Dermatology Commons^™

Periumbilical Perforating Pseudoxanthoma Elasticum, Ana L. Duarte-Summers, Anna Chen, Morgan E. Sussman-Mccrea, Shayan Waseh, Jason B. Lee, Sylvia Hsu

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Hidradenitis Suppurativa Is Associated With An Increased Risk Of Adverse Cardiac Events And All-Cause Mortality, Thomas Z. Rohan, Ramsay Hafer, Teresa Duong, Rishob Dasgupta, Sherry Yang

Department of Dermatology and Cutaneous Biology Faculty Papers

Background: Hidradenitis suppurativa (HS) has been previously associated with greater rates of major adverse cardiac events (MACEs) compared to the general population. This study aims to better elucidate the association between HS, MACEs, and other cardiovascular diseases. Methods: We utilized TriNetX, a global database of electronic health records, to conduct a retrospective cohort study. HS patients were matched on demographic and cardiovascular disease risk factors to both healthy and psoriasis groups as controls. Results: After adjusting for cardiovascular disease risk factors, HS patients had a relative risk (RR) (95% CI) of 2.06 (1.83-2.32) for myocardial infarction, 1.62 …

A Guide To Diagnosis And Management Of Hypertrichosis, Rahib K. Islam, Victoria T. Tong, Shari R. Lipner

School of Medicine Faculty Publications

Hypertrichosis is a phenotype characterized by excessive hair growth in areas not typically prone to dense hair coverage. It may be congenital or acquired, and has significant clinical and psychosocial implications, often leading to psychological distress and social stigmatization. Diagnostic approaches emphasize the importance of thorough clinical evaluation and differentiation from hirsutism. Treatment options include topical and systemic treatments, as well as mechanical methods and laser therapies. Special considerations are given to pediatric patients regarding the psychosocial aspects of the phenotype. This review aims to provide physicians and researchers with a thorough understanding of hypertrichosis to facilitate better diagnosis, treatment, …

A Case Of Biopsy-Proven Atopic Dermatitis Perpetuated By Psychosomatic Factors, Henry Lim, Jamie Y. Choe, Marshall Hall, Arianne Felicitas, Christian Scheufele, Garrett Furth, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Introduction: Psychodermatology is an interdisciplinary branch of psychosomatic medicine that addresses interactions between the psyche and skin. Stress is often a key exacerbating factor and highlights the bidirectional relationship between psychological factors and skin disorders. Atopic dermatitis (AD) is a chronic skin condition affecting pediatric and adult populations with an estimated global prevalence of approximately 2.6%, or approximately 204 million people. AD classically presents with a red, scaly, pruritic rash. Here, we present a case of biopsy-proven AD induced by stress-associated behaviors related to patient-identified obsessive-compulsive habits. Case Presentation: A 61-year-old female presented for persistent itching and white discoloration in …

Investigating The Relationship Between Skin Color, Ethnicity, And The Fitzpatrick Skin Scale, Henry Lim, Dana Olsen, Reem Ayoub, Maria Francesca Ysabelle Martinez, Rafael Do Valle, Kristina Kafle, Christina Guo, Marshall Hall, Christian Scheufele, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Introduction: The Fitzpatrick skin scale has long been used as a proxy for skin tone categorization. However, its initial creation was to classify reactivity of white skin to ultraviolet A radiation. A reported one-third of dermatologists conflate the Fitzpatrick skin scale for race and ethnicity. Approximately half of the dermatologists also reported utilizing the Fitzpatrick scale to describe skin color. The goal of this study was to compare the Fitzpatrick scale to skin color and ethnicity in a larger, cohort including the full spectrum of skin tones. Methods: Subjects completed a standardized questionnaire. The questionnaire encompassed subjective classification methods: self-reported …

A Case Of Neutrophilic Dermatosis Of The Dorsal Hands With Post-Traumatic Onset, Marshall Hall, Kristina Kafle, Henry Lim, Christian Scheufele, Garrett Furth, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Background Sweet Syndrome is an acute, febrile neutrophilic dermatosis that is characterized by painful red lesions, fever, and neutrophilia with histological findings of dermal neutrophilic infiltrate. Neutrophilic Dermatosis of the Dorsal Hands is a localized variant of Sweet Syndrome. Neutrophilic Dermatosis of the Dorsal Hands presents with focused lesions on the dorsal hands, most commonly between the index finger and thumb, typically with fewer systemic manifestations. This condition presents significant diagnostic challenges as it can mimic infectious processes, potentially leading to delayed appropriate treatment. Case Information A 64-year-old male presented to the emergency department with wounds on the bilateral hands. …

Inked And Infected: A Case That Highlights The Emerging Concern Of Tattoo-Associated Mycobacterium Abscessus, Tory Starzyk, Neena Edupuganti

West Florida Division GME Research Day 2025

No abstract provided.

