Dermatology Commons^™

Seeing Skin, Seeking Evidence: Lessons From A Dermatology Internship, Isabella Floyd

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: Indoor tanning exposes individuals to artificial ultraviolet (UV) radiation through devices such as tanning beds and sunlamps, increasing the risk of skin damage and malignancy. Prior research suggests associations between indoor tanning and melanoma, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC), with potential variation based on age of initiation and cumulative exposure.

Purpose: The purpose of this literature review was to examine the association between indoor tanning and skin cancer risk, with a focus on age at first exposure, frequency, and duration of tanning bed use across melanoma, BCC, and SCC outcomes.

Methodology: A structured literature review …

Postmarketing Safety Of Bimekizumab For Hidradenitis Suppurativa: An Early Pharmacovigilance Analysis Using The United States Food And Drug Administration Adverse Event Reporting System, Simona A. Alomary, Nicole J. Baker, Temitayo Ogunleye, Susan C. Taylor

Student Papers, Posters & Projects

No abstract provided.

Occupational Epidemiology Of Acral Lentiginous Melanoma, Lily Guo, Robin Kikuchi, April W. Armstrong, Suephy C. Chen

Department of Dermatology and Cutaneous Biology Faculty Papers

Acral lentiginous melanoma (ALM) classically presents in glabrous skin. Some studies suggest an association between mechanical stress and ALM development. People working jobs with long periods of standing/walking may be exposed to near-daily mechanical stress. To investigate the relationship between occupation type and ALM development, we performed a retrospective cohort study using Optum’s Clinformatics Database (2007—2023). We compared the risk of ALM in adults with occupational data (n = 9,270,935). Retired patients had the highest prevalence (0.081) and incidence per 1,000,000 person-years (0.514, 95% confidence interval = 0.487—0.542) of ALM. We performed multivariate logistic regression, adjusted for demographics and insurance, …

Directional Association Between Irritable Bowel Syndrome And Dermatological Disease: A Large-Scale Retrospective Study, Alex Y. Liu, Naomi T. Matsuno, Houston Nelson, David Johnson, David Pariser

Department of Medicine Faculty Publications

Background/Objectives: Microbial dysbiosis is implicated with a pathogenic role in both irritable bowel syndrome (IBS) and several dermatological conditions. Yet, few studies have assessed a potential overlapping epidemiologic association. We aimed to assess the 1-year prevalence of common dermatologic conditions following an initial IBS diagnosis and to evaluate the reverse association using reciprocal analyses. Methods: We conducted a retrospective study using TriNetX. Patients aged 18–50 with no history of inflammatory bowel disease, celiac disease, or infectious intestinal disease were matched 1:1 to healthy controls by demographics and comorbidities. The primary outcome was the prevalence of acne vulgaris, psoriasis, …

Visit Complexity Differs Between Scarring And Nonscarring Alopecia: A 5-Year Dataderm Analysis, Ian Noel Encarnacion, Noelle Desir, Nicholas Schell, Apoorva Mehta, Temitayo Ogunleye, Susan Taylor

Department of Medicine Faculty Publications

[Introduction] Accurate coding is a critical component of dermatologic practice, influencing reimbursement and documentation of clinical complexity. Although alopecia has significant psychosocial and financial burdens, Current Procedural Terminology (CPT) coding patterns in alopecia management remain largely understudied. Our population-level study using the American Academy of Dermatology's DataDerm clinical registry¹ evaluates alopecia CPT coding trends, pre-2021 and post-2021 evaluation and management (E/M) CPT coding updates,² aiming to inform coding practices and visit complexity, which have significant reimbursement implications.

Characterizing Global Dermatologic Engagement And Needs: A Cross-Sectional Study From 83 Countries, Alexis G. Strahan, Christine Li, Maud Guérin, Tom Allison, Gene Colón, Jehireh Peraza-Williams, Olyvia Zarchin, Morvarid Zehtab, Ann M. Pacheco, Jadesola Akinwuntan, Shivani Jain, Marlous L. Grijsen, Wendemagegn Enbiale, Wingfield Rehmus, L. Claire Fuller, Karolyn Wanat, Esther E. Freeman

School of Medicine Faculty Publications

No abstract provided.

