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Publisher: eScholarship   (Total: 54 journals)   [Sort by number of followers]

Showing 1 - 54 of 54 Journals sorted alphabetically
Asian Pacific American Law J.     Open Access   (Followers: 3)
Berkeley Planning J.     Open Access   (Followers: 5, SJR: 0.105, CiteScore: 0)
Berkeley Review of Education     Open Access   (Followers: 7)
Berkeley Scientific J.     Full-text available via subscription  
Berkeley Undergraduate J.     Full-text available via subscription   (Followers: 1)
Berkeley Undergraduate J. of Classics     Open Access   (Followers: 6)
California Agriculture     Open Access   (Followers: 2, SJR: 0.451, CiteScore: 1)
California Italian Studies J.     Full-text available via subscription   (Followers: 6)
Carte Italiane     Open Access   (Followers: 4)
Chicana/o-Latina/o Law Review     Open Access   (Followers: 2)
Cliodynamics     Open Access   (Followers: 1, SJR: 0.267, CiteScore: 0)
Critical Planning     Open Access   (Followers: 5)
Dermatology Online J.     Open Access   (Followers: 1, SJR: 0.327, CiteScore: 1)
Electronic Green J.     Open Access   (Followers: 3, SJR: 0.101, CiteScore: 0)
Empowering Sustainability Intl. J.     Open Access   (Followers: 2)
Global Societies J.     Open Access  
HAUNT J. of Art     Open Access   (Followers: 1)
Himalayan Linguistics     Open Access   (SJR: 0.249, CiteScore: 0)
InterActions: UCLA J. of Education and Information     Open Access   (Followers: 19, SJR: 0.1, CiteScore: 0)
Intl. J. of Comparative Psychology     Open Access   (Followers: 1)
J. for Learning Through the Arts     Open Access   (Followers: 7)
J. of Citrus Pathology     Open Access  
J. of Critical Mixed Race Studies     Open Access   (Followers: 3)
J. of Islamic and Near Eastern Law     Open Access   (Followers: 4)
J. of Scholarly Perspectives     Open Access  
J. of Transnational American Studies     Open Access   (Followers: 3, SJR: 0.118, CiteScore: 0)
L2 J.     Open Access   (Followers: 5)
Languages of the Caucasus     Open Access  
Lucero     Open Access  
Mester     Open Access  
National Black Law J.     Open Access   (Followers: 1)
New German Review : A J. of Germanic Studies     Open Access   (Followers: 2)
Nutrition Bytes     Open Access   (Followers: 5)
Pacific Basin Law J.     Open Access  
PaleoBios     Open Access   (Followers: 1)
Paroles gelées     Full-text available via subscription  
Places     Full-text available via subscription   (Followers: 5)
Room One Thousand     Open Access  
San Francisco Estuary and Watershed Science     Open Access   (SJR: 0.835, CiteScore: 2)
Spaces for Difference: An Interdisciplinary J.     Open Access  
Streetnotes     Open Access   (Followers: 1)
Structure and Dynamics: eJ. of Anthropological and Related Sciences     Open Access   (Followers: 2, SJR: 0.208, CiteScore: 0)
Technology Innovations in Statistics Education (TISE)     Open Access   (Followers: 2)
Textos Híbridos : Revista de estudios sobre la crónica latinoamericana     Open Access  
TRANSIT     Open Access  
Transmodernity : J. of Peripheral Cultural Production of the Luso-Hispanic World     Open Access   (Followers: 2)
UC Merced Undergraduate Research J.     Open Access  
UCLA Entertainment Law Review     Open Access  
UCLA Historical J.     Open Access   (Followers: 1)
UCLA Women's Law J.     Open Access   (Followers: 2)
Ufahamu : A J. of African Studies     Open Access   (Followers: 2)
Voices     Open Access   (Followers: 1)
Western J. of Emergency Medicine     Open Access   (Followers: 8, SJR: 0.664, CiteScore: 1)
World Cultures eJ.     Full-text available via subscription  
Journal Cover
Dermatology Online Journal
Journal Prestige (SJR): 0.327
Citation Impact (citeScore): 1
Number of Followers: 1  

  This is an Open Access Journal Open Access journal
ISSN (Online) 1087-2108
Published by eScholarship Homepage  [54 journals]
  • Subcutaneous panniculitis-like T-cell lymphoma responsive to combination
           therapy with methotrexate and corticosteroids

    • Abstract: Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare condition that falls underneath the umbrella of primary cutaneous T-cell lymphomas (CTCLs). SPTCL can be very difficult to diagnose as it may mimic other subtypes of CTCL, such as γ/δ T-cell lymphoma (TCL), or other forms of panniculitis. Confirmation of diagnosis often requires immunohistochemical analysis and is essential for proper prognosis and therapeutic management. Herein, we present a case of SPTCL that mimicked lupus panniculitis and was successfully treated with prednisone taper and methotrexate.
      PubDate: Thu, 25 Oct 2018 00:00:00 +000
  • The ginseng pimple: an inflammatory papule following ginseng consumption

    • Abstract: Ginseng is a popular herbal remedy derived from the plant roots of the Panax genus and has been used in traditional Asian medicine for thousands of years. In the United States, it has become increasingly popular and is taken for many conditions, including as an immune enhancer. Cutaneous adverse effects have been reported to occur following ginseng consumption, although detailed clinical descriptions are limited. A 60-year-old woman who repeatedly developed inflammatory papules following ginseng consumption is described and the characteristics of ginseng use in healthcare are reviewed.
      PubDate: Thu, 25 Oct 2018 00:00:00 +000
  • Secukinumab for psoriasis in a patient with hepatitis B

    • Abstract: The case reported describes a 48-year-old man with congenital hepatitis B receiving secukinumab for treatment of psoriasis. Some biologic therapies have been associated with an increased risk of reactivation of hepatitis B. In the case of this patient, secukinumab has successfully managed his psoriasis without evidence of hepatitis B virus reactivation.
      PubDate: Thu, 25 Oct 2018 00:00:00 +000
  • Tuberculosis and interleukin blocking monoclonal antibodies: Is there

    • Abstract: Several new monoclonal antibodies that interfere with interleukin (IL) cascades have come to market in recent years. They follow a generation of drugs that block tumor necrosis factor (TNF). It has been well established that TNF is important in the containment of Mycobacterium tuberculosis (Mtb) and that blocking this cytokine increases the risk of tuberculosis (TB) infection. Thus, judicious screening for Mtb of patients taking TNF blocking drugs has been the standard of care. It remains unclear if the newer monoclonal, interleukin blocking drugs, which affect IL-12, IL-23, and IL-17 pathways are associated with risk of Mtb reactivation. Herein we discuss what is known about the immunologic response to Mtb and discuss the data that is currently available for the new interleukin monoclonal antibody blocking medications regarding the risk of latent TB reactivation or active TB infection.
      PubDate: Thu, 25 Oct 2018 00:00:00 +000
  • Seven-year itch: a perplexing case of lichen planus-lupus erythematosus
           overlap syndrome

    • Abstract: Lichen planus-lupus erythematosus overlap syndrome is a rare disorder characterized by clinical and histopathological features of both lichen planus (LP) and lupus erythematosus (LE). Cutaneous lesions commonly affect the distal arms, legs, face, and trunk and these plaques are often large, scaly, painful, and atrophic, often exhibiting hypopigmentation or a red to blue-violet color. We report a case of LP-LE overlap syndrome diagnosed in a man previously believed to have atypical lichen planus who presented with an exacerbation of exuberant pruritic erythematous scaly plaques. The patient had six separate skin biopsies all of which displayed features of LP. Because the clinical symptoms did not correlate to the histopathological picture, a seventh skin biopsy with direct immunofluorescence (DIF) was performed and immunologic markers measured. The DIF demonstrated early lupus bands; serologic testing exhibited elevated ANA and anti-SSA. These findings established the diagnosis...
      PubDate: Thu, 25 Oct 2018 00:00:00 +000
  • Editorial boards of dermatology journals and their potential financial
           conflict of interest

    • Abstract: Background: Financial relationships between editorial board members of peer-reviewed journals and pharmaceutical and medical device manufacturing companies can potentially lead to biases and loss of objectivity of the medical literature. The purpose of this study was to evaluate the potential financial conflicts of interest that exist among editorial board members of dermatology journals. Methods: Editorial board members for 36 dermatology journals were identified and searched using the Open Payments database on the Center for Medicare and Medicaid Services website. The total amount of general payments made to these physician editors were collected and stratified using a tier system: 1) nothing reported, 2) >$0 and <$10,000, 3) >$10,000 and <$100,000, and 4) >$100,000. Results: We identified 551 editors from 36 dermatology journals for use in our analysis. Some form of general payment was made to 87% of these physicians (480 of 551). Four journals had >25% of...
      PubDate: Thu, 25 Oct 2018 00:00:00 +000
  • The successful treatment with ixekizumab in a multi-failure psoriasis

    • Abstract: We report a patient with severe psoriasis who failed to respond to phototherapy, conventional systemic treatment and four biologic agents (etanercept, ustekinumab, adalimumab and secukinumab). Combination of a higher-dose secukinumab regimen with phototherapy had no success. Remarkably, ixekizumab, an IL-17A inhibitor, provided almost complete psoriasis clearance after 24 weeks of treatment. The reason for the success of ixekizumab after the failure to respond to a biologic with same mechanism of action is still unknown. Interestingly, failure of secukinumab does not preclude future therapeutic success with a second IL-17A-inhibitor.
      PubDate: Thu, 25 Oct 2018 00:00:00 +000
  • Effective treatment of nail psoriasis with apremilast: report of two cases
           and review of the literature

    • Abstract: Nail psoriasis can cause great morbidity and a negative impact on the personal and work-related life of the patients. However, it responds more poorly to most drug therapies. Classically, the first line of treatment for nail psoriasis has been topical medication, but the new biological drugs seem to be the most effective treatment. Apremilast is another systemic oral drug that has shown a significant reduction of the severity in moderate-severe plaque psoriasis, as well as nail and scalp psoriasis. We present two cases of patients who exhibited a rapid response to treatment with apremilast.
      PubDate: Thu, 25 Oct 2018 00:00:00 +000
  • Aplasia cutis congénita con defecto óseo subyacente: evolución
           favorable tras manejo conservador

    • Abstract: La aplasia cutis congénita es una rara alteración caracterizada por la ausencia de áreas localizadas de piel en el momento del nacimiento. Suele manifestarse como una lesión solitaria localizada principalmente en el cuero cabelludo, que puede estar asociada con otras malformaciones congénitas. Las complicaciones pueden ser fatales, por lo que es necesario un tratamiento individualizado que vendrá determinado por el tamaño, localización y grado de afectación de estructuras subyacentes. Presentamos un caso de aplasia cutis congénita del cuero cabelludo con múltiples lesiones y defecto óseo subyacente de 3 × 1.5 cm de tamaño, pero sin otras anomalías asociadas. El manejo conservador permitió una adecuada y completa epitelización cutánea con cierre del defecto óseo subyacente sin necesidad de procedimientos invasivos.
      PubDate: Thu, 25 Oct 2018 00:00:00 +000
  • The use of notable protagonists in dermatology clinical cases: A
           quasi-randomized controlled trial

