Foreign body type of granulomatous reaction to green tattoo pigment
Background: Permanent tattoos can be complicated by infection, neoplasm, as well as inflammatory reactions. Despite transitions away from metal salts in tattoo ink inflammatory reactions are still frequently observed. Inflammatory reactions from tattoo ink include allergic hypersensitivity, granulomatous, lichenoid as well as pseudolymphomatous. Reactions from tattoo ink most frequently occur due to red pigment, whereas allergy to green ink is relatively uncommon. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Folliculotrophic mycosis fungoides in a pediatric patient and review of current prognostic guidelines
Folliculotrophic mycosis fungoides (MF) is an aggressive variant of cutaneous T-cell lymphoma that typically appears on the head and neck in adults and historically was thought to have a worse prognosis than other forms of MF. Folliculotrophic MF used to be staged via the tumor-node-metastasis system, but these stages did not correlate with clinically meaningful prognosis information. Recently, a large prospective cohort study found that cases of folliculotrophic MF can be subdivided into indolent vs aggressive forms based on their histopathological appearance, with those tumors that looked like early plaque stage patholog...
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Frontal fibrosing alopecia: Histopathological and immunohistochemical study of the inflammatory infiltrate and the sebaceous gland receptors
Introduction: Frontal fibrosing alopecia (FFA) is a primary scarring alopecia characterized by a recession of the frontotemporal hairline and, frequently, alopecia of the eyebrows. The etiopathogenesis of FFA is unknown, but an autoimmune reaction mediated by T lymphocytes has been suggested. The characteristic localization, the predominance of postmenopausal women and the clinical stabilization with oral antiandrogenic drugs suggest that hormonal imbalance may play a pathogenic role. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Gender balance in clinical research: Why it matters, an introduction
Introduction: Gender balance has finally become an important goal in our society as we attempt to achieve it both in our professional and personal lives. Interestingly, this has not been the case in medical research; gender balance is rarely mentioned in the literature in both animal studies and human trials. In dermatology research we have seen an interesting correlation between the efficacy of biologics and sex. For example adalimumab shows 70-80% efficacy in psoriasis where 70-80% of patients enrolled in the trials were male. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Genetic profile of acral lentiginous melanoma and nevi in a Chilean population
Introduction: Acral lentiginous melanoma (ALM) represents 2-8% of melanomas and has reduced overall survival and disease-free survival. ALM shows chromosomic aberrations in CCDN1, TERT and KIT. There are few studies comparing the genetic profile or protein expression between ALM and acral nevus (AN). (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Genital plaques in a patient with SLE
Genital lesions associated with lupus erythematosus (LE) are rarely reported in the literature despite an estimated prevalence of 5% in females with systemic lupus erythematosus (SLE). Investigation of the manifestations of lupus in the genitals can improve the care of lupus patients and further our understanding of this heterogeneous disease. A 38-year-old female with systemic lupus erythematosus (SLE) presented with three weeks of painful oral and vaginal erosions. Her SLE had been well controlled on hydroxychloroquine for five years, until four months prior, when she had worsening joint pain and nephritis. (Source: Jour...
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Giant rheumatoid nodule
A 50-year-old female with history of rheumatoid arthritis presented with a large nodule on right medial knee. The lesion had been present for several years and was progressively growing causing her pain. Recently the lesion had begun to ulcerate and drain a yellow liquid. The patient was on methotrexate 20 mg weekly, hydroxychloroquine 200 mg daily, and prednisone 5 mg daily for her rheumatoid arthritis. On her right medial knee, she had a 6.8 cm soft, slightly compressible, yellowish nodule. The lesion was surgically resected under local anesthesia and the defect primarily repaired. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Glucagonoma: When to think of this diagnosis?
