Dermatology Commons^™

Eccrine Poroma: The Prominent Mimicker, Nahla Shihab, Inge Ade Kristanti, Adhimukti T. Sampurna, Larisa Paramitha Wibawa

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Eccrine poroma (EP) is an adnexal benign tumor arising from the eccrine duct epithelium. The appearance of EP can mimic benign and malignant skin tumors, thus often making the diagnosis delayed or inaccurate.

Case Illustration: We report two cases of EP, with clinical and dermoscopic features mimicking Bowen’s disease, verruca vulgaris, pyogenic granuloma, skin metastases of breast cancer, and amelanotic melanoma. Both patients were surgically excised and biopsied. Histopathology examination of both cases revealed eccrine poroma.

Discussion: Both cases showed similarity with the theories, that EP is most found in middle age population and its predilection …

Elevated Homeostatic Model Assessment Of Insulin Resistance Level Increases The Risk Of Acne, Stefani Nurhadi, Igaa Praharsini, Aagp Wiraguna

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Insulin resistance and high carbohydrate diets are currently considered to be influential in acne aetiology. Insulin is a hormone that does not only regulate the concentration of blood glucose but also affects the production of sebum and through the Insulin Growth Factor-1 (IGF-1) receptor stimulates androgen synthesis which will increase the proliferation of keratinocytes duct and the production of sebum in acne of the pilosebaceous.

Methods: This is a cross sectional observational analytic study involving 38 acne patients and 38 controls. This study aims to determine whether the increase in Homeostatic Model Assessment of Insulin Resistance …

Efficacy Of Low Level Laser Therapy In The Treatment Of Postherpetic Neuralgia, Lili Legiawati, Marsha Bianti

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Postherpetic neuralgia (PHN) is the most common complication of herpes zoster (HZ) and defined as pain that persists for more than 90 days after the onset of HZ rash. The chronic pain of PHN is debilitating and often associated with significant morbidity. It is a neuropathic pain and manifests as allodynia, hyperalgesia, or spontaneous pain. Although it is not considered to be life-threatening, sometime HZ is inadequately treated and may result in more severe PHN. Various treatment protocols for PHN are available; however, the result remains unsatisfactorily. The use of low level laser therapy (LLLT) in pain management …

Diagnostic Procedures In Pediatric Dermatology, Arini Astasari Widodo, Githa Rahmayunita, Triana Agustin, Rinadewi Astriningrum

Journal of General - Procedural Dermatology and Venereology Indonesia

Diagnostic procedures in pediatric dermatology are different and significantly more challenging than those in adult patients, especially on how to approach the patients. We need to acknowledge that pediatric patients have unique anatomical, physiological, and psychological aspects. Compared to adults, children have smaller procedure area, are less cooperative, and more difficult to understand. For these reasons, we should perform diagnostic procedures on children cautiously. Having extensive knowledge in this field can facilitate us to carry out an ethical, efficient, targeted procedure with less risk. This article reviewed the most appropriate, most comfortable, and least invasive diagnostic procedures for children. Some …

Profile Of Vitiligo Patients And Distribution Of Narrowband-Uvb Therapy At Dr. Cipto Mangunkusumo General Hospital, Lis Surachmiati Suseno, Putu Martha Gerynda Sukma, Rahadi Rihatmadja, Triana Agustin, Githa Rahmayunita, Endi Novianto

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Vitiligo is a disease marked by depigmented macules. Prevalence of vitiligo varies between 0.1- 2.3% worldwide. The objectives of this study are to identify the socio-demographic profile of vitiligo patients and distribution of narrowband-UVB given as a treatment modality. However, in Indonesia, including at dr. Cipto Mangunkusumo General Hospital, there has not been any study on the profile of vitiligo patients. Therefore, a preliminary study on the patients’ profile would be very useful for healthcare providers in calculating the need for narrowband-UVB equipment and evaluation of its current use.

