Skin and Connective Tissue Diseases Commons^™

Treatment Of Basal Cell Carcinoma With Vismodegib, Sunitha Johns, Katlyn Brown, Emily Loudermilk, Crystal Zheng, Anh Dao Le, Sophocles Chrissobolis

Pharmacy and Wellness Review

The most prevalent nonmelanoma skin cancers are basal cell carcinoma (BCC) and locally advanced basal cell carcinoma (aBCC). Current, effective first-line treatments for BCC aim to remove and destroy cancerous skin cells through excision surgery, Mohs surgery, radiation therapy and cryotherapy, while treatment of aBCC remains limited. An emerging treatment option for aBCC that promotes tumor size reduction is vismodegib, a pharmaceutical product approved in 2012 by the U.S. Food and Drug Administration (FDA). Vismodegib was approved for the treatment of aBCC, metastasized HCC (mBCC) or recurrent BCC after surgery as well as for use in adults who are not …

Trametinib And Dabrafenib: New Agents For Advanced Stage Melanoma, Kelsey Weisenburger, Kevin Krivanek, Armond Cosiano, Kasie Bellmann, Mark E. Olah

Pharmacy and Wellness Review

Melanoma, the deadliest form of skin cancer, is caused primarily by exposure to ultraviolet radiation. Tumor formation occurs early in disease progression and can easily metastasize. The development of the disease can be described by one of four stages, characterized by tumor size and risk of spreading. The B-rafprotein plays an important role in cell proliferation and has the ability to develop a mutation for continuous activation, resulting in uncontrolled cell growth. Sixty percent of melanomas possess a V600E mutation in the BRAF gene. Recently, drug developers have turned the focus of melanoma treatments toward preventing the activation of the …

Evidence For The Potential Use Of Polyphenols And Their Derivatives In Moderating Allergic Immune Responses, Jamie Kellner, Lindsay Mark, Kasie Bellmann, Kelly Shields

Pharmacy and Wellness Review

Polyphenols are naturally occurring compounds that are found within numerous plant sources. They have a wide variety of structures and functions and have potential clinical uses in multiple disease states. Emerging studies involving polyphenols have demonstrated their antioxidative properties, as well as reduced risks of cardiovascular diseases and certain types of cancer. Due to these discoveries, there has been a marked increase in research related to the chemical properties of polyphenols and their potential uses in prevention of common acquired and inherited disease states. This article focuses on the effects that some polyphenolic compounds exert on immune function in regard …

Overview Of Stevens-Johnson Syndrome And Toxic Epidermal Necrolysis, Christina Spinaris, Sarah Kradel, Tara Tokar, Zachary Crawford, Michael M. Milks

Pharmacy and Wellness Review

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are immunologic reactions that typically present due to drug hypersensitivity. These reactions present with serious mucocutaneous manifestations that can lead to significant morbidity and mortality. The pathogeneses of SJS and TEN have yet to be clearly elucidated, but three potential immunologic mechanisms have been defined in literature: granulysin, Fas-FasL, and perforin and granzyme B. Medications have been immunologically linked as the primary causative agents of SJS/TEN. Corticosteroids, intravenous immunoglobulin administration (IVIG) and cyclosporine have been employed as treatments; however, none have resulted in consistent positive outcomes. Pharmacists have a significant role in …

Ecthyma Gangrenosum In An Immunocompromised Patient Without Detectable Bacteremia, Jonathan Miles, Alex Mari, Matthew Crabtree, Vinod Nambudiri, Jilian Sansbury

Dermatology

Ecthyma gangrenosum (EG) is typically pathognomonic of Pseudomonas aeruginosa bacteremia among immunocompromised patients, particularly with underlying malignancy. Recently, other pathogens and clinical histories have been implicated, challenging the classic picture of patients with EG. The cutaneous findings in patients follow a pattern of lesion progression from indurated pustules and hemorrhagic vesicles evolving to necrotic ulcers with central black eschar and surrounding erythema. While lesions typically occur on the perineum or lower extremities, their presence has also been described elsewhere. Herein, we describe a case of an immunocompromised man with chronic lymphocytic leukemia and multiple myeloma actively undergoing chemotherapy presenting with …

Treatment Of Podoconiosis With Complicating Polyinfections Within Rural African Villages: A Case Study, Amanda R. Beering, Abigail R. Florence, Soon Bahrami Md

Journal of Refugee & Global Health

This case study aims to provide a treatment plan for the treatment of podoconiosis with complicating polyinfections in a resource poor setting. A second objective is to help healthcare providers teach preventive measures to villagers in affected regions.

High-Dose Finasteride Is An Effective Treatment Modality For Androgenic Alopecia In Postmenopausal Women, Joshua T. Gaudette

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Oliveira-Soares R, Silva JE, Correia M, André M. Finasteride 5 mg/day treatment of patterned hair loss in normo-androgenetic postmenopausal women. International Journal of Trichology. 2013;5(1):22-25. doi: 10.4103/0974-7753.114709.

