1
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Keen JA, Fisher MD, Yu CY, Swick BL, Shriver EM. Elevated Intraocular Pressure in Periorbital Sweet's Syndrome. Ophthalmic Plast Reconstr Surg 2023; 39:e115-e117. [PMID: 36893059 DOI: 10.1097/iop.0000000000002373] [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] [Indexed: 03/10/2023]
Abstract
A 66-year-old immunocompromised man presented with cellulitis around the left eye that was initially concerning for necrotizing fasciitis. Exam findings were remarkable for exquisite periocular tenderness with rigid, immobile eyelids resulting from severe erythema, edema, and induration. Given the concern for orbital compartment syndrome and a necrotizing infection, the patient was taken urgently to the operating room for debridement of the eyelid skin as well as an urgent lateral canthotomy and cantholysis. His eye exam revealed 360° of hemorrhagic chemosis, no relative afferent pupillary defect, and an ipsilateral elevated intraocular pressure of 35 mm Hg. No visual acuity measurement could be obtained secondary to the patient's altered mental status. His intraocular pressure normalized after treatment with antihypertensive drops and further extension of the canthotomy. Histopathological analysis showed extensive neutrophilic infiltrate of the dermis which was compatible with a diagnosis of Sweet's syndrome.
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Affiliation(s)
- Jamie A Keen
- University of Iowa Department of Ophthalmology and Visual Sciences, University of Iowa
| | - Mark D Fisher
- University of Iowa Department of Plastic Surgery, University of Iowa
| | - Caroline Y Yu
- University of Iowa Department of Ophthalmology and Visual Sciences, University of Iowa
| | - Brian L Swick
- University of Iowa Department of Dermatology, University of Iowa
- University of Iowa Department of Pathology, University of Iowa, Iowa City, Iowa, U.S.A
| | - Erin M Shriver
- University of Iowa Department of Ophthalmology and Visual Sciences, University of Iowa
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2
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Tan KW, Jamison AS, Swick BL, Ferguson NN. Metastatic extraskeletal myxoid chondrosarcoma presenting as a forehead mass. JAAD Case Rep 2022; 28:40-43. [PMID: 36097623 PMCID: PMC9463557 DOI: 10.1016/j.jdcr.2022.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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3
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Vest BE, Harview CL, Liu V, Swick BL, Berrebi KG, Olivares S, Stone MS, Sargen MR, Gerami P. Cutaneous melanocytic tumor with CRTC1::TRIM11 fusion and prominent epidermal involvement: A case report. J Cutan Pathol 2022; 49:1025-1030. [PMID: 35751643 PMCID: PMC10086857 DOI: 10.1111/cup.14287] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 04/13/2022] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 11/26/2022]
Abstract
Cutaneous melanocytic tumor with CRTC1::TRIM11 fusion (CMCT) is a recently described entity with only 13 cases reported in the literature. Histopathologically, the neoplasm consists of atypical epithelioid to spindled cells that form a well-circumscribed nodule confined to the dermis and subcutis with cytological features including large vesicular nuclei with prominent nucleoli and abundant eosinophilic cytoplasm. Immunohistochemistry shows variable expressivity of melanocytic markers. Currently, there is limited data regarding long-term outcomes of this newly described entity. Most cases have done well, but there is one case reported with an adverse event. Hence, further studies are needed to accurately classify this tumor. Definitive diagnosis is made by laboratory evidence of CRTC1::TRIM11 fusion. Herein, we report the first case of CMCT with epidermal involvement in the youngest patient known to be affected to date.
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Affiliation(s)
- Blake E Vest
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Christina L Harview
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Vincent Liu
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Brian L Swick
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Kristen G Berrebi
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.,Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Shantel Olivares
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Mary S Stone
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Michael R Sargen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Pedram Gerami
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
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4
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Cheung K, Bossler AD, Mott SL, Zeisler M, McKillip J, Zakharia Y, Swick BL, Powers JG. The Genetics of Early-Stage Melanoma in a Veteran Population. Front Oncol 2022; 12:887768. [PMID: 35712493 PMCID: PMC9196270 DOI: 10.3389/fonc.2022.887768] [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: 03/02/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
To improve understanding of the genetic signature of early-stage melanomas in Veterans, hotspot mutation profiling using next-generation sequencing (NGS) was performed on melanoma tissue samples from patients at the Iowa City Veterans Affairs Medical Center (VAMC). Genetic analysis identified BRAF (36.3%), TP53 (25.9%), NRAS (19.3%), CDKN2A (11.1%), KIT (8.1%), and BAP1 (7.4%) mutations with the highest prevalence. Although common variants in BRAF were detected at lower rates than what is reported for the general population, 55.6% of cases showed activating mutations in the RAS/RAF pathways. Variants in TP53 and KIT were detected at higher rates than in the general population. Veterans with prior history of melanoma were at significantly higher odds of having TP53 mutation (OR = 2.67, p = 0.04). This suggests that TP53 may be a marker for recurrent melanoma and possibly alternative exposures in the military population. This study provides new information regarding the genetics of melanoma in a Veteran population and early-stage melanomas, highlighting risk factors unique to this population and contributing to the conversation about preventing melanoma deaths in US Military personnel.
