Dermatology Commons^™

Drug-Induced Hyperpigmentation Due To Levofloxacin, Miriam Motlak, Steven Manders

Cooper Rowan Medical Journal

Drug-induced hyperpigmentation is responsible for up to 20% of acquired hyperpigmentation cases, especially among the elderly population. The pathogenesis varies depending on the medication involved and may include melanin accumulation, drug deposition, production of special pigments, and iron deposition. We report the case of an elderly, immunocompromised patient with a history significant for leukemia presenting with black-blue hyperpigmentation of the upper and lower extremities, associated with iron deposition following levofloxacin exposure.

Case Report: Cold Urticaria Diagnosed In The Emergency Department, Philip Carhart, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Cold urticaria can be primary (idiopathic) or can be due to underlying hematologic or infectious diseases. Here we present the case of a young female patient with no past medical history who was diagnosed with cold urticaria in the emergency department setting, using a cold stimulation test. Most cases are idiopathic. The reaction can be triggered in individual cases by exposure to cold objects or to generalized cold ambient temperatures, as was the case in the patient presented here. The physical response is most commonly pruritic wheals (urticaria). However, more severe symptoms may occur up to angioedema with hoarseness and …

Case Report: Heating Pad Usage Leading To Rhabdomyolysis And Acute Kidney Injury, Meghna Kurup, Swet Patel, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report the case of a 26-year-old male with a significant psychiatric and substance use history who came to the emergency department (ED) with deep partial second degree burns to his back subsequent to using a heating pad for unknown periods of time prior to presentation. Rhabdomyolysis and acute kidney injury that occurred in this patient due to his burns. It is important to understand that although beneficial, if heating pads are misused or overused, they can cause injury.

Phenotypic Spectrum Of Gna11 R183c Mosaicism., Donglin Zhang, Luis Fernando Sánchez-Espino, Marta Ivars, Elena Pope, Amy J. Nopper, Lisa M. Arkin, Megha M. Tollefson, Cinzia E. Lavarino, Maya Muldowney, Nagore Gené Olaciregui, Sonia Paco, Beth A. Drolet, Eulàlia Baselga

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Many vascular anomalies harbor postzygotic somatic variants in GNAQ and GNA11; however, the phenotype of specific G-protein variants has not been well described. We report the clinical characteristics of 17 patients with a GNA11 R183C variant.

METHODS: This case series is derived from a multinational cohort of vascular anomaly patients whose pathogenic mutations were identified using high-depth next generation sequencing. Data include vascular anomaly features, imaging reports, and extracutaneous manifestations of the GNA11 R183C variant.

RESULTS: We identified 17 subjects (median age 18 years [range 6-67]) with somatic GNA11 R183C variant. All patients had vascular lesions of the skin …

Frozen Section Mohs: A Hybrid Technique And One Plastic Surgeon's Experience With 1714 Consecutive Skin Cancer Removals, Michael L. Chang, Steven L. Chang, Fady Gerges, Matthew M. Delancy, Amanda C. Yang, Lawrence D. Chang

Student Papers, Posters & Projects

While US nonmelanoma skin cancer (NMSC) mortality rate has decreased in the past decade, its incidence is rising. Traditional surgical treatments include wide local excision, intraoperative frozen section analysis (IFSA), and Mohs micrographic surgery (MMS). IFSA and MMS are techniques that provide intraoperative analysis allowing the surgeon to confirm margins clear of malignancy and minimize tissue damage, especially in cosmetically sensitive subunits. MMS, with cure rates up to 99%-100%, is considered the gold standard but is limited geographically and financially because of specialized training. We report a hybrid surgical technique that effectively excises cutaneous malignancy but can be utilized by …

Analyzing Social Media Trends In Cosmeceuticals: Insights From Google Trends And Tiktok Analytics, E. Correia, Jenna Mandel, Stephanie R. Jackson Cullison

Department of Dermatology and Cutaneous Biology Faculty Papers

OBJECTIVE: Social media usage has surged, particularly since the COVID-19 pandemic. Dermatology invokes intense interest on social media, and cosmeceuticals are among the most trending topics, offering a unique space for dermatologists to share their expertise. By using tools like Google Trends and TikTok viewership, we aim to capture cosmeceutical trends to guide dermatologists' educational efforts.

