Rebecca Lapides, Hannah J Porter, Rachael Chacko, Matthew Davis, Julia Barker, Joseph Pierson, Shane Chapman
Congenital malalignment of the great toenail is a dystrophic disorder that is characterized by lateral deviation of the nail plates. It is usually present at birth and diagnosed very early in life. Late onset of this condition, often referred to as, “acquired,” is very uncommon. Mechanical stress and repeated microtraumas to the nail can cause complications that can worsen the appearance of the nail and make the condition more obvious in older individuals, however, there are other triggers for this condition as well, such as drugs that can cause nail changes. Properly diagnosing this condition can prevent patients from undergoing unnecessary treatments and also facilitate the efficient initiation of the correct treatment in patients. Here, we discuss 3 cases of acquired congenital malalignment of the great toenail in patients during their 5th, 8th, and 7th decades of life.
{"title":"Acquired Congenial Malalignment of the Great Toenails: A Case Series","authors":"Rebecca Lapides, Hannah J Porter, Rachael Chacko, Matthew Davis, Julia Barker, Joseph Pierson, Shane Chapman","doi":"10.25251/skin.8.3.4","DOIUrl":"https://doi.org/10.25251/skin.8.3.4","url":null,"abstract":"Congenital malalignment of the great toenail is a dystrophic disorder that is characterized by lateral deviation of the nail plates. It is usually present at birth and diagnosed very early in life. Late onset of this condition, often referred to as, “acquired,” is very uncommon. Mechanical stress and repeated microtraumas to the nail can cause complications that can worsen the appearance of the nail and make the condition more obvious in older individuals, however, there are other triggers for this condition as well, such as drugs that can cause nail changes. Properly diagnosing this condition can prevent patients from undergoing unnecessary treatments and also facilitate the efficient initiation of the correct treatment in patients. Here, we discuss 3 cases of acquired congenital malalignment of the great toenail in patients during their 5th, 8th, and 7th decades of life.","PeriodicalId":22013,"journal":{"name":"SKIN The Journal of Cutaneous Medicine","volume":"84 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140983195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Danny Zakria, Milaan Shah, Joshua Burshtein, Brian Berman, Neal Bhatia, Roger Ceilley, Aaron Farberg, M. Lebwohl, Dawn Merritt, Keyvan Nouri, Linda Stein Gold, Darrell Rigel
Background: Actinic keratosis is a very common disease that affects over 40 million people in the United States. In addition to the clinically visible lesion, patients may present with surrounding field cancerization based on their history of ultraviolet exposure. While lesion-directed therapy such as cryosurgery can effectively treat individual actinic keratoses it does not treat subclinical lesions or field cancerization. Objective: To create consensus recommendations on the role of field cancerization in selecting appropriate therapy for actinic keratoses. Methods: A comprehensive literature search of PubMed, Google Scholar, and Embase was conducted using the keywords “actinic keratos*,” “treatment,” and “field cancerization” for English-language original research articles without date restrictions. Articles were included that either discussed the role of FC in treating AKs or compared various AK field therapies. The relevant articles were then distributed to a panel of nine dermatologists with significant expertise in managing AKs. Each panelist reviewed the articles and assigned them a level of evidence based on Strength of Recommendation Taxonomy (SORT) criteria. The panel then convened on to discuss the studies and develop consensus statements on the role of FC in selecting AK therapy. The panel utilized a modified Delphi process to approve the adoption of each statement and gave each one a strength of recommendation based on SORT criteria. Results: The initial literature search produced 243 articles that met search criteria. After a thorough screening of these articles for relevance to the research question, 21 articles were chosen to be reviewed by the panel and assigned a level of evidence. Of the 21 articles that were reviewed, the panel assigned level 1 evidence to three articles, level 2 evidence to six articles, and level 3 evidence to twelve articles. The panel created seven consensus statements related to AK management and FC. All seven statements received a unanimous (9/9) vote for adoption. Each of the statements was given a strength of recommendation according to sort criteria Conclusion: Field cancerization due to chronic ultraviolet exposure leads to subclinical AK lesions in addition to lesions that are clinically apparent. In order to address these lesions, field therapy is an important component of an adequate regimen and can be used in conjunction with lesion-directed therapy for optimal results.
