Dermatology Commons^™

Follicular Occlusion Syndrome: Diagnosis, Management, And Emerging Insights, Henry Lim, Reem Ayoub, Rafael Do Valle, Marshall Hall, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Follicular Occlusion Syndromes (FOS) are rare chronic relapsing skin disorders characterized by abnormal follicular hyperkeratinization, plugging, and inflammation. FOS are more commonly discussed as a ‘triad’ or ‘tetrad’ based on the patient’s clinical presentation. The triad includes hidradenitis suppurativa, acne conglobata, and dissecting cellulitis of the scalp. The tetrad in addition to the triad includes a history of pilonidal cysts. These disorders have a considerably negative effect on quality of life due to chronic pain, psychological distress, and body image concerns. Delayed or misdiagnosis can exacerbate patient outcomes, heightening the importance of timely identification and multidisciplinary treatment. We present two …

Body Dysmorphic Disorder Presenting As Alopecia Anxiety: A Case Report, Henry Lim, Paige Loux, Arianne Felicitas, Marshall Hall, Christian Scheufele, Garrett Furth, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Background: Body dysmorphic disorder (BDD) involves a preoccupation with a nonexistent or insignificant physical defect that causes clinically significant distress and impacts a patient's daily functioning. We present a case of a patient with body dysmorphia that manifested as anxiety about hair loss. Case Information: A 48-year-old otherwise healthy female presented to the dermatology clinic with the chief complaint of 8 months of hair loss. She had been seen previously by 2 other dermatologists. She brought 28 pages of paperwork to her first appointment detailing previous work-up, including four separate skin punch biopsies consistent with androgenetic, non-cicatricial (non-scarring) alopecia. Other …

Skin Color Cannot Be Confined To Six Categories: Comparing The Fitzpatrick Scale And Colorimetric Measures, Henry Lim, Kristina Kafle, Reem Ayoub, Dana Olsen, Ysabelle Martinez, Rafael Do Valle, Christina Guo, Marshall Hall, Christian Scheufele, Michael Carletti, Stephen E. Weis

North Texas Research Forum 2025

Purpose The Fitzpatrick Scale (FS), originally developed to dose photochemotherapy in Caucasian skin, has become widely adopted for skin color categorization. It originally included types I-IV, with types V-VI added later for darker skin. The FS was designed for UV radiation reactivity assessment. However, it is increasingly used as a proxy for objective skin color classification, despite being based on a subjective questionnaire. Individual Typology Angle (ITA), a validated colorimetric measurement, presents a potential alternative. Previous studies examining these classification systems have been limited by small sample sizes and uneven distribution across skin tones with subjects predominantly having lighter skin …

An Unusual Case Of Indolent Systemic Mastocytosis: Diagnostic Insights In The Absence Of Classic Systemic Symptoms, Henry Lim, Jonah Gutierrez, Rafael Do Valle, Reem Ayoub, Marshall Hall, Christian Scheufele, Garrett Furth, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Introduction: Mastocytosis is a disorder characterized by an abnormal clonal accumulation and subsequent activation of mast cells within one or more organs. It is generally classified as either cutaneous, with or without systemic involvement, or systemic without cutaneous disease based on major and minor criterion. Indolent systemic mastocytosis (ISM) is a subclass of systemic mastocytosis with generally good prognosis. While the etiology of ISM is not completely understood, those who are affected typically have the KIT D816V mast cell receptor mutation. Given that ISM is mast cell mediated, patients predominantly present with a wide range of symptoms related to mast …

Current Trends In School Nursing For Diabetes & Dermatology, Ali Al-Nahi, Jeffrey Dickerson, Enith Espinosa Palmett, Shterna Frand, Garrett Furth, Matthew Gutzmer, Marshall Hall, Sana Khan, Shana-Kay Lambert-Johnson, Henry Lim, Kelly Mofor, Lakshmi Morla, Ali Nazim, Rui Zhang, Christian Scheufele, Zara Soomro, Michele Mccarroll, Taylor Pickering, Jasmine Silva, Brina Gonzalez, Devika Adusumilli, Sherri Morgan, Nischal Pokhrel

North Texas Research Forum 2025

Background: School nurses are on the front lines of assessing, identifying and treating school-age children with a number of health complications. Implementing nursing services in schools has previously demonstrated improved medical care costs for students, less productivity loss for parents, and less productivity loss for teachers. As a result, nursing services in schools provide a cost-beneficial investment of public money, and warrant both financial support from policy makers as well as educational support from local healthcare services. Aim Statement: This quality improvement project addressed the targeted continuing education gap topics of Dermatology and Diabetes management in school age children. Methods: …

A Case Of Neutrophilic Dermatosis Of The Dorsal Hands With Post-Traumatic Onset, Marshall Hall, Kristina Kafle, Henry Lim, Christian Scheufele, Garrett Furth, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Background Sweet Syndrome is an acute, febrile neutrophilic dermatosis that is characterized by painful red lesions, fever, and neutrophilia with histological findings of dermal neutrophilic infiltrate. Neutrophilic Dermatosis of the Dorsal Hands is a localized variant of Sweet Syndrome. Neutrophilic Dermatosis of the Dorsal Hands presents with focused lesions on the dorsal hands, most commonly between the index finger and thumb, typically with fewer systemic manifestations. This condition presents significant diagnostic challenges as it can mimic infectious processes, potentially leading to delayed appropriate treatment. Case Information A 64-year-old male presented to the emergency department with wounds on the bilateral hands. …