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Affiliation(s)
- Kevin Cheung
- Department of Dermatology, University of Iowa, Iowa City, IA, United States
| | - Aaron D Bossler
- Department of Pathology, H. Lee Moffitt Cancer Center, Tampa, FL, United States
| | - Sarah L Mott
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, United States
| | - Megan Zeisler
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, United States
| | - Julie McKillip
- Department of Dermatology, University of Iowa, Iowa City, IA, United States
| | - Yousef Zakharia
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, United States
| | - Brian L Swick
- Department of Dermatology, University of Iowa, Iowa City, IA, United States
| | - Jennifer G Powers
- Department of Dermatology, University of Iowa, Iowa City, IA, United States
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5
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Richey PM, Patrick AP, Swick BL, Van Beek MJ. Skeletal Muscle Regeneration: A Potential Histologic Pitfall for the Mohs Surgeon. Dermatol Surg 2022; 48:462-463. [PMID: 35013045 DOI: 10.1097/dss.0000000000003372] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Patricia M Richey
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Ashley P Patrick
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Brian L Swick
- Department of Dermatology and Pathology, University of Iowa Hospitals and Clinics and VA Medical Center, Iowa City, Iowa
| | - Marta J Van Beek
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
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6
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Cheung K, Bossler AD, Mott SL, Aadland M, McKillip J, Swick BL, Powers JG. 26901 The genetics of early-stage melanoma in a veteran population. J Am Acad Dermatol 2021. [DOI: 10.1016/j.jaad.2021.06.505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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7
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Patrick AP, Swick BL. Skeletal muscle regeneration in post-myofascial flap reconstruction specimens mimicking sarcoma: A potential diagnostic pitfall. J Cutan Pathol 2021; 48:1303-1306. [PMID: 34086358 DOI: 10.1111/cup.14074] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/06/2021] [Accepted: 05/30/2021] [Indexed: 11/27/2022]
Abstract
Skeletal muscle regeneration (SMR) encompasses a sequence of events that unfolds after injury to muscle fibers. Nearby satellite cells become activated and function as precursor muscle cells by proliferating and differentiating into myoblasts, which eventually fuse to form myotubes and ultimately mature muscle fibers. Compared to other forms of mesenchymal repair, SMR has higher morphologic heterogeneity with the potential to show histopathologic similarities to sarcomas and other malignancies. It is important to recognize SMR and settings in which this can occur to avoid misdiagnosis. We report two cases where a diagnosis of SMR was made from tissue taken from locations previously treated with Mohs micrographic surgery followed by myofascial flap reconstruction. In both cases, histopathologic features identified with hematoxylin and eosin as well as immunostaining were used to support the diagnosis of SMR. These cases highlight the importance of recognizing this clinic entity to ensure accurate diagnosis.
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Affiliation(s)
- Ashley P Patrick
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Brian L Swick
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.,Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.,Department of Medicine, Iowa City Veterans Affairs Medical Center, Iowa City, Iowa, USA
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8
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Richey PM, Laageide L, Swick BL. Stimulant use in patients presenting with psychocutaneous disorders. J Am Acad Dermatol 2021; 86:1002-1009. [PMID: 33878406 DOI: 10.1016/j.jaad.2021.04.033] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 04/04/2021] [Accepted: 04/13/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Psychocutaneous disorders are often attributed to stimulant medications, yet this relationship has never been fully elucidated. Literature on psychocutaneous disorders largely focuses on clinical presentation and treatment rather than disease etiology or exacerbation. OBJECTIVE To determine whether patients presenting with psychocutaneous disorders display high rates of stimulant use and psychiatric comorbidity. METHODS We undertook a retrospective cohort study of patients with psychocutaneous disorders presenting to a single center. It was hypothesized that these patients would have high rates of stimulant use and psychiatric comorbidity. Following analysis of baseline demographics, the patients were assigned to 1 of 2 groups: those with a psychotic disorder and those with a neurotic disorder. RESULTS Sixty percent of the patients (n = 317) with psychocutaneous disease had recently used a stimulant and more than 80% (270 of 317) carried an additional psychiatric diagnosis. The neurotic disorder group (n = 237) was younger and had higher rates of stimulant use. The psychotic disorder group (n = 80) had higher rates of psychosis, medical comorbidity, and illicit stimulant drug use. LIMITATIONS The predominantly Caucasian population may limit generalizability of findings as may the retrospective nature. CONCLUSIONS Patients with psychocutaneous disease have high rates of stimulant use and most have at least 1 psychiatric comorbidity.
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Affiliation(s)
- Patricia M Richey
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
| | - Leah Laageide
- Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Brian L Swick
- Department of Dermatology and Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa; Veterans' Affairs Medical Center, Iowa City, Iowa
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9
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Kobayashi T, Swick BL, Cho C. Clinical image: chronic skin ulcers in a patient with rheumatoid arthritis on immunosuppressant therapy. Clin Rheumatol 2020; 39:3517-3518. [PMID: 32592006 DOI: 10.1007/s10067-020-05251-9] [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] [Received: 05/29/2020] [Revised: 06/12/2020] [Accepted: 06/18/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Takaaki Kobayashi
- Department of Internal Medicine, University of Iowa Hospitals & Clinics, 200 Hawkins Drive, SW34 GH, Iowa, IA, USA.
| | - Brian L Swick
- Department of Pathology, University of Iowa Hospitals & Clinics, Iowa, IA, USA
| | - Christine Cho
- Department of Internal Medicine, University of Iowa Hospitals & Clinics, 200 Hawkins Drive, SW34 GH, Iowa, IA, USA.,Iowa Inflammation Program, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, and Veterans Administration Medical Center, Iowa, IA, USA
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10
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Dickinson KE, Price L, Wanat KA, Swick BL. Dermal elastolysis in the setting of combination immunotherapy. J Cutan Pathol 2019; 46:684-687. [DOI: 10.1111/cup.13492] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 04/28/2019] [Accepted: 04/30/2019] [Indexed: 11/26/2022]
Affiliation(s)
| | - Lulit Price
- Department of DermatologyUniversity of Iowa Hospitals and Clinics Iowa City IA
- Department of DermatologyGeisinger Holy Spirit Camp Hill PA
| | - Karolyn A. Wanat
- Department of DermatologyUniversity of Iowa Hospitals and Clinics Iowa City IA
- Department of DermatopathologyUniversity of Iowa Hospitals and Clinics Iowa City IA
- Department of DermatologyGeisinger Holy Spirit Camp Hill PA
- Department of DermatologyMedical College of Wisconsin Milwaukee WI
- Department of DermatopathologyMedical College of Wisconsin Milwaukee WI
| | - Brian L. Swick
- Department of DermatologyUniversity of Iowa Hospitals and Clinics Iowa City IA
- Department of DermatopathologyUniversity of Iowa Hospitals and Clinics Iowa City IA
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11
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Affiliation(s)
- Jessica Harms
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Brian L. Swick
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Karolyn A. Wanat
- Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin
- Correspondence to: Karolyn A. Wanat, MD, Department of Dermatology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226.
