Dermatology Commons^™

In Vitro And In Vivo Correlation Of Skin And Cellular Responses To Nucleic Acid Delivery, M. Bosnjak, K. Znidar, A. Sales Conniff, T. Jesenko, B. Markelc, Nina Semenova, J. Tur, K. Kohena, S. Kranjc Brezar, L. Heller, M. Cemazar

Bioelectrics Publications

Skin, the largest organ in the body, provides a passive physical barrier against infection and contains elements of the innate and adaptive immune systems. Skin consists of various cells, including keratinocytes, fibroblasts, endothelial cells and immune cells. This diversity of cell types could be important to gene therapies because DNA transfection could elicit different responses in different cell types. Previously, we observed the upregulation and activation of cytosolic DNA sensing pathways in several non-tumor and tumor cell types as well in tumors after the electroporation (electrotransfer) of plasmid DNA (pDNA). Based on this research and the innate immunogenicity of …

Diagnosis And Interpretation Of Testing For Cat Scratch Disease, Nasim Khalfe, Doris Lin

Faculty, Staff and Students Publications

Cat scratch disease (CSD) is an infectious disease caused by Bartonella henselae that presents as regional lymphadenopathy which can appear within weeks after a cat scratch. There is no gold standard for diagnosis. Rather, clinicians rely on an amalgam of criteria to make a definitive diagnosis. We describe a case of a 44-year-old woman with six cats who presented with a painful left inguinal mass, had splenic lesions on imaging, and had positive serology but a negative polymerase chain reaction test for B. henselae.

Squamous Cell Carcinoma Arising In An Epidermal Inclusion Cyst, Suzanne Alkul, Christopher N Nguyen, Nisha S Ramani, Mahmud Alkul, Ida Orengo, Ikue Shimizu, Bhuvaneswari Krishnan

Faculty, Staff and Students Publications

Squamous cell carcinoma (SCC) arising from an epidermal inclusion cyst (EIC) is uncommon. We present a case of a 70-year-old man with a scalp nodule with persistent discharge that was resected based on the clinical impression of an EIC. Histopathologic exam showed an infundibular EIC with an epidermal type of squamous epithelium; however, some of the cyst lining and lumen was replaced by squamous proliferation with malignant features. There are 56 cases of SCC arising in EICs reported in the English literature. Though suspected EICs are commonly benign, a thorough pathologic evaluation is required to rule out malignancy.

Granuloma Annulare: An Updated Review Of Epidemiology, Pathogenesis, And Treatment Options, Tejas P Joshi, Madeleine Duvic

Faculty, Staff and Student Publications

Granuloma annulare (GA) is an inflammatory granulomatous skin disease that can be localized (localized GA) or disseminated (generalized GA), with patch, perforating, and subcutaneous subtypes being less common variants of this benign condition. Recently, new research has emerged that further elucidates GA epidemiology and etiopathogenesis; importantly, new therapeutic options for GA have also been described, although there remains a paucity of randomized controlled studies. In this review, we summarize recent updates on GA epidemiology and etiopathogenesis and offer an updated review of the therapeutic options for GA currently reported in the literature. We hope that the current review galvanizes randomized …

Online Dermatology Curriculum Experiences Among Us Dermatology Residents And Faculty, Quoc-Bao D Nguyen, Caroline T Starling, Imran T Baig, Misha V Koshelev, Kelly C Nelson

Faculty, Staff and Student Publications

Many dermatology residency programs adapted to the COVID-19 pandemic by transitioning to online teaching methods. This may impact the quality of education and the satisfaction of residents. Dermatology faculty and residents nationwide were surveyed regarding their experiences with the novel online curricula. A total of 65 individuals representing at least 20 ACGME-accredited dermatology programs responded. Many programs implemented a predominantly online curriculum (78%). Most participants reported that both clinical dermatology and dermatopathology were online during the pandemic's peak (90%). Among those who had experienced a live curriculum prior to the pandemic, 49% reported that a virtual curriculum had similar effectiveness, …

