Dermatology Commons^™

Bullous Pemphigoid With Excoriation Disorder In A 59 Year Old Woman, Kaitlin Mcgowan, Stephen Poos, Nguyen Vo

Rowan-Virtua Research Day

Bullous pemphigoid is the most common autoimmune blistering disease. Classic symptoms include blisters overlying urticarial plaques on the torso and extremities. The condition can result in intense pruritus that begins during the prodromal period.

Excoriation disorder is related to obsessive compulsive disorder (OCD) and is characterized by recurrent skin picking that results in lesions, repeated attempts to stop or decrease the picking, and resultant mental distress or impairment in functioning.

We present a case of a 59-year-old Caucasian female who presented with diffuse rash on most of her body. This particular case is notable for its concurrent severe dermatological and …

Association Of Flame-Retardant Clothing With Mycosis Fungoides: A Retrospective Analysis, Katherine E Park, Vignesh Ramachandran, Jessica Tran, Tejas P Joshi, Naveen Garg, Madeleine Duvic

Faculty, Staff and Student Publications

Introduction: Mycosis fungoides (MF), the most prevalent form of cutaneous T-cell lymphoma (CTCL), has been associated with a variety of environmental and occupational exposures. Flame-retardant clothing (FRC), in contrast to flame-resistant clothing, is chemically treated and may constitute a previously unrecognized occupational hazard.

Objectives: To report an association between FRC and MF.

Methods: After encountering several young male patients whose onset of MF coincided with the occupational use of FRC and occupation as fire fighters, we did a retrospective search. Additional biopsy proven MF patients with use of FRC were identified by the EPIC electronic medical record using the search …

New Practical Aspects Of Sweet Syndrome, Tejas P Joshi, Sarah K Friske, David A Hsiou, Madeleine Duvic

Faculty, Staff and Student Publications

Sweet syndrome (SS), or acute febrile neutrophilic dermatosis, is an inflammatory, non-infectious skin reaction characterized clinically by tender, erythematous papules/plaques/pustules/nodules commonly appearing on the upper limbs, trunk, and head and neck; histologically, SS is characterized by dense neutrophilic infiltrate in the dermis. SS is accompanied by fever; an elevation of inflammatory markers (e.g., erythrocyte sedimentation rate, C reactive protein) in serum may also be observed. Although most cases of SS are idiopathic, SS also occurs in the setting of malignancy or following administration of an associated drug. SS has also been reported in association with pregnancy and a burgeoning list …

Linear Cutaneous Lupus Erythematosus Following Blaschko’S Lines On The Scalp: Additional Cases And Review Of The Literature, Heather Reagin, Daniel A. Nguyen, Marc R. Lewin, Gregory A. Hosler, Eric Weisberg, Stephen E. Weis

HCA Healthcare Journal of Medicine

Alopecia of the scalp has various causes and presentations. However, linear alopecia is unusual and lupus erythematosus presenting as linear alopecia is exceedingly rare. To date, there have been 16 documented cases of linear alopecia diagnosed as chronic cutaneous lupus erythematosus occurring in a linear configuration following Blaschko's lines. We report 2 additional cases and review the clinical and histologic features along with treatment. This Blaschkoid linear variant of cutaneous lupus erythematosus has distinct clinical and histologic characteristics that set it apart from other causes of alopecia and from classic forms of cutaneous lupus. These distinct features include a linear …

A Case Of Blue Toes: Dic As The Initial Presentation Of Metastatic Pancreatic Adenocarcinoma, Bipul Gnyawali, Christina E. Borchers, Sarah Doell, Katherine House

Dermatology Faculty Publications

Disseminated intravascular coagulopathy (DIC) is the widespread deposition of thrombin and fibrin in microvascular circulation. It is a condition in which clots form throughout the body leading to blockage of small blood vessels. The pathologic clotting in DIC is due to the consumption of coagulation factors and platelets. Patients can present with complications of bleeding or vascular thrombi. Most common causes of DIC include sepsis, malignancy, pregnancy complications, major trauma, and surgery.

Pediatric Dermatology Econsult Program With Dermoscopy: Sub Analysis Of Infantile Hemangiomas, Peggy R. Cyr, Madeline Prentiss, Laura Houk, Elizabeth Seiverling

Costas T. Lambrew Research Retreat 2022

There are no pediatric dermatologists in Maine. Greater distance from a dermatologist is associated with delays in care and nonadherence to treatment. Timely care is especially crucial for patients with infantile hemangiomas (IH) due to a narrow “window of opportunity” for optimal treatment. A store and forward electronic consultation eConsult ) platform was implemented within our electronic medical record (Epic) to triage referrals from primary care providers ( PCPs). Here we present an analysis of the program outcomes in respect to pediatric eConsults with emphasis on treatment for IH.

