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Zaino ML, Pixley JN, Subramanian VM, Sirdeshmukh D, Feldman SR, Pichardo RO. Monitoring adherence to vulvar lichen sclerosus treatment - a prospective study. J DERMATOL TREAT 2024; 35:2285725. [PMID: 38240095 DOI: 10.1080/09546634.2023.2285725] [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: 08/31/2023] [Accepted: 11/15/2023] [Indexed: 01/23/2024]
Abstract
Background: Vulvar lichen sclerosus treatment consists of topical corticosteroids followed by maintenance therapy. Self-reported adherence to topical corticosteroids in vulvar lichen sclerosus is approximately 66-70.4% and adherence to chronic topical medications is poor.Objective: To measure treatment adherence for vulvar lichen sclerosus.Methods: Adults with vulvar lichen sclerosus who were receiving or who were candidates to receive treatment with topical clobetasol propionate 0.05% ointment twice daily received medication tubes equipped with adherence monitors capturing the time and amount of dose dispensed. After 2 months, monitors were returned, and patients were surveyed regarding their adherence.Results: Ten patients participated for a median (range) of 8.5 (7-11) weeks. Eight (80%) and 7 (70%) caps captured medication timing and dosing events, respectively. Median (interquartile range) adherence was 65% (42-77) and median (interquartile range) medication dispensed per use was 0.15 (0.14 - 0.5) grams. Of the 8 patients using active adherence monitors, 2 did not clinically improve; adherence rates and mean quantity dispensed for these two patients were 31% and 0.13 grams, and 9% and 0.74 grams, respectively.Conclusion: Poor adherence to both twice daily application and prescribed medication quantity occurred frequently. Factors related to self-reported non-adherence included perceived greater efficacy, inconvenience, and time-constraints. Patient adherence to recommended treatment and clinical outcomes are areas for improvement in patients with vulvar lichen sclerosus.
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Affiliation(s)
- Mallory L Zaino
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Jessica N Pixley
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | | | | | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Rita O Pichardo
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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2
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Baroudi B, Bashyam AM, Feldman SR, Pichardo RO. Dapsone to Treat Moderate-to-Severe Hidradenitis Suppurativa: A Retrospective Case-Series. J Drugs Dermatol 2023; 22:e12-e16. [PMID: 37943259 DOI: 10.36849/jdd.4936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
BACKGROUND Management of hidradenitis suppurativa (HS) is challenging since no single treatment provides consistently effective results, leaving patients with frequent relapses. Dapsone combines anti-microbial and anti-inflammatory properties that address aspects of HS pathogenesis. Few studies have evaluated the efficacy of oral dapsone on HS, especially in severe disease. OBJECTIVE This study aims to evaluate the clinical outcomes of patients with moderate-to-severe HS treated with dapsone. METHODS This retrospective chart review evaluated HS patients treated with oral dapsone over the past 10 years at one center. Treatment outcomes were classified based on Hurley staging, physician exam, and symptom progression. Adverse effects and concomitant treatment with dapsone were reviewed. RESULTS Nineteen (19) patients with moderate-to-severe (Hurley Stage II-III) HS treated with oral dapsone were identified. Within 1-3 months, on dosages of dapsone varying from 25-100 mg/day, 3 patients (15.8%) had a clinically significant improvement in symptoms, 10 patients (52.6%) had a slight improvement, and 6 patients (31.6%) had no change in disease state; no patients deteriorated. The majority who improved were also on other medications, most commonly adalimumab. 4 patients experienced adverse effects, with nausea being most common; otherwise, dapsone was well-tolerated. CONCLUSIONS Dapsone may have some efficacy for moderate-to-severe HS and seems well-tolerated. J Drugs Dermatol. 2023;22(11):e12-e16 doi:10.36849/JDD.4936e.