Real-World Evidence Of An Emollient Device For Atopic And Contact Dermatitis In Pediatric To Adult Patients – Data From A Post-Marketing Surveillance, Adelaide Ann Hebert

Faculty, Staff and Student Publications

PURPOSE: Atopic and contact dermatitis have been attributed to skin barrier abnormalities, immune system dysfunction and inflammation leading to pruritus. As these factors may involve oxidative stress, emollient devices containing antioxidants furfuryl palmitate and tocopherol may help reduce itching and inflammation. In this study, a post-marketing questionnaire was carried out of 40 users of a novel emollient device containing furfuryl palmitate and tocopherol (Relizema™ cream), who purchased it from a pharmacy or health-care professional to ascertain the emollient device's action on itching, flushing and moisturizing.

PATIENTS AND METHODS: The post-marketing questionnaire, administered by trained pharmacy and health-care staff, collected data …

Erythema Multiforme After Third Covid-19 Vaccination (Pfizer-Biontech), Sonali Batta, Austinn C Miller, Susuana Adjei, Laurie A Temiz, Stephen K Tyring

Faculty, Staff and Student Publications

We present a case of erythema multiforme (EM) associated with a third (booster) dose of COVID-19 vaccination in a patient who had no cutaneous reactions to previous doses. To our knowledge, this is the first documented case of vaccine-associated EM occurring after a third/booster vaccination. Furthermore, our case emphasizes the need to remain vigilant for vaccine-associated EM in any patient recently vaccinated, regardless of whether previous vaccinations were administered without cutaneous reactions.

Re-Thinking Therapeutic Development For Cns Metastatic Disease, Chantal Saberian, Michael A Davies

Faculty, Staff and Student Publications

There has been unprecedented progress in the development of systemic therapies for patients with metastatic melanoma over the last decade. There is now tremendous potential and momentum to further and markedly reduce the impact of this disease. However, developing more effective treatments for metastases to the CNS remains a critical challenge for patients with melanoma. Melanoma patients with active CNS metastases have largely been excluded from both early-phase and registration trials for all currently approved targeted and immune therapies for this disease. While this exclusion has generally been justified in clinical research due to concerns about poor prognosis, lack of …

Mapping Melanoma Risk And Locating High-Need Regions For Dermoscopy And Skin Biopsy Training, Calla Hladky, Madeline Prentiss, Henry Stoddard, Kathryn Stevens, Elizabeth Seiverling, Peg Cyr

MaineHealth Maine Medical Center

Background- Dermoscopy and skin biopsy trainings have been shown to help improve PCPs’ knowledge of and confidence in detecting skin cancer. The goal of this project was to determine where to focus training efforts in order to maximize our impact and reach regions that face the highest burden of melanoma in the state.

Dermoscopic Features Of Uncomplicated Tinea Versus Steroid-Modified Tinea: An Observational Study In Indian Patients, Mithila Ninad Gadekar, Nausheen Syed, Ashutosh Chate, Sushrut Save

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Tinea is one of the most common superficial fungal skin infections. Steroid-modified tinea infections may present with atypical morphology. This study aims to observe the difference between dermoscopic features of uncomplicated dermatophytosis and steroid-modified dermatophytosis.
Methods: This observational study was conducted in 60 patients with tinea cruris, tinea corporis and tinea faciei in the outpatient dermatology department of a tertiary care center. Patients were divided into group A and group B. Group A included 30 patients with no history of steroid use in the past three months. Group B included 30 patients with a history of steroid …

Plasma Malondialdehyde Levels Related To Acne Vulgaris Severity, Fitri Puspita, Nelva Karmila Jusuf, Ariyati Yosi

