1
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Martinez-Cabriales S, Coulombe J, Aaron M, Hussain SH, Linggonegoro D, Lara-Corrales I, Barootes H, Brandling-Bennett H, Covelli I, Kirkorian AY, Shah N, Castelo-Soccio L, McKenzie P, Arkin LM, Heinze A, Liy-Wong C, Travis N, Rieder M, Del Pozzo-Magana BR, Schoch JJ, Monir R, Glick SA, Uwakwe L, Skillman S, Hekman DP, Lethebe BC, Ramien ML. Preliminary summary and reclassification of cases from the Pediatric Research of Management in Stevens-Johnson syndrome and Epidermonecrolysis (PROMISE) study: A North American, multisite retrospective cohort. J Am Acad Dermatol 2024; 90:635-637. [PMID: 37926378 DOI: 10.1016/j.jaad.2023.08.112] [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: 10/03/2022] [Revised: 08/18/2023] [Accepted: 08/27/2023] [Indexed: 11/07/2023]
Affiliation(s)
| | | | | | | | | | | | | | | | - Isabela Covelli
- Seattle Children's Hospital/University of Washington, Seattle, Washington
| | | | - Nidhi Shah
- Children's National Hospital, Washington, DC
| | | | - Paige McKenzie
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Lisa M Arkin
- University of Wisconsin-Madison, Madison, Wisconsin
| | - Adam Heinze
- University of Wisconsin-Madison, Madison, Wisconsin
| | - Carmen Liy-Wong
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Nicole Travis
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | | | | | | | | | - Sharon A Glick
- SUNY Downstate Health Sciences University, Brooklyn, New York
| | - Laura Uwakwe
- SUNY Downstate Health Sciences University, Brooklyn, New York
| | - Sarah Skillman
- Indiana University School of Medicine, Indianapolis, Indiana
| | - Dan P Hekman
- Indiana University School of Medicine, Indianapolis, Indiana
| | | | - Michele L Ramien
- Alberta Children's Hospital, Calgary, Alberta, Canada; University of Calgary, Calgary Alberta, Canada.
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2
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Moran S, Derrick KM, McGovern J, Glick SA. Annular Erythema of Infancy. J Pediatr 2024; 266:113857. [PMID: 38008213 DOI: 10.1016/j.jpeds.2023.113857] [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: 10/15/2023] [Revised: 11/18/2023] [Accepted: 11/21/2023] [Indexed: 11/28/2023]
Affiliation(s)
- Shannon Moran
- Department of Dermatology, The State University of New York Downstate School of Medicine, Brooklyn, New York
| | - Kristina M Derrick
- Department of Dermatology, State University of New York Downstate School of Medicine, Brooklyn, New York; Department of Dermatology, Maimonides Medical Center, Brooklyn, New York
| | - John McGovern
- Department of Dermatology, State University of New York Downstate School of Medicine, Brooklyn, New York; Department of Dermatology, Maimonides Medical Center, Brooklyn, New York
| | - Sharon A Glick
- Department of Dermatology, State University of New York Downstate School of Medicine, Brooklyn, New York; Department of Dermatology, Maimonides Medical Center, Brooklyn, New York
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3
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Mazori DR, Kleitsch J, Kabir S, Uwakwe LN, Glick SA. A fatal case of hemophagocytic lymphohistiocytosis due to neonatal lupus erythematosus. Pediatr Dermatol 2024; 41:104-107. [PMID: 37666795 DOI: 10.1111/pde.15408] [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: 02/21/2023] [Accepted: 07/18/2023] [Indexed: 09/06/2023]
Abstract
Neonatal lupus erythematosus (NLE) is an autoimmune disease caused by the passive transfer of autoantibodies from mother to child during pregnancy. A rare complication of NLE is hemophagocytic lymphohistiocytosis (HLH), a potentially life-threatening hyperinflammatory state more commonly associated with other rheumatologic disorders. Herein, we describe a fatal case of NLE-associated HLH.
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Affiliation(s)
- Daniel R Mazori
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York, USA
| | - Julianne Kleitsch
- College of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Soodeh Kabir
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Laura N Uwakwe
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Sharon A Glick
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
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4
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Scollan ME, Levin LE, Lucky AW, Hook KP, Peoples K, Bruckner AL, Feinstein JA, Pope E, McCuaig CC, Powell J, Eichenfield LF, Levy ML, Diaz L, Glick SA, Paller AS, Browning JC, Morel KD. Characterization of wound microbes in epidermolysis bullosa: A focus on Pseudomonas aeruginosa. Pediatr Dermatol 2023; 40:863-865. [PMID: 37364926 PMCID: PMC10543531 DOI: 10.1111/pde.15383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 06/10/2023] [Indexed: 06/28/2023]
Abstract
The most common bacteria isolated from wound cultures in patients recorded in the Epidermolysis Bullosa Clinical Characterization and Outcomes Database (EBCCOD) are Staphylococcus aureus and Pseudomonas aeruginosa. Given the prevalence of P. aeruginosa in this patient population and prior research implicating P. aeruginosa's potential role in carcinogenesis, we sought to further analyze patients with recorded wound cultures positive for Pseudomonas aeruginosa in the EBCCOD. We provide a descriptive analysis of this subset of patients and highlight potential avenues for future longitudinal studies that may have significant implications in our wound care management for patients with epidermolysis bullosa.