Don’T Sweat It: A Case Of Solid Cystic Hidradenoma, Anthony Concilla, Michelle Militello, Angelia Stepien, Juan Rosario-Collazo

South Atlantic Division GME Research Day 2025

No abstract provided.

Dermoscopic Features Of Sebaceous Adenoma, Abigail M. Lowe, Michelle Militello, Karthik Krishnamurthy, Sarah Ferrer-Bruker

South Atlantic Division GME Research Day 2025

No abstract provided.

Follicular Occlusion Syndrome: Diagnosis, Management, And Emerging Insights, Henry Lim, Reem Ayoub, Rafael Do Valle, Marshall Hall, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Follicular Occlusion Syndromes (FOS) are rare chronic relapsing skin disorders characterized by abnormal follicular hyperkeratinization, plugging, and inflammation. FOS are more commonly discussed as a ‘triad’ or ‘tetrad’ based on the patient’s clinical presentation. The triad includes hidradenitis suppurativa, acne conglobata, and dissecting cellulitis of the scalp. The tetrad in addition to the triad includes a history of pilonidal cysts. These disorders have a considerably negative effect on quality of life due to chronic pain, psychological distress, and body image concerns. Delayed or misdiagnosis can exacerbate patient outcomes, heightening the importance of timely identification and multidisciplinary treatment. We present two …

A Case-Control Comparison Of Alopecia Areata And Inflammatory Bowel Disease, Mohammad Fardos, Amritpal Kooner, Rawle A. Sekhon, Beniamin Zeka, Aditya Dutt, Richard Miller

West Florida Division GME Research Day 2025

No abstract provided.

Perceived Risk Of Skin Cancer: Influence Of Family History, Age, Ethnicity, And Fitzpatrick Type, Henry Lim, Reem Ayoub, Rafael Do Valle, Kristina Kafle, Dana Olsen, Ysabelle Martinez, Christina Guo, Marshall Hall, Christian Scheufele, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Background: Skin cancer in the United States accounts for approximately 50% of new early cancer diagnoses. Despite this, many individuals underestimate their personal risk, leading to lower engagement in preventative behaviors. Several factors may influence an individual’s perceived risk, including family history, age, race, ethnicity, skin type, and gender. While some individuals recognize their increased susceptibility based on personal, familial, and cultural experiences, others may have a lower perceived risk due to misconceptions or limited awareness. This study examines how these demographic factors influence individuals' perceived risk of skin cancer. Methods: This study analyzed data from 333 individuals aged 19 …

An Unusual Case Of Indolent Systemic Mastocytosis: Diagnostic Insights In The Absence Of Classic Systemic Symptoms, Henry Lim, Jonah Gutierrez, Rafael Do Valle, Reem Ayoub, Marshall Hall, Christian Scheufele, Garrett Furth, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Introduction: Mastocytosis is a disorder characterized by an abnormal clonal accumulation and subsequent activation of mast cells within one or more organs. It is generally classified as either cutaneous, with or without systemic involvement, or systemic without cutaneous disease based on major and minor criterion. Indolent systemic mastocytosis (ISM) is a subclass of systemic mastocytosis with generally good prognosis. While the etiology of ISM is not completely understood, those who are affected typically have the KIT D816V mast cell receptor mutation. Given that ISM is mast cell mediated, patients predominantly present with a wide range of symptoms related to mast …

More Than Skin Deep: A Long Term Cyst Masquerades Breast Cancer Metastasis, Paola Torres-Laboy, Juan Rosario Collazo

South Atlantic Division GME Research Day 2025

No abstract provided.

Adult-Onset Iga Vasculitis And Nephropathy In Alcoholic Cirrhosis: A Case Report And Brief Review, Brett Thomas, Summer Wong, Walaa Abualhuda, Siddhi Patodia, Elaine Bruno, David Esguerra, Richard Miller

West Florida Division GME Research Day 2025

No abstract provided.