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Parks EA, Zaino ML, Pixley JN, Subramanian VM, Sirdeshmukh D, Feldman SR, Pichardo RO. Patients with vulvar lichen sclerosus prioritize education on disease etiology, triggers and treatment. J DERMATOL TREAT 2023; 34:2262632. [PMID: 37905436 DOI: 10.1080/09546634.2023.2262632] [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: 09/19/2023] [Accepted: 09/19/2023] [Indexed: 11/02/2023]
Affiliation(s)
- Emily A Parks
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Mallory L Zaino
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Jessica N Pixley
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | | | | | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
- Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Rita O Pichardo
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
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4
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Pixley JN, Kontzias C, Feldman SR, Pichardo RO. Coping Strategies Are Associated With Social Anxiety in Hidradenitis Suppurativa. J Cutan Med Surg 2023; 27:526-528. [PMID: 37489891 DOI: 10.1177/12034754231188324] [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] [Indexed: 07/26/2023]
Affiliation(s)
- Jessica N Pixley
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Christina Kontzias
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Steven R Feldman
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Rita O Pichardo
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Williams J, Lacy A, Ranpariya VK, Pichardo RO. Treatment Patterns for Hydroxychloroquine, Methotrexate, and Mycophenolate Mofetil in Lichen Planopilaris: A Retrospective Chart Review. J Cutan Med Surg 2023; 27:403-405. [PMID: 37559372 DOI: 10.1177/12034754231188323] [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] [Indexed: 08/11/2023]
Affiliation(s)
- Josiah Williams
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Alexa Lacy
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Varun K Ranpariya
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Rita O Pichardo
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
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6
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Singh R, Kelly KA, Senthilnathan A, Feldman SR, Pichardo RO. Stigmatization, a social perception which may have a debilitating impact on hidradenitis suppurativa patients: an observational study. Arch Dermatol Res 2023; 315:1049-1052. [PMID: 36315267 PMCID: PMC9628443 DOI: 10.1007/s00403-022-02412-5] [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: 04/19/2022] [Accepted: 10/13/2022] [Indexed: 11/26/2022]
Abstract
Hidradenitis suppurativa (HS) is a debilitating disease and patients are prone to feelings of stigmatization. In our cohort, we assessed how feelings of stigmatization may relate to patient quality of life (QOL), depression, and social anxiety. Participants completed the Dermatology Life Quality Index (DLQI) to assess QOL, Patient Health Questionnaire 9 (PHQ-9) to assess depression, the Brief Fear of Negative Evaluation (BFNE) to assess social anxiety, and an adapted version of the Feelings of Stigmatization (FoS) to assess stigmatization. The FoS also correlated with DLQI (R = 0.68), PHQ-9 (R = 0.42), and BFNE (R = 0.52). Participants with greater FoS were also more likely to have worse QOL (18.1), higher levels of depression (11.1), and higher social anxiety (30.1), as compared to those with less FoS (6.7, P < 0.001; 4.9, P < 0.001; 23.2, P < 0.001, respectively). HS is a chronic disease with no definitive treatment. Effective screening protocols, coupled with pharmacological and nonpharmacological interventions, may help patients with HS's psychosocial burden.
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Affiliation(s)
- Rohan Singh
- Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, 1 Medical Center Boulevard, Winston-Salem, NC, 27157-1071, USA.
