Dermatology Commons^™

Efficacy And Safety Of Once-Daily Roflumilast Cream 005% In Pediatric Patients Aged 2-5 Years With Mild-To-Moderate Atopic Dermatitis (Integument-Ped): A Phase 3 Randomized Controlled Trial, Lawrence F Eichenfield, Rocco Serrao, Vimal H Prajapati, John C Browning, Lisa Swanson, Tracy Funk, Mercedes E Gonzalez, Adelaide A Hebert, Mark Lee, Mark Boguniewicz, Eric L Simpson, Melissa S Seal, David Krupa, Diane Hanna, Scott Snyder, Patrick Burnett, David H Chu, Erin Almaraz, Robert C Higham, David R Berk

Faculty, Staff and Student Publications

Background/objectives: Efficacy and safety of roflumilast cream 0.15% were demonstrated in patients aged ≥ 6 years with atopic dermatitis (AD) in two Phase 3 trials. This Phase 3 parallel-group, double-blind trial (INTEGUMENT-PED; NCT04845620) compared the efficacy and safety of roflumilast cream 0.05% and a vehicle in patients aged 2-5 years with AD.

Methods: Patients aged 2-5 years with mild-to-moderate AD were treated with once-daily roflumilast cream 0.05% or vehicle for 4 weeks. The primary efficacy endpoint was Validated Investigator Global Assessment for AD (vIGA-AD) Success (0 [Clear] or 1 [Almost Clear] plus ≥ 2-grade improvement from baseline) at Week …

A Linear Presentation Of Cutaneous Rosai Dorfman Disease, Emily Sheetz, Ryan C. Saal, Molly K. Smith, Rachel Chikowski Byrd

Department of Medicine Faculty Publications

[Case description] A 53-year-old female with type II diabetes and hypertension presented to the dermatology clinic with a 3-month history of an asymptomatic linear eruption along the right knee that extended distally along the shin. Initial biopsy showed an atypical lymphohistiocytic infiltrate (Fig 1), which was found to be polyclonal. At her 3-month follow up visit, the eruption demonstrated significant clinical progression with numerous indurated papules and papulonodules, some of which were tender, along the right knee and pretibial surface (Fig 2). No improvement was noted with topical triamcinolone prescribed at her initial visit.

Delayed Tooth Eruption As An Early Clinical Indicator Of Genetical Tooth Agenesis: A Family-Based Study Of Cases With Whole-Exome Sequencing, Yu-Chen Jeng, I-Ting Chen, Hui-Ching Cheng, Hsin-Yu Huang, Chao-Kai Hsu, Yu-Fen Yen

Journal of Dental Sciences

Delayed tooth eruption is frequently considered a benign developmental variation but may represent an early sign of genetically driven tooth agenesis. We evaluated a 22-month-old female presenting with markedly delayed eruption (only eight primary teeth) and a positive family history of ectodermal features. Given the inconclusive early radiographic findings, whole-exome sequencing (WES) was utilized. WES revealed the proband carried a heterozygous EDARADD variant (NM_080738:c.328G>T; p.Asp110Tyr). Subsequent familial segregation analysis identified an additional heterozygous WNT10A variant (NM_025216:c.637G>A; p.Gly213Ser) within the broader family. The EDARADD variant alone was associated with varying presentations from normal dentition to delayed eruption. Furthermore, the …

Petechiae And A Persistent Violaceous Nodule: A Presentation Of Blastic Plasmacytoid Dendritic Cell Neoplasm To Dermatology., Madison Anzelc, Christina Druskovich, Austin Cusick, Matthew Franklin

Ambulatory and Primary Care Articles

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare, highly aggressive CD4+ CD56+ hematopoietic malignancy. The cutaneous presentation is variable but often includes violaceous nodules. We present a rare case of BPDCN, which featured dermatological findings consisting of erythematous macules, petechiae, purpura, and a violaceous nodule. A skin biopsy and peripheral blood smear supported a diagnosis of BPDCN. With BPDCN favoring cutaneous involvement, we urge dermatologists to be aware of the possibility of a BPDCN diagnosis in patients who present with purpuric nodules and petechial skin findings, especially when it is not easily explainable by another pathology or medication.

