Dermatology Commons^™

Risankizumab In Patients With Moderate-To-Severe Atopic Dermatitis: A Phase 2, Randomized, Double-Blind, Placebo-Controlled Study, Stephen K Tyring, Phoebe Rich, Yayoi Tada, Stefan Beeck, Izabella Messina, Jie Liu, Xiaohong Huang, Stephen Shumack

Faculty, Staff and Student Publications

INTRODUCTION: Atopic dermatitis (AD) is a heterogeneous disease, with involvement of the T-helper cell (Th) 2, Th22, and potentially Th17 pathways, supporting the use of interleukin (IL)-23 and IL-22 blockade in AD.

METHODS: This phase 2, multicenter, randomized, double-blind, placebo-controlled trial (NCT03706040) evaluated the efficacy and safety of risankizumab, an IL-23 inhibitor, in patients (≥ 12 years old) with moderate-to-severe AD, defined by an Eczema Area and Severity Index (EASI) ≥ 16, affected body surface area ≥ 10%, and a Validated Investigator Global Assessment for AD (vIGA-AD) score ≥ 3. Patients were randomized 2:2:1 to 16-week treatment with risankizumab 150 …

Subacute Cutaneous Lupus Erythematosus After Mrna-Based Sars-Cov-2 Vaccination, Sarah Rimmer, Long Ly, Erin Boh

School of Medicine Faculty Publications

No abstract provided.

Rare Variants Of Dermatofibrosarcoma Protuberans: Clinical, Histologic, And Molecular Features And Diagnostic Pitfalls, Celestine M Trinidad, Sintawat Wangsiricharoen, Victor G Prieto, Phyu P Aung

Faculty, Staff and Student Publications

Dermatofibrosarcoma protuberans (DFSP) is a dermal malignant mesenchymal tumor. Most variants are associated with a high risk of local recurrence and a low risk of metastasis. The classic histomorphology of this tumor is made up of uniform, spindle-shaped cells, arranged in a storiform pattern. Tumor cells characteristically infiltrate the underlying subcutis in a honeycomb pattern. Less common variants of DFSP have been identified: myxoid, pigmented, myoid, granular cell, sclerosing, atrophic, and fibrosarcomatous. Only the fibrosarcomatous variant has been shown to differ significantly from classic DFSP in terms of clinical outcome; fibrosarcomatous DFSP has been shown to be associated with a …

Expert Opinions And Clinical Experiences With Chlormethine Gel As Maintenance Treatment For Patients With Mycosis Fungoides, Larisa Geskin, Christiane Querfeld, Emmilia Hodak, Neda Nikbakht, Evangelia Papadavid, Marco Ardigò, Ulrike Wehkamp, Martine Bagot

Department of Dermatology and Cutaneous Biology Faculty Papers

Maintenance treatment can be recommended for patients with mycosis fungoides (MF) whose disease responds to primary treatment. While positive outcomes have been observed in small studies with maintenance therapy, there is a lack of practical guidelines and agreement on when and how maintenance therapy for MF should be approached. In this article, we discuss expert opinions and clinical experiences on the topic of maintenance therapy for patients with MF, with a focus on chlormethine gel. Ideally, patients should have a durable response before initiating maintenance therapy. The definition of and required duration of durable response are topics that are open …

Topical Antibiotic Treatment In Dermatology, Matthew Dallo, Kavina Patel, Adelaide A Hebert

Faculty, Staff and Student Publications

Many indications in dermatology can be effectively managed with topical antibiotics, including acne vulgaris, wound infections, secondarily infected dermatitis, and impetigo. Dermatologists must be familiar with the wide spectrum of topical antibiotics available, including indications, mechanisms of action, adverse events, and spectra of activity. Dermatologists must also keep antibiotic resistance in mind when utilizing these medications. Due to the widespread use of topical antibiotics and their importance in dermatology, a literature review was performed using a systematic search of PubMed and Google Scholar with the terms topical antibiotics, skin infections, dermatology, antimicrobials, and inflammatory dermatoses to identify English-language articles published …