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12
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Pelletier DJ, Brown-Joel ZO, Swick BL. Periungual thumb papule on a 62-year-old man. Clin Exp Dermatol 2019; 44:670-673. [PMID: 30693568 DOI: 10.1111/ced.13873] [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] [Accepted: 10/09/2018] [Indexed: 11/30/2022]
Affiliation(s)
- D J Pelletier
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Z O Brown-Joel
- Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - B L Swick
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.,Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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13
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Vidal CI, Armbrect EA, Andea AA, Bohlke AK, Comfere NI, Hughes SR, Kim J, Kozel JA, Lee JB, Linos K, Litzner BR, Missall TA, Novoa RA, Sundram U, Swick BL, Hurley MY, Alam M, Argenyi Z, Duncan LM, Elston DM, Emanuel PO, Ferringer T, Fung MA, Hosler GA, Lazar AJ, Lowe L, Plaza JA, Prieto VG, Robinson JK, Schaffer A, Subtil A, Wang WL. Appropriate use criteria in dermatopathology: Initial recommendations from the American Society of Dermatopathology. J Cutan Pathol 2018; 45:563-580. [DOI: 10.1111/cup.13142] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 02/21/2018] [Accepted: 03/13/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Claudia I. Vidal
- Departments of Dermatology and Pathology; Saint Louis University School of Medicine; St. Louis Missouri
| | - Eric A. Armbrect
- Center for Health Outcomes Research; Saint Louis University; St. Louis Missouri
| | - Aleodor A. Andea
- Departments of Dermatology and Pathology; University of Michigan Medical Center; Ann Arbor Michigan
| | | | - Nneka I. Comfere
- Department of Dermatology and Laboratory Medicine and Pathology; Mayo Clinic; Rochester Minnesota
| | - Sarah R. Hughes
- Department of Pathology; Gundersen Health System; La Crosse Wisconsin
| | - Jinah Kim
- Departments of Dermatology and Pathology; Stanford University School of Medicine; Stanford California
| | | | - Jason B. Lee
- Departments of Dermatology and Cutaneous Biology; Sidney Kimmel Medical College at Thomas Jefferson University; Philadelphia Pennsylvania
| | - Konstantinos Linos
- Department of Pathology and Laboratory Medicine; Dartmouth-Hitchcock Medical Center and Geisel School of Medicine at Dartmouth Lebanon; Hanover New Hampshire
| | - Brandon R. Litzner
- Departments of Dermatology and Pathology, Via Christi Clinic; Ascension Medical Group; Wichita Kansas
- Department of Family Medicine; University of Kansas Medical Center-Wichita; Wichita Kansas
| | - Tricia A. Missall
- Departments of Dermatology and Pathology; Saint Louis University School of Medicine; St. Louis Missouri
| | - Roberto A. Novoa
- Departments of Dermatology and Pathology; Stanford University School of Medicine; Stanford California
| | - Uma Sundram
- Department of Anatomic Pathology; Oakland University William Beaumont School of Medicine and Beaumont Health Systems; Royal Oak Michigan
| | - Brian L. Swick
- Departments of Dermatology and Pathology; University of Iowa; Iowa City Iowa
| | - Maria Yadira Hurley
- Departments of Dermatology and Pathology; Saint Louis University School of Medicine; St. Louis Missouri
| | - Murad Alam
- Departments of Dermatology Otolaryngology, and Surgery; Feinberg School of Medicine, Northwestern University; Chicago Illinois
| | - Zsolt Argenyi
- Department of Pathology; University of Washington; Seattle Washington
| | - Lyn M. Duncan
- Pathology Service and Dermatopathology Unit; Massachusetts General Hospital and Harvard Medical School; Boston Massachusetts
| | - Dirk M. Elston
- Department of Dermatology; Dermatologic Surgery, Medical University of SC; Charleston South Carolina
| | - Patrick O. Emanuel
- Department of Pathology and Molecular Medicine; University of Auckland; Auckland New Zealand
| | - Tammie Ferringer
- Departments of Dermatology and Laboratory Medicine; Geisinger Medical Center; Danville Pennsylvania
| | - Maxwell A. Fung
- Departments of Dermatology and Pathology and Laboratory Medicine; University of California, Davis School of Medicine; Sacramento California
| | - Gregory A. Hosler
- ProPath; Departments of Dermatology and Pathology; University of Texas Southwestern Medical Center; Dallas Texas
| | - Alexander J. Lazar
- Departments of Pathology, Dermatology, & Genomic Medicine; The University of Texas MD Anderson Cancer Center; Houston Texas
| | - Lori Lowe
- Departments of Dermatology and Pathology; University of Michigan Medical Center; Ann Arbor Michigan
| | | | - Victor G. Prieto
- Departments of Pathology, Dermatology, & Genomic Medicine; The University of Texas MD Anderson Cancer Center; Houston Texas
| | - June K. Robinson
- Department of Dermatology; Northwestern University; Chicago Illinois
| | | | - Antonio Subtil
- Department of Dermatology; Yale School of Medicine; New Haven Connecticut
| | - Wei-Lien Wang
- Departments of Pathology and Translational Molecular Pathology, Division of Pathology and Laboratory Medicine; The University of Texas MD Anderson Cancer Center; Houston Texas
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Erickson BA, Tesdahl BA, Voznesensky MA, Breyer BN, Voelzke BB, Alsikafi NF, Vanni AJ, Broghammer JA, Buckley JC, Myers JB, Brant WO, Zhao LC, Smith Iii TG, Swick BL, Dahmoush L. Urethral lichen sclerosus under the microscope: a survey of academic pathologists. Can J Urol 2018; 25:9328-9333. [PMID: 29900821] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Given the poor understanding of the pathophysiology of genital lichen sclerosus (GLS) and a lack of accepted definitive diagnostic criteria, we proposed to survey pathologists regarding their understanding of GLS. We hypothesized that significant disagreement about GLS will exist. MATERIALS AND METHODS All urologists participating in the Trauma and Urologic Reconstruction Network of Surgeons identified genitourinary (GUP) and dermatopathologists (DP) at their respective institutions who were then invited to participate in an online survey regarding their experience with diagnosing GLS, GLS pathophysiology and its relationship to urethral stricture disease. RESULTS There were 23 (12 DP, 11 GUP) pathologists that completed the survey. The most agreed upon criteria for diagnosis were dermal collagen homogenization (85.7%), loss of the normal rete pattern (33.3%) and atrophic epidermis (28.5%). No pathologists believed GLS had an infectious etiology (19% maybe, 42% unknown) and 19% believed GLS to be an autoimmune disorder (42% maybe, 38% unknown); 19% believed LS to be premalignant, but 52% believed it was associated with cancer; 80% believed that LS could involve the urethra (DP (92%) versus GUP (67%); p = 0.272). Of those diagnosing urethral GLS, 80% of DUP believed that GLS must first involve the glans/prepuce before involving the urethra, while all GUP believed that urethral disease could exist in isolation (p = 0.007). CONCLUSIONS There was significant disagreement in this specialized cohort of pathologists when diagnosing GLS. A logical first step appears to be improving agreement on how to best describe and classify the disease. This may lead to improve treatments.
