Dermatology Commons^™

Speaking Good (And Safe) Dermatologic English, Lawrence Charles Parish, W. Clark Lambert

Department of Dermatology and Cutaneous Biology Faculty Papers

Periodically, our feathers become ruffled about the use or misuse of English in dermatology. 1, 2 We have railed against the derogatory term for crusted scabies3, suggested a contrived term to lessen the burden connoted by decubitus ulcers4, and discouraged renaming atopic dermatitis to atopiform dermatitis. 5 Imagine what the dermatologic lexicographers, Morris Leider (1908-1987) 6and Morris Rosenbaum, might be saying were they here today. 7

Using an appropriate word or words to describe an anatomic part or a portion of the skin is just good medical practice. We do not believe a lightning bolt will descend as portrayed in …

The Practice Of Dermatology Ain't What It Used To Be: The Preauthorization Catastrophe., Lawrence Charles Parish, Jennifer L. Parish, W. Clark Lambert, Carmela Ciferni

Department of Dermatology and Cutaneous Biology Faculty Papers

Many of us remember when a dermatology practice was cash only, and $5 cash was considered appropriate for a specialist. The general practitioner received $2 for an office visit and $4 for a home call. If you recall those days, “dearie you are much older than I.” 1

Not so long ago, the practitioner was confronted with obtaining a referral from the Health Maintenance Organization (HMO) in order to see the patient. Some plans permitted only four such referrals for specialists, annually, so the patient, who might have had a visit or two for gastritis and a similar number of …

Photodynamic Therapy As A New Therapeutic Approach Of Oral Lichen Planus, Sandra Milena Tocut, Madalina Irina Mitran, Cristina Iulia Mitran, Mircea Tampa, Maria Isabela Sarbu, Gabriela Loredana Popa, Simona Roxana Georgescu

Journal of Mind and Medical Sciences

Oral lichen planus (OLP) is a chronic, immunologically mediated disease, defined by periods of exacerbation and quiescence. The disease is associated with a low mortality risk, but in some instances, morbidity can be important, especially in extensive, erosive forms, with a significant impact on the quality of life. OLP is a chronic T-cell mediated inflammatory disease involving the oral cavity, the most common lesions being located on the oral mucosa, tongue and gums. Its etiology remains in part unknown, but several factors proved to be involved in the development of the disease (drugs, dental materials, infectious agents, psychological factors, autoimmunity …

Validity Of An Atopic Dermatitis Outcome Measure For Real-World Clinical Practice, Christina Topham, Dylan Haynes, Molly Brazil, Eric Simpson

OHSU-PSU School of Public Health Annual Conference

Introduction: Atopic dermatitis (AD) is the most common chronic inflammatory skin disease in the United States. AD is associated with reduced quality of life and substantial financial costs, making it burdensome at an individual and population level. Disease severity outcome measures are validated tools to assess severity and therapeutic response. Recent consensus statements have identified gold-standard outcome measures for AD in clinical trials, but further work is needed evaluating outcome measures feasible for clinical practice.

Objective: To investigate the validity and feasibility of the product of investigator global assessment and body surface area (IGA x BSA) as an outcome measure …

Improving Access To Rare Disease Clinical Trials Through Telemedicine, Dylan Haynes, Christina Topham, Teri Greiling

OHSU-PSU School of Public Health Annual Conference

Introduction: Rare diseases affect nearly 400 million individuals worldwide. The geographic density of any single disease, however, can prohibit access to care and research efforts. Telemedicine has improved access barriers in the clinical setting, though its application in rare disease trials has not been evaluated.

Objective: To assess the impact on access to care of videoconferencing in a rare disease clinical trial.