A Gain-Of-Function Tpc2 Variant R210c Increases Affinity To Pi(3,5)P2 And Causes Lysosome Acidification And Hypopigmentation, Qiaochu Wang, Zengge Wang, Yizhen Wang, Zhan Qi, Dayong Bai, Chentong Wang, Yuanying Chen, Wenjian Xu, Xili Zhu, Jaepyo Jeon, Jian Xiong, Chanjuan Hao, Michael Xi Zhu, Aihua Wei, Wei Li

Faculty, Staff and Student Publications

Albinism is a group of inherited disorders mainly affecting skin, hair and eyes. Here we identify a de novo point mutation, p.R210C, in the TPCN2 gene which encodes Two Pore Channel 2 (TPC2) from a patient with albinism. TPC2 is an endolysosome and melanosome localized non-selective cation channel involved in regulating pigment production. Through inside-out recording of plasma membrane targeted TPC2 and direct recording of enlarged endolysosomal vacuoles, we reveal that the R210C mutant displays constitutive channel activation and markedly increased affinity to PI(3,5)P2. Mice harboring the homologous mutation, R194C, also exhibit hypopigmentation in the fur and skin, as well …

Racial Differences In Perceived Risk And Sunscreen Usage, Rebecca Fliorent, Alicia Podwojniak, Lianne Adolphe, Katharine Milani

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Background Although White individuals have higher incidence of melanoma, clinical outcomes are worse among patients with skin of color. This disparity arises from delayed diagnoses and treatment that are largely due to clinical and sociodemographic factors. Investigating this discrepancy is crucial to decrease melanoma-related mortality rates in minority communities. A survey was used to investigate the presence of racial disparities in perceived sun exposure risks and behaviors. Methods A survey consisting of 16 questions was deployed via social media to assess skin health knowledge. Over 350 responses were recorded, and the extracted data were analyzed using statistical software. Results Of …

Inherited Human Itk Deficiency Impairs Ifn-Γ Immunity And Underlies Tuberculosis, Masato Ogishi, Rui Yang, Rémy Rodriguez, Dominic P Golec, Emmanuel Martin, Quentin Philippot, Jonathan Bohlen, Simon J Pelham, Andrés Augusto Arias, Taushif Khan, Manar Ata, Fatima Al Ali, Flore Rozenberg, Xiao-Fei Kong, Maya Chrabieh, Candice Laine, Wei-Te Lei, Ji Eun Han, Yoann Seeleuthner, Zenia Kaul, Emmanuelle Jouanguy, Vivien Béziat, Leila Youssefian, Hassan Vahidnezhad, V Koneti Rao, Bénédicte Neven, Claire Fieschi, Davood Mansouri, Mohammad Shahrooei, Sevgi Pekcan, Gulsum Alkan, Melike Emiroğlu, Hüseyin Tokgöz, Jouni Uitto, Fabian Hauck, Jacinta Bustamante, Laurent Abel, Sevgi Keles, Nima Parvaneh, Nico Marr, Pamela L Schwartzberg, Sylvain Latour, Jean-Laurent Casanova, Stéphanie Boisson-Dupuis

Department of Dermatology and Cutaneous Biology Faculty Papers

Inborn errors of IFN-γ immunity can underlie tuberculosis (TB). We report three patients from two kindreds without EBV viremia or disease but with severe TB and inherited complete ITK deficiency, a condition associated with severe EBV disease that renders immunological studies challenging. They have CD4+ αβ T lymphocytopenia with a concomitant expansion of CD4-CD8- double-negative (DN) αβ and Vδ2- γδ T lymphocytes, both displaying a unique CD38+CD45RA+T-bet+EOMES- phenotype. Itk-deficient mice recapitulated an expansion of the γδ T and DN αβ T lymphocyte populations in the thymus and spleen, respectively. Moreover, the patients' T lymphocytes secrete small amounts of IFN-γ in …

Unveiling The Mystery: Paraneoplastic Syndrome Masquerading As Skin Thickening And Arthritis, Megan Schermerhorn, Md, Qian Leng, Md, Atish Dey, Md

Poster Presentations

No abstract provided.