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Acne vulgaris (AV) is a multifactorial disorder characterized by the formation of open and closed comedones, papules, pustules, nodules, and cysts. Oxidative stress plays a role in the pathogenesis of AV. Reactive Oxygen Species (ROS), especially lipid peroxides (LPO), plays a role in mediating acne inflammation. Malondialdehyde (MDA) is one of the byproducts of LPO commonly used as a biomarker of cell damage.
Methods: This cross-sectional analytic study consisted of sixty patients with AV. The samples were taken from the blood plasma of AV subjects. An enzyme-linked immunosorbent assay (ELISA) examination was performed. The normality of data …

The Differences Of Blood Type In Relation To Psoriasis And Its Onset: Cross Sectional Study, Nugrohoaji Dharmawan, Suci Widhiati, Triasari Oktavriana, Irene Jessica Pinarsinta Harahap

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Psoriasis is a chronic skin disease caused by inflammatory response and attacks 2% of population, with the prevalence influenced by age, geographical location, and genetic background. Until this day, there are several studies that discuss about the relationship between blood type with disease. However, discussion about the difference between blood type and the relationship with skin disease remains limited. The objective of this study is to know the relationship between blood type, psoriasis, and onset of psoriasis.
Methods: This study adopted cross-sectional design of analytic observational study. The subjects of this study were patients in Department of …

Indonesian Clinical Practice Guidelinesfor Systemic And Biologic Agents For Adults With Plaque Psoriasis, Novianto E, Budianti Wk, Fitri Em, Wiryadi Be, Soebaryo Rw, Pusponegoro Ehd, Effendi Eh, Rahmayunita G

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: In response to various biologic and non-biologic systemic agents available in Indonesia, proper and accredited treatment guidelines are required to ensure patient safety. Appropriate treatment is crucial and may affect remission time and morbidities. These guidelines were developed by the Indonesian Society of Dermatology and Venereology – Kelompok Studi Psoriasis Indonesia (INSDV-KSPI) to provide updated decision-making algorithms for the biologic and non-biologic systemic agents for the treatment of adult patients with plaque psoriasis.
Methods: Experts from twelve institutions across Indonesia were involved in developing the guidelines. Subsequently, a focus group discussed various journals, researchable questions, eligibility criteria, …

Platelet-Rich-Fibrin For Venous Leg Ulcer Therapy, Karin Rachmani, Lis Surachmiati Suseno, Mutiara Ramadhiani

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Venous leg ulcer (VLU) is a chronic condition in the chronic venous insufficiency clinical spectrum. It’s becoming a burden because of its chronicity, slower wound healing, accumulated high cost, and treatment is a challenging task. Platelet-rich-fibrin (PRF) is one of the newer modalities available for treating VLU. Previous studies have shown successful results by using PRF in leg ulcers. We reported a case of venous leg ulcer treated with PRF.
Case Illustration: A 47-year-old male came with an ulcer on the lower left leg for one year. The ulcer was preceded with a reddish, tender nodule with …

Intense Pulsed Light (Ipl) As Adjuvant Therapy For Acne Vulgaris: A Case Series, Widyaningsih Oentari, Angie Regina Sutrisno, Nelva Karmila Jusuf, Khairina Nasution

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous follicle with polymorphic clinical manifestation typically found on facial, neck and/or back area. The pathogenesis is complex and multifactorial. Management of acne vulgaris is determined based on its severity. Adjuvant therapies, such as intense pulsed light (IPL), have been described in accelerating the healing process during treatment.
Case Illustration: We report two cases regarding the usage of IPL as adjuvant therapy in acne vulgaris. Both patients were diagnosed with moderate acne vulgaris. The first patient was given topical adapalene 0.1% gel every night and sunscreen in the …

Management Of Basal Cell Carcinoma With Excision Followed By Rotation Advancement Flap, Remenda Siregar, Fitri Puspita, Widyaningsih Oentari, Ari Karmila Sari