| | - Katherine A Kelly
- Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, 1 Medical Center Boulevard, Winston-Salem, NC, 27157-1071, USA
| | - Aditi Senthilnathan
- Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, 1 Medical Center Boulevard, Winston-Salem, NC, 27157-1071, USA
| | - Steven R Feldman
- Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, 1 Medical Center Boulevard, Winston-Salem, NC, 27157-1071, USA
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Rita O Pichardo
- Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, 1 Medical Center Boulevard, Winston-Salem, NC, 27157-1071, USA
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7
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Singh R, Kelly KA, Paris PH, Senthilnathan A, Feldman SR, Pichardo RO. Social support is associated with reduced impact of hidradenitis suppurativa on quality of life: an observational study. Dermatol Online J 2023; 29. [PMID: 37040919 DOI: 10.5070/d329160222] [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: 02/16/2023] [Accepted: 02/16/2023] [Indexed: 02/27/2023] Open
Affiliation(s)
- Rohan Singh
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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8
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Kontzias CL, Pixley JN, Feldman SR, Pichardo RO. Marriage Is Associated With Improved Social Support and Quality-of-Life in Hidradenitis Suppurativa. J Cutan Med Surg 2023; 27:178-179. [PMID: 36820492 DOI: 10.1177/12034754231157647] [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: 02/24/2023]
Affiliation(s)
- Christina L Kontzias
- 12279 Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Jessica N Pixley
- 12279 Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Steven R Feldman
- 12279 Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA.,12279 Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA.,12279 Department of Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Rita O Pichardo
- 12279 Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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9
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Kelly KA, Edminister J, Pichardo RO, Feldman SR. A case series of tumor necrosis factor inhibitor-induced psoriasis in patients with hidradenitis suppurativa. Dermatol Online J 2022; 28. [PMID: 36809103 DOI: 10.5070/d328659732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022] Open
Affiliation(s)
- Katherine A Kelly
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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10
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Singh R, Chan WH, Senthilnathan A, Kolli SS, Feldman SR, Pichardo RO. 35154 The role of common environmental triggers in hidradenitis suppurativa patients. J Am Acad Dermatol 2022. [DOI: 10.1016/j.jaad.2022.06.877] [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: 10/14/2022]
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Hrin ML, Williams J, Bowers NL, Pichardo RO, Jorizzo JL, Feldman SR, Huang WW. Evaluation of Methotrexate in the Management of Sweet Syndrome. J Cutan Med Surg 2022; 26:532-533. [PMID: 35822306 DOI: 10.1177/12034754221111992] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Matthew L Hrin
- 12279 Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Josiah Williams
- 12279 Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Nathan L Bowers
- 12279 Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Rita O Pichardo
- 12279 Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Joseph L Jorizzo
- 12279 Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Steven R Feldman
- 12279 Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA.,12279 Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA.,12279 Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Department of Dermatology, University of Southern Denmark, Odense, Denmark
| | - William W Huang
- 12279 Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
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12
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Singh R, Mohney L, Senthilnathan A, Feldman- SR, Pichardo RO. Educational attainment is inversely correlated with hidradenitis suppurativa severity. Dermatol Online J 2022; 28. [DOI: 10.5070/d328357842] [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] [Received: 06/21/2022] [Accepted: 06/21/2022] [Indexed: 11/08/2022] Open
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13
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Singh R, Balogh EA, Senthilnathan A, Richardson IM, Kaplan SG, Feldman SR, Pichardo RO. Fear of Negative Evaluation in Hidradenitis Suppurativa Patients is Correlated with Worse Quality of Life: An Observational Study. Br J Dermatol 2022; 187:788-790. [DOI: 10.1111/bjd.21694] [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: 02/23/2022] [Revised: 05/17/2022] [Accepted: 05/31/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Rohan Singh
- Center for Dermatology Research, Department of Dermatology Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Esther A. Balogh
- Center for Dermatology Research, Department of Dermatology Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Aditi Senthilnathan
- Center for Dermatology Research, Department of Dermatology Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Irma M. Richardson
- Center for Dermatology Research, Department of Dermatology Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Sebastian G. Kaplan
- Department of Psychiatry and Behavioral Medicine Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Steven R. Feldman
- Center for Dermatology Research, Department of Dermatology Wake Forest School of Medicine Winston‐Salem North Carolina USA
- Department of Pathology Wake Forest School of Medicine Winston‐Salem North Carolina USA
- Department of Public Health Sciences Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Rita O. Pichardo
- Center for Dermatology Research, Department of Dermatology Wake Forest School of Medicine Winston‐Salem North Carolina USA
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14
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Perche PO, Singh R, Senthilnathan A, Feldman SR, Pichardo RO. Hidradenitis Suppurativa’s Impact on Social Activities: An Observational Study. Cureus 2022; 14:e25292. [PMID: 35637919 PMCID: PMC9128839 DOI: 10.7759/cureus.25292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2022] [Indexed: 11/05/2022] Open
Abstract
Hidradenitis suppurativa (HS) can severely impact patients’ quality of life. However, its specific impact on participation in everyday social activities is not well characterized. We recruited a cohort of patients with HS to complete a survey assessing the degree of interference HS has on participation in social activities. Patients also completed the Brief Fear of Negative Evaluation (BFNE) to assess levels of social anxiety. The majority of patients in our cohort, regardless of Hurley Stage, reported interference with social activities, and patients with more painful nodules and greater body region involvement reported greater interference with social activities. BFNE scores were high in our cohort, and patients with higher BFNE scores reported greater interference in all social activities assessed. Both the physical and psychological effects of HS may interfere with patients’ participation in social activities, and efforts to treat both aspects may improve quality of life.
