Dermatology Commons^™

Bridging The Dermatology Divide: A Literature Review Of Artificial Intelligence–Enabled Point-Of-Care Tools For Skin Cancer Detection In Primary Care, Jared Hensley, Smaran Marupudi, Maria Villegas

School of Medicine Publications

The United States faces a critical dermatology workforce shortage, with more than 60% of counties lacking specialist access. Primary care providers (PCPs) are often tasked with managing suspicious skin lesions but demonstrate lower diagnostic accuracy than dermatologists. Artificial intelligence (AI) tools offer potential solutions, and meta-analytic evidence demonstrates that AI assistance improves PCP sensitivity by 13 percentage points and specificity by 11 percentage points. Yet only 1 Food and Drug Administration–authorized device (January 2024) is cleared for nondermatologist use in the United States. This device achieves 96% sensitivity but only 21% specificity, meaning most positive results are false alarms. A …

Expanding Treatment Frontiers In Hidradenitis Suppurativa: Double Immunomodulator Therapy In Severe Refractory Cases, Christina Tolete, Adam Friedman, Teresa Duong, Leonardo Tjahjono

Student Papers, Posters & Projects

No abstract provided.

Predictors Of Adalimumab Durability In Hidradenitis Suppurativa: A Multicenter Cohort Study, Albert T. Young, Arashleen Pannu, Alexander Velaoras, Roland Leyson, Rayad B. Shams, Alexandra Turfe, Andrea Dai, Mohsen Mokhtari, Sarah Bassett, Joshua Vazhappilly, Richard W. Hass, Iltefat Hamzavi, Christopher J. Sayed, Qing-Sheng Mi, Sherry Yang

Department of Dermatology and Cutaneous Biology Faculty Papers

BACKGROUND: Adalimumab is widely used for hidradenitis suppurativa (HS), but treatment durability varies and predictors of sustained benefit remain uncertain.

OBJECTIVE: To identify clinical and laboratory factors associated with adalimumab treatment durability in HS.

METHODS: We retrospectively studied 135 adults with HS who initiated adalimumab as first biologic therapy across three academic centers from 2013 to 2023. Outcomes were categorized as primary failure (12-24 weeks), secondary failure (24 weeks-2 years), or sustained response (>2 years) based on discontinuation for inefficacy. Predictors of treatment durability were evaluated using ordinal logistic regression.

RESULTS: In univariable analyses, Hurley stage 3, higher body …

Ulcerative Cutaneous Sarcoidosis Without Systemic Involvement: An Isolated Presentation, Kayla Brockmeyer, Simona A. Alomary, Ananya Udyaver, Lauren Banner, Alessio Gianni, Sweta Subhadarshani

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Under The Surface: A Rare Case Of The En Coup De Sabre Subtype Of Linear Morphea In The Rio Grande Valley, Miguel Lopez, Jared Hensley, Maria Villegas

School of Medicine Publications

Localized scleroderma, also referred to as 'morphea,' is a rare autoimmune disorder that affects the superficial layers of the skin and is characterized by both erythematous and bruise-like lesions with signs of central skin tightening or sclerosis; deeper lesions may be identified as edematous, erythematous plaques in the absence of well-defined borders. A subtype named en coup de sabre (ECDS) exists in the classification of linear morphea and presents with a linear induration on either the face or scalp. Our patient is a 21-year-old Hispanic female initially residing outside of the South Texas region who experienced an onset of skin …

Differences In Response Rates To A Previsit Electronic Portal Questionnaire In Outpatient Clinics: A Retrospective Observational Study Of The Standard Dermatology Outcome Measures, Rene F. Chen, Udeyvir S. Cheema, Beiyu Liu, Cynthia L. Green, Matilda W. Nicholas, Suephy C. Chen

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Dabrafenib-Induced Cutaneous Eruptions In A Patient With Langerhans Cell Histiocytosis, Jaanvi Mehta, Julianna Tolotta, Eleanor Matthews, Daniel Joffe, Safiyyah Bhatti, Lauren Banner, Jenna Mandel, Molly Wallace, Timothy G. Webster, Jason B. Lee, Neda Nikbakht

