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Jordan KM, Saxena S, Ortega AA, Kiuru M, Tartar D. Management of generalized eruptive keratoacanthomas: A case report and literature review. JAAD Case Rep 2024; 46:73-77. [PMID: 38577498 PMCID: PMC10992273 DOI: 10.1016/j.jdcr.2024.01.037] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024] Open
Affiliation(s)
- Kristiana Marie Jordan
- University of California, Davis, School of Medicine, Sacramento, California
- Department of Dermatology, University of California, Davis, Sacramento, California
| | - Sarthak Saxena
- Department of Dermatology, University of California, Davis, Sacramento, California
| | | | - Maija Kiuru
- Department of Dermatology, University of California, Davis, Sacramento, California
| | - Danielle Tartar
- Department of Dermatology, University of California, Davis, Sacramento, California
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2
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Haughton R, Herbert S, Meyer S, Kam O, Maverakis E, Kiuru M. Support Group Participation Among Patients With Alopecia Areata. JAMA Dermatol 2024; 160:358-360. [PMID: 38324294 PMCID: PMC10851135 DOI: 10.1001/jamadermatol.2023.6037] [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: 09/17/2023] [Accepted: 12/08/2023] [Indexed: 02/08/2024]
Abstract
This cross-sectional study describes support group use and experience among patients with alopecia areata.
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Affiliation(s)
- Reneé Haughton
- Department of Dermatology, University of California, Davis, Sacramento
| | - Samantha Herbert
- Department of Dermatology, University of California, Davis, Sacramento
| | - Summer Meyer
- Department of Dermatology, University of California, Davis, Sacramento
| | - Olivia Kam
- Department of Dermatology, University of California, Davis, Sacramento
| | - Emanual Maverakis
- Department of Dermatology, University of California, Davis, Sacramento
| | - Maija Kiuru
- Department of Dermatology, University of California, Davis, Sacramento
- Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento
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3
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Hai J, Meyer SN, Wong SL, Li Y, Simmons E, Miglioretti D, Fung M, Kiuru M. Comparison of S100A8 and PRAME as biomarkers for distinguishing melanoma from melanocytic nevus: a case-control analysis. Clin Exp Dermatol 2024:llae005. [PMID: 38306117 DOI: 10.1093/ced/llae005] [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: 07/09/2023] [Revised: 12/08/2023] [Accepted: 01/31/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND S100A8 is a melanoma biomarker expressed in the melanoma-associated epidermal keratinocytes, but its diagnostic utility has not been compared to other biomarkers, including PRAME. OBJECTIVES This case-control study compares the utility of S100A8 and PRAME immunohistochemistry in the differential diagnosis of melanoma and nevi. METHODS A previously described cohort of 209 melanomas and nevi dual-immunostained for S100A8 and PRAME were included. For S100A8, previously reported scores indicating the proportion of tumor-associated epidermis stained (0=indeterminate; 1= 0-4%; 2= 5-25%; 3= 26-50%; 4= 51-75%; 5> 75%) were utilized. PRAME IHC was reviewed by at least two reviewers and a consensus score assigned, with score indicating the proportion of tumor stained (0=indeterminate; 1= 0%; 2= 1-50%; 3> 50%). A positive test was defined as >50% staining. RESULTS The area under the receiver operating characteristic curves for S100A8 (0.833) and PRAME (0.874) were not significantly different from each other (p=0.22). The diagnostic sensitivity and specificity (95% CI) was 42.4% (32.55%-52.77%) and 98.2% (93.6%-99.8%) for S100A8, and 79.8% (70.5%-87.2%) and 87.3% (79.6%-92.9%) for PRAME, respectively. A combined test requiring both S100A8 and PRAME IHC positivity had a sensitivity of 39.4% (29.7%-49.7%) and specificity of 99.1% (95.0%-100.0%). CONCLUSION S100A8 and PRAME have utility in the diagnostic workup of melanoma, with S100A8 being more specific and PRAME being more sensitive when using this threshold. Our findings suggest that these two immunohistochemical markers may favorably complement one another to improve the detection of melanoma.
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Affiliation(s)
- Josephine Hai
- Department of Dermatology, School of Medicine, University of California, Davis, Sacramento, California, USA
| | - Summer N Meyer
- Department of Dermatology, School of Medicine, University of California, Davis, Sacramento, California, USA
| | - Samantha L Wong
- Department of Dermatology, School of Medicine, University of California, Davis, Sacramento, California, USA
| | - Yueju Li
- Department of Public Health Sciences, University of California, Davis, Davis, California, USA
| | - Elanee Simmons
- Department of Dermatology, School of Medicine, University of California, Davis, Sacramento, California, USA
| | - Diana Miglioretti
- Department of Public Health Sciences, University of California, Davis, Davis, California, USA
| | - Maxwell Fung
- Department of Dermatology, School of Medicine, University of California, Davis, Sacramento, California, USA
- Department of Pathology and Laboratory Medicine, School of Medicine, University of California Davis, Sacramento, California, USA
| | - Maija Kiuru
- Department of Dermatology, School of Medicine, University of California, Davis, Sacramento, California, USA
- Department of Pathology and Laboratory Medicine, School of Medicine, University of California Davis, Sacramento, California, USA
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4
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Meyer SN, Le S, Caro-Chang LA, Awasthi S, Fung MA, Kiuru M. Localized calcium oxalate crystals in primary cutaneous aspergillosis. J Cutan Pathol 2024; 51:88-91. [PMID: 37699723 PMCID: PMC10872998 DOI: 10.1111/cup.14533] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/18/2023] [Accepted: 08/27/2023] [Indexed: 09/14/2023]
Abstract
Select Aspergillus species can produce oxalate as a fermentation byproduct, which may react with calcium ions to produce insoluble calcium oxalate crystals in tissues. These crystals are frequently associated with pulmonary Aspergillus infections, yet are rarely described in primary cutaneous aspergillosis. Herein, we report the presence of calcium oxalate crystals detected on cutaneous specimens from primary cutaneous Aspergillus niger and Aspergillus fumigatus infections in an immunocompromised, premature infant. No metabolic sources of oxalosis were found.
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Affiliation(s)
- Summer N. Meyer
- Department of Dermatology, University of California Davis School of Medicine, Sacramento CA, USA
| | - Stephanie Le
- Department of Dermatology, University of California Davis School of Medicine, Sacramento CA, USA
| | - Leah Antoinette Caro-Chang
- Department of Dermatology, University of California Davis School of Medicine, Sacramento CA, USA
- Department of Laboratory and Pathology Medicine, University of California Davis School of Medicine, Sacramento CA, USA
| | - Smita Awasthi
- Department of Dermatology, University of California Davis School of Medicine, Sacramento CA, USA
| | - Maxwell A. Fung
- Department of Dermatology, University of California Davis School of Medicine, Sacramento CA, USA
- Department of Laboratory and Pathology Medicine, University of California Davis School of Medicine, Sacramento CA, USA
| | - Maija Kiuru
- Department of Dermatology, University of California Davis School of Medicine, Sacramento CA, USA
- Department of Laboratory and Pathology Medicine, University of California Davis School of Medicine, Sacramento CA, USA
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5
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Firoz WA, Sen F, Kiuru M, Huang V, Riess JW. A Case of ROS1-Fusion Non-Small Cell Lung Cancer with Acquired BRAF Mutation Developing Unusual Skin Metastasis. Clin Lung Cancer 2024:S1525-7304(24)00011-1. [PMID: 38429142 DOI: 10.1016/j.cllc.2024.01.008] [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: 11/13/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 03/03/2024]
Affiliation(s)
- Wahed A Firoz
- UC Davis Comprehensive Cancer Center, Sacramento, CA
| | - Fatma Sen
- Department of Radiology, University of California, Davis, Sacramento, CA
| | - Maija Kiuru
- Department of Dermatology, University of California, Davis, Sacramento, CA; Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, CA
| | - Victor Huang
- Department of Dermatology, University of California, Davis, Sacramento, CA
| | - Jonathan W Riess
- UC Davis Comprehensive Cancer Center, Sacramento, CA; Division of Hematology/Oncology, Department of Internal Medicine, University of California, Davis, Sacramento, CA.