Comparison Of The Efficacy Of Topical Cetirizine 1% Versus Topical Minoxidil 5% Solution In Treatment Of Male Androgenetic Alopecia, Hadeer Samy Abd-Elfattah, Bothaina Mahrous Ghanem, Farid Abd-Elreheim Badria, Mohammed Samir Sultan

Mansoura Medical Journal

Background: Androgenetic alopecia (AGA) is a common form of non-scaring hair loss characterized by extensive miniaturization of scalp hair follicles. Minoxidil is a standard topical treatment. Cetirizine, an antihistamine with anti-inflammatory properties, may be beneficial by modulating prostaglandins—specifically by inhibiting PGD2 and promoting PGE2, both of which have essential roles in hair cycle regulation. Aim: To compare the efficacy and safety of topical cetirizine 1% versus minoxidil 5% in treating male AGA. Patients and Methods: Forty male patients were randomly allocated in this randomized controlled study to receive topical cetirizine 1% or minoxidil 5%. Clinical photographs and dermoscopic evaluations were …

Apocrine Breast Cancer With Psammoma Bodies In A Male Patient, Alena Bashinskaya, Eric W. Baum, Michael B. Morgan

HCA Healthcare Journal of Medicine

Introduction

While male breast carcinoma is a relatively uncommon occurrence, its incidence is on the rise, potentially attributed to sporadic pathophysiological mechanisms, primarily involving hormonal imbalances. Invasive apocrine carcinoma represents a small fraction of global breast malignancies, with limited instances reported among male patients in the literature. The clinical presentation of an apocrine breast carcinoma closely resembles that of other breast cancer subtypes, as it is most often described as a solitary ulcerative nodular lesion occupying a retro-areolar region of the breast. Herein, we describe a novel case of an apocrine male breast carcinoma metastasizing to the skin, given that …

Clinical Variant Of Serpentine Supravenous Hyperpigmentation Following Subcutaneous Bortezomib Injection, Madelyn Richards, Stephen E. Weis

HCA Healthcare Journal of Medicine

Introduction

Bortezomib is a reversible proteasome inhibitor that is a first-line chemotherapeutic agent for multiple myeloma. Bortezomib can be administered intravenously or subcutaneously with similar efficacy. Subcutaneous administration has fewer side effects. Many cutaneous reactions have been associated with bortezomib treatment. These include morbilliform exanthems, erythematous nodules and papules, leukocytoclastic vasculitis, Sweet syndrome, and rarely Stevens-Johnson Syndrome.

Case Presentation

This paper reports the occurrence of serpentine supravenous hyperpigmentation (SSH) after subcutaneous administration of bortezomib. SSH is a rare, characteristic cutaneous reaction that has been reported following intravenous administration of chemotherapeutic agents. Intravenous administration of bortezomib rarely results in documented cases …

Port-Wine Stain Treatment With 577-Nm Laser: Treatment Outcomes Of Superficial Versus Deep Lesions, Yulia Siskawati

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Port-wine stains (PWS), or capillary malformations (CM), are congenital vascular anomalies characterized by gradual enlargement of the superficial cutaneous vascular plexus, leading to low-flow malformations in the skin. Laser therapy remains the preferred treatment for PWS. The 577-nm vascular laser system is particularly suited for treating cutaneous vascular disorders. This study evaluates the efficacy of the 577-nm vascular laser for both superficial and deep PWS lesions.

Case Illustration: Three adult patients, all aged over 17 years old, were treated with the 577-nm laser. In the first case with deeper PWS, four treatment sessions resulted in flattening of hypertrophic areas, …

Onycholysis In An Elderly Woman: Proposal For Treatment With Coix Seed Extract Administration, Yasuhiro Horiuchi

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: The exact etiology of onycholysis, which is characterized by the painless separation of the nail from the nail bed, remains unclear. Currently, there are no established effective treatments for this condition. Coix seed extract (C-S extract), a traditional Chinese medicine, is recognized for its various biological properties.

Case Illustration: This report describes a case of onycholysis affecting the left index finger of a 62-year-old female patient, with initial symptoms appearing three months prior. Despite ongoing internal administration of C-S extract, the patient experienced a recurrence of onycholysis on both the index finger and pinky finger of the left hand …

Systemic Antibiotic Selection In Skin And Soft Tissue Infections, Shafira Anindya Purnawan, Windy Keumala Budianti, Sandra Widaty

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Antibiotics are used in daily practice. To properly select antibiotics, it is important to pay attention to the definitive diagnosis, class of antibiotic, dose, interval, route of administration, and exact duration of use.