Department of Dermatology and Cutaneous Biology Faculty Papers

Langerhans cell histiocytosis (LCH) is a rare malignancy marked by clonal proliferation of Langerhans cells, with BRAF V600E mutations identified in over 50% of the cases. BRAF inhibitors (BRAFi), such as dabrafenib, have shown efficacy in treating BRAF V600E-mutant LCH. However, BRAFi therapy is associated with cutaneous adverse effects, including the development of new melanocytic nevi, verrucae, and keratinocyte carcinoma (KC). This case report describes a 78-year-old woman with BRAF V600E-mutant LCH who developed multiple dermatologic side effects following dabrafenib salvage therapy. Seven weeks into treatment, the patient presented with eruptive palmoplantar nevi, verrucae, and a basal cell carcinoma (BCC). …

Subcutaneous Nodules On The Elbows Of A Teenager, Arman Haveric, Jayci G. Rhein, Jason B. Lee, Shayan Waseh, Sylvia Hsu, Afton R. Metkowski

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Long-Term Quality Of Life For Patients With Merkel Cell Carcinoma Receiving Standard-Of-Care Adjuvant Radiation Therapy, Christian Paul D. Denolan, Kelsey N. Nordlund, Aya F. Salem, Devarati Mitra

Summer Research Program Abstracts

No abstract provided.

Clinical Presentations Of Pemphigus Vulgaris In Patients With Skin Of Color: A Systematic Literature Review, Haya Alkiswani, Simona Alomary, Jared Boetes, Nicole J. Baker, Susan C. Taylor

SKMC Student Presentations and Publications

Background: Pemphigus vulgaris (PV) is a rare, often severe autoimmune disease affecting skin and mucous membranes. Despite the scarce literature on PV in skin of color (SOC) populations (Fitzpatrick III-VI), existing studies suggest that there are misdiagnosis, delayed treatment, and recurrence of symptoms in SOC patients with PV. Objective: This review explores the clinical presentations of PV reported in patients with SOC, diagnostic challenges and delays, treatments, and patient outcomes to allow for an improved understanding of how PV manifests clinically in darker skin. Methods: A systematic literature review was conducted using articles found in PubMed and Embase. Two independent …

The Dermatologic Effects Of Climate Change On Skin Of Color Populations: A Comprehensive Review, Grace Ugwueke, Simona A. Alomary, Nicole J. Baker, Susan C. Taylor Md, Nada Elbuluk Md

Student Papers, Posters & Projects

Background: Climate change contributes to rising temperatures, worsening air pollution, increasing UV exposure, and more frequent extreme weather events with downstream consequences for dermatologic conditions. However, limited research has examined how these climate-related effects can impact skin of color (SOC) populations, who often face disproportionate environmental exposures and structural inequities. Objective: To summarize the dermatologic implications of climate and environmental stressors on SOC populations. Methods: A literature search of PubMed and Embase (2000-2025) identified studies assessing dermatologic outcomes related to climate change or environmental exposures. Of 1254 records screened, 133 duplicates were removed, leaving 1121 studies for evaluation. Twenty-three studies …

Response To Kodali Et Al., “Hailey-Hailey Disease: A Review And An Approach To Management”, Christina Tolete, Teresa Duong, Adam Friedman, Leonardo Tjahjono

Department of Medicine Faculty Papers

No abstract provided.

Symmetrical Drug-Related Intertriginous And Flexural Exanthema Associated With Tirzepatide, William Goodman, Karan Pandher, Mahaa Ayub

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Demystifying Longitudinal Melanonychia: Low-Cost 3d-Printed Nail Models For Patient Education, Nuran C. Golbasi, Zachary J.K. Neubauer, Nataliedeana Badillo, Shari R. Lipner

Student Papers, Posters & Projects

No abstract provided.