    • Abstract: Background: Educators have attempted several methods to create more entertaining problem-based learning (PBL) experiences and more engaging PBL patients. To this end, our study compared the use of unique, memorable PBL characters with generic, unmemorable characters. Methods: This prospective quasi-randomized controlled study utilized 476 university students. All subjects read ten medical cases that focused on dermatological illnesses. Cases were identical for everyone except subjects were allocated to have notable protagonists (NP) (i.e. cartoon characters or celebrities) or generic protagonists (GP) as patients in their cases. Surveys and tests were completed immediately, 7-10 days later, and 28-31 days later. Results: There were no significant differences in post-test scores at any point between the groups. The only significant difference with regard to the subjective learning experience was for the entertainment level of the cases. The NP mean was 64.1±24.2, whereas the GP...
      PubDate: Wed, 24 Oct 2018 00:00:00 +000
  • Nodular amyloidosis in a patient with systemic scleroderma

    • Abstract: Primary cutaneous amyloidosis may be characterized as macular amyloidosis, lichenoid amyloidosis, or nodular amyloidosis. Nodular amyloidosis results from the deposition of immunoglobulin light chains and may rarely be associated with systemic amyloidosis. We report an unusual case of a patient with systemic scleroderma who developed primary cutaneous nodular amyloidosis on the left lower leg. The diagnosis was confirmed with a skin biopsy with Congo red staining and a novel technique using a laser microdissection and mass spectrometry-based proteomic analysis method for amyloid protein characterization. A work-up for systemic amyloidosis was negative and the patient improved symptomatically with wound care. Patients with primary cutaneous nodular amyloidosis should be followed clinically over time for the possible development of systemic amyloidosis, although the risk of disease progression is likely low.
      PubDate: Wed, 24 Oct 2018 00:00:00 +000
  • The development of primary cutaneous CD4+ small/medium-sized pleomorphic
           T-cell lymphoproliferative disorder at the site of a melanoma excision

    • Abstract: Primary cutaneous CD4+ small/medium-sized pleomorphic T-cell lymphoproliferative disorder (PCSM-LPD) is a rare and low-grade form of cutaneous T-cell lymphoma (CTCL), representing 2% of all primary cutaneous lymphomas. Because of its rarity, the etiology or exact clinicopathology of PCSM-LPD remains unclear. We present the first case of PCSM-LPD, to our knowledge, arising at a past melanoma excision site. A 72-year-old woman with a past medical history significant for melanoma-in-situ excised 36 years ago presented to our clinic for evaluation of a single, erythematous plaque of the posterior arm within a melanoma excision scar. A biopsy was performed, revealing PCSM-LPD. Reports of the development of other T-cell lymphoproliferative disorders after prior skin trauma such as chemical burns, thermal injury, and mechanical trauma exist in the literature. Physicians should be aware of the possibility of the appearance of T-cell lymphoproliferative disorders at the site of scars or...
      PubDate: Wed, 24 Oct 2018 00:00:00 +000
  • Scabies presenting as cutaneous nodules or malar erythema: reports of
           patients with scabies surrepticius masquerading as prurigo nodularis or
           systemic lupus erythematosus

    • Abstract: Scabies surrepticius is a unifying term that represents non-classical presentations of scabies mite infestation. A patient with scabies surrepticius is described: a man with scabies masquerading as prurigo nodularis. The 91-year-old man had metastatic prostate cancer and presented with diffuse pruritic nodules. Prurigo nodularis was suspected; however, the biopsy revealed scabies mites in the stratum corneum. He was successfully treated with topical permethrin 5% cream and oral ivermectin. In addition, the features of a woman with scabies mimicking systemic lupus erythematosus are summarized. The 47-year-old woman had idiopathic thrombocytopenic purpura and presented with malar erythema and a positive antinuclear antibody (titer 1:320). A diagnosis of systemic lupus erythematous was entertained until skin scraping and mineral oil preparation revealed scabies mites; she was successfully treated with oral ivermectin. In conclusion, Sarcoptes scabiei infestation can present with...
      PubDate: Wed, 24 Oct 2018 00:00:00 +000
  • Genital Rejuvenation: The Next Frontier in Medical and Cosmetic

    • Abstract: Genital rejuvenation encompasses not only the nonsurgical interventions but also the surgical procedures that are utilized to improve the functional aspects and/or enhance the aesthetic presentation of the genitalia of women (vaginal rejuvenation) and men (scrotal rejuvenation). Vaginal rejuvenation was introduced into the medical literature in 2007; yet, within the last decade, physician and patient interest in this field has markedly increased. In contrast, the term scrotal rejuvenation was only coined in 2018. Rejuvenation of the genitalia may be considered for hair-associated (alopecia and hypertrichosis), morphology-associated (vulvovaginal atrophy, excess clitoral or labial tissue, scrotal wrinkling, and vaginal or scrotal laxity), and vascular-associated (angiokeratomas) changes of the vagina and scrotum. As women and men gain insight into the conditions that are amendable to genital rejuvenation, the demand for vaginal rejuvenation and scrotal rejuvenation will likely...
      PubDate: Wed, 24 Oct 2018 00:00:00 +000
  • A trichogenic tumor with aggressive features initially diagnosed as basal
           cell carcinoma

    • Abstract: Trichoblastic carcinoma is a rare carcinoma often arising in a pre-existing trichoblastoma. It may resemble basal cell carcinoma, posing a diagnostic challenge. Trichoblastic carcinoma is divided into low-grade and high-grade tumors. Low-grade tumors resemble basal cell carcinomas and are therefore synonymous in some classifications. High-grade tumors, which commonly present on the scalp in older individuals or in patients with Brooke-Spiegler syndrome, have been associated with a higher potential for distant metastasis and death. We present a case in which a 73-year-old female had a long-standing scalp nodule for over 30 years that rapidly increased in size. The patient's lesion was initially diagnosed as basal cell carcinoma on shave biopsy, but upon excision, revealed features concerning for trichoblastic carcinoma such as brisk mitotic activity and comedo-like necrosis. Sudden change in an atypical scalp lesion that has been present for many years should increase suspicion...
      PubDate: Wed, 24 Oct 2018 00:00:00 +000
  • Dermatologic features in good film characters who turn evil: the

    • Abstract: Dermatologic depictions in film are often used to symbolize evil. To ascertain whether certain dermatologic characteristics are more representative of evil in movies, skin findings in film characters before and after evil transformation were compared using the Good Movie Characters Turned Bad poll courtesy of The Internet Movie Database (IMDb). The poll ranked the 35 most remarkable moral transformations in cinema. Data was analyzed from 27 characters who met study criteria and there was a statistically significant, greater number of dermatologic features seen in characters after an evil transformation. Periorbital hyperpigmentation, infraorbital edema, alopecia, pallor, and nonspecific hyperpigmented skin abnormalities (telangiectasias, ecchymosis) were dermatologic traits that were found at a statistically significantly higher frequency post-evil transformation. This work suggests an effort should be made to educate audiences and film makers that skin conditions in reality...
      PubDate: Wed, 24 Oct 2018 00:00:00 +000
  • Infantile hemangiomas: our current understanding and treatment options

    • Abstract: Infantile hemangioma (IH) is the most common vascular tumor of infancy, affecting up to 10% of all infants. Our understanding of IH and its management has greatly evolved. The etiology of IH is unclear but hypoxia is thought to play a key role. Furthermore, GLUT1, IGF2, and HIF-1-' are thought to be important mediators. Current management options include active observation, medical treatment, and surgical intervention. The goals of treatment are preventing cosmetic disfiguration, psychosocial distress, and life-threatening complications. Infantile hemangioma should be managed with an individual, patient-centered approach. Generally, uncomplicated IH can be observed up to 18 months. However, IH should be treated in the setting of bleeding, ulceration, functional compromise, or eventual failure to regress.
      PubDate: Tue, 23 Oct 2018 00:00:00 +000
  • Psoriasis therapy and aortic inflammation — translating statistical
           to clinical significance

    • Abstract: Psoriasis patients are known to have comorbid aortic vascular inflammation, which is one of the leading causes of cardiovascular morbidity and mortality in this population. Many studies report statistically significant improvements in aortic vascular inflammation after use of tumor necrosis factor inhibitors or interleukin-12/23 antagonists. However, the clinical significance in reduction of adverse cardiovascular events in psoriatic patients owing to biologic therapy has not been examined. Regardless of clinically significant cardiovascular benefits, dermatologists should continue to treat psoriasis patients optimally to mitigate the unfavorable effect this disease has on quality of life.
      PubDate: Tue, 23 Oct 2018 00:00:00 +000
  • Ehlers-Danlos syndrome caused by the c.934C>T, p. Arg312Cys mutation in
           COL1A1 gene: an Italian family without cardiovascular events

    • Abstract: Classic Ehlers-Danlos syndrome (cEDS) is characterized by skin hyperelasticity, joint hypermobility, increased tendency to bruise, and abnormal scarring. Mutations in type V collagen, a regulator of type I collagen fibrillogenesis, underlie this type of EDS. In this article we report a genetic and clinical analysis of an Italian family that carried missense mutation c.934 C>T (p.R312C) in the COL1A1 gene. Literature review showed an association between this missense mutation and vascular complications. Genetic screening conducted on Italian family members, revealed that vascular events are absent. In conclusion, genetic and clinical data confirm the extreme heterogeneity of EDS. Nevertheless, vascular events could be a risk factor and periodical clinical evaluation could be relevant.This article was retracted by the authors.
      PubDate: Mon, 15 Oct 2018 00:00:00 +000
  • Successful treatment of two individual cases of generalized granuloma
           annulare with amoxicillin/clavulanic acid and a combination of doxycycline
           and pentoxifylline

    • Abstract: Granuloma annulare is a benign inflammatory skin disease potentially related to a delayed hypersensitivity reaction to the dermis. Generalized granuloma annulare (GGA) manifests as diffuse skin-colored to erythematous annular or nummular plaques affecting at least the trunk and either upper or lower extremities, or both. GGA is resistant to many therapeutic modalities, making it difficult to treat. Different therapeutic approaches to GGA have been attempted but definitive treatment for this disease remains elusive. This article focuses on the use of amoxicillin/clavulanic acid and a combination of doxycycline and pentoxifylline therapy as treatment options for GGA in two patients with histopathology-proven interstitial GGA. Both amoxicillin/clavulanic acid and doxycycline inhibit bacterial cell growth, raising the possibility that a bacterial pathogenesis may be of significance in GGA. This is the first reported case of successful treatment of GGA with these regimens.
      PubDate: Wed, 3 Oct 2018 00:00:00 +0000
  • A case of granuloma annulare mimicking tinea cruris

