Dermatology Commons^™

A 61-Year-Old Filipino Man With Lichen Planus Concomitant With Cicatricial Alopecia, Mimicking Discoid Lupus Erythematosus, Lie Michelle E. Harris, Benedicto Dl Carpio, Eileen Regalado-Morales, Amelita Tanglao-De Guzman, Armelia Lapitan-Torres

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Lichen planus (LP) is an idiopathic inflammatory disease affecting the skin, mucous membranes, hair, and nails. Even though rare, LP may also present as cicatricial alopecia or a condition referred to as lichen planopilaris (LPP). On the other hand, lupus erythematosus (LE) is an autoimmune disorder with a possibility of systemic involvement. Classical discoid lupus erythematosus (DLE) is the most common form of LE and has a hallmark of scarring alopecia.

Case Illustration: A 61-year-old Filipino man presented with a 7-month history of persistent multiple erythematous hairless scarring plaques on the scalp with multiple erythematous–violaceous to hyperpigmented …

Effects Of 5% Astaxanthin Gel On Angiogenesis And Granulation Tissue In Second-Degree Burn Animal Model, Aunur Rofiq, Anggun Putri Yuniaswan, Rizki Hapsari Nugraha

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Burn injuries generate more free radicals and lead to complex immune dysfunction, which can delay wound healing compared to other wound types. Angiogenesis, essential for wound healing, requires granulation tissue as a marker for successful wound healing. Low concentrations of reactive oxygen species (ROS) are necessary to initiate this process. Astaxanthin is a potent antioxidant with anti-inflammatory properties, known to activate angiogenesis and modulate ROS signaling during wound healing.

Methods: This experimental study aimed to evaluate 5% astaxanthin gel on second-degree burns using 30 male Wistar rats. Simple random sampling was utilized. A total of 6 groups …

The Importance Of Multidisciplinary Approach In Management Of Pressure Injury In Elderly With Multiple Comorbidities, Dina Kusumawardhani, Shannaz Nadia Yusharyahya, Lili Legiawati, Rinadewi Astriningrum, Kara Adistri

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Pressure injury (PI) can occur as a result of prolonged bed rest in immobilized patients. The healing process is often slow if the wounds are not managed comprehensively, particularly in elderly patients or patients with neurological disorder, diabetes mellitus, and malnutrition. Proper treatment can improve the healing process.

Case illustration: A 66-year-old female with multiple comorbidities presented with PI on the left lower back, as well as the sacral and right gluteal regions. She was diagnosed with grade 3 and unstageable PI, and was treated using a multidisciplinary approach. Her wounds were treated with a combination of …

User Acceptance Of Deskab Mobile Application For Early Detection Of Scabies In Indonesia, Sandra Widaty, Dewi Friska, Kusmarinah Bramono, Siti Maulidya Sari, Irene Darmawan, Aria Kekalih

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Individual case management strategy is not suitable for reducing scabies transmission, especially in high prevalence settings. A community-based approach has been proposed to control scabies. We developed a mobile application, called DeSkab, to empower non-medical personnel in crowded populations e.g., boarding schools, and to aid the identification of skin lesions suggesting scabies based on the cardinal signs of scabies. Early treatment and prevention of scabies transmission is expected to follow this approach. This was the initial development of the DeSkab mobile application which aims to assess user acceptance.

Methods: The DeSkab mobile application was designed using Java …

The Effect Of Bakuchiol In The Skin Aging Process: A Systematic Review, Olivia Jovina Priyanto, Yosef Ferdinand Rahmat Sugiyanto, Darryl Samuel Salim

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: With aging, the skin gradually loses its structural and morphological coherence, decreasing its function. With aging and chronic ultraviolet (UV) exposure, the skin becomes thin and loses elasticity, and wrinkles, pigmentation, and texture irregularities appear. Today, people of all ages become interested in the cosmetic industry, aiming to make their skin appropriate to their age or look younger. Bakuchiol is a pure meroterpene phenol found mainly in the seeds of the Indian plant Psoralea corylifolia (babchi). It triggers antioxidant and anti-inflammatory activity and has anti-aging properties like retinol. The study aimed to know the effect of bakuchiol on …

Histoid Leprosy Mimicking Lichen Planus, Kesya Kimberly, Annisa Alviariza, Siti Aisha Nabila Ferina, Prima Kartika Esti, Lenti Br. Peranginangin, Eka Komarasari

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Histoid leprosy is a rare variant of lepromatous leprosy (LL), characterized by unique clinical, histopathological, and microbiological features. This type of leprosy is caused by multidrug therapy (MDT) drug resistance, train mutation of Mycobacterium leprae, or genetic factors.