Methods: A retrospective descriptive study, using secondary data …

Cumulative Exposure To Solar Ultraviolet A & B Increases Apoptosis Of Peripheral Blood Cutaneous Lymphocyte Antigen (Cla)+ T-Lymphocytes In Outdoor Workers, Afif Nurul Hidayati, Saut Sahat Pohan, Widodo J. Pudjirahardjo, Isaac Effendy

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Exposure to ultraviolet A & B (UVA-UVB) plays a role in the survival of human life, but it may cause negative effects, such as immunosuppression and skin cancer. The effect of solar UVA-UVB exposure on apoptosis (Bax/Bcl-2 ratio) of peripheral blood cutaneous lymphocyte antigen (CLA)+ T-lymphocyte; the immune competent cells in the skin, has not been investigated. Apoptosis of peripheral blood CLA+ Tlymphocyte affects its function; which serves as the skin's resistance and is involved in infectious diseases, skin inflammation, and malignancies. This study observed the effect of solar UVA-UVB to apoptosis (Bax/Bcl2 ratio) of peripheral blood CLA+ …

Agep Overlap Induced By Hydroxychloroquine: A Case Report And Literature Review., Christopher Mercogliano, Muhammad Khan, Catherine Lin, Elan Mohanty, Ryan Zimmerman

Reading Hospital Internal Medicine Residency

Acute Generalized Exanthematous Pustulosis (AGEP) is a rare drug reaction manifesting as pustular lesions with surrounding erythema following exposure. The disease is often self-limited and treatment is supportive. It may present in an atypical variant with vesicles that desquamate into erosions, which classifies the disease as an AGEP/SJS Overlap. This overlap syndrome can carry a substantial mortality rate and necessitate elevation in the level of care. Hydroxychloroquine has been implicated in cases of AGEP, and we present a case of AGEP/SJS overlap attributed to this common medication. Given the prevalence of drug eruptions, it is critical for the physicians to …

Impact Of Copper And Iron Binding Properties On The Anticancer Activity Of 8-Hydroxyquinoline Derived Mannich Bases., Veronika F.S. Pape, Nóra V. May, G. Tamás Gál, István Szatmári, Flóra Szeri, Ferenc Fülöp, Gergely Szakács, Éva A. Enyedy

Department of Dermatology and Cutaneous Biology Faculty Papers

The anticancer activity of 8-hydroxyquinolines relies on complex formation with redox active copper and iron ions. Here we employ UV-visible spectrophotometry and EPR spectroscopy to compare proton dissociation and complex formation processes of the reference compound 8-hydroxyquinoline (Q-1) and three related Mannich bases to reveal possible correlations with biological activity. The studied derivatives harbor a CH2-N moiety at position 7 linked to morpholine (Q-2), piperidine (Q-3), and chlorine and fluorobenzylamino (Q-4) substituents. Solid phase structures of Q-3, Q-4·HCl·H2O, [(Cu(HQ-2)2)2]·(CH3OH)2·Cl4·(H2O)2, [Cu(Q-3)2]·Cl2 and [Cu(HQ-4)2(CH3OH)]·ZnCl4·CH3OH were characterized by single-crystal X-ray diffraction analysis. In addition, the redox properties of the copper and iron complexes …

The Genomic Landscape Of Cutaneous Scc Reveals Drivers And A Novel Azathioprine Associated Mutational Signature., Gareth J. Inman, Jun Wang, Ai Nagano, Ludmil B. Alexandrov, Karin J. Purdie, Richard G. Taylor, Victoria Sherwood, Jason Thomson, Sarah Hogan, Lindsay C. Spender, Andrew P. South, Michael Stratton, Claude Chelala, Catherine A. Harwood, Charlotte M. Proby, Irene M. Leigh