    • Abstract: Granuloma annulare (GA) is a benign, self-limited skin disease of unknown etiology characterized by annular, flesh-colored to erythematous grouped papules or plaques. Lesions of GA are typically located on the lateral or dorsal surfaces of the hands and feet, arms, thighs, and trunk. We present the case of a patient with GA who presented with erythematous, annular plaques localized to the bilateral inguinal folds, mimicking tinea cruris. On clinical examination, the lesions were thought to be tinea cruris. A subsequent punch biopsy revealed the lesions to be granuloma annulare. This case highlights an unusual location where GA can first present in a patient. It also suggests that GA should be considered among the differential diagnoses along with tinea cruris, when evaluating localized annular lesions of the groin.
      PubDate: Wed, 3 Oct 2018 00:00:00 +0000
  • Lymphangioma circumscriptum of glans penis: a report of two cases

    • Abstract: Lymphangioma circumscriptum is a developmental anomaly of lymphatic vessels, which appear as aggregates of clear or hemorrhagic vesicles on the skin or mouth. Glans penis involvement is very uncommon. Because of the sensitivity of the area, possible functional, cosmetic, or psychologic disturbances can result. Lymphangioma circumscriptum is rarely found on this location; hence, vigilance and awareness of this entity is necessary for a swift and proper diagnosis. Two cases are presented on the account of their rarity and unique representation.
      PubDate: Tue, 2 Oct 2018 00:00:00 +0000
  • New onset erythematous nodules in an elderly woman

    • Abstract: An 86-year- old woman with a history of recurrent bronchitis and giant cell arteritis presented for new onset, cyclic and migratory erythematous nodules associated with fatigue and weight loss. Although a systemic vasculitis was initially suspected, elevated inflammatory markers and symptoms persisted despite aggressive corticosteroid therapy. Excisional biopsy of one nodule showed dense suppurative and granulomatous inflammation that was rife with acid-fast bacilli. The patient was urgently admitted for empiric treatment of disseminated mycobacterial infection. Although T-SPOT Tuberculosis testing and direct mycobacterial PCR were negative, mass spectrometry demonstrated Mycobacterium chelonae. The patient was treated with a macrolide and quinolone combination regimen and then discharged to a rehabilitation facility.
      PubDate: Tue, 2 Oct 2018 00:00:00 +0000
  • Erosio interdigitalis blastomycetica: A review of interdigital candidiasis

    • Abstract: Erosio interdigitalis blastomycetica (EIB) is a Candida infection affecting the third web space, between the third and fourth fingers. In 1915, Gougerot and Goncea first described saccharomycetic organisms isolated from the hands and feet. Johannes Fabry later named it in 1917, well before the genus Candida was introduced in 1923. EIB is most common among those who work with their hands frequently in water, such as dishwashers, launderers, bartenders, and homemakers. Clinical presentation most commonly consists of a central erythematous erosion surrounded by a rim of white macerated skin involving at least one interdigital web space. The differential diagnosis is narrow, consisting of irritant contact dermatitis (ICD), erythrasma, inverse psoriasis, and bacterial infection (i.e. impetigo). The diagnosis is made by clinical examination in addition to fungal culture and KOH testing. The prognosis is good and treatment options include avoidance of frequent water immersion and topical...
      PubDate: Tue, 2 Oct 2018 00:00:00 +0000
  • Varicella zoster virus reactivation and the increased risk of
           cerebrovascular accidents: the unexpected role dermatologists can play

    • Abstract: Varicella zoster virus (VZV) primary infection usually causes varicella and its reactivation may lead to different clinical manifestations depending on the site of viral reactivation and its subsequent tissue spread. There is a growing recognition of the association between VZV reactivation and ensuing cerebrovascular accidents (CVA). The virus can spread to cerebral arteries, causing a wide clinical spectrum related to VZV vasculopathy. Herein we present an 80-year-old man with a previously undiagnosed immunosuppressive condition, admitted with disseminated herpes zoster, who subsequently developed an acute ischemic CVA and showed a substantial neurologic recovery under antiviral therapy.
      PubDate: Tue, 2 Oct 2018 00:00:00 +0000
  • Assessment of melanoma follow-up trends in Medicare patients: a large
           scale, multi-regional analysis

    • Abstract: Background: Research on patient follow-up compliance after a diagnosis of melanoma has been limited.Objective: To assess the timelines for follow-up among patients who are diagnosed with melanoma and to assess the socioeconomic and provider factors which influence follow-up adherence.Methods: A retrospective, population-based study using nationally representative data from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database was conducted to evaluate 10,813 patients who were diagnosed with melanoma from 2005-2013. Results: We found that 97% of the individuals with melanoma had at least one follow-up visit, with 80.5% having their first follow-up visit within the first 6 months and 88.6% having their first follow-up visit within 12 months. Patients who had a dermatologist as the diagnosing provider were significantly more likely to follow up. Additionally, patients who returned were more likely to live in a community with a higher socioeconomic...
      PubDate: Tue, 2 Oct 2018 00:00:00 +0000
  • Corrigendum: Complications associated with intimate body piercings

    • Abstract: The original article was published on July15, 2017 and corrected on August 15, 2018.The revised version of the article includes a correction to the spelling of an author. The change appears in the revised online PDF copy of this article.
      PubDate: Tue, 2 Oct 2018 00:00:00 +0000
  • PatientsLikeMe and atopic dermatitis: characterizing the atopic dermatitis
           patient profile

    • Abstract: Introduction: Atopic Dermatitis (AD) is a common dermatologic disorder that affects 17.8 million individuals in the United States. Online medical communities have become increasingly popular over the last several years, providing an additional avenue of therapy for patients.Purpose: This retrospective analysis looks to characterize the AD patient profile to better assess features of the AD community and appraise PatientsLikeMe data with current AD literature.Methods: PatientsLikeMe data recorded by April 2018 from persons who reported AD as their primary or secondary diagnosis were included in the analysis.Results: The PatientsLikeMe database had 410 individuals reporting AD as of April 2018. Of these, 61.46% (252/410) report AD as their primary disease. Of those reporting, 180/199 (90.45%) were diagnosed by a medical professional whereas 19/199 (9.55%) were self-diagnosed. The number of persons recording predefined PatientsLikeMe symptoms are as follows:...
      PubDate: Tue, 2 Oct 2018 00:00:00 +0000
  • Nodular scabies: a persistent nodular eruption

    • Abstract: Nodular scabies is a hypersensitivity reaction to scabietic infestation characterized by persistent pruritic nodules that can remain even after treatment of the initial infestation. We present a demonstrative case of an infant who presented with nodular scabies.
      PubDate: Tue, 2 Oct 2018 00:00:00 +0000
  • Florid cutaneous papillomatosis as a marker of neoplastic recurrence

    • Abstract: Florid cutaneous papillomatosis is a rare paraneoplastic dermatosis, most commonly associated with gastric adenocarcinoma. It is characterized by a sudden onset of hyperkeratotic papules, clinically indistinguishable from viral warts. We report an 80-year-old man who presented to our department with a two-month history of multiple verrucous lesions affecting the face, perioral region, and hands. Two years before, he was treated for a gastric adenocarcinoma with a subtotal gastrectomy, but showed no evidence of residual disease or recurrence. Given the clinical background, a diagnosis of florid cutaneous papillomatosis was considered. Skin biopsy excluded a viral origin, and tumour recurrence was later identified through an abdominal ultrasound. The onset of this entity is typically prior or concurrent with the diagnosis of the internal malignancy, but it may also represent the first sign of recurrence of a previously treated neoplasm. Its early recognition is essential to ensure...
      PubDate: Tue, 2 Oct 2018 00:00:00 +0000
  • Neoplasia de celulas dendriticasblastica plasmocitoide

    • Abstract: Plasmacytoid blast dendritic cell neoplasia (NCDBP) is an uncommon malignant neoplasm, presenting clinically with cutaneous involvement and subsequent lymph node and bone marrow extension. It characteristically expresses the markers: CD56, CD4, and CD123. There is no optimal treatment, relapses are frequent, and the survival time is short. We present the case of an elderly patient with NCDBP who initially presented with cutaneous lesions, but experienced rapid systemic progression and did not, respond to treatment.
      PubDate: Tue, 2 Oct 2018 00:00:00 +0000
  • Cutaneous Crohn disease without gastrointestinal involvement in a
           9-year-old boy

    • Abstract: Cutaneous Crohn disease (CCD) is a rare dermatologic manifestation of Crohn disease and is defined as noncaseating, granulomatous skin lesions noncontiguous with the gastrointestinal tract. It most commonly affects the skin of the legs, although genital CCD is the most common presentation in children. Diagnosis of CCD is made by a combination of clinical and histopathological findings. Therapeutic options include topical, intralesional, and systemic corticosteroids as well as topical and systemic immunosuppressants and immunomodulators. Surgical excision may be considered for refractory cases. We report CCD in a 9-year old boy with penile swelling, granulomatous cheilitis-like lesions, and perianal plaques.
      PubDate: Tue, 2 Oct 2018 00:00:00 +0000
  • Reaccion acneiforme noduloquistica secundaria a vemurafenib con buena
           respuesta a isotretinoina oralSevere acneiform eruption associated with
           vemurafenib with response to isotretinoin

    • Abstract: Vemurafenib, a kinase inhibitor that targets tumors with the BRAF V600E mutation, is a promising option for unresectable or metastatic melanoma. Cutaneous side-effects have been reported including alopecia, photosensitivity, squamous cell carcinoma, keratoacanthomas, keratosis pilaris-like eruption, and palmoplantar hyperkeratosis. Acneiform eruptions have been reported in 3%-6% of the patients treated with BRAF inhibitors,and 5 cases are described in the literature. Although they responded well to topical therapies, oral antibiotics, or observation, one case required oral etretinate and the withdrawal of vemurafenib because the adverse event reached grade 3. We report one case of a severe acneiform eruption associated with vemurafenib with a good response to isotretinoin allowing continuation of the BRAF inhibitor.
      PubDate: Tue, 2 Oct 2018 00:00:00 +0000
  • Varicella zoster virus reactivation antedating ipsilateral brainstem

    • Abstract: itor Title: Varicella zoster virus reactivation antedating ipsilateral brainstem stroke
      Authors : Giuliana Galassi1, Maurilio Genovese2, Marisa Meacci3, Marcella Malagoli2 Affiliations: 1Department of Biomedical, Metabolic, Neural Sciences, University Hospital of Modena, Italy, 2Neuroradiology Service, University Hospital of Modena, Italy, 3Department of Laboratory Medicine and Patholgy, Microbiology and Virology Unit, University Hospital of Modena, Italy Corresponding Author: Giuliana Galassi, MD, Department of Biomedical, Metabolic, Neural Sciences, University Hospital of Modena, Via P. Giardini 1455, Modena, Italy, Tel: 39-3497325802, Email: : Varicella zoster virus (VZV) infection and reactivation are associated with a number of neurologic conditions. Unifocal large vessel infarcts may follow zoster in the trigeminal or cervical distribution as a result of transaxonal transport of virus from trigeminal or cervical afferent fibers that innervate...
      PubDate: Tue, 2 Oct 2018 00:00:00 +0000
  • Enzyme-linked immunosorbent assay as a helpful diagnostic tool for
           pemphigus erythematosus with equivocal histologic and immunofluorescent