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6
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Meyer SN, Simmons E, Studer AC, Rauen KA, Kiuru M. Melanocytic neoplasms in neurofibromatosis type 1: a systematic review. Melanoma Res 2023; 33:437-446. [PMID: 37578532 PMCID: PMC10615867 DOI: 10.1097/cmr.0000000000000912] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Neurofibromatosis type 1 ( NF1 ) is commonly mutated in melanoma, yet the risk of melanoma in individuals with NF1 is incompletely understood. We performed a systematic review to investigate the risk and characteristics of melanoma and melanocytic nevi in NF1 individuals. PubMed was searched for articles describing NF1 individuals with melanoma, or melanocytic nevi. Those with cutaneous and ocular melanomas were compared to the general population using Surveillance, Epidemiology, and End Results data. Fifty-three articles describing 188 NF1 patients were included (melanoma n = 82, melanocytic nevi n = 93, melanocytic nevi, and melanoma n = 13). Compared to the general population, NF1 patients with cutaneous melanomas had earlier melanoma diagnoses (49.1 vs. 58.6 years, P = 0.012), thicker tumors (3.7 vs. 1.2 mm, P = 0.006), and more frequent disease-specific deaths (27.3% vs. 8.6%, P = 0.005) with shorter survival (12.9 vs. 34.2 months, P = 0.011). Ocular melanomas made up 15.0% of all melanomas in NF1 patients versus 1.5% in the general population ( P < 0.001). In pooling all population-based studies describing melanoma in NF1 populations, NF1 individuals had 2.55 higher odds of having melanoma compared to the general population. A nevus spilus was commonly reported among NF1 individuals with nevi (44.8%, 39/87). Our findings suggest that NF1 individuals may have a higher risk for developing melanomas and tend to have thicker melanomas and worse survival compared to the general population, highlighting the importance of cutaneous and ophthalmologic surveillance in NF1 patients. Our review also supports the association between NF1 and nevus spilus.
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Affiliation(s)
- Summer N. Meyer
- Department of Dermatology, University of California, Davis School of Medicine, Sacramento, CA, USA
| | - Elanee Simmons
- Department of Dermatology, University of California, Davis School of Medicine, Sacramento, CA, USA
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Amy C. Studer
- Blaisdell Medical Library, University of California, Davis, Sacramento, CA, USA
| | - Katherine A. Rauen
- Department of Pediatrics, University of California, Davis School of Medicine, Sacramento, CA, USA
| | - Maija Kiuru
- Department of Dermatology, University of California, Davis School of Medicine, Sacramento, CA, USA
- Department of Pathology and Laboratory Medicine, University of California, Davis School of Medicine, Sacramento, CA, USA
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7
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Meyer SN, Vaughn A, Li Y, Studer AC, Rauen KA, Kiuru M. The association between juvenile xanthogranulomas in neurofibromatosis type 1 patients and the development of leukaemia: A systematic review. J Eur Acad Dermatol Venereol 2023; 37:e1380-e1383. [PMID: 37422708 PMCID: PMC10774451 DOI: 10.1111/jdv.19321] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 06/26/2023] [Indexed: 07/10/2023]
Affiliation(s)
- S N Meyer
- Department of Dermatology, University of California, Davis School of Medicine, Sacramento, California, USA
| | - A Vaughn
- Department of Dermatology, University of California, Davis School of Medicine, Sacramento, California, USA
| | - Y Li
- Department of Public Health Sciences, University of California, School of Medicine, Sacramento, California, USA
| | - A C Studer
- Blaisdell Medical Library, University of California, Davis, Sacramento, California, USA
| | - K A Rauen
- Department of Pediatrics, University of California, Davis School of Medicine, Sacramento, California, USA
| | - M Kiuru
- Department of Dermatology, University of California, Davis School of Medicine, Sacramento, California, USA
- Department of Pathology and Laboratory Medicine, University of California, Davis School of Medicine, Sacramento, California, USA
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8
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Baron M, Tagore M, Wall P, Zheng F, Barkley D, Yanai I, Yang J, Kiuru M, White RM, Ideker T. Desmosome mutations impact the tumor microenvironment to promote melanoma proliferation. bioRxiv 2023:2023.09.19.558457. [PMID: 37786690 PMCID: PMC10541613 DOI: 10.1101/2023.09.19.558457] [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] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Desmosomes are transmembrane protein complexes that contribute to cell-cell adhesion in epithelia and other tissues. Here, we report the discovery of frequent genetic alterations in the desmosome in human cancers, with the strongest signal seen in cutaneous melanoma where desmosomes are mutated in over 70% of cases. In primary but not metastatic melanoma biopsies, the burden of coding mutations on desmosome genes associates with a strong reduction in desmosome gene expression. Analysis by spatial transcriptomics suggests that these expression decreases occur in keratinocytes in the microenvironment rather than in primary melanoma tumor cells. In further support of a microenvironmental origin, we find that loss-of-function knockdowns of the desmosome in keratinocytes yield markedly increased proliferation of adjacent melanocytes in keratinocyte/melanocyte co-cultures. Thus, gradual accumulation of desmosome mutations in neighboring cells may prime melanocytes for neoplastic transformation.
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Affiliation(s)
- Maayan Baron
- Department of Medicine, University of California San Diego, La Jolla, CA USA
| | - Mohita Tagore
- Cancer Biology and Genetics, Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Patrick Wall
- Department of Medicine, University of California San Diego, La Jolla, CA USA
| | - Fan Zheng
- Department of Medicine, University of California San Diego, La Jolla, CA USA
| | - Dalia Barkley
- Institute for Computational Medicine, NYU School of Medicine, New York, NY USA
| | - Itai Yanai
- Institute for Computational Medicine, NYU School of Medicine, New York, NY USA
| | - Jing Yang
- Department of Pharmacology, University of California San Diego, La Jolla, CA USA
| | - Maija Kiuru
- Depts. of Dermatology and Pathology, University of California Davis, Sacramento, CA USA
| | - Richard M White
- Cancer Biology and Genetics, Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Trey Ideker
- Department of Medicine, University of California San Diego, La Jolla, CA USA
- Department of Bioengineering, University of California San Diego, La Jolla, CA USA
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9
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Meyer SN, Ren Y, Taylor S, Kiuru M, Eisen DB. Mohs micrographic surgery versus wide local excision for the treatment of atypical fibroxanthoma: A retrospective cohort analysis. JAAD Int 2023; 12:174-176. [PMID: 37520753 PMCID: PMC10371835 DOI: 10.1016/j.jdin.2023.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023] Open
Affiliation(s)
- Summer N. Meyer
- Department of Dermatology, University of California, Davis School of Medicine, Sacramento, California
| | - Yunyi Ren
- Department of Public Health Sciences, University of California, Davis School of Medicine, Sacramento, California
| | - Sandra Taylor
- Department of Public Health Sciences, University of California, Davis School of Medicine, Sacramento, California
| | - Maija Kiuru
- Department of Dermatology, University of California, Davis School of Medicine, Sacramento, California
- Department of Pathology and Laboratory Medicine, University of California, Davis School of Medicine, Sacramento, California
| | - Daniel B. Eisen
- Department of Dermatology, University of California, Davis School of Medicine, Sacramento, California
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10
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Meyer SN, Simmons EM, McPherson JD, Awasthi S, Kiuru M. SCALP syndrome with a germline heterozygous DOCK6 mutation and somatic mosaic NRAS Q61R mutation. Pediatr Dermatol 2023; 40:523-527. [PMID: 36456540 PMCID: PMC10250009 DOI: 10.1111/pde.15184] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/18/2022] [Indexed: 12/04/2022]
Abstract
We present a case of SCALP syndrome, which was diagnosed in a male infant with the characteristic findings of sebaceous nevi, central nervous system malformations, aplasia cutis congenita, limbal dermoid, and giant congenital melanocytic nevi, or pigmented nevi. We identified a germline compound heterozygous DOCK6 mutation and a somatic mosaic NRAS Q61R mutation in the giant congenital melanocytic nevus. This report will increase clinician awareness of SCALP syndrome and augment the literature in characterizing this rare syndrome, including its genetic background.