Introduction: Necrolytic migratory erythema (NME) may correspond to a paraneoplastic syndrome. It usually occurs in patients with glucagonoma, an alpha cell pancreatic tumor. When associated with weight loss, angular stomatitis, glossitis, diabetes mellitus, anemia and neuropsychiatric disorders defines the glucagonoma syndrome. NME lesions present as erythematous maculopapules with blisters and ulceration, occurring mostly on perineum, lower abdomen, extremities and face. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Global periorbital skin rejuvenation by a topical eye cream containing low molecular weight heparan sulfate (LMW-HS) and a blend of naturally derived extracts
Maintaining a youthful appearance is a priority for many people, resulting in a rising demand for efficacious antiaging cosmetic products and procedures. Global eye rejuvenation is sought more frequently and at a younger age than other treatments. Major concerns around the eye area are periorbital hyperpigmentation, puffiness, and lines and wrinkles. Glycosaminoglycans (GAGs) are complex carbohydrates that modulate skin health, repair and renewal. Heparan sulfate (HS) is the most biologically active GAG though it is too large and polar to penetrate the skin. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Glycopyrronium cloth improves axillary hyperhidrosis across a broad spectrum of patients: Post hoc analyses of the ATMOS-1 and ATMOS-2 phase 3 randomized controlled trials in patient subpopulations
Introduction: Glycopyrronium tosylate (GT) is a topical anticholinergic approved in the US for primary axillary hyperhidrosis in patients ≥9 years (glycopyrronium cloth, 2.4%). The efficacy and safety of GT were established in two double-blind, vehicle (VEH)-controlled Phase 3 trials (NCT02530281; NCT02530294). To evaluate the potential impact of patient characteristics, we analyzed GT efficacy in patient subpopulations, including g ender, location of areas affected by hyperhidrosis, race and age across multiple outcomes. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Gram-negative folliculitis caused by Morganella morganii
A 30-year-old man referred to our clinic with a 1-year history of resistant nodulocystic acne on his face and neck. The patient had already been treated with several courses of antibiotics including doxycycline, azithromycin and clindamycin with only partial improvement. On physical examination, multiple pustular and nodulocystic lesions noted mainly on his cheeks and neck. Using an aseptic technique, pure pus obtained from the lesions and was sent for gram staining and culture. Gram staining returned positive for gram-negative rods. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Hair care practices, scalp disorders and psychological effects on women in Nigeria
Background: The African hair has been found to be fragile with a tendency to break easily because of the curly, dry nature with less tensile strength. Various techniques developed to manage African hair are associated with certain hair and scalp disorders and are sources of distress. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Halobetasol and tazarotene: Further defining the role of a unique fixed combination topical lotion in moderate-to-severe plaque psoriasis in a Hispanic population
Background: Psoriasis is a chronic inflammatory condition that occurs worldwide. Few studies have examined the role of ethnicity, and there is little evidence available on the efficacy and safety of topical therapies for the treatment of psoriasis in Hispanic patients. The Investigator Global Assessment multiplied by body surface area (IGAxBSA) composite tool is a simple, effective, validated measure for assessing improvement in psoriasis severity. It correlates well with the Psoriasis Area and Severity Index (PASI) and demonstrates sensitivity to changes from baseline in patients with both mild and moderately severe disea...
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Henoch-Sch önlein purpura (IgA vasculitis) in an adult following hepatitis A and B vaccinations
Background: Henoch-Sch önlein purpura (HSP), an IgA vasculitis, most commonly occurs in children. The IgA immune complex deposition is commonly triggered by infection but also has been seen following vaccination. In 2018, Louisville, Kentucky had an outbreak of hepatitis A with over 950 reported cases and 6 deaths. Vacci nation was strongly encouraged and available to the community as a response to the outbreak. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Hermansky-Pudlak syndrome: An ancestral disease in Puerto Rico
Hermasky-Pudlak syndrome (HPS) is an autosomal recessive disorder characterized by the dysfunction of diverse cytoplasmic organelles resulting in oculocutaneous albinism, hemorrhagic diathesis, and others systemic manifestations. Currently, ten genetic mutations affecting the biogenesis of these organelles are known. Investigative efforts suggest that some HPS subtypes emerged from founder genetic mutations that occurred in the 19th century, which are still carried by discrete population. The high incidence of HPS in Puerto Rico (PR) makes the island an ideal geographic venue for genetic studies of historical and scientifi...