Biological Pathway Involvement In Melanoma Heterogeneity And Drug-Induced Resistance, Sarah V. Pack

STAR Program Research Presentations

Tumors develop resistance to numerous drug therapies, and this remains a major obstacle in treating many types of non-surgical cancers. Melanoma provides a good model system for studying drug resistance in cancer due to its high propensity to incur resistance after a significant initial response to a drug. Genes that are highly expressed in melanoma cancer cells have been studied, but in order to further understand the collective function of these highly expressed genes we must analyze gene sets, or pathways. A single gene’s function is rarely independent of other genes, and pathway analysis takes this into account.

Our objective …

Visualizing Ischemic Skin Flap Necrosis Through Phasor Analysis Of Autofluorescence Lifetime Images, Hallie Ramser Toomer

Graduate Theses and Dissertations

Necrotic skin flaps are difficult to predict and treat due to the lack of quantitative biomarkers. Label-free multiphoton microscopy is well suited for non-invasively monitoring skin metabolism through NAD(P)H and other intrinsic fluorophores, and offers immediate future directions for assessing necrosis in the clinic. The objective of this study was to assess whether phasor FLIM could be used to evaluate skin flap status and treatment efficacy in ex vivo skin sections. Phasor maps revealed differences in growth factor treatment and region, but changes in skin flap autofluorescence at 755nm excitation and 460nm emission were not just related to NAD(P)H. A …

Perianal Necrotizing Fasciitis With Retroperitoneal Extension: A Case Report From Pakistan, Mirza Zain Baig, Abeer Aziz, Umme E Hani Abdullah, Muhammad Salman Khalil, Sumiya Abbasi

Section of Neurosurgery

Necrotizing fasciitis is a rare but potentially fatal condition. It is defined as a rapidly spreading infection of the subcutaneous soft tissue. Extension into the retroperitoneum may further complicate this deadly condition. We report a case of a 45-year-old gentleman who presented to our institute with perianal necrotizing fasciitis with extension into the retroperitoneum. He was managed with antibiotics and prompt surgical debridement. Our patient had a positive outcome which may be due to the fact that we had a high clinical suspicion, on the basis of which we opted for early operative management rather than delaying definitive treatment by …

Recurrent Perianal Wart Therapy With 90% Trichloroacetate (Tca) Solution In Aids Patients, Sri Linuwih Sw Menaldi, Ika Anggraini, Hanny Nilasari

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Being the most commonly found sexually-transmitted infection (STI), anogenital warts are mainly caused by human papilloma virus (HPV) type 6 and 11. These infections are often recurrent, leading to loss of time and medical expenses. Various therapeutic modalities can be chosen singularly or in combination with varying results. Treatments with less responsive results usually occur when acquired comorbidities are present, such as HIV infection.

Case Illustration: A 28-year-old homosexual male was reported to have a recurrent perianal wart for the duration of eight months. He was also diagnosed with AIDS and pulmonary tuberculosis. Initially, patient was treated …

Ulcus Vulvae Acutum - A Rare Case, Irene Dorthy Santoso, Ika Anggraini, Wresti Indriatmi, Yudo Irawan, Hanny Nilasari, Melani Marissa, Sondang P. Sirait, Rahadi Rihatmadja

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Ulcus vulvae acutum, also known as Lipschütz ulcer, is a rare condition characterized by multiple, painful, and acute genital ulceration in young women without venereal infections, associated with systemic symptoms like malaise, fever, and inguinal lymphadenopathy.

Case Illustration: A 24-year-old woman developed multiple and painful vulvar ulcers that recurred for almost a year. The patient was primarily diagnosed and treated as genital herpes in several hospitals with only slight improvement and no complete healing. The patient came to our hospital for examinations to rule out sexually-transmitted infection (STI) (genital herpes, syphilis, HIV, and chancroid) and possibility of …

Clinical Diagnostic Matrix (Cdm) As A Tool To Diagnose Subtypes Of Epidermolysis Bullosa Cases In Children, Suci Widhiati, Benazier Marcella, Susanti Rosmala Dewi, Anggana Rafika Paramitasari, Endra Yustin Ellistari, Indah Julianto

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Epidermolysis bullosa (EB) is a rare genetic skin disease characterized by trauma-induced blisters, which appear shortly after birth. Immunofluorescence antigen mapping and mutational analysis are essential for establishing an accurate diagnosis of EB. However, in limited resource settings like in Indonesia, such techniques are not always readily available, forcing many clinicians to diagnose EB based on clinical features alone that is often inaccurate. Recently, a novel clinical diagnostic matrix (CDM) tool has been developed to improve the diagnostic accuracy of EB in such settings.

Case Illustration: We examined clinical photographs and medical records of patients registered at …

Efficacy Of Inosine Pranobex As An Adjuvant Oral Therapy In Anogenital Warts: An Evidence-Based Case Report, Benny Nelson, Indina Sastrini, Lidwina Anissa, Patricsia Manalu, Peppy Fourina, Rahmaniar Desianti Kuraga, Wresti Indriatmi

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Human papillomavirus (HPV) causes the most prevalent sexually transmitted infection and is an important etiological factor in genital cancer. HPV infection manifests in broad spectrum, from genital warts to cervical intraepithelial neoplasia and cancers. Genital warts remain a frequent problem in primary care. Current modalities provide unsatisfactory result in curing genital warts completely. To date, there are many convincing studies encouraging oral inosine pranobex as an adjuvant therapy to improve post-conventional therapy cure-rate.

