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1.
2.
JAAD Case Rep ; 5(5): 471-473, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31192991
3.
J Drugs Dermatol ; 18(5): 477-479, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-31141858

RESUMO

Here, we present a case of arsenic-induced Bowen's disease treated with a regimen consisting of topical 5-fluouracil and oral nicotinamide. The use of this therapy modality resulted in near complete resolution of all of the patient's lesions except for those on her palms, soles, and scalp. Excellent wound care and treatment adherence were major factors contributing to the success of this treatment option. Our results ultimately provide an alternative approach to treating multiple arsenical keratoses in patients who are limited to a drug plan involving 5-FU and oral nicotinamide and who are able to be rigorously compliant with application of medication and wound care. J Drugs Dermatol. 2019;18(5):477-479.


Assuntos
Antimetabólitos Antineoplásicos/uso terapêutico , Arsênico/efeitos adversos , Doença de Bowen/diagnóstico , Fluoruracila/uso terapêutico , Neoplasias Cutâneas/diagnóstico , Poluentes da Água/efeitos adversos , Administração Cutânea , Administração Oral , Antimetabólitos Antineoplásicos/administração & dosagem , Doença de Bowen/induzido quimicamente , Doença de Bowen/tratamento farmacológico , Diagnóstico Diferencial , Quimioterapia Combinada , Feminino , Fluoruracila/administração & dosagem , Humanos , Pessoa de Meia-Idade , Niacinamida/administração & dosagem , Niacinamida/uso terapêutico , Neoplasias Cutâneas/induzido quimicamente , Neoplasias Cutâneas/tratamento farmacológico , Abastecimento de Água
4.
Dermatol Online J ; 25(2)2019 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-30865416

RESUMO

Pretibial myxedema or thyroid dermopathy constitutes dermal deposition of mucin, primarily hyaluronic acid and chondroitin sulfate. It is a manifestation of autoimmune thyroiditis, seen more in Graves disease than in Hashimoto thyroiditis. The time delay from treatment of hyperthyroidism to appearance of localized myxedema varies from one month to 16 years (mean 5.13 years). Despite a variety of therapeutic options, failure and relapse rates are high. Therapeutic options reported in the literature include compression, topical and intralesional corticosteroids, oral pentoxifylline, octreotide, rituximab, plasmapheresis, and high-dose intravenous immunoglobulin. We share our experience in two patients who were treated with electrosurgical debulking of selected longstanding myxedematous lesions, with one positive result and one negative result.


Assuntos
Procedimentos Cirúrgicos de Citorredução/métodos , Eletrocirurgia , Dermatoses do Pé/cirurgia , Dermatoses da Perna/cirurgia , Mixedema/cirurgia , Feminino , Humanos , Dermatoses da Perna/patologia , Pessoa de Meia-Idade , Mixedema/patologia
5.
Adv Genomics Genet ; 8: 17-21, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30050362

RESUMO

Infantile systemic hyalinosis (ISH) is a rare autosomal recessive disorder and an allelic form of hyaline fibromatosis syndrome that is caused by mutations in the ANTRX2 gene encoding the transmembrane anthrax toxin receptor 2. Its main features include characteristic skin lesions, joint contractures, persistent diarrhea, and failure to thrive due to accumulation of hyaline material in multiple organs. The resulting severe malnutrition can cause death in early infancy. Because of its rarity and high fatality rate, timely diagnosis is difficult and ISH may be underdiagnosed. In this report, we describe a 10-month-old male with severe protein-losing enteropathy, skin lesions, and painful joint contractures, diagnosed with ISH based on skin his-topathology and identification of a novel homozygous ANTRX2 mutation, c.1127_1128delTG (p.V376Gfs*14). While its clinical outcome is poor without curative treatment, establishing a diagnosis of ISH starting from clinical suspicion to molecular analysis is important for appropriate medical management and for risk and carrier assessment of family members.

6.
Cutis ; 101(5): 367-369, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29894526

RESUMO

Refractory pityriasis rubra pilaris (PRP) often is treated off-label with the same biologic therapies that are approved for the treatment of psoriasis, most commonly tumor necrosis factor (TNF) α antagonists and ustekinumab; however, the IL-17A antagonist secukinumab also has shown efficacy in the treatment of PRP. We report 2 new cases of severe refractory PRP that responded rapidly to treatment with secukinumab.