Puzzling Painful Cutaneous Nodules: A Sign To Dig Deeper, Preetha Kamath, Angelia Stepien, Brandon Beal, Courtney Bernett, Karthik Krishnamurthy

South Atlantic Division GME Research Day 2023

No abstract provided.

Forum Discussion Indicates Favorable Views Of Jak Inhibitors For Atopic Dermatitis, Nicole Levin, Karan Rajalingam, Ashley Wentworth, Leila Tolaymat

East Florida Division GME Research Day 2023

Background: There is increasing discussion online concerning the management of atopic dermatitis (AD). Patients often document their subjective experience of a given treatment. It remains to be determined if the experiences vary based on treatment or align with efficacy.

Objective: To determine which treatments are associated with positive or negative experiences.

Methods: The largest online AD platform was searched for posts that only discussed a singular treatment. The discovered 28,159 posts were rated “positive” or “negative” by DistilBERT, a pre-trained sentiment analysis model that derives from BookCorpus, a collection of 11,038 books containing 74 million sentences. Positive sentiment proportions (PSP), …

Slow Mohs For Sebaceous Carcinoma Of The Scalp, Heather Kopecky, Angela Rosenburg, Brett Thomas, Richard Miller

West Florida Division GME Research Day 2023

No abstract provided.

Skin Of Color Representation On Wikipedia, William Kim, Sophia Wolfe, Caterina Zagona-Prizio, Robert P. Dallavalle, Natasha Fazel, Ryan Spilman

Continental, MidAmerica, & Mountain Divisions GME Research Day 2023

No abstract provided.

A Rare Case Of Demodicosis Following Treatment Of Oral Fluconazole, Joshua Bezecny, Emily Bolton, Matthew H. Taylor, Elizabeth G. Berry

Continental, MidAmerica, & Mountain Divisions GME Research Day 2023

No abstract provided.

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.

The Importance Of Recognizing The Many Facets Of Crohn’S Disease, Alexander Howell, Rachel Murray, Ann Church, Karthik Krishnamurthy

South Atlantic Division GME Research Day 2023

No abstract provided.

Skin Lesion Segmentation In Dermoscopic Images With Noisy Data, Norsang Lama, Jason Hagerty, Anand Nambisan, Ronald Joe Stanley, William Van Stoecker

Electrical and Computer Engineering Faculty Research & Creative Works

We Propose a Deep Learning Approach to Segment the Skin Lesion in Dermoscopic Images. the Proposed Network Architecture Uses a Pretrained Efficient Net Model in the Encoder and Squeeze-And-Excitation Residual Structures in the Decoder. We Applied This Approach on the Publicly Available International Skin Imaging Collaboration (ISIC) 2017 Challenge Skin Lesion Segmentation Dataset. This Benchmark Dataset Has Been Widely Used in Previous Studies. We Observed Many Inaccurate or Noisy Ground Truth Labels. to Reduce Noisy Data, We Manually Sorted All Ground Truth Labels into Three Categories — Good, Mildly Noisy, and Noisy Labels. Furthermore, We Investigated the Effect of Such …

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 …

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.

Immune Checkpoint Inhibitors In Advanced Cutaneous Squamous Cell Carcinoma: A Systemic Review And Meta-Analysis, Haoran Zhang, Ai Zhong, Junjie Chen

Faculty, Staff and Student Publications

BACKGROUND: To evaluate the immune checkpoint inhibitors (CPI) for the treatment of patients with advanced cutaneous squamous cell carcinoma (CSCC).

MATERIALS AND METHODS: A meta-analysis was conducted, and the efficacy and safety of CPI were assessed.

RESULTS: A total of 13 studies with 980 patients were included. The pooled objective response rate (ORR) and disease control rate were 47.2% and 64.4%, separately. In addition, patients with primary tumor located in head and neck (odds ratio [OR]: 0.374, 95% confidence interval [CI]: 0.219-0.640, p < 0.001) and positive expression of programmed death ligand 1 (OR: 0.364, 95% CI: 0.158-0.842, P = 0.018) had superior ORR during CPI treatment. The incidence of progression free survival at 6 and 12 months was 59.3% and 52.8%, and 80.6% and 76.4% for overall survival. As for safety, the overall incidence of adverse events with all grades and 3-4 grade was 76.9% and 20.2%.