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Singh R, Mohammed A, Senthilnathan A, Feldman SR, Pichardo RO. Hidradenitis suppurativa may impact clothing patterns even in patients with mild disease and symptoms: an observational study. Br J Dermatol 2022; 187:250-251. [PMID: 35084746 DOI: 10.1111/bjd.21035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/18/2022] [Accepted: 01/22/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Rohan Singh
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, United States
| | - Arooj Mohammed
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, United States
| | - Aditi Senthilnathan
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, United States
| | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, United States.,Department of Pathology, Wake Forest School of Medicine, Winston-Salem, United States.,Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, United States
| | - Rita O Pichardo
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, United States
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16
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Lane J, Emmerich V, Senthilnathan A, Kolli SS, Cardwell LA, Richardson IM, Feldman SR, Pichardo RO. A Comparison of Alternative Medicine Users and Non-Users in Patients With Hidradenitis Suppurativa. J Drugs Dermatol 2021; 20:1072-1074. [PMID: 34636524 DOI: 10.36849/jdd.6046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Hidradenitis suppurativa patients often seek non-prescription therapies. OBJECTIVE To determine the prevalence of alternative medicine use and characterize the differences between patients who report using alternative medications versus those who do not. METHODS We surveyed 67 patients with hidradenitis suppurativa regarding demographics, alternative medicine use, disease severity, and quality of life. RESULTS 25 (37.2%) of the HS subjects reported alternative medicine use. Alternative medicine users tended to be younger (36.7 vs 40.8 years), have a shorter time since diagnosis (12.6 vs14.6 years), and reported worse quality of life (14.1 vs 11.0) than non-users. These differences were not statistically significant. LIMITATIONS Limitations included a small sample size. CONCLUSION Alternative medicine use among patients with hidradenitis is common regardless of disease severity; even mild disease may drive patients to seek alternative treatment. J Drugs Dermatol. 2021;20(10):1072-1074. doi:10.36849/JDD.6046.
