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Kamal K, Riew GJ, Hijaz B, Helfgott SM, Laga AC, Nambudiri VE. Generalized pustular psoriasis-like widespread eruption following COVID-19 infection in a patient with spondyloarthropathy on adalimumab. Exp Dermatol 2024; 33:e14889. [PMID: 37452555 DOI: 10.1111/exd.14889] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 06/28/2023] [Accepted: 07/01/2023] [Indexed: 07/18/2023]
Abstract
Generalized pustular psoriasis (GPP) is a form of pustular psoriasis that is distinguished by recurring or persistent outbreaks of non-acral primary sterile pustules. These eruptions can occur with or without systemic inflammation. Various factors, such as medications, stress and viral infection, have been identified as potential triggers for GPP flares. While several cases have detailed GPP-like eruptions in the setting of coronavirus disease 2019 (COVID-19) infection, few have explored the interplay between infection and biologic use in the development of GPP. In this case, we detail the history and management of a 45-year-old male patient with a prior history of spondyloarthropathy managed on a tumour necrosis factor-α inhibitor and recent COVID-19 infection presenting with a new, spreading pustular rash.
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Affiliation(s)
- Kanika Kamal
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Grant J Riew
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Baraa Hijaz
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Simon M Helfgott
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Rheumatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Alvaro C Laga
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Vinod E Nambudiri
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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Patel S, Hijaz B, Nambudiri VE. Anaemia as a comorbidity in pyoderma gangrenosum hospitalizations. Exp Dermatol 2024; 33:e14925. [PMID: 37726957 DOI: 10.1111/exd.14925] [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: 05/31/2023] [Revised: 08/24/2023] [Accepted: 09/03/2023] [Indexed: 09/21/2023]
Affiliation(s)
- Shrey Patel
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Baraa Hijaz
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Vinod E Nambudiri
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Lu RJ, Hijaz B, Naunheim MR, Stevenson L, Franco RA. The Subglottic Stenosis 6 Questionnaire: A Novel Quality-of-Life Survey Validated to Predict Need for Intervention in Patients With Idiopathic Subglottic Stenosis. Chest 2024; 165:161-171. [PMID: 37544425 DOI: 10.1016/j.chest.2023.07.4217] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Idiopathic subglottic stenosis (iSGS) is a recurrent, chronic disease defined by fibroinflammatory narrowing of the subglottic airway. A key challenge in treatment is monitoring disease progression, which may be debilitating and unpredictable in its timing. RESEARCH QUESTION Can the Subglottic Stenosis 6 (SGS-6) questionnaire be validated as a novel quality-of-life (QOL) instrument to monitor breathing, disease progression, and disease severity proactively in patients with iSGS? STUDY DESIGN AND METHODS Panel data from 51 patients with iSGS were collected from January 2012 through June 2022, representing 1,684 patient encounters including routine office visits and treatment encounters. Subjective QOL scores (including the novel SGS-6 and established RAND-36 and EuroQol Five Dimensions [EQ-5D] Visual Analog Scale) and objective pulmonary function test (PFT) results were collected at each visit. Subjective SGS-6 QOL scores were repeated within 1 week of initial reporting. Panel regression analyses were performed to assess the relationship between SGS-6 scores, PFT results, and a patient's need for intervention. Minimal clinically important differences (MCIDs) for SGS-6 and peak expiratory flow percentage (PEF%) were assessed using receiver operating characteristic (ROC) curve analysis and a patient's need for intervention as the external anchor. RESULTS Each one-point increase in SGS-6 score (of a maximum of 27) was associated with a 3.26% decrease in PEF%, a 1.93-point decrease in RAND-36 Physical Health composite score, a 1.27-point decrease in RAND-36 Mental Health composite score, and a 0.88-point decrease in EQ-5D Visual Analog Scale score. The intracorrelation coefficient for the SGS-6 composite score is 0.838 (95% CI, 0.770-0.888). Compared with patient baselines, SGS-6 scores were 4.66 points greater at the time of intervention with an MCID of 2.25 from a patient's baseline. The area under the ROC curve for SGS-6 and a patient's intervention point was 0.81. INTERPRETATION iSGS disease severity can be modeled using the SGS-6 questionnaire, offering physicians and patients a potentially new method of tracking disease progression and need for intervention remotely.