METHODS: A Google Trends search from January 2004 to December 2023 was performed on retinol, bakuchiol, salicylic acid, glycolic acid, azelaic acid, hydroquinone, niacinamide, vitamin C serum, and hyaluronic acid. Trend lines were created for each term, and yearly percent differences in relative search …

Use Of Upadacitinib For Recalcitrant Oral Erosive Lichen Planus, Connor A. Sheehan, Nicholas D. Brownstone, Jason B. Lee, Sylvia Hsu

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Connecting Disciplines: Dermatologists Discuss Skin Cancer Screening In Physical Therapy, Michael T. Robinson, Lindsay Gietzen

Pacific Journal of Health

Background: This study aims to explore dermatologists’ perspectives on the integration of skin cancer screening within physical therapy practice. The hypothesis is that insights from dermatologists can enhance the efficacy and accuracy of skin cancer screening by physical therapists (PTs), thereby improving early detection rates and patient outcomes. Methods: A total of five dermatologists participated in this study, each with between 5 and 18 years of experience and a diverse range of expert opinions and insights. This qualitative study utilized semi-structured interviews with participating dermatologists. The interview questions focused on their knowledge of skin cancer screening, perceptions of its implementation …

Facial Follicular Porokeratosis Simulating Discoid Lupus Erythematosus In An African American Woman, Pritika Singh, Layna Mager, Jeffrey Y. Liu, Jason B. Lee, Sylvia Hsu

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Condensed Low-Dose Total Skin Electron Beam Therapy For Mycosis Fungoides: An Institutional Retrospective Review And Subgroup Analysis Of Patients With Large Cell Transformation, Louis Cappelli, Megan Cappelli, Nilanjan Haldar, Tiara Paul, Jenna Mandel, Tingting Zhan, Neda Nikbakht, Wenyin Shi

Department of Dermatology and Cutaneous Biology Faculty Papers

Low-dose total skin electron beam therapy (TSEBT) is an effective treatment option for mycosis fungoides (MF) with proven palliative effects and reduced toxicity. Presented is an institutional analysis of survival/response rate and quality of life for MF patients with subgroup analysis of those possessing pathologic large cell transformation (LCT). This is a single institutional retrospective review of patients with mycosis fungicides treated from 2014 to 2023 with low-dose TSEBT. All patients received 12 Gy in 6 fractions every other day with the modified Stanford technique, with boosts to shadowed sites between treatments, completed in 2 weeks. Outcomes evaluated included clinical …

Under The Surface: A Rare Case Of Morphea In The Rio Grande Valley, Miguel A. Lopez, Jared Hensley, Maria Villegas

Research Symposium

Localized scleroderma, also referred to as “morphea,” is a rare autoimmune disorder that occurs in an estimated one out of 10,000 patients per year. Research on the demographics of morphea has shown an increased prevalence in female patients. Its presentation may consist of skin lesions confined to the epidermis and dermis that appear erythematous and bruise-like, 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,” exists among the classification of “linear morphea” and presents with a linear induration either …

Regional Disparities In Melanoma Mortality: A Study Of The Lower Rio Grande Valley In South Texas, Jared Hensley, Smaran Marupudi, Neharika Penmetcha, Blake C. Martin, Natasha Quailes, Elias Arellano Villanueva, Maria Villegas

Research Symposium

Background: Melanoma, a serious skin cancer with substantial morbidity, is influenced by demographic, geographic, and healthcare access factors. South Texas' Lower Rio Grande Valley (LRGV) region—including Starr, Willacy, Cameron, and Hidalgo counties—has a predominantly Hispanic population facing unique barriers to timely diagnosis and treatment. This study investigates the primary causes of death among melanoma patients in the LRGV compared to other Texas regions, aiming to uncover regional disparities that could guide public health interventions.

Methods: We conducted a retrospective cohort analysis using data from the Texas Cancer Registry (1995-2019). Patients were grouped into two cohorts: Group 1 (LRGV counties) and …

Leveraging Ai In Teledermatology: A Literature Review On Advancing Health Equity For Underserved Populations, Jared Hensley, Smaran Marupudi, Blake Martin, Neharika Penmetcha, Maria Villegas

Research Symposium

Background: Health disparities in dermatological care tend to disproportionately affect underserved populations, particularly those in rural and resource-limited settings. Teledermatology, augmented by artificial intelligence (AI), presents an opportunity to address these inequities by providing underserved populations with improved diagnostic capabilities. Despite its promise, AI models in teledermatology can often exhibit biases, such as reduced diagnostic efficacy for Fitzpatrick skin types IV-VI, due to their training on non-representative datasets. This literature review explores AI's role in teledermatology and potential strategies to enhance its utility for underserved populations.

Methods: A comprehensive review of peer-reviewed literature was conducted to evaluate the integration of …

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.

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

School of Medicine Faculty Publications

No abstract provided.

A Case Of Peristomal Pyoderma Gangrenosum With Histological Features Of Pseudoxanthoma Elasticum., Kelly M Kimball, Matthew J Franklin

Ambulatory and Primary Care Articles

No abstract provided.

Current Management Of Skin Conditions In Kenya: Exploring Teledermatology Preferences And Perspectives Among Providers, Jennifer Fernandez, Hashim Kaderbhai, Jennifer Adams, Mary B. Adam, Rodney Adam

Internal Medicine, East Africa

Background: Teledermatology programs may help expand access to care for skin conditions in areas that are underserved by dermatologists such as sub-Saharan Africa, but their success requires input from participating providers.