    • Abstract: Enzyme-linked immunosorbent assay is a sensitive and specific method for the detection of circulating autoantibodies in pemphigus vulgaris and foliaceus. Herein, pemphigus erythematosus with equivocal immunofluorescence and non-diagnostic histology, but confirmed by enzyme-linked immunosorbent assay, is described. As a non-invasive, sensitive, and specific assay with additional utility for monitoring disease activity, this case adds to growing evidence supporting ELISA as the diagnostic method of choice for common and less common variants of pemphigus.
      PubDate: Tue, 2 Oct 2018 00:00:00 +0000
  • Streptococcus dysgalactiae-associated penile bacterial disease in an
           elderly man acquired by fellatio: case report and literature review of
           penile and perianal Streptococcus dysgalactiae in men acquired by
           anilingus and fellatio

    • Abstract: Streptococcus dysgalactiae subspecies equisimilis (SDSE) is a gram-positive, beta-hemolytic, large-colony-forming bacteria belonging to group C and G streptococci. It can be isolated in the normal flora of human skin, nasopharyngeal cavity, genitourinary, and gastrointestinal tracts. However, SDSE has been the cause of perianal bacterial infections associated with sexual practices. A 67-year-old man developed a penile bacterial infection secondary to SDSE. The infection presented as a painful erythematous patch on his penile distal shaft. He was successfully treated with oral cephalexin 500mg and topical mupirocin 2% ointment twice daily, for ten days. The infection resolved within ten days of treatment. Penile and perianal SDSE bacterial disease has been reported in five men, including the patient in this report. The perianal area was involved in 80 percent (4/5) of men; concurrent infection in the gluteal area was present in two men. The probable route of transmission was oral-anal...
      PubDate: Tue, 2 Oct 2018 00:00:00 +0000
  • Polypoid amelanotic melanoma: a diagnostic challenge

    • Abstract: Melanoma is a highly aggressive cutaneous malignancy with considerable risk for metastasis. These malignant tumors are typically pigmented given that they arise from melanocytes capable of producing melanin. Amelanotic melanomas are a rare variant and there is often a delay in diagnosis owing to lack of pigmentation. Although there are various presentations of amelanotic melanoma, a solitary polypoid nodule is unusual and warrants further reporting. Herein, we present a patient with a 3-year history of a tender firm, skin-to-pink colored polypoid nodule. Excisional biopsy and work up showed an aggressive amelanotic melanoma with depth of 20mm and nodal metastasis consistent with stage IIIC disease. This case highlights the necessity of recognition and prompt management of this rare subtype of melanoma.
      PubDate: Tue, 2 Oct 2018 00:00:00 +0000
  • Editorial boards of dermatology journals and their potential financial
           conflict of interest

    • Abstract: Background: Financial relationships between editorial board members of peer-reviewed journals and pharmaceutical and medical device manufacturing companies can potentially lead to biases and loss of objectivity of the medical literature. The purpose of this study was to evaluate the potential financial conflicts of interest that exist among editorial board members of dermatology journals.Methods: Editorial board members for 36 dermatology journals were identified and searched using the Open Payments database on the Center for Medicare and Medicaid Services website. The total amount of general payments made to these physician editors were collected and stratified using a tier system: 1) nothing reported, 2) >$0 and <$10,000, 3) >$10,000 and <$100,000, and 4) >$100,000.Results: We identified 551 editors from 36 dermatology journals for use in our analysis. Some form of general payment was made to 87% of these physicians (480 of 551). Four journals...
      PubDate: Tue, 2 Oct 2018 00:00:00 +0000
  • Clear Cell Acanthoma on the Areola

    • Abstract: Clear cell acanthoma (CCA) is a rare, benign cutaneous condition most often seen on the lower extremities. Lesions are of variable morphology and have been described as polypoid, pigmented, giant, and cystic lesions. Although no racial or gender predilection has been reported, CCA on the breast is a very rare finding that has been observed mainly in young Korean women. Herein, we describe a case of CCA of the areola in an elderly woman with metastatic renal cell carcinoma. Physical exam revealed a pink plaque with central erosions on the left areola. Given the concern for cutaneous metastasis, excisional biopsy was performed, which showed pale glycogenated epithelium consistent with CCA. No evidence of recurrence or new lesions was observed after 6 months of follow-up. Our case exemplifies that clinicians should consider CCA in the differential diagnosis for a new eczematous lesion involving the breast, even in the setting of malignancy.
      PubDate: Wed, 12 Sep 2018 00:00:00 +000
  • A case of folliculosebaceous cystic hamartoma: a rare and clinically
           indistinct lesion

    • Abstract: We report a case of a slowly growing papule on the nasal bridge of an elderly woman. Histopathological findings revealed a very unusual type of folliculosebaceous cystic hamartoma with a retiform and primitive epithelial proliferation associated with the stromal component. Folliculosebaceous cystic hamartoma is an uncommon lesion that involves a cystically dilated follicle embedded in a stroma of distinct mesenchymal tissue. Because folliculosebaceous cystic hamartoma is a rare and clinically indistinct lesion, clinical photographs of the lesion are not widely available. A recent search on PubMed revealed less than 50 published articles on folliculosebaceous cystic hamartoma; among these manuscripts there was a scarcity of clinical images of the lesion. This disparity is to be expected as the lesion typically has a very indistinct presentation. We thus describe an inconspicuously appearing case of folliculosebaceous cystic hamartoma to bring attention to the indistinct clinical...
      PubDate: Wed, 12 Sep 2018 00:00:00 +000
  • Ipilimumab-associated halo-like inflammatory reactions around nevi during
           therapy for metastatic melanoma

    • Abstract: Ipilimumab is an immune-modulating drug that is being used today for various cancers including metastatic malignant melanoma. Owing to its mechanism of action, several adverse events have been reported, including some affecting skin. In this work, we report a novel display of multiple ipilimumab-associated halo lichenoid reactions surrounding benign nevi during treatment of metastatic melanoma. A patient underwent treatment with ipilimumab for treatment of stage IIIC melanoma at our center and was monitored for progress and adverse events throughout treatment. During treatment with ipilimumab, the patient clinically developed multiple halo lichenoid reactions surrounding previously present nevi, which histopathologically showed a lichenoid interface dermatitis associated with the mildly atypical nevi and ill-formed granulomata within the infiltrate. Therefore, ipilimumab may be associated with halo lichenoid reactions surrounding benign nevi and this adverse effect should be added...
      PubDate: Wed, 12 Sep 2018 00:00:00 +000
  • Platelet-rich plasma for androgenic alopecia treatment: A comprehensive

    • Abstract: Androgenic alopecia (AGA) is a chronic, progressive condition affecting millions of individuals worldwide. Treatment modalities for AGA are limited and our understanding of the pathophysiology underlying the disease is still developing. Platelet-rich plasma (PRP), an autologous collection of concentrated platelets and their respective growth factors, has demonstrated efficacy in limiting AGA. The current understanding of AGA pathogenesis is summarized, including our current understanding regarding androgens, inflammation, and arrector pili muscle loss. Furthermore, the molecular pathways induced by PRP in the context of AGA are discussed to ascertain how PRP can prevent disease progression. Well-designed studies investigating the effect of PRP on AGA patients to provide insight on how PRP should be used to achieve consistent clinical results are also presented. Future investigations should focus on elucidating a unifying theory to connect the currently disparate avenues of AGA...
      PubDate: Wed, 12 Sep 2018 00:00:00 +000
  • Botulinum Toxin Type-A as an alternative treatment for gummy smile: a case

    • Abstract: In some cases of dentofacial deformities such as vertical maxillary excess, administration of botulinum toxin has been used as an effective minimally invasive technique to improve the aesthetic disorder of gummy smile. This article presents a case of a woman with excessive gingival exhibition during the smile related to vertical maxillary excess and hyperactive upper lip elevator muscles. This patient was treated using botulinum toxin type A (BT) to camouflage the deformity and improve her facial aesthetic. This therapeutic option proved to be effective and should be a good alternative for patients.
      PubDate: Wed, 12 Sep 2018 00:00:00 +000
  • Development of Patient Decision Aids for Plaque Psoriasis and Acne

    • Abstract: Introduction: Despite proven benefits in other medical specialties, there is a paucity of patient decision aids (PDAs) in dermatology. The present study developed online PDAs for acne and psoriasis, incorporating iterative patient and physician feedback, in accordance with International Patient Decision Aid Standards (IPDAS). Design and Method: Content was adapted from clinical practice guidelines and primary research and formatted for an 8th grade reading level. Feedback on content and format was obtained through focus groups with 15 psoriasis patients and survey with 34 acne patients. Feedback on presentation and clinical utility of the PDAs was gathered by survey from 51 physicians in Canada and the United States. Each data collection stage informed further development. Results: Demand for decision support, and satisfaction with the PDAs was high among patients. Physicians were approving of content and expressed a strong interest in PDA use. Conclusion: Patients and physicians...
      PubDate: Wed, 12 Sep 2018 00:00:00 +000
  • A cross-sectional study of the distribution of psoriasis subtypes in
           different ethno-racial groups

    • Abstract: Skin of colored patients with psoriasis are more likely to remain undiagnosed and experience a greater impact on quality of life than their white counterparts. A better understanding of the ethno-racial differences in the presentation of psoriasis can help address these disparities. To compare the prevalence of psoriatic subtypes (plaque, guttate, pustular, erythrodermic, palmoplantar, and inverse) and lesion locations in Caucasian, Asian, and Hispanic/Latino patients, we analyzed cross-sectional, patient-reported, physician-reviewed survey data from 882 adult and 16 pediatric psoriasis patients seen at the University of California, San Francisco Department of Dermatology between 2006 and 2016. Multivariate logistic regression was used to compare the prevalence of psoriasis subtypes and lesional distributions amongst the ethno-racial groups. Asians and Hispanics/Latinos had higher odds of having pustular psoriasis compared to Caucasians (OR=4.36 [95%CI: 1.24-17.62], P=0.026; and...
      PubDate: Wed, 12 Sep 2018 00:00:00 +000
  • Dermoscopy findings of a one mm lentigo maligna

