Dermatology Commons^™

Barriers To Dermatological Care In Patients Who Received Extensive Mohs Surgery - An In-Depth Qualitative Analysis, Stuti Prajapati, Mallory Zaino, Christina Kontzias, Laura Doerfler, Steven R. Feldman

Rowan-Virtua Research Day

Background: Dermatological care needs to be accessible for the elderly, but they face prominent challenges contributing to delays in diagnosis and treatment. Prolonged management of may lead to widespread cutaneous malignancies, necessitating extensive Mohs surgery.

Objective: To identify areas for early intervention in the geriatric population who have undergone extensive Mohs surgery.

Methods: We performed a qualitative study on 10 patients 65 years and older (68-91) from Atrium Health Wake Forest Baptist dermatology clinics between December 2022 and February 2023, who had extensive Mohs surgery (3 or more layers removed).

Results: Three major areas for potential intervention for cutaneous carcinoma …

Case Report: Facial Mask-Induced Acne ("Maskne"), Gabriel Meister, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

A 42 year old male health care worker presented with complaints of severe mask related acne vulgaris predominately to the cheeks, chin and nose Here we present the case of a N95 and surgical facial mask use has been a requirement for many occupations during the Covid-19 pandemic. Patient states their current position requires use of an N95 respirator to be worn throughout their shift which can range from 9-14 hours, 6 days per week. Extended daily use of such masks may lead to changes in the skin which can induce irritation and precipitate infection.

Case Report And Brief Review: A Case Of Erythema Ab Igne Due To A Space Heater, Adam Kandil, James Espinosa, Alan Lucerna, James Lee, Robin Lahr

Rowan-Virtua Research Day

A 35 year old male presented to the Emergency Department (ED) with a rash of his left lateral lower leg of a 2 months duration. The patient had been using an electric space heater and the affected area was the closest part of his body to the heater. A diagnosis of erythema ab igne was made. Here we discuss erythema ab igne in reference to the medical history of the diagnosis, pathophysiology, modern causative heat sources such as laptop computers and treatment.

New Onset Lichen Planus And Back Pain Leading To Discovery Of A Peri Aortic Abscess, Monica Diep, Wayne Tamaska, Philip Carhart, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Back pain is a common chief complaint in the emergency department. With the differential ranging from musculoskeletal pain to cauda equina, there are a plethora of diagnoses. Differentiating between benign back pain and back pain that warrants further evaluation and even possible emergent surgical intervention is often a challenge in the acute setting. In this case report, a strange combination of all new symptoms including lichen planus, fevers, chills and atraumatic back pain lead to the eerie and very unexpected diagnosis of a peri-aortic abscess.

Calciphylaxis, A Case Series: The Importance Of Early Detection, Nikita Sijapati, Suy Sen Hung Fong, Omar Ansari, Subhasis Misra, Edgar Mercado, My Myers, Vijay Narasimha

HCA Healthcare Journal of Medicine

Introduction

Calciphylaxis is a rare disorder that involves the formation of cutaneous, subcutaneous, and vascular calcifications. Although it is predominantly seen in patients with end-stage renal disease (ESRD), it has also been reported in patients without chronic kidney disease. The presence of multiple risk factors, a poorly understood mechanism, high mortality, and the lack of standardized treatment make calciphylaxis an important subject.

Case Presentation

We describe the clinical presentation, disease course, and management of 3 patients with calciphylaxis and also provide a literature review. In all 3 patients, the diagnosis was confirmed histologically, and the management involved the continuation of …

Dermatologic Manifestations Of Rheumatic Disease: Cutaneous Manifestations Of Vasculitides, Julianna S. Kang, Julia Nunley, Tiffany Ho, Mavra Masood, Fnu Nutan, Beth Rubinstein

Open and Affordable Course Content at VCU

No abstract provided.

Dermatologic Manifestations Of Rheumatic Disease: Malignant Cutaneous Tumors, Divya Shan, Julianna S. Kang, Allison Cinats, Julia R. Nunley, Beth Rubinstein

Open and Affordable Course Content at VCU

No abstract provided.