Department of Dermatology and Cutaneous Biology Faculty Papers

Cutaneous squamous cell carcinoma (cSCC) has a high tumour mutational burden (50 mutations per megabase DNA pair). Here, we combine whole-exome analyses from 40 primary cSCC tumours, comprising 20 well-differentiated and 20 moderately/poorly differentiated tumours, with accompanying clinical data from a longitudinal study of immunosuppressed and immunocompetent patients and integrate this analysis with independent gene expression studies. We identify commonly mutated genes, copy number changes and altered pathways and processes. Comparisons with tumour differentiation status suggest events which may drive disease progression. Mutational signature analysis reveals the presence of a novel signature (signature 32), whose incidence correlates with chronic exposure …

The Dermatologist And Color, Andrzej Grzybowski, Lawrence Charles Parish

Department of Dermatology and Cutaneous Biology Faculty Papers

The idea for an issue on color and the skin was initiated by the 2017 exhibit “Breathing Color” that had been created by the new Design Museum in London, England. While variations in color may play a significant role in diagnosing a skin disease, little attention has been directed towards the influence that color may be used to identify a dermatologic disease and even monitor a therapeutic agent. The reader need only to recall how early dermatology atlases were hand colored to provide a more realistic picture of a disease.

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

Phase 1

Introduction: Skin cancer, the most common form of cancer worldwide, has one of the highest cure rates among cancers if diagnosed and treated early in its course. The Total Body Skin Exam (TBSE) is the primary modality used to screen for skin cancers. Currently, few studies have characterized the effectiveness of the TBSE in contemporary populations.

Objective: Characterizing the number-needed-to-screen (NNS) to diagnose a case of skin cancer through TBSEs will make it possible to better understand its effectiveness as a screening modality and its utility in an increasingly population health-based healthcare system.

Methods: A retrospective chart review of 3155 …

Metformin Clinical Trial In Hpv+ And Hpv- Head And Neck Squamous Cell Carcinoma: Impact On Cancer Cell Apoptosis And Immune Infiltrate., Joseph M. Curry, Jennifer Johnson, Mehri Mollaee, Patrick Tassone, Dev Amin, Alexander Knops, Diana Whitaker Menezes, My Mahoney, Andrew P. South, Ulrich Rodeck, Tingting Zhan, Larry A. Harshyne, Nancy Philp, Adam J. Luginbuhl, David Cognetti, Madalina Tuluc, Ubaldo E. Martinez-Outshoorn, Md

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Background: Metformin, an oral anti-hyperglycemic drug which inhibits mitochondrial complex I and oxidative phosphorylation has been reported to correlate with improved outcomes in head and neck squamous cell carcinoma (HNSCC) and other cancers. This effect is postulated to occur through disruption of tumor-driven metabolic and immune dysregulation in the tumor microenvironment (TME). We report new findings on the impact of metformin on the tumor and immune elements of the TME from a clinical trial of metformin in HNSCC. Methods: Human papilloma virus-(HPV-) tobacco+ mucosal HNSCC samples (n = 12) were compared to HPV+ oropharyngeal squamous cell carcinoma (OPSCC) samples (n …

Biological Therapy In The Treatment Of Melanoma, Simona Roxana Georgescu, Mihaela Roxana Ioghen, Maria Isabela Sarbu, Alexandra-Florentina Ion, Ela Ghita, Cristina-Iulia Mitran, Madalina-Irina Mitran, Vasile Benea, Mircea Tampa

Journal of Mind and Medical Sciences

Melanoma is one of the most aggressive tumors and its incidence is on the rise. The low rates of survival in metastatic melanoma has led to the development of new drugs for this type of patient, such as biological therapy which has shown remarkable results. This therapy is based on stimulation of the immune system to fight tumoral cells through: injection of cytokines with immunomodulatory properties (interleukin-2, alpha-interferon), vaccination with tumor antigens or immune cells that process tumor antigens, adoptive immunotherapy, inhibition of immune checkpoints (PD-1, CTLA-4), inhibition or stimulation of immune modulator molecules (OX-40, LAG-3), inhibition of signaling pathways …

