1
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Vaccarello A, Ouyang K, Treichel AM, Kumar Y, Sharma TR. Diagnostic discordance of Stevens-Johnson syndrome and toxic epidermal necrolysis between dermatologists and primary inpatient teams: a single-institution retrospective chart review. Arch Dermatol Res 2024; 316:128. [PMID: 38662244 DOI: 10.1007/s00403-024-02867-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 02/12/2024] [Accepted: 04/07/2024] [Indexed: 04/26/2024]
Affiliation(s)
| | - Kelsey Ouyang
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Alison M Treichel
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Yash Kumar
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Timmie R Sharma
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
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2
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Johnson JS, Treichel AM, Coolman TD, Cooper KD. Identifying associations between food security and dermatological disease: a twin-based evaluation. Int J Dermatol 2024; 63:e77-e79. [PMID: 38129954 DOI: 10.1111/ijd.16996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/01/2023] [Accepted: 12/10/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Jessica S Johnson
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA
| | - Alison M Treichel
- Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Tyler D Coolman
- Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Kevin D Cooper
- Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
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3
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Treichel AM, Zheng DX, Ranasinghe GC, Zeft AS, Bergfeld WF, Bayart CB. Eosinophilic fasciitis in a young male auto mechanic exposed to organic solvents. Reumatismo 2023; 75. [PMID: 37721352 DOI: 10.4081/reumatismo.2023.1539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 07/08/2023] [Indexed: 09/19/2023] Open
Abstract
We report a case of eosinophilic fasciitis in a teenage auto mechanic who was most likely affected by occupational exposure to organic solvents, including the aromatic hydrocarbons benzene, trimethylbenzene, naphthalene, toluene, and xylene. The patient presented with an 8-month history of painful induration of his extremities and an abnormal gait. A deep excisional biopsy of the fascia was obtained, demonstrating subcutaneous fibrosis with perivascular and interstitial inflammation, with lymphocytes and plasma cells spilling into the sclerosed fascia, and focal fibrinoid necrosis. Treatment was begun with intravenous pulse doses of methylprednisolone, prednisone (20 mg daily), and subcutaneous methotrexate (25 mg weekly), and the patient's painful induration had resolved and gait had normalized at the 6-month follow-up. Our case suggests that exposure to organic solvents could be implicated in the pathogenesis of eosinophilic fasciitis and highlights the importance of a thorough occupational history to prevent repeat exposures to potentially causative agents.
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Affiliation(s)
- A M Treichel
- Department of Dermatology, Cleveland Medical Center University Hospital, Case Western Reserve University, Cleveland, Ohio.
| | - D X Zheng
- Department of Dermatology, Cleveland Medical Center University Hospital, Case Western Reserve University, Cleveland, Ohio.
| | | | - A S Zeft
- Division of Pediatric Rheumatology, Department of Pediatrics, Cleveland Clinic, Ohio.
| | - W F Bergfeld
- Department of Dermatology, Cleveland Clinic, Ohio.
| | - C B Bayart
- Department of Pediatric Dermatology, Cincinnati Children's Hospital Medical Center, Ohio.