Inpatient Dermatology Vignettes: Seborrheic Dermatitis, Garrett Furth, Henry Lim, Marshall Hall, Christian Scheufele, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Seborrheic dermatitis is a common inflammatory disorder characterized by greasy scale, itching, and erythema. It commonly affects areas of the skin that have high sebum production or are sebaceous gland-rich, including the scalp, face, sternum, axilla, groin, and other skin folds. Seborrheic dermatitis can present in infants, adolescents, and adults, and is more common in men. The etiology is not fully understood, but contributing factors include presence of the yeast genus Malassezia, androgen levels, immunosuppression, family history, and stress or lack of sleep. Interestingly, those with neurological and psychiatric conditions, including Parkinsons Disease, spinal cord injury, epilepsy, and tardive dyskinesia, …

Skin Color Cannot Be Confined To Six Categories: Comparing The Fitzpatrick Scale And Colorimetric Measures, Henry Lim, Kristina Kafle, Reem Ayoub, Dana Olsen, Ysabelle Martinez, Rafael Do Valle, Christina Guo, Marshall Hall, Christian Scheufele, Michael Carletti, Stephen E. Weis

North Texas Research Forum 2025

Purpose The Fitzpatrick Scale (FS), originally developed to dose photochemotherapy in Caucasian skin, has become widely adopted for skin color categorization. It originally included types I-IV, with types V-VI added later for darker skin. The FS was designed for UV radiation reactivity assessment. However, it is increasingly used as a proxy for objective skin color classification, despite being based on a subjective questionnaire. Individual Typology Angle (ITA), a validated colorimetric measurement, presents a potential alternative. Previous studies examining these classification systems have been limited by small sample sizes and uneven distribution across skin tones with subjects predominantly having lighter skin …

Clinical Evaluation And Management Of Terra Firma-Forme Dermatosis: Insights From Two Diverse Cases, Henry Lim, Rafael Do Valle, Reem Ayoub, Marshall Hall, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Terra Firma-Forme Dermatosis (TFFD), also known as Duncan’s dirty dermatosis is a benign, asymptomatic dermatologic condition characterized by well-demarcated brown patches to hyperkeratotic papules or plaques. It most commonly affects the neck, trunk, and face but can appear on other body regions. A key diagnostic feature is that these lesions persist despite routine washing with soap and water but can be removed by forcibly wiping the affected area with 70% isopropyl alcohol, revealing normal underlying skin. The exact etiology of TFFD remains unknown, though it is thought to involve abnormal keratinization or delayed desquamation. This condition is often underdiagnosed or …

Development And Validation Of An Accurate And Precise Skin Color Scale, Henry Lim, Christina Guo, Reem Ayoub, Rafael Do Valle, Kristina Kafle, Ysabelle Martinez, Dana Olsen, Marshall Hall, Christian Scheufele, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Introduction: Utilization of the Fitzpatrick scale to describe skin color does not adequately account for variations in pigmentation that are reflective of skin color characteristics of persons from diverse racial and ethnic backgrounds. This study aims to create a better way to describe skin color. Methods: We developed an 11-point color scale. This Skin Color Scale (SCS) was reproduced onto a physical card that could be placed onto a research participant’s inner arms for independent scale interpretation. Participants and two investigators selected the best matching scale interpretation value for each arm. Self-acquired and investigator assessed Fitzpatrick scores were taken. These …

Body Dysmorphic Disorder Presenting As Alopecia Anxiety: A Case Report, Henry Lim, Paige Loux, Arianne Felicitas, Marshall Hall, Christian Scheufele, Garrett Furth, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Background: Body dysmorphic disorder (BDD) involves a preoccupation with a nonexistent or insignificant physical defect that causes clinically significant distress and impacts a patient's daily functioning. We present a case of a patient with body dysmorphia that manifested as anxiety about hair loss. Case Information: A 48-year-old otherwise healthy female presented to the dermatology clinic with the chief complaint of 8 months of hair loss. She had been seen previously by 2 other dermatologists. She brought 28 pages of paperwork to her first appointment detailing previous work-up, including four separate skin punch biopsies consistent with androgenetic, non-cicatricial (non-scarring) alopecia. Other …

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Keloids, Marshall Hall, Alyssa Forsyth, Paige Loux, Henry Lim, Christian Scheufele, Garrett Furth, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Introduction: Keloids are benign, firm nodules resulting from excessive scar formation, typically following trauma, but they can also arise spontaneously. They commonly affect areas like the chest, shoulders, back, cheeks, and earlobes. Their growth exceeds the boundaries of the original injury. Keloids can cause discomfort, pruritus, or cosmetic concerns. While they are more prevalent in individuals with darker skin tones, they occur across all age groups and skin types. Differentiating keloids from conditions such as hypertrophic scars, dermatofibromas, acrochordons, inflamed nevi, cysts, and lipomas i s crucial for proper diagnosis and management. This review highlights the diverse clinical presentations of …

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.