Acute Generalized Exanthematous Pustulosis: A Painful And Pruritic Presentation Of Pustulosis Following Pharmacotherapy For Pharyngeal Phlegmon., Chase Silvers, John Casey

Ambulatory and Primary Care Articles

Acute generalized exanthematous pustulosis (AGEP) is primarily a drug-induced skin eruption, which typically presents within two days of starting an offending medication; it is often self-limiting with spontaneous resolution within two weeks upon medication cessation. We report the case of a patient who presented with generalized desquamation, characteristic pustules, and several morbilliform rashes on the body surface in association with recent amoxicillin-clavulanic acid exposure. This was associated with significant pruritus, which was the associated chief complaint. A multimodal approach to symptomatic management with topical corticosteroids, barrier ointments, oral antihistamines, and analgesics was required, in addition to the cessation of the …

A Case Series Of Primary Cutaneous B-Cell Lymphomas With Atypical Presentations: Diagnostic And Therapeutic Challenges, Emily Correia, Jisun Cha, Shalini Krishnasamy, Megan O'Donnell, Wenyin Shi, Pierluigi Porcu, Neda Nikbakht

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Skin Cancer Biopsy And Detection Rates With Total Body Skin Examination: A Cross-Sectional Retrospective Analysis., Alexander Sherban, Shayan Waseh, Audra Hugo, Michael Bui, Constantine Daskalakis, Elizabeth Jones

Department of Dermatology and Cutaneous Biology Faculty Papers

Research Letter

Emerging Drug Targets And New Drugs In The Treatment Of Psoriatic Arthritis, Carmen Lariccia, Natalie Lennartz, Jessica Lewe, Jeffery Allison

Pharmacy and Wellness Review

Psoriasis is an autoimmune disease characterized by painful skin lesions. When joints and connective tissue also become involved, the condition is referred to as psoriatic arthritis (PsA). Current treatments for moderate to severe PsA include therapies used to treat rheumatoid arthritis (RA) despite differences in disease presentation which includes factors such as peripheral disease, sacroiliitis, stiffness, presence of rheumatoid factor and psoriasis. Treatment out-comes for PsA are measured by the American College of Rheumatology (ACR) Responder Index (ACR20) and the Dis-ease Activity Score for 28 joints (DAS28). First-line treatment includes disease-modifying antirheumatic drugs (DMARDs) such as methotrexate, sulfasalazine or leflunomide …

Naked (N) Mutant Mice Carry A Nonsense Mutation In The Homeobox Of Hoxc13, Carlos J Perez, Lars Mecklenburg, Almudena Fernandez, Marta Cantero, Tiago Antonio De Souza, Kevin Lin, Sharon Y R Dent, Lluis Montoliu, Alexander Awgulewitsch, Fernando Benavides

Faculty, Staff and Student Publications

Loss of function mutations in HOXC13 have been associated with Ectodermal Dysplasia-9, Hair/Nail Type (ECTD9) in consanguineous families, characterized by sparse to complete absence of hair and nail dystrophy. Here we characterize the spontaneous mouse mutation Naked (N) as a terminal truncation in the Hoxc13 (homeobox C13) gene. Similar to previous reports for homozygous Hoxc13 knock-out (KO) mice, homozygous N/N mice exhibit generalized alopecia with abnormal nails and a short lifespan. However, in contrast to Hoxc13 heterozygous KO mice, N/+ mice show generalized or partial alopecia, associated with loss of hair fibres, along with normal lifespan and fertility. Our data …

Human Papillomavirus Associated Prevention: Knowledge, Attitudes, And Perceived Risks Among Men Who Have Sex With Men And Transgender Women In Pakistan: A Qualitative Study, Muslima Ejaz, Anna Mia Ekström, Alyan Ahmed, Aymen Haroon, Dania Ali, Tazeen Saeed Ali, Mariano Salazar

Community Health Sciences

Objectives: Men who have sex with men (MSM) and transgender individuals are at higher risk of genital warts and anal cancer due to sexually transmitted human papillomavirus infection. This study explores MSM and transgender women's perceptions of Human papillomavirus (HPV) infection and HPV prevention strategies (screening and vaccination) in Pakistan.
Design: A qualitative study using focus group discussions (FGD) with self-identified MSM, male sex workers and transgender women were conducted between March 2019 to August 2019 in Karachi, Pakistan.
Methods: Participants were recruited from community-based organization (CBO) working for MSM and transgender women. A total of 38 men and 10 …