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4
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Klonowska K, Giannikou K, Grevelink JM, Boeszoermenyi B, Thorner AR, Herbert ZT, Afrin A, Treichel AM, Hamieh L, Kotulska K, Jozwiak S, Moss J, Darling TN, Kwiatkowski DJ. Comprehensive genetic and phenotype analysis of 95 individuals with mosaic tuberous sclerosis complex. Am J Hum Genet 2023; 110:979-988. [PMID: 37141891 PMCID: PMC10257004 DOI: 10.1016/j.ajhg.2023.04.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/12/2023] [Indexed: 05/06/2023] Open
Abstract
Tuberous sclerosis complex (TSC) is a neurogenetic disorder due to loss-of-function TSC1 or TSC2 variants, characterized by tumors affecting multiple organs, including skin, brain, heart, lung, and kidney. Mosaicism for TSC1 or TSC2 variants occurs in 10%-15% of individuals diagnosed with TSC. Here, we report comprehensive characterization of TSC mosaicism by using massively parallel sequencing (MPS) of 330 TSC samples from a variety of tissues and fluids from a cohort of 95 individuals with mosaic TSC. TSC1 variants in individuals with mosaic TSC are much less common (9%) than in germline TSC overall (26%) (p < 0.0001). The mosaic variant allele frequency (VAF) is significantly higher in TSC1 than in TSC2, in both blood and saliva (median VAF: TSC1, 4.91%; TSC2, 1.93%; p = 0.036) and facial angiofibromas (median VAF: TSC1, 7.7%; TSC2 3.7%; p = 0.004), while the number of TSC clinical features in individuals with TSC1 and TSC2 mosaicism was similar. The distribution of mosaic variants across TSC1 and TSC2 is similar to that for pathogenic germline variants in general TSC. The systemic mosaic variant was not present in blood in 14 of 76 (18%) individuals with TSC, highlighting the value of analysis of multiple samples from each individual. A detailed comparison revealed that nearly all TSC clinical features are less common in individuals with mosaic versus germline TSC. A large number of previously unreported TSC1 and TSC2 variants, including intronic and large rearrangements (n = 11), were also identified.
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Affiliation(s)
- Katarzyna Klonowska
- Cancer Genetics Laboratory, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
| | - Krinio Giannikou
- Cancer Genetics Laboratory, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA; Division of Hematology/Oncology, Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA
| | - Joannes M Grevelink
- Boston Dermatology and Laser Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Barbara Boeszoermenyi
- Cancer Genetics Laboratory, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Aaron R Thorner
- Center for Cancer Genomics, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Zachary T Herbert
- Molecular Biology Core Facilities, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Antara Afrin
- Department of Dermatology, Uniformed Services University, Bethesda, MA 20814, USA; Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Alison M Treichel
- Department of Dermatology, Uniformed Services University, Bethesda, MA 20814, USA; Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University Cleveland, Cleveland, OH 44106, USA
| | - Lana Hamieh
- Cancer Genetics Laboratory, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA; Division of Hospital Medicine, Barnes Jewish Hospital, Washington University in St Louis, St. Louis, MO 63110, USA
| | - Katarzyna Kotulska
- Department of Neurology and Epileptology, Children's Memorial Health Institute, Warsaw 04-736, Poland
| | - Sergiusz Jozwiak
- Department of Neurology and Epileptology, Children's Memorial Health Institute, Warsaw 04-736, Poland; Research Department, Children's Memorial Health Institute, Warsaw 04-736, Poland
| | - Joel Moss
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Thomas N Darling
- Department of Dermatology, Uniformed Services University, Bethesda, MA 20814, USA
| | - David J Kwiatkowski
- Cancer Genetics Laboratory, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
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5
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Zheng DX, Cwalina TB, Treichel AM, Erickson KL, Workman KR, Zhan JJ, Rothermel LD, Levoska MA, Scott JF. Severe psychological distress among patients with skin cancer: a population-based study spanning two decades. Clin Exp Dermatol 2023; 48:403-405. [PMID: 36715365 DOI: 10.1093/ced/llac136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 01/22/2023]
Abstract
In this analysis of the National Health Interview Survey, Americans with lower socioeconomic status, who are unmarried and with comorbidities were found to be at higher odds of severe psychological distress. Our findings may inform targeted support-based psycho-oncological interventions, such as shared medical appointments with other at-risk patients who have skin cancer.
