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Powers CM, Verma H, Orloff J, Piontkowski AJ, Tiersten A, Lamb A, Gulati N. Use of a topical Janus kinase inhibitor in immune checkpoint inhibitor-induced eczematous reaction: a case report. J DERMATOL TREAT 2024; 35:2336118. [PMID: 38565207 DOI: 10.1080/09546634.2024.2336118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 03/22/2024] [Indexed: 04/04/2024]
Abstract
In this report, we describe the case of a 28-year-old female with bilateral breast cancer in the setting of a BRCA1 mutation, who presented to dermatology with an eczematous reaction, ultimately diagnosed as a cutaneous immune-related adverse event (cirAE) secondary to an immune checkpoint inhibitor (ICI), pembrolizumab. Our case report highlights a novel therapeutic option for an eczematous cirAE: the topical JAK 1/2 inhibitor, ruxolitinib. CirAEs can occur in up to 55% of patients on ICIs, a class of medications seeing rapidly increasing use in cancer therapy, and prior research has demonstrated that ICI-induced dermatitis may involve different pathways than traditionally observed in their spontaneous counterparts. Specifically, marked Th1 skewing is noted in ICI-induced dermatitis, as opposed to a predominant Th2 response which typically characterizes spontaneous atopic dermatitis. To our knowledge, this is the first case report in the literature discussing use of a topical JAK inhibitor, ruxolitinib, in the treatment of topical steroid-refractory cirAEs. Furthermore, as topical JAK inhibitors are thought to not carry the risks of systemic JAK inhibitors, including malignancy, ruxolitinib cream is a promising therapeutic option for this challenging patient population.
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Affiliation(s)
- Camille M Powers
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Hannah Verma
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jeremy Orloff
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Austin J Piontkowski
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Amy Tiersten
- Department of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Angela Lamb
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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2
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Poplausky D, Block BR, Chang A, Thakker S, Young JN, Gulati N, Ungar J. Single-institution retrospective review evaluating the impact of the Covid-19 pandemic on isotretinoin prescribing practices. J DERMATOL TREAT 2024; 35:2291326. [PMID: 38102844 DOI: 10.1080/09546634.2023.2291326] [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] [Received: 05/30/2023] [Accepted: 12/30/2023] [Indexed: 12/17/2023]
Affiliation(s)
- Dina Poplausky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brandon R Block
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Annie Chang
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sach Thakker
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jade N Young
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jonathan Ungar
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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3
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Orloff J, Patel DD, Powers CM, Piontkowski AJ, Phelps RG, Richter J, Gulati N. Pityriasis lichenoides et varioliformis acuta in a patient treated with cevostamab. JAAD Case Rep 2024; 47:23-25. [PMID: 38576898 PMCID: PMC10993135 DOI: 10.1016/j.jdcr.2024.02.021] [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)
- Jeremy Orloff
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Dev D. Patel
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Camille M. Powers
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Austin J. Piontkowski
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Robert G. Phelps
- Departments of Dermatology and Pathology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Joshua Richter
- Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
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4
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O'Hagan R, Ngandjui J, Ungar B, Ungar J, Gulati N. A Survey of Demographics and Treatments in Melanoma Case Reports: Retrospective Bibliometric Analysis. JMIR Dermatol 2024; 7:e56684. [PMID: 38648085 DOI: 10.2196/56684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/22/2024] [Accepted: 04/10/2024] [Indexed: 04/25/2024] Open
Abstract
Melanoma case reports show variations in treatment by age and sex.
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Affiliation(s)
- Ross O'Hagan
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Medical Education, Garnet Health, Middletown, NY, United States
| | - Jessie Ngandjui
- Department of Medical Education, Garnet Health, Middletown, NY, United States
| | - Benjamin Ungar
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Jonathan Ungar
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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5
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Brüggen MC, Traidl S, Mitamura Y, Walsh S, French LE, Gulati N, Phillips E, Maverakis E, Ingen-Housz-Oro S. Medical algorithm: Diagnosis and treatment of drug reaction with eosinophilia and systemic symptoms in adult patients. Allergy 2024. [PMID: 38587051 DOI: 10.1111/all.16122] [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: 07/18/2022] [Revised: 03/15/2024] [Accepted: 03/31/2024] [Indexed: 04/09/2024]
Affiliation(s)
- Marie-Charlotte Brüggen
- Faculty of Medicine, University Zurich, Zurich, Switzerland
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
- Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland
- ToxiTEN group of the ERN-skin
| | - Stephan Traidl
- Faculty of Medicine, University Zurich, Zurich, Switzerland
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Yasutaka Mitamura
- Swiss Institute of Allergy and Asthma Research (SIAF) Davos, Davos, Switzerland
| | - Sarah Walsh
- ToxiTEN group of the ERN-skin
- Department of Dermatology, King's College Hospital NHS Foundation Trust, London, UK
| | - Lars E French
- ToxiTEN group of the ERN-skin
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
- Dr. Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Nicholas Gulati
- The Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Elizabeth Phillips
- Center for Drug Safety and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Emanual Maverakis
- Department of Dermatology, University of California, Davis, California, USA
| | - Saskia Ingen-Housz-Oro
- ToxiTEN group of the ERN-skin
- Department of Dermatology, Henri Mondor Hospital, Univ Paris Est Créteil EpidermE, Créteil, Paris, France
- Reference center for severe drug reactions TOXIBUL, Créteil, France
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6
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Powers CM, Piontkowski AJ, Block BR, Orloff J, Guttman-Yassky E, Gulati N. Pemphigoid and atopy: A case-control study in the All of Us database. J Allergy Clin Immunol Pract 2024:S2213-2198(24)00348-9. [PMID: 38588912 DOI: 10.1016/j.jaip.2024.04.005] [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] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 03/19/2024] [Accepted: 04/03/2024] [Indexed: 04/10/2024]
Affiliation(s)
- Camille M Powers
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Austin J Piontkowski
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Brandon R Block
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jeremy Orloff
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Emma Guttman-Yassky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY.
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7
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Powers CM, Piontkowski AJ, Orloff J, Pulsinelli J, Uddin FB, Correa Da Rosa J, Ungar B, Gulati N. Risk of lymphoma in patients with atopic dermatitis: A case-control study in the All of Us database. J Am Acad Dermatol 2024:S0190-9622(24)00554-1. [PMID: 38582238 DOI: 10.1016/j.jaad.2024.03.038] [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: 10/06/2023] [Revised: 02/09/2024] [Accepted: 03/29/2024] [Indexed: 04/08/2024]
Affiliation(s)
- Camille M Powers
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Austin J Piontkowski
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jeremy Orloff
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Juliana Pulsinelli
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Foysal B Uddin
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Joel Correa Da Rosa
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Benjamin Ungar
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.