Secondary Syphilis Mimicking Marginal Zone B-Cell Lymphoma, E. Correia, Laura Gleason, Shalini Krishnasamy, Alexa Cohen, Safiyyah Bhatti, Neda Nikbakht

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Contact Dermatitis Due To Personal Protective Equipment Use And Hygiene Practices During The Covid-19 Pandemic: A Systematic Review Of Case Reports, Zouina Sarfraz, Azza Sarfraz, Muzna Sarfraz, Miguel Felix, Jonathan A. Bernstein, Luz Fonacier, Ivan Cherrez-Ojeda

Department of Paediatrics and Child Health

Background: Prolonged use of personal protective equipment (PPE) may lead to contact dermatitis during the coronavirus disease 19 (COVID-19) pandemic. This paper aims to identify the causative factors of contact dermatitis from PPE and hygiene practices.
Methods: The search was conducted adhering to PRISMA 2020 guidelines. A Delphi process was employed to ensure that the aims of this study were met. PubMed and Web of Science databases were systematically searched through September 12, 2021, using search terms: Contact dermatitis, case report, covid-19. The findings were tabulated as author/year, gender, age, presentation, cause, dermatological diagnosis, testing modality, provided treatment, symptom resolution …

Reactive Oxygen Species Reprogram Macrophages To Suppress Antitumor Immune Response Through The Exosomal Mir-155-5p/Pd-L1 Pathway, Xiang Li, Shaomin Wang, Wei Mu, Jennifer Barry, Anna Han, Richard L Carpenter, Bing-Hua Jiang, Stephen C Peiper, M G Mahoney, A E Aplin, Hong Ren, Jun He

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Background: Cancer cells have an imbalance in oxidation-reduction (redox) homeostasis. Understanding the precise mechanisms and the impact of the altered redox microenvironment on the immunologic reaction to tumors is limited.

Methods: We isolated exosomes from ovarian cancer cells through ultracentrifuge and characterized by Western-blots and Nanoparticle Tracking Analysis. 2D, 3D-coculture tumor model, and 3D live cell imaging were used to study the interactions between tumor cells, macrophages and CD3 T cells in vitro. The role of exosomal miR-155-5p in tumor growth was evaluated in xenograft nude mice models and immune-competent mice models. Flow cytometry and flow sorting were used to …

A Distinguished Career Honored - And The Work Continues

Thomas Jefferson University Research Magazine

The most prestigious award in international dermatology - the World Congress of Dermatology’s Alfred Marchionini Medal in Gold—is bestowed every four years, and in 2019, Jouni Uitto, MD, professor and chair of dermatology and cutaneous biology, was the humble recipient. The award is a recognition of Dr. Uitto’s long and distinguished career, in which he has published nearly 900 peerreviewed articles, textbook chapters and reviews— including 30 new publications over the past year.

Evaluating A Targeted Cancer Therapy Approach Mediated By Rna, Katharina Woess, Yuchen Sun, Hanae Morio, Anna Stierschneider, Anna Kaufmann, Stefan Hainzl, Lisa Trattner, Thomas Kocher, Birgit Tockner, Victoria Leb-Reichl, Markus Steiner, Gabriele Brachtl, Andrew P. South, Johann W Bauer, Julia Reichelt, Tomomi Furihata, Verena Wally, Ulrich Koller, Josefina Piñón Hofbauer, Christina Guttmann-Gruber

Department of Dermatology and Cutaneous Biology Faculty Papers

Conventional anti-cancer therapies based on chemo- and/or radiotherapy represent highly effective means to kill cancer cells but lack tumor specificity and, therefore, result in a wide range of iatrogenic effects. A promising approach to overcome this obstacle is spliceosome-mediated RNA trans-splicing (SMaRT), which can be leveraged to target tumor cells while leaving normal cells unharmed. Notably, a previously established RNA trans-splicing molecule (RTM44) showed efficacy and specificity in exchanging the coding sequence of a cancer target gene (Ct-SLCO1B3) with the suicide gene HSV1-thymidine kinase in a colorectal cancer model, thereby rendering tumor cells sensitive to the prodrug ganciclovir (GCV). In …

Hidradenitis Suppurativa And Cutaneous Crohn’S Disease Without Intestinal Inflammatory Bowel Disease, Ronnie Youssef

View All Washington/Montana GME

Presented at the 2022 Virtual Northwest Medical Research Symposium

Pocus Use In Skin And Soft Tissue Infections: A Case Series, Kyle Davies, Sam Josephsen, Vanessa Hoytfox

View All Washington/Montana GME

Presented at the 2022 Virtual Northwest Medical Research Symposium

Dermatologic Manifestations Of Rheumatic Disease: Cutaneous Manifestations Of Sarcoidosis, Sarah Shapiro, Sindhuja Koppu, Mavra Masood, Beth Rubinstein, Huzaefah Syed

Open and Affordable Course Content at VCU

No abstract provided.