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Affiliation(s)
| | | | - Matthew R Naunheim
- Harvard Medical School, Boston, MA; Mass Eye and Ear, Boston, MA; Massachusetts General Hospital, Boston, MA
| | | | - Ramon A Franco
- Harvard Medical School, Boston, MA; Mass Eye and Ear, Boston, MA; Massachusetts General Hospital, Boston, MA.
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Riew GJ, Kamal K, Hijaz B, Awh KC, Nambudiri VE. Clinical music interventions and music therapy in dermatology. Arch Dermatol Res 2023; 315:2485-2490. [PMID: 37208459 DOI: 10.1007/s00403-023-02634-1] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 02/16/2023] [Accepted: 05/04/2023] [Indexed: 05/21/2023]
Abstract
Music interventions in medicine have been shown to reduce anxiety and depression, decrease pain, and improve quality of life; however, a review of clinical music interventions in dermatology is lacking. Studies have shown that playing music for patients undergoing dermatologic procedures (Mohs surgery and anesthetic injections) can decrease pain and anxiety. Patients with pruritic conditions-such as psoriasis, neurodermatitis, atopic dermatitis, contact eczema, and situations requiring hemodialysis-have exhibited decreased levels of disease burden and pain when listening to preferred music, pre-chosen music, and live music. Studies suggest that listening to certain types of music may also alter serum cytokines, affecting the allergic wheal response. Additional research is necessary to determine the full potential and practical applications for clinical music interventions in dermatology. Future research should focus on targeting skin conditions that may benefit from the psychological, inflammatory, and immune effects of music.
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Affiliation(s)
- Grant J Riew
- Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA, 02115, USA
- Harvard Medical School, Boston, MA, USA
| | - Kanika Kamal
- Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA, 02115, USA
- Harvard Medical School, Boston, MA, USA
| | - Baraa Hijaz
- Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA, 02115, USA
- Harvard Medical School, Boston, MA, USA
| | - Katherine C Awh
- Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA, 02115, USA
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Vinod E Nambudiri
- Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA, 02115, USA.
- Harvard Medical School, Boston, MA, USA.
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Martínez JA, Hijaz B, Subedi S, Boskey ER, Ganor O. Patient and parent perspectives on the utility of telemedicine for initial surgical gender care consultations: A cross-sectional survey. Digit Health 2023; 9:20552076231191619. [PMID: 37559831 PMCID: PMC10408325 DOI: 10.1177/20552076231191619] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 07/13/2023] [Indexed: 08/11/2023] Open
Abstract
Introduction The COVID-19 pandemic has expanded the use of telemedicine to patient populations that were previously constrained to in-person visits. Few studies have investigated the role that telemedicine plays in shaping the care of these patient populations. This project explores the impact of telemedicine for one such population: patients and parents of gender-diverse individuals seeking gender-affirming surgery. Methods A 10-question survey using previously validated questions was completed by 34 patients and 9 parents of patients (aged 15-31) who received virtual care at the Center for Gender Surgery at Boston Children's Hospital between March 2020 and April 2021. The survey was divided into two parts. The first section collected demographic information. The second assessed participant perspectives on remote surgical gender care through a series of Likert-type and open-ended questions. Results A total of 100% of the respondents felt that their telemedicine visit was convenient; 60% (18) of the patients and 87% (7) of the parents stated that they look forward to future use of this modality. Free responses highlighted common perspectives on remote surgical gender care, including the increased accessibility of gender-affirming care through telehealth, the limitations of telehealth for addressing physical and relational aspects of gender care, patients' desire for autonomy and privacy during telehealth visits, and parents' desire to be involved throughout their children's gender journey. Conclusion These results demonstrate the unique ability of telemedicine, if implemented thoughtfully, to enhance outcomes for patients seeking surgical gender affirmation.
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Affiliation(s)
- Joseph A Martínez
- Department of Plastic and Oral Surgery, Center for Gender Surgery, Boston Children's Hospital, Boston, MA, USA
| | | | - Sangeeta Subedi
- Department of Plastic and Oral Surgery, Center for Gender Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Elizabeth R Boskey
- Department of Plastic and Oral Surgery, Center for Gender Surgery, Boston Children's Hospital, Boston, MA, USA
- Department of Surgery, Harvard Medical School, Boston, MA, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Oren Ganor
- Department of Plastic and Oral Surgery, Center for Gender Surgery, Boston Children's Hospital, Boston, MA, USA
- Department of Surgery, Harvard Medical School, Boston, MA, USA
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