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Affiliation(s)
- Bradley A Erickson
- Department of Urology, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA
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15
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Malkhasyan K, Rooney SL, Snow AN, Swick BL, Milhem MM, Zakharia Y. The clinical characteristic of V600R-mutant melanoma: A single institution experience. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e21581] [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: 11/20/2022] Open
Affiliation(s)
| | | | | | | | - Mohammed M. Milhem
- University of Iowa Hospitals and Clinics, Holden Comprehensive Cancer Center, Iowa City, IA
| | - Yousef Zakharia
- University of Iowa Hospitals and Clinics, Holden Comprehensive Cancer Center, Iowa City, IA
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16
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Vidal CI, Armbrect EA, Andea AA, Bohlke AK, Comfere NI, Hughes SR, Kim J, Kozel JA, Lee JB, Linos K, Litzner BR, Missall TA, Novoa RA, Sundram U, Swick BL, Hurley MY, Alam M, Argenyi Z, Duncan LM, Elston DM, Emanuel PO, Ferringer T, Fung MA, Hosler GA, Lazar AJ, Lowe L, Plaza JA, Prieto VG, Robinson JK, Schaffer A, Subtil A, Wang WL. Appropriate use criteria in dermatopathology: Initial recommendations from the American Society of Dermatopathology. J Am Acad Dermatol 2018; 80:189-207.e11. [PMID: 29689323 DOI: 10.1016/j.jaad.2018.04.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 11/22/2017] [Revised: 04/05/2018] [Accepted: 04/15/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Appropriate use criteria (AUC) provide physicians guidance in test selection, and can affect health care delivery, reimbursement policy, and physician decision-making. OBJECTIVES The American Society of Dermatopathology, with input from the American Academy of Dermatology and the College of American Pathologists, sought to develop AUC in dermatopathology. METHODS The RAND/UCLA appropriateness methodology, which combines evidence-based medicine, clinical experience, and expert judgment, was used to develop AUC in dermatopathology. RESULTS With the number of ratings predetermined at 3, AUC were developed for 211 clinical scenarios involving 12 ancillary studies. Consensus was reached for 188 (89%) clinical scenarios, with 93 (44%) considered "usually appropriate" and 52 (25%) "rarely appropriate" and 43 (20%) having "uncertain appropriateness." LIMITATIONS The methodology requires a focus on appropriateness without comparison between tests and irrespective of cost. CONCLUSIONS The ultimate decision to order specific tests rests with the physician and is one where the expected benefit exceeds the negative consequences. This publication outlines the recommendations of appropriateness-the AUC for 12 tests used in dermatopathology. Importantly, these recommendations may change considering new evidence. Results deemed "uncertain appropriateness" and where consensus was not reached may benefit from further research.
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Affiliation(s)
| | - Claudia I Vidal
- Departments of Dermatology and Pathology, Saint Louis University School of Medicine, Saint Louis, Missouri.
| | - Eric A Armbrect
- Center for Health Outcomes Research, Saint Louis University, Saint Louis, Missouri
| | - Aleodor A Andea
- Departments of Dermatology and Pathology, University of Michigan Medical Center, Ann Arbor, Michigan
| | | | - Nneka I Comfere
- Department of Dermatology and Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Sarah R Hughes
- Department of Pathology, Gundersen Health System, La Crosse, Wisconsin
| | - Jinah Kim
- Departments of Dermatology and Pathology, Stanford University School of Medicine, Stanford, California
| | | | - Jason B Lee
- Departments of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Konstantinos Linos
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center and Geisel School of Medicine, Dartmouth College, Lebanon, New Hampshire
| | - Brandon R Litzner
- Departments of Dermatology and Pathology, Via Christi Clinic, Ascension Medical Group, Wichita, Kansas; Department of Family Medicine, University of Kansas Medical Center, Wichita, Kansas
| | - Tricia A Missall
- Departments of Dermatology and Pathology, Saint Louis University School of Medicine, Saint Louis, Missouri
| | - Roberto A Novoa
- Departments of Dermatology and Pathology, Stanford University School of Medicine, Stanford, California
| | - Uma Sundram
- Department of Anatomic Pathology, Oakland University William Beaumont School of Medicine and Beaumont Health Systems, Royal Oak, Michigan
| | - Brian L Swick
- Departments of Dermatology and Pathology, University of Iowa, Iowa City, Iowa
| | - M Yadira Hurley
- Departments of Dermatology and Pathology, Saint Louis University School of Medicine, Saint Louis, Missouri
| | | | - Murad Alam
- Departments of Dermatology Otolaryngology, and Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Zsolt Argenyi
- Department of Pathology, University of Washington, Seattle, Washington
| | - Lyn M Duncan
- Pathology Service and Dermatopathology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Dirk M Elston
- Department of Dermatology, Dermatologic Surgery Medical University of South Carolina, Charleston, South Carolina
| | - Patrick O Emanuel
- Department of Pathology and Molecular Medicine, University of Auckland, Auckland, New Zealand
| | - Tammie Ferringer
- Departments of Dermatology and Laboratory Medicine, Geisinger Medical Center, Danville, Pennsylvania
| | - Maxwell A Fung
- Departments of Dermatology and Pathology and Laboratory Medicine, University of California, Davis School of Medicine, Sacramento, California
| | - Gregory A Hosler
- ProPath and Departments of Dermatology and Pathology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Alexander J Lazar
- Departments of Pathology, Dermatology, and Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lori Lowe
- Departments of Dermatology and Pathology, University of Michigan Medical Center, Ann Arbor, Michigan
| | | | - Victor G Prieto
- Departments of Pathology, Dermatology, and Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - June K Robinson
- Department of Dermatology, Northwestern University, Chicago, Illinois
