eczema?, Jeanne K. Seeberger

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: To determine if Alitretinoin is a safe and effective alternative to current treatments in reducing the symptoms of Hand Eczema (HE)

Is Monotherapy Treatment Of Etanercept Effective Against Plaque Psoriasis?, Joseph Devito

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this systematic review is to determine whether or not monotherapy treatment of etanercept is effective against plaque psoriasis.