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Affiliation(s)
| | - Maria Leszczynska
- Department of Dermatology, Baylor Scott & White Health, Temple, Texas
| | - Lindsay Bicknell
- Texas A&M School of Medicine, Dallas, Texas; Department of Dermatology, Baylor Scott & White Health, Temple, Texas
| | - Sophia Hendrick
- Department of Dermatology, Baylor Scott & White Health, Temple, Texas
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Arffa ML, Leszczynska M, Fox M, Hollmig T. Video-Based Coaching for Dermatology Resident Surgical Education. Cutis 2023; 112:176-177. [PMID: 37988396 DOI: 10.12788/cutis.0867] [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: 11/23/2023]
Affiliation(s)
- Matthew Lee Arffa
- Dr. Arffa is from Bennett Surgery Center, Santa Monica, California. Drs. Leszczynska, Fox, and Hollmig are from Department of Internal Medicine, Division of Dermatology, The University of Texas at Austin Dell Medical School
| | - Maria Leszczynska
- Dr. Arffa is from Bennett Surgery Center, Santa Monica, California. Drs. Leszczynska, Fox, and Hollmig are from Department of Internal Medicine, Division of Dermatology, The University of Texas at Austin Dell Medical School
| | - Matthew Fox
- Dr. Arffa is from Bennett Surgery Center, Santa Monica, California. Drs. Leszczynska, Fox, and Hollmig are from Department of Internal Medicine, Division of Dermatology, The University of Texas at Austin Dell Medical School
| | - Tyler Hollmig
- Dr. Arffa is from Bennett Surgery Center, Santa Monica, California. Drs. Leszczynska, Fox, and Hollmig are from Department of Internal Medicine, Division of Dermatology, The University of Texas at Austin Dell Medical School
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Kojder PL, Pisano C, Leszczynska M, Riddle A, Diaz L, Ahmed AM. Improving Diagnostic Accuracy in Skin of Color Using an Educational Module. Cutis 2023; 112:12-15. [PMID: 37611303 DOI: 10.12788/cutis.0839] [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: 08/29/2023]
Abstract
Dermatologic disparities disproportionately affect patients with skin of color (SOC). This study evaluated the effectiveness of a focused educational module for improving diagnostic accuracy and confidence in the treatment of patients with SOC among interprofessional health care providers. An SOC educational module involving a pretest, 15-minute lecture, immediate posttest, and 3-month posttest was created. One hundred participants completed the pretest and immediate posttest; 36 of them also completed the 3-month post-test. Our results suggest that a focused educational module may provide long-term improvements in diagnostic accuracy and confidence for conditions presenting in patients with SOC.
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Affiliation(s)
- Priscilla Ly Kojder
- Drs. Kojder, Leszczynska, Riddle, Diaz, and Ahmed are from The University of Texas at Austin Dell Medical School. Drs. Kojder, Riddle, Diaz, and Ahmed are from the Division of Dermatology and Dermatologic Surgery, Department of Internal Medicine, and Dr. Leszczynska is from the Division of Pediatric Dermatology, Department of Pediatrics. Dr. Pisano is from the Department of Dermatology, Harvard Medical School, Boston, Massachusetts
| | - Catherine Pisano
- Drs. Kojder, Leszczynska, Riddle, Diaz, and Ahmed are from The University of Texas at Austin Dell Medical School. Drs. Kojder, Riddle, Diaz, and Ahmed are from the Division of Dermatology and Dermatologic Surgery, Department of Internal Medicine, and Dr. Leszczynska is from the Division of Pediatric Dermatology, Department of Pediatrics. Dr. Pisano is from the Department of Dermatology, Harvard Medical School, Boston, Massachusetts
| | - Maria Leszczynska
- Drs. Kojder, Leszczynska, Riddle, Diaz, and Ahmed are from The University of Texas at Austin Dell Medical School. Drs. Kojder, Riddle, Diaz, and Ahmed are from the Division of Dermatology and Dermatologic Surgery, Department of Internal Medicine, and Dr. Leszczynska is from the Division of Pediatric Dermatology, Department of Pediatrics. Dr. Pisano is from the Department of Dermatology, Harvard Medical School, Boston, Massachusetts
| | - Ashley Riddle
- Drs. Kojder, Leszczynska, Riddle, Diaz, and Ahmed are from The University of Texas at Austin Dell Medical School. Drs. Kojder, Riddle, Diaz, and Ahmed are from the Division of Dermatology and Dermatologic Surgery, Department of Internal Medicine, and Dr. Leszczynska is from the Division of Pediatric Dermatology, Department of Pediatrics. Dr. Pisano is from the Department of Dermatology, Harvard Medical School, Boston, Massachusetts
| | - Lucia Diaz