背景：日光性角化病是一种非常常见的疾病，美国有 4000 多万人患病。除了临床可见的病变外，患者还可能因紫外线照射史而出现周围区域癌变。虽然冷冻手术等针对病变的治疗方法可以有效治疗单个的日光性角化病，但不能治疗亚临床病变或野外癌变。目标：就场癌化在选择适当的光化性角化病疗法中的作用提出共识性建议。方法：使用关键词 "光化性角化病*"、"治疗 "和 "视野癌化 "对 PubMed、Google Scholar 和 Embase 中的英文原创研究文章进行了全面的文献检索，没有日期限制。收录的文章要么讨论了 FC 在治疗 AK 中的作用，要么比较了各种 AK 现场疗法。然后，将相关文章分发给由九位在治疗 AK 方面具有丰富专业知识的皮肤科专家组成的小组。每位专家组成员都对文章进行了审阅，并根据推荐强度分类标准（SORT）对文章进行了证据等级划分。然后，专家小组召开会议讨论这些研究，并就 FC 在选择 AK 治疗中的作用达成共识。专家小组采用改良的德尔菲程序批准通过每项声明，并根据 SORT 标准对每项声明给出推荐强度。结果：通过初步文献检索，共有 243 篇文章符合检索标准。在对这些文章与研究问题的相关性进行彻底筛选后，专家小组选择了 21 篇文章进行审查，并确定了证据等级。在审查的 21 篇文章中，专家小组为 3 篇文章评定了 1 级证据，为 6 篇文章评定了 2 级证据，为 12 篇文章评定了 3 级证据。专家小组制定了七项与 AK 管理和 FC 相关的共识声明。所有七项声明均获得一致通过（9/9）。每项声明都根据分类标准给出了推荐强度 结论：长期紫外线照射导致的野外癌变，除了临床表现明显的病变外，还会导致亚临床 AK 病变。为了治疗这些病变，野外疗法是适当治疗方案的重要组成部分，可与病变导向疗法结合使用，以达到最佳效果。
{"title":"The Role of Field Cancerization in Selecting Therapies for Actinic Keratosis: An Expert Consensus Panel","authors":"Danny Zakria, Milaan Shah, Joshua Burshtein, Brian Berman, Neal Bhatia, Roger Ceilley, Aaron Farberg, M. Lebwohl, Dawn Merritt, Keyvan Nouri, Linda Stein Gold, Darrell Rigel","doi":"10.25251/skin.8.3.1","DOIUrl":"https://doi.org/10.25251/skin.8.3.1","url":null,"abstract":"Background: Actinic keratosis is a very common disease that affects over 40 million people in the United States. In addition to the clinically visible lesion, patients may present with surrounding field cancerization based on their history of ultraviolet exposure. While lesion-directed therapy such as cryosurgery can effectively treat individual actinic keratoses it does not treat subclinical lesions or field cancerization. \u0000Objective: To create consensus recommendations on the role of field cancerization in selecting appropriate therapy for actinic keratoses. \u0000Methods: A comprehensive literature search of PubMed, Google Scholar, and Embase was conducted using the keywords “actinic keratos*,” “treatment,” and “field cancerization” for English-language original research articles without date restrictions. Articles were included that either discussed the role of FC in treating AKs or compared various AK field therapies. The relevant articles were then distributed to a panel of nine dermatologists with significant expertise in managing AKs. Each panelist reviewed the articles and assigned them a level of evidence based on Strength of Recommendation Taxonomy (SORT) criteria. The panel then convened on to discuss the studies and develop consensus statements on the role of FC in selecting AK therapy. The panel utilized a modified Delphi process to approve the adoption of each statement and gave each one a strength of recommendation based on SORT criteria. \u0000Results: The initial literature search produced 243 articles that met search criteria. After a thorough screening of these articles for relevance to the research question, 21 articles were chosen to be reviewed by the panel and assigned a level of evidence. Of the 21 articles that were reviewed, the panel assigned level 1 evidence to three articles, level 2 evidence to six articles, and level 3 evidence to twelve articles. The panel created seven consensus statements related to AK management and FC. All seven statements received a unanimous (9/9) vote for adoption. Each of the statements was given a strength of recommendation according to sort criteria \u0000Conclusion: Field cancerization due to chronic ultraviolet exposure leads to