Dermatology Commons^™

Bactericidal Efficacy Of The Combination Of Maresin-Like Proresolving Mediators And Carbenicillin Action On Biofilm-Forming Burn Trauma Infection-Related Bacteria, Anbu Mozhi Thamizhchelvan, Abdul Razak Masoud, Shanchun Su, Yan Lu, Hongying Peng, Yuichi Kobayashi, Yu Wang, Nathan K. Archer, Song Hong

School of Medicine Faculty Publications

Biofilm-associated bacterial infections are the major reason for treatment failure in many diseases including burn trauma infections. Uncontrolled inflammation induced by bacteria leads to materiality, tissue damage, and chronic diseases. Specialized proresolving mediators (SPMs), including maresin-like lipid mediators (MarLs), are enzymatically biosynthesized from omega-3 essential long-chain polyunsaturated fatty acids, especially docosahexaenoic acid (DHA), by macrophages and other leukocytes. SPMs exhibit strong inflammation-resolving activities, especially inflammation provoked by bacterial infection. In this study, we explored the potential direct inhibitory activities of three MarLs on Gram-positive (Staphylococcus aureus) and Gram-negative (Pseudomonas aeruginosa and Escherichia coli) bacteria in their biofilms that are leading …

Covid-19 Infection Increases The Development Of Stevens-Johnson Syndrome And Toxic Epidermal Necrolysis: A Retrospective Cohort Analysis, Kristen K. Curtis, Meghan M. Dillan, Timmie R. Sharma, Joseph Piktel

Student Scholarship

To the Editor: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) represent a spectrum of severe mucocutaneous reactions characterized by extensive epidermal detachment, most commonly due to medications.1 Some viruses, such as the human immunodeficiency virus, have been found to be an independent risk factor for the development of SJS and TEN, though the mechanism is not completely understood.2 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus identified in late 2019, is most commonly associated with mild respiratory illness. However, cutaneous manifestations, including SJS and TEN, have been increasingly reported during and after COVID-19 infection.3 Therefore, the objective …

Angiofibroma Of Soft Tissue: A Case Report, Mehruba Alam, Jake Robins

Annual Research Symposium

Differentiation between benign angiofibromas of soft tissue and malignant sarcomas.

The accurate diagnosis of this tumor is essential to prevent additional unnecessary treatments and/or surgeries. This can be achieved by proper genetic testing for the presence of markers including the NCOA2 fusion gene, CD34, α-SMA, and epithelial membrane antigen. Genetic testing is an essential component of accurate diagnosis as the appearance of these lesions can mimic other, more harmful neoplasms. Immunohistochemical analysis frequently shows the AHRR-NCOA2 driver mutation which is thought to be associated with t(5;8)(p15;q13), also commonly found in AFSTs. In combination, these immunohistochemical findings allow for accurate diagnosis …

Antibody Profiling And Predictive Modeling Discriminate Between Kaposi Sarcoma And Asymptomatic Kshv Infection, Sydney J. Bennett, Dicle Yalcin, Sara R. Privatt, Owen Ngalamika, Salum J. Lidenge, John T. West, Charles Wood

School of Medicine Faculty Publications

Protein-level immunodominance patterns against Kaposi sarcoma-associated herpesvirus (KSHV), the aetiologic agent of Kaposi sarcoma (KS), have been revealed from serological probing of whole protein arrays, however, the epitopes that underlie these patterns have not been defined. We recently demonstrated the utility of phage display in high-resolution linear epitope mapping of the KSHV latency-associated nuclear antigen (LANA/ORF73). Here, a VirScan phage immunoprecipitation and sequencing approach, employing a library of 1,988 KSHV proteome-derived peptides, was used to quantify the breadth and magnitude of responses of 59 sub-Saharan African KS patients and 22 KSHV-infected asymptomatic individuals (ASY), and ultimately to support an application …

Uncommon Presentation Of Kaposi Sarcoma In An Hiv-Negative Patient: A Case Report And Review Of The Literature, Hope Daskalakis, Nina M. Ventura, Joy Anne Lowry, Mara Weinstein Velez

Advances in Clinical Medical Research and Healthcare Delivery

Kaposi Sarcoma (KS) is a multifocal systemic disease first identified in 1872. It most commonly involves the skin, mucous membranes, lymph nodes, and gastrointestinal tract. There are four clinically distinct subtypes of KS that have been identified: Chronic or classic KS, African endemic KS, KS due to iatrogenic immunosuppression, and AIDS-related epidemic KS. The human herpesvirus 8 (HHV-8) has been implicated in all subtypes of KS. We present a unique case of KS in a 79-year-old male with a widespread distribution of skin lesions on his palms, soles, chest, and back. This case report highlights a novel presentation of classical …

Confidence Of Clark County Medical Students In Identifying Dermatologic Conditions On Different Fitzpatrick Skin Types, Ramaditya Srinivasmurthy

Annual Research Symposium

Racial health disparities are apparent in the field of dermatology across the United States. Certain dermatologic conditions are more likely to go undiagnosed in people with skin of color (SOC), leading to increased morbidity/mortality. Underrepresentation of darker skin tones in medical education may be a contributing factor. This study explores the ability and confidence of TUNCOM students to recognize dermatological conditions on various skin tones.