Regional Disparities In The Diagnostic Age Of Skin Carcinomas: An Analysis Of The Rio Grande Valley, Miguel A. Lopez, Natasha Quailes, Elias Arellano Villanueva, Maria Villegas

Research Colloquium

The Rio Grande Valley (RGV) is a region of South Texas with limited dermatologic diagnostic data, particularly among non-melanoma skin carcinomas. The rising rates of chronic conditions and mortality can be attributed to the limited access to healthcare in the region, with skin conditions taking less priority in patients with numerous comorbidities. Data on the age of diagnosis for skin carcinomas between 1995-2019 for Hispanic and non-Hispanic individuals was obtained from the Texas Cancer Registry. It is important to note that the TCR considers primary skin cancers, such as basal and squamous cell carcinoma coded as C44.0-C44.9, as non-reportable cases. …

An Analysis Of The Diagnostic Age Of Skin Carcinomas Across Central Texas, Miguel A. Lopez, Natasha Quailes, Elias Arellano Villanueva, Hamaad Gohar, Maria Villegas

Research Colloquium

Patients seeking healthcare in medically underserved regions often require travel to larger metropolitan hubs across the state of Texas. The Rio Grande Valley (RGV) is home to many such patients who often travel to central Texas for care, which compounds expense and inconvenience. Pockets of central Texas have been reported to have an increased number of dermatologists per 100,000 people. Bexar county ranks among the five most populous counties in the state, with increased access to dermatologic care compared to nearby regions. Using data from the Texas Cancer Registry, this project aims to identify the mean (M) age of diagnosis …

Quality Of Life And Patient Experience In Black Women With Alopecia, Annyella Douglas, Jayson Suriano, Neda Nikbakht

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Analyzing Preventative Skin Care Practices Among Diabetic, Pre-Diabetic And Non-Diabetic Patients, Hetasvi A. Saraiya, Nils Brolis

Rowan-Virtua Research Day

Background and Hypothesis: Diabetes Mellitus refers to a chronic metabolic syndrome where patients have high blood glucose due to the body’s inability to produce adequate amounts of insulin. This hyperglycemia and other factors make diabetic patients more prone to a number of skin conditions such as dry skin, skin rashes, itchiness and bacterial or fungal infections. There are specific skin practices recommended to reduce the risk of these skin ailments including moisturizing regularly, avoiding hot showers, examining feet regularly for any changes, seeing a physician for major cuts/burns/infections amongst several others. However, there is no available literature that analyzes the …

Going Green In Dermatology, Rahib K. Islam, Victoria T. Tong, Shari R. Lipner

School of Medicine Faculty Publications

No abstract provided.

Evaluating The Effectiveness Of Teledermatology For Undeserved Populations During And Post-Covid-19, Jakob Gibbs, Sean Hanshaw

Theses, Dissertations and Capstones

Introduction: Teledermatology, a subset of telemedicine, has gained prominence as a means to increase access to dermatologic care while reducing costs and improving patient satisfaction. The swift expansion of teledermatology during the COVID-19 pandemic was driven by the necessity to limit physical contact and adapt to public health restrictions. This technological shift aimed to address longstanding disparities in dermatology access, especially in rural and underserved populations, and to respond to the rising demand for dermatologic services amid provider shortages.

Purpose of the Study: The purpose of this study was to analyze the effects that teledermatology following the COVID-19 pandemic had …

Challenges In Public Health: The Diagnosis And Treatment Of Crusted Scabies, Marshall Hall, Alyssa Forsyth, Wenquin Du, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Introduction: Common scabies is a parasitic dermatologic condition that often presents as an extremely pruritic rash. A rare and highly contagious variant of common scabies is crusted scabies, formerly known as Norwegian scabies. While infection with common scabies typically involves 10 to 20 mites, individuals with crusted scabies are burdened with thousands to millions of mites. Crusted scabies is characterized clinically by hyperkeratotic papules and plaques, most commonly on the palms and soles. Due to the variety of presentations seen in scabies, it can be difficult to diagnose. Case presentations: We present 4 cases of crusted scabies. An 89-year-old male …

Systemic Therapy Targeting Psoriatic Inflammation Is Associated With Decreased Incidence Of Dementia: An Observational Retrospective Cohort Study, Madison P. Olexson, Ana Ormaza Vera, Chunghwan Ro, Clinton W. Enos

Department Dermatology Faculty Publications

[Introduction] To the Editor: Psoriasis, an immune-mediated chronic inflammatory skin disorder, has been implicated in cognitive impairment and dementia.1, 2, 3 Emerging evidence suggests that systemic inflammation contributes to neuroinflammation and resultant cytokine-driven neurodegeneration, although findings remain inconclusive.1, 2, 3 While systemic therapies such as biologics and conventional disease-modifying antirheumatic drugs are routinely used in psoriasis management, their role in modulating dementia in this population remains underexplored, with research yielding mixed results.1, 2, 3 We conducted a large-scale, retrospective cohort study to investigate the relationship between psoriasis and dementia and whether systemic treatments for psoriasis impact this association.