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Basal cell carcinoma (BCC) is the most common malignant skin tumor and is derived from pluripotent cells in the basal layer of the epidermis. One of the BCC management options is surgery followed by a skin flap to close the wound defect.
Case Illustration: We present a 43-year-old woman with a major complaint of non-healing sores on the left zygomatic region, close to the medial canthus, with frequent episodes of bleeding and itching since one year before admission. The lesion was excised and followed by histopathological examination, which revealed the BCC diagnosis with tumor-free edges. Closure of …

Generalized Pustular Psoriasis And Cushing’S Syndrome In Childhood Due To Corticosteroids Misuse, Fitri Azizah, Yusnita Rahman, Rahadi Rihatmadja, Triana Agustin, Rinadewi Astriningrum, Githa Rahmayunita

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Generalized pustular psoriasis (GPP) is characterized clinically by yellowish sterile pustules surrounded by erythema. GPP in children is very rare and may appear following steroid withdrawal in psoriasis vulgaris.
Case Illustration: A 14-year-old female presented to the emergency unit with generalized erythematous plaques and multiple pustules with lake of pus after abruptly stopped oral and topical corticosteroid for two weeks. The patient had used topical and oral corticosteroids for almost a year to treat psoriasis. Physical examination revealed moderately ill and tachycardic, with short stature, moon face, amenorrhea, and multiple erythematous plaques with multiple pustules and lake …

Low-Calorie Diet Improves Pasi Score In Psoriasis Patients With Obesity: An Evidence-Based Case Report, Kristian Kuniawan, Alessa Fahira, Edwin Ti Ramadan, Windy Keumala Budianti

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: The association between psoriasis and metabolic syndrome is appealing as the two may share a similar cross-linking systemic inflammation process. The inflammation processes occurring in obesity and psoriasis may aggravate one another. This raised the question of whether a low-calorie diet would possibly reverse the aforementioned process. This study aims to determine whether calorie restriction reduces psoriasis area and severity index (PASI) in obese patients with moderate-to-severe psoriasis receiving conventional treatment compared to no calorie restriction.
Methods: We searched Pubmed/Pubmed Central, ScienceDirect, Cochrane library, EBSCOhost, and Scopus databases using keywords derived from our clinical question. The inclusion …

Steroid-Refractory Lichenoid Eruption Associated With Pembrolizumab In A Patient With Non-Small Cell Lung Cancer, Leon Kou, Sanjay Agarwal, Alyssa Miceli, Logan Kolb, Karthik Krishnamurthy, Shawn Schmieder

HCA Healthcare Journal of Medicine

Programmed cell death receptor 1 (PD-1) inhibitors are promising and effective treatments for various cancers. Cutaneous adverse events, such as lichenoid drug eruptions, are well-known common side effects associated with PD-1 inhibitors. Lichenoid drug eruptions associated with PD-1 inhibitors show rapid improvement with high potency topical steroids and do not require cessation of the offending drug. We present the case of an 84-year-old female with progressive pembrolizumab therapy-associated lichenoid eruption that was resistant to several treatments and ultimately required discontinuation of pembrolizumab and treatment with methotrexate to resolve. This report includes histological findings of the pembrolizumab-associated lichenoid eruption.

Symmetrical Drug-Related Intertriginous And Flexural Exanthema Induced By Cellulitis Prophylaxis, Tiffany Truong, Jonathan H. Ryder, Erica Lee, Clayton Mowrer, Ashley Wysong, Jasmine R. Marcelin

Graduate Medical Education Research Journal

Penicillin VK and hydroxyzine are typically well-tolerated antipruritic agents that are indicated in the prophylaxis of cellulitis. We herein report a case of a unique rash occurring during penicillin VK and hydroxyzine treatment in combination with the ingestion of cashews.

A 77-year-old male presented with new onset rash. Eleven days after the administration of penicillin VK and hydroxyzine for cellulitis prophylaxis, he developed a symmetric, erythematous, scaling rash on his buttocks and perineal region with associated pruritus and bleeding without fevers, chills, adenopathy, night sweats, or any other symptoms. He was diagnosed with symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) …