subclinical AK lesions in addition to lesions that are clinically apparent. In order to address these lesions, field therapy is an important component of an adequate regimen and can be used in conjunction with lesion-directed therapy for optimal results.","PeriodicalId":22013,"journal":{"name":"SKIN The Journal of Cutaneous Medicine","volume":"61 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140983638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarcoidosis is an inflammatory granulomatous disease affecting multiple organs with cutaneous sarcoidosis occurring in 25% of patients. There are several treatment options available, but alternative therapies should be considered in patients with refractory disease to standard intervention. Though they are not been FDA-approved for sarcoidosis, TNF-a inhibitors have demonstrated significant therapeutic intervention targeting proinflammatory cytokines involves in pathogenesis of sarcoidosis. Herein, we present a case of refractory cutaneous sarcoidosis successfully treated with infliximab therapy with significant hair regrowth on the scalp.
{"title":"A Case of Refractory Cutaneous Sarcoidosis Successfully Treated with Infliximab","authors":"Roudha Al-Dehneem","doi":"10.25251/skin.8.3.21","DOIUrl":"https://doi.org/10.25251/skin.8.3.21","url":null,"abstract":"Sarcoidosis is an inflammatory granulomatous disease affecting multiple organs with cutaneous sarcoidosis occurring in 25% of patients. There are several treatment options available, but alternative therapies should be considered in patients with refractory disease to standard intervention. Though they are not been FDA-approved for sarcoidosis, TNF-a inhibitors have demonstrated significant therapeutic intervention targeting proinflammatory cytokines involves in pathogenesis of sarcoidosis. Herein, we present a case of refractory cutaneous sarcoidosis successfully treated with infliximab therapy with significant hair regrowth on the scalp.","PeriodicalId":22013,"journal":{"name":"SKIN The Journal of Cutaneous Medicine","volume":"31 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140982911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sonia Wang, Sarah D. Bayefsky, Alexandra J. Coromilas, Kathryn A. Whitaker, Roman Bronfenbrener, M. Rosenbach, Leo L. Wang
Introduction: Synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome may represent one side of a spectrum of disease that also includes chronic nonbacterial osteomyelitis. Case: A 23-year-old male with bone pain in the anterior chest, shoulder, clavicles, left elbow, and left ankle presented to rheumatology clinic after multiple evaluations for infectious osteomyelitis. Imaging and deep bone biopsies of affected areas were consistent with chronic osteomyelitis, with labs notable for elevated erythrocyte sedimentation rate, C-reactive protein, and positivity for HLA-B27. A full skin exam was consistent with hidradenitis suppurativa, and he was started on infliximab and methotrexate with improvement in both his osteoarticular and skin symptoms. Conclusions: Patients presenting with features of follicular occlusion or neutrophilic dermatoses in conjunction with bone pain should be evaluated for SAPHO/CNO. In patients with SAPHO/CNO with vertebral involvement, bisphosphonates in addition to anti-inflammatory medications (such as methotrexate and TNF-inhibitors) can be effective.