Man With An Itchy Back, Katherine Schaffer, Nevin Adamski, Brittany Ambrose, Kathleen Anderson

Department of Emergency Medicine Faculty Publications

[First paragraph] A 61-year old man with no significant past medical history presented with painful bug bites on his lower back 1 day after a 1.5-week-long visit to Africa. He noticed bug bites on his lower back 3 days ago; since then, they have increased in size and become more painful. He was prescribed doxycycline at urgent care earlier that morning and had taken 1 dose. He is taking prophylactic medications for malaria and has had no fever at home. Vital signs, exquisitely tender papular lesions with a central punctum and surrounding erythema in the bilateral paralumbar regions.

Assessment Of Primary Malignancy Risk Following Initiation Of Biologic Therapy In Psoriasis Patients, Chunghwan Ro, Ana Ormaza Vera, Waleed Adawi, Alexander Yap, Clinton W. Enos

Department Dermatology Faculty Publications

Limited evidence exists regarding the long-term oncologic safety of biologic therapies, particularly interleukin (IL)-17 inhibitors (IL-17i) and IL-23i, in the management of psoriasis. This propensity-score-matched retrospective-cohort study assessed the risk of developing a primary malignancy within 10-years following exposure to an FDA-approved biologic among psoriasis patients compared to biologic-naïve controls. After propensity-score-matching, 32,230 biologic-exposed patients were further grouped into cohorts of tumor necrosis factor inhibitors (TNFi, n=16,011), IL-23i (n=5,604), IL-12/23i (n=3,856), and IL-17i (n=5,467). During a 10-year period, TNFi-treated patients had a reduced risk of developing any primary malignancy compared to biologic-naïve psoriasis patients [HR 0.80(0.73-0.87)]. Similarly, a lower incidence …

Addressing Dermatologic Concerns And Teledermatology In Undomiciled And Sheltered Populations, Kennedy Gallagher, Sahithi Talasila, Anna Bistline, Rebecca Krain, Leena Ramani, Elizabeth Jones

Student Papers, Posters & Projects

Homelessness in the United States is a significant public health issue, with dermatologic disease being the most prevalent health concern among the undomiciled and sheltered populations. Despite a growing need for dermatologic care, the supply of dermatologists remains insufficient, contributing to disparities in healthcare access for this vulnerable group. This review aims to detail the spectrum of dermatologic conditions experienced by homeless individuals, identify barriers to adequate care, and explore teledermatology as a potential solution to bridge these gaps. A comprehensive literature review was conducted, analyzing studies and reports on dermatologic issues prevalent among the homeless population and the efficacy …

Increased Risk Of Cutaneous T-Cell Lymphoma Development After Dupilumab Use For Atopic Dermatitis, Jenna Mandel, Jaanvi Mehta, Ramsay Hafer, Mahaa Ayub, Faria Nusrat, Henry Yang, Pierluigi Porcu, Neda Nikbakht

Department of Dermatology and Cutaneous Biology Faculty Papers

There have been several reports of dupilumab use and the development of CTCL; however, the risk of CTCL development has not been adequately evaluated at the population level. The objective of this study is to determine whether dupilumab administration for AD is associated with an increased risk of developing CTCL and to identify at-risk populations within this group. This retrospective cohort study used TriNetX, a deidentified medical record database including over 107 million patients, to identify eligible patients. Treatment and control groups were evaluated for the development of CTCL. Patients of any age with a documented diagnosis of AD were …

Empowering Nonmedical Personnel To Detect Scabies In Endemic Area Using Deskab Instrument: A Diagnostic Study, Sandra Widaty, Aria Kekalih, Dewi Friska, Kusmarinah Bramono, Siti Maulidya Sari, Irene Darmawan, Yufanti Sujudi, David Dwiadiputra Hartanto, Emiliana Kartika, Nikken Rima Oktavia

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Scabies has been added to World Health Organization (WHO) list of neglected tropical disease in 2017. Various methods have been developed to control scabies in highly prevalent communities. In this study we conducted a diagnostic study to evaluate the performance of scabies detection by trained nonmedical personnel (NMP) using Deteksi Skabies (Deskab) instrument which has been validated for NMP.
Methods: Eight NMPs in a boarding school were trained to detect scabies using DeSkab instrument. The NMPs diagnosis were compared to diagnosis of 10 medical doctors. The study was conducted in a religion-affiliated boarding school in West Java, Indonesia. Both …