- Drs. Kojder, Leszczynska, Riddle, Diaz, and Ahmed are from The University of Texas at Austin Dell Medical School. Drs. Kojder, Riddle, Diaz, and Ahmed are from the Division of Dermatology and Dermatologic Surgery, Department of Internal Medicine, and Dr. Leszczynska is from the Division of Pediatric Dermatology, Department of Pediatrics. Dr. Pisano is from the Department of Dermatology, Harvard Medical School, Boston, Massachusetts
| | - Ammar M Ahmed
- Drs. Kojder, Leszczynska, Riddle, Diaz, and Ahmed are from The University of Texas at Austin Dell Medical School. Drs. Kojder, Riddle, Diaz, and Ahmed are from the Division of Dermatology and Dermatologic Surgery, Department of Internal Medicine, and Dr. Leszczynska is from the Division of Pediatric Dermatology, Department of Pediatrics. Dr. Pisano is from the Department of Dermatology, Harvard Medical School, Boston, Massachusetts
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Leszczynska M, Pisano C, Haller CN, Diaz LZ. A case of multiple, bilateral Becker's Nevi of the trunk and lower extremities in a young girl: A case report. SAGE Open Med Case Rep 2022; 10:2050313X221131862. [PMID: 36337161 PMCID: PMC9629542 DOI: 10.1177/2050313x221131862] [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] [Indexed: 01/24/2023] Open
Abstract
A Becker's nevus typically appears as a single unilateral, well-demarcated, hyperpigmented patch over the upper trunk during adolescence. It uncommonly presents as multiple and bilateral patches and rarely involves a lower extremity. We describe the unusual case of a child with multiple, bilateral Becker's nevi of the trunk and lower extremities present since birth.
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Affiliation(s)
- Maria Leszczynska
- Department of Internal Medicine, Division of Dermatology and Dermatologic Surgery, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Catherine Pisano
- Department of Internal Medicine, Division of Dermatology and Dermatologic Surgery, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Courtney N Haller
- Department of Internal Medicine, Division of Dermatology and Dermatologic Surgery, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Lucia Z Diaz
- Department of Internal Medicine, Division of Dermatology and Dermatologic Surgery, Dell Medical School, University of Texas at Austin, Austin, TX, USA,Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, TX, USA,Dell Children’s Medical Center, Austin, TX, USA,Lucia Z Diaz, Department of Internal Medicine, Division of Dermatology and Dermatologic Surgery, Dell Medical School, University of Texas at Austin, Health Transformation Building, 1601 Trinity St Building A, Austin, TX 78712, USA.
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Croce EA, Rathouz PJ, Lopes FCPS, Leszczynska M, Diaz LZ, Levy ML, Ruth JS, Varshney P, Rew L, Matsui EC. Validation of remote atopic dermatitis severity assessment with the Eczema Area and Severity Ondex in children using caregiver-provided photos and videos. Pediatr Dermatol 2022; 39:547-552. [PMID: 35522088 PMCID: PMC9420774 DOI: 10.1111/pde.15003] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 02/19/2022] [Accepted: 03/27/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND/OBJECTIVES We sought to quantify the reliability and validity of remote atopic dermatitis (AD) severity assessment using the Eczema Area and Severity Index (EASI) applied to caregiver-provided photos (p-EASI) and videos (v-EASI). METHODS Children (0-17 years) with a physician diagnosis of AD were recruited. Caregivers took photos and a video of their child's skin. A clinician scored in-person EASI on the same day, then p-EASI and v-EASI for each participant 10 days or more between ratings. Two additional clinicians scored p-EASI and v-EASI. Lin's concordance correlation coefficient (CCC) was employed to assess criterion validity using in-person EASI as the gold standard. Intraclass correlation coefficients (ICCs) were calculated to assess interrater reliability of p-EASI and v-EASI. RESULTS Fifty racially and ethnically diverse children (age [mean ± SD]: 4.3 ± 4.4 years; 42% female) with a range of AD severity (EASI: 6.3 ± 6.4) and Fitzpatrick skin types (1-2: 9%; 3-4: 60%; 5-6: 31%) were enrolled and received in-person EASI assessment. Fifty had p-EASI and 49 had v-EASI by the same in-person rater, and by two additional raters. The CCC and ICC for p-EASI were 0.89, 95% CI [0.83, 0.95] and 0.81, 95% CI [0.71, 0.89], respectively. The CCC and ICC for v-EASI were 0.75, 95% CI [0.63, 0.88] and 0.69, 95% CI [0.51, 0.81], respectively. CONCLUSIONS In this diverse population with a range of skin tones, p-EASI showed good criterion validity and good interrater reliability. v-EASI showed moderate to good criterion validity and moderate interrater reliability. Both may be reliable and valid options for remote AD severity assessment.