| | | | - Antonio Subtil
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Wei-Lien Wang
- Departments of Pathology and Translational Molecular Pathology, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
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17
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Dittmer M, Mutgi KAJ, Liu V, Swick BL. Localized, ovoid urticarial plaques with fine, nonfollicular pustules. Clin Exp Dermatol 2017; 43:209-211. [PMID: 29266388 DOI: 10.1111/ced.13345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2017] [Indexed: 12/01/2022]
Affiliation(s)
- M Dittmer
- Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - K A J Mutgi
- Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - V Liu
- Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.,Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.,Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - B L Swick
- Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.,Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.,Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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18
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Haugh AM, Njauw CN, Bubley JA, Verzì AE, Zhang B, Kudalkar E, VandenBoom T, Walton K, Swick BL, Kumar R, Rana HQ, Cochrane S, McCormick SR, Shea CR, Tsao H, Gerami P. Genotypic and Phenotypic Features of BAP1 Cancer Syndrome: A Report of 8 New Families and Review of Cases in the Literature. JAMA Dermatol 2017; 153:999-1006. [PMID: 28793149 DOI: 10.1001/jamadermatol.2017.2330] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Importance Patients with germline mutations in BAP1 may develop several flesh-colored melanocytic BAP1-mutated atypical intradermal tumors (MBAITs). These tumors generally develop earlier than other BAP1-associated tumors, highlighting an important role for dermatologists in identifying and screening patients with a history suggestive of a germline mutation. Objective To describe 8 new families with germline mutations in BAP1 and provide a comprehensive review of reported cases. Design, Settings and Participants Patients were identified in an outpatient dermatology clinical setting over a 6-month period (10 mutation carriers from 8 families) and through a literature review using PubMed (205 patients). Exposures Mutations were identified through next-generation sequencing of saliva or blood samples, and RNA was extracted from fibroblasts cultured from a patient with an intronic variant to determine the impact of the mutation on the coding sequence. Main Outcomes and Measures All 215 patients were assessed for personal and/or family history and genotype. These findings were compiled and assessed for any association between genotype and phenotype. Results Overall, this study included 215 patients (108 women, 91 men, and 16 gender unspecified; median [range] age, 46.5 [10.0-79.0] years). Nine of the 10 patients who were identified in the outpatient dermatology setting were found to have MBAITs on clinical examination. Forty of 53 patients (75%) identified in the literature review who underwent total-body skin examinations (TBSE) were found to have MBAITs, suggesting a high penetrance in patients who have undergone TBSE. The most prevalent malignancies among BAP1 mutation carriers were uveal melanoma (n = 60 [28%]), mesothelioma (n = 48 [22%]), cutaneous melanoma (n = 38 [18%]), and renal cell carcinoma (n = 20 [9%]). A total of 71 unique mutations in BAP1 have been reported. Conclusions and Relevance Our results indicate that germline mutations in both coding and noncoding regions throughout the BAP1 gene can impair protein function, leading to an increased risk for several associated malignancies. Four of the 8 probands we present had no history of BAP1-associated malignancies and were assessed for germline mutations when found to have MBAITs on dermatologic examination. Dermatologists can identify patients with a high likelihood of the BAP1 cancer syndrome through personal and family history and TBSE for the presence of possible MBAITs.
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Affiliation(s)
- Alexandra M Haugh
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Ching-Ni Njauw
- Massachusetts General Hospital Cancer Center, Boston.,Wellman Center for Photomedicine, Department of Dermatology, Massachusetts General Hospital, Boston
| | - Jeffrey A Bubley
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Anna Elisa Verzì
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Bin Zhang
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Emily Kudalkar
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Timothy VandenBoom
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Kara Walton
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Brian L Swick
- Department of Dermatology, University of Iowa Hospitals and Clinics, and Iowa City VAMC, Iowa City
| | - Raj Kumar
- Wellman Center for Photomedicine, Department of Dermatology, Massachusetts General Hospital, Boston
| | - Huma Q Rana
- Dana Farber Cancer Institute, Boston, Massachusettss
| | | | | | - Christopher R Shea
- Section of Dermatology, University of Chicago Medicine, Chicago, Illinois
| | - Hensin Tsao
- Massachusetts General Hospital Cancer Center, Boston.,Wellman Center for Photomedicine, Department of Dermatology, Massachusetts General Hospital, Boston
| | - Pedram Gerami
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,The Robert H. Lurie Cancer Center, Northwestern University, Chicago, Illinois
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19
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Doberstein T, Swick BL, Singh N. Skin nodule reveals lung cancer in a patient with granulomatosis with polyangiitis. Clin Case Rep 2017; 5:1339-1340. [PMID: 28781854 PMCID: PMC5538075 DOI: 10.1002/ccr3.1072] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 04/06/2017] [Accepted: 06/05/2017] [Indexed: 11/06/2022] Open
Abstract
A 69-year-old male with granulomatosis with polyangiitis presented with new skin nodules. Skin biopsy showed metastatic poorly differentiated lung adenocarcinoma. The skin nodule was the initial presentation of his lung cancer. There is need for increased vigilance for cancer risk in ANCA-associated vasculitis patients.