Waiting For A Cure: Factors Influencing Melanoma Treatment Delays, Lisa Huang, David Rubin, Lothar Vidal, Jordan Riser, Christopher Jones, Samantha Hiester

Rowan-Virtua Research Day

Melanoma, with a five-year survival rate of 94% in early-stage diagnosis, drops significantly when diagnosed at later stages, making identifying barriers to timely treatment crucial. This literature review examines factors influencing melanoma treatment wait times and their impact on patient outcomes. Elderly, male, and Medicare patients, along with those with higher Breslow thickness and severe melanoma stages, experienced longer wait times. Patients receiving intervention within 30 days had better survival rates. Lack of knowledge and misconceptions about melanoma contribute to delayed care, particularly in communities with lower incidence rates. Black patients faced longer waits from diagnosis to surgery, indicating disparities. …

Sunscreen Cost And Its Effect On Skin Cancer In Low-Income Communities: A Systemic Review, John Sauer

Rowan-Virtua Research Day

This research examines the pivotal connection between sunscreen affordability and its impact on skin cancer prevalence, especially in low-income communities. Despite universal dermatological recommendations for daily sunscreen use, stringent criteria contribute to elevated prices, averaging around $10 for a 6 oz unit. This financial strain is compounded for families adhering to recommended application rates, leading to significant economic burdens. Outdoor laborers, less likely to follow guidelines, face heightened risks. Government programs' excluding sunscreen costs further exacerbate challenges for low-income communities, contributing to increased skin cancer incidence. This review aims to establish a correlation between sunscreen cost and skin cancer rates, …

Expanding Global Health Dermatology Leadership: Launching The Gloderm International Mentorship Program, Alexis G. Strahan, Olivia M. Davies, Lucía T. Fernández, Inena Wa Inena Gaylord, Yared Getachew Mekonnen, Marlous L. Grijsen, Jose E. Ollague, Doriane Sabushimike, Luisa Polo Silveira, Toby Maurer, Roni P. Dodiuk-Gad, Archana Singal, Henry W. Lim, Arpita Bhose, Janet E. Lubov, Shivani Jain, Morvarid Zehtab, Tom Allison, Maud Guerin, Wendemagegn Enbiale, Wingfield Rehmus, Karolyn A. Wanat, L Claire Fuller, Elizabeth Bailey, Esther E. Freeman

School of Medicine Faculty Publications

No abstract provided.

Geographic Distribution Of Melanoma Cases In Maine: Identifying Vulnerable Counties For Targeted Intervention, Joshua R. Parbs, Madeline Prentiss, Calla Hladky, Henry Stoddard, Kathryn Stevens, Elizabeth V. Seiverling, Peggy Cyr

Journal of Maine Medical Center

Introduction: Maine has the twelfth highest incidence of melanoma in the United States. The purpose of this study was to determine which Maine counties were the most impacted by melanoma through the use of geographical methods. Identification of counties with the highest prevalence of melanoma will help in targeting future training and public health interventions.

Methods: All melanoma cases (n=5,340) reported to the Maine CDC Cancer Registry from 2013 to 2018 were sorted by pathologic T stage. Data were sorted by county and population-adjusted. Population data and provider data came from Area Health Resource Files. County and zip-code maps were …

Playing It Sun Safe: A Quality Improvement Project, Sarah P. Tarr, Kathryn K. Dambrino, R. David Phillippi, Ashley Karpinos

DNP Projects

Background: Athletes who play outdoor sports have multiple risk factors for the development of skin cancer. Literature highlights the need for the use of evidence-based strategies to improve the knowledge and utilization of sun protection practices in this high-risk population. Methods: Playing it Sun Safe was a multifaceted skin cancer prevention initiative implemented in a population of collegiate soccer athletes in collaboration with a university athletic department and campus health clinic. Evidence-based interventions were designed through application of the Health Belief Model (HBM) and were implemented using the Institute for Healthcare Improvement (IHI) quality improvement framework. Purpose: The two-fold aim …

Surgical Intervention For Diffuse Dermal Angiomatosis Of The Breast, Caroline E. Savoie, Bethany S. Acosta, Harley J. Davis, G. William Poche

School of Medicine Faculty Publications

No abstract provided.