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Affiliation(s)
- Emily A Croce
- Dell Children's Medical Group, Ascension Seton, Austin, Texas, USA.,The University of Texas at Austin School of Nursing, Austin, Texas, USA
| | - Paul J Rathouz
- Department of Population Health, Dell Medical School at The University of Texas at Austin, Austin, Texas, USA
| | - Fabiana C P S Lopes
- Department of Internal Medicine, Dell Medical School at The University of Texas at Austin, Austin, Texas, USA
| | | | - Lucia Z Diaz
- Dell Children's Medical Group, Ascension Seton, Austin, Texas, USA.,Department of Internal Medicine, Dell Medical School at The University of Texas at Austin, Austin, Texas, USA.,Department of Pediatrics, Dell Medical School at The University of Texas at Austin, Austin, Texas, USA
| | - Moise L Levy
- Dell Children's Medical Group, Ascension Seton, Austin, Texas, USA.,Department of Internal Medicine, Dell Medical School at The University of Texas at Austin, Austin, Texas, USA.,Department of Pediatrics, Dell Medical School at The University of Texas at Austin, Austin, Texas, USA
| | - Jennifer S Ruth
- Dell Children's Medical Group, Ascension Seton, Austin, Texas, USA.,Department of Internal Medicine, Dell Medical School at The University of Texas at Austin, Austin, Texas, USA.,Department of Pediatrics, Dell Medical School at The University of Texas at Austin, Austin, Texas, USA
| | - Pooja Varshney
- Dell Children's Medical Group, Ascension Seton, Austin, Texas, USA.,Department of Pediatrics, Dell Medical School at The University of Texas at Austin, Austin, Texas, USA
| | - Lynn Rew
- The University of Texas at Austin School of Nursing, Austin, Texas, USA
| | - Elizabeth C Matsui
- Dell Children's Medical Group, Ascension Seton, Austin, Texas, USA.,Department of Population Health, Dell Medical School at The University of Texas at Austin, Austin, Texas, USA.,Department of Pediatrics, Dell Medical School at The University of Texas at Austin, Austin, Texas, USA
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Croce EA, Rathouz PJ, Lopes FCPS, Leszczynska M, Diaz LZ, Levy ML, Ruth JS, Varshney P, Rew L, Matsui EC. Caregiver Preferences and Barriers Toward Accessing Pediatric Dermatology Care for Childhood Atopic Dermatitis. J Pediatr Health Care 2022; 36:e1-e5. [PMID: 35527176 DOI: 10.1016/j.pedhc.2022.04.003] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/29/2022] [Accepted: 04/02/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Atopic dermatitis (AD) is a common chronic childhood illness. It is often treated by primary care providers (PCPs) though it may require referral to a dermatology specialist. METHOD We administered an exploratory survey to 50 caregivers of children aged 0-17 years with AD to assess their preferences and barriers toward accessing dermatology specialty care for their child's AD. RESULTS Caregivers felt PCPs and specialists equally listened to their child's AD concerns. However, many felt there was a difference in the care provided and control of the AD and preferred to see a specialist for ongoing management. DISCUSSION Caregivers may benefit from their children being referred to dermatology specialists earlier and more often for their AD. Further work must be done to characterize preferences and barriers toward AD care across race and ethnicity.