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Affiliation(s)
- Summer N. Meyer
- Department of Dermatology, University of California Davis, Sacramento California, USA
| | - Elanee M. Simmons
- Department of Dermatology, University of California Davis, Sacramento California, USA
| | - John D. McPherson
- Department of Biochemistry and Molecular Medicine, University of California Davis, Sacramento California, USA
| | - Smita Awasthi
- Department of Dermatology, University of California Davis, Sacramento California, USA
- Department of Pediatrics, University of California Davis, Sacramento California, USA
| | - Maija Kiuru
- Department of Dermatology, University of California Davis, Sacramento California, USA
- Department of Pathology & Laboratory Medicine, University of California Davis, Sacramento California, USA
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11
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Kazmi M, Opene C, Kiuru M. A pruritic pedunculated pink nodule on the leg. Dermatol Online J 2023; 29. [PMID: 37220292 DOI: 10.5070/d329260776] [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: 04/24/2023] [Accepted: 04/24/2023] [Indexed: 05/25/2023] Open
Abstract
Herein, we present a patient with a lipidized fibrous histiocytoma, an underrecognized variant of dermatofibroma (cutaneous fibrous histiocytoma). Our patient presented with a nodule on the ankle that showed foamy histiocytes and hyalinized collagen bundles on histology. This case highlights a classic presentation and features of lipidized fibrous histiocytoma, raising further awareness of this distinctive variant of dermatofibroma that should be distinguished from xanthoma and xanthogranuloma.
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Affiliation(s)
- Maha Kazmi
- Department of Dermatology, University of California Davis, Sacramento, California, USA
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12
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Dang LT, Rybak I, Lyu Y, Konia T, Fung MA, Qi L, Kiuru M. The influence of PRAME immunohistochemistry on the diagnosis, diagnostic confidence and treatment recommendation by dermatopathologists: A single institution prospective survey-based study. J Eur Acad Dermatol Venereol 2023; 37:e49-e51. [PMID: 35989583 PMCID: PMC9771982 DOI: 10.1111/jdv.18536] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 08/16/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Luke T. Dang
- Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, CA
| | - Iryna Rybak
- Department of Dermatology, University of California, Davis, Sacramento, CA
| | - Yue Lyu
- Department of Statistics, University of California, Davis, Sacramento, CA
| | - Thomas Konia
- Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, CA
- Department of Dermatology, University of California, Davis, Sacramento, CA
| | - Maxwell A. Fung
- Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, CA
- Department of Dermatology, University of California, Davis, Sacramento, CA
| | - Lihong Qi
- Department of Public Health Sciences, University of California, Davis, Sacramento, CA
| | - Maija Kiuru
- Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, CA
- Department of Dermatology, University of California, Davis, Sacramento, CA
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13
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Simmons E, Kazmi M, Wilson M, Kiuru M, Tartar DM. Characteristics of patients with juvenile dermatomyositis from 2001-2021 at a tertiary care center. Dermatol Online J 2022; 28. [PMID: 36809089 DOI: 10.5070/d328659719] [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: 12/26/2022] [Accepted: 12/26/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Juvenile dermatomyositis (JDM) is the most common inflammatory myopathy in the pediatric population and can represent a medical emergency. However, many features of JDM remain poorly understood, disease presentation is highly variable, and predictors of disease course have yet to be identified. METHODS This retrospective chart review included 47 JDM patients seen at a tertiary care center over a 20-year period. Characteristics such as demographics, clinical signs and symptoms, antibody positivity, dermatopathology features, and treatments were recorded. RESULTS All patients had evidence of cutaneous involvement, whereas 88.4% experienced muscle weakness. Constitutional symptoms and dysphagia were commonly present. The most frequent cutaneous findings were Gottron papules, heliotrope rash, and nailfold changes. Anti-TIF1? was the most prevalent myositis-specific autoantibody. Management involved systemic corticosteroids in nearly all cases. Strikingly, the dermatology department was only involved in the care of four in every ten (19/47) patients. CONCLUSIONS Prompt recognition of the strikingly reproducible skin findings present in JDM can improve disease outcomes in this population. This study highlights the need for increased education of such pathognomonic findings as well as more multidisciplinary care. In particular, a dermatologist should be involved in the care of patients presenting with muscle weakness and skin changes.
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Affiliation(s)
| | | | | | | | - Danielle M Tartar
- Department of Dermatology, University of California Davis, Sacramento, California.
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14
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Wong SL, Martiniuc D, Kiuru M. CDKN2A exon 1B deletion predisposing to melanoma and neural system tumour syndrome. Clin Exp Dermatol 2022; 47:2284-2285. [PMID: 35904890 PMCID: PMC9712160 DOI: 10.1111/ced.15354] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2022] [Indexed: 11/30/2022]
Abstract
CDKN2A at chromosome positon 9p21 is a tumour suppressor gene encoding the cell cycle regulators p16 and p14ARF. While melanoma is associated with variants affecting both transcripts, families with mutations involving the p14ARF-specific exon 1B may be predisposed to central nervous system tumours. We describe a family with a deletion of exon 1B in CDKN2A, who had multiple cutaneous melanomas, neural tumours and various malignancies.
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Affiliation(s)
- Samantha L. Wong
- Department of Dermatology, University of California, Davis, Sacramento, CA, USA
| | - Daniela Martiniuc
- Hereditary Cancer Program, Comprehensive Cancer Center, University of California, Davis, Sacramento, CA, USA
| | - Maija Kiuru
- Department of Dermatology, University of California, Davis, Sacramento, CA, USA
- Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, CA, USA
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15
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Kiuru M, Li Q, Zhu G, Terrell JR, Beroukhim K, Maverakis E, Keegan THM. Melanoma in women of childbearing age and in pregnancy in California, 1994-2015: a population-based cohort study. J Eur Acad Dermatol Venereol 2022; 36:2025-2035. [PMID: 35870141 PMCID: PMC9560982 DOI: 10.1111/jdv.18458] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 07/12/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Melanoma is one of the most common malignancies during pregnancy. There is debate regarding the impact of pregnancy on the prognosis of melanoma. Recent large population-based studies from the United States are lacking. OBJECTIVES To determine the characteristics and survival of women with pregnancy-associated melanoma. METHODS This population-based, retrospective cohort study used California Cancer Registry data linked with state-wide hospitalization and ambulatory surgery data to identify 15-44-year-old female patients diagnosed with melanoma in 1994-2015, including pregnant patients. Multivariable logistic regression compared demographic and clinical characteristics between pregnant and non-pregnant women with melanoma. Multivariable cox proportional hazards regression models assessed melanoma-specific and overall survival. RESULTS We identified 13 108 patients, of which 1406 were pregnant. Pregnancy-associated melanoma was more frequent in Hispanic compared to non-Hispanic White women. Melanoma occurring post-partum was associated with greater tumour thickness (2.01-4.00 vs. 0.01-1.00 mm, odds ratio 1.75, 95% confidence interval: 1.03-2.98). There were otherwise no significant differences between pregnant and non-pregnant women. Worse survival was associated with Asian, Black and Native American race/ethnicity (vs. non-Hispanic White), lower neighbourhood socio-economic status, public insurance, tumour site, greater tumour thickness and lymph node involvement, but not pregnancy. CONCLUSIONS Melanoma occurring post-partum was associated with greater tumour thickness, but pregnancy status did not affect survival after melanoma. Race/ethnicity, socio-economic status and health insurance impacted survival, emphasizing the importance of reducing health disparities.