In Vitro Transport Of Methotrexate By Drosophila Multidrug Resistance-Associated Protein., Agnes Karasik, András Váradi, Flóra Szeri

Department of Dermatology and Cutaneous Biology Faculty Papers

Methotrexate (MTX) is a widely used chemotherapeutic agent, immune suppressant and antimalarial drug. It is a substrate of several human ABC proteins that confer multidrug resistance to cancer cells and determine compartmentalization of a wide range of physiological metabolites and endo or xenobiotics, by their primary active transport across biological membranes. The substrate specificity and tissue distribution of these promiscuous human ABC transporters show a high degree of redundancy, providing robustness to these key physiological and pharmacological processes, such as the elimination of toxins, e.g. methotrexate from the body. A similar network of proteins capable of transporting methotrexate has been …

The Human Cib1-Ever1-Ever2 Complex Governs Keratinocyte-Intrinsic Immunity To Β-Papillomaviruses., Sarah Jill De Jong, Amandine Créquer, Irina Matos, David Hum, Vignesh Gunasekharan, Lazaro Lorenzo, Fabienne Jabot-Hanin, Elias Imahorn, Andres A. Arias, Hassan Vahidnezhad, Leila Youssefian, Janet G. Markle, Etienne Patin, Aurelia D'Amico, Claire Q.F. Wang, Florian Full, Armin Ensser, Tina M. Leisner, Leslie V. Parise, Matthieu Bouaziz, Nataly Portilla Maya, Xavier Rueda Cadena, Bayaki Saka, Amir Hossein Saeidian, Nessa Aghazadeh, Sirous Zeinali, Peter Itin, James G. Krueger, Lou Laimins, Laurent Abel, Elaine Fuchs, Jouni Uitto, Jose Luis Franco, Bettina Burger, Gérard Orth, Emmanuelle Jouanguy, Jean-Laurent Casanova

Department of Dermatology and Cutaneous Biology Faculty Papers

Patients with epidermodysplasia verruciformis (EV) and biallelic null mutations of TMC6 (encoding EVER1) or TMC8 (EVER2) are selectively prone to disseminated skin lesions due to keratinocyte-tropic human β-papillomaviruses (β-HPVs), which lack E5 and E8. We describe EV patients homozygous for null mutations of the CIB1 gene encoding calcium- and integrin-binding protein-1 (CIB1). CIB1 is strongly expressed in the skin and cultured keratinocytes of controls but not in those of patients. CIB1 forms a complex with EVER1 and EVER2, and CIB1 proteins are not expressed in EVER1- or EVER2-deficient cells. The known functions of EVER1 and EVER2 in human keratinocytes are …

Applying The Phenotype Approach For Rosacea To Practice And Research, J Tan, M Berg, R L Gallo, James Q. Del Rosso

College of Osteopathic Medicine (TUN) Publications and Research

BACKGROUND: Rosacea diagnosis and classification have evolved since the 2002 National Rosacea Society expert panel subtype approach. Several working groups are now aligned to a more patient-centric phenotype approach, based on an individual's presenting signs and symptoms. However, subtyping is still commonplace across the field and an integrated strategy is required to ensure widespread progression to the phenotype approach.

OBJECTIVES: To provide practical recommendations that facilitate adoption of a phenotype approach across the rosacea field.

METHODS: A review of the literature and consolidation of rosacea expert experience.