Materials and Methods: Preliminary analysis was performed on the first five participants to complete our ongoing trial (NCT03485976) evaluating the efficacy of ixekizumab for the treatment of pityriasis rubra pilaris. Participants were required to travel to Oregon Health …

Risk Benefit Analysis Of Treatments For Cystic Acne, Callie Elliott

Undergraduate Honors Theses

Acne is a prevalent skin disorder and is displayed through various different incidences. Cystic acne, a severe form of acne that is difficult to treat, reaches deep into the skin underneath the epidermis layer and produces painful, inflamed cysts that contain sebum, dead skin cells, and Propionobacterium acnes, the acne causing bacteria. Because this is an uncomfortable type of acne and is tough to treat, researchers have developed and tested a number of treatments to determine the best course of treatment for reducing and potentially eradicating cystic acne. These treatments are most commonly in the form of systemic or topical …

Guidance Of Sentinel Lymph Node Biopsy Decisions In Patients With T1-T2 Melanoma Using Gene Expression Profiling., John T. Vetto, Eddy C. Hsueh, Brian R. Gastman, Larry D. Dillon, Federico A. Monzon, Robert W. Cook, Jennifer Keller, Xin Huang, Andrew Fleming, Preston Hewgley, Pedram Gerami, Sancy Leachman, Jeffrey D. Wayne, Adam C. Berger, Martin D. Fleming

Department of Surgery Faculty Papers

AIM: Can gene expression profiling be used to identify patients with T1-T2 melanoma at low risk for sentinel lymph node (SLN) positivity?

PATIENTS & METHODS: Bioinformatics modeling determined a population in which a 31-gene expression profile test predicted <5% SLN positivity. Multicenter, prospectively-tested (n = 1421) and retrospective (n = 690) cohorts were used for validation and outcomes, respectively.

RESULTS: Patients 55-64 years and ≥65 years with a class 1A (low-risk) profile had SLN positivity rates of 4.9% and 1.6%. Class 2B (high-risk) patients had SLN positivity rates of 30.8% and 11.9%. Melanoma-specific survival was 99.3% for patients ≥55 years with class 1A, T1-T2 tumors and 55.0% for class 2B, SLN-positive, T1-T2 tumors.

CONCLUSION: The 31-gene expression profile test identifies patients …

Pediatric Erythromelalgia Treated With Epidural Ropivacaine Infusion, Caroline E. Lee, Kelly Paulk, Kristen Garvie, Elizabeth Grieshaber, Jeffrey Carter, Brian Ball

School of Medicine Faculty Publications

No abstract provided.

Multiple Cellular Neurothekeomas, Megan A. Jones Do, Nektarios I. Lountzis Md, Joshua M. Levin Md

Department of Medicine

No abstract provided.

Sterile Neutrophilic Folliculitis With Vasculopathy In A Young Male Patient With Infective Endocarditis, Carl Barrick Do, Naeha Gupta Do, Richard Mccalin Md, Stephen M. Purcell Do

Department of Medicine

No abstract provided.

Sapho Syndrome, Diana A. Rivers Do, Megan A. Jones Do, Joshua M. Levin Md

Department of Medicine

No abstract provided.

Lichen Planus Pemphigoides In A Patient After Combination Ipilimumab And Nivolumab Therapy, Steven Oberlender Md, Phd, Marc T. Mitton Do

Department of Medicine

No abstract provided.

Shiitake Mushroom-Induced Flagellate Dermatitis, Claire O. Dorfman Do, Nektarios I. Lountzis Md

Department of Medicine

No abstract provided.

Reactive Angioendotheliomatosis, Naeha Gupta Do, Richard Mccalin Md, Nektarios I. Lountzis Md

Department of Medicine

No abstract provided.

