Dermatology Commons^™

Trigeminal Trophic Syndrome In A Pediatric Patient With Diffuse Intrinsic Pontine Glioma., Ezra Hoover, Ryan Jay, Patricia Witman

Ambulatory and Primary Care Articles

A 13-year-old girl with a history of diffuse intrinsic pontine glioma (DIPG) suffered from progressively worsening facial ulcerations secondary to paresthesia-induced self-excoriation. She was diagnosed with trigeminal trophic syndrome (TTS) induced by DIPG and struggled to heal her lesions in the background of this excoriation disorder. A multidisciplinary approach that included mood disorder management with sertraline and amitriptyline helped diminish paresthesia, improve her quality of life, and promote healing of the ulcers despite the progression of her DIPG. This case highlights the multifactorial complexity of TTS in pediatric patients and the need for successful management strategies.

Calciphylaxis, A Case Series: The Importance Of Early Detection, Nikita Sijapati, Suy Sen Hung Fong, Omar Ansari, Subhasis Misra, Edgar Mercado, My Myers, Vijay Narasimha

HCA Healthcare Journal of Medicine

Introduction

Calciphylaxis is a rare disorder that involves the formation of cutaneous, subcutaneous, and vascular calcifications. Although it is predominantly seen in patients with end-stage renal disease (ESRD), it has also been reported in patients without chronic kidney disease. The presence of multiple risk factors, a poorly understood mechanism, high mortality, and the lack of standardized treatment make calciphylaxis an important subject.

Case Presentation

We describe the clinical presentation, disease course, and management of 3 patients with calciphylaxis and also provide a literature review. In all 3 patients, the diagnosis was confirmed histologically, and the management involved the continuation of …

Demographic Data Associated With Digital Inequity Reported In Patient-To-Provider Teledermatology Studies In The United States From 2011 To 2021: Scoping Review, John Miller, Patrick Ioffreda, Shannon Nugent, Elizabeth Jones

Department of Dermatology and Cutaneous Biology Faculty Papers

Background: Patient-to-provider teledermatology relies on a patient’s access to technology to ensure a successful visit. However, access to broadband internet and technology varies across populations in the United States—leading to the digital divide. While teledermatology has been recognized as a model to improve access, little is known about how often demographic data associated with digital inequity are captured in studies. Objective: Given the expansion of teledermatology over the past decade, we sought to determine how often demographic data associated with digital inequity are reported in patient-to-provider teledermatology studies. Methods: A scoping literature review search was conducted using the search term …

Multiple Fibrofolliculomas Within A Fibrous Cephalic Plaque In A Patient With Tuberous Sclerosis, Justin Raman, Annie Jin, Jennifer J. Parker, Conor M. Vickers, Daniela M. Proca, Sylvia Hsu, Jason B. Lee

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Teledermatology In Medical Student, Postgraduate Trainee, And Global Dermatology Education: A Systematic Review, Heli Patel, Rishab Revankar, Aly Valliani, Nikita Revankar, Shivani Yerigeri, Nadine Kaskas, Benjamin Stoff

Student Papers, Posters & Projects

BACKGROUND: In the aftermath of the COVID-19 pandemic, medical students and residents in the U.S. and globally have gained more exposure to teledermatology, both for the purposes of clinical practice and education.

OBJECTIVE: We conducted a systematic review to assess outcomes from teledermatology interventions for dermatology trainees in the U.S. and globally in accordance with Preferred Reporting Items for Systematic Reviews (PRISMA).

METHODS: We searched MEDLINE, EMBASE, Web of Science, and Cochrane CENTRAL for articles written in English and published database inception to November 20, 2022.