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Affiliation(s)
- M Kiuru
- Department of Dermatology, University of California Davis, Sacramento, California, USA
- Department of Pathology and Laboratory Medicine, University of California Davis, Sacramento, California, USA
| | - Q Li
- Center for Oncology Hematology Outcomes Research and Training (COHORT) and Division of Hematology and Oncology, University of California Davis, Sacramento, California, USA
| | - G Zhu
- Department of Dermatology, University of California Davis, Sacramento, California, USA
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - J R Terrell
- Department of Dermatology, University of California Davis, Sacramento, California, USA
| | - K Beroukhim
- Department of Dermatology, University of California Davis, Sacramento, California, USA
| | - E Maverakis
- Department of Dermatology, University of California Davis, Sacramento, California, USA
| | - T H M Keegan
- Center for Oncology Hematology Outcomes Research and Training (COHORT) and Division of Hematology and Oncology, University of California Davis, Sacramento, California, USA
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16
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Kazemi S, Simmons E, Kiuru M, Tartar DM. Multifocal and recurrent cutaneous pseudolymphoma associated with lamotrigine and review of the literature. JAAD Case Rep 2022; 28:44-48. [PMID: 36097625 PMCID: PMC9463559 DOI: 10.1016/j.jdcr.2022.07.040] [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: 11/05/2022] Open
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17
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Wong SL, Rehal BR, Kiuru M. Hyaluronic acid embolus following intra‐articular injection. J Cutan Pathol 2022; 49:842-844. [DOI: 10.1111/cup.14036] [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: 01/25/2021] [Revised: 04/07/2021] [Accepted: 04/12/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Samantha L. Wong
- Department of Dermatology University of California Davis, Sacramento California
| | - B. Renu Rehal
- Department of Dermatology University of California Davis, Sacramento California
| | - Maija Kiuru
- Department of Dermatology University of California Davis, Sacramento California
- Department of Pathology and Laboratory Medicine University of California Davis, Sacramento California
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18
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Engel TN, Abraham TM, Morningstar T, Fung MA, Rangchi A, Kiuru M, Fereidouni F, Levenson R. Pilot study of FIBI (Fluorescence Imitating Brightfield Imaging) for rapid, slide‐free dermatopathology. J Cutan Pathol 2022; 49:1060-1066. [DOI: 10.1111/cup.14308] [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: 12/13/2021] [Revised: 07/11/2022] [Accepted: 08/02/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Tess N. Engel
- School of Medicine University of California Davis Sacramento CA USA
| | - Tanishq Mathew Abraham
- Department of Pathology and Laboratory Medicine University of California Davis Sacramento CA USA
| | - Taryn Morningstar
- Department of Pathology and Laboratory Medicine University of California Davis Sacramento CA USA
| | - Maxwell A. Fung
- Department of Pathology and Laboratory Medicine University of California Davis Sacramento CA USA
- Department of Dermatology University of California Davis Sacramento CA USA
| | - Arshia Rangchi
- Department of Pathology and Laboratory Medicine University of California Davis Sacramento CA USA
| | - Maija Kiuru
- Department of Pathology and Laboratory Medicine University of California Davis Sacramento CA USA
- Department of Dermatology University of California Davis Sacramento CA USA
| | - Farzad Fereidouni
- Department of Pathology and Laboratory Medicine University of California Davis Sacramento CA USA
| | - Richard Levenson
- Department of Pathology and Laboratory Medicine University of California Davis Sacramento CA USA
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19
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Stetkevich SA, Le ST, Ford AR, Brassard A, Kiuru M, Fung MA, Tartar DM. Isolated cutaneous acanthamoebiasis under prophylactic anticryptococcal treatment in an immunocompromised patient. JAAD Case Rep 2022; 28:77-79. [PMID: 36097622 PMCID: PMC9463523 DOI: 10.1016/j.jdcr.2022.08.008] [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: 11/29/2022] Open
Affiliation(s)
- Samuel A. Stetkevich
- Division of Dermatology, Department of Medicine, University of Toledo College of Medicine, Toledo, Ohio
| | - Stephanie T. Le
- Department of Dermatology, University of California, Davis, Davis, California
| | - Adam R. Ford
- Department of Dermatology, University of California, Davis, Davis, California
| | - Alain Brassard
- Department of Dermatology, University of California, Davis, Davis, California
| | - Maija Kiuru
- Department of Dermatology, University of California, Davis, Davis, California
- Department of Dermatopathology, University of California, Davis, Davis, California
| | - Maxwell A. Fung
- Department of Dermatology, University of California, Davis, Davis, California
- Department of Dermatopathology, University of California, Davis, Davis, California
| | - Danielle M. Tartar
- Department of Dermatology, University of California, Davis, Davis, California
- Correspondence to: Danielle M. Tartar, MD, PhD, University of California, Davis, 3301 C Street, Suite 1400, Sacramento, CA 95819.
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20
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Love N, Kiuru M, Simmons E. 630 Cdk2: A marker for invasive melanoma. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.641] [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: 10/17/2022]
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21
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Hai J, Wong S, Li Y, Migloretti D, Fung M, Kiuru M. 632 Comparison of S100A8 and PRAME as biomarkers for diagnosing melanoma. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.643] [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: 11/16/2022]
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22
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Kazmi M, Terrell J, Martiniuc D, McPherson J, Kiuru M. 094 BUB1B germline variant predisposes to cutaneous melanoma and multiple other primary malignancies. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.029] [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: 10/17/2022]
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23
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Terrell JR, Qi L, Wu H, Joo J, Fung MA, Vaughn AR, Kiuru M. Management of atypical junctional melanocytic proliferations: A single‐institution cross‐sectional study. J Eur Acad Dermatol Venereol 2022; 36:e990-e994. [DOI: 10.1111/jdv.18399] [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: 10/17/2022]
Affiliation(s)
| | - Lihong Qi
- Davis Department of Public Health Sciences University of California Davis
| | - Hao Wu
- Davis Department of Statistics University of California Davis
| | - Jayne Joo
- Davis Department of Dermatology University of California Sacramento
| | - Maxwell A. Fung
- Davis Department of Dermatology University of California Sacramento
- Davis Department of Pathology and Laboratory Medicine University of California Sacramento
| | | | - Maija Kiuru
- Davis Department of Dermatology University of California Sacramento
- Davis Department of Pathology and Laboratory Medicine University of California Sacramento
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24
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Simmons E, Foutouhi S, Tartar DM, Kiuru M. Pruritic papules after induction chemotherapy with daunorubicin and cytarabine. Dermatol Online J 2022; 28. [DOI: 10.5070/d328357789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 06/16/2022] [Indexed: 11/08/2022] Open
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25
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Kontaridis MI, Roberts AE, Schill L, Schoyer L, Stronach B, Andelfinger G, Aoki Y, Axelrad ME, Bakker A, Bennett AM, Broniscer A, Castel P, Chang CA, Cyganek L, Das TK, den Hertog J, Galperin E, Garg S, Gelb BD, Gordon K, Green T, Gripp KW, Itkin M, Kiuru M, Korf BR, Livingstone JR, López‐Juárez A, Magoulas PL, Mansour S, Milner T, Parker E, Pierpont EI, Plouffe K, Rauen KA, Shankar SP, Smith SB, Stevenson DA, Tartaglia M, Van R, Wagner ME, Ware SM, Zenker M. The seventh international RASopathies symposium: Pathways to a cure-expanding knowledge, enhancing research, and therapeutic discovery. Am J Med Genet A 2022; 188:1915-1927. [PMID: 35266292 PMCID: PMC9117434 DOI: 10.1002/ajmg.a.62716] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 02/05/2022] [Indexed: 12/15/2022]
Abstract
RASopathies are a group of genetic disorders that are caused by genes that affect the canonical Ras/mitogen-activated protein kinase (MAPK) signaling pathway. Despite tremendous progress in understanding the molecular consequences of these genetic anomalies, little movement has been made in translating these findings to the clinic. This year, the seventh International RASopathies Symposium focused on expanding the research knowledge that we have gained over the years to enhance new discoveries in the field, ones that we hope can lead to effective therapeutic treatments. Indeed, for the first time, research efforts are finally being translated to the clinic, with compassionate use of Ras/MAPK pathway inhibitors for the treatment of RASopathies. This biannual meeting, organized by the RASopathies Network, brought together basic scientists, clinicians, clinician scientists, patients, advocates, and their families, as well as representatives from pharmaceutical companies and the National Institutes of Health. A history of RASopathy gene discovery, identification of new disease genes, and the latest research, both at the bench and in the clinic, were discussed.