Case Illustration: A 21-year-old Indonesian woman with a family history of histoid leprosy complained of multiple hypo-esthetic erythematous partly flat-topped papules around the lesion on the face and bilateral superior and inferior extremities for the last two years. A Slit-skin smear examination revealed acid-fast bacilli with a bacterial index (BI) of 4.17+ and morphological index (MI) of 1%. Histopathological …

Olive Oil And Hydration Based On Clinical Assessment And Transepidermal Water Loss: A Systematic Review, Ni Made Ayu Nadia Paramitha Jaya, Melyawati Hermawan, Regina Regina

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Dry skin or xerosis is a layer of skin that loses moisture due to increased transepidermal water loss (TEWL). Olive oil, one of the most commonly available moisturizers, is often used to keep the skin hydrated. Skin hydration indicates the amount of water in the stratum corneum. This systematic review aimed to determine the association between olive oil application and skin hydration based on clinical assessment and TEWL parameters.

Methods: The research design used was a systematic review based on the criteria of preferred reporting items for systematic reviews and meta-analyses (PRISMA). This systematic review search used …

Immunosequencing Applications In Cutaneous T-Cell Lymphoma, Jenna Mandel, Laura Gleason, Daniel Joffe, Safiyyah Bhatti, Neda Nikbakht

Department of Dermatology and Cutaneous Biology Faculty Papers

Immunosequencing has emerged as a newer clinical test for assessment of T-cell clonality in the blood and skin of cutaneous T-cell lymphoma (CTCL) patients. Utilization of immunosequencing, also known as high-throughput sequencing of the T-cell receptor (HTS-TCR), enables identification and quantification of the precise genetic signature of dominant T-cell clones. Although immunosequencing is more sensitive than commonly used methods such as polymerase chain reaction (PCR) paired with capillary electrophoresis or flow cytometry, it remains underutilized for CTCL management. Nonetheless, incorporation of HTS-TCR in clinical practice offers distinct advantages compared to other molecular analyses that may improve diagnostic evaluation, prognostication, and …

Utility Of T-Cell Immunosequencing In Distinguishing Mycosis Fungoides Progression From Treatment Related Cutaneous Adverse Events, Safiyyah Bhatti, Daniel Joffe, Lauren Banner, Sahithi Talasila, Jenna Mandel, Jason Lee, Pierluigi Porcu, Neda Nikbakht

Department of Dermatology and Cutaneous Biology Faculty Papers

Cutaneous adverse events of both topical and systemic drugs in patients with mycosis fungoides (MF) present a diagnostic challenge as it is often difficult to distinguish drug associated rash from disease progression in the skin. Mogamulizumab and mechlorethamine gel are approved treatments for MF, both of which can cause treatment related cutaneous adverse events. It can often be challenging to distinguish mogamulizumab associated rash (MAR) and mechlorethamine gel associated hypersensitivity dermatitis from MF progression both clinically and histologically. High-throughput sequencing (HTS) of the T-cell receptor (TCR), also known as immunosequencing, can be used to assess T-cell clonality to support a …

Ai’S Next Frontier — Dermatology? How It May Help Close The Health Gap For Dark-Skinned Patients, Gretchen B. Smail

Capstones

This project examines how engineers are creating artificial intelligence systems to help with dermatology diagnosis. Researchers believe that these systems can help close the health care gap in lower income and Black and brown communities, but dermatologists of color worry that these systems are not being trained to recognize skin conditions on patients of color.

Xtx101, A Tumor-Activated, Fc-Enhanced Anti-Ctla-4 Monoclonal Antibody, Demonstrates Tumor-Growth Inhibition And Tumor-Selective Pharmacodynamics In Mouse Models Of Cancer, Kurt A. Jenkins, Miso Park, Magali Pederzoli-Ribeil, Ugur Eskiocak, Parker Johnson, Wilson Guzman, Megan Mclaughlin, Deborah Moore-Lai, Caitlin O'Toole, Zhen Liu, Benjamin Nicholson, Veronica Flesch, Huawei Qiu, Tim Clackson, Ronan C. O'Hagan, Ulrich Rodeck, Margaret Karow, Jennifer O'Neil, John C. Williams

Department of Dermatology and Cutaneous Biology Faculty Papers

INTRODUCTION: The clinical benefit of the anti-CTLA-4 monoclonal antibody (mAb) ipilimumab has been well established but limited by immune-related adverse events, especially when ipilimumab is used in combination with anti-PD-(L)1 mAb therapy. To overcome these limitations, we have developed XTX101, a tumor-activated, Fc-enhanced anti-CTLA-4 mAb.