Assuntos
Anticorpos Monoclonais/uso terapêutico , Pitiríase Rubra Pilar/tratamento farmacológico , Idoso , Anticorpos Monoclonais/administração & dosagem , Anticorpos Monoclonais Humanizados , Feminino , Humanos , Injeções Subcutâneas , Masculino , Pessoa de Meia-Idade , Pitiríase Rubra Pilar/patologia , Índice de Gravidade de Doença
8.
JAAD Case Rep ; 4(2): 143-144, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29387767
10.
Skinmed ; 15(4): 309-310, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28859748

RESUMO

We present a case of postmenopausal-onset nevus comedonicus in a 58-year-old white woman with no relevant medical history. Two years before presentation, the patient had had a solitary red nodule, measuring 3.8 cm wide, on the mid lateral region of her left thigh. This progressed to a large area, 11.4 cm wide and 14 cm long, of multiple pruritic and painful red nodules, cysts, and deep open comedones extending across the lateral part of the left thigh, with less severe segmental extension to the lateral aspect of the left leg.


Assuntos
Fármacos Dermatológicos/uso terapêutico , Isotretinoína/uso terapêutico , Nevo/terapia , Neoplasias Cutâneas/terapia , Procedimentos Cirúrgicos Dermatológicos , Feminino , Humanos , Pessoa de Meia-Idade
11.
Case Rep Dermatol Med ; 2017: 5918708, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28611928

RESUMO

Granuloma annulare (GA) is a benign inflammatory dermatosis characterized clinically by dermal papules and annular plaques. The pathogenesis of GA is not well understood, although it is thought to result from a delayed-type hypersensitivity reaction in which inflammatory cells elicit connective tissue degradation. This condition has been seen following the use of several drugs, including tumor necrosis factor-alpha (TNF-α) inhibitors, which paradoxically have also been reported to treat GA. We report the case of a patient who developed GA in association with secukinumab, an interleukin-17A antagonist, and discuss its implications for our understanding of the pathogenesis of GA.

12.
Dermatol Online J ; 23(1)2017 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-28329479

RESUMO

Recurrent erythema multiforme with oralinvolvement is therapeutically challenging.Apremilast has been used with success in resolvingthe oral aphthae of Behçet disease, prompting theuse of the drug in patients with oral erosions fromerythema multiforme. Three patients with oralerythema multiforme were given apremilast at dosesof 30-60mg daily. Complete clearance of the lesionswere observed in all three patients, including thoserefractory to other standard therapies. Apremilast maypresent an effective option for recurrent erythemamultiforme for patients who have failed trials antiviraland immunosuppressive therapies.


Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Eritema Multiforme/tratamento farmacológico , Doenças da Boca/tratamento farmacológico , Talidomida/análogos & derivados , Adulto , Criança , Eritema Multiforme/patologia , Feminino , Humanos , Masculino , Doenças da Boca/patologia , Recidiva , Talidomida/uso terapêutico , Adulto Jovem
13.
Dermatol Online J ; 23(2)2017 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-28329497

RESUMO

Pityriasis Rosea (PR) is a common skin disorderencountered in daily practice. Although its etiologyhas not been established, there has been widespreadresearch into possibilities. The lack of its characteristicmanifestations, specifically the herald patch andtruncal involvement, can lead to pitfalls in diagnosis.Whereas other conditions in the differential diagnosisshould be considered, PR can at times also manifest inan atypical manner. We wish to illustrate three casesof PR including those that presented with aphthousulcers, vesicles, and an inverse pattern.


Assuntos
Pitiríase Rósea/diagnóstico , Dermatopatias Vesiculobolhosas/diagnóstico , Estomatite Aftosa/diagnóstico , Administração Cutânea , Administração Oral , Corticosteroides/uso terapêutico , Antivirais/uso terapêutico , Emolientes/uso terapêutico , Antagonistas dos Receptores Histamínicos/uso terapêutico , Humanos , Pitiríase Rósea/complicações , Pitiríase Rósea/terapia , Dermatopatias Vesiculobolhosas/etiologia , Dermatopatias Vesiculobolhosas/terapia , Estomatite Aftosa/etiologia , Estomatite Aftosa/terapia , Terapia Ultravioleta
14.
Nucleic Acids Res ; 45(D1): D877-D887, 2017 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-27899610

