Dermatology Commons^™

Disseminated Coccidioidomycosis Discovered Through Skin Biopsy In A Pregnant Patient From Mexico, Henry Lim, Christina Guo, Marshall Hall, Christian Scheufele, Christopher M. Wong

North Texas Research Forum 2024

Introduction: Coccidioidomycosis is an infection caused by the organism Coccidioides immitis, a fungus endemic to the southwestern United States, Mexico, Central and South America. The presentation of coccidioidomycosis can range from symptoms resembling a simple upper respiratory infection, such as cough, to more severe systemic symptoms including fever, malaise, and chills. Cutaneous lesions of coccidioidomycosis demonstrate a large heterogeneity of clinical manifestations but are significant as they may be the presenting sign of disseminated disease. While usually confined to the lungs, extrapulmonary coccidioidomycosis can occur in about 1 in 200 patients, most commonly associated with immunocompromised status. Pregnancy is an …

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Tinea Corporis, Navya Peddireddy, Braden Van Alfen, Christian Scheufele, Marshall Hall, Christopher M. Wong

North Texas Research Forum 2024

Introduction: Tinea corporis, a superficial fungal skin infection, typically manifests as pruritic annular erythematous scaly plaques with central clearing. This condition can involve every body region. Here we present tinea corporis across various skin pigmentations. The goal of this presentation is to highlight distinctions and similarities in light, medium, and dark skin tones, using the Fitzpatrick scale for stratification of skin types. We hope this can aid primary care clinicians in early recognition of this common condition. Case Presentation: We present a series of cases illustrating the diverse manifestations of tinea corporis across different Fitzpatrick skin types. In Figure 2, …

Improving Lesion Diameter Reporting On Skin Biopsy Requisition Forms: A Quality Improvement Project, Christopher Wong, Christian Scheufele, Marshall Hall, Henry Lim, Daniel A. Nguyen

North Texas Research Forum 2024

Background: Skin biopsy requisition forms (SBRFs) are the primary communication tool between dermatologists and dermatopathologists. Diameters of biopsied skin lesions are frequently omitted on SBRFs. This quality improvement project aimed to increase the rate of reporting diameters of neoplasms on SBRFs from an academic dermatology outpatient clinic to greater than 65% within three years. Methods: The Plan-Do-Study-Act model was utilized. An initial audit was performed for SBRFs of biopsies obtained between July 1, 2021, and February 4, 2022 (“Cycle 1”). On February 4, 2022, the authors discussed societal guidelines for lesion diameter reporting on SBRFs (“Intervention A”). Cycle 2 prospectively …

Bilateral Corticosteroid Atrophy Mimicking Morphea En Coup De Sabre: A Case Report, Christopher M. Wong, Jade Pool, Rafael Do Valle, Cassandra Kenny, Dustin V. Wilkes

North Texas Research Forum 2024

Introduction: Corticosteroids affect numerous downstream cytokines to exert anti-inflammatory and immunosuppressive effects. Intralesional corticosteroid injection provides several advantages, including bypassing the stratum corneum to deliver a higher concentration of drug locally, while reducing systemic exposure. Intralesional corticosteroids are used in a variety of dermatologic conditions, and suboccipital steroid injection has been described as a novel treatment for cluster headaches. Case Presentation: A 52-year-old Caucasian female presented to the outpatient dermatologic clinic with indented skin lesions on the scalp and forehead for six weeks. The indentation started on her left frontal scalp and spread down gradually to her forehead and temple. …

In Tint Condition: Analysis Of Actice Ingredients In Popular Tinted Moisturizers And Facial Sunscreens, Nadia El-Hamdi, Peyton Harris, Sloan Long, Sheeva Shahinfar, Palak Parekh

Gulf Coast Division Research Symposium 2024

No abstract provided.

