Skin (Milwood, N.Y.)最新文献

{"title":"History in The Making: The Transformative Impact of TikTok on Dermatology","authors":"K. Sparling","doi":"10.25251/skin.7.4.25","DOIUrl":"https://doi.org/10.25251/skin.7.4.25","url":null,"abstract":"<jats:p>N/A</jats:p>","PeriodicalId":74803,"journal":{"name":"Skin (Milwood, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42709343","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":"Syphilis in HIV Positive Individuals and the Importance of a Skin Exam: A Case Report","authors":"Aditi Chokshi, Amaurys Diaz","doi":"10.25251/skin.7.4.14","DOIUrl":"https://doi.org/10.25251/skin.7.4.14","url":null,"abstract":"Among HIV-positive patients, co-infection with syphilis is estimated to be as high as 20%. The diagnosis of syphilis is often missed due to its asymptomatic nature during its primary stages. A 68-year-old HIV-positive male presented with perianal lesions to his primary care physician twice. He was then referred to two different specialists before a proper physical exam was conducted after which he was diagnosed with otosyphilis and neurosyphilis. Physicians should have a higher index of clinical suspicion for syphilis in HIV-positive patients to allow for prompt diagnosis given the propensity of these patients to develop more severe neurological and ophthalmologic manifestations. This case highlights the importance of a thorough skin exam by a primary care physician when examining patients to allow for an earlier and accurate diagnosis and thus avoiding unnecessary referrals to specialists.","PeriodicalId":74803,"journal":{"name":"Skin (Milwood, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41890453","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":"Dermal Irritation, Sensitization, and Safety of Fixed-Dose Triple-Combination Clindamycin Phosphate 1.2%/Benzoyl Peroxide 3.1%/Adapalene 0.15% Gel in Healthy Participants","authors":"Z. Draelos, E. Tanghetti, L. Stein Gold, L. Kircik, N. Bhatia, J. Zeichner, Jeffrey Sugarman","doi":"10.25251/skin.7.supp.227","DOIUrl":"https://doi.org/10.25251/skin.7.supp.227","url":null,"abstract":"Introduction: IDP-126 polymeric mesh gel (clindamycin phosphate 1.2%/benzoyl peroxide [BPO] 3.1%/adapalene 0.15%) is the first triple-combination, fixed-dose topical acne product in development and it addresses major acne pathophysiological processes. IDP-126 demonstrated superior efficacy to vehicle and component dyads, with good safety/tolerability in a phase 2 study of participants with moderate-to-severe acne. The objectives of this study were to assess dermal irritation/sensitization and safety of IDP-126 gel in two phase 1 studies and to compare irritancy of IDP-126 gel and commercially available BPO 2.5%/adapalene 0.3% gel in one phase 1 study of healthy participants. \u0000Methods: Two phase 1, randomized, evaluator-blinded, within-participant, dermal safety studies enrolled healthy participants aged ≥18 years (N=234, repeat insult patch test [RIPT]; N=45, cumulative irritation patch test [CIPT]). Patches were applied to the upper back multiple times over 6-8 weeks (RIPT) or every 24 hours for 21 days (CIPT). Patches contained: IDP-126 gel, vehicle gel, saline 0.9% (RIPT/CIPT), sodium lauryl sulfate (SLS) 0.5% (CIPT), or branded BPO 2.5%/adapalene 0.3% gel (CIPT). Participants in each study received all treatments. Endpoints comprised sensitization potential (RIPT), mean cumulative/total irritation scores, and treatment-emergent adverse events (TEAEs). \u0000Results: Overall, irritation with IDP-126 was moderate and not clinically significant. CIPT: IDP-126 was “moderately irritating” (mean score: 1.29), which was significantly less irritating than BPO/adapalene (1.96; P<0.001), statistically similar to SLS (1.17), and more irritating than saline or vehicle (~0.30; P<0.001). RIPT: no participants had investigator-confirmed sensitization to any treatments. In both studies, no TEAEs were related to treatment. \u0000Conclusions: In two phase 1 studies, fixed-dose, triple-combination clindamycin phosphate 1.2%/ BPO 3.1%/adapalene 0.15% polymeric mesh gel had moderate irritancy and no confirmed sensitization in healthy participants. Additionally, IDP-126 demonstrated significantly less irritation versus commercially available, branded BPO 2.5%/adapalene 0.3% gel. IDP-126 demonstrated good safety/tolerability, mirroring the phase 2 study results. \u0000  \u0000Funding: Ortho