METHODS: XTX101 consists of an anti-human CTLA-4 mAb covalently linked to masking peptides that block the complementarity-determining regions, thereby minimizing the mAb binding to CTLA-4. The masking peptides are designed to be released by proteases that are typically dysregulated within the tumor microenvironment (TME), resulting in activation of XTX101 intratumorally. Mutations within the Fc region …

Metformin: A Potential Treatment For Acne, Hidradenitis Suppurativa And Rosacea, Minah Cho, Yu Ri Woo, Sang Hyun Cho, Jeong Deuk Lee, Hei Sung Kim

Faculty, Staff and Student Publications

Metformin is a widely used drug for treatment of diabetes mellitus, due to its safety and efficacy. In addition to its role as an antidiabetic drug, numerous beneficial effects of metformin have enabled its use in various diseases. Considering the anti-androgenic, anti-angiogenic, anti-fibrotic and antioxidant properties of metformin, it may have the potential to improve chronic inflammatory skin diseases. However, further evidence is needed to confirm the efficacy of metformin in dermatological conditions, This review focuses on exploring the therapeutic targets of metformin in acne vulgaris, hidradenitis suppurativa and rosacea, by studying their pathogeneses.

Use Of Interleukin-12/23 Inhibitor For The Management Of Acne Fulminans., Hannah Gier, Alexa Israeli, Austin Cusick, Dawn Merritt

Ambulatory and Primary Care Articles

Acne fulminans (AF) is a rare disorder marked by severe eruptions of inflamed nodules, hemorrhagic crusts, and ulcers accompanied by systemic symptoms and often laboratory abnormalities. Commonly affecting adolescent males with pre-existing acne, AF has been associated with isotretinoin therapy and elevated testosterone levels. With unknown pathogenesis, lesions frequently involve the trunk and face and are managed standardly with corticosteroids and isotretinoin. Uncontrolled or recurrent cases pose challenges due to prolonged high-dose corticosteroid use with increased scarring. In this study, we present a case of AF in a 17-year-old male unresponsive to corticosteroid and isotretinoin therapy, successfully treated with ustekinumab, …

Use Of Interleukin-12/23 Inhibitor For The Management Of Acne Fulminans., Hannah Gier, Alexa Israeli, Austin Cusick, Dawn Merritt

Ambulatory and Primary Care Articles

Acne fulminans (AF) is a rare disorder marked by severe eruptions of inflamed nodules, hemorrhagic crusts, and ulcers accompanied by systemic symptoms and often laboratory abnormalities. Commonly affecting adolescent males with pre-existing acne, AF has been associated with isotretinoin therapy and elevated testosterone levels. With unknown pathogenesis, lesions frequently involve the trunk and face and are managed standardly with corticosteroids and isotretinoin. Uncontrolled or recurrent cases pose challenges due to prolonged high-dose corticosteroid use with increased scarring. In this study, we present a case of AF in a 17-year-old male unresponsive to corticosteroid and isotretinoin therapy, successfully treated with ustekinumab, …

Chromoblastomycosis Presenting As A Solitary Lesion In A Non-Endemic Region, Yelena Dokic, Gordana Verstovsek, Theodore Rosen

Faculty, Staff and Students Publications

Chromoblastomycosis is a neglected tropical disease typically found in endemic tropical and subtropical regions. Herein, we discuss a rare case of a 55-year-old man in Texas who presented with an exophytic papule on the forearm, diagnosed to have chromoblastomycosis by shave biopsy and subsequent histopathological analysis. Treatment options for chromoblastomycosis include long-term oral antifungal therapy with itraconazole, physical modalities such as heat therapy in conjunction with oral antifungals, and surgical interventions such as cryosurgery or surgical excision.