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8
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Obi A, McKinley J, Oladunjoye E, Williams A, Li V, Wu J, Yang C, Darwin E, Gulati N, Haskin A, Correa da Rosa J, Svidzinski C. Doxycycline for central centrifugal cicatricial alopecia: A single center retrospective analysis. J Am Acad Dermatol 2024:S0190-9622(24)00474-2. [PMID: 38458568 DOI: 10.1016/j.jaad.2024.01.086] [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: 10/10/2023] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 03/10/2024]
Affiliation(s)
- Ashley Obi
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York; Meharry Medical College, Nashville, Tennessee
| | - Jayvon McKinley
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Esther Oladunjoye
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Akilah Williams
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Vivian Li
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York; Lake Erie College of Osteopathic Medicine, Erie, Pennsylvania
| | - Jianni Wu
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Connie Yang
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Evan Darwin
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Joel Correa da Rosa
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
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9
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Agarwal A, Gulati N. Characterizing Occupational Skin Disease Incidence, 2017-2021. Dermatitis 2024; 35:184-186. [PMID: 37335944 DOI: 10.1089/derm.2023.0090] [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: 06/21/2023]
Affiliation(s)
- Aneesh Agarwal
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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10
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Faldetta C, Kaleci S, Chester J, Ruini C, Ciardo S, Manfredini M, Guida S, Chello C, Cantisani C, Young JN, Cabral P, Gulati N, Guttman-Yassky E, Pellacani G, Farnetani F. Melanoma clinicopathological groups characterized and compared with dermoscopy and reflectance confocal microscopy. J Am Acad Dermatol 2024; 90:309-318. [PMID: 37988042 DOI: 10.1016/j.jaad.2023.09.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Dermoscopic and reflectance confocal microscopy (RCM) correlations between morphologic groups of melanoma have not yet been described. OBJECTIVE Describe and compare dermoscopic and RCM features of cutaneous melanomas with histopathological confirmation. METHODS Single center, retrospective analysis of consecutive melanomas evaluated with RCM (2015-2019). Lesions were clinically classified as typical, nevus-like, amelanotic/nonmelanoma skin cancer (NMSC)-like, seborrheic keratosis (SK)-like and lentigo/lentigo maligna (LM)-like. Presence or absence of common facial and nonfacial melanoma dermoscopic and RCM patterns were recorded. Clusters were compared with typical lesions by multivariate logistic regression. RESULTS Among 583 melanoma lesions, significant differences between clusters were evident (compared to typical lesions). Observation of dermoscopic features (>50% of lesions) in amelanotic/NMSC-like lesions consistently displayed 3 patterns (atypical network, atypical vascular pattern + regression structures), and nevus-like and SK-like lesions and lentigo/LM-like lesions consistently displayed 2 patterns (atypical network + regression structures, and nonevident follicles + heavy pigmentation intensity). Differences were less evident with RCM, as almost all lesions were consistent with melanoma diagnosis. LIMITATIONS Small SK-like lesions sample, single RCM analyses (no reproduction of outcome). CONCLUSION RCM has the potential to augment our ability to consistently and accurately diagnose melanoma independently of clinical and dermoscopic features.
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Affiliation(s)
- Cristina Faldetta
- Dermatology Clinic, University of Modena and Reggio Emilia, Modena, Italy
| | - Shaniko Kaleci
- Dermatology Clinic, University of Modena and Reggio Emilia, Modena, Italy
| | - Johanna Chester
- Dermatology Clinic, University of Modena and Reggio Emilia, Modena, Italy
| | - Cristel Ruini
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany; Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Silvana Ciardo
- Dermatology Clinic, University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Manfredini
- Dermatology Clinic, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefania Guida
- School of Medicine Vita Salute San Raffaele University, Milan, Italy; Dermatologic Clinic, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Camilla Chello
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Carmen Cantisani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Jade N Young
- Department of Dermatology, Mount Sinai, New York, New York
| | | | | | | | - Giovanni Pellacani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
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11
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Pagan AD, Obi A, McKinley J, Oladunjoye E, Kasago I, Gulati N, Phelps RG, Svidzinski C. Birt-Hogg-Dubé syndrome in skin of color: Literature review. J Am Acad Dermatol 2024; 90:412-414. [PMID: 37838258 DOI: 10.1016/j.jaad.2023.09.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 09/13/2023] [Accepted: 09/19/2023] [Indexed: 10/16/2023]
Affiliation(s)
- Angel D Pagan
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Medicine, Ponce Health Sciences University, School of Medicine, Ponce, Puerto Rico
| | - Ashley Obi
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Medicine, Meharry Medical College, Nashville, Tennessee
| | - Jayvon McKinley
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Esther Oladunjoye
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Israel Kasago
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Robert G Phelps
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
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12
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Poplausky D, Piontkowski AJ, Phelps RG, Gulati N. Microcystic lymphatic malformation following a double mastectomy. JAAD Case Rep 2024; 44:74-76. [PMID: 38304102 PMCID: PMC10831273 DOI: 10.1016/j.jdcr.2023.12.011] [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: 02/03/2024] Open
Affiliation(s)
- Dina Poplausky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Austin J. Piontkowski
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Robert G. Phelps
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
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13
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Young JN, Rivera-Oyola R, Poplausky D, Suemitsu Y, Kim RH, Doroshow D, Gulati N. A case of urticarial vasculitis associated with atezolizumab. JAAD Case Rep 2024; 43:30-33. [PMID: 38162407 PMCID: PMC10757233 DOI: 10.1016/j.jdcr.2023.09.042] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Affiliation(s)
- Jade N. Young
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Ryan Rivera-Oyola
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Dina Poplausky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Yamato Suemitsu
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Randie H. Kim
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Deborah Doroshow
- Division of Hematology and Medical Oncology, Department of Medicine, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
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14
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Navrazhina K, Garcet S, Williams SC, Gulati N, Kiecker F, Frew JW, Mitsui H, Krueger JG. Laser capture microdissection provides a novel molecular profile of human primary cutaneous melanoma. Pigment Cell Melanoma Res 2024; 37:81-89. [PMID: 37776566 PMCID: PMC10841058 DOI: 10.1111/pcmr.13121] [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: 12/23/2022] [Revised: 08/08/2023] [Accepted: 08/16/2023] [Indexed: 10/02/2023]
Abstract
Melanoma accounts for the majority of skin cancer-related mortality, highlighting the need to better understand melanoma initiation and progression. In-depth molecular analysis of neoplastic melanocytes in whole tissue biopsies may be diluted by inflammatory infiltration, which may obscure gene signatures specific to neoplastic cells. Thus, a method is needed to precisely uncover molecular changes specific to tumor cells from a limited sample of primary melanomas. Here, we performed laser capture microdissection (LCM) and gene expression profiling of patient-derived frozen sections of pigmented lesions and primary cutaneous melanoma. Compared to bulk tissue analysis, analysis of LCM-derived samples identified 9528 additional differentially expressed genes (DEGs) including melanocyte-specific genes like PMEL and TYR, with enriched of pathways related to cell proliferation. LCM methodology also identified potentially targetable kinases specific to melanoma cells that were not detected by bulk tissue analysis. Taken together, our data demonstrate that there are marked differences in gene expression profiles depending on the method of sample isolation. We found that LCM captured higher expression of melanoma-related genes while whole tissue biopsy identified a wider range of inflammatory markers. Taken together, our data demonstrate that LCM is a valid approach to identify melanoma-specific changes using a relatively small amount of primary patient-derived melanoma sample.
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Affiliation(s)
- Kristina Navrazhina
- Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY, USA
- Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD program, New York, NY
| | - Sandra Garcet
- Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY, USA
| | - Samuel C. Williams
- Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY, USA
- Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD program, New York, NY
| | - Nicholas Gulati
- Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY, USA
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Felix Kiecker
- Department of Dermatology and Allergy, Skin Cancer Center, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - John W. Frew
- Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY, USA
| | - Hiroshi Mitsui
- Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY, USA
- Department of Dermatology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - James G. Krueger
- Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY, USA
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Luu Y, Han J, Agarwal A, Elkady N, Jaroonwanichkul S, Gulati N, Gittler J. Risk for second primary cancers among pediatric and young adult melanoma survivors. Pediatr Dermatol 2024; 41:12-15. [PMID: 37776000 DOI: 10.1111/pde.15421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 08/05/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND/OBJECTIVES Second primary cancers (SPCs) are a leading cause of morbidity and mortality among cancer survivors. In this study, we aimed to characterize the incidence of SPCs among pediatric and young adult survivors of CM. METHODS Using the Surveillance, Epidemiology, and End Results Program data spanning 2000-2018, we calculated standardized incidence ratios (SIR) to assess SPC risk in all pediatric (0-18 years) and young adult (19-29 years) patients with a first primary cancer diagnosis of CM. RESULTS Of 7,169 total CM survivors, 632 (8.82%) developed a SPC, corresponding to a 5-fold increased risk (standardized incidence ratio [SIR] 4.98; 95% confidence interval [CI] 4.60-5.38) compared to the general population. There was a highly elevated risk for second primary melanoma across all age groups (SIR 32.5; 95% CI 29.7-35.6), constituting the majority of SPC diagnoses (N = 485). Infants diagnosed with CM before 1 year of age had the highest risk for any SPC (SIR 164; 95% CI 19.8-592) and young adults diagnosed at 25-29 years had the lowest risk (SIR 4.64; 95% CI 4.19-5.13). SPC incidence was highest within the first year of CM diagnosis (SIR 27.5; 95% CI 23.7-31.6) and progressively decreased with time. CONCLUSIONS Variation exists in the incidence and type of SPC according to age among pediatric and young adult survivors of CM.