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Pona A, Alberto Cardenas-de la Garza J, Broderick A, Bowers N, Pichardo RO. 18178 Clinical characteristics and treatment of lupus erythematosus tumidus. J Am Acad Dermatol 2020. [DOI: 10.1016/j.jaad.2020.06.457] [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: 10/22/2022]
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18
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Cline A, Cuellar-Barboza A, Jorizzo JL, Pichardo RO. Methotrexate for the Treatment of Recalcitrant Erosive Lichen Planus of the Vulva. JAMA Dermatol 2020; 156:215-217. [PMID: 31895434 DOI: 10.1001/jamadermatol.2019.4062] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Abigail Cline
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Adrian Cuellar-Barboza
- Department of Dermatology, Hospital Universitario Dr José E. Gonzalez, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Joseph L Jorizzo
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Rita O Pichardo
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
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Cuellar-Barboza A, Bashyam AM, Ghamrawi RI, Aickara D, Feldman SR, Pichardo RO. Methotrexate for the treatment of recalcitrant genital and extragenital lichen sclerosus: A retrospective series. Dermatol Ther 2020; 33:e13473. [PMID: 32347617 DOI: 10.1111/dth.13473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/20/2020] [Accepted: 04/23/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Adrian Cuellar-Barboza
- Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Arjun M Bashyam
- Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Rima I Ghamrawi
- Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Divya Aickara
- Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Steven R Feldman
- Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.,Department of Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.,Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.,Department of Dermatology, University of Southern Denmark, Odense, Denmark
| | - Rita O Pichardo
- Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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Abstract
Background: Systemic methotrexate (MTX) is a useful treatment for many dermatologic conditions, however, the risk of adverse events prevents its use in patients with minimal or localized disease. Topical application of MTX may be an option to avoid the systemic adverse effects of oral MTX.Objective: To assess what is known about the efficacy and safety of topical methotrexate.Methods: A search on Pubmed was conducted. There were no limits on publication date.Results: A total of 963 articles were discovered. Using our exclusion criteria, 916 articles were excluded; 47 articles were used for full text assessment. Topical MTX has been used primarily in psoriasis but also in mycosis fungoides, lymphomatoid papulosis, and oral precancerous lesions. Optimal delivery system and formulation for adequate penetration is still under investigation.Conclusion: The quality of evidence for the utility of topical methotrexate in psoriasis is good, however, for other dermatologic diseases, the quality is poor. Topical MTX with improved delivery methods may be a viable tool against certain localized dermatologic conditions for patients who do not tolerate oral MTX. Further double-blinded randomized controled studies are needed to substantiate the utility of topical methotrexate.
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Affiliation(s)
- Divya Aickara
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Arjun M Bashyam
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Rita O Pichardo
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Department of Dermatology, University of Southern Denmark, Odense, Denmark
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Kolli SS, Habet KA, Herrera A, Haidari W, Pichardo RO. Is there an association between hidradenitis suppurativa and fibromyalgia? Cutis 2020; 105:E32-E33. [PMID: 32352448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Sree S Kolli
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Kyle A Habet
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Alejandra Herrera
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Wasim Haidari
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Rita O Pichardo
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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Senthilnathan A, Kolli SS, Cardwell LA, Richardson IM, Feldman SR, Pichardo RO. Emotional Well-Being Is Impaired in Hidradenitis Suppurativa Patients. Skin Appendage Disord 2019; 5:366-369. [PMID: 31799265 DOI: 10.1159/000502296] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 07/23/2019] [Indexed: 11/19/2022] Open
Abstract
Background Hidradenitis suppurativa (HS) is a chronic inflammatory condition. Objective To measure emotional well-being in HS patients and compare to other populations, assess if there is an effect of disease severity on emotional well-being, and determine if emotional well-being is correlated with quality of life and depression. Methods A total of 153 HS subjects were recruited, and 66 Positive and Negative Affect Schedule (PANAS) surveys assessing emotional well-being were completed. Norms for comparison populations (disease-free undergraduates and adults) were used. A validated self-assessment tool was used to determine disease severity. Subjects completed the Patient Health Questionnaire-9 (PHQ-9) and Dermatology Life Quality Index (DLQI) to examine depression and quality of life, respectively. Results HS subjects had lower positive affect than undergraduates and higher negative affect than adults. There were no differences in PANAS scores by Hurley stage (p > 0.05). PANAS scores for HS subjects correlated with worse quality of life (r = 0.66, p < 0.00001) and depression (r = 0.74, p < 0.00001). Conclusion HS patients have poor emotional well-being. PANAS scores correlated with worse quality of life and depression. Providing appropriate resources and treatments may be beneficial for HS patients.
