Breast cancer affects approximately 1 in 8 women and is the most common malignancy among women. Alopecia neoplastica is a rare cutaneous manifestation of breast adenocarcinoma with less than 30 reported cases worldwide. The skin is typically not a target organ for cutaneous metastasis, however, breast adenocarcinoma carries a higher risk. Here, the author describes the case of woman with a history of breast carcinoma who was clinically disease free for over 11 years. She presented to Dermatology with rapid-onset alopecia and was diagnosed with alopecia neoplastica and subsequent diagnosis of metastatic disease. This case illustrates the importance of considering alopecia neoplastica as a differential diagnosis in adult women presenting with localized alopecia who also have a history of breast carcinoma.
{"title":"Metastatic Breast Cancer Manifesting as Alopecia: A Case Report","authors":"Sara Wilchowski","doi":"10.58744/001c.72022","DOIUrl":"https://doi.org/10.58744/001c.72022","url":null,"abstract":"Breast cancer affects approximately 1 in 8 women and is the most common malignancy among women. Alopecia neoplastica is a rare cutaneous manifestation of breast adenocarcinoma with less than 30 reported cases worldwide. The skin is typically not a target organ for cutaneous metastasis, however, breast adenocarcinoma carries a higher risk. Here, the author describes the case of woman with a history of breast carcinoma who was clinically disease free for over 11 years. She presented to Dermatology with rapid-onset alopecia and was diagnosed with alopecia neoplastica and subsequent diagnosis of metastatic disease. This case illustrates the importance of considering alopecia neoplastica as a differential diagnosis in adult women presenting with localized alopecia who also have a history of breast carcinoma.","PeriodicalId":93653,"journal":{"name":"Journal of dermatology for physician assistants : Official journal of the Society of Dermatology Physician Assistants","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79981687","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}
{"title":"Hold the Cannonfire, Eat the Peanuts: What the Thymus Tells Us About Diplomacy and Fellowship","authors":"Peter A. Young","doi":"10.58744/001c.72028","DOIUrl":"https://doi.org/10.58744/001c.72028","url":null,"abstract":"","PeriodicalId":93653,"journal":{"name":"Journal of dermatology for physician assistants : Official journal of the Society of Dermatology Physician Assistants","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78017682","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}
Statistical concepts such as p-value, confidence interval, measures of central tendency, and relative ratio are commonly used by clinicians for data interpretation. This article will serve as a refresher for these concepts and give readers an idea of their practical application. Healthcare providers can use this knowledge to identify clinical relevance as well as any misinterpretation or misrepresentation of data.
{"title":"Overview of Statistical Concepts for Interpreting Data and Clinical Trial Results","authors":"Amy Baum Jones","doi":"10.58744/001c.72030","DOIUrl":"https://doi.org/10.58744/001c.72030","url":null,"abstract":"Statistical concepts such as p-value, confidence interval, measures of central tendency, and relative ratio are commonly used by clinicians for data interpretation. This article will serve as a refresher for these concepts and give readers an idea of their practical application. Healthcare providers can use this knowledge to identify clinical relevance as well as any misinterpretation or misrepresentation of data.","PeriodicalId":93653,"journal":{"name":"Journal of dermatology for physician assistants : Official journal of the Society of Dermatology Physician Assistants","volume":"161 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78550741","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}
Suicide is a major public health concern. It is the tenth leading cause of death in the United States, the second leading cause of death for individuals ages 10 to 34, and the fourth leading cause of death for individuals ages 35 to 44.1 In 2019, approximately 12.2 million adults in the United States considered death by suicide and 1.2 million people attempted suicide.2 According to the Center for Disease Control and Prevention, in 2020, a total of 45,979 people died by suicide; that is one person dying by suicide every 11 minutes.2 Approximately 54 percent of Americans have been affected by a suicide death leading to emotional, physical, and economic sequelae.1 It is estimated that 1 out of 7 young adults reported suicidal thoughts at some point in their lives and at least five percent had made an attempt.3 More than 90 percent of adults who survive a suicide attempt do not go on to die by suicide.2,4 Identifying patients who have a history of a previous