Dermatologics","PeriodicalId":74803,"journal":{"name":"Skin (Milwood, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46852793","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":"A Case of a Large, Painful Dermatofibrosarcoma Protuberans Arising from a Traumatic Scar","authors":"D. Fischer, Graham H Litchman","doi":"10.25251/skin.7.3.16","DOIUrl":"https://doi.org/10.25251/skin.7.3.16","url":null,"abstract":"Here we report a case of dermatofibrosarcoma protuberans (DFSP) that presented originally to the emergency department with chief complaint of ‘chest pain arising from a chest wall mass’. This case is unique for multiple reasons including the fact that the DFSP caused this patient severe pain that radiated from the site of the mass to the patient’s back. The lesion originated from a traumatic scar that the patient had obtained following a car accident two years prior to presentation. In addition, the DFSP was significantly larger in size than what has typically been reported in the literature. This case illustrates that DFSP has the potential to present with multiple atypical features.","PeriodicalId":74803,"journal":{"name":"Skin (Milwood, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43789049","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":"Acne symptoms and impact of acne on social functioning, emotional functioning, and activities of daily living (ADL) among patients with moderate to severe non-nodular Acne Vulgaris (AV) in community practices across the U.S","authors":"E. Graber, H. Baldwin, A. Alexis, J. D. Del Rosso, R. Fried, J. Harper, Adelaide Hebert, L. Kircik, E. Rieder, L. Stein Gold, Siva Narayanan, V. Koscielny, I. Kasujee","doi":"10.25251/skin.7.supp.208","DOIUrl":"https://doi.org/10.25251/skin.7.supp.208","url":null,"abstract":"Objective: Evaluate patient self-perceived AV symptoms and impact of AV on emotional/social functioning and ADL, among AV patients in community practices across the U.S. Methods: Single-arm, prospective cohort study (PROSES: NCT04820673) was conducted with moderate-to-severe non-nodular AV patients >9yrs who were prescribed sarecycline in real-world U.S community practices. Validated ASIS questionnaire (with Signs and Impact (emotional & social) domains) and an Expert Panel Questionnaire (EPQ; emotional functioning (items 1-4), social functioning (items 5-7), and ADL (items 8-11)) were completed by patients (>12yrs) and caregivers (for patients 9-11yrs) at baseline and week-12. All items were scored on five-point adjectival response scale (score: 0 (never/not at all) – 4 (all the time/very much/extremely)); a higher ASIS domain score indicate severe symptoms or negative impact of AV. ASIS domain scores and proportion of patients reporting score=2/3/4 (moderate to high burden/impact or parent understanding (EPQ10)) for EPQ items at baseline were analyzed. Results: A total of 253 AV patients completed the study (pediatric: 39.92%; female: 66.40%; moderate AV: 86.56%; severe AV: 13.44%). At baseline, patients reported moderate AV burden in most domains, as depicted by the following domain score: signs: 1.96, impact: 2.06, emotional impact subdomain: 2.43; social impact subdomain: 0.98. From EPQ items, proportion of patients reporting score=2/3/4 (moderate to severe burden) at baseline were: patients’ mood/anger (EPQ1) – 56.13%; worries about AV worsening (EPQ2) – 79.45%; thinking about acne (EPQ3) – 84.19%; level of acne worries (EPQ4) – 72.73; patients’ social media/’selfie’ activity (EPQ5) – 51.38%; impact on real-life plans (EPQ6) – 44.66%; efforts to hide AV (EPQ7) – 72.73%; picked-on/judged due to AV (EPQ8) – 26.88%; ability to reach future goals (EPQ9) – 27.27%; sleep impact (EPQ11) – 27.67%; parent understanding of AV concerns (for patients<18yrs; EPQ10) – 84.16%. Conclusion: Moderate to severe AV burden/impact was observed in this prospective cohort of AV patients in the U.S. Emotional impact and social impact of AV were especially more pronounced among the AV population.","PeriodicalId":74803,"journal":{"name":"Skin (Milwood, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41496159","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":"Subtype performance of the ancillary diagnostic 23- and 35-gene expression profile (GEP) tests for difficult-to-diagnose melanocytic lesions","authors":"J. Plaza, Sarah I. Estrada, B. Russell, J. Siegel, Jason