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Affiliation(s)
- Yen Luu
- Department of Dermatology, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Joseph Han
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Aneesh Agarwal
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Nadine Elkady
- Department of Dermatology, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Sandra Jaroonwanichkul
- Department of Dermatology, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Julia Gittler
- Department of Medicine, Division of Dermatology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
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16
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Young JN, Verma H, El Kashlan N, Poplausky D, Lamb AJ, Guttman-Yassky E, Gulati N. The use of biologic medications for the treatment of cutaneous immune-related adverse events secondary to immune checkpoint inhibitors: A single-institution real-life study. JAAD Case Rep 2024; 43:1-3. [PMID: 38090670 PMCID: PMC10711396 DOI: 10.1016/j.jdcr.2023.09.041] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024] Open
Affiliation(s)
- Jade N. Young
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Hannah Verma
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Nour El Kashlan
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Dina Poplausky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Angela J. Lamb
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Emma Guttman-Yassky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
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17
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O'Hagan R, Poplausky D, Young JN, Gulati N, Levoska M, Ungar B, Ungar J. The Accuracy and Appropriateness of ChatGPT Responses on Nonmelanoma Skin Cancer Information Using Zero-Shot Chain of Thought Prompting. JMIR Dermatol 2023; 6:e49889. [PMID: 38096013 PMCID: PMC10755659 DOI: 10.2196/49889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 10/02/2023] [Accepted: 12/03/2023] [Indexed: 12/31/2023] Open
Affiliation(s)
- Ross O'Hagan
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Dina Poplausky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Jade N Young
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Melissa Levoska
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Benjamin Ungar
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Jonathan Ungar
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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18
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O'Hagan R, Ungar B, Gulati N. Atopic dermatitis increases the risk of mature T/NK-cell lymphomas in a Finnish population: A two-sample Mendelian randomization study. J Eur Acad Dermatol Venereol 2023. [PMID: 38059414 DOI: 10.1111/jdv.19673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/14/2023] [Indexed: 12/08/2023]
Affiliation(s)
- Ross O'Hagan
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Benjamin Ungar
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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19
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Dubin DP, Yassky D, Poplausky D, Young JN, Tan KJ, Gulati N. Dupilumab to treat drug reaction with eosinophilia and systemic symptoms: A case series. J Allergy Clin Immunol Pract 2023; 11:3789-3791. [PMID: 37634806 DOI: 10.1016/j.jaip.2023.08.028] [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] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/15/2023] [Accepted: 08/17/2023] [Indexed: 08/29/2023]
Affiliation(s)
- Danielle P Dubin
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Daniel Yassky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Dina Poplausky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jade N Young
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Kathryn J Tan
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY.
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20
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Agarwal A, Chang A, Gulati N. Economic Costs and Implications of Occupational Skin Disease, 2011-2020. Dermatitis 2023. [PMID: 37669456 DOI: 10.1089/derm.2023.0203] [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: 09/07/2023]
Affiliation(s)
- Aneesh Agarwal
- Department of Dermatology Icahn School of Medicine at Mount Sinai New York, NY USA
| | - Annie Chang
- Department of Dermatology Icahn School of Medicine at Mount Sinai New York, NY USA
| | - Nicholas Gulati
- Department of Dermatology Icahn School of Medicine at Mount Sinai New York, NY USA
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21
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Diaz A, Tai H, Gulati N. Common warts superinfected with monkeypox. Int J Dermatol 2023; 62:1208-1209. [PMID: 36371716 DOI: 10.1111/ijd.16513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/12/2022] [Accepted: 11/05/2022] [Indexed: 11/15/2022]
Affiliation(s)
- Aisleen Diaz
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hansen Tai
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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22
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Poplausky D, Young JN, Dubin DP, Tremblay D, Gulati N. Dasatinib-Associated Acneiform Eruption Successfully Treated With Sarecycline in a Patient With Chronic Myeloid Leukemia. Cureus 2023; 15:e45697. [PMID: 37868438 PMCID: PMC10590148 DOI: 10.7759/cureus.45697] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2023] [Indexed: 10/24/2023] Open
Abstract
Dasatinib is a second-generation tyrosine inhibitor that is used for the treatment of patients with chronic myeloid leukemia (CML). It can cause a myriad of skin toxicities, including pruritis, pigmentary abnormalities of hair and skin, and maculopapular rashes. Rarely, it can be associated with acneiform eruptions, which are typically treated with doxycycline. However, doxycycline may not be an ideal therapy, especially for long-term use, due to the risk of gut flora disruption, antimicrobial resistance, and side effects. We present a case of a CML patient who developed an acneiform eruption associated with dasatinib and was successfully treated with sarecycline, a narrow-spectrum tetracycline. Given its targeted spectrum of activity, sarecycline has a lower risk of antimicrobial resistance and an improved safety profile compared to first- and second-generation tetracyclines such as doxycycline. As acneiform drug eruptions can have a significant impact on a patient's quality of life, effective management by dermatologists is paramount. Sarecycline may be a suitable treatment with a favorable safety profile, making it an appropriate choice for patients, especially those who require long-term therapy.
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Affiliation(s)
- Dina Poplausky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Jade N Young
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Danielle P Dubin
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Douglas Tremblay
- Division of Hematology and Medical Oncology, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, USA
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23
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Owji S, Aguwa C, Han J, Yassky D, Luu Y, Glausser M, Gulati N, Ungar B, Napolitano D, Ungar J. A worthwhile tool in evaluating worrisome lesions. J Fam Pract 2023; 72:E1-E22. [PMID: 37729140 DOI: 10.12788/jfp.0655] [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] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
This study demonstrated the value of using electrical impedance spectroscopy in primary care to manage and diagnose pigmented skin lesions.