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Affiliation(s)
- Taylor Doberstein
- Division of Immunology Department of Internal Medicine University of Iowa Hospitals and Clinics Iowa City Iowa
| | - Brian L Swick
- Department of Dermatology and Pathology University of Iowa Hospitals and Clinics Iowa City Iowa
| | - Namrata Singh
- Division of Immunology Department of Internal Medicine University of Iowa Hospitals and Clinics Iowa City Iowa
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20
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Farah RS, Holahan HM, Moye MS, Stone MS, Swick BL. Hereditary hypotrichosis simplex of the scalp. Cutis 2017; 100:E12-E14. [PMID: 28873114] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Ronda S Farah
- Department of Dermatology, University of Minnesota, Minneapolis, USA
| | - Heather M Holahan
- Department of Dermatology, Rutgers Robert Wood Johnson Medical School, Somerset, New Jersey, USA
| | - Molly S Moye
- Forefront Dermatology, Louisville, Kentucky, USA
| | - Mary S Stone
- Department of Dermatology, University of Iowa, Iowa City, USA
| | - Brian L Swick
- Department of Dermatology, University of Iowa, Iowa City, USA
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21
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Boes EE, Selby JC, Swick BL. 'Super bloom' dermatitis. Clin Exp Dermatol 2017; 42:430-431. [PMID: 28397285 DOI: 10.1111/ced.13078] [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] [Accepted: 07/27/2016] [Indexed: 11/28/2022]
Affiliation(s)
- E E Boes
- Des Moines University, 3200 Grand Avenue, Des Moines, IA, 50312, USA
| | - J C Selby
- Department of Dermatology, University of Iowa, VA Medical Center, Iowa City, IA, USA
| | - B L Swick
- Department of Dermatology, University of Iowa, VA Medical Center, Iowa City, IA, USA.,Department of Pathology, University of Iowa, Iowa City, IA, USA
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22
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Affiliation(s)
- Pooja Chitgopeker
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City
| | - Anthony J Little
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City
| | - Brian L Swick
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City2Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City
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23
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Connor CJ, Swick BL. SkIndia Quiz 33: Solitary pigmented plaque containing a blue-gray papule. Indian Dermatol Online J 2017; 8:70-72. [PMID: 28217486 PMCID: PMC5297284 DOI: 10.4103/2229-5178.193928] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Cody J Connor
- Carver College of Medicine, University of Iowa, Iowa City Veterans Affairs Medical Center, Iowa, USA
| | - Brian L Swick
- Department of Dermatology and Pathology, University of Iowa, Iowa City Veterans Affairs Medical Center, Iowa, USA
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24
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Dore E, Swick BL, Link BK, Ghahramani GK, Liu V. Follicular lymphomatoid papulosis with follicular mucinosis: a clinicopathologic study of 3 cases with literature review and conceptual reappraisal. J Cutan Pathol 2017; 44:360-366. [DOI: 10.1111/cup.12871] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 11/02/2016] [Accepted: 12/13/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Emilie Dore
- Department of DermatologyUniversity of Iowa Iowa City Iowa
| | - Brian L. Swick
- Department of DermatologyUniversity of Iowa Iowa City Iowa
- Department of Dermatology and PathologyUniversity of Iowa Iowa City Iowa
| | - Brian K. Link
- Department of OncologyUniversity of Iowa Iowa City Iowa
| | | | - Vincent Liu
- Department of DermatologyUniversity of Iowa Iowa City Iowa
- Department of Dermatology and PathologyUniversity of Iowa Iowa City Iowa
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25
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Phadke SD, Ghabour R, Swick BL, Swenson A, Milhem M, Zakharia Y. Pembrolizumab Therapy Triggering an Exacerbation of Preexisting Autoimmune Disease: A Report of 2 Patient Cases. J Investig Med High Impact Case Rep 2016; 4:2324709616674316. [PMID: 27826593 PMCID: PMC5084516 DOI: 10.1177/2324709616674316] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [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: 07/02/2016] [Revised: 09/15/2016] [Accepted: 09/18/2016] [Indexed: 11/26/2022] Open
Abstract
Historically, metastatic melanoma was uniformly and rapidly lethal, and treatment options were limited. In recent years, however, checkpoint inhibitors have emerged as an accepted standard treatment for patients with advanced melanoma. In clinical trials, these agents have been largely well tolerated and have the potential to result in durable responses. Importantly though, one must recognize the unique side effect profile of these therapies, which can trigger or exacerbate underlying autoimmune disease. Whether this autoimmune activation is associated with a clinical response to therapy has been debated, and while not definitive, there is evidence in the literature of a possible association. The 2 cases presented describe this autoimmune phenomenon, along with a review of the existing literature on the relationship between response to immunotherapy and autoimmune side effects.
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Affiliation(s)
- Sneha D Phadke
- Department of Internal Medicine, Divison of Hematology/Oncology, University of Iowa Hospitals & Clinics, Iowa City, IA, USA
| | - Ramez Ghabour
- Department of Internal Medicine, University of Iowa Hospitals & Clinics, Iowa City, IA, USA
| | - Brian L Swick
- Department of Dermatology, University of Iowa Hospitals & Clinics, Iowa City, IA, USA
| | - Andrea Swenson
- Department of Neurology, University of Iowa Hospitals & Clinics, Iowa City, IA, USA
| | - Mohammed Milhem
- Department of Internal Medicine, Divison of Hematology/Oncology, University of Iowa Hospitals & Clinics, Iowa City, IA, USA
| | - Yousef Zakharia
- Department of Internal Medicine, Divison of Hematology/Oncology, University of Iowa Hospitals & Clinics, Iowa City, IA, USA
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26
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Little AJ, Seline AE, Swick BL, Wanat KA. Cutaneous metastasis of breast adenoid cystic carcinoma to the scalp. J Cutan Pathol 2016; 43:684-7. [DOI: 10.1111/cup.12706] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Revised: 02/02/2016] [Accepted: 03/05/2016] [Indexed: 01/15/2023]
Affiliation(s)
- Anthony J. Little
- Department of Dermatology; University of Iowa Hospitals and Clinics; Iowa City IA USA
| | - Alison E. Seline
- Department of Dermatology; University of Iowa Hospitals and Clinics; Iowa City IA USA
| | - Brian L. Swick
- Department of Dermatology and Pathology; University of Iowa Hospitals and Clinics, and Iowa City VAMC; Iowa City IA USA
| | - Karolyn A. Wanat
- Department of Dermatology and Pathology; University of Iowa Hospitals and Clinics, and Iowa City VAMC; Iowa City IA USA
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27
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Seline AE, Swick BL. Secondary syphilis. Cutis 2016; 97:16-46. [PMID: 26919360] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Alison E Seline