suicide attempt or who are at risk for a suicide attempt may be effective in preventing a subsequent potentially lethal event. All healthcare providers in primary care and medical subspecialties, including dermatology, have a responsibility for suicide prevention. Routine screening of patients for suicide risk and appropriate referrals to mental health services will decrease the number of patients who end their lives by suicide each year.1 This program has been CME reviewed and is approved for a maximum of 1 hour of AAPA Category I CME credit by the Physician Assistant Review Panel. Approval is valid for 1 year from the issue date of September 1, 2022. Participants may submit the self-assessment exam at any time during that period. This program was planned in accordance with AAPA’s CME Standards for Enduring Material Programs and for Commercial Support of Enduring Material Programs. SDPA members may access the post-test at https://www.dermpa.org/JDPA_Exams
{"title":"Basics in Mental Health Screening for Suicide Risk Assessment in Dermatology","authors":"C. Judd","doi":"10.58744/001c.71399","DOIUrl":"https://doi.org/10.58744/001c.71399","url":null,"abstract":"Suicide is a major public health concern. It is the tenth leading cause of death in the United States, the second leading cause of death for individuals ages 10 to 34, and the fourth leading cause of death for individuals ages 35 to 44.1 In 2019, approximately 12.2 million adults in the United States considered death by suicide and 1.2 million people attempted suicide.2 According to the Center for Disease Control and Prevention, in 2020, a total of 45,979 people died by suicide; that is one person dying by suicide every 11 minutes.2 Approximately 54 percent of Americans have been affected by a suicide death leading to emotional, physical, and economic sequelae.1 It is estimated that 1 out of 7 young adults reported suicidal thoughts at some point in their lives and at least five percent had made an attempt.3 More than 90 percent of adults who survive a suicide attempt do not go on to die by suicide.2,4 Identifying patients who have a history of a previous suicide attempt or who are at risk for a suicide attempt may be effective in preventing a subsequent potentially lethal event. All healthcare providers in primary care and medical subspecialties, including dermatology, have a responsibility for suicide prevention. Routine screening of patients for suicide risk and appropriate referrals to mental health services will decrease the number of patients who end their lives by suicide each year.1 This program has been CME reviewed and is approved for a maximum of 1 hour of AAPA Category I CME credit by the Physician Assistant Review Panel. Approval is valid for 1 year from the issue date of September 1, 2022. Participants may submit the self-assessment exam at any time during that period. This program was planned in accordance with AAPA’s CME Standards for Enduring Material Programs and for Commercial Support of Enduring Material Programs. SDPA members may access the post-test at https://www.dermpa.org/JDPA_Exams","PeriodicalId":93653,"journal":{"name":"Journal of dermatology for physician assistants : Official journal of the Society of Dermatology Physician Assistants","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91339660","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}
This case of a gentleman with a chronic foot lesion and onychodystrophy illustrates one of the various forms that pemphigus vulgaris can take. We present diagnostic testing, including histology, direct immunofluorescence testing (DIF), and indirect immunofluorescence (IIF). We discuss the incidence of pemphigus, the variants of pemphigus, and the treatment objectives in this patient population.
{"title":"Something is Afoot: Case of Pemphigus Vulgaris Mimicking Infections","authors":"Cynthia F. Griffith, Loderick A. Matthews, R. Son","doi":"10.58744/001c.71331","DOIUrl":"https://doi.org/10.58744/001c.71331","url":null,"abstract":"This case of a gentleman with a chronic foot lesion and onychodystrophy illustrates one of the various forms that pemphigus vulgaris can take. We present diagnostic testing, including histology, direct immunofluorescence testing (DIF), and indirect immunofluorescence (IIF). We discuss the incidence of pemphigus, the variants of pemphigus, and the treatment objectives in this patient population.","PeriodicalId":93653,"journal":{"name":"Journal of dermatology for physician assistants : Official journal of the Society of Dermatology Physician Assistants","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87781258","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}
Advances in genomic technology have allowed providers to evaluate pigmented lesions with greater reliability. Using all available methods to evaluate changing lesions has led to earlier detection and actionable results.