    • Abstract: A 66-year-old man presented with a grayish 1mm macule on the left cheek. Dermatoscopic examination revealed annular-granular structures partially surrounding a single follicular ostium. Histopathologic examination demonstrated atypical, confluent single melanocytes at the basal layer with nesting, crowding, and upward migration descending along the hair follicle, consistent with the diagnosis of lentigo maligna (LM). This case presents evidence in support of the Schiffner progression model for LMs, starting with asymmetric pigmented follicular openings composed of annular-granular structures, which later coalesce into gray to dark black/brown streaks, and then form pseudo-networks or rhomboidal structures. The finding of annular-granular structures partially surrounding a single hair follicle may be the earliest recognizable dermatoscopic feature of an LM and may help clinicians diagnose facial LMs earlier.
      PubDate: Wed, 12 Sep 2018 00:00:00 +000
  • No pain no gain: tender nodules in a competitive bodybuilder

    • Abstract: The subculture of bodybuilding is rife with people willing to do whatever is necessary to achieve the perfect physique. One particularly concerning behavior is the injection of site-enhancing-oils (SEO) into lagging muscle groups to achieve instant size and symmetry. The typical SEO is a combination of lidocaine, alcohol, and oil; it is rarely, if ever, administered by a qualified professional. As a result, there are a variety of potential complications that can manifest in the skin and other organ systems. In our case, a 41-year-old former competitive bodybuilder was referred to our clinic for excision of a subcutaneous nodule. The initial histopathology was concerning for lymphoma, but a more thorough history and review of systems were completely negative. The patient underwent a negative systemic lymphoma workup and it was not until we discussed the prospects of radiation and other forms of treatment that he revealed a history of SEO use, as well as other identical nodules...
      PubDate: Wed, 12 Sep 2018 00:00:00 +000
  • Brown-gray hyperpigmentation in a photosensitive distribution after
           levofloxacin exposure

    • Abstract: Photosensitive drug reactions resulting in hyperpigmentation occur when there is an accumulation in the skin of melanin, heavy metals, or the drug itself. Herein we describe an immunocompromised orthotopic liver transplant patient with levofloxacin-induced hyperpigmentation with iron deposition. To identify the causal agent, consideration was given to medications the patient had taken long-term, as well as medications introduced more recently before the event. Levofloxacin and posaconzole emerged as the most likely culprit drugs, neither of which have a strong history in the literature of being associated with photosensitive hyperpigmentation. Levofloxacin was determined to be the culprit drug when the hyperpigmentation gradually resolved several weeks after discontinuation of levofloxacin, with continuation of posaconazole and all other long-term medications. This case highlights the challenges in identifying the causal agent in photosensitive drug reactions when patients are...
      PubDate: Wed, 12 Sep 2018 00:00:00 +000
  • Complications associated with intimate body piercings

    • Abstract: Intimate body piercings involving the nipple and genitalia have increased in prevalence in both men and women. Despite this increase, there is a deficiency in the literature regarding the short and long-term complications of body piercings, including an increased risk of infection, malignancy, and structural damage to the associated tissue. Breast abscesses associated with nipple piercing can be mistaken as inflammatory carcinoma. Male genital piercings have been associated with urethral rupture, paraphimosis, urethral obstruction, scar formation, and squamous cell carcinoma, whereas female genital piercings may lead to a higher risk of pregnancy and sexually transmitted infections. There are additional problems related to piercings during pregnancy and thereafter. Nipple piercings can hinder breast feeding by inhibiting the milk letdown reflex, increasing nipple sensitivity, and causing discomfort to the infant. Removal of genital piercings during pregnancy could introduce bacteria...
      PubDate: Wed, 12 Sep 2018 00:00:00 +000
  • Intraosseous epidermoid cyst of the skull: case study and radiological
           imaging considerations

    • Abstract: We report an atypical case of an epidermoid cyst associated with a skull defect to emphasize the diagnostic utility of bedside ultrasonography for the evaluation of subcutaneous scalp nodules. A 24-year-old woman presented with what appeared to be a benign cyst on the right parietal scalp. The cyst was first noticed one year prior to presentation and caused only mild irritation. Upon excision of the cyst, a notable calvarial defect was found in the frontoparietal bone and surgical excision was suspended. Head and brain imaging was performed confirming the calvarial defect with mild mass effect on the brain. A neurosurgical consultation was obtained, and the patient underwent craniotomy followed by cranioplasty with titanium plate placement. The histological evaluation confirmed the suspicion of an intraosseous epidermoid cyst. We hope to raise awareness of the potential for intraosseous involvement of otherwise routine scalp nodules and emphasize the utility of bedside ultrasonography...
      PubDate: Wed, 12 Sep 2018 00:00:00 +000
  • Tratamiento de la alopecia areata, un recorrido desde las opciones
           terapéuticas clásicas hasta los nuevos fármacos aparecidos en los
           últimos años

    • Abstract: La alopecia areata constituye un reto terapéutico, sobre todo en sus formas extensas. Antes de iniciar cualquier tratamiento es necesario tener en cuenta algunas consideraciones. Se trata de una enfermedad que no afecta de forma directa a la salud del paciente y que puede presentar resolución espontánea. Las formas extensas, las que se inician en la infancia y las de larga evolución son muy rebeldes a los tratamientos y asocian recaídas. Todos los tratamientos tienen efectos secundarios. Ningún tratamiento ha demostrado alterar el curso de la enfermedad, muy pocos han demostrado eficacia en ensayos clínicos aleatorizados y no existen guías terapéuticas salvo la publicada en 2003 y actualizada en 2012 en el British Journal of Dermatology. Por todo ello, es necesario elaborar un plan de tratamiento individualizado en cada paciente. Se debe comenzar con los fármacos más seguros e inocuos, y pasar al siguiente escalón terapéutico cuando el actual haya demostrado su ineficacia durante...
      PubDate: Wed, 12 Sep 2018 00:00:00 +000
  • Linear IgA bullous dermatosis associated with ulcerative proctitis:
           treatment challenge

    • Abstract: Linear IgA bullous dermatosis is a rare bullous disease in children and adults that can be associated with autoimmune conditions, malignancies, infections, or medication exposure. The definitive diagnosis relies on the biopsy. A 58-year-old man presented to our clinic with a pruritic vesicular and bullous eruption. Histology showed the classic findings of a subepidermal blister with neutrophilic infiltrate and linear IgA deposition along the dermal-epidermal junction. Upon further evaluation, he was diagnosed with ulcerative proctitis. His therapy was complicated owing to side effects and lack of response to the standard treatment options. Dapsone, a first-line therapy, caused symptomatic methemoglobinemia whereas niacinamide with doxycycline were not effective. He required intravenous and oral steroids to reach improvement followed by transitioning to methotrexate.
      PubDate: Wed, 12 Sep 2018 00:00:00 +000
  • Prescribing trends for biologic drugs among Ohio dermatologists

    • Abstract: The role of biologic therapies in the field of dermatology continues to evolve as newer drugs and biosimilars are introduced to the U.S. market. Prescribing patterns and expenditures regarding biologic drugs are not well described. To address this knowledge gap, a retrospective review was conducted using the Medicare Provider Utilization and Payment Data: Part D Prescriber dataset between January 1st, 2013 and December 31st, 2015. The primary outcome was claims per provider per calendar year. Secondary outcomes included drug cost, shared cost per dermatologist, and practice location. Median claims per provider remained stable between 2013 and 2014 (24 versus 23, respectively; P=0.64). The majority of 2015 claims were for adalimumab (50.1%) and etanercept (41.4%). Total spending from Medicare payment data for biologic drugs prescribed by Ohio dermatologists increased by $3 million during the study period. The Gini coefficient for provider contributions to overall costs was 0.47,...
      PubDate: Wed, 12 Sep 2018 00:00:00 +000
  • Ehlers-Danlos syndrome caused by the c.934C>T, p. Arg312Cys mutation in
           COL1A1 gene: an Italian family without cardiovascular events

    • Abstract: Classic Ehlers-Danlos syndrome (cEDS) is characterized by skin hyperelasticity, joint hypermobility, increased tendency to bruise, and abnormal scarring. Mutations in type V collagen, a regulator of type I collagen fibrillogenesis, underlie this type of EDS. In this article we report a genetic and clinical analysis of an Italian family that carried missense mutation c.934 C>T (p.R312C) in the COL1A1 gene. Literature review showed an association between this missense mutation and vascular complications. Genetic screening conducted on Italian family members, revealed that vascular events are absent. In conclusion, genetic and clinical data confirm the extreme heterogeneity of EDS. Nevertheless, vascular events could be a risk factor and periodical clinical evaluation could be relevant.
      PubDate: Wed, 12 Sep 2018 00:00:00 +000
  • Ocrelizumab-induced psoriasiform dermatitis in a patient with multiple

    • Abstract: Multiple Sclerosis (MS) is a chronic autoimmune disease that presents with a wide variety of sensory and motor deficiencies. New medications targeting B cells have been approved to treat MS, but the side effect profile has not been widely explored. Herein, we report a case of drug-induced psoriasiform dermatitis following ocrelizumab treatment. Physicians should be cognizant of this possible side effect in patients receiving treatment for MS.
      PubDate: Wed, 12 Sep 2018 00:00:00 +000
  • Scalp porocarcinoma and lichen planopilaris

    • Abstract: Porocarcinoma (PC) is a malignant neoplasm arising from the intraepidermal ductal portion of the sweat gland duct. Lichen planopilaris (LPP) is a not so rare variant of cutaneous lichen planus (LP) with a preferential involvement of hair follicles, consisting of a chronic lymphocytic inflammation, leading to cicatricial alopecia. A 42-year-old woman, recently diagnosed with HIV infection, was referred to our clinic because of an alopecic patch of 6 years' duration. In the upper region of the alopecia a 1.5cm nodule was noticed, which the patient stated had started growing soon after the appearance of the hair loss. Biopsy of the alopecia margin confirmed the diagnosis of LPP, whereas biopsy of the nodule revealed an infiltrating tumor consistent with the diagnosis of PC. We present a scalp PC emerging in a background of LPP in an HIV patient. We do not know the role, if any, HIV infection and LPP played in this particular case. Immunosuppression and HIV have been implicated in...
      PubDate: Wed, 12 Sep 2018 00:00:00 +000
  • Lichen striatus-like eruption in an adult following hepatitis B
           vaccination: a case report and review of the literature

    • Abstract: Lichen striatus is a rare inflammatory dermatosis that follows the lines of Blaschko. This paper discusses an unusual presentation of lichen striatus following hepatitis B vaccination and reviews the literature of vaccine-induced lichen striatus.
      PubDate: Wed, 12 Sep 2018 00:00:00 +000
  • Darier Nests or Pautrier microabscesses: highlighting the confusion of a