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Affiliation(s)
- Emily A Croce
- Emily A. Croce, Pediatric Nurse Practitioner, Dell Children's Medical Center, and PhD Candidate, the University of Texas at Austin School of Nursing, Austin, TX..
| | - Paul J Rathouz
- Paul J. Rathouz, Professor of Population Health, Dell Medical School at The University of Texas at Austin, Austin, TX
| | - Fabiana Castro Porto Silva Lopes
- Fabiana Castro Porto Silva Lopes, Research Volunteer, Department of Internal Medicine, Dell Medical School at The University of Texas at Austin, Austin, TX
| | - Maria Leszczynska
- Maria Leszczynska, Pediatrician, Dell Children's Medical Center, Austin, TX
| | - Lucia Z Diaz
- Lucia Z. Diaz, Chief of Pediatric Dermatology, Dell Children's Medical Center, and Associate Professor of Pediatrics and Internal Medicine (Dermatology), Dell Medical School at The University of Texas at Austin, Austin, TX
| | - Moise L Levy
- Moise L. Levy, Pediatric Dermatologist, Dell Children's Medical Center, and Assistant Professor of Pediatrics and Internal Medicine (Dermatology), Dell Medical School at The University of Texas at Austin, Austin, TX
| | - Jennifer S Ruth
- Jennifer S. Ruth, Pediatric Dermatologist, Dell Children's Medical Center, and Professor of Pediatrics and Internal Medicine (Dermatology), Dell Medical School at The University of Texas at Austin, Austin, TX
| | - Pooja Varshney
- Pooja Varshney, Pediatric Allergy/Immunologist, Dell Children's Medical Center, and Associate Professor of Pediatrics, Dell Medical School at The University of Texas at Austin, Austin, TX
| | - Lynn Rew
- Lynn Rew, Professor of Nursing and PhD Program Director, The University of Texas at Austin School of Nursing, Austin, TX
| | - Elizabeth C Matsui
- Elizabeth C. Matsui, Pediatric Allergy/Immunologist, Dell Children's Medical Center, and Professor of Pediatrics and Population Health, Dell Medical School at The University of Texas at Austin, Austin, TX
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Abstract
Hidradenitis suppurativa (HS) is a chronic, inflammatory follicular disorder that most commonly involves the intertriginous areas. It is characterized by recurrent nodules that may progress into deeper abscesses and sinus tracts. Treatment is challenging and often involves a combination of lifestyle modifications, medical therapies, and procedures to control symptoms. Deroofing is a tissue-saving surgical technique that has been well studied in adults and in our clinical experience is an important adjunct therapy in pediatric patients with moderate-to-severe HS. We describe the step-by-step process of deroofing, including surgical clinical pearls specific to the pediatric population.
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Affiliation(s)
- Maria Leszczynska
- Division of Dermatology and Dermatologic Surgery, Department of Internal Medicine, Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | - Lucia Z Diaz
- Division of Dermatology and Dermatologic Surgery, Department of Internal Medicine, Dell Medical School, University of Texas at Austin, Austin, Texas, USA.,Division of Pediatric Dermatology, Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, Texas, USA.,Dell Children's Medical Center, Austin, Texas, USA
| | - Venessa Peña-Robichaux
- Division of Dermatology and Dermatologic Surgery, Department of Internal Medicine, Dell Medical School, University of Texas at Austin, Austin, Texas, USA
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Croce E, Rathouz P, Porto Silva Lopes FC, Leszczynska M, Diaz L, Levy M, Ruth J, Varshney P, Matsui E. Validation of Remote AD Severity Assessment with the Eczema Area and Severity Index (EASI) Using Photos and Videos: Preliminary Reliability and Validity. J Allergy Clin Immunol 2022. [DOI: 10.1016/j.jaci.2021.12.502] [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: 10/19/2022]