RESUMO

The MalaCards human disease database (http://www.malacards.org/) is an integrated compendium of annotated diseases mined from 68 data sources. MalaCards has a web card for each of ∼20 000 disease entries, in six global categories. It portrays a broad array of annotation topics in 15 sections, including Summaries, Symptoms, Anatomical Context, Drugs, Genetic Tests, Variations and Publications. The Aliases and Classifications section reflects an algorithm for disease name integration across often-conflicting sources, providing effective annotation consolidation. A central feature is a balanced Genes section, with scores reflecting the strength of disease-gene associations. This is accompanied by other gene-related disease information such as pathways, mouse phenotypes and GO-terms, stemming from MalaCards' affiliation with the GeneCards Suite of databases. MalaCards' capacity to inter-link information from complementary sources, along with its elaborate search function, relational database infrastructure and convenient data dumps, allows it to tackle its rich disease annotation landscape, and facilitates systems analyses and genome sequence interpretation. MalaCards adopts a 'flat' disease-card approach, but each card is mapped to popular hierarchical ontologies (e.g. International Classification of Diseases, Human Phenotype Ontology and Unified Medical Language System) and also contains information about multi-level relations among diseases, thereby providing an optimal tool for disease representation and scrutiny.


Assuntos
Biologia Computacional , Bases de Dados Genéticas , Estudos de Associação Genética/métodos , Algoritmos , Biologia Computacional/métodos , Predisposição Genética para Doença , Variação Genética , Genômica/métodos , Humanos , Anotação de Sequência Molecular , Navegador
15.
Skinmed ; 14(3): 221-4, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27502264

RESUMO

An 11-year-old Tanzanian girl presented with diffuse verrucous lesions of varying morphology, scarring alopecia, and keloid scars over the face with a predilection for the ears. Physical examination revealed dark keratoderma and patches of hypopigmentation near the midline of the dorsal trunk (Figure 1a). Her forearms were densely covered by verrucous lesions with the exception of a clear linear patch on the dorsal aspect of the left forearm (Figure 1b). The perioral area was notable for white spires projecting from verrucous papules (Figure 1c) while the oral mucosa and teeth appeared normal on visual examination. The rest of her body, including the palms and soles, was covered by patchy, scaly lesions of varying severity.


Assuntos
Hipopigmentação/patologia , Queloide/patologia , Ceratose/patologia , Nevo/patologia , Poroceratose/patologia , Alopecia/complicações , Alopecia/patologia , Criança , Pavilhão Auricular/patologia , Face/patologia , Feminino , Humanos , Hipopigmentação/complicações , Queloide/complicações , Ceratose/complicações , Nevo/complicações , Poroceratose/complicações
16.
Biochem Mol Biol Educ ; 44(3): 224-9, 2016 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-26762678

RESUMO

The Krebs Cycle is a highly taught biochemical pathway that is traditionally difficult to learn. Twenty-seven undergraduate students were randomized to a rote memorization arm or to a mnemonic arm. They were given a pre-test, then shown a lecture corresponding to their assigned method, and then given an immediate Week 0 post-test and a Week 4 post-test. Groups scored comparably low on the pre-test (p = 0.7113). Students in the mnemonic arm performed better on the Week 0 post-test than those using rote (p = 0.0055). By Week 4, there was evidence of knowledge decay, with both arms' having comparably low scores (mnemonic vs. rote, p = 0.3739). The mnemonic assists in rapid acquisition of knowledge but probably has to be reviewed iteratively over time to demonstrate its full potential over rote memorization. A limited number of students from only one school was used. © 2016 by The International Union of Biochemistry and Molecular Biology, 44:224-229, 2016.


Assuntos
Ciclo do Ácido Cítrico , Educação de Graduação em Medicina , Imaginação , Rememoração Mental , Retenção Psicológica , Ensino , Estudos de Casos e Controles , Avaliação Educacional/métodos , Feminino , Humanos , Aprendizagem , Masculino , Memória de Longo Prazo , Modelos Estatísticos
17.
J Am Acad Dermatol ; 74(4): 746-53, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26792592