    • Abstract: Lucien Marie Pautrier was a skilled dermatologist whose work led to the creation of numerous manuscripts within the field of dermatology. His name, though, most often lends itself to a histopathological finding that was not his own discovery. For years, the origin of the term "pautrier microabscess" was thought to be the result of a misattribution by Louis H. Winer at the 66th annual meeting of the American Dermatological Association in 1946. However, a recently reported citing of the term in a 1932 article has led to speculation that the term could, in fact, have been first coined at a meeting of the New York Society of Dermatology in 1927.
      PubDate: Wed, 12 Sep 2018 00:00:00 +000
  • Corrigendum: Leukemia cutis as the presenting symptom of acute myeloid
           leukemia: report of three cases

    • Abstract: The original article was published on July19, 2017 and corrected on June 15, 2018.The revised version of the article adds appropriate in-text references to Figures 3B, C and 5B, C, and correctly renumbers the list of References. The changes appear in the revised online PDF copy of this article.
      PubDate: Thu, 23 Aug 2018 00:00:00 +000
  • Striking enhancement at the site of radiation for nivolumab-induced
           Stevens-Johnson syndrome

    • Abstract: Stevens-Johnson syndrome is a rare adverse cutaneous drug reaction characterized by epidermal detachment of <10% body surface area with an average mortality rate of 1-5%. The mechanism of SJS is not fully understood. Nivolumab is a monoclonal antibody directed against programmed cell death-1 protein (PD-1), a receptor with immune checkpoint inhibitory and antineoplastic activities. We present a case of SJS in a patient being treated with anti-PD-1 therapy nivolumab for metastatic squamous cell carcinoma of the oropharynx. This case is unusual because of the severe accentuation with striking enhancement at his prior radiation site and in the cutaneous region with heavier tumor burden from his metastatic disease. This reaction may give insight to the underlying pathophysiology of SJS, suggesting that immune checkpoint inhibitors can activate T-cells to target keratinocytes and that external factors may be involved in creating distinct epitopes for T-cell recognition. We hope...
      PubDate: Wed, 22 Aug 2018 00:00:00 +000
  • Characteristics and diagnostic performance of pathologists who enjoy
           interpreting melanocytic lesions

    • Abstract: Diagnostic discrepancy among pathologists interpreting melanocytic skin lesions (MSL) is an ongoing concern for patient care. Given that job satisfaction could impact patient care, this study aimed to characterize which pathologists enjoy interpreting MSL and estimate the association between enjoyment and diagnostic accuracy. Pathologists' demographics, training, and experience were obtained by a cross-sectional survey. Associations between these characteristics and self-reported enjoyment when interpreting MSL were estimated by Pearson's Chi-square tests. Diagnostic accuracy was determined by comparing pathologists' MSL interpretations with reference standard diagnoses. Associations between enjoyment and diagnostic accuracy were evaluated by generalized estimating equations (GEE) models. One hundred and eighty-seven (90%) pathologists completed the study. Seventy percent agreed that interpreting MSL is enjoyable. Pathologists who enjoyed interpreting MSL were more likely to be...
      PubDate: Wed, 22 Aug 2018 00:00:00 +000
  • Addressing public criticism: a potential HIPAA violation

    • Abstract: Although patients are able to speak openly about their healthcare experience in negative reviews, laws protecting the privacy of the patient constrain providers from responding as freely. Unfortunately, violation of this principle occurs when responding to online patient criticism. We describe a case of a physician assistant revealing protected health information of a patient in response to a critical New York Times article. Providers must be wary of violating patients' privacy, even when they are criticized online. Addressing patients' concerns and neutral, caring online responses may be the physician's best options for responding to negative reviews.
      PubDate: Wed, 22 Aug 2018 00:00:00 +000
  • Cannabinoids in dermatology: a scoping review

    • Abstract: The therapeutic applications of cannabis and cannabinoids are an increasingly conspicuous topic as de-criminalization and legalization of these products continues to expand. A limited number of cannabinoid compounds have been approved for a specific set of conditions. However, the current role of cannabinoids for the treatment of dermatologic conditions remains to be defined. We conducted a review of the current literature to determine the applications of cannabinoids for the therapy of various skin diseases. After conducting our analysis, we found that cannabinoid products have the potential to treat a variety of skin conditions, including acne vulgaris, allergic contact dermatitis, asteatotic dermatitis, atopic dermatitis, hidradenitis suppurativa, Kaposi sarcoma, pruritus, psoriasis, skin cancer, and the cutaneous manifestations of systemic sclerosis. However, the majority of available data on these compounds are pre-clinical and there is a corresponding lack of high-quality...
      PubDate: Wed, 22 Aug 2018 00:00:00 +000
  • Golimumab-associated persistent erythema multiforme in a patient with
           ulcerative colitis in full remission

    • Abstract: Erythema multiforme is an immune-mediated cutaneous disorder that is thought to represent a hypersensitivity reaction to infections, drugs, vaccines, malignancies, autoimmune diseases, radiation, and menstruation. Golimumab is a human IgG1-kappa anti-TNF antibody that has been approved for the treatment of rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and ulcerative colitis. We report herein a 41-year-old woman with persistent erythema multiforme, that occurred 18 months after onset of golimumab treatment of her ulcerative colitis; the latter remains in full remission over a period of 36 months.
      PubDate: Wed, 22 Aug 2018 00:00:00 +000
  • Reviewing the use of imiquimod for molluscum contagiosum

    • Abstract: We discuss imiquimod associated with non-application site mucosal reactions and two of our own clinical cases. In one of our patients, erosive cheilitis developed in a young boy after using topical imiquimod 5% cream for 5 nights weekly on bilateral cheeks, chin, and near vermillion border for molluscum contagiosum. The case is discussed with concerns for imiquimod use in molluscum contagiosum when used near mucosal surfaces.
      PubDate: Wed, 22 Aug 2018 00:00:00 +000
  • Epidermotropic cutaneous metastases of squamous cell carcinoma from
           primary esophageal cancer: report of a case and review of the literature

    • Abstract: Metastatic squamous cell carcinoma (SCC) to the skin can be distinguished histologically from primary cutaneous squamous cell carcinoma as, unlike the latter, it is typically separated from the normal overlying squamous epithelium. Rare cases have been reported of cutaneous metastases of SCC that demonstrate continuity with the overlying benign squamous epithelium, termed "epidermotropic cutaneous metastases of SCC." We report the first case of epidermotropic cutaneous metastases of SCC originating from primary esophageal SCC with a review of the literature on this rare histological phenomenon.
      PubDate: Wed, 22 Aug 2018 00:00:00 +000
  • Giant fibrous hamartoma of infancy: pitfall of CD34 positive dermal
           mesenchymal tumor

    • Abstract: Fibrous hamartoma of infancy (FHI) is a rare benign soft tissue tumor with a triphasic organoid histologic appearance. The authors present a case of a 21-month-old healthy girl with a slowly growing flesh-colored subcutaneous plaque 12cm in size on the lower back, with overlying hypertrichosis. A punch biopsy revealed a proliferation of spindle cells infiltrating the dermis and hypodermis organized in a dense storiform pattern with a strong diffuse positivity for CD34. The diagnosis of congenital dermatofibrosarcoma protuberans (DFSP) was considered and an excision was performed. Histopathologic analysis showed an extensive poorly demarcated mass infiltrating the dermis and hypodermis, composed of different components: a monomorphous fibroblastic/myofibroblastic component, a mature adipose component, and an immature mesenchymal basophilic component. The clinical aspects with the histologic and immunohistochemical features led to the diagnosis of giant fibrous hamartoma of infancy....
      PubDate: Wed, 22 Aug 2018 00:00:00 +000
  • Fixed drug eruption related to sunitinib: a case report

    • Abstract: Sunitinib is an oral multi-targeted tyrosine kinase inhibitor. It has been approved for the treatment of gastro-intestinal stromal tumor and advanced renal cell carcinoma. Fixed drug eruption related to sunitinib is a rare cutaneous adverse drug reaction.
      PubDate: Tue, 21 Aug 2018 00:00:00 +000
  • Mycoplasma pneumoniae, more than a lung disease

    • Abstract: Mycoplasma pneumoniae-induced rash and mucositis (MIRM) is a recently described clinical entity and should be considered in children who present with oral (94% of patients), ocular (82% of patients), and urogenital lesions (63% of patients). MIRM was first described as a distinct clinical entity from Stevens Johnson syndrome/Toxic epidermal necrolysis (SJS)/(TEN) in 2015 [1]. As a new, uncommon diagnosis it frequently poses a diagnostic and therapeutic challenge for pediatricians and dermatologists. We report a case of MIRM in a previously healthy 15-year-old boy.
      PubDate: Tue, 21 Aug 2018 00:00:00 +000
  • A recalcitrant case of Jacquet erosive diaper dermatitis after surgery for
           Hirschsprung disease in a boy with Waardenburg-Shah syndrome

    • Abstract: We herein present a 4 year-old boy with Waardenburg-Shah syndrome who developed Jacquet erosive diaper dermatitis following a total colectomy and ileoanal anastomosis procedure for Hirschsprung disease. The diagnosis was made according to history and typical clinical findings. Complete resolution of the recalcitrant lesions after an ileostomy procedure supported the diagnosis. This case highlights the importance of being familiar with the predisposing factors and clinical presentation of this rare and severe form of chronic irritant dermatitis, since it may easily be misdiagnosed as other diseases in children and may lead to unnecessary diagnostic procedures, treatments, and anxiety due to suspicion of child abuse.
      PubDate: Tue, 21 Aug 2018 00:00:00 +000
  • Addressing the average lifespan of skin diseases is critical to good
           patient care

    • Abstract: Dermatology patients routinely ask how long their skin condition may last, yet this critical aspect of their care has not been emphasized in the literature. When a given diagnosis may be self-limited, it is essential that clinicians meet patient expectations by properly discussing the possible time course for resolution. Furthermore, being aware of, and prioritizing the knowledge of the duration of a skin disease can help limit continued exposure to side effects of prescribed treatments once the condition may have self-resolved or remitted.
      PubDate: Tue, 21 Aug 2018 00:00:00 +000
  • Cadaveric simulation for improving surgical training in dermatology

    • Abstract: Simulation models are rapidly changing medical education, especially the training of dermatology residents. Various models are available, including cadaveric simulations. Our study evaluates the impact of a cadaveric simulation on the training of dermatology residents. Over a period of three years, cadaveric simulation was shown to increase the surgical knowledge of residents. Residents were more confident in their knowledge of surgical anatomy and also surgical skills. Cadaveric simulation may offer a positive impact on resident training in dermatology.
      PubDate: Tue, 21 Aug 2018 00:00:00 +000
  • Subungual nail bed melanoma masquerading as tinea ungium