Rogers, J. Wilkinson, S. Kurley, M. Goldberg, K. Motaparthi","doi":"10.25251/skin.7.supp.214","DOIUrl":"https://doi.org/10.25251/skin.7.supp.214","url":null,"abstract":"Background: Histopathological examination is adequate for most melanocytic neoplasms; however, there is a subset of lesions that are difficult to diagnose. The 23- and 35-gene expression profile (GEP) tests deliver results of suggestive of benign neoplasm, suggestive of malignant neoplasm, or intermediate (cannot exclude malignancy). They are intended to provide clinicians with objective results to be interpreted in the context of clinical, laboratory, and histopathological features to achieve a definitive diagnosis. Both GEPs are stand-alone tests that are independently validated and clinically available. Greater than 99% benign or malignant reporting is achieved clinically when the 23-GEP test is processed first, and if an intermediate result or test failure occurs, the 35-GEP is utilized. \u0000Methods: The performance of the 23- and 35-GEP tests using this methodology was tested on unequivocal cases from a variety of subtypes (101 benign, 249 malignant). Lesions were included if 2/3 dermatopathologist diagnoses were concordant. Subtype designation was determined by the dermatopathologist that submitted the lesion for the study. \u0000Results: The overall accuracy metrics in this cohort were 96.0% sensitivity and 87.8% specificity. The results demonstrated 100% sensitivity in several melanoma subtypes including acral lentiginous (n=15), desmoplastic (n=20), melanoma in situ (n=16), and nevoid (n=16). Other melanoma subtypes showed sensitivity metrics of: lentigo maligna, 96.7% (n=31); nodular, 95.1% (n=81); superficial spreading, 97.7% (n=42); and spitzoid, 85.0% (n=20). Subtypes of benign nevi showed a specificity of: blue, 96.7% (n=30); compound, 85.7% (n=42); junctional, 77.8% (n=18); and Spitz, 100% (n=7). \u0000Conclusions: Overall, we demonstrate that use of the 23- and 35-GEP diagnostic test workflow results in high accuracy across many subtypes of benign and malignant melanocytic neoplasms. \u0000Financial Disclosures: JAP has served as a consultant for Castle Biosciences, Inc. SIE is a consultant and shareholder of Castle Biosciences, Inc. BHR, JJS, JHR, JKW, SJK, and MSG are employee shareholders of Castle Biosciences, Inc. KM has served as a consultant and investigator for studies supported by Castle Biosciences, Inc. This study was supported by Castle Biosciences, Inc.","PeriodicalId":74803,"journal":{"name":"Skin (Milwood, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43446754","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":"High-grade Undifferentiated Pleomorphic Sarcoma Presenting as Acquired Lymphangioma Circumscriptum","authors":"P. Rambhia, S. D’Angelo, P. Shah","doi":"10.25251/skin.7.3.20","DOIUrl":"https://doi.org/10.25251/skin.7.3.20","url":null,"abstract":"A previously healthy woman in her 40s presented to the dermatology clinic with a 1-year history of a tender, draining, enlarging mass on the left buttock. Physical examination revealed an extensively indurated hyperpigmented nodule with numerous overlying clustered exophytic verrucous papules on the L medial buttock (see figure 1). Initial skin biopsy of verrucous lesions was notable for lymphangioma with overlying condyloma, D2-40 positive. MRI abdomen and pelvis with contrast demonstrated a left gluteal enhancing subcutaneous soft tissue mass, 10.3 x 8.2 x 8.8 cm in size, overlying and involving the left gluteus maximus, along with satellite nodules present in the medial gluteus maximus and paraspinal muscles, with bilateral pelvic and inguinal adenopathy. Excisional deep tissue biopsy revealed a diagnosis of a high-grade, multifocal spindle and undifferentiated pleomorphic sarcoma. The patient subsequently underwent 4 cycles of neoadjuvant chemotherapy AIM (doxorubicin, iphosphamide, MESNA), followed by radical resection of the left gluteal region, with positive margins, followed by repeat surgical resection and reconstruction with left-sided latissimus dorsi myocutaneous free flap. The patient has now completed radiation therapy. \u0000Soft tissue sarcoma is a heterogeneous group of rare malignancies of mesenchymal origin, that represents 0.8% of all adult cancers. Prognostic factors associated with poor outcome include high histologic grade, large tumor size, presence of metastases, and unresectability1. Herein, we report a novel