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Affiliation(s)
- Shayan Owji
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY (Drs. Owji, Han, Gulati, B. Ungar, and J. Ungar and Daniel Yassky); Meharry Medical College, Nashville, TN (Chibuzo Aguwa); University of Missouri-Kansas City School of Medicine (Dr. Luu); The Institute for Family Health, New York, NY (Dr. Glausser); Community Healthcare Network, New York, NY (Dr. Napolitano)
| | - Chibuzo Aguwa
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY (Drs. Owji, Han, Gulati, B. Ungar, and J. Ungar and Daniel Yassky); Meharry Medical College, Nashville, TN (Chibuzo Aguwa); University of Missouri-Kansas City School of Medicine (Dr. Luu); The Institute for Family Health, New York, NY (Dr. Glausser); Community Healthcare Network, New York, NY (Dr. Napolitano)
| | - Joseph Han
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY (Drs. Owji, Han, Gulati, B. Ungar, and J. Ungar and Daniel Yassky); Meharry Medical College, Nashville, TN (Chibuzo Aguwa); University of Missouri-Kansas City School of Medicine (Dr. Luu); The Institute for Family Health, New York, NY (Dr. Glausser); Community Healthcare Network, New York, NY (Dr. Napolitano)
| | - Daniel Yassky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY (Drs. Owji, Han, Gulati, B. Ungar, and J. Ungar and Daniel Yassky); Meharry Medical College, Nashville, TN (Chibuzo Aguwa); University of Missouri-Kansas City School of Medicine (Dr. Luu); The Institute for Family Health, New York, NY (Dr. Glausser); Community Healthcare Network, New York, NY (Dr. Napolitano)
| | - Yen Luu
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY (Drs. Owji, Han, Gulati, B. Ungar, and J. Ungar and Daniel Yassky); Meharry Medical College, Nashville, TN (Chibuzo Aguwa); University of Missouri-Kansas City School of Medicine (Dr. Luu); The Institute for Family Health, New York, NY (Dr. Glausser); Community Healthcare Network, New York, NY (Dr. Napolitano)
| | - Margaret Glausser
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY (Drs. Owji, Han, Gulati, B. Ungar, and J. Ungar and Daniel Yassky); Meharry Medical College, Nashville, TN (Chibuzo Aguwa); University of Missouri-Kansas City School of Medicine (Dr. Luu); The Institute for Family Health, New York, NY (Dr. Glausser); Community Healthcare Network, New York, NY (Dr. Napolitano)
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY (Drs. Owji, Han, Gulati, B. Ungar, and J. Ungar and Daniel Yassky); Meharry Medical College, Nashville, TN (Chibuzo Aguwa); University of Missouri-Kansas City School of Medicine (Dr. Luu); The Institute for Family Health, New York, NY (Dr. Glausser); Community Healthcare Network, New York, NY (Dr. Napolitano)
| | - Benjamin Ungar
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY (Drs. Owji, Han, Gulati, B. Ungar, and J. Ungar and Daniel Yassky); Meharry Medical College, Nashville, TN (Chibuzo Aguwa); University of Missouri-Kansas City School of Medicine (Dr. Luu); The Institute for Family Health, New York, NY (Dr. Glausser); Community Healthcare Network, New York, NY (Dr. Napolitano)
| | - Daniel Napolitano
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY (Drs. Owji, Han, Gulati, B. Ungar, and J. Ungar and Daniel Yassky); Meharry Medical College, Nashville, TN (Chibuzo Aguwa); University of Missouri-Kansas City School of Medicine (Dr. Luu); The Institute for Family Health, New York, NY (Dr. Glausser); Community Healthcare Network, New York, NY (Dr. Napolitano)
| | - Jonathan Ungar
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY (Drs. Owji, Han, Gulati, B. Ungar, and J. Ungar and Daniel Yassky); Meharry Medical College, Nashville, TN (Chibuzo Aguwa); University of Missouri-Kansas City School of Medicine (Dr. Luu); The Institute for Family Health, New York, NY (Dr. Glausser); Community Healthcare Network, New York, NY (Dr. Napolitano)
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24
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Young JN, Ross O'Hagan, Poplausky D, Levoska MA, Gulati N, Ungar B, Ungar J. The utility of ChatGPT in generating patient-facing and clinical responses for melanoma. J Am Acad Dermatol 2023; 89:602-604. [PMID: 37207953 DOI: 10.1016/j.jaad.2023.05.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 04/26/2023] [Accepted: 05/03/2023] [Indexed: 05/21/2023]
Affiliation(s)
- Jade N Young
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Ross O'Hagan
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Dina Poplausky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Melissa A Levoska
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Benjamin Ungar
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jonathan Ungar
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.
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25
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Young JN, Krishnamurthy N, Chang A, Poplausky D, Gulati N, Ungar J. Outcomes and Follow-Up Data From Two Skin Cancer Screening Events. Cureus 2023; 15:e43938. [PMID: 37746437 PMCID: PMC10513346 DOI: 10.7759/cureus.43938] [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] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
This study investigated the outcomes and follow-up behaviors of participants from two free skin cancer screening events in the United States. This survey, with 296 participants and a 31% response rate, gathered information on participant demographics, personal history of skin cancer, knowledge of skin screening practices, and follow-up behaviors. There was a high follow-up rate of 92.3% among individuals recommended for further dermatological consultation, but a low (22%) concordance rate between the preliminary diagnoses from the screening and patient-recalled diagnoses. Additionally, about one-sixth of participants identified limited access to care as a motivation for participating in the screening. The study emphasizes the need to improve awareness about the limitations of free screenings, enhance participant education, and ensure equitable access to skin cancer screening. Future research should focus on factors influencing follow-up behaviors and the development of targeted interventions to increase awareness and access to skin cancer screening.
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Affiliation(s)
- Jade N Young
- Dermatology, Icahn School of Medicine at Mount Sinai, New York, USA
| | | | - Annie Chang
- Dermatology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Dina Poplausky
- Dermatology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Nicholas Gulati
- Dermatology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Jonathan Ungar
- Dermatology, Icahn School of Medicine at Mount Sinai, New York, USA
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26
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Han J, Owji S, Agarwal A, Kamat S, Luu Y, Mubasher A, Niedt G, Ray C, Cho HJ, Gulati N, Lamb A. Bortezomib-Induced Reticular Eruption in Patient with Multiple Myeloma. Dermatopathology (Basel) 2023; 10:226-230. [PMID: 37489455 PMCID: PMC10366922 DOI: 10.3390/dermatopathology10030031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/06/2023] [Accepted: 07/17/2023] [Indexed: 07/26/2023] Open
Abstract
Bortezomib is the first proteasome inhibitor to treat a variety of malignancies and is currently part of the standard of care regimen for the initial treatment of patients with newly diagnosed multiple myeloma. While bortezomib is generally well tolerated, it has been associated with various side effects, which have limited its use in some patients. Here, we describe a unique case with histological confirmation of a reticular eruption that appeared at the site of a subcutaneous administration of bortezomib in a 62-year-old male who was newly diagnosed with IgG kappa multiple myeloma. A skin biopsy was performed, which revealed superficial perivascular dermatitis predominantly composed of lymphocytes with rare eosinophils. The patient was successfully treated with betamethasone dipropionate 0.05% cream. When consulted, dermatologists should advise the oncology team of multiple myeloma patients treated with bortezomib to maintain a high threshold before discontinuing the drug when a patient experiences an atypical, reticular rash following subcutaneous administration. Additionally, potent topical corticosteroids, such as betamethasone dipropionate 0.05% cream, should be considered in managing the cutaneous reticular eruptions related to bortezomib administration, in order to maintain an optimal treatment regimen for patients with multiple myeloma.
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Affiliation(s)
- Joseph Han
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Shayan Owji
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Aneesh Agarwal
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Samir Kamat
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Yen Luu
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA
| | - Adnan Mubasher
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - George Niedt
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Chloe Ray
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Hearn Jay Cho
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Angela Lamb
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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27
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Pagan AD, Jung S, Caldas S, Ungar J, Gulati N, Ungar B. Cross-Sectional Study of Psoriasis, Atopic Dermatitis, Rosacea, and Alopecia Areata Suggests Association With Cardiovascular Diseases. J Drugs Dermatol 2023; 22:576-581. [PMID: 37276159 DOI: 10.36849/jdd.7424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND A growing body of evidence suggests that several inflammatory skin diseases (ISDs) are associated with systemic inflammation and cardiovascular disease (CVDs). METHODS We used the TriNetX analytics platform to conduct a retrospective, cross-sectional, single-center study in the Mount Sinai Health System network. Cases (all patients ≥18 years of age with a diagnosis of 1 of the 4 ISDs studied) were compared with matched controls (no history of any of these ISDs) to evaluate odds ratios for being diagnosed with CVD. RESULTS We identified a total of 70,090 patients with ISDs, including 35,160 patients with atopic dermatitis, 19,490 with psoriasis, 12,470 with rosacea, and 2,970 with alopecia areata, and 70,090 propensity score-matched controls without any of these ISDs. Patients with atopic dermatitis and psoriasis had significantly increased odds of all CVD diagnoses analyzed compared to controls (P<0.001 for all comparisons). Patients with rosacea had significantly increased odds of being diagnosed with all diseases of the circulatory system (P<0.001), hypertensive diseases (P<0.001), cerebrovascular diseases (P=0.037), and arterial disease (P<0.001) compared to controls. Patients with alopecia areata had increased odds for all diseases of the circulatory system (P<0.001), hypertensive diseases (P<0.001), and arterial disease (P<0.001). The prevalence of patients with elevated C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels was significantly greater in all ISD groups compared to controls. CONCLUSION This study identified significant associations between ISDs and several CVD diagnoses. Furthermore, CRP and ESR were elevated in all ISD groups compared to controls. Pagan AD, Jung S, Caldas S, et al. Cross-sectional study of psoriasis, atopic dermatitis, rosacea, and alopecia areata suggests association with cardiovascular diseases. J Drugs Dermatol. 2023;22(6):576-581. doi:10.36849/JDD.7424.