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Affiliation(s)
- David X Zheng
- Departments of Dermatology and University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
- Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Thomas B Cwalina
- Departments of Dermatology and University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Alison M Treichel
- Departments of Dermatology and University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Kayley L Erickson
- Departments of Dermatology and University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Kaelynn R Workman
- Departments of Dermatology and University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Jesse J Zhan
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Luke D Rothermel
- Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Melissa A Levoska
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jeffrey F Scott
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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6
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Treichel AM, Boeszoermenyi B, Lee CCR, Moss J, Kwiatkowski DJ, Darling TN. Diagnosis of Mosaic Tuberous Sclerosis Complex Using Next-Generation Sequencing of Subtle or Unusual Cutaneous Findings. JID Innov 2023; 3:100180. [PMID: 36960317 PMCID: PMC10030254 DOI: 10.1016/j.xjidi.2023.100180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 01/11/2023] Open
Abstract
Skin findings can be critical to determining whether a patient with lymphangioleiomyomatosis (LAM), a progressive pulmonary disease that predominantly affects adult women, has sporadic LAM or LAM in association with tuberous sclerosis complex (TSC). Three individuals with LAM underwent evaluation for TSC-associated mucocutaneous and internal findings. We used our previously published algorithm to confirm the clinical suspicion for mosaicism and guide the selection of tissue specimens and genetic workup. Next-generation sequencing of cutaneous findings was used to confirm clinical suspicion for mosaic TSC in individuals with LAM. Two individuals previously thought to have sporadic LAM were diagnosed with mosaic TSC-associated LAM upon next-generation sequencing of unilateral angiofibromas in one and an unusual cutaneous hamartoma in the other. A third individual, diagnosed with TSC in childhood, was found to have a mosaic pathogenic variant in TSC2 in cutaneous tissue from a digit with macrodactyly. Accurate diagnosis of mosaic TSC-associated LAM may require enhanced genetic testing and is important because of the implications regarding surveillance, prognosis, and risk of transmission to offspring.
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Affiliation(s)
- Alison M. Treichel
- Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Barbara Boeszoermenyi
- Cancer Genetics Laboratory, Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Chyi-Chia Richard Lee
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Joel Moss
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - David J. Kwiatkowski
- Cancer Genetics Laboratory, Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Thomas N. Darling
- Department of Dermatology, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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7
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Russell E, Treichel AM, Honda K, Rady P, Tyring S, Cooper K, Rohr BR, Sharma TR. Recurrent flares of verruca plana arising at the site of embedded metal shrapnel exacerbated by ultraviolet exposure. JAAD Case Rep 2023; 35:25-27. [PMID: 37078014 PMCID: PMC10106338 DOI: 10.1016/j.jdcr.2023.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2023] Open
Affiliation(s)
- Emma Russell
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Alison M. Treichel
- Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Kord Honda
- Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Peter Rady
- Department of Dermatology, The University of Texas McGovern Medical School, Houston, Texas
| | - Stephen Tyring
- Department of Dermatology, The University of Texas McGovern Medical School, Houston, Texas
| | - Kevin Cooper
- Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Bethany R. Rohr
- Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Timmie R. Sharma
- Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
- Correspondence to: Timmie R. Sharma, MD, Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Ave, Lakeside 3500, Cleveland, OH 44106.
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8
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Treichel AM, Pithadia DJ, Lee CCR, Oyerinde O, Moss J, Darling TN. Histopathological features of fibrous cephalic plaques in tuberous sclerosis complex. Histopathology 2021; 79:619-628. [PMID: 33882161 DOI: 10.1111/his.14392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/15/2021] [Accepted: 04/17/2021] [Indexed: 02/03/2023]
Abstract
AIMS Fibrous cephalic plaques (FCPs) in individuals with tuberous sclerosis complex (TSC) may be excised for cosmetic reasons or biopsied to confirm lesion identification and TSC diagnosis. The aim of this study was to determine the range of histopathological features of FCPs. METHODS AND RESULTS A retrospective analysis was conducted on 119 adults with TSC. Twenty-one lesions from 16 individuals were evaluated by a dermatopathologist. Additionally, we assessed whether lesion colour or histology varied by anatomical location. Seventy-six lesions were observed in 36 of 119 individuals. Erythematous lesions were more commonly found on the forehead, face or neck than on the scalp (odds ratio = 12.6, P = 0.0001). Thickened and disorganised collagen fibre bundles were present in 95% (20/21) of lesions. Perifollicular fibrosis was observed in 95% (20/21) of lesions, enhanced vascularity was observed in 52% (11/21) of lesions, and features of fibrofolliculoma were observed in 43% (9/21) of lesions. Other abnormalities included features similar to trichofolliculoma, follicular-derived, infundibular-type cysts, and abnormally arranged primitive hair follicles. CONCLUSIONS FCPs in TSC show thickened bundles of collagen, and hamartomatous changes involving hair follicles. Recognition of these histopathological features may raise the possibility of unsuspected TSC or confirm FCP identification.