Atypical Presentation Of Eruptive Syringomas On The Forearms Of A 19-Year-Old Patient, Margo Waters, Sami Osman, Jacob Hostetter, Joy Mosser-Goldfarb

West Florida Division GME Research Day 2025

No abstract provided.

Porokeratosis Ptychotropica: Diagnostic Insights Into A Rare Dermatosis, Layal Antoury, Sadia Salim, Karthik Krishnamurthy

South Atlantic Division GME Research Day 2025

No abstract provided.

The Critical Role Of Early Diagnosis, Multidisciplinary Management, And Social Determinants In Eczema Herpeticum: A Case Study Of A 24-Year-Old Man, Benjamin R. Cooper, Taha Rasul, Christian Castro-Ruiz, Karthik Krishnamurthy

South Atlantic Division GME Research Day 2025

No abstract provided.

The Quality-Of-Life Benefits And Risk Of Isotretinoin (Accutane) In Acne Treatment: A Systematic Review, Noelia Valencia Zuniga

Honors Undergraduate Theses

Acne vulgaris is a prevalent dermatological condition, particularly affecting adolescents and young adults. While often treated as a cosmetic issue, acne can significantly impair a patient's mental health and overall quality of life (QoL). Isotretinoin, commonly known as Accutane, is widely regarded as the most effective treatment for severe and persistent acne. However, its use is controversial due to a range of potential side effects, including psychiatric symptoms, teratogenicity, and other systemic complications. To better understand the risk-benefit profile of isotretinoin in acne treatment, we conducted a systematic review, focusing on the QoL benefits and risks associated with its use. …

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 …

Apocrine Breast Cancer With Psammoma Bodies In A Male Patient, Alena Bashinskaya, Eric W. Baum, Michael B. Morgan

HCA Healthcare Journal of Medicine

Introduction

While male breast carcinoma is a relatively uncommon occurrence, its incidence is on the rise, potentially attributed to sporadic pathophysiological mechanisms, primarily involving hormonal imbalances. Invasive apocrine carcinoma represents a small fraction of global breast malignancies, with limited instances reported among male patients in the literature. The clinical presentation of an apocrine breast carcinoma closely resembles that of other breast cancer subtypes, as it is most often described as a solitary ulcerative nodular lesion occupying a retro-areolar region of the breast. Herein, we describe a novel case of an apocrine male breast carcinoma metastasizing to the skin, given that …

Port-Wine Stain Treatment With 577-Nm Laser: Treatment Outcomes Of Superficial Versus Deep Lesions, Yulia Siskawati

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Port-wine stains (PWS), or capillary malformations (CM), are congenital vascular anomalies characterized by gradual enlargement of the superficial cutaneous vascular plexus, leading to low-flow malformations in the skin. Laser therapy remains the preferred treatment for PWS. The 577-nm vascular laser system is particularly suited for treating cutaneous vascular disorders. This study evaluates the efficacy of the 577-nm vascular laser for both superficial and deep PWS lesions.

Case Illustration: Three adult patients, all aged over 17 years old, were treated with the 577-nm laser. In the first case with deeper PWS, four treatment sessions resulted in flattening of hypertrophic areas, …

Onycholysis In An Elderly Woman: Proposal For Treatment With Coix Seed Extract Administration, Yasuhiro Horiuchi

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: The exact etiology of onycholysis, which is characterized by the painless separation of the nail from the nail bed, remains unclear. Currently, there are no established effective treatments for this condition. Coix seed extract (C-S extract), a traditional Chinese medicine, is recognized for its various biological properties.

Case Illustration: This report describes a case of onycholysis affecting the left index finger of a 62-year-old female patient, with initial symptoms appearing three months prior. Despite ongoing internal administration of C-S extract, the patient experienced a recurrence of onycholysis on both the index finger and pinky finger of the left hand …