{"title":"A Non-invasive Technique for Detecting Melanoma","authors":"D. Ruppenthal, M. Hyde","doi":"10.58744/001c.71333","DOIUrl":"https://doi.org/10.58744/001c.71333","url":null,"abstract":"Advances in genomic technology have allowed providers to evaluate pigmented lesions with greater reliability. Using all available methods to evaluate changing lesions has led to earlier detection and actionable results.","PeriodicalId":93653,"journal":{"name":"Journal of dermatology for physician assistants : Official journal of the Society of Dermatology Physician Assistants","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78186872","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}
Hidradenitis suppurativa (HS), a chronic skin disorder of the intertriginous areas that frequently presents with draining abscesses, deep painful nodules, possible sinus tracts, and the development of widespread scarring, can significantly impact a patient’s quality of life (QoL), therefore early diagnosis and initiation of treatment is vital. This article reviews the existing evidence-based treatment guidelines for HS as described in the literature, stages of HS as categorized by the Hurley system, available treatment options, and short- and long-term disease management strategies, all key to improved patient satisfaction. Common physical and psychological comorbidities of HS, such as hypertension, metabolic syndrome, polycystic ovarian syndrome, depression, and anxiety are also discussed with emphasis on the dermatology physician assistant’s role in comorbidities screening and managing referrals when necessary. This program has been CME reviewed and is approved for a maximum of 1 hours of AAPA Category I CME credit by the Physician Assistant Review Panel. Approval is valid for 1 year from the issue date of June 1, 2022. Participants may submit the self-assessment exam at any time during that period. This program was planned in accordance with AAPA’s CME Standards for Enduring Material Programs and for Commercial Support of Enduring Material Programs. SDPA members may access the post-test at https://www.dermpa.org/JDPA_Exams (https://www.dermpa.org/JDPA_Exams)
{"title":"Hidradenitis Suppurativa: Managing a Complex Disease with Multiple Comorbidities","authors":"Susan Smith","doi":"10.58744/001c.70416","DOIUrl":"https://doi.org/10.58744/001c.70416","url":null,"abstract":"Hidradenitis suppurativa (HS), a chronic skin disorder of the intertriginous areas that frequently presents with draining abscesses, deep painful nodules, possible sinus tracts, and the development of widespread scarring, can significantly impact a patient’s quality of life (QoL), therefore early diagnosis and initiation of treatment is vital. This article reviews the existing evidence-based treatment guidelines for HS as described in the literature, stages of HS as categorized by the Hurley system, available treatment options, and short- and long-term disease management strategies, all key to improved patient satisfaction. Common physical and psychological comorbidities of HS, such as hypertension, metabolic syndrome, polycystic ovarian syndrome, depression, and anxiety are also discussed with emphasis on the dermatology physician assistant’s role in comorbidities screening and managing referrals when necessary. This program has been CME reviewed and is approved for a maximum of 1 hours of AAPA Category I CME credit by the Physician Assistant Review Panel. Approval is valid for 1 year from the issue date of June 1, 2022. Participants may submit the self-assessment exam at any time during that period. This program was planned in accordance with AAPA’s CME Standards for Enduring Material Programs and for Commercial Support of Enduring Material Programs. SDPA members may access the post-test at https://www.dermpa.org/JDPA_Exams (https://www.dermpa.org/JDPA_Exams)","PeriodicalId":93653,"journal":{"name":"Journal of dermatology for physician assistants : Official journal of the Society of Dermatology Physician Assistants","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90349098","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}
Merkel cell carcinoma is a rare, but aggressive cutaneous neuroendocrine neoplasm that can be difficult to diagnose due to the absence of many distinctive clinical features. It is often confused with other skin tumors, benign and malignant. Over 50 percent of Merkel cell carcinomas occur on the head and neck in people over the age of 50, especially in areas of actinically damaged skin. Local and distant metastases occur in many patients, and the recurrence rate is high. The mortality rate rivals that of malignant melanoma. Early diagnosis and appropriate treatment are key to preventing metastasis and death.