RESULTS: We identify challenges to implementing a phenotype approach in rosacea and offer …

Listeria Monocytogenes As A Vector For Cancer Immunotherapy: Current Understanding And Progress, John C. Flickinger, Ulrich Rodeck, Adam E. Snook

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Listeria monocytogenes, a Gram-positive facultative anaerobic bacterium, is becoming a popular vector for cancer immunotherapy. Indeed, multiple vaccines have been developed utilizing modified Listeria as a tool for generating immune responses against a variety of cancers. Moreover, over a dozen clinical trials testing Listeria cancer vaccines are currently underway, which will help to understand the utility of Listeria vaccines in cancer immunotherapy. This review aims to summarize current views on how Listeria-based vaccines induce potent antitumor immunity and the current state of Listeria-based cancer vaccines in clinical trials. © 2018 by the authors. Licensee MDPI, Basel, Switzerland.

The Role Of Human Papillomaviruses And Polyomaviruses In Braf-Inhibitor Induced Cutaneous Squamous Cell Carcinoma And Benign Squamoproliferative Lesions, Karin J. Purdie, Charlotte M. Proby, Hasan Rizvi, Heather Griffin, John Doorbar, Mary Sommerlad, Mariet C. Feltkamp, Els Van Der Meijden, Gareth J. Inman, Andrew P. South, Irene M. Leigh, Catherine A. Harwood

Department of Dermatology and Cutaneous Biology Faculty Papers

Background: Human papillomavirus (HPV) has long been proposed as a cofactor in the pathogenesis of cutaneous squamous cell carcinoma (cSCC). More recently, the striking clinico-pathological features of cSCCs that complicate treatment of metastatic melanoma with inhibitors targeting BRAF mutations (BRAFi) has prompted speculation concerning a pathogenic role for oncogenic viruses. Here, we investigate HPV and human polyomaviruses (HPyV) and correlate with clinical, histologic, and genetic features in BRAFi-associated cSCC. Materials and Methods: Patients receiving BRAFi treatment were recruited at Barts Health NHS Trust. HPV DNA was detected in microdissected frozen samples using reverse line probe technology and degenerate and nested …

Quantifying Photodamage By Noninvasive Mesoscopic Skin Imaging, Christina E. Borchers, Trevor Bihl, Chien Poon, Daniel J. Rohrbach, Samia Borchers, Julian Trevino, Max Rubin, Heidi Donnelly, Karl Kellawan, Lydia Carpenter, Shalini Bahl, Craig Rohan, Elizabeth Muennich, Scott Guenther, Holly Hahn, Ali Rkein, Marc Darst, Nico Mousdicas, Jeffery B. Travers, Ulas Sunar

Dermatology Faculty Publications

Ultraviolet light exposure is the major cause for photodamage. Pathologic effects of UVradiation include precancerous actinic keratosis which can progress into squamous cellcarcinoma. UV exposures commonly encountered include sunlight and indoor tanning bedexposure. Actinic neoplasia (precancerous actinic keratosis and non-melanoma skincancer) are highly prevalent in elderly patients with fair skin, and those with lower immunesystems. The impact on our healthcare system is substantial, as currently the averageannual cost to treat non-melanoma skin cancer is 5 billion dollars [1]. Though often asource of considerable morbidity due to extensive surgical procedures to remove the skincancers in the normal populations, squamous cell carcinomas …

Dietary Recommendations For Adults With Psoriasis Or Psoriatic Arthritis From The Medical Board Of The National Psoriasis Foundation: A Systematic Review, Adam Ford, Michael Siegel, Jerry Bagel, Kelly M. Cordoro, Amit Garg, Alice Gottlieb, April W. Armstrong

NYMC Faculty Publications

Importance: Psoriasis is a chronic, inflammatory skin disease and has significant associated morbidity and effect on quality of life. It is important to determine whether dietary interventions help reduce disease severity in patients with psoriatic diseases. Objective: To make evidence-based dietary recommendations for adults with psoriasis and/or psoriatic arthritis from the Medical Board of the National Psoriasis Foundation. Evidence Review: We used literature from prior systematic reviews as well as additional primary literature from the MEDLINE database from January 1, 2014, to August 31, 2017, that evaluated the impact of diet on psoriasis. We included observational and interventional studies of …