Virtual Surgical Planning In Craniomaxillofacial Surgery: A Structured Review, Kaye Verlarde, Rentor Cafino, Armando Isla Jr., Karen Mae Ty, Xavier-Lewis Palmer, Lucas Potter, Larry Nadorra, Luchin Valrian Pueblos, Lemuel Clark Velasco

Electrical & Computer Engineering Faculty Publications

Craniomaxillofacial (CMF) surgery is a challenging and very demanding field that involves the treatment of congenital and acquired conditions of the face and head. Due to the complexity of the head and facial region, various tools and techniques were developed and utilized to aid surgical procedures and optimize results. Virtual Surgical Planning (VSP) has revolutionized the way craniomaxillofacial surgeries are planned and executed. It uses 3D imaging computer software to visualize and simulate a surgical procedure. Numerous studies were published on the usage of VSP in craniomaxillofacial surgery. However, the researchers found inconsistency in the previous literature which prompted the …

When Are Inpatient And Emergency Dermatology Consultations Appropriate?, Hershel Dobkin, Timothy Blackwell, Robin Ashinoff

Rowan-Virtua Research Day

Hospitalists and emergency physicians continue to struggle with the assessment of dermatologic conditions, often consulting dermatology whenever a patient has a “rash” or skin concern. Dermatology is still not emphasized in medical education and often is taught to most medical students in an abbreviated fashion, which results in physicians feeling ill-equipped to deal with any dermatologic condition—either mundane or potentially life-threatening.

Better guidelines are needed for physicians in the ED and on inpatient units to guide them on appropriate use of dermatologic consultation outside the ambulatory office and the clinic. We constructed a consultation flowchart to help guide the triage …

Dermatologic Manifestations Of Rheumatic Disease: Cutaneous Manifestations Of Sarcoidosis, Sarah Shapiro, Sindhuja Koppu, Mavra Masood, Beth Rubinstein, Huzaefah Syed

Open and Affordable Course Content at VCU

No abstract provided.

A Clinical Study Of Venereal And Non Venereal Genital Dermatoses In Women, Lakkireddygari Sujana, Savitha L. Beergouder, Alekhya Rallapalli, Prasanthi Chidipudi, Sujatha Alla

Engineering Management & Systems Engineering Faculty Publications

Background: Any genital lesion or related symptoms are erroneously considered to be sexually transmitted as it is the most covered regions of the body and seems truly to be a forgotten pelvic organ it is the significant and important group of dermatological conditions may be associated with considerable morbidity, discomfort, and embarrassment. The most common conditions seen in a Dermatology Clinic are vulvar dermatoses, which comprise of lichen sclerosis, lichen planus, vulvar eczema, and psoriasis. Other conditions such as vulvar pain syndromes, vulvar disorders associated with systemic diseases, and blistering diseases are also seen.

Materials and Methods: This was a …

Gene Expression Profiling Of Mapk Pathway Inhibitor Resistance In Cutaneous Melanoma: Can Bioinformatics Be Used To Select Better Melanoma Cell Lines?, Stephen Luebker

Theses & Dissertations

Melanoma is the deadliest form of skin cancer, and incidence has continued to increase. Half of all melanomas have a BRAF V600E mutation and respond to MAPK pathway inhibitors, including BRAF inhibitor therapy or BRAF/MEK inhibitor combination therapy, but nearly all patients develop treatment resistance. Melanoma cell lines produce variable results as models of MAPK pathway inhibitor resistance. To better understand how the genomic similarity of a melanoma cell line to patient-derived tumors affects resistance mechanisms, differences in DNA mutations and copy-number alterations were compared between melanoma cell lines profiled by the Cancer Cell Line Encyclopedia and cutaneous melanoma tumors …

Implementation Of A Cost-Effective Treatment Algorithm For The Management Of Acne Vulgaris In College Students, Cristina Borsilli