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, …

Multidisciplinary Care In The Management Of Pleomorphic Dermal Sarcoma: A Single-Center Case Series And Review, Jaanvi Mehta, Leena Wardeh, Jayson Suriano, Rishob Dasgupta, Ramsay Hafer, Alexandra Elder, Safiyyah Bhatti, Jason B. Lee, Atrayee B. Mallick, Neda Nikbakht

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Cutaneous Rosai-Dorfman Disease Misdiagnosed As Granulomatous Dermatitis: A Diagnostic Pitfall, Sri Naidnur, Jamie Hedrick, Smaran Marupudi, Kara Asbury, Kelly Maedo, Bryan Gammon, Rick Lin

School of Medicine Publications

Cutaneous Rosai-Dorfman disease (CRDD) is an uncommon non-Langerhans cell histiocytosis that may occur without systemic involvement and lacks specific clinical features. We report a 17-year-old female with a slowly enlarging chest lesion initially diagnosed as granulomatous dermatitis on a 4-mm punch biopsy. The lesion was treated as an inflammatory process without improvement. Complete excision revealed a multinodular dermal and subcutaneous infiltrate of large histiocytes demonstrating emperipolesis, confirming CRDD. Systemic evaluation was negative. The initial limited biopsy did not capture defining features, delaying diagnosis.

Persistent nodular lesions that fail to respond to therapy should prompt reconsideration and more representative tissue sampling. …

Exploring The Landscape Of Hair And Scalp Disorders In The Pediatric Skin Of Color Population: A Scoping Review, Nicole Baker, Simona A. Alomary, Jake H. Shapira, Cheryssa Hislop, Esther Zhang, Michelle Oboite, Temitayo Ogunleye

Department of Medicine Faculty Papers

No abstract provided.

From A Papule To Friable Papillary Projections: A Case Of Old World Cutaneous Leishmaniasis, Zamanali Khakhar, Adil Salyani, Soraiya Manji, Rajiv Patel, Sayed Karar

Internal Medicine, East Africa

This case aims to characterize an unusual cutaneous manifestation in a patient with confirmed cutaneous leishmaniasis, highlighting clinical features that are often underrecognized and may contribute to diagnostic uncertainty. By exploring this atypical presentation, it underscores the potential for misdiagnosis and its implications for patient management. Additionally, it emphasizes the broad spectrum of cutaneous lesions that can mimic Old World cutaneous leishmaniasis, further increasing the risk of diagnostic error.

Use Of Hybrid Versus Video-Only Teledermatology Varies By Condition: A Cross-Sectional Study Of 2064 Encounters, Jacqueline Penn, Kathryn Achuck, Christine Deng, Richard W. Hass, Elizabeth Jones

Department of Medicine Faculty Papers

No abstract provided.

Late-Career Transitions From Private Practice To Academic Dermatology: Financial Drivers, Professional Rewards, And Practical Steps, Joshua R. Jennings, Thomas Helm, Jeremy D. Jackson, Robert T. Brodell, N A

School of Medicine

Independent practice dermatology once promised near-total clinical autonomy and robust profit margins, yet more and more dermatologists have been leaving their “private” practices and contemplating a mid- or late-career move to academia [1]. Openings are available! Over the last 25 years, many academic health centers have evolved to engage clinician educators in support of their educational mission, which requires more clinical rotations for larger student bodies and to provide income to offset losses in research support [23, 39]. Leaving private practice is neither anecdotal nor sentimental; it reflects quantifiable changes in reimbursement, overhead, and the …

Systematic Review And Meta-Analysis Of Placebo Cure In Onychomycosis Clinical Trials, Julianne M. Falotico, Zachary J.K. Neubauer, Anjile An, Shari R. Lipner

Student Papers, Posters & Projects

No abstract provided.

Dementia Incidence In Patients With Prurigo Nodularis: An Observational Retrospective Cohort Study, Madison P. Olexson, Ana Ormaza Vera, Chunghwan Ro, Clinton W. Enos

Department Dermatology Faculty Publications

[Introduction] Prurigo nodularis (PN) is a chronic neuroinflammatory dermatosis of unknown etiology characterized by severely pruritic, symmetrically-distributed nodules with a negative impact on quality of life [1]. While some consider PN a primary idiopathic disorder, it often arises as a secondary manifestation of underlying conditions, including atopic dermatitis (AD), chronic kidney disease (CKD), human-immunodeficiency-virus (HIV), and thyroid disorders [2]. Although patients with PN are at higher risk for psychiatric comorbidities including depression, anxiety, and suicidal ideation [3] research which investigates associations between PN and neurodegenerative disorders is limited [4]. Moreover, emerging evidence implicating sustained systemic inflammation, characteristic of psoriasis and …