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 …

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 …

Molluscum Dermatitis In A Pediatric Patient, Garrett Furth, Olivia Mayer, Marshall Hall, Henry Lim, Christian Scheufele, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Atopic dermatitis (AD) is a chronic relapsing condition characterized by irritation, redness, inflammation, and itching of the skin. The cause of AD is theorized to be multifactorial, including genetic components, such as mutations in filaggrin, environmental exposures, and immune predisposition. AD often presents in childhood and adolescence, but can appear at any age. AD eruptions arise through various triggers, which commonly include soaps, detergents, fabrics, and cold or hot weather. Importantly, viral infections can also serve as a trigger, causing systemic inflammation via host defense mechanisms. Molluscum contagiosum (MC) is a double-stranded DNA virus that classically manifests as small, dome-shaped, …

Clinical Evaluation And Management Of Terra Firma-Forme Dermatosis: Insights From Two Diverse Cases, Henry Lim, Rafael Do Valle, Reem Ayoub, Marshall Hall, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Terra Firma-Forme Dermatosis (TFFD), also known as Duncan’s dirty dermatosis is a benign, asymptomatic dermatologic condition characterized by well-demarcated brown patches to hyperkeratotic papules or plaques. It most commonly affects the neck, trunk, and face but can appear on other body regions. A key diagnostic feature is that these lesions persist despite routine washing with soap and water but can be removed by forcibly wiping the affected area with 70% isopropyl alcohol, revealing normal underlying skin. The exact etiology of TFFD remains unknown, though it is thought to involve abnormal keratinization or delayed desquamation. This condition is often underdiagnosed or …

Development And Validation Of An Accurate And Precise Skin Color Scale, Henry Lim, Christina Guo, Reem Ayoub, Rafael Do Valle, Kristina Kafle, Ysabelle Martinez, Dana Olsen, Marshall Hall, Christian Scheufele, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Introduction: Utilization of the Fitzpatrick scale to describe skin color does not adequately account for variations in pigmentation that are reflective of skin color characteristics of persons from diverse racial and ethnic backgrounds. This study aims to create a better way to describe skin color. Methods: We developed an 11-point color scale. This Skin Color Scale (SCS) was reproduced onto a physical card that could be placed onto a research participant’s inner arms for independent scale interpretation. Participants and two investigators selected the best matching scale interpretation value for each arm. Self-acquired and investigator assessed Fitzpatrick scores were taken. These …

The Potential Of Vitamin D As An Adjunct Therapy For Eczema, Kimberly Hill

Graduate Research Projects

No abstract provided.

Decoding Tattoo And Permanent Makeup Pigments: Linking Physicochemical Properties To Absorption, Distribution, Metabolism, And Elimination Profiles Using Quantitative Structure-Activity Relationship (Qsar)-Based New Approach Methodologies (Nams), Girija Bansod, Ajay Vikram Singh, Preeti Bhardwaj, Tulika Rai, Sweta Vijay Nakhale, Amruta Shelar, Rajendra Patil, Peter Laux, Andreas Luch, Christopher J. Osgood, Michael W. Stacey

Biological Sciences Faculty Publications

The safety and quality of tattoo and permanent makeup (PMU) pigments are subject to increased scrutiny due to their potential to cause adverse effects like anaphylaxis, photoallergic responses, and long-term toxicity. These undesirable reactions governed by their chemical structure possess varied physicochemical properties and absorption, distribution, metabolism, and elimination (ADME) characteristics. These properties control the pigment behavior during application, stability, and interaction with human tissue. The correlation between these physicochemical characteristics and ADME parameters of tattoo/PMU pigments remain under-explored despite the current advances in toxicology. Our study aims to address and bridge the gap by leveraging open-access QSAR computational toxicology …

Irritable Bowel Syndrome Risk In Acne Patients: Implications For Dermatologic Care, Alex Y. Liu, Ana Ormaza Vera, Clinton W. Enos

Department Dermatology Faculty Publications

[Practice points]

• Clinicians should consider monitoring for early signs of irritable bowel syndrome (IBS) in adult patients with acne to facilitate prompt diagnosis and intervention.
• Clinicians should remain judicious when prescribing antibiotics for acne management to minimize potential disruptions to the gut microbiota and the risk for IBS.
• Isotretinoin may serve as a safer alternative to antibiotics in patients with acne, particularly those with gastrointestinal concerns.

Porokeratosis Ptychotropica: Diagnostic Insights Into A Rare Dermatosis, Layal Antoury, Sadia Salim, Karthik Krishnamurthy

South Atlantic Division GME Research Day 2025

No abstract provided.

Don’T Sweat It: A Case Of Solid Cystic Hidradenoma, Anthony Concilla, Michelle Militello, Angelia Stepien, Juan Rosario-Collazo

South Atlantic Division GME Research Day 2025

No abstract provided.

The Critical Role Of Early Diagnosis, Multidisciplinary Management, And Social Determinants In Eczema Herpeticum: A Case Study Of A 24-Year-Old Man, Benjamin R. Cooper, Taha Rasul, Christian Castro-Ruiz, Karthik Krishnamurthy

South Atlantic Division GME Research Day 2025

No abstract provided.

Medical Spa Directorship And Cosmetic Procedures In Jacksonville, Florida, Michelle Militello, Rachel Dykes, Karthik Krishnamurthy

South Atlantic Division GME Research Day 2025

No abstract provided.

Dermoscopic Features Of Sebaceous Adenoma, Abigail M. Lowe, Michelle Militello, Karthik Krishnamurthy, Sarah Ferrer-Bruker

South Atlantic Division GME Research Day 2025

No abstract provided.

More Than Skin Deep: A Long Term Cyst Masquerades Breast Cancer Metastasis, Paola Torres-Laboy, Juan Rosario Collazo

South Atlantic Division GME Research Day 2025

No abstract provided.