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Affiliation(s)
- Maria I. Kontaridis
- Department of Biomedical Research and Translational MedicineMasonic Medical Research InstituteUticaNew YorkUSA
- Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMassachusettsUSA
- Department of Biological Chemistry and Molecular PharmacologyHarvard Medical SchoolBostonMassachusettsUSA
| | - Amy E. Roberts
- Department of CardiologyBoston Children's HospitalBostonMassachusettsUSA
- Division of Genetics, Department of PediatricsBoston Children's HospitalBostonMassachusettsUSA
| | - Lisa Schill
- RASopathies Network USAAltadenaCaliforniaUSA
| | | | | | - Gregor Andelfinger
- Cardiovascular Genetics, Department of Pediatrics, Centre Hospitalier Universitaire Saint‐Justine Research CentreUniversité de MontréalMontréalCanada
| | - Yoko Aoki
- Department of Medical GeneticsTohoku University School of MedicineSendaiJapan
| | - Marni E. Axelrad
- Section of Psychology, Department of PediatricsBaylor College of MedicineHoustonTexasUSA
| | | | - Anton M. Bennett
- Yale Center for Molecular and Systems MetabolismYale University School of MedicineNew HavenConnecticutUSA
| | - Alberto Broniscer
- Division of Hematology‐OncologyUPMC Children's Hospital of PittsburghPittsburghPennsylvaniaUSA
| | - Pau Castel
- Department of Biochemistry and Molecular PharmacologyNYU Grossman School of MedicineNew YorkNew YorkUSA
| | - Caitlin A. Chang
- Department of Medical GeneticsBC Women and Children's HospitalVancouverBritish ColumbiaCanada
| | - Lukas Cyganek
- Stem Cell Unit, Clinic for Cardiology and PneumologyUniversity Medical Center GöttingenGöttingenGermany
| | - Tirtha K. Das
- Department of Cell, Developmental, and Regenerative BiologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Jeroen den Hertog
- Hubrecht Institute‐KNAW and University Medical Center UtrechtUtrechtThe Netherlands
- Institute Biology LeidenLeiden UniversityLeidenThe Netherlands
| | - Emilia Galperin
- Department of Molecular and Cellular BiochemistryUniversity of KentuckyLexingtonKentuckyUSA
| | - Shruti Garg
- Division of Neuroscience & Experimental Psychology, Faculty of Biology, Medicine and Health, School of Biological Sciences, Royal Manchester Children's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Sciences CentreUniversity of Manchester & Child & Adolescent Mental Health ServicesManchesterUK
| | - Bruce D. Gelb
- Mindich Child Health and Development Institute and the Departments of Pediatrics and Genetics and Genomic SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Kristiana Gordon
- Lymphovascular Medicine, Dermatology DepartmentSt. George's UniversityLondonUK
| | - Tamar Green
- Division of Interdisciplinary Brain Sciences, Department of Psychiatry and Behavioral SciencesStanford University School of MedicineStanfordCaliforniaUSA
| | - Karen W. Gripp
- Department of GeneticsAI duPont Hospital for ChildrenWilmingtonDelawareUSA
| | - Maxim Itkin
- Center for Lymphatic Disorders, Department of RadiologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvaniaUSA
| | - Maija Kiuru
- Department of Dermatology, Department of Pathology & Laboratory MedicineUniversity of California DavisSacramentoCaliforniaUSA
| | - Bruce R. Korf
- Department of GeneticsUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | | | - Alejandro López‐Juárez
- Department of Health and Biomedical SciencesUniversity of Texas Rio Grande ValleyTexasUSA
| | - Pilar L. Magoulas
- Department of Molecular and Human Genetics, Baylor College of MedicineTexas Children's HospitalHoustonTexasUSA
| | - Sahar Mansour
- Molecular and Clinical Sciences InstituteSt George's UniversityLondonUK
- South West Thames Regional Genetics ServiceSt George's NHS Foundation TrustLondonUK
| | | | | | - Elizabeth I. Pierpont
- Division of Clinical Behavioral Neuroscience, Department of PediatricsUniversity of MinnesotaMinneapolisMinnesotaUSA
| | | | - Katherine A. Rauen
- Department of Pediatrics, Division of Genomic Medicine, MIND InstituteUniversity of California DavisSacramentoCaliforniaUSA
| | - Suma P. Shankar
- Department of Pediatrics, Division of Genomic Medicine, MIND InstituteUniversity of California DavisSacramentoCaliforniaUSA
- Department of Ophthalmology and Vision Science, School of MedicineUniversity of California DavisSacramentoCaliforniaUSA
| | | | - David A. Stevenson
- Department of Pediatrics, Division of Medical GeneticsStanford UniversityStanfordCaliforniaUSA
| | - Marco Tartaglia
- Genetics and Rare Diseases Research DivisionOspedale Pediatrico Bambino Gesù, IRCCSRomeItaly
| | - Richard Van
- Helen Diller Family Comprehensive Cancer CenterUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Morgan E. Wagner
- NCI RAS Initiative, Cancer Research Technology ProgramFrederick National Laboratory for Cancer ResearchFrederickMarylandUSA
| | - Stephanie M. Ware
- Department of Pediatrics, Department of Medical and Molecular GeneticsIndiana University School of MedicineIndianapolisIndianaUSA
| | - Martin Zenker
- Institute of Human Genetics, University HospitalOtto‐von‐Guericke UniversityMagdeburgGermany
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26
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Ortega-Springall MF, Kiuru M, Fung MA. The "spade sign" as a pathognomonic histopathologic feature of acne keloidalis: Analysis of 33 cases of cicatricial alopecia. J Am Acad Dermatol 2022; 86:1405-1406. [PMID: 34111500 PMCID: PMC9907723 DOI: 10.1016/j.jaad.2021.06.003] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/26/2021] [Accepted: 06/01/2021] [Indexed: 11/19/2022]
Affiliation(s)
| | - Maija Kiuru
- Department of Dermatology, Hospital General "D. Manuel Gea González", Mexico City, Mexico; Department of Dermatology and Pathology and Laboratory Medicine, University of California, Davis, Sacramento
| | - Maxwell A Fung
- Department of Dermatology, Hospital General "D. Manuel Gea González", Mexico City, Mexico; Department of Dermatology and Pathology and Laboratory Medicine, University of California, Davis, Sacramento.
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27
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Dang LT, Terrell JR, Konia T, Fung MA, McPherson JD, Kiuru M. Characteristics of amelanotic acantholytic-like melanoma resembling squamous cell carcinoma. J Cutan Pathol 2022; 49:500-503. [PMID: 35118708 PMCID: PMC9473664 DOI: 10.1111/cup.14210] [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: 07/19/2021] [Revised: 01/27/2022] [Accepted: 01/30/2022] [Indexed: 01/26/2023]
Affiliation(s)
- Luke T. Dang
- Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, CA
| | - Jessica R. Terrell
- Department of Dermatology, University of California, Davis, Sacramento, CA
| | - Thomas Konia
- Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, CA,Department of Dermatology, University of California, Davis, Sacramento, CA
| | - Maxwell A. Fung
- Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, CA,Department of Dermatology, University of California, Davis, Sacramento, CA
| | - John D. McPherson
- Department of Biochemistry and Molecular Medicine, University of California, Davis, Sacramento, CA
| | - Maija Kiuru
- Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, CA,Department of Dermatology, University of California, Davis, Sacramento, CA
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28
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Kiuru M, Kriner MA, Wong S, Zhu G, Terrell JR, Li Q, Hoang M, Beechem J, McPherson JD. High-Plex Spatial RNA Profiling Reveals Cell Type‒Specific Biomarker Expression during Melanoma Development. J Invest Dermatol 2022; 142:1401-1412.e20. [PMID: 34699906 PMCID: PMC9714472 DOI: 10.1016/j.jid.2021.06.041] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 06/15/2021] [Accepted: 06/23/2021] [Indexed: 01/26/2023]
Abstract
Early diagnosis of melanoma is critical for improved survival. However, the biomarkers of early melanoma evolution and their origin within the tumor and its microenvironment, including the keratinocytes, are poorly defined. To address this, we used spatial transcript profiling that maintains the morphological tumor context to measure the expression of >1,000 RNAs in situ in patient-derived formalin-fixed, paraffin-embedded tissue sections in primary melanoma and melanocytic nevi. We profiled 134 regions of interest (each 200 μm in diameter) enriched in melanocytes, neighboring keratinocytes, or immune cells. This approach captured distinct expression patterns across cell types and tumor types during melanoma development. Unexpectedly, we discovered that S100A8 is expressed by keratinocytes within the tumor microenvironment during melanoma growth. Immunohistochemistry of 252 tumors showed prominent keratinocyte-derived S100A8 expression in melanoma but not in benign tumors and confirmed the same pattern for S100A8's binding partner S100A9, suggesting that injury to the epidermis may be an early and readily detectable indicator of melanoma development. Together, our results establish a framework for high-plex, spatial, and cell type‒specific resolution of gene expression in archival tissue applicable to the development of biomarkers and characterization of tumor microenvironment interactions in tumor evolution.