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Herpes vegetans: Atypical perineal HSV infection in an immunocompromised patient
A 48-year-old woman with a history of AIDS and stage IV Hodgkin lymphoma status post chemotherapy and stem cell transplant presented with 8 months of painful perineal erosions and exophytic plaques. Her medical history was significant for acyclovir-resistant herpes simplex virus (HSV) and multiple opportunistic infections. Examination revealed diffuse discontinuous eroded plaques in the perineum, and scattered skin-colored and hyperpigmented exophytic plaques with raised borders and central craters overlying the sacrum, gluteal cleft, and perineum. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Hidradenitis suppurativa associated with sorafenib initiation
We report the development of hidradenitis suppurativa (HS) in a patient after initiation of treatment with sorafenib. To our knowledge, sorafenib-induced HS in the axillary and inguinal skin folds has not been previously reported. A 33-year-old male on sorafenib for papillary thyroid cancer presented for evaluation of “boils” that began when he initiated chemotherapy 5 years prior and had continued to progress. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

High incidence of latent tuberculosis infection in indigent patients receiving biologics in New York City
Introduction: Despite the known association between the use of biologic medications and reactivation of latent tuberculosis infection (LTBI) the rate of LTBI among indigent Hispanic psoriatic patients living in the U.S. has not been studied. Little is known about the overall impact LTBI may pose on their treatment of psoriasis and/or psoriatic arthritis. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Hidradenitis suppurativa: The evolution of disease terminology with histopathologic discoveries
Introduction: Hidradenitis suppurativa (HS) is an inflammatory condition characterized by recurrent abscesses, primarily in skin folds. The disease has been referred to by a multitude of terms, reflecting histopathologic discoveries. We review historical developments in the terminology and pathogenesis of HS, highlighting how many terms may be a misnomer. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Hot feet! Dancing the chilblains Cha Cha
Chilblains, a benign inflammatory condition, typically presents after exposure to cold conditions. It is a vascular reaction of the skin to a change in weather conditions typically found on the dorsum of the digits. The etiology is not well known, but could be due to vasoconstriction or autoimmunity. It usually presents in young or middle aged Caucasian women as erythematous papules appearing on the extremities. There are different types including idiopathic and those associated with connective tissue disease, most commonly lupus erythematosus. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

How patients experience being diagnosed with skin-cancer: Comparative analysis between basal cell carcinoma and relapse-free melanoma. Results of “Objectifs Peau-Cancers Cutanés,” a French study evaluating the impact and management of skin cancer
This study aimed to compare the feelings of patients when diagnosed with early-stage MM versus BCC. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Identification of novel autoantibodies in psoriasis using an autoantigen array
In this study, we developed a protein array system harboring a variety of antigens seen in rheumatic diseases, in addition to skin antigens, inflammatory mediators, and recognized antigens in psoriasis. Antigens on the array were interrogated using sera from patients with psoriasis (N = 73). (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Human –pet relationship and pet abandonment in patients infected with zoophilic dermatophytes
Background: The zoophilic dermatophytosis is getting attention because animals come with risks for spreading fungal infections. However, the human –pet relationship and pet abandonment in who infected with zoophilic dermatophytes have never been concerned (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

How to navigate dermatology care for the uninsured
Literature regarding health disparities in dermatology demonstrates underinsured patients have worse outcomes, such as increased rates of hospitalization and length of stay. While the percentage of uninsured adults in the U.S. has decreased since the establishment of the Affordable Care Act in 2010, a variety of reasons, including the gaps in coverage and lack of Medicaid expansion, have left millions of adults without health care. These issues are multifactorial, in both ethical and practical terms, and the potential solutions are of value in treating some of our sickest patients. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

If in doubt, cut it out: A skin lesion raises suspicion for systemic disease
Case: A 27-year-old female presented with a 2-year history of a 1.2 cm enlarging soft pink telangiectatic nodule to the right parietal scalp. A shave removal was performed to rule out basal cell carcinoma or Merkel cell tumor. Pathology report indicated the lesion was a cutaneous myxoma, raising concern for Carney complex (CNC). Physical exam demonstrated widespread lentigines in sun-exposed areas, without abnormal pigmentation in the mouth, conjunctivae, or eyelids. No blue nevi were found. The patient ’s mother and grandmother also display lentigines of the upper body. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Idiopathic calcinosis cutis in a young female