RESULTS: In total, 15 studies met the inclusion criteria. Outcomes reported ranged broadly from …

Atezolizumab-Induced Psoriasiform Drug Eruption Successfully Treated With Ixekizumab: A Case Report And Literature Review, Laura Gleason, E Hunter, Alexa J. Cohen, Jayson Suriano, Neda Nikbakht

Department of Dermatology and Cutaneous Biology Faculty Papers

Immune-related cutaneous adverse events (ircAE) are commonly seen with immune checkpoint inhibitors such as atezolizumab. Atezolizumab-induced psoriasis has been previously reported as an ircAE, especially in patients with pre-existing psoriasis. The severity of the reaction influences treatment of the cutaneous eruption. Biologics should be considered as a treatment option for severe refractory psoriasiform eruptions even in patients with complex medical conditions like chronic infections and malignancy. This is the first reported case of successful treatment of atezolizumab-induced psoriasiform eruption with ixekizumab, a neutralizing IL17A monoclonal antibody, to the best of our knowledge. Herein, we present a 63-year-old man with a …

Itch And Janus Kinase Inhibitors, Yujin Han, Yu Ri Woo, Sang Hyun Cho, Jeong Deuk Lee, Hei Sung Kim

Faculty, Staff and Student Publications

Itch is a common skin symptom, with complex aetiology and pathogenesis. It is mediated by 2 pathways, the histaminergic and non-histaminergic pathways. Chronic itch is understood to be processed by the latter and is difficult to treat with traditional pruritus therapies. The Janus kinase and signal transducer and activator of transcription pathway is a signalling mechanism that regulates gene expression through various cytokines. Janus kinase inhibitors, which have been tested and used for several autoimmune diseases, have also been shown to be effective for itch through clinical trials and case reports. Janus kinase inhibitors could be a good choice for …

Reduced Spag17 Expression In Systemic Sclerosis Triggers Myofibroblast Transition And Drives Fibrosis, Paulene Sapao, Elisha D O Roberson, Bo Shi, Shervin Assassi, Brian Skaug, Fred Lee, Alexandra Naba, Bethany E Perez White, Carlos Córdova-Fletes, Pei-Suen Tsou, Amr H Sawalha, Johann E Gudjonsson, Feiyang Ma, Priyanka Verma, Dibyendu Bhattacharyya, Mary Carns, Jerome F Strauss, Delphine Sicard, Daniel J Tschumperlin, Melissa I Champer, Paul J Campagnola, Maria E Teves, John Varga

Faculty, Staff and Student Publications

Systemic sclerosis (SSc) is a clinically heterogeneous fibrotic disease with no effective treatment. Myofibroblasts are responsible for unresolving synchronous skin and internal organ fibrosis in SSc, but the drivers of sustained myofibroblast activation remain poorly understood. Using unbiased transcriptome analysis of skin biopsies, we identified the downregulation of SPAG17 in multiple independent cohorts of patients with SSc, and by orthogonal approaches, we observed a significant negative correlation between SPAG17 and fibrotic gene expression. Fibroblasts and endothelial cells explanted from SSc skin biopsies showed reduced chromatin accessibility at the SPAG17 locus. Remarkably, mice lacking Spag17 showed spontaneous skin fibrosis with increased …

Lichenoid Drug Eruption Induced By Erenumab, Meryl Musicante, Yamila Goenaga-Vázquez, Natasha Klimas

Faculty, Staff and Student Publications

No abstract provided.

Risankizumab In Patients With Moderate-To-Severe Atopic Dermatitis: A Phase 2, Randomized, Double-Blind, Placebo-Controlled Study, Stephen K Tyring, Phoebe Rich, Yayoi Tada, Stefan Beeck, Izabella Messina, Jie Liu, Xiaohong Huang, Stephen Shumack

Faculty, Staff and Student Publications

INTRODUCTION: Atopic dermatitis (AD) is a heterogeneous disease, with involvement of the T-helper cell (Th) 2, Th22, and potentially Th17 pathways, supporting the use of interleukin (IL)-23 and IL-22 blockade in AD.

METHODS: This phase 2, multicenter, randomized, double-blind, placebo-controlled trial (NCT03706040) evaluated the efficacy and safety of risankizumab, an IL-23 inhibitor, in patients (≥ 12 years old) with moderate-to-severe AD, defined by an Eczema Area and Severity Index (EASI) ≥ 16, affected body surface area ≥ 10%, and a Validated Investigator Global Assessment for AD (vIGA-AD) score ≥ 3. Patients were randomized 2:2:1 to 16-week treatment with risankizumab 150 …

Subacute Cutaneous Lupus Erythematosus After Mrna-Based Sars-Cov-2 Vaccination, Sarah Rimmer, Long Ly, Erin Boh

School of Medicine Faculty Publications

No abstract provided.