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Affiliation(s)
- Maija Kiuru
- Department of Dermatology, University of California Davis, Sacramento, California, USA,Department of Pathology & Laboratory Medicine, University of California Davis, Sacramento, California, USA
| | | | - Samantha Wong
- Department of Dermatology, University of California Davis, Sacramento, California, USA
| | - Guannan Zhu
- Department of Dermatology, University of California Davis, Sacramento, California, USA,Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Jessica R. Terrell
- Department of Dermatology, University of California Davis, Sacramento, California, USA
| | - Qian Li
- Center for Oncology Hematology Outcomes Research and Training (COHORT) and Division of Hematology and Oncology, University of California, Davis, Sacramento, CA
| | | | | | - John D. McPherson
- Department of Biochemistry & Molecular Medicine, University of California Davis, Sacramento, California, USA
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29
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Ladenheim A, Tartar DM, Kiuru M. Polyarthritis, neuropathy, and persistent violaceous plaques. JAAD Case Rep 2021; 15:97-99. [PMID: 34466642 PMCID: PMC8384766 DOI: 10.1016/j.jdcr.2021.01.030] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Alexander Ladenheim
- Department of Pathology and Laboratory Medicine, University of California, Davis, California
| | - Danielle M Tartar
- Department of Dermatology, University of California, Davis, California
| | - Maija Kiuru
- Department of Pathology and Laboratory Medicine, University of California, Davis, California.,Department of Dermatology, University of California, Davis, California
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30
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Kazmi M, Terrell J, Li Q, Zhu G, Beroukhim K, Tartar D, Keegan T, Maverakis E, Kiuru M. 544 Melanoma in pregnancy: Profiling the tumor microenvironment. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.570] [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: 11/28/2022]
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31
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Barton VR, Toussi A, Awasthi S, Kiuru M. Treatment of pediatric alopecia areata: A systematic review. J Am Acad Dermatol 2021; 86:1318-1334. [PMID: 33940103 PMCID: PMC8556406 DOI: 10.1016/j.jaad.2021.04.077] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [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: 07/02/2020] [Revised: 04/13/2021] [Accepted: 04/21/2021] [Indexed: 11/28/2022]
Abstract
Background: Alopecia areata (AA) is an autoimmune, nonscarring hair loss disorder with slightly greater prevalence in children than adults. Various treatment modalities exist; however, their evidence in pediatric AA patients is lacking. Objective: To evaluate the evidence of current treatment modalities for pediatric AA. Methods: We conducted a systematic review on the PubMed database in October 2019 for all published articles involving patients <18 years old. Articles discussing AA treatment in pediatric patients were included, as were articles discussing both pediatric and adult patients, if data on individual pediatric patients were available. Results: Inclusion criteria were met by 122 total reports discussing 1032 patients. Reports consisted of 2 randomized controlled trials, 4 prospective comparative cohorts, 83 case series, 2 case-control studies, and 31 case reports. Included articles assessed the use of aloe, apremilast, anthralin, anti-interferon gamma antibodies, botulinum toxin, corticosteroids, contact immunotherapies, cryotherapy, hydroxychloroquine, hypnotherapy, imiquimod, Janus kinase inhibitors, laser and light therapy, methotrexate, minoxidil, phototherapy, psychotherapy, prostaglandin analogs, sulfasalazine, topical calcineurin inhibitors, topical nitrogen mustard, and ustekinumab. Limitations: English-only articles with full texts were used. Manuscripts with adult and pediatric data were only incorporated if individual-level data for pediatric patients were provided. No meta-analysis was performed. Conclusion: Topical corticosteroids are the preferred first-line treatment for pediatric AA, as they hold the highest level of evidence, followed by contact immunotherapy. More clinical trials and comparative studies are needed to further guide management of pediatric AA and to promote the potential use of pre-existing, low-cost, and novel therapies, including Janus kinase inhibitors.
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Affiliation(s)
- Virginia R Barton
- Department of Dermatology, University of California Davis, Sacramento, California
| | - Atrin Toussi
- Department of Dermatology, University of California Davis, Sacramento, California
| | - Smita Awasthi
- Department of Dermatology, University of California Davis, Sacramento, California; Department of Pediatrics, University of California Davis, Sacramento, California
| | - Maija Kiuru
- Department of Dermatology, University of California Davis, Sacramento, California; Department of Pathology and Laboratory Medicine, University of California Davis, Sacramento, California.
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32
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Terrell JR, Rybak I, Lyu Y, Konia T, Fung MA, Qi L, Kiuru M. The influence of p16 immunohistochemistry on diagnosis and management recommendation of melanocytic neoplasms by dermatopathologists: A prospective study. J Cutan Pathol 2020; 48:1094-1097. [PMID: 33103266 DOI: 10.1111/cup.13907] [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: 05/03/2020] [Revised: 10/01/2020] [Accepted: 10/04/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Jessica R Terrell
- Department of Dermatology, University of California, Sacramento, California, USA
| | - Iryna Rybak
- Department of Dermatology, University of California, Sacramento, California, USA
| | - Yue Lyu
- Department of Statistics, University of California, Sacramento, California, USA
| | - Thomas Konia
- Department of Dermatology, University of California, Sacramento, California, USA.,Department of Pathology and Laboratory Medicine, University of California, Sacramento, California, USA
| | - Maxwell A Fung
- Department of Dermatology, University of California, Sacramento, California, USA.,Department of Pathology and Laboratory Medicine, University of California, Sacramento, California, USA
| | - Lihong Qi
- Department of Public Health Sciences, University of California, Sacramento, California, USA
| | - Maija Kiuru
- Department of Dermatology, University of California, Sacramento, California, USA.,Department of Pathology and Laboratory Medicine, University of California, Sacramento, California, USA
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33
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Engel T, Rangchi A, Fung M, Kiuru M, Fereidouni F, Levenson R. 904 Fluorescence Imitating Brightfield Imaging (FIBI): A novel application of rapid, non-destructive and slide-free skin tissue imaging. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.920] [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: 10/24/2022]
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34
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Kiuru M, Li Q, Zhu G, Terrell J, Beroukhim K, Keegan T. 420 Melanoma in pregnancy in California, 1994-2015: A population-based study. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.428] [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: 10/24/2022]
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35
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Kiuru M, Kriner M, Zhu G, Terrell J, Hoang M, Beechem J, McPherson J. 691 Identification of RNA biomarker candidates in melanocytic tumors using digital spatial profiling. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.703] [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: 11/29/2022]
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Toussi A, Barton VR, Le ST, Agbai ON, Kiuru M. Psychosocial and psychiatric comorbidities and health-related quality of life in alopecia areata: A systematic review. J Am Acad Dermatol 2020; 85:162-175. [PMID: 32561373 DOI: 10.1016/j.jaad.2020.06.047] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [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: 03/20/2020] [Revised: 05/14/2020] [Accepted: 06/11/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Alopecia areata (AA) is an immune-mediated disease resulting in nonscarring hair loss. Systematic reviews on the psychosocial and psychiatric comorbidities, health-related quality of life, and interventions targeting psychosocial well-being are limited. OBJECTIVE To conduct a systematic review of the psychosocial comorbidities, health-related quality of life, and treatment options targeting psychosocial well-being in adult and pediatric AA patients. METHODS A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines within the PubMed database. Specific search terms included, but were not limited to, alopecia areata, psychosocial, psychiatry, and quality of life. Studies were then evaluated for their design and categorized into corresponding levels of evidence according to the guidelines adapted from the Oxford Center for Evidence Based Medicine. FINDINGS Seventy-three reports met inclusion criteria, involving approximately 414,319 unique participants. AA patients were found to have psychiatric comorbidities, particularly anxiety and depression. Health-related quality of life is reduced in AA patients, but data on pediatric AA quality of life are limited. Psychotherapy is often recommended as adjuvant treatment. CONCLUSION AA has substantial psychosocial impact on patients and results in reduced health-related quality of life. Addressing this should be an active part of treatment.
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Affiliation(s)
- Atrin Toussi
- Department of Dermatology, University of California, Davis, Sacramento, California; School of Medicine, University of California, Davis, Sacramento, California
| | - Virginia R Barton
- Department of Dermatology, University of California, Davis, Sacramento, California
| | - Stephanie T Le
- Department of Dermatology, University of California, Davis, Sacramento, California
| | - Oma N Agbai
- Department of Dermatology, University of California, Davis, Sacramento, California
| | - Maija Kiuru
- Department of Dermatology, University of California, Davis, Sacramento, California; Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, California.