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28
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Poplausky D, Young JN, Tai H, Rivera-Oyola R, Gulati N, Brown RM. Dermatologic Manifestations of Neurofibromatosis Type 1 and Emerging Treatments. Cancers (Basel) 2023; 15:2770. [PMID: 37345107 DOI: 10.3390/cancers15102770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 04/21/2023] [Accepted: 04/26/2023] [Indexed: 06/23/2023] Open
Abstract
Neurofibromatosis type 1 (NF1) is an autosomal dominant tumor predisposition syndrome that increases one's risk for both benign and malignant tumors. NF1 affects every organ in the body, but the most distinctive symptoms that are often the most bothersome to patients are the cutaneous manifestations, which can be unsightly, cause pain or pruritus, and have limited therapeutic options. In an effort to increase awareness of lesser-known dermatologic associations and to promote multidisciplinary care, we conducted a narrative review to shed light on dermatologic associations of NF1 as well as emerging treatment options. Topics covered include cutaneous neurofibromas, plexiform neurofibromas, diffuse neurofibromas, distinct nodular lesions, malignant peripheral nerve sheath tumors, glomus tumors, juvenile xanthogranulomas, skin cancer, and cutaneous T-cell lymphoma.
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Affiliation(s)
- Dina Poplausky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Jade N Young
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Hansen Tai
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Ryan Rivera-Oyola
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Rebecca M Brown
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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Agarwal A, Patel S, Gulati N. Characterizing Dermatologic Health Needs Among Ukrainian Forced Migrants. J Eur Acad Dermatol Venereol 2023. [PMID: 37060271 DOI: 10.1111/jdv.19114] [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: 02/12/2023] [Accepted: 04/07/2023] [Indexed: 04/16/2023]
Affiliation(s)
- Aneesh Agarwal
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Han J, Correa da Rosa J, Agarwal A, Owji S, Yassky D, Luu Y, Shah A, Estrada Y, Ungar J, Sarin KY, Krueger JG, Gulati N. Modulation of Inflammatory Proteins in Serum May Reflect Cutaneous Immune Responses in Cancer Immunotherapy. JID Innov 2023; 3:100179. [PMID: 36876222 PMCID: PMC9982329 DOI: 10.1016/j.xjidi.2022.100179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 11/28/2022] [Accepted: 12/05/2022] [Indexed: 01/30/2023] Open
Abstract
Diphencyprone (DPCP), a topical contact sensitizer, has shown efficacy in treating cutaneous melanoma metastases, including at times beyond the directly treated sites, but biomarkers indicative of treatment response have not been characterized. Thus, we performed a proteomic analysis of the skin and serum of five patients with cutaneous melanoma metastases treated with DPCP on days 0, 63, and 112 of the treatment course. In the serum, we found a significant upregulation (P < 0.05) in 13 of 96 assessed immuno-oncology proteins after DPCP treatment. Upregulated proteins included those of the T helper 1 axis (CXCL9, CXCL10), immune checkpoint proteins (PD-1), and various proteins with roles in promoting tumor immunity such as CD80 and TNFRSF4/9. Given the positive clinical response to topical treatment noted in the five patients studied, these proteins may represent prognostic biomarkers in the serum for evaluating the efficacy of DPCP treatment of cutaneous melanoma metastases. Because DPCP does not lead to nonspecific immune-related adverse events seen with immune checkpoint inhibitors, our study provides evidence for potential tumor-specific systemic immune activation and systemic antitumor effectors elicited by topical DPCP.
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Affiliation(s)
- Joseph Han
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Joel Correa da Rosa
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Aneesh Agarwal
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Shayan Owji
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Daniel Yassky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Yen Luu
- School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Aatman Shah
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Yeriel Estrada
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jonathan Ungar
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Kavita Y Sarin
- Department of Dermatology, Stanford University School of Medicine, Stanford, California, USA
| | - James G Krueger
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, New York, USA
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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31
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Han J, Baek P, Correa Da Rosa J, Young JN, Poplausky D, Tai H, Owji S, Ungar B, Gulati N, Ungar J. The pursuit of equity in skin cancer prevention: a survey-based investigation of total body skin exam awareness and utilization across Fitzpatrick Skin Type. Clin Exp Dermatol 2023; 48:540-541. [PMID: 36702794 DOI: 10.1093/ced/llad009] [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: 12/14/2022] [Accepted: 01/26/2023] [Indexed: 01/28/2023]
Abstract
Disparities in early detection of skin cancer are reflected in the disproportionate melanoma-associated mortality amongst people of color. To better characterize the drivers of this disparity, we sought to investigate differences in skin cancer surveillance by total body skin exam (TBSE) stratified by Fitzpatrick Skin Type (FPST) through patient surveys during focused dermatology clinic visits at a tertiary academic institution.
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Affiliation(s)
- Joseph Han
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York NY
| | - Peter Baek
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York NY
| | - Joel Correa Da Rosa
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York NY
| | - Jade N Young
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York NY
| | - Dina Poplausky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York NY
| | - Hansen Tai
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York NY
| | - Shayan Owji
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York NY
| | - Benjamin Ungar
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York NY
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York NY
| | - Jonathan Ungar
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York NY
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Han J, Baek P, Poplausky D, Agarwal A, Young JN, Mubasher A, Niedt G, Patel V, Gulati N. A case of lichenoid drug eruption associated with relugolix. JAAD Case Rep 2023; 33:33-35. [PMID: 36843662 PMCID: PMC9946818 DOI: 10.1016/j.jdcr.2023.01.003] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- Joseph Han
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Peter Baek
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Dina Poplausky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Aneesh Agarwal
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jade N. Young
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Adnan Mubasher
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York,Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - George Niedt
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York,Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Vaibhav Patel
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York,Correspondence to: Nicholas Gulati, MD, PhD, Department of Dermatology, 5 East 98th St, Fifth Floor, New York, NY 10029.
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Han J, Tai H, Poplausky D, Young J, Revankar R, Baek P, Walsh S, Gulati N. Management of lentiginous melanoma with imiquimod assessed by reflectance confocal microscopy. Skin Health and Disease 2023; 3:e212. [PMID: 37013121 PMCID: PMC10066750 DOI: 10.1002/ski2.212] [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] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Joseph Han
- Department of Dermatology Icahn School of Medicine at Mount Sinai New York New York USA
| | - Hansen Tai
- Department of Dermatology Icahn School of Medicine at Mount Sinai New York New York USA
| | - Dina Poplausky
- Department of Dermatology Icahn School of Medicine at Mount Sinai New York New York USA
| | - Jade Young
- Department of Dermatology Icahn School of Medicine at Mount Sinai New York New York USA
| | - Rishab Revankar
- Levy Library Icahn School of Medicine at Mount Sinai New York New York USA
| | - Peter Baek
- Department of Dermatology Icahn School of Medicine at Mount Sinai New York New York USA
| | - Samantha Walsh
- Levy Library Icahn School of Medicine at Mount Sinai New York New York USA
| | - Nicholas Gulati
- Department of Dermatology Icahn School of Medicine at Mount Sinai New York New York USA
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Luu Y, Han J, Owji S, Kamat S, Luu C, Ungar J, Gulati N. Accelerated Healing from Severe Radiation Dermatitis Using Noncontact, Low-frequency Ultrasound-assisted Saline Wash Therapy. Adv Skin Wound Care 2023; 36:41-43. [PMID: 36537774 DOI: 10.1097/01.asw.0000897440.98255.e5] [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] [Indexed: 05/24/2023]
Abstract
ABSTRACT Radiotherapy (RT) is a modality for cancer management that frequently causes critical injury to tissues adjacent to the targeted cancer site. Acute radiation dermatitis (RD) is one of the most common adverse effects of RT and may lead to secondary infection, disfigurement, and discontinuation of therapy. The authors report the efficacy of a multidisciplinary collaboration between radiation oncology, dermatology, and wound care teams in the management of severe, acute RD. This case report describes the use of noncontact, low-frequency ultrasound (NCLFU)-assisted saline wash therapy leading to accelerated healing of severe RD in an older man treated with RT for scalp squamous cell carcinoma. Although NCLFU-assisted saline wash therapy provides gentle debridement of wound surfaces and has demonstrated efficacy in the management of chronic wounds, the potential role for NCLFU therapy in RD management has not yet been explored.