Background: Calcinosis cutis (CC) is characterized by localized deposition of calcium in the skin and subcutaneous tissues. Several types of CC categories exist. Dystrophic CC occurs with normal serum calcium (Ca) and phosphate (PO4) due to local tissue damage; it is seen in connective tissue disease. Metastatic CC occurs due to abnormal Ca or PO4 metabolism. Idiopathic CC occurs in the absence of local tissue injury or of abnormal Ca or PO4 metabolism. Iatrogenic CC occurs due to medical causes. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Immediate and long-lasting benefits in hydration from a body moisturizer utilizing an interpenetrating polymer network
As opposed to facial, body skin is thicker, less oily and has slower keratinocyte turnover, thus its hydration requirements also differ. A new body formula was developed that is rich in essential fatty acids and fortified with osmolytes to permeate the epidermis with humectants and anti-oxidants embedded in a tridimensional (3D3P) molecular matrix. A single-center, 4-week study was conducted in healthy females, ages 35-65 from all ethnicities, with dry and aged skin. Skin attributes were assessed at baseline and at weeks 1 and 4 after initiating twice daily application to arms and legs. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Immune reconstitution inflammatory syndrome (IRIS) presenting as alopecia areata following highly active antiretroviral therapy (HAART)
We present a case of a 48-year-old male who developed patchy hair loss on the scalp and limbs clinically consistent with alopecia areata, two months following re-commencement of HAART. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Impact of mirikizumab treatment on psoriasis disease activity at week 16 in patients based upon prior treatment with biologic therapy
The objective of this study is to determine treatment response at Week 16 in patients with psoriasis who previously received biologic therapy (Prior) and those who are naive to biologic therapy (Naive). (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Impact of mirikizumab maintenance dosing on patients who had < PASI 90 response at week 16: A phase 2 study analysis using the DLQI
The objective of this study is to determine whether mirikizumab maintenance dosing improves health-related quality of life (HRQoL) as measured by the Dermatology Life Quality Index (DLQI) in patients who had (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Impact of mirikizumab maintenance dosing on patient-reported signs and symptoms of psoriasis: A phase 2 study analysis in patients with < PASI 90 response at week 16
Introduction: Interleukin-23 (IL-23) is critical to the pathogenesis of psoriasis. Mirikizumab (miri) is a humanized monoclonal antibody directed against the p19 subunit of IL-23. Objective: We determined if miri maintenance dosing to Week 52 (Wk 52) improves signs and symptoms of psoriasis measured by the Psoriasis Symptom Scale (PSS) in patients (pts) with (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Immune-related cutaneous adverse events associated with immune-checkpoint inhibitors: Our experience
Introduction: New “immune checkpoint inhibitors” (ICPI) are a group of monoclonal antibodies specifically created to activate cytotoxic T- cell response in order to fight against malignant cells. The activation of these pathways unbalance the immune system; there has been described numerous different immunologica l effects in multiple organs of the body. The aim of our study is to describe the cutaneous adverse events (CAE) related to the use of these drugs. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Immune-related adverse events: A new great mimicker? A case of prurigo nodularis-like bullous pemphigoid due to anti-CTLA-1 and anti-PD-1 inhibitors responding to rituximab
A female in her forties with metastatic sacral chordoma was treated with ipilimumab and nivolumab, as part of the Dual Anti-CTLA-4 and Anti-PD-1 blockade in Rare Tumors trial. Shortly after starting treatment, she developed numerous pruritic excoriated papules and hypertrophic nodules on the trunk, arms and legs. This eruption persisted four months after discontinuing checkpoint inhibitor therapy. The presence of widespread hypertrophic excoriated papules and nodules, in the absence of bullae, initially appeared consistent with prurigo nodularis. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Improving the tolerability of ingenol mebutate treatment of sun-damaged skin with hypochlorous acid spray gel in a community dermatology practice
Introduction: Field therapies are preferred when multiple actinic keratoses (AKs) and signs of sun damage suggest field cancerization and possible subclinical AKs. The long duration of treatment and local skin responses (LSRs) associated with many topical therapies may make adherence challenging. In our clinic, patients treated with ingenol mebutate gel as a 2- or 3-day therapy have reported intense symptoms of burning and itching that interfered with daily activities and sleep. To examine the effects of using an antipruritic agent on these symptoms, we selected 2 patients to apply a hypochlorous acid spray gel to one of t...