{"title":"Chronic Nonbacterial Osteomyelitis, Hidradenitis Suppurativa, and SAPHO Syndrome","authors":"Sonia Wang, Sarah D. Bayefsky, Alexandra J. Coromilas, Kathryn A. Whitaker, Roman Bronfenbrener, M. Rosenbach, Leo L. Wang","doi":"10.25251/skin.8.3.12","DOIUrl":"https://doi.org/10.25251/skin.8.3.12","url":null,"abstract":"Introduction: Synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome may represent one side of a spectrum of disease that also includes chronic nonbacterial osteomyelitis. \u0000Case: A 23-year-old male with bone pain in the anterior chest, shoulder, clavicles, left elbow, and left ankle presented to rheumatology clinic after multiple evaluations for infectious osteomyelitis. Imaging and deep bone biopsies of affected areas were consistent with chronic osteomyelitis, with labs notable for elevated erythrocyte sedimentation rate, C-reactive protein, and positivity for HLA-B27. A full skin exam was consistent with hidradenitis suppurativa, and he was started on infliximab and methotrexate with improvement in both his osteoarticular and skin symptoms. \u0000Conclusions: Patients presenting with features of follicular occlusion or neutrophilic dermatoses in conjunction with bone pain should be evaluated for SAPHO/CNO. In patients with SAPHO/CNO with vertebral involvement, bisphosphonates in addition to anti-inflammatory medications (such as methotrexate and TNF-inhibitors) can be effective.","PeriodicalId":22013,"journal":{"name":"SKIN The Journal of Cutaneous Medicine","volume":"88 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140984695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Zakria, Nicholas Brownstone, Klaus Fritz, Carmen Salavastru, Darrell S Rigel
Background: Even the most experienced dermatologists may forego a biopsy on as many as one-third of malignant melanomas (MMs). Electrical impedance spectroscopy (EIS) is a noninvasive technology that send a painless, very low voltage electrical current through a pigmented lesion to determine if it is benign or malignant. This study aimed to determine if EIS data can improve the decision to biopsy a pigmented lesion even beyond dermoscopy. Methods: A survey with 49 images of MMs, severe dysplastic nevi (SDNs), and benign pigmented skin lesions (PSLs) was shown to dermatologists at a national conference. They were asked if they would biopsy the lesion after first seeing the clinical image, then again after seeing the dermoscopic image, and again after receiving the EIS score. Results: 151 dermatologists completed the survey. Respondents significantly increased correct biopsy decisions (biopsy MMs and SDNs and forego biopsy of benign PSLs) with the addition of dermoscopy versus clinical image alone for MM (78.5% vs. 56.2%, p<0.01) and SDN (62.7% vs. 43.8%, p<0.01). Participants also demonstrated a statistically significant increase in correct biopsy decisions beyond the dermoscopic evaluation when integrating the EIS score for MM (86.2% vs. 78.9%, p<0.01), SDN (68.1% vs. 62.7%, p<0.05) and benign lesions (58.7% vs. 48.0% vs, p<0.01). Conclusion: EIS was able to further improve the rate of correct biopsy choice for MMs and SDNs even beyond dermoscopic evaluation. While dermoscopy worsened diagnostic accuracy for benign PSLs, EIS results were able to significantly improve decision making for these lesions as well. This study demonstrates the clinical utility of EIS technology for improving melanoma diagnosis.