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Affiliation(s)
- Aditi Senthilnathan
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Sree S Kolli
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Leah A Cardwell
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Irma M Richardson
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.,Department of Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.,Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Rita O Pichardo
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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Cline A, Pichardo RO. Successful treatment of hidradenitis suppurativa in the setting of Crohn disease with combination adalimumab and ustekinumab. Dermatol Online J 2019; 25:13030/qt0hw2w4nr. [PMID: 31738849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 10/10/2019] [Indexed: 06/10/2023] Open
Abstract
Herein we report the combination of adalimumab and ustekinumab to successfully treat a 39-year-old woman who presented for evaluation of hidradenitis suppurativa in the setting of Crohn disease of both the small and large intestine. The patient reported previous control of her hidradenitis when she was using adalimumab for her Crohn disease. She had recently been started on ustekinumab for Crohn disease and had flaring of her hidradenitis. The patient re-started on adalimumab weekly and ustekinumab every 8 weeks. After one month, the patient reported clear improvement in her hidradenitis and Crohn disease with the combined therapy.
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Affiliation(s)
- Abigail Cline
- Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, Winston-Salem, NC.
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Kolli SS, Senthilnathan A, Cardwell LA, Richardson IM, Feldman SR, Pichardo RO. Hidradenitis suppurativa has an enormous impact on patients' lives. J Am Acad Dermatol 2019; 82:236-238. [PMID: 31302191 DOI: 10.1016/j.jaad.2019.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 05/11/2019] [Accepted: 07/02/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Sree S Kolli
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
| | - Aditi Senthilnathan
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Leah A Cardwell
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Irma M Richardson
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina; Department of Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina; Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Rita O Pichardo
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
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Senthilnathan A, Kolli SS, Cardwell LA, Richardson IM, Feldman SR, Pichardo RO. Even mild hidradenitis suppurativa impairs quality of life. Br J Dermatol 2019; 181:838-839. [PMID: 30916383 DOI: 10.1111/bjd.17928] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- A Senthilnathan
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, U.S.A
| | - S S Kolli
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, U.S.A
| | - L A Cardwell
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, U.S.A
| | - I M Richardson
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, U.S.A
| | - S R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, U.S.A.,Department of Pathology , Wake Forest School of Medicine, Winston-Salem, NC, U.S.A.,Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, U.S.A
| | - R O Pichardo
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, U.S.A
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Senthilnathan A, Kolli SS, Cardwell LA, Richardson I, Feldman SR, Pichardo RO. Validation of a Hidradenitis Suppurativa Self-Assessment Tool. J Cutan Med Surg 2019; 23:388-390. [DOI: 10.1177/1203475419839965] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Background: Hidradenitis suppurativa (HS) is a debilitating dermatologic condition presenting with recurrent abscesses. While there are multiple scales to determine HS severity, none are designed for self-administration. A validated severity self-assessment tool may facilitate survey research and improve communication by allowing patients to objectively report their HS severity between clinic visits. Objectives: The purpose of this study was to assess a self-administered HS measure. Methods: An HS self-assessment tool (HSSA) with 10 photographs of different Hurley stages was developed. The tool was administered to patients diagnosed with HS who visited the Wake Forest Baptist Health dermatology clinic over a span of 2 months. Physician-administered Hurley stage was recorded to determine criterion validity. To assess test-retest reliability of the measure, patients completed the HSSA again at least 30 minutes after the first completion. Results: Twenty-four patients completed the measure, and 20 of these patients completed it twice. Agreement between physician-determined Hurley stage and self-determined Hurley stage was 66.7% with a weighted kappa of 0.57 (95% confidence interval [CI]: 0.30-0.84). The weighted kappa for agreement between patients’ initial and second completion of the HSSA was 0.81 (95% CI: 0.64-0.99). Conclusions: The self-administered measure provides moderate agreement with physician-determined Hurley stage and good test-retest reliability.