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Improving subungual melanoma detection through nail technician video education
Introduction: Subungual melanoma (SM) is a type of acral lentiginous melanoma that emerges from the nail matrix and may involve the nail-bed, hyponychium, and proximal nail-fold. Early detection can improve survival, but lack of recognition and misdiagnosis contributes to delayed diagnosis and poor prognosis. Thus, education is essential for promoting early follow-up with clinicians. Hairdressers are a useful screening tool for head and neck melanoma detection, and online video training demonstrated improved melanoma knowledge and detection efficacy. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Improvement in absolute Psoriasis Area and Severity Index score through 3 years of continuous treatment with guselkumab in the VOYAGE 1 trial
Background: VOYAGE 1 is a phase 3, randomized, double-blind, placebo/active comparator-controlled trial comparing guselkumab (GUS), a fully human monoclonal antibody targeting interleukin-23, with adalimumab (ADA) in the treatment of patients with psoriasis. We assessed long-term responses based on absolute Psoriasis Area and Severity Index (PASI) scores through 3 years of continuous GUS treatment in VOYAGE 1. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Improved risk assessment through incorporation of a prognostic 31-gene expression profile test for AJCC stage IB-IIA cutaneous melanoma
Introduction: Risk assessment is critical for guiding patient care decisions and treatment of cutaneous melanoma (CM), especially as options in the adjuvant setting expand. Additional prognostic tools are needed because many patients who die from melanoma are initially diagnosed with stage I-II disease. A 31-gene expression profile (31-GEP) test has been shown to have prognostic accuracy and inform follow-up intensity, sentinel lymph node biopsy (SLNB) guidance, surveillance, and possibly adjuvant therapy in stage I-III CM. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Incidence and risk factors for developing herpes zoster among a cohort of patients diagnosed with lymphoma at a community cancer center
The majority of viral infections in patients with lymphoma result from the reactivation of viruses such as varicella zoster causing herpes zoster (HZ). Even though most cases of HZ are self-limited, lymphoma patients are at greater risk for recurrences and more serious and atypical complications such as meningoencephalitis. There are various established risk factors for developing HZ, but the impact of baseline absolute lymphocyte count (ALC), treatment received, histologic type, and stage of lymphoma on the risk of developing HZ is not well described. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Incidence of cutaneous T-cell lymphoma (CTCL) after chronic exposure to thiazides: pharmacovigilance analysis from the RADAR (Research on Adverse Drug events And Reports) Program
Introduction: Thiazides (TZ) have been reported to be associated with an increased risk for both malignant melanoma (MM) and keratinocyte cancers (BCC and SCC). Moreover, although an association between TZ and the most common subtypes: mycosis fungoides (MF) and S ézary syndrome (SS) has previously been reported, there have been no large population studies reporting data for such an association with CTCL overall. The aim of this study is to explore the association between all CTCL and chronic TZ exposure in a large “real world-setting” database: the Nort hwestern Medicine Enterprise Data Warehouse (NMEDW...
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Innovate: A phase 2 study investigating VP-102, a drug-device combination containing a novel topical formulation of cantharidin, for the treatment of molluscum contagiosum
Background: Molluscum contagiosum (MC) is a common pediatric skin infection caused by a DNA poxvirus. There is a paucity of high-quality evidence for decision making in treating MC. Cantharidin, a topical vesicant, is a commonly-used treatment for MC. Despite prevalent use, cantharidin is not FDA approved and lacks clinical evidence regarding safety, efficacy and systemic exposure from a standardized formulation and dose regimen. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Infection mimicker: Neutrophilic dermatoses versus cutaneous anthrax
A 64-year-old man with history of myelodysplastic syndrome (MDS) presented for evaluation of bilateral hand lesions. The lesions first appeared four days after the patient skinned a sheep with his bare hands on a hunting trip in New Mexico. The lesions began as painful, dark papules, each with a small pustule on top, which then coalesced and ulcerated. His primary care physician started him on oral Augmentin twice daily for one week. Despite antibiotics, the lesions continued to worsen. He was admitted to the hospital and started on IV vancomycin and ceftriaxone for one week. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Indirect comparison of ixekizumab versus risankizumab for up to 12 weeks of treatment in patients with moderate-to-severe psoriasis
Introduction: Psoriasis is a common chronic inflammatory skin disorder, and the time needed to achieve clinically significant improvement is important to patients. Ixekizumab (IXE), an anti-interleukin (IL)-17A monoclonal antibody, is approved for the treatment of moderate-to-severe psoriasis and has demonstrated superior efficacy over ustekinumab (UST) and placebo (PBO) in clinical trials. Due to lack of head-to-head trials of IXE with certain comparators of interest, we indirectly compared psoriasis clinical trial efficacy data between IXE and selective IL-23 inhibitors. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Increased mortality in elderly patients with Stevens-Johnson syndrome and toxic epidermal necrolysis
Elderly patients are commonly associated with a greater comorbidity burden and complication rate than nonelderly patients. Comorbidities and hospital-related complications of Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) in elderly patients were evaluated. A retrospective analysis of patient cases found in the National Inpatient Sample (NIS) database was performed. Patients with a primary diagnosis of SJS/TEN made from 2003-2012 were included. Differences in hospital complications and comorbidities were assessed between elderly ( ≥65 years) and nonelderly patients. (Source: Journal of the American Ac...