背景：即使是最有经验的皮肤科医生也可能会放弃对多达三分之一的恶性黑色素瘤（MM）进行活组织检查。电阻抗光谱（EIS）是一种无创技术，它能通过色素病变发出无痛、电压极低的电流，以确定病变是良性还是恶性。本研究旨在确定 EIS 数据是否能改善对色素性病变进行活检的决定，甚至超过皮肤镜检查。研究方法在一次全国性会议上向皮肤科医生展示了一份调查表，其中包含 49 幅 MMs、严重发育不良痣 (SDN) 和良性色素性皮肤病变 (PSL) 的图像。他们被问及在第一次看到临床图像后是否会对病变进行活组织检查，在看到皮肤镜图像后是否会再次进行活组织检查，在得到 EIS 评分后是否会再次进行活组织检查。结果：151 名皮肤科医生完成了调查。对于 MM（78.5% 对 56.2%，P<0.01）和 SDN（62.7% 对 43.8%，P<0.01），受访者做出正确活检决定（对 MM 和 SDN 进行活检，并放弃对良性 PSL 进行活检）的比例明显高于仅使用临床图像的比例。对于 MM（86.2% vs. 78.9%，p<0.01）、SDN（68.1% vs. 62.7%，p<0.05）和良性病变（58.7% vs. 48.0% vs，p<0.01），在整合 EIS 评分后，参与者在皮肤镜评估之外做出正确活检决定的比例也有统计学意义的显著提高。结论EIS 能够进一步提高 MM 和 SDN 活检选择的正确率，甚至超过皮肤镜评估。虽然皮肤镜检查会降低良性 PSL 的诊断准确性，但 EIS 的结果也能显著改善这些病变的决策。这项研究证明了 EIS 技术在改善黑色素瘤诊断方面的临床实用性。
{"title":"Utilizing Data from Electrical Impedance Spectroscopy Significantly Improves the Decision to Biopsy Pigmented Skin Lesions Beyond Clinical Evaluation and Dermoscopy","authors":"D. Zakria, Nicholas Brownstone, Klaus Fritz, Carmen Salavastru, Darrell S Rigel","doi":"10.25251/skin.8.3.5","DOIUrl":"https://doi.org/10.25251/skin.8.3.5","url":null,"abstract":"Background: Even the most experienced dermatologists may forego a biopsy on as many as one-third of malignant melanomas (MMs). Electrical impedance spectroscopy (EIS) is a noninvasive technology that send a painless, very low voltage electrical current through a pigmented lesion to determine if it is benign or malignant. This study aimed to determine if EIS data can improve the decision to biopsy a pigmented lesion even beyond dermoscopy. \u0000Methods: A survey with 49 images of MMs, severe dysplastic nevi (SDNs), and benign pigmented skin lesions (PSLs) was shown to dermatologists at a national conference. They were asked if they would biopsy the lesion after first seeing the clinical image, then again after seeing the dermoscopic image, and again after receiving the EIS score. \u0000Results: 151 dermatologists completed the survey. Respondents significantly increased correct biopsy decisions (biopsy MMs and SDNs and forego biopsy of benign PSLs) with the addition of dermoscopy versus clinical image alone for MM (78.5% vs. 56.2%, p<0.01) and SDN (62.7% vs. 43.8%, p<0.01). Participants also demonstrated a statistically significant increase in correct biopsy decisions beyond the dermoscopic evaluation when integrating the EIS score for MM (86.2% vs. 78.9%, p<0.01), SDN (68.1% vs. 62.7%, p<0.05) and benign lesions (58.7% vs. 48.0% vs, p<0.01). \u0000Conclusion: EIS was able to further improve the rate of correct biopsy choice for MMs and SDNs even beyond dermoscopic evaluation. While dermoscopy worsened diagnostic accuracy for benign PSLs, EIS results were able to significantly improve decision making for these lesions as well. This study demonstrates the clinical utility of EIS technology for improving melanoma diagnosis.","PeriodicalId":22013,"journal":{"name":"SKIN The Journal of Cutaneous Medicine","volume":"7 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140983091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Open Payments, established in 2013 to address concerns about industry-driven healthcare influence, aims to enhance transparency regarding financial relationships between industry and physicians. This study investigates trends in industry payments to dermatologists between 2015 and 2022, a topic that has not been explored since a prior characterization in 2014. Methods: We conducted a retrospective review of United States dermatologists appearing in the Open Payments database between 2015 and 2022. A Joinpoint analysis was performed to calculate the average annual percentage change (AAPC) across study years. A sensitivity analysis excluding 2020-2021 data was conducted. Results: This study reviewed 2,616,289 payments totaling $494,271,790 made to dermatologists during the study period. The average annual percentage change (AAPC) across these years for the number of recipient dermatologists, total value of payments, and total number of payments were 1.5%, 5.5%, and 3.9%, respectively, with confirmed positive growth when excluding data from 2020-2021. Conclusions: Payments per dermatologist have increased over the years, even when adjusting for inflation, but this growth is likely attributed to the overall expansion of the specialty. Most individual payments to dermatologists were less than $50. However, a substantial proportion of dermatologists (60%) received total payments exceeding $1000 during the study period. These findings suggest a longitudinal nature of industry-dermatologist relationships and emphasize the financial significance of payments over time. Notably, the impact of physician-industry relationships on patient care in dermatology remains debated but may influence medical decision-making and engender patient distrust.