RESUMO

The conventional treatment for patients with pemphigus vulgaris (PV) centers on global immunosuppression, such as the use of steroids and other immunosuppressive drugs, to decrease titers of antidesmoglein autoantibodies responsible for the acantholytic blisters. Global immunosuppressants, however, cause serious side effects. The emergence of anti-CD20 biologic medications, such as rituximab, as an adjunct to conventional therapy has shifted the focus to targeted destruction of autoimmune B cells. Next-generation biologic medications with improved modes of delivery, pharmacology, and side effect profiles are constantly being developed, adding to the diversity of options for PV treatment. We review promising monoclonal antibodies, including veltuzumab, obinutuzumab (GA-101), ofatumumab, ocaratuzumab (AME-133v), PRO131921, and belimumab.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Produtos Biológicos/uso terapêutico , Imunossupressores/uso terapêutico , Pênfigo/diagnóstico , Pênfigo/tratamento farmacológico , Anticorpos Monoclonais/efeitos adversos , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais Humanizados/efeitos adversos , Produtos Biológicos/efeitos adversos , Estudos de Coortes , Feminino , Previsões , Humanos , Imunossupressores/efeitos adversos , Masculino , Prognóstico , Estudos Prospectivos , Medição de Risco , Rituximab/efeitos adversos , Rituximab/uso terapêutico , Resultado do Tratamento
18.
Dermatol Online J ; 21(11)2015 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-26632926

RESUMO

BACKGROUND: A variety of skin simulators are available on which to practice procedures; however, choice of a suboptimal substitute compromises realism and productive practice. OBJECTIVE: Skin simulators for basic dermatological procedures are reviewed. METHODS: The authors' anecdotal experience with various skin simulators for different procedures is shared. RESULTS: The following simulators are suggested:  an unripe banana for elliptical excision, pork belly for undermining, pork belly for simple interrupted and buried suture, capped needle on a human shoulder for intramuscular injection, ripe tomato or hotdog with skin for intradermal injection, eggplant for shave biopsy, pork belly for punch biopsy, plastic tape over a dark surface for cryosurgery, and beef liver for electrosurgery.  Flaps are best practiced with foam sandwiched between foam tape or artificial anatomical models created specifically for this purpose. LIMITATIONS: The utility of one simulator over another was not compared in a controlled study. CONCLUSION: Efficient, realistic skin simulators are readily available for practice, which should enhance the safety of the practitioner and improve outcomes of novices.


Assuntos
Competência Clínica , Dermatologia/educação , Dermatologia/métodos , Humanos
19.
Dermatol Online J ; 21(6)2015 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-26158359

RESUMO

Although most trainees in dermatology learn that different suturing techniques are designated for a specific purpose (i.e., certain functional and cosmetic outcomes), students often have a difficult time visualizing how a given suture functions in its designated capacity. In this article, we address the logic behind the most common suturing techniques in dermatologic surgery, including the direction and magnitude of their pulling force with respect to the wound edges and the ensuing displacement of dermal and epidermal structures. To aid better understanding, we diagram the vectors of suture force with each of the techniques discussed.


Assuntos
Procedimentos Cirúrgicos Dermatológicos , Derme/cirurgia , Epiderme/cirurgia , Técnicas de Sutura , Hemostasia Cirúrgica , Humanos
20.
Dermatol Online J ; 21(4)2015 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-25933070

RESUMO

We designed an imagery mnemonic to help medical students and residents learn the porphyrin pathway and associated diseases. Fourth year medical students at the Icahn School of Medicine at Mount Sinai in the spring of 2014 participated. One group (n=11) received the porphyrin pathway in a lecture explaining a mnemonic, whereas a second group (n=11) was simply taught the steps of the pathway. A pre-intervention assessment before the lectures was given to assess baseline differences in knowledge of the porphyrin pathway between the groups. Immediately following the lecture, 1 week after the lecture, and 3 weeks after the lecture, the students were given quizzes to assess their knowledge. Students were aware of the week 1 quiz and were asked not to study for it. The week 3 quiz was a surprise. There were no statistically significant differences in knowledge of the pathway at baseline (p=.45), at the immediate post-intervention (p=.22), or one week post-intervention (p=.40). Three weeks after the lecture, students in the mnemonic group scored 20% higher than controls (p=.02). Students who had learned the mnemonic demonstrated better long-term retention of information than students learning by the control method. This mnemonic minimizes study time while improving long-term retention.


Assuntos
Educação de Graduação em Medicina/métodos , Ensino/métodos , Avaliação Educacional , Humanos , Memória de Longo Prazo , Redes e Vias Metabólicas , Porfirinas/metabolismo , Retenção Psicológica
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