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Toussi A, Mans N, Welborn J, Kiuru M. Germline mutations predisposing to melanoma. J Cutan Pathol 2020; 47:606-616. [PMID: 32249949 DOI: 10.1111/cup.13689] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 12/20/2019] [Revised: 03/03/2020] [Accepted: 03/06/2020] [Indexed: 12/11/2022]
Abstract
Nearly 15% of melanomas occur in patients with a family history and a subset of these patients have a germline mutation in a melanoma predisposing gene. CDKN2A mutations are responsible for the majority of hereditary melanoma, but many other susceptibility genes have been discovered in recent years, including CDK4, TERT, ACD, TERF2IP, POT1, MITF, MC1R, and BAP1. Additionally, melanoma risk is increased in mixed cancer syndromes caused by mutations in PTEN, BRCA2, BRCA1, RB1, and TP53. While early onset, multiple tumors, and family cancer history remain the most valuable clinical clues for hereditary melanoma, characteristic epithelioid cytology of melanocytic tumors may suggest an underlying BAP1 mutation. Herein, we review the clinical and histopathologic characteristics of melanocytic tumors associated with these germline mutations and discuss the role of genetic counseling.
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Affiliation(s)
- Atrin Toussi
- Department of Dermatology, University of California, Davis, Sacramento, California, USA
| | - Nicole Mans
- Hereditary Cancer Program, Comprehensive Cancer Center, University of California, Davis, Sacramento, California, USA
| | - Jeanna Welborn
- Hereditary Cancer Program, Comprehensive Cancer Center, University of California, Davis, Sacramento, California, USA
| | - Maija Kiuru
- Department of Dermatology, University of California, Davis, Sacramento, California, USA.,Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, California, USA
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Ellis SR, Vierra AT, Millsop JW, Lacouture ME, Kiuru M. Dermatologic toxicities to immune checkpoint inhibitor therapy: A review of histopathologic features. J Am Acad Dermatol 2020; 83:1130-1143. [PMID: 32360716 DOI: 10.1016/j.jaad.2020.04.105] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 04/03/2020] [Accepted: 04/20/2020] [Indexed: 02/08/2023]
Abstract
Antineoplastic agents that use the immune system have revolutionized cancer treatment. Specifically, implementation of immune checkpoint inhibitors, monoclonal antibodies that block cytotoxic T-lymphocyte-associated antigen-4, programmed cell death protein 1, or programmed cell death ligand 1 show improved and sustained responses in patients with cancer. However, these agents are associated with a plethora of adverse events, many manifesting in the skin. As the clinical application of cancer immunotherapies expands, understanding the clinical and histopathologic features of associated cutaneous toxicities becomes increasingly important to dermatologists, oncologists, and pathologists to ensure timely diagnosis and appropriate care. This review discusses cutaneous reactions to immune checkpoint inhibitors, focusing on histopathologic features.
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Affiliation(s)
- Samantha R Ellis
- Department of Dermatology, University of California, Davis, Sacramento, California; PotozkinMD Skincare Center, Danville, California
| | - Aren T Vierra
- Department of Dermatology, University of California, Davis, Sacramento, California
| | - Jillian W Millsop
- Department of Dermatology, Vacaville Medical Center, The Permanente Medical Group, Vacaville, California
| | - Mario E Lacouture
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Maija Kiuru
- Department of Dermatology, University of California, Davis, Sacramento, California; Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, California.
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Nguyen M, Hai J, Bovenberg MSS, Wilken R, Kiuru M, Brassard A, Tartar D. A patient with anti-NXP2-positive dermatomyositis and syphilis. Dermatol Online J 2020; 26:13030/qt0783v3nx. [PMID: 32239891] [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] [Received: 03/26/2020] [Accepted: 03/26/2020] [Indexed: 06/11/2023] Open
Abstract
Dermatomyositis is an auto-immune inflammatory myopathy that primarily affects the skin and muscle and can be triggered by exposure to various environmental factors. We present a patient with active syphilis infection who developed dermatomyositis and discuss the significance of anti-NXP2 autoantibody positivity.
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Affiliation(s)
| | | | | | | | | | | | - Danielle Tartar
- Department of Dermatology, University of California Davis, Sacramento, CA.
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40
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Kiuru M, Urban J, Zhu G, Rybak I, Terrell JR, Qi L, McPherson JD, Marghoob AA, Rauen KA. RAS pathway influences the number of melanocytic nevi in cardiofaciocutaneous and Costello syndromes. J Am Acad Dermatol 2020; 82:1091-1093. [PMID: 32001297 DOI: 10.1016/j.jaad.2020.01.038] [Citation(s) in RCA: 5] [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: 10/11/2019] [Revised: 12/20/2019] [Accepted: 01/19/2020] [Indexed: 10/25/2022]
Affiliation(s)
- Maija Kiuru
- Department of Dermatology, University of California, Davis, Sacramento; Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento.
| | - Jennifer Urban
- Department of Dermatology, University of California, Davis, Sacramento
| | - Guannan Zhu
- Department of Dermatology, University of California, Davis, Sacramento; Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Iryna Rybak
- Department of Dermatology, University of California, Davis, Sacramento
| | - Jessica R Terrell
- Department of Dermatology, University of California, Davis, Sacramento
| | - Lihong Qi
- Department of Public Health Sciences, University of California, Davis, Sacramento
| | - John D McPherson
- Department of Biochemistry and Molecular Medicine, University of California, Davis, Sacramento
| | - Ashfaq A Marghoob
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York
| | - Katherine A Rauen
- Department of Pediatrics, University of California, Davis, Sacramento
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41
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Urban J, Qi L, Zhao H, Rybak I, Rauen KA, Kiuru M. Comparison of hair manifestations in cardio-facio-cutaneous and Costello syndromes highlights the influence of the RAS pathway on hair growth. J Eur Acad Dermatol Venereol 2020; 34:601-607. [PMID: 31736117 DOI: 10.1111/jdv.16082] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 11/13/2019] [Indexed: 01/26/2023]
Abstract
BACKGROUND Abnormal hair growth is a defining feature of RASopathies, syndromes caused by germline mutations in the RAS pathway. However, detailed hair manifestations and the mechanisms of altered hair growth in RASopathies are poorly delineated. OBJECTIVES To identify distinguishing clinical features and investigate how the RAS pathway influences hair growth by performing a systematic and detailed side-by-side comparison of hair manifestations in cardio-facio-cutaneous syndrome (CFCS) and Costello syndrome (CS), two RASopathies caused by mutations in the downstream and upstream elements of the RAS pathway, respectively. METHODS Sixteen individuals with CFCS and 23 individuals with CS were enrolled. Mutation data were recorded. Scalp hair, eyebrows and eyelashes of individuals with CFCS or CS were examined for texture, colour, density and morphology. Scalp hairs were examined by light microscopy. RESULTS While both syndromes displayed abnormal hair, striking differences were observed, including darker and thicker scalp hair and sparse eyebrows and eyelashes in CFCS. By contrast, synophrys, trichomegaly and abnormalities of the scalp hair shafts were observed in CS. Possible correlation with straight hair and genotype was observed in CS. CONCLUSION The results emphasize the role of the RAS pathway in hair growth, improve accuracy of clinical diagnosis of CFCS and CS and provide a foundation for identification of therapeutic targets.
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Affiliation(s)
- J Urban
- Department of Dermatology, University of California, Davis, Sacramento, CA, USA
| | - L Qi
- Department of Public Health Sciences, University of California, Davis, Davis, CA, USA
| | - H Zhao
- Department of Food Science, Zhejiang University, Hangzhou, China
| | - I Rybak
- Department of Dermatology, University of California, Davis, Sacramento, CA, USA
| | - K A Rauen
- Department of Pediatrics, University of California, Davis, Sacramento, CA, USA
| | - M Kiuru
- Department of Dermatology, University of California, Davis, Sacramento, CA, USA.,Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, CA, USA
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42
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Nguyen M, Hai J, Bovenberg MSS, Wilken R, Kiuru M, Brassard A, Tartar D. A patient with anti-NXP2-positive dermatomyositis and syphilis. Dermatol Online J 2020. [DOI: 10.5070/d3262047413] [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: 11/08/2022] Open
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Abstract
Surgical excision is standard-of-care for primary invasive melanoma, but best care can be unclear for patients who are surgically high-risk or for whom resection may be excessively morbid. Alternatives to surgical excision have emerged for treatment of metastatic melanoma but have not yet been explored for primary invasive melanoma. Two elderly patients with primary invasive melanoma with many medical co-morbidities who were not surgical candidates were determined to be appropriate candidates for an intralesional IL-2 based regimen. Herein we report their clinical and histological outcome. An intralesional-based regimen (intralesional IL-2, topical imiquimod cream 5%, and tretinoin cream 0.1% under occlusion to the treatment site) was administered over the course of six to seven weeks, followed by two weeks of topical-only therapy. A complete response was seen after eight to nine weeks of treating invasive melanomas that were ≥1.85 mm and 5.5 mm thick. For patients with primary invasive melanoma on high morbidity sites and patients who are poor surgical candidates, a neoadjuvant intralesional IL-2-based approach may be a reasonable alternative. The two cases presented here suggest that alternative intralesional-based treatment modalities may minimize the size of the excision site and can be associated with complete histological clearance of invasive melanoma.