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Affiliation(s)
- Alison M Treichel
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.,Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Deeti J Pithadia
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.,Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Chyi-Chia R Lee
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Oyetewa Oyerinde
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.,Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Joel Moss
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Thomas N Darling
- Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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9
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Cartron AM, Buccine D, Treichel AM, Lee CR, Moss J, Darling TN. Miliary fibromas in tuberous sclerosis complex. J Eur Acad Dermatol Venereol 2021; 35:1226-1229. [PMID: 33565654 DOI: 10.1111/jdv.17161] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 01/27/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Tuberous sclerosis complex (TSC) is a hamartoma syndrome characterized by multiple skin lesions, such as angiofibromas, shagreen patch and miliary fibromas (MiF). OBJECTIVE To determine the clinical and histological features of MiF. METHODS A retrospective analysis was conducted on 133 adults with TSC. Photography was used to characterize the appearance and location of MiF. Histological features in five skin samples from four individuals were evaluated by a board-certified dermatopathologist. RESULTS MiF were observed in 19 of 133 (14%) individuals with TSC. MiF were 1- to 3-mm skin-coloured, sessile papules scattered on the back and rarely buttocks or thighs. Most were scattered in a bilaterally symmetric distribution, but others were asymmetric or associated with a shagreen patch. Histological features of MiF included expansion of the papillary and periadnexal dermis with variable hamartomatous abnormalities involving adjacent epithelial components. CONCLUSIONS MiF are distinct from other cutaneous lesions in TSC such as shagreen patches and angiofibromas. Recognition of this entity is important in defining the spectrum of TSC disease and reassuring individuals with TSC that these lesions are benign.
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Affiliation(s)
- A M Cartron
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.,Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - D Buccine
- Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - A M Treichel
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.,Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - C R Lee
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - J Moss
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - T N Darling
- Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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10
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Treichel AM, Teske N, Vandergriff T, Dominguez A, Mauskar MM, Nguyen KD. Kikuchi disease with cutaneous involvement complicated by features of hemophagocytic lymphohistiocytosis. J Cutan Pathol 2021; 48:343-346. [PMID: 33470433 DOI: 10.1111/cup.13720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/12/2020] [Accepted: 04/20/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Alison M Treichel
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Noelle Teske
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Travis Vandergriff
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Arturo Dominguez
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Melissa M Mauskar
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Khang D Nguyen
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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11
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Cartron AM, Treichel AM, Pithadia DJ, Moss J, Darling TN. Hair graying may occur early in life in tuberous sclerosis complex and is distinct from poliosis. J Am Acad Dermatol 2020; 84:788-790. [PMID: 32416202 DOI: 10.1016/j.jaad.2020.05.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/03/2020] [Accepted: 05/11/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Alexander M Cartron
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland; Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Alison M Treichel
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland; Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Deeti J Pithadia
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland; Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Joel Moss
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Thomas N Darling
- Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
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12
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Pithadia DJ, Treichel AM, Jones AM, Julien-Williams P, Machado T, Moss J, Darling TN. Dermatological adverse events associated with use of oral mechanistic target of rapamycin inhibitors in a cohort of individuals with tuberous sclerosis complex. Br J Dermatol 2020; 183:588-589. [PMID: 32282933 DOI: 10.1111/bjd.19124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- D J Pithadia
- Department of Dermatology, Uniformed Services University, Bethesda, MD, USA.,Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - A M Treichel