The Koolungar Moorditj Healthy Skin Project: Elder And Community Led Resources Strengthen Aboriginal Voice For Skin Health, Bernadette M. Ricciardo, Jacinta Walton, Noel Nannup, Dale Tilbrook, Heather-Lynn Kessaris, Carol Michie, Brad Farrant, Roni Forrest, Annette Garlett, Joanne Hill, Larissa Jones, Natasha Kickett, Sally Smith, Delys Walton, Taleah Ugle, Nadia Rind, Richelle Douglas, Jodie Ingrey, Brenda Carter, Ainslie Poore, Ingrid Amgarth-Duff, Hannah Thomas, Prasad S. Kumarasinghe, Jonathan R. Carapetis, Asha C. Bowen

Journal of the Australian Indigenous HealthInfoNet

In partnership with local Aboriginal Community Controlled Health Organisations, the Elder-led co-designed Koolungar Moorditj Healthy Skin project is guided by principles of reciprocity, capacity building, respect, and community involvement. Through this work, the team of Elders, community members, clinicians and research staff have gained insight into the skin health needs of urban-living Aboriginal koolungar (children); and having identified a lack of targeted and culturally appropriate health literacy and health promotion resources on moorditj (strong) skin, prioritised development of community-created healthy skin resources. Community members self-appointed to Aboriginal Community Advisory Groups (CAG) on Whadjuk (Perth) …

Development Of Solitary Keratoacanthoma From A Cutaneous Wart, Joshua M. Ninan, Veronica Salazar

Research Symposium

Background: Common cutaneous warts, referred to in medicine as verrucae vulgaris, are proliferative lesions caused by human papillomavirus. These lesions are mostly benign and usually resolve without incident, except in the case of the patient mentioned in this report. Our patient developed a solitary keratoacanthoma, currently accepted as a clinical variant of squamous cell carcinoma, as a result of several risk factors and traumatic exposure. The current literature does not have an established association of HPV with solitary keratoacanthomas. This case report explores the presentation and pathogenesis of solitary keratoacanthomas within the setting of HPV.

Case Presentation: 48-year-old Caucasian female …

Covid-19 Infection Increases The Development Of Stevens-Johnson Syndrome And Toxic Epidermal Necrolysis: A Retrospective Cohort Analysis, Kristen K. Curtis, Meghan M. Dillan, Timmie R. Sharma, Joseph Piktel

Student Scholarship

To the Editor: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) represent a spectrum of severe mucocutaneous reactions characterized by extensive epidermal detachment, most commonly due to medications.1 Some viruses, such as the human immunodeficiency virus, have been found to be an independent risk factor for the development of SJS and TEN, though the mechanism is not completely understood.2 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus identified in late 2019, is most commonly associated with mild respiratory illness. However, cutaneous manifestations, including SJS and TEN, have been increasingly reported during and after COVID-19 infection.3 Therefore, the objective …

Confidence Of Clark County Medical Students In Identifying Dermatologic Conditions On Different Fitzpatrick Skin Types, Ramaditya Srinivasmurthy

Annual Research Symposium

Racial health disparities are apparent in the field of dermatology across the United States. Certain dermatologic conditions are more likely to go undiagnosed in people with skin of color (SOC), leading to increased morbidity/mortality. Underrepresentation of darker skin tones in medical education may be a contributing factor. This study explores the ability and confidence of TUNCOM students to recognize dermatological conditions on various skin tones.

A 23 question survey was given to 173 second year students to examine their ability and confidence in identifying dermatologic conditions on non-SOC (Fitzpatrick I-III) and SOC (Fitzpatrick IV-VI). Images of common skin disorders on …

Health Economic Consequences Associated With Covid-19-Related Delay In Melanoma Diagnosis In Europe, Lara V Maul, Dagmar Jamiolkowski, Rebecca A Lapides, Alina M Mueller, Axel Hauschild, Claus Garbe, Paul Lorigan, Jeffrey E Gershenwald, Paolo Antonio Ascierto, Georgina V Long, Michael Wang-Evers, Richard A Scolyer, Babak Saravi, Matthias Augustin, Alexander A Navarini, Stefan Legge, István B Németh, Ágnes J Jánosi, Simone Mocellin, Anita Feller, Dieter Manstein, Alexander Zink, Julia-Tatjana Maul, Alessandra Buja, Kaustubh Adhikari, Elisabeth Roider

Faculty, Staff and Student Publications

IMPORTANCE: The COVID-19 pandemic resulted in delayed access to medical care. Restrictions to health care specialists, staff shortages, and fear of SARS-CoV-2 infection led to interruptions in routine care, such as early melanoma detection; however, premature mortality and economic burden associated with this postponement have not been studied yet.

OBJECTIVE: To determine the premature mortality and economic costs associated with suspended melanoma screenings during COVID-19 pandemic lockdowns by estimating the total burden of delayed melanoma diagnoses for Europe.

DESIGN, SETTING, AND PARTICIPANTS: This multicenter economic evaluation used population-based data from patients aged at least 18 years with invasive primary cutaneous …