Discussion: The World Health Organization (WHO) categorizes antibiotics into three groups: Access, Watch, and Reserve—known as the AWaRe classification—to help guide appropriate usage and combat antibiotic resistance. The Gyssens flowchart serves as a valuable tool for clinicians to qualitatively evaluate antibiotic utilization. In skin and soft tissue infections (SSTIs), treatment strategies are tailored according to the characteristics of the infection, including purulence, necrosis, and overall severity. …

Non–Invasive Vulvovaginal Rejuvenation: A Review, Jesryn Dhillon, Nelva Karmila Jusuf

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Non–invasive vulvovaginal rejuvenation is a promising option for women who want to restore the appearance and function of the vagina. Vaginal atrophy and vulvovaginal laxity are caused by several circumstances, including ageing, menopause, delivery, and others. Until now, non–invasive vulvovaginal rejuvenation has not been medically indicated, but it is estimated to be the focus of cosmetic dermatology in the future.

Discussion: Non–invasive vulvovaginal rejuvenation can be divided into two methods: using energy-based devices and injectables. Carbon dioxide, Erbium:YAG laser and radiofrequency are the commonly used energy-based devices. Injectables most frequently used are hyaluronic acid and platelet–rich plasma. Some additional …

Drug-Induced Hypersensitivity Syndrome With Liver Injury Due To Phenytoin: A Case Report, Lorettha Wijaya, Stella Adevita, Steven Alvianto, Yoseveline Christiani, Alius Cahyadi, Raesa Yolanda

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Drug-induced hypersensitivity syndrome (DIHS) is a rare and severe systemic drug reaction characterized by skin involvement, internal organ complications, and hematologic disorders. Management of this condition is challenging due to its wide range of cutaneous manifestations and 10% mortality rate.

Case Illustration: A 52-year-old male presented with widespread redness throughout his body with a prior history of regular phenytoin consumption. The rash continued to spread despite the patient’s abrupt discontinuation of the suspected medication. He was diagnosed with atypical DIHS according to J-SCAR criteria and was given high-dose corticosteroid. Drastic clinical improvement was observed after nine days of therapy, …

Bowen’S Disease Mimicking Lichen Simplex Chronicus In A 56-Year-Old Filipino Man: A Case Report, Cynthia Angela Karim, Elisabeth Ryan, Reynaldo Ugalde

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Bowen's disease (BD) is a chronic skin condition presenting clinically as erythematous plaques with scales on sun-exposed areas. BD is generally regarded as a squamous cell carcinoma (SCC) in situ. In contrast, lichen simplex chronicus (LSC), also known as neurodermatitis, is a chronic skin disorder characterized by extreme pruritus. In LSC, lichenified plaques form primarily on accessible body parts due to repeated scratching or rubbing.

Case Illustration: A 56-year-old male presented with a solitary chronic plaque with a central ulcer and erosions on his left upper thigh. Dermoscopy findings were glomerular vessels and a scaly surface, which are …

Comparison Of Quality Of Life, Anxiety, And Depression Levels Based On Acne Vulgaris Severity, Annisaul Husna, Satya Wydya Yenny, Desmawati Desmawati, Gardenia Akhyar, Masrul Masrul, Yulistini Yulistini

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Acne vulgaris is a chronic inflammation of the pilosebaceous unit. Although acne vulgaris is not fatal, it can cause psychological effects. This study aimed to compare the quality of life, anxiety, and depression levels based on the severity of acne vulgaris among medical students at Andalas University.

Methods: This was an observational-analytic study with a cross-sectional design. It was conducted from May to June 2023. The population included the third-grade students of the Medical Study Program of the Faculty of Medicine, Andalas University, who had acne vulgaris. The respondents were 70 people, recruited with consecutive sampling techniques. This research …

Dermoscopy And 30% Potassium Hydroxide Direct Examination As Diagnostic Tools For Distal Lateral Subungual Onychomycosis, Evangelina Lumban Gaol, Eliza Miranda, Sondang Pandjaitan Sirait

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Culture and histopathological examination are gold standards for diagnosing onychomycosis. However, these examinations are subject to several limitations. Dermoscopy has the potential to become a promising diagnostic tool for onychomycosis. Direct examination of potassium hydroxide (KOH) also has advantages similar to dermoscopy. Knowing the accuracy of both examinations can help clinical decision-making. Our objectives are to assess the diagnostic value of dermoscopy, KOH examination, and their combination for distal lateral subungual onychomycosis compared to culture or histopathology.