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Jodeh DS, Ross JM, Leszczynska M, Qamar F, Dawkins RL, Cray JJ, Rottgers SA. Determination of Ethnic Variation in Infant Nasolabial Anthropometry Using 3D Photographs: Implications for Bilateral Cleft Lip Nasal Correction. Cleft Palate Craniofac J 2021; 59:693-700. [PMID: 34132122 DOI: 10.1177/10556656211024470] [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] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE We aimed to assess significant ethnic variabilities in infants' nasolabial anthropometry to motivate variations in surgical correction of a synchronous bilateral cleft lip/nasal anomaly, specifically whether a long columella is a European feature, therefore accepting a short columella and/or delayed columellar lengthening suitable for reconstruction in ethnic patients. METHODS Thirty-three infants without craniofacial pathology (10 African American [AA], 7 Hispanic [H], and 16 of European descent [C]), ages 3 to 8 months, presenting to the Johns Hopkins All Children's general pediatric clinic were recruited. Four separate 3D photographs (2 submental and frontal views each) were taken using the Vectra H1 handheld camera (Canfield Imaging). Eighteen linear facial distances were measured using Mirror 3D analysis (Canfield Imaging Systems). Difference between ethnicities was measured using analysis of variance with the Bonferroni/Dunn post hoc comparisons. Pearson correlation was employed for interrater reliability. All statistical analyses were carried out using SPSS version 21.0 (IBM Corp), with statistical significance set at P < .05. RESULTS Nasal projection (sn-prn) and columella length (sn-c) did not differ significantly between groups (P = .9). Significant differences were seen between ethnic groups in nasal width (sbal-sbal [C-AA; P = .02]; ac-ac [C-AA; P = .00; H-AA; P = .04]; al-al [C-AA; P = .00; H-AA; P = .001]) and labial length (sn-ls [C-AA; P = .041]; sn-sto [C-AA; P = .005]; Cphs-Cphi L [C-AA; P = .013]; Cphs-Cphi R [C-AA; P = .015]). Interrater reliability was good to excellent and significantly correlated for all measures. CONCLUSIONS African American infants exhibited wider noses and longer lips. No difference was noted in nasal projection or columella length, indicating that these structures should be corrected during the primary cleft lip and nasal repair for all patients and should not be deferred to secondary correction.
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Affiliation(s)
- Diana S Jodeh
- Department of General Surgery, 54055University of Pittsburgh Medical Center Pinnacle, Harrisburg, PA, USA
| | - Jacqueline M Ross
- Department of Plastic Surgery, Morsani College of Medicine, 33697University of South Florida, Tampa, FL, USA
| | - Maria Leszczynska
- Department of General Pediatrics, 7582Johns Hopkins All Children's Hospital, St Petersburg, FL, USA
| | - Fatima Qamar
- Division of Plastic and Reconstructive Surgery, 7582Johns Hopkins All Children's Hospital, St Petersburg, FL, USA
| | - Rachel L Dawkins
- Department of General Pediatrics, 7582Johns Hopkins All Children's Hospital, St Petersburg, FL, USA
| | - James J Cray
- Department of Biomedical Education and Anatomy, 12305The Ohio State University College of Medicine, Columbus, OH, USA
| | - S Alex Rottgers
- Division of Plastic and Reconstructive Surgery, 7582Johns Hopkins All Children's Hospital, St Petersburg, FL, USA
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Abstract
ABSTRACT Hidradenitis suppurativa (HS) is a chronic and recurrent inflammatory skin condition resulting in the formation of nodules, sinus tracts, and abscesses in intertriginous areas. We provide recommendations for the management of children presenting to the emergency department with acute HS flares, based on a review of literature and insights from our own clinical experience. The purpose of the recommendations is to educate clinicians on specific considerations that should be made when caring for children with HS.