Objective: This study assesses teledermatology preferences among healthcare providers in Kenya.

Methods: An anonymous cross-sectional survey of nondermatology providers was conducted in Kenya from January to March 2024 at Aga Khan University Hospital-Nairobi and Kijabe Hospital.

Results: Among the 38 providers, 81.6% were physicians. Patient population was primarily Fitzpatrick skin types V and VI. Almost all (97.4%) regularly encountered patients with skin disorders, yet only …

Confluent Soft Nodules On Buttocks, Awa Bakayoko, Chiamaka Ohanenye, Jason B. Lee, Shaan Patel, Sylvia Hsu

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Utilization Of Suprathel® In Delayed Surgical Management Of Toxic Epidermal Necrolysis (Ten): A Case Report, Isabella Lipkin, Michelle Hughes, W. B. Hughes Md

Jefferson Hospital Staff Papers and Presentations

Given the lack of established practice guidelines for the management of cutaneous symptoms associated with toxic epidermal necrolysis, treatments range from various dressings to skin substitutes. The following report details a case of a 21-year-old male patient with this diagnosis who presented nine days after rash eruption from an outside hospital with no signs of healing. The patient was then successfully managed surgically eleven days after symptom onset with debridement of epidermal blisters and placement of Suprathel®. To our knowledge, this publication is the first to describe the potential of this synthetic skin substitute in promoting epidermal regeneration for delayed …

Self Supervised Artificial Intelligence Predicts Poor Outcome From Primary Cutaneous Squamous Cell Carcinoma At Diagnosis, Nicolas Coudray, Michelle C. Juarez, Maressa C. Criscito, Adalberto Claudio Quiros, Reason Wilken, Stephanie R. Jackson Cullison, Mary L. Stevenson, Nicole A. Doudican, Ke Yuan, Jamie D. Aquino, Daniel M. Klufas, Jeffrey P. North, Siegrid S. Yu, Fadi Murad, Emily Ruiz, Chrysalyne D. Schmults, Cristian D. Cardona Machado, Javier Cañueto, Anirudh Choudhary, Alysia N. Hughes, Alyssa Stockard, Zachary Leibovit-Reiben, Aaron R. Mangold, Aristotelis Tsirigos, John A. Carucci

Department of Dermatology and Cutaneous Biology Faculty Papers

Primary cutaneous squamous cell carcinoma (cSCC) is responsible for ~10,000 deaths annually in the United States. Stratification of risk of poor outcome at initial biopsy would significantly impact clinical decision-making during the initial post operative period where intervention has been shown to be most effective. Using whole-slide images (WSI) from 163 patients from 3 institutions, we developed a self supervised deep-learning model to predict poor outcomes in cSCC patients from histopathological features at initial diagnosis, and validated it using WSI from 563 patients, collected from two other academic institutions. For disease-free survival prediction, the model attained a concordance index of …

Patient Perception Of Delays In The Dermatology Clinic, Emily Hunter, Safiyyah Bhatti, Lauren N. Mcgrath, Stephanie R. Jackson Cullison, Elizabeth Jones

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, …

Notalgia Paresthetica: Case Report, Emily M. Garelick, David Kasper

The Journal of Integrated Primary Care

Notalgia paresthetica (NP) is a dermatologic condition that causes pruritus of the skin on the medial border of the inferior scapula and/or upper back. It is a chronic neurologic dysesthesia caused by pain from nerve fiber damage at the thoracic spine, levels two to six. Patients can also experience paresthesia, allodynia, and pruritus that is exacerbated by heat. It has been shown in multiple case reports that thoracic nerve impingement could be responsible for this problem, specifically herniated intervertebral discs, vertebral changes, and osteoarthritic lesions. Multiple methods of treatment have been reported to be effective including topical steroids and anesthetics, …

Mechanisms Of Familial And Uv-Induced Melanoma, Jeri D. Hughes

Pursuit - The Journal of Undergraduate Research at The University of Tennessee

Melanoma is the most common form of skin cancer in the United States. Melanoma is a disease where cancerous cells derive from melanocytes. Common melanoma susceptibility genes induce dysregulation in the mitogen-activated protein kinase (MAPK) pathway, phosphatase and tensin homolog (PTEN),and AKT expression. Melanoma can be induced through prolonged UV-radiation or familial diagnosis. This article aims to discuss the mechanisms of both familial and UV-induced melanomagenesis

Intraumbilical Mass With Cyclical Drainage, Alexis Coican, Angelia Stepien, Laszlo Karai

South Atlantic Division GME Research Day 2025

No abstract provided.

Disseminated Mycobacterium Marinum Presenting As Bursitis In A Patient With Psoriatic Arthritis On Adalimumab, Mallory Suhling, Aditya Dutt, Olivia Cook, Summer Moon

West Florida Division GME Research Day 2025

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 …

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 …