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Innumerable squamous cell carcinomas in a Vietnam War veteran exposed to chemical defoliants
In cutaneous oncology, physicians are confronted with a seemingly overwhelming management challenge when treating patients with extremely numerous (>20) keratinocyte carcinomas (KCs) and clinically obvious field cancerization of multiple body sites. These patients have rapid, synchronous emergence of multiple lesions requiring coordinated multidisciplinary therapeutic and preventative interventions. An immunocompetent 84-year-old white man presented to cutaneous oncology clinic with at least 30 squamous cell carcinomas (SCCs) of the scalp, head, neck, and upper extremities including a 4cm SCC on the vertex of the scalp ...
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Insurance status in cutaneous melanoma: Effects of the Affordable Care Act
This study ’s objective was to examine the effects of this Medicaid expansion on patients diagnosed with cutaneous melanoma and the new legislation’s implications on survival outcomes. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Inpatient Medicare spending on cellulitis: Analysis of 2011-2015 trends and volume
Cellulitis is one of the most common reasons for hospital admission in the United States, accounting for over two million emergency department visits and 650,000 hospital admissions every year. As many of these patients are Medicare beneficiaries given the demographics of cellulitis, we sought to investigate trends in Medicare spending on inpatient cellulitis. We analyzed all publicly available reports released by the Center for Medicare and Medicaid Services (CMS) for more than 3,000 hospitals that received Medicare payments from 2011 to 2015. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Interaction of skin to fractional picosecond laser in Asian: Analysis of histology, reflectance confocal microscopy, and sonography
In this study, we evaluated the fractionated picosecond laser to skin interaction in Asian skin. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Integrating electrical impedance score into decision to biopsy increases biopsy efficiency
Background: Number needed to biopsy (NNB) is a measure of diagnostic accuracy and is measured as the number of lesions biopsied divided by the number of lesions that are positive for a disease outcome. Increasing biopsy efficiency can be achieved using noninvasive imaging technologies. One such technology relies on the principle of electrical impedance spectroscopy (EIS) to classify malignant versus benign lesions before biopsy. Nevisense is an FDA-approved device that has demonstrated high sensitivity in melanoma diagnosis (Scibase, Stockholm, Sweden). (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Intertriginous and photodistributed rash with docetaxel
Case Description: A 67-year-old male with history of adenosquamous prostate cancer status post prostatectomy, cystectomy, diverting loop colostomy with urostomy, leuprolide, and radiation was recently started on chemotherapy with docetaxel. He presented to emergency room 3 days after his first docetaxel infusion with complains of fever, nausea, and skin rash in bilateral axillae, and arms. The rash was mildly pruritic and painful. The patient had a recent episode of mild sunburn a week prior to his infusion, which had completely resolved before infusion. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research

Interest of an anti –hair loss shampoo supplement used alone and in association with the reference treatment in the management of hair loss
Reactional and chronic hair loss affect both men and women impairing the quality of life. The effectiveness of topical Minoxidil ® in hair loss has been demonstrated in numerous studies. However, there is a need to enhance its bioavailabity in hair follicles. Our laboratory developed a hair loss supplement shampoo promoting hair growth when being used alone, and potentiating Minoxidil® and preparing scalp and hair to reacti vate their vital functions, when being used together. We performed 2 different studies. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - August 21, 2019 Category: Dermatology Source Type: research