{"title":"Trend Analysis of Industry Payments to Dermatologists in the United States from 2015-2022","authors":"Nicole J. Hardy, C. Gronbeck, Hao Feng","doi":"10.25251/skin.8.3.7","DOIUrl":"https://doi.org/10.25251/skin.8.3.7","url":null,"abstract":"Background: Open Payments, established in 2013 to address concerns about industry-driven healthcare influence, aims to enhance transparency regarding financial relationships between industry and physicians. This study investigates trends in industry payments to dermatologists between 2015 and 2022, a topic that has not been explored since a prior characterization in 2014. \u0000Methods: We conducted a retrospective review of United States dermatologists appearing in the Open Payments database between 2015 and 2022. A Joinpoint analysis was performed to calculate the average annual percentage change (AAPC) across study years. A sensitivity analysis excluding 2020-2021 data was conducted. \u0000Results: This study reviewed 2,616,289 payments totaling $494,271,790 made to dermatologists during the study period. The average annual percentage change (AAPC) across these years for the number of recipient dermatologists, total value of payments, and total number of payments were 1.5%, 5.5%, and 3.9%, respectively, with confirmed positive growth when excluding data from 2020-2021. \u0000Conclusions: Payments per dermatologist have increased over the years, even when adjusting for inflation, but this growth is likely attributed to the overall expansion of the specialty. Most individual payments to dermatologists were less than $50. However, a substantial proportion of dermatologists (60%) received total payments exceeding $1000 during the study period. These findings suggest a longitudinal nature of industry-dermatologist relationships and emphasize the financial significance of payments over time. Notably, the impact of physician-industry relationships on patient care in dermatology remains debated but may influence medical decision-making and engender patient distrust.","PeriodicalId":22013,"journal":{"name":"SKIN The Journal of Cutaneous Medicine","volume":"6 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140985295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniel Fischer, Joseph Gofman, Graham Litchman, Sourab Choudhury
While beta-adrenergic blocking agents (beta blockers) are generally safe, their incidence of medication-induced cutaneous eruptions remain under-recognized in the primary care setting. The adverse dermatologic effects of these medications may arise in the days to years following drug initiation, contributing to its delayed diagnosis and management. Here we report a case of a papulosquamous drug eruption in an older adult due to atenolol. We also discuss pertinent morphologic findings, diagnostic methods, management, and how to distinguish this type of eruption from other papulosquamous disorders.
{"title":"Identifying a Case of an Atenolol-induced Papulosquamous Eruption","authors":"Daniel Fischer, Joseph Gofman, Graham Litchman, Sourab Choudhury","doi":"10.25251/skin.8.3.10","DOIUrl":"https://doi.org/10.25251/skin.8.3.10","url":null,"abstract":"While beta-adrenergic blocking agents (beta blockers) are generally safe, their incidence of medication-induced cutaneous eruptions remain under-recognized in the primary care setting. The adverse dermatologic effects of these medications may arise in the days to years following drug initiation, contributing to its delayed diagnosis and management. Here we report a case of a papulosquamous drug eruption in an older adult due to atenolol. We also discuss pertinent morphologic findings, diagnostic methods, management, and how to distinguish this type of eruption from other papulosquamous disorders.","PeriodicalId":22013,"journal":{"name":"SKIN The Journal of Cutaneous Medicine","volume":"76 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140983243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Psoriasis and autoimmune bullous diseases have been shown to coexist in certain patients. Notably, anti-p200 pemphigoid has been associated with psoriasis. We present a case of a patient who presented with psoriasis and was also found to have anti-p200 pemphigoid. This case highlights the importance of recognizing this association, which may aid in diagnosis but also poses an interesting challenge in co-managing these two entities.