Evidence-Based Practice Project Reports

Acne is one of the most common skin disorders in the United States, occuring in over 5.1 million Americans. Of those with acne, 53.8% are adults between the ages of 18 and 44 years old (American Academy of Dermatology [AAD], 2017). Acne can lead to multiple issues such as scarring, poor self-esteem, anxiety, and depression (Zaenglein et al., 2016). Acne can also negatively impact quality of life (Cengiz & Gurel, 2020). The purpose of this evidence-based project was to develop a cost-effective treatment algorithm for the management of acne vulgaris in adult college students. A literature search determined the best …

Rare Variant Of Porokeratosis: A Case Report, Nardin Awad

Rowan-Virtua 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 …

Implementation Of The Visualdx Application By Nurse Practitioners And Physician Assistants Aimed At Improving Diagnostic Accuracy In Skin Of Color Patients, Jill M. Maddox

Evidence-Based Practice Project Reports

In 2016 the United States black population stood at over 43 million with a projected increase of 41% by 2060, and the “two or more races” category will increase by 197.8% (Vespa et al., 2020), thus intensifying the need for diagnostic accuracy of skin diseases for these demographics. The American Academy of Dermatology (https://www.aad.org, 2020) brochures as well as dermatology textbooks underrepresent skin of color (SOC) cutaneous appearance (Louie and Wilkes, 2018), and darker skin tone dermatology education is limited. This underrepresentation leads to misperceptions, misdiagnoses, and poorer outcomes. The purpose of this evidence-based practice project was evaluation of a …

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, …

Efficacy Of Platelet-Rich Plasma (Prp) Injections Vs Topical Minoxidil In Adults With Androgenetic Alopecia, Yuan-Jane Qiu

Capstone Showcase

Androgenetic alopecia is a condition mediated by androgen (specifically DHT) and genetic factors that causes hair loss and thinning of the scalp in men and women. The hairs’ anagen phase is shortened and terminal hairs transition into vellus hairs. Although this condition is considered cosmetic in nature, it has psychologically detrimental effects. There are medical treatments available to prevent further hair loss but there is currently no cure. Topical minoxidil (Rogaine) is the most commonly used medication for androgenetic alopecia that stops hair loss and, in some cases, helps hair regrowth. However, it can cause an allergic contact dermatitis, local …

Cyclosporine Shows Benefit As Compared To Methotrexate For Treatment Of Pediatric Atopic Dermatitis Refractory To Topical Medications When Rapidity Of Clinical Response Is Of Key Importance To The Patient, Connor R. Buechler, Steven Daveluy Md

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising El-Khalawany MA, Hassan H, Shaaban D, Ghonaim N, Eassa B. Methotrexate versus cyclosporine in the treatment of severe atopic dermatitis in children: a multicenter experience from Egypt. European Journal of Pediatrics. 2012;172(3):351-356. https://doi.org10.1007/s00431-012-1893-3 for a pediatric patient with severe atopic dermatitis.

The Role Of Adhesives In Dermatologic Surgery: Tips, Tricks And Review, Adam Chahine, Stefanie Lynn Altmann, Mariam Salman, Karthik Krishnamurthy

Dermatology

Background: The utilization of tissue adhesives for wound closure has historically been well established in the emergency department setting. More recently, it has been adopted by dermatologists and other surgical specialties as an alternative or adjunct to more traditional bilayered wound closures.

Purpose: This serves as a comprehensive review of the available scientific literature on the utilization of tissue adhesives compared to traditional bilayered closures. We discuss benefits, drawbacks, as well as novel surgical techniques, as applicable to dermatologic surgery.

Methods: A literature review was performed using Pubmed and MEDLINE for relevant articles related to the use of adhesives and …

Fracture Blisters, Jessica Khabra, Jinal K. Patel, Gauthier L. Stepman, Kulveer Dabb, Kenny Hernandez, Debra Angelo, Johnathan Frunzi

West Florida Division GME Research Day 2020

Fracture blisters are tense vesicles or bullae that develop on edematous skin following some acute long bone fractures. Fracture blisters are infrequently seen, as the reported incidence is 2.9% to 6.6%.¹ This rare complication, may not regularly be encountered by Physicians in the hospital. Fracture blisters typically occur within 24-48 hours following high energy trauma injuries & may last up to several weeks. Ultimately, this condition can lead to prolonged hospital stay due to an increased risk of infection and delay in surgical intervention.² Early recognition of this dermatologic complication may be helpful in reducing hospital stays.