    • Abstract: Subungual amelanotic melanoma can masquerade as onychomycosis. Recently a man whose amelanotic nail bed melanoma presented as persistent onychodystrophy was reported in the Dermatology Online Journal. The patient had a persistent nail dystrophy; culture and biopsy of the nail demonstrated Candida and dermatophyte infection, respectively. However, he subsequently presented with a nodule that was biopsied and demonstrated melanoma. Similar to that patient, we recently described a 67-year-old woman with a four-year history of persistent nail dystrophy of the left fourth fingernail who had a periodic acid-Schiff staining of the nail plate demonstrating fungal hyphae. Her nail plate subsequently detached, demonstrating a friable nodule; a biopsy of the nodule demonstrated melanoma. In conclusion, in individuals with new morphologic changes to a dystrophic nail or with persistent nail dystrophy despite appropriate therapy, it is important for clinicians to consider performing additional...
      PubDate: Tue, 21 Aug 2018 00:00:00 +000
  • Eruptive melanocytic nevi in HIV infected patients: report of three cases

    • Abstract: The abrupt development of multiple melanocytic nevi has been described in association with many conditions, including human immunodeficiency virus infection. We report three cases of eruptive nevi in men with human immunodeficiency virus type 1 infection. One patient developed this phenomenon during the stage of acquired immunodeficiency syndrome. The other two patients had human immunodeficiency virus infection recently diagnosed and presented to our clinic reporting the development of multiple melanocytic nevi after starting highly active antiretroviral treatment, with improvement of their immunity. To our knowledge, this is the first report of eruptive melanocytic nevi as a possible consequence of the immune reconstitution inflammatory syndrome.
      PubDate: Tue, 21 Aug 2018 00:00:00 +000
  • Pheniramine maleate: an apparently safe drug causing bullous fixed drug

    • Abstract: Fixed drug eruption is a delayed type hypersensitivity reaction to a drug seen most frequently with antibiotics such as tetracyclines, sulfonamides, and NSAIDs such as naproxen and ibuprofen. Although H1-antihistamines rarely elicit cutaneous adverse effects, there have been a few reports in the literature implicating them in causing fixed drug eruption, particularly the piperazine derivatives (hydroxyzine, cetirizine, levocetirizine), and loratadine. However, cutaneous drug reactions with the alkylamine derivatives like pheniramine maleate are extremely uncommon and fixed drug eruptions have not been reported with any of the alkylamine antihistamines to date. We herein report a case of multifocal bullous fixed drug eruption following ingestion of pheniramine maleate.
      PubDate: Tue, 21 Aug 2018 00:00:00 +000
  • Crusted scabies masquerading as psoriasis plaques in a patient suffering
           from burn scars

    • Abstract: A 30-year-old woman, presented with erythematous scaling plaques on her trunk with severe pruritus and a burning sensation that began 3 months prior to her visit. She had a history of a thermal burn in that area, three years prior. Topical corticosteroid application for 3 months had no positive effects. Skin biopsy was done and scabies mites were found.
      PubDate: Tue, 21 Aug 2018 00:00:00 +000
  • A survey study with assessment of esophageal screening and genetic
           counseling in patients with Howel-Evans syndrome

    • Abstract: Background: It is important to better understand the role that environmental risk factors play on the development of esophageal cancer in Howel-Evans families. Additionally, there is little published about appropriate esophageal cancer screening practices in families genetically confirmed to have this condition.Methods: Surveys were distributed to 47 addresses of an American family with Howel-Evans syndrome, of which 29 responded and met inclusion criteria. Data was collected about demographics, environmental risk factors, and medical history of participants.Results : We report characteristics of family members with tylosis, rates of esophageal cancer, rates of genetic counseling, and levels of environmental risk factors. Of the survey respondents, 43% reported features of tylosis, 71.4% were male and 28.6% were female and 28.6% reported leukoplakia. Only 21.4% of tylotic family members smoked, 65% drank alcohol, and 28.6% drank well water. More than half (57.1%)...
      PubDate: Tue, 21 Aug 2018 00:00:00 +000
  • Estrogen receptor positive, progesterone receptor negative, leiomyoma of
           the areola of a male patient

    • Abstract: Leiomyoma of the nipple and areola is a rare subtype of genital leiomyoma. The etiology of the tumor is not well understood. However, sex hormones like estrogen and progesterone have been implicated in the tumorigenesis. Hereby, we report a 47-year-old man with an estrogen receptor positive, progesterone receptor negative, leiomyoma of the areola.
      PubDate: Mon, 20 Aug 2018 00:00:00 +000
  • Atrophic dermatofibroma in an elderly male - a rarely described variant of
           a common lesion

    • Abstract: Dermatofibroma frequently presents as a red-brown nodule on the extremities of the middle aged. Atrophic dermatofibroma is a rare variant that has been most commonly described as an atrophic depressed, erythematous lesion in females. The correct diagnosis of atrophic dermatofibroma is often hindered by its infrequent presentation. It has a female preponderance with an occurrence ratio of 10:1. We describe a case of an atrophic dermatofibroma on the back of an elderly man. Skin biopsy demonstrated a spindle cell proliferation in a storiform pattern, loss of elastic fibers, and substantial atrophy of both the underlying dermis and subcutaneous tissue. An aggregation of elastic fibers was found in the periphery of the tumor. These histologic features supported the diagnosis of atrophic dermatofibroma. The dermal and adipocyte atrophy was likely responsible for the retracted appearance of the lesion.
      PubDate: Mon, 20 Aug 2018 00:00:00 +000
  • Expediting patient appointments with dermatology rapid access clinics

    • Abstract: Background: Lengthy wait times for dermatology appointments in the U.S. limit care access. The University of Pennsylvania's Department of Dermatology has established an urgent care clinic (UCC) and an intermediate care clinic (ICC) to expedite appointments for higher acuity patients.Objective: To describe our rapid access clinics' operations, referral patterns, and distributions of diagnoses. Methods: We performed a retrospective review of dermatology consult order and appointment data for UCC, ICC, and routine care to determine the number of orders, consult appointments, and follow-up appointments; appointment wait times; and frequencies of diagnoses in referring provider and consult appointments. Press Ganey patient satisfaction ratings were also analyzed.Results: The median (interquartile range) wait times for UCC, ICC, and routine care, appointments were 3 (1-8) days, 36 (15-64) days, and 45 (12-97) days, respectively (P<0.001). The proportion of referrals...
      PubDate: Mon, 20 Aug 2018 00:00:00 +000
  • Leukemia cutis as the presenting symptom of acute myeloid leukemia: report
           of three cases

    • Abstract: Leukemia cutis (LC), a rare cutaneous manifestation of leukemia, can precede, follow, occur concurrently with, or present in the absence of (aleukemic) systemic leukemia. Leukemia cutis is especially rare as the presenting symptom of leukemia and is associated with a poor prognosis. Although more commonly seen in acute leukemias of myeloid and monocytic lineage, lymphocytic/lymphoblastic leukemias can also involve the skin. Three cases of LC presented with diverse skin lesions ranging from an erythematous rash to violaceous macules and papules to subcutaneous nodules. One case clinically mimicked fixed drug eruption. All the patients had acute myeloid leukemia (AML). Lesions showed two overarching histologic patterns: atypical perivascular infiltrate or nodular dermal histiocytoid infiltrate. Our cases expressed myeloperoxidase (MPO), a helpful marker to distinguish myeloid from non-myeloid cells, and CD68, a monocytic marker frequently expressed in cutaneous AML. CD14, a marker...
      PubDate: Thu, 26 Jul 2018 00:00:00 +000
  • Acquired bullous acrodermatitis enteropathica as a histologic mimic of
           pemphigus foliaceus in a patient on parenteral nutrition

    • Abstract: The original article was published on July19, 2017 and corrected on May 15, 2018. The revised version of the article includes a funding source for Dr. Maija Kiuru’s participation in this case report, awarded by the National Cancer Institute, National Institutes of Health grant K12CA138464. This change appears in the revised online PDF copy of this article.
      PubDate: Thu, 26 Jul 2018 00:00:00 +000
  • Scalp-to-toes application of permethrin for patients with scabies

    • Abstract: Scabies is an infestation of Sarcoptes scabiei resulting in intensely pruritic erythematous papules tipped with hemorrhagic crusts. Current guidelines and medication labels instruct application of topical permethrin 5% cream from neck down for treatment of adult patients with scabies. Although scalp and head involvement are observed in infants, it is rare in older children and adults. Herein, we present a case of an 11-month-old patient who had scalp involvement, and required a scalp-to-toes application of permethrin. We also present a 77-year-old patient with scabies involving the head, who failed initial treatment when permethrin was applied neck down, but had subsequent resolution when it was applied scalp-to-toes. These cases provide impetus for review of current guidelines to reflect application of topical permethrin 5% cream to all external surfaces of the body including the scalp and head.
      PubDate: Thu, 26 Jul 2018 00:00:00 +000
  • Diffuse vesiculobullous eruption with systemic findings

    • Abstract: Drug induced linear IgA bullous dermatosis (LABD) is a rare blistering disease that has been shown to be associated with the use of various medications. Although rarely seen together, some of the medications associated with LABD can lead to the syndrome drug reaction with eosinophilia and systemic symptoms (DRESS), which presents with fever, cutaneous eruption, and multi-organ involvement. We present a patient who developed fever and a generalized vesiculobullous eruption after recently starting amlodipine and meloxicam. Initial laboratory tests demonstrated elevated liver function tests, leukocystosis, and eosinophilia. Histopathologic examination of the punch biopsy revealed a bulla with sub-epidermal split and numerous neutrophils. Direct immunofluorescence demonstrated broad deposition of IgA along the dermal-epidermal junction. These findings were consistent with an overlap between LABD and DRESS. Drug induced LABD and DRESS are independently both rare diseases. It is even...
      PubDate: Thu, 26 Jul 2018 00:00:00 +000
  • Firm, hyperpigmented subcutaneous nodule in the inguinal fold of an infant

    • Abstract: Subcutaneous juvenile xanthogranuloma (JXG) of the inguinal fold, an unusual location, was diagnosed in an infant. Subcutaneous JXG should be included in the differential diagnosis of subcutaneous nodules of the lower body, despite the absence of the characteristic yellowish hue usually associated with JXG.
      PubDate: Wed, 25 Jul 2018 00:00:00 +000
  • Bullous pemphigoid and neurological disorders among a Jewish population

    • Abstract: A retrospective case control study included data regarding 65 Jewish bullous pemphigoid (BP) patients diagnosed in a tertiary medical center and a control group consisting of 182 matched Jewish patients. The study indicates that Jewish patients with BP suffer from a higher prevalence of neurological diseases compared to patients with no BP, similarly to previous reports showing high prevalence of neurological diseases among BP patients from different ethnic groups.
      PubDate: Wed, 25 Jul 2018 00:00:00 +000
  • Toxic epidermal necrolysis-like acute cutaneous lupus erythematosus:
           report of a case and review of the literature