CONCLUSIONS: Our systematic review confirmed the satisfying efficacy and acceptable toxicity of CPI for advanced CSCC.

Evaluating Kentucky Advanced Practice Registered Nurses’ Confidence, Comfort, And Knowledge Levels Regarding Dermatology Care After A Web-Based Video Training, Victoria Hayden

DNP Projects

Background: It can take an average of 38.9 days to see dermatology from referral to initial appointment. As a result, delays in diagnosis and treatment of life-threatening conditions such as malignant melanoma could occur. Primary care providers frequently refer patients for benign conditions that can be appropriately managed in the primary care setting; often due to lack of knowledge or confidence in their clinical management skills. Educational resources equip providers with the knowledge and tools to feel confident in their management of various skin conditions in a primary care setting. Purpose: The purpose of this project was to …

Dermatological Concerns For Women And Girls With Turner Syndrome, David Rodriguez-Buritica, Meaghan Mones, Siddharth K Prakash, Michelle Rivera, Melissa Aldrich, Megan Rogge, Kate Richardson

Faculty, Staff and Student Publications

Introduction: Turner syndrome (TS) is associated with distinct manifestations in women and girls including short stature, cardiac abnormalities, premature ovarian failure as well as dermatological features, including lymphedema, keloids, onychodystrophy, and acne. Although many dermatological concerns present during the first few decades of life, the overwhelming majority of respondents are not provided with dermatology referrals at diagnosis.

Methods: This cross-sectional study utilized an author designed survey to assess self-reported dermatological manifestations, dermatology referral experience, common therapies for select dermatological conditions, as well as a validated 10-question Dermatology Life Quality Index (DLQI) to assess quality-of-life impact in women and girls with …

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

Open Textbooks and Course Materials

This OER is a part of the Dermatologic Manifestations of Rheumatic Disease project, which provides overviews of the identification, diagnosis, and workup for different rheumatologic diseases, with a focus on providing examples from persons of color (POC). This work seeks to fill gaps and exclusionary practices in medical education practices and resources and diagnostic frameworks in regards to skin of color. This lack of representation bodes significant repercussions on the ability of future physicians to deliver equitable care for an increasingly diverse US population. Each module consists of a similar Powerpoint format, which includes key objectives, hypothetical disease cases, an …

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

Open Textbooks and Course Materials

This OER is a part of the Dermatologic Manifestations of Rheumatic Disease project, which provides overviews of the identification, diagnosis, and workup for different rheumatologic diseases, focusing on providing examples from persons of color (POC). This work seeks to fill gaps and exclusionary practices in medical education practices and resources and diagnostic frameworks in regards to the skin of color. This lack of representation bodes significant repercussions on the ability of future physicians to deliver equitable care for an increasingly diverse US population. Each module consists of a similar Powerpoint format, which includes key objectives, hypothetical disease cases, an overview …

Dermatoses Of The Breast During Lactation, Divya Shan, Sindhuja Koppu, Valerie Coleman, Gauri Gulati, Kimberly Salkey

Open Textbooks and Course Materials

Dermatoses of the Breast during Lactation is a PowerPoint-based learning module that focuses on skin diseases of the breast and nipple that occur during lactation. It is a tailored resource for medical learners that provides an overview of the diagnosis, workup, and management of dermatoses of the breast that occur during breastfeeding, with a focus on providing examples in skin of color. The goal of this module is to provide students with the ability to differentiate the wide range of breast and nipple lesions that can arise during lactation and gain awareness of the skin conditions that present in breastfeeding …

Storage Stability Of Atheroglitatide, An Echogenic Liposomal Formulation Of Pioglitazone Targeted To Advanced Atheroma With A Fibrin-Binding Peptide, Khalid Alghamdi, Zeyad Alehaideb, Ashok Kumar, Hamad Al-Eidi, Sahar S Alghamdi, Rasha Suliman, Rizwan Ali, Feras Almourfi, Saleh M Alghamdi, Mohamed Boudjelal, Sabine Matou-Nasri