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Affiliation(s)
- Elizabeth A Wang
- Department of Dermatology, UC Davis School of Medicine, Sacramento, CA, USA
| | - Jason Kao
- Department of Dermatology, UC Davis School of Medicine, Sacramento, CA, USA
| | - Chelsea Ma
- Department of Dermatology, UC Davis School of Medicine, Sacramento, CA, USA
| | - Michelle Y Cheng
- Department of Dermatology, UC Davis School of Medicine, Sacramento, CA, USA
| | - Virginia R Barton
- Department of Dermatology, UC Davis School of Medicine, Sacramento, CA, USA
| | | | - Maija Kiuru
- Department of Dermatology, UC Davis School of Medicine, Sacramento, CA, USA.,Department of Pathology, UC Davis School of Medicine, Sacramento, CA, USA
| | - Emanual Maverakis
- Department of Dermatology, UC Davis School of Medicine, Sacramento, CA, USA
| | - Amanda R Kirane
- Department of Surgery, UC Davis School of Medicine, Sacramento, CA, USA
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Terrell JR, Urban JR, Fung MA, Tartar DM, Kiuru M. Pink verrucous plaque in a man with systemic mastocytosis. Dermatol Online J 2019; 25:13030/qt4js2h2cj. [PMID: 31735012] [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] [Received: 11/08/2019] [Accepted: 11/08/2019] [Indexed: 06/10/2023] Open
Abstract
Porokeratosis ptychotropica is a rare and commonly misdiagnosed subtype of porokeratosis involving the body folds. We present a 53-year-old man with systemic mastocytosis who presented with a pruritic, verrucous plaque in the gluteal fold that showed multiple cornoid lamellae on histopathologic evaluation, diagnostic of porokeratosis ptychotropica. Various treatments have been reported, including topical corticosteroids, retinoids, vitamin D analogs, calcineurin inhibitors, imiquimod, phototherapy, cryotherapy, or ablative laser therapy, but recurrences are common.
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Affiliation(s)
| | | | | | | | - Maija Kiuru
- Department of Dermatology, University of California Davis, Sacramento, CA Department of Pathology and Laboratory Medicine University of California, Davis, CA.
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45
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Alexanian C, Cheng M, Kiuru M, Wang JZ, Le ST, Tartar DM. Eosinophilic fasciitis presenting as a unilateral, solitary plaque. Dermatol Online J 2019; 25:13030/qt4dr7v7zz. [PMID: 31553865] [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] [Received: 09/09/2019] [Accepted: 09/09/2019] [Indexed: 06/10/2023] Open
Abstract
Eosinophilic fasciitis is a rare connective tissue disorder characterized by inflammation of the fascia that leads to painful, indurated skin. Because of its variable clinical presentation and overlap with conditions, such as morphea, the diagnosis of eosinophilic fasciitis can be challenging and relies on clinical presentation, histopathologic and laboratory analysis, and response to therapy. Herein, we present an unusual, solitary, isolated plaque with pathologic features and response to therapy most consistent with eosinophilic fasciitis.
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Affiliation(s)
- Claire Alexanian
- Department of Dermatology, University of California Davis Medical Center, Sacramento, CA Georgetown University School of Medicine, Washington, DC
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Jena PK, Sheng L, Mcneil K, Chau TQ, Yu S, Kiuru M, Fung MA, Hwang ST, Wan YJY. Long-term Western diet intake leads to dysregulated bile acid signaling and dermatitis with Th2 and Th17 pathway features in mice. J Dermatol Sci 2019; 95:13-20. [PMID: 31213388 DOI: 10.1016/j.jdermsci.2019.05.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [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: 10/15/2018] [Revised: 05/09/2019] [Accepted: 05/28/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Dietary interventions are implicated in the development of atopic dermatitis, psoriasis, and acne. OBJECTIVE To investigate the effect of diet and the bile acid (BA) receptors, such as TGR5 (Takeda G protein receptor 5) and S1PR2 (sphingosine-1-phosphate receptor 2) in the development of dermatitis. METHODS C57BL/6 mice were fed a control diet (CD) or Western diet (WD) since weaning until they were 10 months old followed by analyzing histology, gene expression, and BA profiling. RESULTS Mice developed dermatitis as they aged and the incidence was higher in females than males. Additionally, WD intake substantially increased the incidence of dermatitis. Cutaneous antimicrobial peptide genesS100A8, S100A9, and Defb4 were reduced in WD-fed mice, but increased when mice developed skin lesions. In addition, Tgr5 and TGR5-regulated Dio2 and Nos3 were reduced in WD intake but induced in dermatitic lesions. Trpa1 and Trpv1, which mediate itch, were also increased in dermatitic lesions. The expression of S1pr2 and genes encoding sphingosine kinases, S1P phosphatases, binding protein, and transporter were all reduced by WD intake but elevated in dermatitic lesions. Furthermore, dermatitis development increased total cutaneous BA with an altered profile, which may change TGR5 and S1PR2 activity. Moreover, supplementation with BA sequestrant cholestyramine reduced epidermal thickening as well as cutaneous inflammatory cytokines. CONCLUSION In summary, activation of TGR5 and S1PR2, which regulate itch, keratinocyte proliferation, metabolism, and inflammation, may contribute to WD-exacerbated dermatitis with Th2 and Th17 features. In addition, elevated total BA play a significant role in inducing dermatitis and cutaneous inflammation.
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Affiliation(s)
- Prasant Kumar Jena
- Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, CA, 95817, USA
| | - Lili Sheng
- Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, CA, 95817, USA
| | - Kyle Mcneil
- Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, CA, 95817, USA
| | - Thinh Q Chau
- Department of Dermatology, University of California, Davis, Sacramento, CA, 95817, USA
| | - Sebastian Yu
- Department of Dermatology, University of California, Davis, Sacramento, CA, 95817, USA
| | - Maija Kiuru
- Department of Dermatology, University of California, Davis, Sacramento, CA, 95817, USA
| | - Maxwell A Fung
- Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, CA, 95817, USA; Department of Dermatology, University of California, Davis, Sacramento, CA, 95817, USA
| | - Samuel T Hwang
- Department of Dermatology, University of California, Davis, Sacramento, CA, 95817, USA
| | - Yu-Jui Yvonne Wan
- Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, CA, 95817, USA.
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47
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Truong A, Le S, Kiuru M, Maverakis E. Nummular dermatitis on guselkumab for palmoplantar psoriasis. Dermatol Ther 2019; 32:e12954. [PMID: 31070862 DOI: 10.1111/dth.12954] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 04/24/2019] [Accepted: 05/06/2019] [Indexed: 11/27/2022]
Abstract
A 40-year-old man with chronic history of refractory palmoplantar psoriasis presented with new onset of well-demarcated oval erythematous asteatotic plaques on bilateral shins after starting guselkumab therapy. Histopathology revealed chronic spongiotic dermatitis consistent with a diagnosis of nummular dermatitis. This case highlights a previously unreported adverse event to guselkumab therapy.
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Affiliation(s)
- Allison Truong
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Stephanie Le
- Department of Dermatology, University of California Davis School of Medicine, Sacramento, California
| | - Maija Kiuru
- Department of Dermatology, University of California Davis School of Medicine, Sacramento, California
| | - Emanual Maverakis
- Department of Dermatology, University of California Davis School of Medicine, Sacramento, California
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48
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Kiuru M, Terrell J, McPherson J. 408 POFUT1 mutation in a patient with flexural and acral hyperpigmented reticulated macules. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.484] [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: 10/27/2022]
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49
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Kiuru M, Urban J, Rybak I, Terrell J, Rauen K. 416 Regulation of the number of melanocytic nevi by the RAS pathway in cardio-facio-cutaneous and Costello syndromes. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.492] [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: 10/27/2022]
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50
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Alexanian C, Cheng M, Kiuru M, Wang JZ, Le ST, Tartar DM. Eosinophilic fasciitis presenting as a unilateral, solitary plaque. Dermatol Online J 2019. [DOI: 10.5070/d3258045130] [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: 11/08/2022] Open
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