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Affiliation(s)
- Yen Luu
- Yen Luu, BA, is Medical Student Research Fellow, University of Missouri, Kansas City. At Icahn School of Medicine at Mount Sinai, Department of Dermatology, New York, New York, Joseph Han, BS, Shayan Owji, BS, and Samir Kamat, BA, are Medical Student Research Fellows. Chuc Luu is Undergraduate Student Research Fellow, University of California, Los Angeles. Also at Icahn School of Medicine at Mount Sinai, Department of Dermatology, Jonathan Ungar, MD, is Instructor and Nicholas Gulati, MD, PhD, is Assistant Professor
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Han J, Stratman S, Young JN, Poplausky D, Owji S, Luu Y, Estrada Y, Correa da Rosa J, Krueger JG, Gulati N. Unique protein signatures evolve during the course of a delayed-type hypersensitivity reaction in human skin. J Dermatol 2022. [PMID: 36578124 DOI: 10.1111/1346-8138.16688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/18/2022] [Accepted: 12/06/2022] [Indexed: 12/30/2022]
Abstract
Diphencyprone (DPCP) is a hapten that causes a delayed-type hypersensitivity reaction when applied topically. It has clinical uses in the treatment of various conditions such as melanoma metastases, warts, and alopecia areata, but the mechanisms are currently not well understood in humans. To further characterize the immunologic effects of DPCP, the authors performed a proteomic analysis of normal skin of eight healthy volunteers following a single application of DPCP and compared them with placebo-treated skin from the same volunteers. A total of 96 proteins were examined using the Olink immuno-oncology panel at 3 days (peak response), 14 days (partially resolved response), and 120 days (completely resolved response). Our analysis revealed significant upregulation of markers of immune cell activation (interleukin [IL] 8), vascular and tissue remodeling (matrix metallopeptidase 12 [MMP12], nitric oxide synthase 3 [NOS3]), antineoplastic markers (granzyme B [GZMB]), and the Th1 axis (interferon gamma [IFNG], chemokine (C-X-C motif) ligand [CXCL] 9, CXCL10, CXCL11) at days 3 and 14 compared with placebo (p < 0.05). In addition, several negative regulators of immune function such as programmed cell death 1 (PD1), programmed cell death ligand 1 (PDL1) (p < 0.001), and lymphocyte activation gene 3 (LAG3) (p < 0.05) were significantly upregulated at days 3 and 14. This induction of negative regulators may explain the seemingly paradoxical therapeutic benefits of DPCP in autoimmune conditions such as alopecia areata. The current analysis also indicated IL-4 upregulation only at day 3, followed by IL-12 upregulation only at day 14, suggesting a transient Th2 response followed by Th1 polarization. Overall, these data suggest a complex and evolving immunological delayed-type hypersensitivity response to a single application of DPCP over time. Future proteomic studies of samples from patients with melanoma metastases, warts, and alopecia areata treated long term with DPCP are needed to further evaluate its pharmacologic mechanisms.
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Affiliation(s)
- Joseph Han
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Scott Stratman
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jade N Young
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Dina Poplausky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Shayan Owji
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Yen Luu
- School of Medicine, University of Missouri, Kansas City, Missouri, USA
| | - Yeriel Estrada
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Joel Correa da Rosa
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - James G Krueger
- Laboratory for Investigative Dermatology, Rockefeller University, New York, New York, USA
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Han J, Agarwal A, Young JN, Owji S, Luu Y, Poplausky D, Yassky D, Estrada Y, Ungar J, Krueger JG, Gulati N. Proteomic profiling of a patient with cutaneous melanoma metastasis regression following topical contact sensitizer diphencyprone and immune checkpoint inhibitor treatment. Sci Rep 2022; 12:22364. [PMID: 36572780 PMCID: PMC9792448 DOI: 10.1038/s41598-022-27020-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022] Open
Abstract
Immune checkpoint inhibitors (ICIs) such as pembrolizumab have revolutionized the treatment of advanced melanoma, but many patients do not respond to ICIs alone, and thus there is need for additional treatment options. Topical immunomodulators such as diphencyprone (DPCP) also have clinical use in advanced melanoma, particularly in the treatment of cutaneous metastases. In a previous report, we characterized the enhanced clinical response to dual agent immunotherapy with pembrolizumab and DPCP in a patient with cutaneous melanoma metastases. To improve mechanistic understanding of this response, we analyzed proteomic data using the Olink immuno-oncology panel of 96 biomarkers from tissue and serum samples of this patient throughout his treatment course. Particular attention was paid to programmed death-1 (PD-1), programmed death-ligand 1 (PD-L1), and lymphocyte-activation gene 3 (LAG-3) given they are all targeted by ICIs in clinical practice. These proteins were upregulated during the period of DPCP monotherapy, then downregulated during pembrolizumab monotherapy, and then robustly upregulated again during dual therapy. Although not exclusively, the induction of checkpoint inhibitor proteins in the presence of DPCP suggests potential synergy between this agent and ICIs in the treatment of cutaneous melanoma metastases. Large-scale investigation is warranted to further evaluate this potential novel combination therapeutic approach.
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Affiliation(s)
- Joseph Han
- grid.59734.3c0000 0001 0670 2351Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, New York, NY 10029 USA
| | - Aneesh Agarwal
- grid.59734.3c0000 0001 0670 2351Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, New York, NY 10029 USA
| | - Jade N. Young
- grid.59734.3c0000 0001 0670 2351Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, New York, NY 10029 USA
| | - Shayan Owji
- grid.59734.3c0000 0001 0670 2351Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, New York, NY 10029 USA
| | - Yen Luu
- grid.266756.60000 0001 2179 926XSchool of Medicine, University of Missouri-Kansas City, Kansas City, MO USA
| | - Dina Poplausky
- grid.59734.3c0000 0001 0670 2351Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, New York, NY 10029 USA
| | - Daniel Yassky
- grid.59734.3c0000 0001 0670 2351Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, New York, NY 10029 USA
| | - Yeriel Estrada
- grid.59734.3c0000 0001 0670 2351Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, New York, NY 10029 USA
| | - Jonathan Ungar
- grid.59734.3c0000 0001 0670 2351Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, New York, NY 10029 USA
| | - James G. Krueger
- grid.134907.80000 0001 2166 1519Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY USA
| | - Nicholas Gulati
- grid.59734.3c0000 0001 0670 2351Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, New York, NY 10029 USA
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Owji S, Ungar B, Dubin DP, Poplausky D, Young JN, Ghalili S, Han J, Srinivasan D, Packer S, Pavel AB, Correa da Rosa J, Guttman-Yassky E, Gulati N. No association between dupilumab use and short-term cancer development in atopic dermatitis patients. J Allergy Clin Immunol Pract 2022; 11:1548-1551. [PMID: 36581076 DOI: 10.1016/j.jaip.2022.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 12/03/2022] [Accepted: 12/12/2022] [Indexed: 12/28/2022]
Affiliation(s)
- Shayan Owji
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Benjamin Ungar
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Danielle P Dubin
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Dina Poplausky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jade N Young
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Sabrina Ghalili
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Joseph Han
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - Sarah Packer
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ana B Pavel
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Joel Correa da Rosa
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Emma Guttman-Yassky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY.