An Atypical Presentation Of A Rare Disease, Elizabeth Schoenberg, Kathleen P. Mcguinn, Deirdre Connolly, Sherry Yang

Department of Dermatology and Cutaneous Biology Faculty Papers

A 76-year-old white woman presented for evaluation of asymptomatic skin lesions on her right shin, right buttock, and left arm. All lesions initially underwent slow growth and plateaued and then remained stable in size. A complete review of systems revealed normal results. She had 3 well-demarcated erythematous round plaques ranging from 1.5 to 3 cm, all with a central depression, yellow hue, and prominent telangiectasias (Figs 1 and 2). An excisional biopsy was performed. Histologically, there were palisading granulomas within the papillary and reticular dermis, predominantly composed of a histiocytic cell population with multiple large giant cells (S100^-; …

Genetic Susceptibility To Alopecia., Jouni Uitto

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Efficacy Of Combination Of Immunotherapies In A Murine In A Murine Squamous Cell Carcinoma Model, E. Correia, C. Portocarrero, U. Rodeck

Phase 1

Introduction: Head and neck squamous cell carcinomas (HNSCCs) are a type of neoplasm found in the epithelium of the oral cavity, oropharynx, nasopharynx, larynx, or hypopharynx. Recent evidence has demonstrated that 70-90% of HNSCC are associated with Human Papillomavirus (HPV), particularly strain 16 producing oncogenic proteins E6/E7. Currently, HNSCCs are treated with surgery, chemotherapy, and radiation, however immunotherapy with immune checkpoint (PD-1) blocking agents promises to improve outcomes in HNSCC.

Objective: This study examined the therapeutic effects of dual and triple combination immunotherapies in a mouse model of HPV-associated HNSCC.

Methods: Treatment modalities included a tumor vaccine (attenuated Listeria monocytogenes …

High Density Of Tumor-Associated Macrophage Staining Correlates With Poor Clinicopathologic Markers In Head And Neck Squamous Cell Carcinoma: A Meta-Analysis, Alexander Knops, Ba, Ayan Kumar, Bs, Brian Swendseid, Md, Ubaldo E. Martinez-Outshoorn, Md, Larry Harshyne, Phd, Nancy Philp, Phd, Ulrich Rodeck, Md, Phd, Christopher Snyder, Adam Luginbuhl, Md, David Cognetti, Md, Jennifer Johnson, Md, Joseph Curry, Md

Phase 1

Background: Head and neck squamous cell carcinoma (HNSCC) develops within a complex cellular microenvironment that promotes tumor growth, but also represents many potential therapeutic targets. Macrophage presence within that environment has been implicated in the growth, aggression, and persistence of HNSCC. Current literature reports variable degrees of association between tumor-associated macrophage (TAMs) density and clinicopathologic markers of disease.Inconsistent findings may result from grouping of TAM subtypes, which include both M1 (pro-inflammatory) and M2 (immunosuppressive). Our aim is to define the prognostic significance of the phenotypes of tumor-associated macrophages in HNSCC.

Methods: We conducted a meta-analysis of the existing publications investigating …

Total Body Skin Exam And Number Needed To Screen, Audra Hugo, Michael Bui, Alexander Sherban, Shayan Waseh, Elizabeth Jones, Md

Phase 1

Introduction/Background: Skin cancer screening could impact mortality and morbidity in US adults; however, the effectiveness of widespread screening remains unclear. Further research is necessary to determine what age groups, with what risk factors, might benefit from routine total body skin exams (TBSE) in the US.

Objective: This study sought to determine, on average, the number of patients, per decade, needed to screen via TBSE to identify one person with skin cancer.

Methods: A retrospective review of Jefferson Dermatology outpatient data in Epic was conducted. All patient charts from 1/1/2017 - 1/1/2018 were reviewed if they received a TBSE. The type …

The Doctor's Office Is The Best Setting For Most Cutaneous Procedures., Hannah J. Anderson, Matthew Keller

Department of Dermatology and Cutaneous Biology Faculty Papers

Although most dermatologic procedures are done in an office setting, some providers are performing them instead in ambulatory surgery centers (ASCs). This relocation of care comes with significantly higher expenses for patients and insurers. Compounding the issue of increased costs is the paucity of evidence demonstrating better outcomes associated with the use of ASCs. The most common cutaneous procedures have low complication rates when performed in an office setting and regular use of ASCs for these procedures is not justified.