Differentiating Desquamating Skin Lesions: A Case Of Methotrexate Epidermal Necrosis, Sahifah Ansari, Dina H Zamil, Edgar Rodriguez, Carly Dunn, Soo Jung Kim

Faculty, Staff and Students Publications

Desquamating skin lesions are a non-specific finding that requires urgent evaluation given the life-threatening severity of one of the potential causes, Stevens-Johnson syndrome (SJS). Methotrexate toxicity, also known in its cutaneous form as methotrexate epidermal necrosis (MEN), is another entity that presents similarly to SJS and is described here in a patient with increased risk due to his age, chronic kidney disease, and increased dose of methotrexate. His diagnosis was complicated by other historical risk factors, including antibiotic use, but was eventually elucidated when he was noted to have bone marrow suppression. Given the pathophysiology of SJS, a T-cell mediated …

Skin Cancers In Medicare Beneficiaries With Actinic Keratoses, Cassandra Mohr, Yao Li, Lucy J Navsaria, Candice L Hinkston, Sanjay S Shete, David J Margolis, Mackenzie R Wehner

Faculty, Staff and Student Publications

Importance: Actinic keratoses (AK) are common premalignant skin lesions with a small risk of progressing to cutaneous squamous cell carcinoma (SCC). There is some evidence that patients with AKs also have increased risks of other skin cancers beyond SCC. However, the absolute risks of skin cancer in patients with AKs are unknown.

Objective: To calculate the absolute and relative risks of future skin cancer in Medicare beneficiaries with AKs.

Design, setting, and participants: This retrospective cohort study was performed using a deidentified, random sample of 4 999 999 fee-for-service Medicare beneficiaries from 2009 through 2018. Patients with treated AKs were …

Skin Barrier Function: The Interplay Of Physical, Chemical, And Immunologic Properties, Paola Baker, Christina Huang, Rakan Radi, Samara B Moll, Emmanuela Jules, Jack L Arbiser

Student Papers, Posters & Projects

An intact barrier function of the skin is important in maintaining skin health. The regulation of the skin barrier depends on a multitude of molecular and immunological signaling pathways. By examining the regulation of a healthy skin barrier, including maintenance of the acid mantle and appropriate levels of ceramides, dermatologists can better formulate solutions to address issues that are related to a disrupted skin barrier. Conversely, by understanding specific skin barrier disruptions that are associated with specific conditions, such as atopic dermatitis or psoriasis, the development of new compounds could target signaling pathways to provide more effective relief for patients. …

A Desmosomal Cadherin Controls Multipotent Hair Follicle Stem Cell Quiescence And Orchestrates Regeneration Through Adhesion Signaling, William V. J. Hariton, Katja Schulze, Siavash Rahimi, Taravat Shojaeian, Laurence Feldmeyer, Roman Schwob, Andrew M. Overmiller, Beyza S. Sayar, Luca Borradori, Mỹ G. Mahoney, Arnaud Galichet, Eliane J. Müller

Department of Dermatology and Cutaneous Biology Faculty Papers

Stem cells (SCs) are critical to maintain tissue homeostasis. However, it is currently not known whether signaling through cell junctions protects quiescent epithelial SC reservoirs from depletion during disease-inflicted damage. Using the autoimmune model disease pemphigus vulgaris (PV), this study reveals an unprecedented role for a desmosomal cadherin in governing SC quiescence and regeneration through adhesion signaling in the multipotent mouse hair follicle compartment known as the bulge. Autoantibody-mediated, mechanical uncoupling of desmoglein (Dsg) 3 transadhesion activates quiescent bulge SC which lose their multipotency and stemness, become actively cycling, and finally delaminate from their epithelial niche. This then initiates a …

Advances In Melanoma: Epidemiology, Diagnosis, And Prognosis, Shayan Waseh, Jason B. Lee

Department of Dermatology and Cutaneous Biology Faculty Papers

Unraveling the multidimensional complexities of melanoma has required concerted efforts by dedicated community of researchers and clinicians battling against this deadly form of skin cancer. Remarkable advances have been made in the realm of epidemiology, classification, diagnosis, and therapy of melanoma. The treatment of advanced melanomas has entered the golden era as targeted personalized therapies have emerged that have significantly altered the mortality rate. A paradigm shift in the approach to melanoma classification, diagnosis, prognosis, and staging is underway, fueled by discoveries of genetic alterations in melanocytic neoplasms. A morphologic clinicopathologic classification of melanoma is expected to be replaced by …