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Han J, Correa da Rosa J, Owji S, Yassky D, Luu Y, Estrada Y, Ungar J, Ji A, Krueger JG, Gulati N. Skin proteomic analysis of immune activation associated with regression of melanoma metastases induced by diphencyprone. JAAD Int 2022; 9:65-68. [PMID: 36147215 PMCID: PMC9486131 DOI: 10.1016/j.jdin.2022.08.006] [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: 11/29/2022] Open
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Owji S, Dubin DP, Yassky D, Han J, Tan K, Jagannath S, Parekh S, Gulati N. Dupilumab in Multiple Myeloma: A Case Series. Clin Lymphoma Myeloma Leuk 2022; 22:928-932. [PMID: 36243663 DOI: 10.1016/j.clml.2022.09.002] [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] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 01/26/2023]
Affiliation(s)
- Shayan Owji
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th St, 5th Floor, New York, NY 10029
| | - Danielle P Dubin
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th St, 5th Floor, New York, NY 10029
| | - Daniel Yassky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th St, 5th Floor, New York, NY 10029
| | - Joseph Han
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th St, 5th Floor, New York, NY 10029
| | - Kathryn Tan
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th St, 5th Floor, New York, NY 10029
| | - Sundar Jagannath
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 1190 One Gustave L. Levy Place, New York, NY, United States
| | - Samir Parekh
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 1190 One Gustave L. Levy Place, New York, NY, United States
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th St, 5th Floor, New York, NY 10029.
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Agarwal A, Han J, Luu Y, Gulati N. Medicare Opt-Out Trends Among Dermatologists May Reflect Systemic Health Policy: Cross-sectional Analysis. JMIR Dermatol 2022; 5:e42345. [PMID: 37632903 PMCID: PMC10334940 DOI: 10.2196/42345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/11/2022] [Accepted: 10/16/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Provider opt-out of accepting Medicare insurance is a nationally tracked metric by the Centers for Medicare & Medicaid Services (CMS) for all physicians, including dermatologists. Although this usually only consists of a small number of providers, the magnitude of opting out has varied historically, often tracing changes in systemic health care policy. OBJECTIVE In this paper, we explored dermatologist opt-out data since 2001, as reported by the CMS, to characterize trends and provide evidence that shifts in provider opt-out may represent a potential indicator of the state of health policy and possible needs for reform as it pertains to Medicare. METHODS The publicly available Opt Out Affidavits data set, available from the CMS, was evaluated for providers in all dermatologic specialties from January 1, 2001, to May 27, 2022. RESULTS There were a total of 196 dermatology opt-outs in the overall period, with the largest spike being 33 providers in 2016, followed by generally consistent decreases through 2021. In the most recent 12 months of data, the number of new monthly opt-outs from January 2022 to May 2022 was significantly higher than that of the trailing 7 months of 2021 (P=.03). CONCLUSIONS Despite decreasing numbers of dermatologist opt-outs in the late-2010s, 2022 was marked by a significant increase in opt-outs. The reduced acceptance of Medicare by dermatologists may present risks to care access, so it is important to frequently assess physician opt-out data and changes over time.
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Affiliation(s)
- Aneesh Agarwal
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Joseph Han
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Yen Luu
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Owji S, He H, Han J, Baek P, Yassky D, Gulati N, Ungar B, Ungar J. Use of dynamic optical coherence tomography in a corticosteroid vasoconstrictor assay: a pilot study. Int J Dermatol 2022. [PMID: 36318649 DOI: 10.1111/ijd.16473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/07/2022] [Accepted: 10/18/2022] [Indexed: 05/24/2023]
Affiliation(s)
- Shayan Owji
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Helen He
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Joseph Han
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Peter Baek
- School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia, USA
| | - Daniel Yassky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Benjamin Ungar
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jonathan Ungar
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Serrallach BL, Kralik SF, Tran BH, Huisman TAGM, Patel RP, Allen CE, McClain KL, Gulati N, Dillard-Ilboudo CQ, Hicks MJ, Mohila CA, Desai NK. Neuroimaging in Pediatric Patients with Juvenile Xanthogranuloma of the CNS. AJNR Am J Neuroradiol 2022; 43:1667-1673. [PMID: 36265894 PMCID: PMC9731252 DOI: 10.3174/ajnr.a7683] [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: 05/31/2022] [Accepted: 08/08/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND PURPOSE Juvenile xanthogranuloma is a rare clonal, myeloid, neoplastic disorder. Typically, juvenile xanthogranuloma is a self-limited disorder of infancy, often presenting as a solitary red-brown or yellow skin papule/nodule. A small subset of patients present with extracutaneous, systemic juvenile xanthogranuloma, which may include the CNS. The goal of this retrospective study was to evaluate and categorize the neuroimaging findings in a representative cohort of pediatric patients with CNS juvenile xanthogranuloma. MATERIALS AND METHODS The brain and/or spine MR imaging data of 14 pediatric patients with pathology-proven juvenile xanthogranuloma were categorized and evaluated for the location; the signal intensity of xanthogranulomas on T1WI, T2WI, DWI, and a matching ADC map for the pattern and degree of contrast enhancement; and the presence of perilesional edema, cysts, or necrosis. RESULTS Fourteen pediatric patients (8 girls, 6 boys; mean age, 84 months) were included in the study. Patients presented with a wide variety of different symptoms, including headache, seizure, ataxia, strabismus, hearing loss, facial paresis, and diabetes insipidus. Juvenile xanthogranuloma lesions were identified in a number of different sites, including supra- and infratentorial as well as intracranial and spinal leptomeningeal. Five patients were categorized into the neuroradiologic pattern unifocal CNS juvenile xanthogranuloma; 8, into multifocal CNS juvenile xanthogranuloma; and 1, into multifocal CNS juvenile xanthogranuloma with intracranial and spinal leptomeningeal disease. In most cases, xanthogranulomas were small-to-medium intra-axial masses with isointense signal on T1WI (compared with cortical GM), iso- or hyperintense signal on T2WI, had restricted diffusion and perilesional edema. Almost all xanthogranulomas showed avid contrast enhancement. However, we also identified less common patterns with large lesions, nonenhancing lesions, or leptomeningeal disease. Four cases had an additional CT available. On CT, all xanthogranulomas were homogeneously hyperdense (solid component) without evident calcifications. CONCLUSIONS CNS juvenile xanthogranuloma may demonstrate heterogeneous neuroimaging appearances potentially mimicking other diseases, such as primary brain neoplasms, metastatic disease, lymphoma and leukemia, other histiocytic disorders, infections, or granulomatous diseases.
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Affiliation(s)
- B L Serrallach
- From the Edward B. Singleton Department of Radiology (B.L.S., S.F.K., B.H.T., T.A.G.M.H., R.P.P., N.K.D.)
| | - S F Kralik
- From the Edward B. Singleton Department of Radiology (B.L.S., S.F.K., B.H.T., T.A.G.M.H., R.P.P., N.K.D.)
| | - B H Tran
- From the Edward B. Singleton Department of Radiology (B.L.S., S.F.K., B.H.T., T.A.G.M.H., R.P.P., N.K.D.)
| | - T A G M Huisman
- From the Edward B. Singleton Department of Radiology (B.L.S., S.F.K., B.H.T., T.A.G.M.H., R.P.P., N.K.D.)
| | - R P Patel
- From the Edward B. Singleton Department of Radiology (B.L.S., S.F.K., B.H.T., T.A.G.M.H., R.P.P., N.K.D.)
| | - C E Allen
- Department of Pediatrics (C.E.A., K.L.M., N.G., C.Q.D.-I.), Section of Hematology-Oncology
| | - K L McClain
- Department of Pediatrics (C.E.A., K.L.M., N.G., C.Q.D.-I.), Section of Hematology-Oncology
| | - N Gulati
- Department of Pediatrics (C.E.A., K.L.M., N.G., C.Q.D.-I.), Section of Hematology-Oncology
| | - C Q Dillard-Ilboudo
- Department of Pediatrics (C.E.A., K.L.M., N.G., C.Q.D.-I.), Section of Hematology-Oncology
| | - M J Hicks
- Department of Pathology and Immunology (M.J.H., C.A.M.), Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
| | - C A Mohila
- Department of Pathology and Immunology (M.J.H., C.A.M.), Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
| | - N K Desai
- From the Edward B. Singleton Department of Radiology (B.L.S., S.F.K., B.H.T., T.A.G.M.H., R.P.P., N.K.D.)