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Affiliation(s)
- Aditi Senthilnathan
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Sree S. Kolli
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Leah A. Cardwell
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Irma Richardson
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Steven R. Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Rita O. Pichardo
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Cline A, Pichardo RO. Successful treatment of hidradenitis suppurativa in the setting of Crohn disease with combination adalimumab and ustekinumab. Dermatol Online J 2019. [DOI: 10.5070/d3259045519] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Affiliation(s)
- Aditi Senthilnathan
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Steven R. Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Rita O. Pichardo
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
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Affiliation(s)
- Stephanie Cohen
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Lindsay C. Strowd
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Rita O. Pichardo
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Affiliation(s)
- M R Namazi
- Dermatology Department, Wake-Forest University Baptist Medical Center, North Carolina, USA.
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Abstract
BACKGROUND Smooth muscle tumors of the skin with cytologic pleomorphism and mitotic activity have traditionally been characterized as leiomyosarcomas, despite having a benign clinical course. In the uterus, there is a smooth muscle tumor known as symplastic leiomyoma, which typically has cytologic pleomorphism without significant mitotic activity. OBJECTIVE The objective was to illustrate by case report the unusual histologic variant of the cutaneous pilar leiomyoma analogous to the symplastic leiomyoma of the uterus. METHODS A 54-year-old woman presented with a clinical picture of cutaneous leiomyoma but had histologic features of nuclear hyperchromasia and pleomorphism, but rare mitoses. RESULTS Management of this patient included excision of the involved area. CONCLUSION Symplastic leiomyoma is an atypical uterine leiomyoma with cytologic atypia. We present the case of a patient with cutaneous leiomyomas that histologically demonstrated similar features to a uterine symplastic leiomyoma. We believe that this represents a distinct histologic variant of the cutaneous pilar leiomyoma analogous to the symplastic leiomyoma of the uterus.
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Abstract
Dermatomyositis (DM) is an inflammatory myopathy of skeletal muscle with characteristic cutaneous findings. It is a rare disorder with a bimodal age distribution that affects almost twice as many women as men. One category of DM, normal-enzyme DM, is characterized by cutaneous changes only at baseline, normal serum muscle enzyme levels and myositis demonstrated by electromyography (EMG) and/or muscle biopsy specimens. Typically, patients with normal-enzyme DM progress to severe muscle involvement and require systemic corticosteroid therapy. The patient we report has normal-enzyme DM confirmed by serial serum enzymes, EMG, and skin and muscle biopsies but is unique in that she never experienced progression of muscle weakness although muscle involvement was documented histologically and by EMG. Follow-up examination after 1 year revealed near-complete resolution of cutaneous involvement after topical therapy and no evidence of muscle weakness.
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Affiliation(s)
- J R Jordan
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1071, USA
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Abstract
BACKGROUND Granular parakeratosis is suspected to result from an error in epidermal differentiation, leading to variably pruritic, hyperpigmented-to-erythematous patches and plaques. Characteristic histopathologic features include a thickened stratum corneum, compact parakeratosis with retention of keratohyalin granules, vascular proliferation, and ectasia. The pathogenesis of this entity is uncertain. METHODS We present a case of axillary granular parakeratosis and review the literature. RESULTS The lesion showed a thickened stratum corneum with compact parakeratosis, slight epidermal hyperplasia, and a sparse perivascular lymphohistiocytic infiltrate. Keratohyalin granules were diffusely present within the parakeratotic stratum corneum, and the retained granular layer showed focal vacuolization. CONCLUSIONS Granular parakeratosis is a rare form of parakeratosis most often seen in the axilla, although other intertriginous areas may be affected. Unique histopathologic findings allow for a specific diagnosis to be made. Although an irritant contact reaction appears causative, mechanical irritation may also play a role in inducing these skin changes.