case of high-grade soft-tissue undifferentiated pleomorphic sarcoma, masquerading as acquired lymphangioma circumscriptum (ALC), as noted on initial skin biopsy of grouped flesh-colored verrucous papules overlying an indurated tender mass. ALC is a lymphatic malformation occurring as sequela to any process which interrupts previously normal lymphatic drainage. As such, subcutaneous lymphatic cisterns are unable to drain completely into the general lymphatic system, resulting in lymphatic dilation and subsequent development of vesicular and papular lesions on the trunk, extremities, and anogenital areas.2 ALC can mimic common infectious growths including molluscum contagiosum and condyloma accuminata, and accordingly be mismanaged. Etiologic causes of ALC including malignancy, and has previously been reported in the setting of cervical carcinoma, vulvar carcinoma, endometrial carcinoma, Hodgkin lymphoma, rhabdomyosarcoma, rectal carcinoma, melanoma, and high-grade penile dysplasia2,3,4. Other etiologic causes can include surgery, trauma, radiation therapy, chronic inflammatory conditions including hidradenitis suppurativa, and inflammatory bowel disease. \u0000 To date, acquired lymphangioma circumscriptum has not been reported in the setting of underlying high-grade pleomorphic soft tissue sarcoma. As such, clinical presence of grouped frogspawn-like or verrucous papules, in an area of tender induration or lymphedema, should ","PeriodicalId":74803,"journal":{"name":"Skin (Milwood, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45151527","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":"Treatment of Severe Recalcitrant Atopic Dermatitis with Dupilumab in a Kidney Transplant Patient","authors":"Vivian Li, Sophie Guenin, M. Lebwohl","doi":"10.25251/skin.7.3.10","DOIUrl":"https://doi.org/10.25251/skin.7.3.10","url":null,"abstract":"This case report highlights the successful treatment of refractory atopic dermatitis (AD) in an immunosuppressed patient using dupilumab, a biologic agent that selectively targets cytokines crucial in the pathogenesis of AD. The patient had a history of failed treatment with numerous topical and systemic immunomodulating agents, including corticosteroids and immunosuppressive drugs for organ transplant. Dupilumab treatment resulted in significant improvement of symptoms, including reduced pruritus, and ultimately achieved disease control. Importantly, the patient experienced no adverse effects apart from one COVID-19 infection over three years of co-administration of dupilumab with immunosuppressive transplant rejection treatment. The safety of dupilumab in immunocompromised and transplant patients has been a concern, but studies have shown its safety and efficacy in these patient populations. This case highlights the potential for dupilumab as a safe and effective treatment option for patients with severe AD who are immunocompromised or have undergone solid organ transplantation. \u0000 ","PeriodicalId":74803,"journal":{"name":"Skin (Milwood, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46221145","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":"Efficacy and Safety of Calcipotriene/Betamethasone Dipropionate Cream for the Treatment of Plaque Psoriasis Evaluated from Pooled Phase 3 Data","authors":"L. Stein Gold, A. Pinter, M. Augustin","doi":"10.25251/skin.7.supp.204","DOIUrl":"https://doi.org/10.25251/skin.7.supp.204","url":null,"abstract":"","PeriodicalId":74803,"journal":{"name":"Skin (Milwood, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42212448","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":"Disseminated Varicella-zoster Virus Infection in an Immunocompetent Host","authors":"Alan G. Mulholland, Brandon Tang, S. Shumak, Linda Zhou","doi":"10.25251/skin.7.3.19","DOIUrl":"https://doi.org/10.25251/skin.7.3.19","url":null,"abstract":"\u0000 \u0000 \u0000 \u0000Disseminated varicella-zoster virus (VZV) infection has devastating impacts on patients’ quality of life, with increasing morbidity and mortality. Thus, it is imperative that a diagnosis be made early. This case description illustrates a unique and dramatic presentation of disseminated VZV infection with important clinical implications. \u0000 \u0000 \u0000 \u0000","PeriodicalId":74803,"journal":{"name":"Skin (Milwood, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46110110","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}