- Carver College of Medicine, University of Iowa, Iowa City, USA
| | - Brian L Swick
- Departments of Dermatology and Pathology, University of Iowa, Iowa City, and the Iowa City VA Health Care System, USA
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28
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Affiliation(s)
- E E Boes
- College of Osteopathic Medicine, Des Moines University, Des Moines, IA, USA
| | - H W Walling
- Town Square Dermatology, Coralville, IA, USA
| | - B L Swick
- Departments of Dermatology and Pathology, University of Iowa and Iowa City VAMC, Iowa City, IA, USA
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29
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Moye MS, Swick BL, Wanat KA. A Growing Scar on the Abdomen of a Middle-aged Woman. JAMA 2015; 314:1169-70. [PMID: 26372587 DOI: 10.1001/jama.2015.4082] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Molly S Moye
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City
| | - Brian L Swick
- Departments of Dermatology and Pathology, University of Iowa Hospitals and Clinics, Iowa City Veterans Affairs Medical Center, Iowa City
| | - Karolyn A Wanat
- Departments of Dermatology and Pathology, University of Iowa Hospitals and Clinics, Iowa City Veterans Affairs Medical Center, Iowa City
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30
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Boes EE, Walling HW, Swick BL. Winter eruption on the thighs. Clin Exp Dermatol 2015. [PMID: 26206610 DOI: 10.1111/ced.12737] [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: 11/27/2022]
Affiliation(s)
- E E Boes
- Des Moines University, Des Moines, Iowa, IA, USA
| | - H W Walling
- Town Square Dermatology, Coralville, Iowa, IA, USA
| | - B L Swick
- University of Iowa Departments of Dermatology and Pathology and Iowa City VAMC, Iowa City, Iowa, IA, USA
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31
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Affiliation(s)
| | - Brian L Swick
- Department of Dermatology, University of Iowa, Iowa City, IA.,Department of Pathology, University of Iowa, Iowa City, IA.,Iowa City Veterans Affairs Medical Center, Iowa City, IA
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32
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Dore E, Noe MH, Swick BL. Trichoblastoma, syringocystadenoma papilliferum, desmoplastic trichilemmoma and tumor of the follicular infundibulum with signet-ring cells, all arising in nevus sebaceus. J Cutan Pathol 2015; 42:645-51. [DOI: 10.1111/cup.12489] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 12/13/2014] [Accepted: 01/25/2015] [Indexed: 12/18/2022]
Affiliation(s)
- Emilie Dore
- Carver College of Medicine; University of Iowa; Iowa City IA USA
| | - Megan H. Noe
- Department of Dermatology; University of Iowa; Iowa City IA USA
| | - Brian L. Swick
- Department of Dermatology; University of Iowa; Iowa City IA USA
- Department of Pathology, Iowa City Veterans Affairs Medical Center; University of Iowa; Iowa City IA USA
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33
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Abstract
We report a case of ulcerated atypical Spitz nevi that demonstrated a yellow to light orange background under dermoscopy, which can be seen in juvenile xanthogranuloma (JXG) and is referred to as the "setting sun" appearance. This yellow to orange appearance was due to serous crusting and not histiocytic infiltration, which is seen in JXG. This case highlights overlapping dermatoscopic features between the two skin lesions and polymorphous vascular structures, which are unique to atypical Spitz nevi.
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Affiliation(s)
- Grant K Ghahramani
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
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34
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Hochwalt PC, Fernandez KH, Swick BL. Large subcutaneous masses. Cutis 2014; 94:E6-E8. [PMID: 25566583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Phillip C Hochwalt
- University of Iowa Hospitals and Clinics, Department of Dermatology, 200 Hawkins Dr, Iowa City, IA 52242, USA.
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35
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Lester EB, Swick BL. Eosinophils in biopsy specimens of lichen sclerosus: a not uncommon finding. J Cutan Pathol 2014; 42:16-21. [PMID: 25404144 DOI: 10.1111/cup.12445] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [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: 03/02/2014] [Revised: 04/26/2014] [Accepted: 04/26/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Evolving lesions of lichen sclerosus (LS) pose a diagnostic challenge owing to an absence of classic findings of epidermal atrophy, dermal sclerosis, a band-like lymphocytic infiltrate and the presence of eosinophils. METHODS Retrospective specimens of LS were reviewed. Demographic information, biopsy vs. excision and the following histopathological characteristics were noted: presence and number of eosinophils, epidermal hyperplasia, spongiosis, early/transitional LS, well-developed LS and coexisting squamous cell carcinoma (SCC). Linear regression analysis was performed. RESULTS The data consisted of 66 biopsies (36 male [M], 30 female [F]), from 53 individuals (33M, 20F), including 57 genital and 9 extragenital biopsies. Seven biopsies showed SCC, 28 showed epidermal hyperplasia and 14 exhibited spongiosis. Thirty-five specimens were early/transitional LS and commonly exhibited epidermal hyperplasia (57%), epidermotropism of lymphocytes (97%) and basement membrane thickening (97%). Thirty-five biopsies (53%) contained eosinophils (23 early/transitional lesions). Male gender (p = 0.074) was associated with increased eosinophils. The presence of SCC (p = 0.014) was a significant predictors of eosinophil number. CONCLUSIONS Epidermal hyperplasia, epidermotropism of lymphocytes and basement membrane thickening are helpful features in identifying early LS. Eosinophils are not an uncommon finding in LS and are most common in male genital lesions and in LS associated with SCC.
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36
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Holahan HM, Farah RS, Swick BL. Pretibial myxedema. Cutis 2014; 94:60-74. [PMID: 25184646] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
| | | | - Brian L Swick
- University of Iowa Hospitals and Clinics, Department of Dermatology, 200 Hawkins Dr, Iowa City, IA 52242, USA.
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37
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Moye MS, Farah RS, Swick BL. Folliculocentric papules and alopecia. Clin Exp Dermatol 2014; 39:661-3. [PMID: 24888435 DOI: 10.1111/ced.12348] [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] [Accepted: 01/15/2014] [Indexed: 12/01/2022]
Affiliation(s)
- M S Moye
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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38
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Farah RS, Holahan HM, Swick BL. Giant cell tumor of the tendon sheath. Cutis 2014; 93:174-182. [PMID: 24818183] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Ronda S Farah
- University of Iowa Hospitals and Clinics, Department of Dermatology, 200 Hawkins Dr, Iowa City, IA 52242, USA.