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Affiliation(s)
- Kavina Patel
- From the Medical Student, Department of Medical Education, Long School of Medicine, University of Texas Health San Antonio, San Antonio
| | - Maria Leszczynska
- Dermatology Research Fellow, Dermatologist and Assistant Professor, Department of Internal Medicine, Division of Dermatology
| | - Venessa Peña-Robichaux
- Dermatology Research Fellow, Dermatologist and Assistant Professor, Department of Internal Medicine, Division of Dermatology
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Leszczynska M, Clarke EL, Diaz LZ. Depigmented patches in a child. JAAD Case Rep 2021; 10:8-10. [PMID: 33728368 PMCID: PMC7935687 DOI: 10.1016/j.jdcr.2021.01.029] [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)
- Maria Leszczynska
- Division of Dermatology and Dermatologic Surgery, Department of Internal Medicine, Dell Medical School at the University of Texas at Austin, Austin, Texas
| | - Emily L Clarke
- Dell Medical School at the University of Texas at Austin, Austin, Texas
| | - Lucia Z Diaz
- Division of Dermatology and Dermatologic Surgery, Department of Internal Medicine, Dell Medical School at the University of Texas at Austin, Austin, Texas.,Dell Children's Medical Center, Austin, Texas
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Leszczynska M, Jodeh DS, Reed D, Lynskey EM, Bittles MA, Mayer JL, Rottgers SA. Alveolar soft-part sarcoma: Case demonstrating principles for uncommon vascular lesions. Pediatr Int 2019; 61:978-981. [PMID: 31219648 DOI: 10.1111/ped.13920] [Citation(s) in RCA: 3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 05/22/2019] [Accepted: 06/18/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Alveolar soft-part sarcoma (ASPS) is an uncommon malignancy that may present in a manner similar to benign vascular tumors. METHODS A 6-year-old boy with autism spectrum disorder was referred to the Johns Hopkins All Children's Hospital vascular anomalies clinic for the evaluation of a tongue mass. RESULTS Prior to the presentation, at 5 years of age, neck computed tomography (CT) was performed. This showed a well circumscribed, enhancing mass at the anterior aspect of the tongue. The radiologic impression was that this lesion was most likely a hemangioma. Two years later, the patient was evaluated in the vascular anomalies clinic. At that examination a 2-3 cm swelling was noted on the dorsal aspect of the tongue. The mass was fleshy and firm with discrete borders. Handheld Doppler examination indicated a high-flow lesion. The patient underwent an excisional biopsy. The lesion was identified as an alveolar soft-part sarcoma based on pathologic characteristics. CONCLUSION Familiarity with common vascular tumors and malformations allows providers to diagnose the majority of these lesions on a combination of clinical history and physical examination. Atypical and combined lesions do benefit from imaging to help characterize and aid in the differential diagnosis. Biopsy enables definitive diagnosis but is necessary in the minority of cases. When in doubt, referral to a specialized, multidisciplinary vascular anomalies clinic will ensure that these patients receive management for this challenging collection of conditions.
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Affiliation(s)
- Maria Leszczynska
- Department of General Pediatrics, Johns Hopkins All Children's Hospital, St Petersburg, Florida, USA
| | - Diana S Jodeh
- Division of Plastic and Reconstructive Surgery, Johns Hopkins All Children's Hospital, St Petersburg, Florida, USA
| | - Damon Reed
- Cancer and Blood Disorders Institute, Johns Hopkins All Children's Hospital, St Petersburg, Florida, USA
| | - Elisa M Lynskey
- Division of Otolaryngology, Johns Hopkins All Children's Hospital, St Petersburg, Florida, USA
| | - Mark A Bittles
- Department of Radiology, Johns Hopkins All Children's Hospital, St Petersburg, Florida, USA
| | - Jennifer Lr Mayer
- Cancer and Blood Disorders Institute, Johns Hopkins All Children's Hospital, St Petersburg, Florida, USA
| | - S Alex Rottgers
- Division of Plastic and Reconstructive Surgery, Johns Hopkins All Children's Hospital, St Petersburg, Florida, USA
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Leszczynska M, Liu X, Wrobel W, Malys M, Norberg ST, Hull S, Krok F, Abrahams I. Total scattering analysis of cation coordination and vacancy pair distribution in Yb substituted δ-Bi2O3. J Phys Condens Matter 2013; 25:454207. [PMID: 24141081 DOI: 10.1088/0953-8984/25/45/454207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Reverse Monte Carlo (RMC) modelling of neutron total scattering data, combined with conventional Rietveld analysis of x-ray and neutron data, has been used to describe the cation coordination environments and vacancy pair distribution in the oxide ion conducting electrolyte Bi3YbO6. The thermal variation of the cubic fluorite unit cell volume, monitored by variable temperature x-ray and neutron experiments, reveals significant curvature, which is explained by changes in the oxide ion distribution. There is a significant increase in tetrahedral oxide ion vacancy concentration relative to δ-Bi2O3, due to the creation of Frenkel defects associated with the Yb(3+) cation. The tetrahedral oxide ion vacancy concentration increases from room temperature to 800 °C, but little change is observed in the vacancy pair distribution with temperature. The vacancy pair distributions at both temperatures are consistent with a favouring of [100] vacancy pairs.
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Affiliation(s)
- M Leszczynska
- Faculty of Physics, Warsaw University of Technology, Koszykowa 75, 00-662 Warszawa, Poland
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