Cutaneous Squamous Cell Carcinoma Staging May Influence Management In Users: A Survey Study., Vishal A. Patel, Catherine Mccullum, Andrew D. Sparks, Chrysalyne D Schmults, Sarah T Arron, Anokhi Jambusaria-Pahlajani

Dermatology Faculty Publications

PURPOSE: This study aims to determine whether there is consensus regarding staging and management of cutaneous squamous cell carcinoma (CSCC) across the various specialties that manage this disease.

MATERIALS AND METHODS: A survey regarding CSCC high-risk features, staging, and management was created and emailed to cutaneous oncology experts including dermatology, head and neck surgery/surgical oncology, radiation oncology, and medical oncology.

RESULTS: One hundred fifty-six (46%) of 357 invited physicians completed the survey. Depth of invasion (92%), perineural invasion (99%), histologic differentiation (85%), and patient immunosuppression (90%) achieved consensus (>80%) as high-risk features of CSCC. Dermatologists were more likely to …

The Impact Of Head And Neck Surgical Scars On Appearance And Acceptance Of Dermatography As A Cosmetic Intervention, Simcha Chaitoff

Honors Undergraduate Theses

Many surgical procedures in the head and neck regions produce visible scarring. The most common of these surgeries are tracheotomies and thyroidectomies. The recent COVID-19 pandemic has caused an increase in tracheotomy scars, particularly in those who survived severe infection with the disease and required long-term ventilation. Individuals with neck scars are at an increased risk of health consequences such as reduced quality of life, depression, and negative body image. Research on attitudes toward and reactions to individuals with such scarring is limited. The purpose of this study is to examine how people rate images of scarred individuals on personality …

A Clinical Study Of Venereal And Non Venereal Genital Dermatoses In Women, Lakkireddygari Sujana, Savitha L. Beergouder, Alekhya Rallapalli, Prasanthi Chidipudi, Sujatha Alla

Engineering Management & Systems Engineering Faculty Publications

Background: Any genital lesion or related symptoms are erroneously considered to be sexually transmitted as it is the most covered regions of the body and seems truly to be a forgotten pelvic organ it is the significant and important group of dermatological conditions may be associated with considerable morbidity, discomfort, and embarrassment. The most common conditions seen in a Dermatology Clinic are vulvar dermatoses, which comprise of lichen sclerosis, lichen planus, vulvar eczema, and psoriasis. Other conditions such as vulvar pain syndromes, vulvar disorders associated with systemic diseases, and blistering diseases are also seen.

Materials and Methods: This was a …

In Vitro And In Vivo Correlation Of Skin And Cellular Responses To Nucleic Acid Delivery, M. Bosnjak, K. Znidar, A. Sales Conniff, T. Jesenko, B. Markelc, Nina Semenova, J. Tur, K. Kohena, S. Kranjc Brezar, L. Heller, M. Cemazar

Bioelectrics Publications

Skin, the largest organ in the body, provides a passive physical barrier against infection and contains elements of the innate and adaptive immune systems. Skin consists of various cells, including keratinocytes, fibroblasts, endothelial cells and immune cells. This diversity of cell types could be important to gene therapies because DNA transfection could elicit different responses in different cell types. Previously, we observed the upregulation and activation of cytosolic DNA sensing pathways in several non-tumor and tumor cell types as well in tumors after the electroporation (electrotransfer) of plasmid DNA (pDNA). Based on this research and the innate immunogenicity of …

Incidence And Potential Co-Morbidities In Facial Pigmentary Demarcation Lines In Indian Populations, Lakkireddygari Sujana, Savitha L. Beergouder, Alekhya Rallapalli, Sujatha Alla, Prasanthi Chidipudi