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39
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Crawford KD, Sheth S, Swick BL. Subcutaneous mass. Clin Exp Dermatol 2014; 39:425-7. [PMID: 24635096 DOI: 10.1111/ced.12288] [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] [Accepted: 11/11/2013] [Indexed: 11/28/2022]
Affiliation(s)
- K D Crawford
- Department of Internal Medicine, Louis A. Weiss Memorial Hospital, Chicago, IL, USA
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40
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Affiliation(s)
| | - Adam Asarch
- Department of Dermatology; University of Iowa; Iowa IA USA
| | - Brian L. Swick
- Department of Dermatology; University of Iowa; Iowa IA USA
- Department of Pathology; University of Iowa; Iowa IA USA
- Iowa City Veterans Affairs Medical Center; Iowa IA USA
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41
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Rysgaard C, Alexander E, Swick BL. Nodular secondary syphilis with associated granulomatous inflammation: case report and literature review. J Cutan Pathol 2014; 41:370-9. [DOI: 10.1111/cup.12293] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Accepted: 01/12/2014] [Indexed: 11/30/2022]
Affiliation(s)
| | - Erik Alexander
- Dermatology Associates of Wisconsin; S.C.; Wauwatosa WI USA
| | - Brian L. Swick
- Department of Pathology; University of Iowa; Iowa City IA USA
- Department of Dermatology; University of Iowa; Iowa City IA USA
- Iowa City Veterans Affairs Medical Center; Iowa City IA USA
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42
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Hegg RM, Alkousakis TJ, Swick BL. What is your diagnosis? Old world Leishmaniasis. Cutis 2014; 93:67-70. [PMID: 24605349] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
| | | | - Brian L Swick
- Department of Dermatology, University of Iowa, 200 Hawkins Dr, 40025 PFP, Iowa City, IA 52245, USA.
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Ferguson NN, Wendel A, Farah R, Liu V, Swick BL. Postsurgical erosive papulonodular dermatosis. J Am Acad Dermatol 2013; 69:e188-9. [DOI: 10.1016/j.jaad.2013.04.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 04/07/2013] [Accepted: 04/15/2013] [Indexed: 11/29/2022]
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Farah RS, Ferguson NN, Swick BL. Lichen planopilaris. Cutis 2013; 92:11-18. [PMID: 23961528] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Ronda S Farah
- Department of Dermatology, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA 52242, USA.
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Swick BL, Srikantha R, Messingham KN. Specific analysis of KIT and PDGFR-alpha expression and mutational status in Merkel cell carcinoma. J Cutan Pathol 2013; 40:623-30. [PMID: 23621836 DOI: 10.1111/cup.12160] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2011] [Revised: 05/20/2012] [Accepted: 05/28/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND The purpose of this study was to explore the immunohistochemical and mutational status of the tyrosine kinases KIT and platelet derived growth receptor-alpha (PDGFRA) in Merkel cell carcinoma (MCC). Specifically, we examined the mutated exons in gastrointestinal stromal cell tumors that may confer a treatment response to imatinib mesylate. METHODS We evaluated KIT and PDGFRA immunostaining in 23 examples of MCC utilizing laser capture microdissection to obtain pure samples of tumor genomic DNA from 18 of 23 examples of MCC. PCR amplification and sequencing of KIT exons 9, 11, 13 and 17, and PDGFRA exons 10, 12, 14 and 18 for mutations was performed. RESULTS Fifteen of 23 tumors (65%) demonstrated CD117 expression and 22 of 23 tumors (95%) demonstrated PDGFRA expression. A single heterozygous KIT exon 11 base change resulting in an E583K mutation was discovered in 12 of 18 (66%) examples of MCC. In addition, a single nucleotide polymorphism was detected in eight of 18 tumors (44%) in exon 18 of PDGFRA (codon 824; GTC > GTT). CONCLUSIONS We discovered a novel somatic KIT exon 11 E583K mutation in 66% of tumors. This mutation has been previously described in a human with piebaldism and appears to represent an inactivating mutation. Therefore, despite expression of CD117 and PDGFRA, the absence of activating mutations in these tyrosine kinases makes KIT and PDGFRA unlikely candidates of MCC oncogenesis.
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Affiliation(s)
- Brian L Swick
- Department of Dermatology, University of Iowa, Iowa City, IA 52242, USA.
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Farah RS, Hochwalt PC, Swick BL. Congenital facial papule. Clin Exp Dermatol 2013; 38:439-40. [PMID: 23496775 DOI: 10.1111/ced.12112] [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] [Accepted: 11/04/2012] [Indexed: 11/30/2022]
Affiliation(s)
- R S Farah
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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Hochwalt PC, Swick BL, Liu V. Nonhealing ulcer of the left fifth finger. ACTA ACUST UNITED AC 2012; 148:849-54. [PMID: 22801625 DOI: 10.1001/archderm.148.7.849-c] [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: 11/14/2022]
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Walling HW, Swick BL. Interstitial granulomatous dermatitis associated with chronic inflammatory demyelinating polyneuropathy. Cutis 2012; 90:30-32. [PMID: 22908730] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A 44-year-old man presented with an eruption of pruritic erythematous plaques on his lower extremities of 6 months' duration that were unresponsive to antifungal cream or topical corticosteroid. His medical history was notable for chronic inflammatory demyelinating polyneuropathy (CIDP), which was diagnosed 1 year prior to presentation and was associated with lower extremity weakness and imbalance of 3 years' duration. Punch biopsy of lesional skin showed a superficial and deep perivascular and interstitial lymphohistiocytic infiltrate with abundant interstitial neutrophils and rare eosinophils. He was diagnosed with interstitial granulomatous dermatitis (IGD), and the eruption improved with the initiation of oral dapsone 50 mg twice daily.
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Affiliation(s)
- Hobart W Walling
- Town Square Dermatology, 1100 6th St, Ste 202, Coralville, IA 52241, USA.
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