- Department of Dermatology, Uniformed Services University, Bethesda, MD, USA.,Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - A M Jones
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - P Julien-Williams
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - T Machado
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - J Moss
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - T N Darling
- Department of Dermatology, Uniformed Services University, Bethesda, MD, USA
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13
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Treichel AM, Kwiatkowski DJ, Moss J, Darling TN. A diagnostic algorithm for enhanced detection of mosaic tuberous sclerosis complex in adults. Br J Dermatol 2019; 182:235-237. [PMID: 31287558 DOI: 10.1111/bjd.18332] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- A M Treichel
- Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - D J Kwiatkowski
- Division of Pulmonary Medicine and of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, U.S.A
| | - J Moss
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - T N Darling
- Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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14
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Treichel AM, Hamieh L, Nathan NR, Tyburczy ME, Wang JA, Oyerinde O, Raiciulescu S, Julien-Williams P, Jones AM, Gopalakrishnan V, Moss J, Kwiatkowski DJ, Darling TN. Phenotypic distinctions between mosaic forms of tuberous sclerosis complex. Genet Med 2019; 21:2594-2604. [PMID: 31114024 PMCID: PMC7875483 DOI: 10.1038/s41436-019-0520-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 04/12/2019] [Indexed: 11/09/2022] Open
Abstract
Purpose: To determine if mosaic tuberous sclerosis complex (TSC) can be stratified into subtypes that correspond with prognosis and extent of disease. Methods: Next-generation sequencing of skin tumor and other samples was used to identify patients with mosaic pathogenic variants in TSC1 or TSC2. Extent of disease, onset age, and family history of TSC were determined through retrospective analysis of patient records. Results: The median number of disease findings and age at penetrance differed between mosaic patients with asymmetrically distributed facial angiofibromas (4 findings, 24y, n=7), mosaic patients with bilaterally symmetric facial angiofibromas (8 findings, 10y, n=12), and germline TSC patients (10 findings, 4y, n=29). Cutaneous and internal organ involvement positively correlated in mosaic (R=0.62, p=0.005), but not germline (R=−0.24, p=0.24) TSC. Variant allele fraction (VAF) in the blood (range: 0-19%) positively correlated with the number of major features (R=0.55, p=0.028). Five had a TSC2 variant identified in the skin that was below detection in the blood. One of 12 children from a mosaic parent had TSC. Conclusion: The phenotype of mosaic TSC ranged from mild to indistinguishable from germline disease. Patients with mosaicism and asymmetric facial angiofibromas exhibited fewer findings, later onset, and lower VAF in the blood.
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Affiliation(s)
- Alison M Treichel
- Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Lana Hamieh
- Division of Pulmonary Medicine and of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Neera R Nathan
- Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Magdalena E Tyburczy
- Division of Pulmonary Medicine and of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ji-An Wang
- Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Oyetewa Oyerinde
- Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Sorana Raiciulescu
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Patricia Julien-Williams
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Amanda M Jones
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Vissaagan Gopalakrishnan
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Joel Moss
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - David J Kwiatkowski
- Division of Pulmonary Medicine and of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Thomas N Darling
- Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
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15
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Pithadia DJ, Treichel AM, Lee CCR, Cowen EW, Linehan WM, Moss J, Darling TN. Birt-Hogg-Dubé syndrome initially diagnosed as tuberous sclerosis complex. JAAD Case Rep 2019; 5:368-371. [PMID: 31008171 PMCID: PMC6453834 DOI: 10.1016/j.jdcr.2019.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Deeti J Pithadia
- Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, Maryland.,Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Alison M Treichel
- Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, Maryland.,Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Chyi-Chia Richard Lee
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Edward W Cowen
- Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland
| | - W Marston Linehan
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Joel Moss
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Thomas N Darling
- Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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