Engineering Management & Systems Engineering Faculty Publications

Background: The most noticeable part of human body is face. The obvious boundaries on the skin known as Pigmentary Demarcation Lines (PDL) found over face and have clear borders of abrupt transition between more hyper-pigmented skin and areas of normal skin pigmentation due to differences in melanocyte distribution that may be influenced by multiple factors. Facial pigmentary demarcation lines (PDL) directly reflect on patient’s physical appearance and self-image as they may contribute to dysmorphism and even central to depressive illness in susceptible individuals posing cosmetic concern for the patient and a challenge for dermatologist. Therefore, it is important for early …

Erythema Multiforme After Third Covid-19 Vaccination (Pfizer-Biontech), Sonali Batta, Austinn C Miller, Susuana Adjei, Laurie A Temiz, Stephen K Tyring

Faculty, Staff and Student Publications

We present a case of erythema multiforme (EM) associated with a third (booster) dose of COVID-19 vaccination in a patient who had no cutaneous reactions to previous doses. To our knowledge, this is the first documented case of vaccine-associated EM occurring after a third/booster vaccination. Furthermore, our case emphasizes the need to remain vigilant for vaccine-associated EM in any patient recently vaccinated, regardless of whether previous vaccinations were administered without cutaneous reactions.

Differential Cd4+ T-Cell Cytokine And Cytotoxic Responses Between Reactivation And Latent Phases Of Herpes Zoster Infection, Wenjie Jin, Mike Fang, Ismail Sayin, Carson Smith, Jeffrey L Hunter, Brian Richardson, Jackelyn B Golden, Christopher Haley, Kenneth E Schmader, Michael R Betts, Stephen K Tyring, Cheryl M Cameron, Mark J Cameron, David H Canaday

Faculty, Staff and Student Publications

BACKGROUND: CD4+ T cells are a critical component of effective immune responses to varicella zoster virus (VZV), but their functional properties during the reactivation acute vs latent phase of infection remain poorly defined.

METHODS: Here we assessed the functional and transcriptomic properties of peripheral blood CD4+ T cells in persons with acute herpes zoster (HZ) compared to those with a prior history of HZ infection using multicolor flow cytometry and RNA sequencing.

RESULTS: We found significant differences between the polyfunctionality of VZV-specific total memory, effector memory, and central memory CD4+ T cells in acute vs prior HZ. VZV-specific CD4+ memory …

Mapping Melanoma Risk And Locating High-Need Regions For Dermoscopy And Skin Biopsy Training, Calla Hladky, Madeline Prentiss, Henry Stoddard, Kathryn Stevens, Elizabeth Seiverling, Peg Cyr

MaineHealth Maine Medical Center

Background- Dermoscopy and skin biopsy trainings have been shown to help improve PCPs’ knowledge of and confidence in detecting skin cancer. The goal of this project was to determine where to focus training efforts in order to maximize our impact and reach regions that face the highest burden of melanoma in the state.

Online Dermatology Curriculum Experiences Among Us Dermatology Residents And Faculty, Quoc-Bao D Nguyen, Caroline T Starling, Imran T Baig, Misha V Koshelev, Kelly C Nelson

Faculty, Staff and Student Publications

Many dermatology residency programs adapted to the COVID-19 pandemic by transitioning to online teaching methods. This may impact the quality of education and the satisfaction of residents. Dermatology faculty and residents nationwide were surveyed regarding their experiences with the novel online curricula. A total of 65 individuals representing at least 20 ACGME-accredited dermatology programs responded. Many programs implemented a predominantly online curriculum (78%). Most participants reported that both clinical dermatology and dermatopathology were online during the pandemic's peak (90%). Among those who had experienced a live curriculum prior to the pandemic, 49% reported that a virtual curriculum had similar effectiveness, …

Real-World Evidence Of An Emollient Device For Atopic And Contact Dermatitis In Pediatric To Adult Patients – Data From A Post-Marketing Surveillance, Adelaide Ann Hebert

Faculty, Staff and Student Publications

PURPOSE: Atopic and contact dermatitis have been attributed to skin barrier abnormalities, immune system dysfunction and inflammation leading to pruritus. As these factors may involve oxidative stress, emollient devices containing antioxidants furfuryl palmitate and tocopherol may help reduce itching and inflammation. In this study, a post-marketing questionnaire was carried out of 40 users of a novel emollient device containing furfuryl palmitate and tocopherol (Relizema™ cream), who purchased it from a pharmacy or health-care professional to ascertain the emollient device's action on itching, flushing and moisturizing.

PATIENTS AND METHODS: The post-marketing questionnaire, administered by trained pharmacy and health-care staff, collected data …