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Gulati N, Eckstein O, Agrusa J, Kamdar K, Rouce R, Curry C, Fisher K, Forbes L, Grim A, Peckham-Gregory E, McClain K, Allen C, El-Mallawany N. THE CHALLENGE OF PROSPECTIVE DISTINCTION BETWEEN NON-NEOPLASTIC VERUS NEOPLASTIC EBV-ASSOCIATED HLH. Leuk Res 2022. [DOI: 10.1016/s0145-2126(22)00202-8] [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: 11/07/2022]
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44
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Kim H, Joo E, Bae J, Park J, Bang Y, Park C, Gulati N, Park W. 096 Deconvolution of adult T-cell leukemia/lymphoma with single-cell RNA-seq using frozen archived skin tissue reveals new subset of cancer-associated fibroblast. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.031] [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: 11/24/2022]
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45
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Han J, Da Rosa JC, Owji S, Estrada Y, Ungar J, Krueger J, Gulati N. 282 Modulation of inflammatory proteins in blood may reflect cutaneous immune responses in topical cancer immunotherapy. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.290] [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: 11/25/2022]
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46
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Lim Y, Kang S, Kim H, Mun J, Roh M, Gulati N, Yang H, Moon J, Won C, Park C. 631 Determining intra-tumoral heterogeneity and immune escape mechanisms in melanoma using spatial transcriptomics. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.642] [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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47
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Lim Y, Kang SJ, Cho BK, Kim HJ, Mun JH, Roh MR, Gulati N, Yang HJ, Moon JH, Won CH, Park CG. Intra-tumoral heterogeneity and immune escape of melanoma arising from congenital melanocytic nevus revealed by spatial gene expression profiling. J Eur Acad Dermatol Venereol 2022; 36:e1044-e1047. [PMID: 35857376 DOI: 10.1111/jdv.18443] [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] [Indexed: 11/27/2022]
Affiliation(s)
- Youngkyoung Lim
- Department of Dermatology, Seoul National University Hospital, Seoul, Korea
| | - Seong-Jun Kang
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Beom Keun Cho
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - Hyun Je Kim
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Korea.,Genome Medicine Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Je-Ho Mun
- Department of Dermatology, Seoul National University Hospital, Seoul, Korea
| | - Mi Ryung Roh
- Department of Dermatology, Gangnam Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York
| | - Hee Joo Yang
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Hwan Moon
- Samsung Genome Institute, Samsung Medical Center, Seoul, Korea
| | - Chong Hyun Won
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chung-Gyu Park
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Korea
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48
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Han J, von Csiky-Sessoms S, Owji S, Yao CJ, Ungar J, Gulati N, Marmur E. Distinct Approaches to Perioperative Management of Anticoagulation and Antiplatelet Therapy among Providers Performing Cutaneous Surgery. J Drugs Dermatol 2022; 21:766-772. [PMID: 35816060 DOI: 10.36849/jdd.6726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND Despite increasing cross-collaboration between providers who perform cutaneous surgery, a disparity still exists in the current practices regarding perioperative management. This could lead to treatment delays, patient confusion, and increased morbidity, such as clotting, infection, and discomfort of patients. OBJECTIVE To characterize the management practices of different providers in regards to perioperative anticoagulation and antiplatelet therapy for cutaneous surgery. METHODS AND MATERIALS This study used an electronic survey to assess current perioperative management practices of dermatologic surgeons and plastic and reconstructive surgeons. RESULTS 177 physicians (115 dermatologic surgeons and 62 plastic and reconstructive surgeons) responded to the survey. For all therapeutic agents, dermatologic surgeons were significantly more likely than their plastic and reconstructive surgery colleagues to continue all anticoagulant and antiplatelet agents perioperatively for cutaneous surgery (vitamin K antagonists, antiplatelets, LMWH, direct Xa inhibitors, direct thrombin inhibitors, NSAIDS: P<0.001; fish oil, vitamin E: P<0.01). CONCLUSION Our data highlight the significant practice gaps that exist between dermatologic surgeons and plastic and reconstructive surgeons. Reducing this disparity will facilitate improved continuity of care, especially when patients are referred from dermatologic surgeons to plastic and reconstructive surgeons for more complex repairs, and potentially reduce morbidity and mortality associated with medication discontinuation. J Drugs Dermatol. 2022;21(7):766-772. doi:10.36849/JDD.6726.
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Han J, Russo G, Stratman S, Psomadakis CE, Rigo R, Owji S, Luu Y, Mubasher A, Gonzalez BR, Ungar J, Harp J, Magro C, Ungar B, Lamb A, Gulati N. Toxic Epidermal Necrolysis-like Linear IgA Bullous Dermatosis after Third Moderna COVID-19 Vaccine in the Setting of Oral Terbinafine. JAAD Case Rep 2022; 24:101-104. [PMID: 35571457 PMCID: PMC9077902 DOI: 10.1016/j.jdcr.2022.04.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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50
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Joo EH, Bae JH, Park J, Bang YJ, Han J, Gulati N, Kim JI, Park CG, Park WY, Kim HJ. Deconvolution of Adult T-Cell Leukemia/Lymphoma With Single-Cell RNA-Seq Using Frozen Archived Skin Tissue Reveals New Subset of Cancer-Associated Fibroblast. Front Immunol 2022; 13:856363. [PMID: 35464471 PMCID: PMC9021607 DOI: 10.3389/fimmu.2022.856363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 03/08/2022] [Indexed: 11/13/2022] Open
Abstract
Adult T-cell Leukemia/Lymphoma (ATLL) is a rare aggressive T-cell malignancy caused by human T-cell leukemia virus type 1 (HTLV-1) infection. However, little is known about the underlying activated molecular pathways at the single cell level. Moreover, the intercellular communications between the tumor microenvironment (TME) and tumor cells in this malignancy are currently unknown. Difficulties in harvesting fresh tissue in a clinical setting have hampered our deeper understanding of this malignancy. Herein, we examined ATLL using archived fresh frozen tissue after biopsy using single-cell RNA sequencing (scRNA-seq) with T-cell receptor (TCR) clonal analysis. Highly clonal tumor cells showed multiple activating pathways, suggesting dynamic evolution of the malignancy. By dissecting diverse cell types comprising the TME, we identified a novel subset of cancer-associated fibroblast, which showed enriched epidermal growth factor receptor (EGFR)-related transcripts including early growth response 1 and 2 (EGR1 and EGR2). Cancer associated fibroblasts (CAFs) of ATLL play an important role for CD4 T-cell proliferation via FGF7-FGF1 and PDGFA-PDGFRA/B signaling, and CAFs, particularly EGR-enriched, are also associated with CD8 and NKT expansion by EGFR. These findings suggest a potential targeted therapeutic pathway to better treat this neoplasm.
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Affiliation(s)
- Eun-Hye Joo
- Samsung Genomic Institute, Samsung Medical Center, Seoul, South Korea.,Samsung Advanced Institute of Health Science and Technology, Sungkyunkwan University, Seoul, South Korea
| | - Jai Hee Bae
- Department of Dermatology, Samsung Medical Center, Seoul, South Korea
| | - Jihye Park
- Department of Dermatology, Samsung Medical Center, Seoul, South Korea
| | - Yoon Ji Bang
- Department of Biomedical Science, Seoul National University Graduate School, Seoul, South Korea
| | - Joseph Han
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Jong-Il Kim
- Genome Medicine Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Chung-Gyu Park
- Department of Biomedical Science, Seoul National University Graduate School, Seoul, South Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Woong-Yang Park
- Samsung Genomic Institute, Samsung Medical Center, Seoul, South Korea.,Samsung Advanced Institute of Health Science and Technology, Sungkyunkwan University, Seoul, South Korea
| | - Hyun Je Kim
- Genome Medicine Institute, Seoul National University College of Medicine, Seoul, South Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
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