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Affiliation(s)
- Christopher A Wallace
- Department of Dermatology, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA
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Pichardo RO, Lu D, Sangueza OP, Kien MC. What is your diagnosis? Granulomatus slack skin syndrome. Am J Dermatopathol 2002; 24:509-10. [PMID: 12481778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Affiliation(s)
- Rita O Pichardo
- Department of Pathology, Wake Forest University, School of Medicine, The Bowman Gray Campus, Winston-Salem, North Carolina 27157-1072, USA
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Pichardo RO, Lu D, Sangueza OP, Selim MA. What is your diagnosis? Lupus profundus. Am J Dermatopathol 2002; 24:507-8. [PMID: 12481774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Affiliation(s)
- Rita O Pichardo
- Department of Pathology, Wake Forest University, School of Medicine, The Bowman Gray Campus, Winston-Salem, North Carolina 27157-1072, USA
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Pichardo RO, Lu D, Sangueza OP. What is your diagnosis? Cutaneous infection with Fusarium. Am J Dermatopathol 2002; 24:512-3. [PMID: 12481776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Affiliation(s)
- Rita O Pichardo
- Department of Pathology, Wake Forest University, School of Medicine, The Bowman Gray Campus, Winston-Salem, North Carolina 27157-1072, USA
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Pichardo RO, Lu D, Sangueza OP, Ball RA. What is your diagnosis? Canalicular adenoma. Am J Dermatopathol 2002; 24:505-6. [PMID: 12481772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Affiliation(s)
- Rita O Pichardo
- Department of Pathology, Wake Forest University, School of Medicine, The Bowman Gray Campus, Winston-Salem, North Carolina 27157-1072, USA
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Pichardo RO, Lu D, Sangueza OP, Prieto VG. What is your diagnosis? Bacterial dermatitis due to Corynebacterium species. Am J Dermatopathol 2002; 24:510-1. [PMID: 12481775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Affiliation(s)
- Rita O Pichardo
- Department of Pathology, Wake Forest University, School of Medicine, The Bowman Gray Campus, Winston-Salem, North Carolina 27157-1072, USA
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Pichardo RO, Lu D, Sangueza OP, Barzilai A. What is your diagnosis? Kaposi's sarcoma, lymphangioma-like variant. Am J Dermatopathol 2002; 24:511-2. [PMID: 12481777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Affiliation(s)
- Rita O Pichardo
- Department of Pathology, Wake Forest University, School of Medicine, The Bowman Gray Campus, Winston-Salem, North Carolina 27157-1072, USA
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Pichardo RO, Lu D, Sangueza OP, Guitart J. What is your diagnosis? Diffuse dermal angiomatosis secondary to anitcardiolipin antibodies. Am J Dermatopathol 2002; 24:502-3. [PMID: 12454604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Affiliation(s)
- Rita O Pichardo
- Department of Pathology, Wake Forest University, School of Medicine, The Bowman Gray Campus, Winston-Salem, North Carolina 27157-1072, USA
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Pichardo RO, Lu D, Sangueza OP, Tucker R. What is your diagnosis? Secondary syphilis. Am J Dermatopathol 2002; 24:503-4. [PMID: 12481770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Affiliation(s)
- Rita O Pichardo
- Department of Pathology, Wake Forest University, School of Medicine, The Bowman Gray Campus, Winston-Salem, North Carolina 27157-1072, USA
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Pichardo RO, Lu D, Sangueza OP, Horenstein M. What is your diagnosis? Desmoplastic melanocytic nevus. Am J Dermatopathol 2002; 24:506-7. [PMID: 12481773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Affiliation(s)
- Rita O Pichardo
- Department of Pathology, Wake Forest University, School of Medicine, The Bowman Gray Campus, Winston-Salem, North Carolina 27157-1072, USA
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Pichardo RO, Lu D, Sangueza OP. What is your diagnosis? Infantile fibrosarcoma. Am J Dermatopathol 2002; 24:504-5. [PMID: 12481771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Affiliation(s)
- Rita O Pichardo
- Department of Pathology, Wake Forest University, School of Medicine, The Bowman Gray Campus, Winston-Salem, North Carolina 27157-1072, USA
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