Methods: This was a cross-sectional diagnostic study of nails with suspected distal lateral subungual onychomycosis. Sixty nails were included in this study. …

The Spectrum Of Cutaneous Manifestations In Covid-19 Patients At Dr. Cipto Mangunkusumo Hospital, Sandra Widaty, Sri Linuwih Susetyo Wardhani Menaldi, Eliza Miranda, Melani Marissa, Hanny Nilasari, Thong Felicia Melinda, Emilina Faradila Cornain

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Cutaneous manifestations are identified in 0.2%–20% of COVID-19 cases, both in adult and pediatric patients. They can occur before, simultaneously with, or after the systemic symptoms of COVID-19. This study aims to analyze the association between cutaneous manifestations, severity, and outcomes of patients with COVID-19.

Methods: This observational study was conducted from April 2020 to April 2021 in Dr. Cipto Mangunkusumo Hospital, a referral center for COVID-19 in Jakarta, Indonesia. Medical records were used to collect demographic, clinical, and laboratory data.

Results: A total of 0.61% (31/5070) of COVID-19 cases showed cutaneous manifestations, consisting of maculopapular (80.6%), vesicular …

Telogen Effluvium Incidence In Women Wearing Hijab Compared To Non-Hijab: A Cross-Sectional Study, Sondang Pandjaitan Sirait, Sandra Widaty, Lili Legiawati, Lis Surachmiati Suseno, Roro Inge Ade Krisanti, Windy Keumala Budianti, Eliza Miranda, Rahadi Rihatmadja, Caroline Oktarina, Paulus Anung Anindita Pandelaki, Irhen Situmeang

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Hair loss is a normal experience, but if the amount of hair loss exceeds what is considered normal, it will usually cause anxiety for the patient. In Indonesia, almost every Muslim woman wears a hijab. The hijab is one of many factors believed to cause hair loss. Telogen effluvium (TE) itself is a hair cycle disorder in which the anagen phase terminates prematurely, resulting in diffuse club hair loss without scarring, and TE itself has many risk factors. The purpose of this study was to determine the relationship between the incidence of TE in women who wear hijabs …

A Prospective Study In The Treatment Of Androgenic Alopecia Using Combination Of Procapil, Capixyl, Redensyl, Garima Bansal, Rishi Bansal

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Androgenic alopecia is characterized by its diffuse loss and the miniaturization of the hair. The study aimed to assess the safety and efficacy of procapil, redensyl, capixyl, bicapil, and anagain in topical hair growth serum in androgenic alopecia.

Methods: A prospective study was conducted on 110 healthy subjects aged 18-60 with androgenic alopecia in the Department of Dermatology, Tundla, Etmadhpur. Each subject applied 1 ml of serum on a dry scalp and was followed up on the 4^th, 8^th, 12^th, and 16^th week. Mean, median, and standard deviation were calculated. A repeated measure …

A Clinician’S Guide To Pediatric And Adolescent Alopecia Areata Treatments, Heli A. Patel, Rishab R. Revankar, Jenna E. Koblinski, Benjamin Ungar, Emma Guttman-Yassky, Jamie B. Mackelfresh, Dirk Elston, Peter Lio

Student Papers, Posters & Projects

Background: Available treatment options for pediatric alopecia areata are limited and may even exacerbate the physical and psychosocial burden. Objective: This article aimed to provide a treatment classification system and counseling recommendations. Recommendations: Topical corticosteroids are appropriate for initial treatment due to their ease of use and safety. Topical minoxidil and dithranol are often used as adjunctive treatments based on mixed data. Intralesional corticosteroids are effective for localized disease, but injections may be challenging in children. Contact immunotherapy, systemic corticosteroids, and immunosuppressive agents such as topical and oral Janus kinase (JAK) inhibitors, dupilumab, and low-dose methotrexate demonstrate varying effectiveness, adverse …

A Sticky Mess—Are Moisturizers Overused In Dermatitis Care?, Susan Nedorost

Faculty Scholarship

Microbial dysbiosis is increasingly understood to influence allergic sensitization and skin barrier defects in dermatitis. Occlusion, such as from moisturizers, fosters microbial dysbiosis, and increases itch in many patients with dermatitis. Nevertheless, use of moisturizers in dermatitis remains part of dermatologic guidelines. This is a review of the evidence of benefits and adverse effects of moisturizers in dermatitis and a proposal for moderation in their clinical use.