A 23 question survey was given to 173 second year students to examine their ability and confidence in identifying dermatologic conditions on non-SOC (Fitzpatrick I-III) and SOC (Fitzpatrick IV-VI). Images of common skin disorders on …

A Review Of Current And Pipeline Drugs For Treatment Of Melanoma, Nicole Natarelli, Sarah J. Aleman, Isabella M. Mark, Jasmine T. Tran, Sean Kwak, Elizabeth Botto, Shaliz Aflatooni, Michael J. Diaz, Shari R. Lipner

School of Medicine Faculty Publications

Malignant melanoma is the most aggressive form of skin cancer. Standard treatment options include surgery, radiation therapy, systemic chemotherapy, targeted therapy, and immunotherapy. Combining these modalities often yields better responses. Surgery is suitable for localized cases, sometimes involving lymph node dissection and biopsy, to assess the spread of the disease. Radiation therapy may be sometimes used as a standalone treatment or following surgical excision. Systemic chemotherapy, while having low response rates, is utilized as part of combination treatments or when other methods fail. The development of resistance to systemic chemotherapies and associated side effects have prompted further research and clinical …

Health Economic Consequences Associated With Covid-19-Related Delay In Melanoma Diagnosis In Europe, Lara V Maul, Dagmar Jamiolkowski, Rebecca A Lapides, Alina M Mueller, Axel Hauschild, Claus Garbe, Paul Lorigan, Jeffrey E Gershenwald, Paolo Antonio Ascierto, Georgina V Long, Michael Wang-Evers, Richard A Scolyer, Babak Saravi, Matthias Augustin, Alexander A Navarini, Stefan Legge, István B Németh, Ágnes J Jánosi, Simone Mocellin, Anita Feller, Dieter Manstein, Alexander Zink, Julia-Tatjana Maul, Alessandra Buja, Kaustubh Adhikari, Elisabeth Roider

Faculty, Staff and Student Publications

IMPORTANCE: The COVID-19 pandemic resulted in delayed access to medical care. Restrictions to health care specialists, staff shortages, and fear of SARS-CoV-2 infection led to interruptions in routine care, such as early melanoma detection; however, premature mortality and economic burden associated with this postponement have not been studied yet.

OBJECTIVE: To determine the premature mortality and economic costs associated with suspended melanoma screenings during COVID-19 pandemic lockdowns by estimating the total burden of delayed melanoma diagnoses for Europe.

DESIGN, SETTING, AND PARTICIPANTS: This multicenter economic evaluation used population-based data from patients aged at least 18 years with invasive primary cutaneous …

Advancing Virtual At-Home Care For Community Health Center Patients Using Patient Self-Care Tools, Technology, And Education [Letter], Cheryl Modica, Joy H. Lewis, Curtis Bay

SOMA Faculty Publications

Abstract

Introduction

Health centers are community-based, patient directed primary care providers that offer accessible, high-quality primary care within medically underserved communities. Screening for cancer and managing complex chronic conditions such as diabetes, hypertension, obesity, and depression are vital services for the vulnerable populations seen by community health centers. Delivering care for complex chronic conditions and preventive services using virtual models that integrate self-care tools and technology is an important approach to increasing access for hard-to-reach patients served by health centers.

Objective

This study aimed to explore the use of a virtual care model, applied using a systems approach and patient-driven …

The Curious Case Of A Painful Leg Ulcer, Jay R Patel, Rubi Montejano, Christina Hopkins, Hanna Siatecka, Theodore Rosen

Faculty, Staff and Students Publications

Sickle cell disease is a condition that can involve numerous organ systems secondary to vascular occlusion. Herein, we present a case of a 21-year-old male with sickle cell disease requiring long-term hydroxyurea therapy. Upon migrating to the United States from Yemen, the patient developed a rapidly progressive, exquisitely painful ulcer on his right lower extremity. Given his country of origin, a broad differential, including select infectious diseases, was essential. Moreover, establishing the unequivocally correct diagnosis was crucial to determine proper and safe therapy. Ultimately, a lesional biopsy demonstrated numerous sickled red blood cells occluding blood vessels, leading to the diagnosis …