Rare Variants Of Dermatofibrosarcoma Protuberans: Clinical, Histologic, And Molecular Features And Diagnostic Pitfalls, Celestine M Trinidad, Sintawat Wangsiricharoen, Victor G Prieto, Phyu P Aung

Faculty, Staff and Student Publications

Dermatofibrosarcoma protuberans (DFSP) is a dermal malignant mesenchymal tumor. Most variants are associated with a high risk of local recurrence and a low risk of metastasis. The classic histomorphology of this tumor is made up of uniform, spindle-shaped cells, arranged in a storiform pattern. Tumor cells characteristically infiltrate the underlying subcutis in a honeycomb pattern. Less common variants of DFSP have been identified: myxoid, pigmented, myoid, granular cell, sclerosing, atrophic, and fibrosarcomatous. Only the fibrosarcomatous variant has been shown to differ significantly from classic DFSP in terms of clinical outcome; fibrosarcomatous DFSP has been shown to be associated with a …

Expert Opinions And Clinical Experiences With Chlormethine Gel As Maintenance Treatment For Patients With Mycosis Fungoides, Larisa Geskin, Christiane Querfeld, Emmilia Hodak, Neda Nikbakht, Evangelia Papadavid, Marco Ardigò, Ulrike Wehkamp, Martine Bagot

Department of Dermatology and Cutaneous Biology Faculty Papers

Maintenance treatment can be recommended for patients with mycosis fungoides (MF) whose disease responds to primary treatment. While positive outcomes have been observed in small studies with maintenance therapy, there is a lack of practical guidelines and agreement on when and how maintenance therapy for MF should be approached. In this article, we discuss expert opinions and clinical experiences on the topic of maintenance therapy for patients with MF, with a focus on chlormethine gel. Ideally, patients should have a durable response before initiating maintenance therapy. The definition of and required duration of durable response are topics that are open …

Topical Antibiotic Treatment In Dermatology, Matthew Dallo, Kavina Patel, Adelaide A Hebert

Faculty, Staff and Student Publications

Many indications in dermatology can be effectively managed with topical antibiotics, including acne vulgaris, wound infections, secondarily infected dermatitis, and impetigo. Dermatologists must be familiar with the wide spectrum of topical antibiotics available, including indications, mechanisms of action, adverse events, and spectra of activity. Dermatologists must also keep antibiotic resistance in mind when utilizing these medications. Due to the widespread use of topical antibiotics and their importance in dermatology, a literature review was performed using a systematic search of PubMed and Google Scholar with the terms topical antibiotics, skin infections, dermatology, antimicrobials, and inflammatory dermatoses to identify English-language articles published …

A Gain-Of-Function Tpc2 Variant R210c Increases Affinity To Pi(3,5)P2 And Causes Lysosome Acidification And Hypopigmentation, Qiaochu Wang, Zengge Wang, Yizhen Wang, Zhan Qi, Dayong Bai, Chentong Wang, Yuanying Chen, Wenjian Xu, Xili Zhu, Jaepyo Jeon, Jian Xiong, Chanjuan Hao, Michael Xi Zhu, Aihua Wei, Wei Li

Faculty, Staff and Student Publications

Albinism is a group of inherited disorders mainly affecting skin, hair and eyes. Here we identify a de novo point mutation, p.R210C, in the TPCN2 gene which encodes Two Pore Channel 2 (TPC2) from a patient with albinism. TPC2 is an endolysosome and melanosome localized non-selective cation channel involved in regulating pigment production. Through inside-out recording of plasma membrane targeted TPC2 and direct recording of enlarged endolysosomal vacuoles, we reveal that the R210C mutant displays constitutive channel activation and markedly increased affinity to PI(3,5)P2. Mice harboring the homologous mutation, R194C, also exhibit hypopigmentation in the fur and skin, as well …