{"title":"Coexisting Psoriasis and Anti-P200 Pemphigoid: A Case Report","authors":"Samantha Hunt","doi":"10.25251/skin.8.3.18","DOIUrl":"https://doi.org/10.25251/skin.8.3.18","url":null,"abstract":"Psoriasis and autoimmune bullous diseases have been shown to coexist in certain patients. Notably, anti-p200 pemphigoid has been associated with psoriasis. We present a case of a patient who presented with psoriasis and was also found to have anti-p200 pemphigoid. This case highlights the importance of recognizing this association, which may aid in diagnosis but also poses an interesting challenge in co-managing these two entities.","PeriodicalId":22013,"journal":{"name":"SKIN The Journal of Cutaneous Medicine","volume":"9 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140982183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Verma, Mojahed M. K. Shalabi, Aubrey C. Hartmann, Daniel P. Friedmann
Linear porokeratosis (LP) is a rare and uncommon variant of porokeratosis presenting as linear annular papules or plaques along Blaschko’s lines. It may arise spontaneously, although evidence of genetic predisposition exists via point mutations in the mevalonate pathway of cholesterol biosynthesis. Malignant transformation is the most serious complication of this chronic, progressive dyskeratosis. We review the currently available treatment options for LP, including topical, systemic, laser, photodynamic, and surgical therapies.
{"title":"A Review of Therapeutic Options for Linear Porokeratosis","authors":"K. Verma, Mojahed M. K. Shalabi, Aubrey C. Hartmann, Daniel P. Friedmann","doi":"10.25251/skin.8.3.3","DOIUrl":"https://doi.org/10.25251/skin.8.3.3","url":null,"abstract":"Linear porokeratosis (LP) is a rare and uncommon variant of porokeratosis presenting as linear annular papules or plaques along Blaschko’s lines. It may arise spontaneously, although evidence of genetic predisposition exists via point mutations in the mevalonate pathway of cholesterol biosynthesis. Malignant transformation is the most serious complication of this chronic, progressive dyskeratosis. We review the currently available treatment options for LP, including topical, systemic, laser, photodynamic, and surgical therapies.","PeriodicalId":22013,"journal":{"name":"SKIN The Journal of Cutaneous Medicine","volume":"93 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140984445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marisa Tandy, Caroline Kruithoff, Michael Noparstak
Basal cell carcinoma (BCC) is a common nonmelanoma skin cancer, frequently present on the face and head. BCC is linked to the Sonic Hedgehog (Shh) signaling pathway. Mutations within the Shh signaling pathway, involving the activation of the ligand-independent pathway by the Smoothened (Smo) protein, can lead to unregulated proliferation of basal cells, resulting in BCC. Vismodegib, a hedgehog pathway inhibitor, is a chemotherapy drug approved for targeting the Shh signaling pathway. We herein report a presentation of nodular BCC in a Caucasian female who was treated with Vismodegib. This case highlights the effectiveness of pulse dosing treatment to minimize side effects.
{"title":"Pulse Dosing Vismodegib Therapy as an Effective Treatment of Basal Cell Carcinoma: A Case Report","authors":"Marisa Tandy, Caroline Kruithoff, Michael Noparstak","doi":"10.25251/skin.8.3.19","DOIUrl":"https://doi.org/10.25251/skin.8.3.19","url":null,"abstract":"Basal cell carcinoma (BCC) is a common nonmelanoma skin cancer, frequently present on the face and head. BCC is linked to the Sonic Hedgehog (Shh) signaling pathway. Mutations within the Shh signaling pathway, involving the activation of the ligand-independent pathway by the Smoothened (Smo) protein, can lead to unregulated proliferation of basal cells, resulting in BCC. Vismodegib, a hedgehog pathway inhibitor, is a chemotherapy drug approved for targeting the Shh signaling pathway. We herein report a presentation of nodular BCC in a Caucasian female who was treated with Vismodegib. This case highlights the effectiveness of pulse dosing treatment to minimize side effects.","PeriodicalId":22013,"journal":{"name":"SKIN The Journal of Cutaneous Medicine","volume":"12 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140984104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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