Incorporating Dermatologic Clinical Research Into Private Practice: A Review.

Clinical research is beneficial for the continued progression of medicine and the larger body of scientific knowledge. Clinical research can be incorporated into a range of settings, ranging from larger learning institutions to small private practices. With the need for continued advancement of the development of pharmaceutical interventions as well as other forms of clinical understanding, it is advantageous to create an environment where smaller, private practices feel comfortable and guided in establishing clinical research. It can be difficult to find the best methods to incorporate in-house clinical research. This review aims to address this gap in the literature, making the establishment of clinical trials, specifically clinical drug trials, more accessible in dermatology for private practices.

Toxic Erythema of Chemotherapy, Vasculitic Eruption With Malignant Intertrigo Characteristics, and Superimposed Infection Post-bevacizumab Initiation.

Drug reactions are a known risk in combined anti-cancer therapy. Less commonly recognized risks of chemotherapies and targeted immunotherapies include toxic erythema of chemotherapy reactions. With the immunosuppressive quality of cancer combined with anti-cancer treatments, patients are also susceptible to increased infection. We report a rare case of combined targeted anti-cancer treatment with bevacizumab and lorlatinib, and an associated transformation of an eczematous process into a toxic erythema of chemotherapy vasculitic eruption, with combined malignant intertrigo characteristics and superimposed infection following the initiation of bevacizumab.

Adrenergic Urticaria: An Updated Review.

It can be difficult to delineate the cause of urticarial eruptions, and in chronic cases, it can be a challenging condition to effectively treat. Several forms of urticarial eruptions are well documented and established. Our review focuses on a form of urticaria that is less commonly reported: adrenergic urticaria. In this review, we aim to consolidate the literature in the hopes that this urticarial subtype is considered in urticarial differentials, as well as highlight potential gaps in the research and future directions in treatment options.

40-Gene Expression Profile Representative of Metastatic Risk of Squamous Cell Carcinoma in a Mohs Surgical Patient.

This case study examines using a 40-gene expression profile (40-GEP) as an independent predictor of metastatic risk in a 74-year-old male with cutaneous squamous cell carcinoma on the scalp. The patient's previous medical history included melanoma and non-melanoma skin cancers. While conventional staging methods, such as the American Joint Committee on Cancer 8th edition (AJCC8) and Brigham and Women's Hospital (BWH) staging, indicated a higher metastatic risk, the 40-GEP testing classified the patient as low risk (Class 1 result) for metastasis within three years. The patient underwent successful Mohs surgery with no evidence of perineural invasion. This case highlights the discrepancy between current staging techniques and gene expression profile testing, demonstrating the potential of the 40-GEP as a more accurate predictor of metastatic risk. The study contributes to the growing body of literature on the use of gene expression profile testing in cutaneous cancers, emphasizing the need for further research in this area to improve patient care outcomes using 40-GEP testing.

A Rare Case of Diffuse Large B-Cell Lymphoma Found in the Subcutaneous Scalp.

Subcutaneous scalp manifestations of diffuse large b-cell lymphoma are uncommon and can be an easily overlooked diagnosis. Today we report a rare case of a 60-year-old male with a previous history of treatment and removal of multiple benign cysts who presented to the office for the removal of a subcutaneous mass on the left occipital scalp. Intraoperatively the mass did not resemble a cyst. Pathology results showed diffuse large b-cell lymphoma, highlighting the importance of thorough management of subcutaneous masses.

A Case of an Atraumatic Posterior Perirenal Lumbar Hernia.

Retroperitoneal lumbar hernias are a rare entity. Atraumatic posterior perirenal hernias are an exceptionally rare form of retroperitoneal lumbar hernias. Because of their infrequency, there are no standardized methods of surgical care for the treatment of atraumatic (primary spontaneous) posterior perirenal hernias. This report documents the finding and management of an atraumatic posterior perirenal lumbar hernia in a 69-year-old female.

Recurrent Left-Sided Pleural Effusions in a Patient With Chronic Lymphedema.

Chronic lymphedema can lead to several long-term complications. The causes of lymphedema can be primary, due to a genetic source, or secondary to procedures, trauma, or other conditions. Primary hereditary lymphedema, as in the case of Milroy's disease, is rare. Because of the condition's rarity, case reports mostly involve presentations to monitor for. Here we document a case of Milroy's disease in a 70-year-old woman with recurrent left lung effusions.