Racial Differences In Perceived Risk And Sunscreen Usage, Rebecca Fliorent, Alicia Podwojniak, Lianne Adolphe, Katharine Milani

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Background Although White individuals have higher incidence of melanoma, clinical outcomes are worse among patients with skin of color. This disparity arises from delayed diagnoses and treatment that are largely due to clinical and sociodemographic factors. Investigating this discrepancy is crucial to decrease melanoma-related mortality rates in minority communities. A survey was used to investigate the presence of racial disparities in perceived sun exposure risks and behaviors. Methods A survey consisting of 16 questions was deployed via social media to assess skin health knowledge. Over 350 responses were recorded, and the extracted data were analyzed using statistical software. Results Of …

Inherited Human Itk Deficiency Impairs Ifn-Γ Immunity And Underlies Tuberculosis, Masato Ogishi, Rui Yang, Rémy Rodriguez, Dominic P Golec, Emmanuel Martin, Quentin Philippot, Jonathan Bohlen, Simon J Pelham, Andrés Augusto Arias, Taushif Khan, Manar Ata, Fatima Al Ali, Flore Rozenberg, Xiao-Fei Kong, Maya Chrabieh, Candice Laine, Wei-Te Lei, Ji Eun Han, Yoann Seeleuthner, Zenia Kaul, Emmanuelle Jouanguy, Vivien Béziat, Leila Youssefian, Hassan Vahidnezhad, V Koneti Rao, Bénédicte Neven, Claire Fieschi, Davood Mansouri, Mohammad Shahrooei, Sevgi Pekcan, Gulsum Alkan, Melike Emiroğlu, Hüseyin Tokgöz, Jouni Uitto, Fabian Hauck, Jacinta Bustamante, Laurent Abel, Sevgi Keles, Nima Parvaneh, Nico Marr, Pamela L Schwartzberg, Sylvain Latour, Jean-Laurent Casanova, Stéphanie Boisson-Dupuis

Department of Dermatology and Cutaneous Biology Faculty Papers

Inborn errors of IFN-γ immunity can underlie tuberculosis (TB). We report three patients from two kindreds without EBV viremia or disease but with severe TB and inherited complete ITK deficiency, a condition associated with severe EBV disease that renders immunological studies challenging. They have CD4+ αβ T lymphocytopenia with a concomitant expansion of CD4-CD8- double-negative (DN) αβ and Vδ2- γδ T lymphocytes, both displaying a unique CD38+CD45RA+T-bet+EOMES- phenotype. Itk-deficient mice recapitulated an expansion of the γδ T and DN αβ T lymphocyte populations in the thymus and spleen, respectively. Moreover, the patients' T lymphocytes secrete small amounts of IFN-γ in …

Unveiling The Mystery: Paraneoplastic Syndrome Masquerading As Skin Thickening And Arthritis, Megan Schermerhorn, Md, Qian Leng, Md, Atish Dey, Md

Poster Presentations

No abstract provided.

Puzzling Painful Cutaneous Nodules: A Sign To Dig Deeper, Preetha Kamath, Angelia Stepien, Brandon Beal, Courtney Bernett, Karthik Krishnamurthy

South Atlantic Division GME Research Day 2023

No abstract provided.

Forum Discussion Indicates Favorable Views Of Jak Inhibitors For Atopic Dermatitis, Nicole Levin, Karan Rajalingam, Ashley Wentworth, Leila Tolaymat

East Florida Division GME Research Day 2023

Background: There is increasing discussion online concerning the management of atopic dermatitis (AD). Patients often document their subjective experience of a given treatment. It remains to be determined if the experiences vary based on treatment or align with efficacy.

Objective: To determine which treatments are associated with positive or negative experiences.

Methods: The largest online AD platform was searched for posts that only discussed a singular treatment. The discovered 28,159 posts were rated “positive” or “negative” by DistilBERT, a pre-trained sentiment analysis model that derives from BookCorpus, a collection of 11,038 books containing 74 million sentences. Positive sentiment proportions (PSP), …