Expression Of Atoh1, Gfi1, And Pou4f3 In The Mature Cochlea Reprograms Nonsensory Cells Into Hair Cells, Melissa M Mcgovern, Ishwar V Hosamani, Yichi Niu, Ken Y Nguyen, Chenghang Zong, Andrew K Groves

Faculty, Staff and Students Publications

Mechanosensory hair cells of the mature mammalian organ of Corti do not regenerate; consequently, loss of hair cells leads to permanent hearing loss. Although nonmammalian vertebrates can regenerate hair cells from neighboring supporting cells, many humans with severe hearing loss lack both hair cells and supporting cells, with the organ of Corti being replaced by a flat epithelium of nonsensory cells. To determine whether the mature cochlea can produce hair cells in vivo, we reprogrammed nonsensory cells adjacent to the organ of Corti with three hair cell transcription factors: Gfi1, Atoh1, and Pou4f3. We generated numerous hair cell–like …

Cd133-Dependent Activation Of Phosphoinositide 3-Kinase /Akt/Mammalian Target Of Rapamycin Signaling In Melanoma Progression And Drug Resistance, Naji Kharouf, Thomas W. Flanagan, Abdulhadi A. Alamodi, Youssef Al Hmada, Sofie Yasmin Hassan, Hosam Shalaby, Simeon Santourlidis, Sarah Lilly Hassan, Youssef Haikel, Mossad Megahed, Robert T. Brodell, Mohamed Hassan

School of Medicine Faculty Publications

Melanoma frequently harbors genetic alterations in key molecules leading to the aberrant activation of PI3K and its downstream pathways. Although the role of PI3K/AKT/mTOR in melanoma progression and drug resistance is well documented, targeting the PI3K/AKT/mTOR pathway showed less efficiency in clinical trials than might have been expected, since the suppression of the PI3K/mTOR signaling pathway-induced feedback loops is mostly associated with the activation of compensatory pathways such as MAPK/MEK/ERK. Consequently, the development of intrinsic and acquired resistance can occur. As a solid tumor, melanoma is notorious for its heterogeneity. This can be expressed in the form of genetically divergent …

Mechanisms Of Melanoma Progression And Treatment Resistance: Role Of Cancer Stem-Like Cells, Youssef Al Hmada, Robert T. Brodell, Naji Kharouf, Thomas W. Flanagan, Abdulhadi A. Alamodi, Sofie Yasmin Hassan, Hosam Shalaby, Sarah Lilly Hassan, Youssef Haikel, Mosaad Megahed, Simeon Santourlidis, Mohamed Hassan

School of Medicine Faculty Publications

Melanoma is the third most common type of skin cancer, characterized by its heterogeneity and propensity to metastasize to distant organs. Melanoma is a heterogeneous tumor, composed of genetically divergent subpopulations, including a small fraction of melanoma-initiating cancer stem-like cells (CSCs) and many non-cancer stem cells (non-CSCs). CSCs are characterized by their unique surface proteins associated with aberrant signaling pathways with a causal or consequential relationship with tumor progression, drug resistance, and recurrence. Melanomas also harbor significant alterations in functional genes (BRAF, CDKN2A, NRAS, TP53, and NF1). Of these, the most common are the BRAF and NRAS oncogenes, with 50% …

Hidradenitis Suppurativa Disease Severity And Outcomes Among Black Patients From Low-Income Neighborhoods At A Tertiary Care Hospital: A Retrospective Review, Anna M. Catinis, Olivia A. Gioe, Caroline Savoie, Erika Rosen, Deborah Hilton

School of Medicine Faculty Publications

Hidradenitis suppurativa (HS) is a debilitating, inflammatory condition of apocrine sweat glands. Black patients are disproportionately affected, a finding largely attributed to lower socioeconomic status (SES) in the literature; yet, most HS studies include majority White cohorts. We present, to our knowledge, the first retrospective review of an entirely Black patient population living in low-income neighborhoods diagnosed with hidradenitis suppurativa (HS) to identify potentially modifiable factors related to disease severity and outcomes. We reviewed charts of Black patients with an encounter for HS from 2010-2020 in the New Orleans University Medical Center database. Hurley stage III (HSt III) disease was …

Chlormethine Gel In Combination With Other Therapies For Treatment Of Mycosis Fungoides: A Review With Patient Cases, Marco Ardigò, Neda Nikbakht, Miriam Teoli, Laura Gleason, Liliana Crisan, Christiane Querfeld

Department of Dermatology and Cutaneous Biology Faculty Papers

Topical chlormethine gel has been approved as monotherapy for treatment of adult patients with mycosis fungoides (MF), the most common form of cutaneous T-cell lymphoma. In clinical practice, chlormethine gel is often combined with other skin-directed or systemic therapies to optimize response and target recalcitrant lesions. Positive outcomes with combination regimens using chlormethine gel and topical corticosteroids, phototherapy, retinoids, methotrexate, or interferon-α have been reported in literature. However, there are no treatment guidelines on the use of combination regimens with chlormethine gel. To provide real-world evidence and guidance on the use of chlormethine gel combination regimens, several cases of patients …