Central Centrifugal Cicatricial Alopecia In Pediatric Patients: A Retrospective Analysis, Radhika Gupta, Nikhita Perry, Noelle Desir, Iain Encarnacion, Jonathan Miles, Susan Taylor, Michelle Oboite, Temitaya Ogunleye

Department Dermatology Faculty Publications

[Introduction] Central centrifugal cicatricial alopecia (CCCA) is a scarring alopecia that predominantly affects middle-aged women of African descent.¹ It begins at the vertex scalp and expands centrifugally, and given that symptoms may be absent, many patients have scarring at presentation. CCCA is primarily described in adult populations, with limited reports of CCCA in children.²^-⁴ We aimed to characterize demographics, clinical findings, and histological features among pediatric patients with CCCA to facilitate earlier diagnoses, prior to irreversible alopecia.

Glucagon-Like Peptide-1-Based Therapies And The Intersection Of Metabolic And Skin Disease, Ana Ormaza-Vera, Clinton W. Enos

Department Dermatology Faculty Publications

[Introduction] To the Editor: The development of the glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1RAs) and the dual glucose-dependent insulinotropic polypeptide/GLP-1RAs is revolutionizing the management of metabolic disease. Perhaps most impressive is that their clinical significance extends far beyond their approved indications and touches seemingly every organ system, even the skin.

Cold-Sensitive Acral Hand Lesions, Avery H. Seward, Jocelyn H. Larocque

Department of Medicine Faculty Publications

[Case description] An otherwise healthy woman in her 60s presented with a 2-year history of a persistent, itchy, and tender rash on the dorsal hands. The rash fluctuated in severity with the seasons, worsening during the colder months. The patient denied joint pain and fatigue, or lesions elsewhere.

Examination revealed partially blanchable violaceous plaques on the dorsal hands with partial sparing of the proximal and distal interphalangeal joints (Fig 1). A few punctate, crusted erosions and purpuric macules were present on the dorsal and volar distal phalanges (Figs 2 and 3).

Enlarging Fingertip Nodule Mimicking A Pyogenic Granuloma In A Man In His 60'S, Avery H. Seward, Jocelyn H. Larocque, Stephen M. Hughes

Department of Medicine Faculty Publications

[Case presentation] A man in his 60's with a history of hypertension, hyperlipidemia, and resected colon cancer in remission presented with a 4-month history of an enlarging nodule on the right fourth fingertip. The patient recalled having a splinter removed from the same site a few weeks prior to the development of the lesion. The lesion was initially diagnosed by an orthopaedist as a pyogenic granuloma (Figure 1a), and the patient was advised to apply table salt to the area several times daily. However, the lesion continued to enlarge over 3 months with occasional bleeding and mild tenderness. Physical examination …

Educational Case: Hidradenitis Suppurativa, Ryan C. Saal, Linnea Lackstrom Westerkam, Cristo A. Carrasco Mendoza, Paul B. George, Christopher J. Sayed

Department of Medicine Faculty Publications

[Introduction] The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology. For additional information, and a full list of learning objectives for all three competencies, see https://doi.org/10.1016/j.acpath.2023.100086.1¹

Objective SK1.1: Pathophysiology of changes in the skin. Describe the pathophysiologic basis for changes in the color, surface texture, swelling, temperature, and sensitivity of skin.

Competency 2: Organ system pathology, Topic: Skin (SK); Learning Goal 1: …

Dual Clinical Presentation Of A Birthmark: A Quiz, Avery H. Seward, Jacqueline E. Leyrer, Sarah H. Carlock

Department of Medicine Faculty Publications

[Introduction] A man in his early 30s presented with a longstanding birthmark on the lift thigh that was first noticed at age 12. As a teenager, the lesion was treated with a CO2 laser at an outside institution; however, the lesion continued to slowly enlarge over the past several years. The patient reported recurrent irritation and swelling from a construction safety harness with occasional bleeding and frequent bruising. Recently, the area became inflamed, prompting an ER visit, where the patient was evaluated for cellulitis, underwent a normal ultrasound and was placed on cephalexin 500 gm twice daily for 10 days.