{"title":"Evaluation and Management of Merkel Cell Carcinoma","authors":"Mandy Firth","doi":"10.58744/001c.71329","DOIUrl":"https://doi.org/10.58744/001c.71329","url":null,"abstract":"Merkel cell carcinoma is a rare, but aggressive cutaneous neuroendocrine neoplasm that can be difficult to diagnose due to the absence of many distinctive clinical features. It is often confused with other skin tumors, benign and malignant. Over 50 percent of Merkel cell carcinomas occur on the head and neck in people over the age of 50, especially in areas of actinically damaged skin. Local and distant metastases occur in many patients, and the recurrence rate is high. The mortality rate rivals that of malignant melanoma. Early diagnosis and appropriate treatment are key to preventing metastasis and death.","PeriodicalId":93653,"journal":{"name":"Journal of dermatology for physician assistants : Official journal of the Society of Dermatology Physician Assistants","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81688929","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 a multisystem, granulomatous, inflammatory condition. There are numerous clinical manifestations of cutaneous sarcoidosis, the most common being papular sarcoidosis, which presents as red-brown or violaceous papules on the face, trunk, or extremities. Cutaneous lesions of sarcoidosis can present similarly to other conditions such as psoriasis, lichen planus, nummular eczema, granuloma annulare, and cutaneous T-cell lymphoma. It is important that an accurate diagnosis is made when patients present with cutaneous lesions as sarcoidosis can affect multiple organ systems. A patient diagnosed with sarcoidosis will typically require comprehensive care with dermatology, rheumatology, pulmonology, and other specialties as needed. Clinicians often face difficulty determining the best and most effective treatment for cutaneous sarcoidosis while keeping side effects in mind. In this article, the author presents a clinical vignette of a patient with cutaneous sarcoidosis then reviews the disease process, diagnostic work up, and treatment/management.
{"title":"Cutaneous Sarcoidosis: A Review and Approach to Treatment","authors":"Parth M Patel","doi":"10.58744/001c.70410","DOIUrl":"https://doi.org/10.58744/001c.70410","url":null,"abstract":"Sarcoidosis is a multisystem, granulomatous, inflammatory condition. There are numerous clinical manifestations of cutaneous sarcoidosis, the most common being papular sarcoidosis, which presents as red-brown or violaceous papules on the face, trunk, or extremities. Cutaneous lesions of sarcoidosis can present similarly to other conditions such as psoriasis, lichen planus, nummular eczema, granuloma annulare, and cutaneous T-cell lymphoma. It is important that an accurate diagnosis is made when patients present with cutaneous lesions as sarcoidosis can affect multiple organ systems. A patient diagnosed with sarcoidosis will typically require comprehensive care with dermatology, rheumatology, pulmonology, and other specialties as needed. Clinicians often face difficulty determining the best and most effective treatment for cutaneous sarcoidosis while keeping side effects in mind. In this article, the author presents a clinical vignette of a patient with cutaneous sarcoidosis then reviews the disease process, diagnostic work up, and treatment/management.","PeriodicalId":93653,"journal":{"name":"Journal of dermatology for physician assistants : Official journal of the Society of Dermatology Physician Assistants","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87124560","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}
Objective: To introduce a case report of a patient developing guttate psoriasis following a COVID-19 infection. The case report reviews the patient presentation, diagnosis, treatment plan, and reviews current literature. The overall goal of this case report is to inform medical providers that COVID-19 may cause guttate psoriasis. This is important because guttate psoriasis can be induced by streptococcus bacterial infections and less commonly viral infections. A comprehensive literature search using the key words “guttate psoriasis and COVID-19 infection,” “guttate psoriasis post viral infection,” and “guttate psoriasis and COVID-19 vaccination,” was conducted using databases including Google Scholar, PubMed, and ScienceDirect.
{"title":"COVID-19: A New Etiology for Guttate Psoriasis","authors":"K. Harrison","doi":"10.58744/001c.70408","DOIUrl":"https://doi.org/10.58744/001c.70408","url":null,"abstract":"Objective: To introduce a case report of a patient developing guttate psoriasis following a COVID-19 infection. The case report reviews the patient presentation, diagnosis, treatment plan, and reviews current literature. The overall goal of this case report is to inform medical providers that COVID-19 may cause guttate psoriasis. This is important because guttate psoriasis can be induced by streptococcus bacterial infections and less commonly viral infections. A comprehensive literature search using the key words “guttate psoriasis and COVID-19 infection,” “guttate psoriasis post viral infection,” and “guttate psoriasis and COVID-19 vaccination,” was conducted using databases including Google Scholar, PubMed, and ScienceDirect.","PeriodicalId":93653,"journal":{"name":"Journal of dermatology for physician assistants : Official journal of the Society of Dermatology Physician Assistants","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89461023","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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