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Cover page of Localized, Alopecic Myxedema of the Scalp

Localized, Alopecic Myxedema of the Scalp

(2023)

Localized myxedema is a rare complication ofautoimmune thyroid diseases including the Hashimoto thyroiditis and Graves’ disease.Localized myxedema results from the accumulation of glycosaminoglycans in the dermis and subcutaneous layer of the skin.

Fibroblast-produced hyaluronic acid is the mainglycosaminoglycan in localized myxedema. Localized myxedema presents bilaterally with a “boggy” thickening of the skin. Lesions classically have “waxy” swelling and induration.Myxedematous lesions of the skin most often appear on the anterior aspects of the legs and dorsum of the feet. They are often asymptomatic. Targeted treatment to cutaneous lesions is usually reserved for symptomatic cases.

Cover page of Analyzing Patient-Provider Communication Characteristics After Mohs Micrographic Surgery (MMS)

Analyzing Patient-Provider Communication Characteristics After Mohs Micrographic Surgery (MMS)

(2023)

Teledermatology is an emerging field withindermatology that has allowed for increased access to care through web portals such as MyChart. MyChart is a password-protected website that offers patients 24-hour access to personal health information and permits patients to send messages and photographs pertaining to their medical concerns.

MMS is a microscopically controlled surgery used to treat skin cancers such as Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC), and Melanoma.

Mohs surgeons have increasingly utilized such portals post-operatively to keep track of patient progress2, but there has been sparse research that analyzes the characteristics of patient-initiated electronic and telephone communication after MMS. This study identifies the attributes and factors that contribute to patient-initiated contact after MMS.

Cover page of Can PRAME immunohistochemistry be used to differentiate sebaceous carcinoma from basal cell carcinoma?

Can PRAME immunohistochemistry be used to differentiate sebaceous carcinoma from basal cell carcinoma?

(2023)

The histopathology of sebaceous carcinoma (SBC) can mimic other skin neoplasms, including basal cell carcinoma (BCC).Therefore, diagnostic biomarkers are needed for a subset of cases. Normal sebaceous glands express PRAME (PRAME nuclearreceptor transcriptional regulator), a melanoma-associated biomarker.Donell et al. showed that PRAME has strong immunoreactivity with basaloid sebocytes in SBC. Ng et al. reported patchy cytoplasmic staining in the germinative sebocytes only.Sebaceous glands (H&E stain and PRAME stain)

Objective: to evaluate the utility of PRAME immunohistochemistry as a diagnostic biomarker for SBC and its usefulness in the distinction of SBC from BCC.

Cover page of Mohs micrographic surgery versus wide local excision for the treatment of atypical fibroxanthoma: a retrospective cohort study

Mohs micrographic surgery versus wide local excision for the treatment of atypical fibroxanthoma: a retrospective cohort study

(2023)

Atypical fibroxanthoma (AFX) is a rare pleomorphic, spindle cell neoplasm that typically presents as a solitary pink/red papule on the head or neck in elderlyindividuals.

Although they rarely metastasize, it is not uncommon for these tumors to locally recur, highlighting the importance of complete removal with negative surgical margins.

Current treatment guidelines recommend Mohs micrographic surgery (MMS) or wide local excision (WLE), yet MMS is generally preferred in clinical practice based on the limited data supporting superior recurrence rates.

However, there are very few studies that have compared these two surgical modalities, and some did not find meaningful differences in the rates of recurrence.

Cover page of How Do FDA approved Biologics Compare to Narrow-Band Ultra-Violet B Light for the treatment of moderate to severe Psoriasis and AtopicDermatitis?

How Do FDA approved Biologics Compare to Narrow-Band Ultra-Violet B Light for the treatment of moderate to severe Psoriasis and AtopicDermatitis?

(2023)

One percent to 3% of adults worldwide are impacted by psoriasis. 2% of US adults are impacted by atopic dermatitis. Psoriasis and atopic dermatitis are chronic illnesses with compounding costs of treatment. Biologics are desirable treatments for moderate to severe psoriasis and atopic dermatitis. Purpose: Provide a cost benefit analysis of all biologics compared to narrow band ultraviolet B(NVUVB) light therapy for the management of atopic dermatitis and psoriasis.

Cover page of Nipple thrush or dermatitis: a retrospective cohort study of nipple-areolar complex conditions and call for coordinated, multidisciplinary care

Nipple thrush or dermatitis: a retrospective cohort study of nipple-areolar complex conditions and call for coordinated, multidisciplinary care

(2023)

Determine which elements of a lactating patient’s clinical presentation, including breast pump use and symptoms, are associated with a diagnosis of nipple thrush.

Cover page of The association between juvenile xanthogranulomas in neurofibromatosis type 1 patients and the development of leukemia: A systematic review

The association between juvenile xanthogranulomas in neurofibromatosis type 1 patients and the development of leukemia: A systematic review

(2023)

Neurofibromatosis type 1 (NF1) is an inherited tumor syndrome caused by heterozygous germline mutations in the NF1 gene, occurring in approximately 1/2600 individuals. A subset of patients with neurofibromatosis type 1 (NF1) develop juvenile xanthogranulomas (JXGs), a non-Langerhans cell histiocytosis, and some of these patients also develop juvenile myelomonocytic leukemia (JMML).Yet, these associations are poorly delineated.JXG is a benign proliferation of non-Langerhans cells histiocytes characterized by small yellow/brown papulonodules ranging from 1-20 mm in size. JMML is a mixed myeloproliferative-myelodysplastic disorder that affects children, most often before age 6.4. The first and only systematic review on this described therisk of developing JMML 20 to 30 times higher in patients with NF1 with JXG lesions compared to those without JXG. Since then, mostly isolated case reports have either refuted or confirmed this triple association.

Cover page of Effect of Body Mass Index on Cutaneous Malignancy Screenings at Dermatology Visits

Effect of Body Mass Index on Cutaneous Malignancy Screenings at Dermatology Visits

(2022)

Dermatologists perform total body skin exams (TBSEs) for 81% of new patients. To date, there exists little research on the effect of body mass index on the likelihood of receiving TBSEs. Many factors including implicit bias regarding obesity, mobility issues, and patient preferences may affect the care patients with obesity receive and may have impacts on health outcomes such as rates of missed skin cancers.

Cover page of CHARACTERIZING PATIENTS WITH DERMATOMYOSITIS FROM 2011-2021 AT A TERTIARY CARE CENTER

CHARACTERIZING PATIENTS WITH DERMATOMYOSITIS FROM 2011-2021 AT A TERTIARY CARE CENTER

(2022)

Dermatomyositis (DM) is the most common idiopathic inflammatory condition defined by distinct skin manifestations and varying systemic manifestations. Due to its heterogeneity, the true prevalence is difficult to determine, but current estimates are between 1/10,000-50,000 persons. The cutaneous manifestations of dermatomyositis can be defined as: Pathognomonic: Gottron papules, Gottron sign, and heliotrope rash. Characteristic: nailfold changes, shawl sign, V-sign, Holster sign and scalp involvement. Compatible: poikiloderma, periorbital edema and facial swelling. Less common: vesiculobullous, necrotic or ulcerative lesions, cutaneous vasculitis, and calcinosis cutis. Rare: mechanic’s hands, flagellate erythema, deck chair sign, follicular hyperkeratosis, panniculitis, mucinosis, erythroderma, and oral mucosal changes. Nonspecific: Raynaud Systemic manifestations are variable, including myopathy, cardiopulmonary involvement, gastrointestinal disease, and malignancy.