Improving Access To Rare Disease Clinical Trials Through Telemedicine, Dylan Haynes, Christina Topham, Teri Greiling

OHSU-PSU School of Public Health Annual Conference

Introduction: Rare diseases affect nearly 400 million individuals worldwide. The geographic density of any single disease, however, can prohibit access to care and research efforts. Telemedicine has improved access barriers in the clinical setting, though its application in rare disease trials has not been evaluated.

Objective: To assess the impact on access to care of videoconferencing in a rare disease clinical trial.

Materials and Methods: Preliminary analysis was performed on the first five participants to complete our ongoing trial (NCT03485976) evaluating the efficacy of ixekizumab for the treatment of pityriasis rubra pilaris. Participants were required to travel to Oregon Health …

Pediatric Erythromelalgia Treated With Epidural Ropivacaine Infusion, Caroline E. Lee, Kelly Paulk, Kristen Garvie, Elizabeth Grieshaber, Jeffrey Carter, Brian Ball

School of Medicine Faculty Publications

No abstract provided.

Patient Acceptance Of Remote Scribing Powered By Google Glass In Outpatient Dermatology: Cross-Sectional Study, Sandra Odenheimer, Deepika Goyal, Veena Jones, Ruth Rosenblum, Lam Ho, Albert Chan

Faculty Publications

Background: The ubiquitous use of electronic health records (EHRs) during medical office visits using a computer monitor and keyboard can be distracting and can disrupt patient-health care provider (HCP) nonverbal eye contact cues, which are integral to effective communication. Provider use of a remote medical scribe with face-mounted technology (FMT), such as Google Glass, may preserve patient-HCP communication dynamics in health care settings by allowing providers to maintain direct eye contact with their patients while still having access to the patient’s relevant EHR information. The medical scribe is able to chart patient encounters in real-time working in an offsite location, …

P16-Ki67-Hmb45 Immunohistochemical Profiling May Help Discriminate Between Spitzoid Melanoma And Atypical Spitz Nevi, Robert E. Garola, Vivekanand Singh

Posters

Background

When Spitz nevi have increased vertical thickness (>1.5 MM), show ulceration and deep seated mitosis, the differential diagnostic considerations of atypical Spitz nevus (ASN) or a Spitzoid melanoma (SM) enter into consideration. While expert consultation from a dermatopathologist is most often sought to resolve the differential diagnosis, it could be expensive and time consuming. Recently, the use of molecular genetic testing has also been advocated in the work group up of atypical melanocytic proliferations. On the contrary, immunohistochemistry is a more routinely used technique in most pathology centers may be more simple to apply. A single immunohistochemical marker …

Visualdx, Tariq Rahaman

Library Learn - Complete Video Collection

VisualDx is a clinical decision support tool and is available via NSU Libraries. The attached PDF contains instructions for accessing the mobile app.

• Click here to access VisualDx!

For tutorials on using the VisualDx platform, visit the website.

The Postfinasteride Syndrome; An Overview, David L. Rowland, Ion G. Motofei, Florian Popa, Vlad D. Constantin, Adriana Vasilache, Ioana Păunică, Cristian Bălălău, Georgeta P. Păunică, Petrisor Banu, Stana Păunică

Journal of Mind and Medical Sciences

As a 5-α reductase inhibitor, Finasteride has proven effective in ameliorating two conditions documented to be androgen dependent, namely male androgenic alopecia and benign prostatic hyperplasia. Therapeutic results are maintained as long as the drug is administered, with treatment cessation generally leading to the return of symptomatology for each condition. In addition, during the therapeutic phase, several adverse effects have been reported, some of which persist long or indefinitely after treatment cessation, known as “post-finasteride syndrome.”

Herein we present and discuss the most common finasteride side effects, along with a psycho-neuroendocrine rationale that could explain the persistence of many adverse …