Aim: To assess the efficacy of inosine pranobex as an adjuvant oral therapy in anogenital warts.

Methods: Literature search was performed using Pubmed, …

The Effect Of Face Washing Frequency On Acne Vulgaris Patients, Rini Hastuti, Etty Farida Mustifah, Imroatul Ulya, Muhammad Risman, Prasetyadi Mawardi

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Patients with acne often wash their faces twice a day, but there are not many studies supporting this practice.

Methods: A single-blind randomized clinical trial was conducted in 38 subjects, divided into three groups based on face washing frequency (once, twice, and thrice a day). All groups used the same cleanser. The acne vulgaris severity and the number of lesions were assessed prior to study. After eight weeks, we re-assessed the acne severity, the number of lesions, the adverse event and patient’s self-evaluation. SPSS 17 was used to analyze the face washing frequency and the number of …

Dapsone Hypersensitivity Syndrome Overlaps Reversal Reaction In Leprosy Patient, Chesia Christiani Liuwan, Medhi Denisa, M Yulianto Listiawan

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Leprosy is a chronic granulomatous infectious disease that primarily involves the skin and peripheral nerve and is caused by Mycobacterium leprae. Clinical features may vary depending on the patient’s immune response. Reversal reaction due to increased immunity is common after treatment in patients with borderline leprosy. Dapsone hypersensitivity syndrome (DHS) is an adverse effect from dapsone therapy that may occur in 5-6 weeks to 6 months after initial treatment.

Case Illustration: A 47-year-old female complained of a spreading red patches on the skin of her trunk and extremities for three weeks duration. She also felt itchiness and …

Efficacy And Safety Of 5% Imiquimod Cream Compared To 10% Koh Solution For Elimination Of Molluscum Contagiosum Lesions In Adults, Marsha Bianti, Agung Muhammad Rheza, Arinda Marina, Rizka Farah Hilma, Sarah Mahri, Teffy Nuary, Rahadi Rihatmadja

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Molluscum contagiosum (MC) is a benign infection caused by the Molluscipox virus that most often affects children and sexually active adolescents. Various topical therapeutic options are available, however, no single intervention is convincingly effective. Potassium hydroxide (KOH) solution is widely used but its usefulness is hampered with adverse effects. Newer preparation, 5% imiquimod cream seems to be as, if not more, effective. However, it is not legally available yet in Indonesia.

Aim: To assess the efficacy and safety of 5% imiquimod cream in treating adult molluscum contagiosum.

Methods: Literature search was done through Pubmed, EBSCO, dan …

Influence Of Demodex Mites On Life Quality Of Patients With Acne And Rosacea, Anzhela Kravchenko

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Ulcus vulvae acutum, also known as Lipschütz ulcer, is a rare condition characterized by multiple, painful, and acute genital ulceration in young women without venereal infections, associated with systemic symptoms like malaise, fever, and inguinal lymphadenopathy.

Case Illustration: A 24-year-old woman developed multiple and painful vulvar ulcers that recurred for almost a year. The patient was primarily diagnosed and treated as genital herpes in several hospitals with only slight improvement and no complete healing. The patient came to our hospital for examinations to rule out sexually-transmitted infection (STI) (genital herpes, syphilis, HIV, and chancroid) and possibility of …

Panniculectomy Performed In Conjunction With Gynecologic Surgery In The Morbidly Obese Patient - A Nsqip Analysis And Meta-Analysis Of The Literature, Shayoni Nag, Tirth Patel, Steven C. Bonawitz

Rowan-Virtua Research Day

Purpose: Panniculectomy is a common procedure in plastic surgery, often performed following massive weight loss and in morbidly obese patients. It can be performed in combination with various gynecologic procedures based on the rational that it will reduce complication rates.^{1, 2, 3} These studies fail to provide proof of these claims for reasons including study design and the lack of inclusion of both morbidly obese and non-morbidly obese patients. Recent medical practice has focused increasingly on minimizing patient morbidity and trends in reimbursement are moving towards penalizing practices which increase complications.

Methods/Results:We reviewed the NSQIP database to assess …

Viral Whole Genome Sequencing For Antiviral Resistance In A Child With Dock8 Deficiency And Recurrent Hsv-1, Sean Stout, A. L. Greninger, Rangaraj Selvarangan, A. F. Freeman, Brandon D. Newell, Erin Stahl, Dwight Yin

Posters

We present the case of a child with dedicator of cytokinesis 8 (DOCK8) deficiency and chronic, resistant HSV-1 mucocutaneous infections to illustrate the clinical utility of viral whole genome sequencing to detect active and latent HSV resistance mutations.