Etanercept-Induced Iga Vasculitis, Marshall Hall, Christian Scheufele, Christopher Wong, Michael Carletti, Stephen E. Weis

North Texas Research Forum 2024

Introduction: IgA vasculitis, formerly known as Henoch-Schoenlein purpura, is a subtype of leukocytoclastic vasculitis (LCV) and approximately 90% are seen in the pediatric population. In the adult population, it is more frequently associated with a more severe clinical course. Causes of IgA vasculitis may be idiopathic or may be secondary to infections or medications. Etanercept is a tumor necrosis factor-alpha fusion protein that has been rarely associated with LCV. Case presentation: A 59-year-old female with a 2-year history of red-to-violaceous purpuric papules on the bilateral lower extremities. She noted that after etanercept administration her lesions would get redder and would …

An Unusual Presentation Of Tapinarof-Induced Folliculitis, Ysabelle Martinez, Christian J. Scheufele, Christopher Wong, Stephen E. Weis

North Texas Research Forum 2024

Introduction: Tapinarof 1% cream is a novel non-steroidal topical medication recently FDA-approved for plaque psoriasis. Tapinarof’s non-steroidal mechanism allow for longer treatment periods without topical corticosteroid side effects e.g. skin atrophy, hypopigmentation, telangiectasias, and striae. Adverse events identified during pivotal trials may not be completely defined before widespread clinical use. This case reports a new presentation of folliculitis with tapinarof use. Case Presentation: A 25-year-old female with trisomy-21 presented for a rash on her left lower leg. The eruption began one year earlier. The eruption was not associated with pruritus, joint pain or nail changes. A clinical diagnosis of …

Crusted Scabies: A Case Report, Marshall Hall, Philip Oh, Michael Carletti, Stephen E. Weis

North Texas Research Forum 2024

Introduction: Scabies is a parasitic dermatologic condition that often presents as an extremely pruritic rash. A rare and highly contagious variant of scabies is crusted scabies, formerly known as Norwegian scabies. Crusted scabies presents with hyperkeratotic papules and plaques, most commonly on the palms and soles. Due to the variety of presentations seen in scabies, it can be difficult to diagnose. Case presentation: Case 1: An 89-year-old male with a history of dementia, anxiety, and benign prostatic hyperplasia presented with a 2-month history of a generalized pruritic rash. He lived in a memory care center. The physical exam showed an …

Favorable Benefits Of Autologous Serum Therapy In Chronic Spontaneous Urticaria, Sanjana Agrahara Shantharaju, Amrita Hongal, Diksha Gupta, Girishma Jonnagadla

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: In chronic spontaneous urticaria (CSU), autologous serum therapy (AST) is an alternative treatment modality that provides promising benefit of extended relief period without side effects and economic burden of pills. This study aimed to assesses the efficacy of AST in CSU patients irrespective of their autologous serum skin test (ASST) result.

Methods: Patients were enrolled based on inclusion and exclusion criteria after taking written informed consent. A detailed history and clinical examination & relevant investigations were done. ASST was performed and irrespective of the test result AST was given to all study subjects that included weekly intramuscular …

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 & 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 …

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 & 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 …

Lichen Amyloidosis Treated With Topical Combination Therapy And Narrowband Ultraviolet B Phototherapy, Ulfah Hasna Hasibah, Siti Aisha Nabila Ferina, Eka Komarasari, Prima Kartika Esti, Lenti Perangin Angin

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Lichen amyloidosis (LA) is characterized by linear rows of firm, pigmented, grouped, hyperkeratotic papules that can form a plaque, usually occurring on the shins and forearms, with intense itch as the prominent symptom.

Case Illustration: A 57-year-old female complained of brown spots on her shins and arms that gradually thickened six years ago. The lesions were brown, multiple, discrete, slightly scaly papules forming hyperpigmented plaques. The result of the histopathology examination showed an acanthotic epidermis with hyperkeratotic foci and eosinophilic amorphous mass deposits in the papillary dermis with brown pigments. The working diagnosis was lichen amyloidosis. Topical …

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 & 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 …

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 & 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 …

Item Generation In The Development Of A Questionnaire For Predicting Multidrug Therapy Compliance In Leprosy, Yulia Siskawati, Sali Rahadi Asih, Aria Kekalih, Sri Linuwih Menaldi, Herqutanto Herqutanto, Kusmarinah Bramono

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Lengthy therapeutic regimens in leprosy are prone to defaults, contributing to more antibiotic-resistant Mycobacterium. Intervening patients’ medical habits midway would be more complicated than understanding their perception of undergoing such regimens in advance. We study the factors considered relevant to leprosy patients’ compliance to construct a novel self-reporting questionnaire that can predict the patients’ adherence before initiating multidrug therapy.

Methods: According to the Delphi methods, we conducted three rounds of interviews with twenty-three respondents from various backgrounds, including dermatologists, government officials, healthcare workers, and patients with leprosy, to infer the associated factors of the included items. Each …

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 & 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 …

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 & 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 …

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 & 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 …

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 …