Faculty, Staff and Student Publications

There is no first-line treatment for vitiligo, a skin disease characterized by a lack of melanin produced by the melanocytes, resulting in an urgent demand for new therapeutic drugs capable of stimulating melanocyte functions, including melanogenesis. In this study, traditional medicinal plant extracts were tested for cultured human melanocyte proliferation, migration, and melanogenesis using MTT, scratch wound-healing assays, transmission electron microscopy, immunofluorescence staining, and Western blot technology. Of the methanolic extracts, Lycium shawii L. (L. shawii) extract increased melanocyte proliferation at low concentrations and modulated melanocyte migration. At the lowest tested concentration (i.e., 7.8 μg/mL), the L. shawii …

Social Protection And Foundational Cognitive Skills During Adolescence: Evidence From A Large Public Works Program, Nader Aboul-Fettouh, Kevin P Lee, Natalie Kash, Kathleen Kroger, Sirunya Silapunt

Faculty, Staff and Student Publications

INTRODUCTION: Reddit, a popular social media website, has numerous forums where users may discuss healthcare-related topics and request diagnostic and treatment advice for dermatologic conditions. We sought to analyze and grade user-submitted requests for dermatologic advice and their top responses on Reddit.

METHODS: User-submitted posts requesting diagnostic advice and their respective responses on two popular Reddit forums, SkinCareAddiction (ScA) and DermatologyQuestions (DQ), were reviewed by three board-certified dermatologists using a grading rubric designed for this study.

RESULTS: 300 posts and comments were reviewed. Diagnoses among all graders matched in 52.3% of posts with a mean grader confidence score of 4/5 …

Demographics Of Skin Cancer Knowledge Among Middle And High Schoolers In Texas, Dina H Zamil, Shangyi Fu, Zahra Majd, Emily Powell, Jenna H Zamil, Zeena Y Nawas, Ida F Orengo

Faculty, Staff and Students Publications

INTRODUCTION: Adolescents, an age group that can reduce sun exposure early, may benefit from school-based skin cancer education programs. Literature regarding the demographics of melanoma knowledge is sparse.

OBJECTIVES: This study sought to evaluate melanoma knowledge among students in Texas viewing John Wayne Cancer Foundation Block the Blaze (JWCFBTB) presentations and identify group differences with regard to sociodemographic factors.

METHODS: Before JWCFBTB presentations delivered in Houston and Dallas by health professions students, a pre-presentation melanoma knowledge quiz was distributed. This survey was adapted from a 2000 study evaluating melanoma knowledge in middle and high schoolers in Houston and Dallas. Respondents …

Oral Gauze For Bleeding Control In Perioral And Perinasal Dermatologic Surgery, Riyad N H Seervai, Jose A Cervantes, Ikue Shimizu, Ida F Orengo

Faculty, Staff and Students Publications

The use of oral gauze is a quick, cheap, and effective method of preventing bleeding into the patient's mouth during dermatologic surgery. We recommend this technique combined with appropriate positioning for lesions in the perioral and perinasal regions. Similar approaches may be applied for the prevention of bleeding into the ear canal during facial/periauricular surgery.

Squamous Cell Carcinoma With Unusual Benign-Appearing Cystic Features On Histology, Usman Asad, Suzanne Alkul, Ikue Shimizu, Jennifer Ranario

Faculty, Staff and Students Publications

Squamous cell carcinoma (SCC) is a malignancy that arises from keratinocytes of the epidermis. Cystic variants of several types of cutaneous neoplasms have been rarely described in the literature. We report a case of biopsy-proven, well-differentiated invasive SCC treated with Mohs surgery. On frozen sections, the pathology slides showed benign-appearing cystic structures in the margins that persisted after it had appeared that the original malignancy had been cleared. After taking another Mohs stage due to clinical suspicion, additional SCC was found and was subsequently cleared after two more Mohs stages. To the best of our knowledge, this is the first …