    • Abstract: Severe bullous eruptions in systemic lupus erythematosus (SLE) patients include bullous SLE, Rowell syndrome, toxic epidermal necrolysis (TEN), and TEN-like eruption of acute cutaneous lupus (TEN-like ACLE). TEN-like ACLE, a rare manifestation of SLE that closely mimics TEN, can be distinguished by characteristic clinical and laboratory findings. A 27-year-old man with SLE who developed TEN-like ACLE after initiating mycophenolate mofetil for active SLE is reported. The reports of 37 women and six men  including our patient with TEN-like ACLE were also reviewed. The diagnosis of SLE or subacute cutaneous lupus erythematosus was either previously confirmed or established at the time of diagnosis of TEN-like ACLE in 41 patients. Fever was present in 59% of patients. The onset of TEN-like ACLE was either subacute (73%) or acute (27%). Thirteen cases did not clarify the nature of disease onset. The skin lesions often presented initially on sun-exposed sites (29 patients) and involved...
      PubDate: Wed, 25 Jul 2018 00:00:00 +000
  • Rapidly growing subcutaneous mass in an infant

    • Abstract: Fibrous hamartoma of infancy (FHI) is a benign mesenchymal tumor of young children. It has a broad clinical differential diagnosis and is often clinically confused for vascular and malignant soft tissue neoplasms. Recognition of the unique histologic features of FHI, a triphasic population of mature adipose tissue, mature fibrous tissue, and immature mesenchymal tissue, will ensure the correct diagnosis. In this report we present a case of this rare entity, including the associated clinical, radiologic, and histologic findings.
      PubDate: Wed, 25 Jul 2018 00:00:00 +000
  • Clostridium difficile arising in a patient with hidradenitis suppurativa
           on clindamycin and rifampin

    • Abstract: We report a case of Clostridium difficile infection in a patient with hidradenitis suppurativa who was taking clindamycin and rifampin. Clostridium difficile infection treatment prompted discontinuation of the medication. Clostridium difficile infection is known to develop after antibiotic treatment, such as clindamycin, but has rarely been associated with anti-tuberculosis agents, such as rifampin. Clinicians should be aware of the risk of Clostridium difficile infection in patients with hidradenitis suppurativa, even in those receiving rifampin.
      PubDate: Wed, 25 Jul 2018 00:00:00 +000
  • Squamous cell carcinoma of the cervix arising in a patient on adalimumab
           � a need for cervical screenings in patients on tumor necrosis factor

    • Abstract: Adalimumab, a tumor necrosis factor (TNF) inhibitor, has been approved for treatment of hidradenitis suppurativa. We report a case of cervical cancer in a patient with hidradenitis suppurativa taking adalimumab, which prompted discontinuation of the medication. Physicians should obtain a detailed cervical medical history before putting a female patient on a TNF inhibitor. Patients on TNF inhibitors who have pre-existing cervical issues such as human papillomavirus (HPV), dysplasia, or high grade intraepithelial lesions should be counseled about an increased risk of developing squamous cell carcinoma (SCC) of the cervix while on a TNF inhibitor. Furthermore, patients on TNF inhibitors should comply with the national screening guidelines for cervical cancer and be tested for human papillomavirus.
      PubDate: Wed, 25 Jul 2018 00:00:00 +000
  • Generalized retiform purpura as a presenting sign of diffuse dermal

    • Abstract: A 49-year-old man presented with progressive, painful, ulcerative, retiform purpuric patches on the torso and extremities. Multiple skin biopsies revealed a prominent pan-dermal vascular proliferation but no occlusive vasculopathy or cutaneous vasculitis. Diffuse dermal angiomatosis should be considered in the differential diagnosis of retiform purpura, especially in patients with atherosclerotic disease or underlying hypercoagulable states.
      PubDate: Wed, 25 Jul 2018 00:00:00 +000
  • Diffuse dermal angiomatosis of the breast with adjacent fat necrosis: a
           case report and review of the literature

    • Abstract: Diffuse dermal angiomatosis (DDA) is a type of reactive skin angioproliferation. Clinically, this rare disorder presents as red-violet purpuric papules and/or plaques (some with a greater tendency towards necrosis and ulceration), which can be localized in any body area, but is most often seen in the upper and lower extremities. Localization in the breast commonly presents with severe intractable breast pain and characteristic reticular violaceous erythematous plaques with central ulcerations. Histological examination is fundamental for the diagnosis and is characterized by varied patterns of lobular or diffuse hyperplasia of endothelial cells at the extravascular level. The condition is associated with various underlying conditions, many of which result in local tissue ischemia. In this report, we present a patient with DDA with an underlying mass lesion of the breast, which proved to be an adjacent fat necrosis. Various treatments have proven beneficial, including revascularization,...
      PubDate: Wed, 25 Jul 2018 00:00:00 +000
  • Cutaneous collagenous vasculopathy: development after coronary artery
           bypass surgery

    • Abstract: Cutaneous collagenous vasculopathy (CCV) is a rare benign microangiopathy of the superficial dermal vessels. Clinically, it is characterized by widespread, asymptomatic development of cutaneous telangiectasia in the absence of systemic symptoms. Morphologically, it most resembles generalized essential telangiectasia and other telangiectatic syndromes such as telangiectasia macularis eruptiva perstans (TMEP), ataxia telangiectasia, and hereditary hemorrhagic telangiectasia. It is distinctive in its histology, showing characteristic dilated thick-walled blood vessels in the superficial dermis. The thickened walls of these superficial dermal blood vessels demonstrate reduplication of the basement membrane on PAS staining. We report a 63-year-old man with CCV with this condition for 20 years, starting in 1996. He was diagnosed in the past as having essential telangiectasia. The development of the telangectasias occurred after coronary artery bypass grafting, also performed in 1996....
      PubDate: Wed, 25 Jul 2018 00:00:00 +000
  • Lymphomatoid papulosis in patients with chronic lymphocytic leukemia/small
           lymphocytic lymphoma: case report and literature review

    • Abstract: Background: Chronic lymphocytic leukemia (CLL) is a B cell lymphoproliferative disorder that characteristically presents in older individuals. Small lymphocytic lymphoma (SLL) occurs when CLL cells infiltrate lymph nodes and other tissues but spare peripheral blood and bone marrow. Lymphomatoid papulosis (LyP) is an indolent cutaneous CD30+ lymphoproliferative disorder characterized by papules and nodules that develop and spontaneously regress over weeks to months. Methods: An 84-year-old man with CLL who developed LyP is described. The features of other patients who concurrently had both of these conditions are reviewed. Results: A man was diagnosed with CLL at age 50 years. At 84 years of age, he presented with red papules on his buttocks, which demonstrated a CD30+ lymphoproliferative disorder on biopsy. Correlation of the lesion history, morphology, and histopathology established the diagnosis of LyP. LyP and CLL/SLL, including in this patient, has only been reported in 11...
      PubDate: Tue, 24 Jul 2018 00:00:00 +000
  • Chinese institutional payments for publishing dermatology journal articles

    • Abstract: Cash prizes for academic publication were introduced by the Department of Physics at Nanjing University in the 1990s. Most Chinese universities and research institutions have established cash rewards for first authors of publications. Potential payments ranged from ~$14,000 for an original research article in JAAD to ~$2000 for a case report in JAMA Dermatology. We examined rewards for publication of academic dermatological articles in China by searching for the cash-reward policies of general and dermatology Chinese hospitals. Specific cash-rewards for publication in the top three highest impact dermatological journals were recorded and compared between two dermatological hospitals, four general hospitals, and Chinese national core journals. Rewards were based upon the Science Citation Index (SCI), impact factor (IF) and publication type. Payment policies were compared between dermatological hospital and general hospitals using the t-test. There was no statistically significant...
      PubDate: Tue, 24 Jul 2018 00:00:00 +000
  • Tracking Mohs micrographic surgery referrals at the VA

    • Abstract: Large dermatology centers such as the Veterans Affairs health care system carry the challenge of providing adequate care for patients within an appropriate timeline. Herein we begin a discussion about the tracking systems in place at busy hospitals, such as the VA, where numerous biopsies are referred to outside providers for further treatment. The complex psychosocial aspect of providing care specifically to veterans is also addressed. Finally, we describe our system, which monitors malignant skin biopsies that are referred to outside clinics for Mohs Micrographic Surgery (MMS).
      PubDate: Tue, 24 Jul 2018 00:00:00 +000
  • Progestins and acne vulgaris: a review

    • Abstract: The role of exogenous progestin in the development of acne is unclear. Progestins are known for their androgenic potential, but newer generations of progestins have low or anti-androgenic activity. This review will evaluate the association between progestins found in hormonal long-acting reversible contraceptives (intrauterine devices and subdermal implants) and acne, as well as the role of oral contraceptives in acne management. Our review demonstrates that the cause and effect relationship between progestins and acne is difficult to establish and future studies that seek to understand how progestins modulate acne are necessary.
      PubDate: Tue, 24 Jul 2018 00:00:00 +000
  • Perforating disorder secondary to leflunomide and review of the literature
           of medications associated with perforating disorder

    • Abstract: The perforating dermatoses are a group of disorders characterized by transepidermal elimination of a material from the upper dermis. The most widely accepted classification consists of four primary perforating disorders that are defined by the type of material eliminated and the type of epidermal disruption. Pathogenesis of the perforating dermatoses is poorly understood, but some appear to have a genetic component. There are also acquired forms, which have been associated with underlying systemic diseases and the use of certain drugs. In this report, we describe a perforating disorder that occurred secondary to leflunomide therapy. To our knowledge, this is the first case in which this has been reported. We also review the recent literature on medications associated with perforating disorders.
      PubDate: Tue, 24 Jul 2018 00:00:00 +000
  • HIV-associated erythema elevatum diutinum: a case report and review of a
           clinically distinct variant

    • Abstract: A 24-year-old man with untreated human immunodeficiency virus (HIV) infection consulted our outreach clinic owing to the development of numerous asymptomatic nodules on his palms and fingers. Histopathologic evaluation revealed leukocytoclastic vasculitis and prominent fibrosis with a neutrophilic infiltrate consistent with erythema elevatum diutinum (EED). We referred the patient for initiation of antiretroviral therapy and started him on dapsone. The pathogenesis of EED is not completely understood, but it has been associated with numerous systemic conditions that may be infectious, inflammatory, or neoplastic. Only recently has EED been recognized as a defined reactive dermatosis of HIV. We present an exemplary case of HIV-associated EED and review the differential diagnosis, highlighting clinical features of EED that appear to be more frequently encountered in the HIV-infected population.
      PubDate: Tue, 24 Jul 2018 00:00:00 +000
  • A glimpse into the underground market of melanotan

    • Abstract: Melanotan-I and melanotan-II are alpha-melanocyte stimulating hormone (a-MSH) analogues that can be purchased illicitly online with relative ease and are injected subcutaneously to stimulate a tan. Little is known about the use of these unregulated substances. An observational survey was posted to an online forum in which participants share their experiences using melanotan-I or melanotan-II. Users were asked to complete this voluntary, anonymous survey, which had questions focusing on motivation and hesitation for and against using melanotan, difficulty in acquiring it, and plans for continuing to use melanotan in the future.
      PubDate: Tue, 24 Jul 2018 00:00:00 +000
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