Development Of A Novel Covalently Bonded Conjugate Of Caprylic Acid Tripeptide (Isoleucine–Leucine–Aspartic Acid) For Wound-Compatible And Injectable Hydrogel To Accelerate Healing, Sachin B. Baravkar, Yan Lu, Abdul Razak Masoud, Qi Zhao, Jibao He, Song Hong

School of Medicine Faculty Publications

Third-degree burn injuries pose a significant health threat. Safer, easier-to-use, and more effective techniques are urgently needed for their treatment. We hypothesized that covalently bonded conjugates of fatty acids and tripeptides can form wound-compatible hydrogels that can accelerate healing. We first designed conjugated structures as fatty acid–aminoacid1–amonoacid2–aspartate amphiphiles (Cn acid–AA1–AA2–D), which were potentially capable of self-assembling into hydrogels according to the structure and properties of each moiety. We then generated 14 novel conjugates based on this design by using two Fmoc/tBu solid-phase peptide synthesis techniques; we verified their structures and purities through liquid chromatography with tandem mass spectrometry and nuclear …

Cases From A Community Hospital…Jchimp Series #2: 66-Year-Old Man With Recurrent Painful Rashes And Oral Ulcerations, Fatima Halilu, Jing Wu, Joseph Fuscaldo, Nathan Dunsmore, Zain Syed, Pauline Daley

Journal of Community Hospital Internal Medicine Perspectives

This is part of a series of case reports detailing scenarios from our community hospital. The cases are selected to feature clinical dilemmas, provide a review on what is currently known about the topic with expert perspective. A 66-year-old black man presented to the primary care clinic with his fourth episode of generalized painful rash and oral ulcerations without a diagnosis despite two emergency room (ED) visits alongside doxycycline treatment. Symptoms interfered with daily activities with skin exam notable for widespread erythematous patches and plaques. In office biopsies were obtained with final diagnosis of erythema multiforme. Etiologic workup revealed positive …

Clinical Efficacy Of 5-Fluorouracil And Bleomycin In Dermatology, Suyeon Kim, Yu Ri Woo, Sang Hyun Cho, Jeong Deuk Lee, Hei Sung Kim

Faculty, Staff and Student Publications

Bleomycin and 5-fluorouracil (5-FU) are widely used in various dermatological disorders. Both drugs are well-recognized as antineoplastic drugs and exert their effect by blocking the cell cycle. Topical and intralesional formulations are available and have been studied in both non-neoplastic and cancerous lesions. However, data comparing the effect of bleomycin and 5-FU in the dermatological disorders are limited. This review outlines the action mechanisms of both drugs and compares their clinical efficacies in a wide range of dermatologic diseases including hypertrophic scar, wart, skin cancer, vascular malformation, hemangioma, and vitiligo, and discusses the overall safety of the drugs. Intralesional bleomycin …

Meta-Narrative Synthesis: The Effectiveness Of Diagnosing And Treating Melanoma With Micrographically Oriented Histograph Surgery Mohs Technique, Gabriella Casas Ms, Nida Mubeen Ms, Nicole Rivera Ms, Tan Thien Tang Mr., Mark A. Bailey Mr, Mary Coolbaugh-Murphy, Denise M. Juroske Short Mrs

Research Methods Poster Session 2024

This meta-narrative synthesis highlights the effectiveness of diagnosing and treating melanoma with Micrographically Oriented Histography Surgery (MOHS) technique. Initiating the questions: What techniques does MOHS surgery involve when diagnosing and treating non-metastasized Melanoma? How will it provide positive outcomes for the patient? The significance of using MOHS excision technique and diagnosis of localized facial melanoma compared to traditional cancer excision techniques is designed to remove affected tissue while preserving anatomical facial structure in an aesthetic fashion. Providing an overview of the technique’s diagnostic professional capabilities as well as its strengths, limitations, improvement for upcoming studies, and potential prognosis. Melanoma, a …

Eye Code Protocol, Christina Anderson Md, Maiya Dietz, Kelsey Bade, Mallory Mondloch

Nursing Posters

Purpose of EYE CODE:

• Retinal artery occlusion (RAO) is a rare but detrimental adverse effect of cosmetic facial filler injections.
• Requires prompt treatment and reversal to avoid patient blindness.
• EYE CODE is a new protocol in place to avoid this complication.
• Assist staff during a high stress event. •Improve patient safety & staff confidence. Way to receive continuing education credits through the clinic.