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Affiliation(s)
- Margaret E Scollan
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Laura E Levin
- Department of Dermatology, Columbia University Irving Medical Center, New York, New York, USA
| | - Anne W Lucky
- Departments of Pediatrics and Dermatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Kristen P Hook
- Department of Dermatology, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | | | - Anna L Bruckner
- Departments of Dermatology and Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - James A Feinstein
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Elena Pope
- Section of Dermatology, Division of Paediatric Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Catherine C McCuaig
- Departments of Pediatrics and Dermatology, CHU Sainte-Justine, University of Montreal, Montreal, Qubec, Canada
| | - Julie Powell
- Department of Dermatology, CHU Sainte- Justine, University of Montreal, Montreal, Qubec, Canada
| | - Lawrence F Eichenfield
- Departments of Pediatrics and Dermatology, University of California San Diego, San Diego, California, USA
| | - Moise L Levy
- Departments of Pediatrics and Dermatology, Dell Children's Medical Center, Austin, Texas, USA
| | - Lucia Diaz
- Department of Dermatology, Dell Children's Medical Center, Austin, Texas, USA
| | - Sharon A Glick
- Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, New York, USA
| | - Amy S Paller
- Departments of Pediatrics and Dermatology, Northwestern University, Chicago, Illinois, USA
| | - John C Browning
- Department of Dermatology, The Children's Hospital of San Antonio, San Antonio, Texas, USA
| | - Kimberly D Morel
- Departments of Pediatrics and Dermatology, Columbia University Irving Medical Center, New York, New York, USA
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5
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Kleitsch J, Mazori DR, Masson M, Izmirly PM, Saxena A, Buyon JP, Glick SA. Cutaneous Neonatal Lupus in Patients with Skin of Color: A Retrospective Cohort Study from a National Registry. J Am Acad Dermatol 2023:S0190-9622(23)00513-3. [PMID: 36997071 DOI: 10.1016/j.jaad.2023.03.028] [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: 11/30/2022] [Revised: 03/03/2023] [Accepted: 03/19/2023] [Indexed: 03/30/2023]
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6
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Phillips GS, Huang A, Augsburger BD, Kaplan L, Peoples K, Bruckner AL, Khuu P, Tang JY, Lara-Corrales I, Pope E, Wiss K, Levin LE, Morel KD, Hook KP, Paller AS, Eichenfield LF, McCuaig CC, Powell J, Castelo-Soccio L, Levy ML, Price HN, Schachner LA, Browning JC, Jahnke M, Shwayder T, Bayliss S, Lucky AW, Glick SA. A retrospective analysis of diagnostic testing in a large North American cohort of patients with epidermolysis bullosa. J Am Acad Dermatol 2022; 86:1063-1071. [PMID: 34634382 DOI: 10.1016/j.jaad.2021.09.065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 09/03/2020] [Revised: 06/03/2021] [Accepted: 09/09/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Accurate diagnosis of epidermolysis bullosa (EB) has significant implications for prognosis, management, and genetic counseling. OBJECTIVE To describe diagnostic testing patterns and assess diagnostic concordance of transmission electron microscopy (TEM), immunofluorescence mapping (IFM), and genetic analysis for EB. METHODS A retrospective cohort included patients enrolled in the Epidermolysis Bullosa Clinical Characterization and Outcomes Database from January 1, 2004, to July 8, 2019. Tests concluding the same EB type (EB simplex, junctional EB, dominant dystrophic EB, and recessive dystrophic EB) were considered concordant; those concluding different EB types were considered discordant; and those with nonspecific/nondefinitive results were equivocal. RESULTS A total of 970 diagnostic tests were conducted from 1984 to 2018 in 771 patients. Genetic analyses were performed chronologically later than IFM or TEM (P < .001). The likelihood of undergoing genetic analysis was greater for junctional EB and recessive dystrophic EB, and the same for dominant dystrophic EB as compared with EB simplex. TEM results in 163 patients were equivocal (55%), concordant (42%), and discordant (3%). IFM results in 185 patients were equivocal (54%), concordant (42%), and discordant (4%). LIMITATIONS Retrospective design. CONCLUSIONS Diagnostic testing has shifted in favor of genetic analysis. TEM and IFM frequently offer equivocal findings when compared to the specificity afforded by genetic analysis.
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Affiliation(s)
- Gregory Scott Phillips
- Department of Dermatology, State University of New York Downstate Health Sciences University, Brooklyn, New York
| | - Amy Huang
- Department of Dermatology, State University of New York Downstate Health Sciences University, Brooklyn, New York
| | | | - Laura Kaplan
- Department of Dermatology, State University of New York Downstate Health Sciences University, Brooklyn, New York
| | | | - Anna L Bruckner
- Department of Dermatology, University of Colorado School of Medicine, Aurora, Colorado
| | - Phuong Khuu
- Department of Dermatology, Stanford University School of Medicine, Stanford, California
| | - Jean Y Tang
- Department of Dermatology, Stanford University School of Medicine, Stanford, California
| | - Irene Lara-Corrales
- Section of Dermatology, Division of Paediatric Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Elena Pope
- Section of Dermatology, Division of Paediatric Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Karen Wiss
- Departments of Dermatology and Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Laura E Levin
- Department of Dermatology, Columbia Irving Medical Center, New York, New York
| | - Kimberly D Morel
- Department of Dermatology, Columbia Irving Medical Center, New York, New York; Department of Pediatrics, Columbia Irving Medical Center, New York, New York
| | - Kristen P Hook
- Department of Dermatology, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Amy S Paller
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Lawrence F Eichenfield
- Departments of Dermatology and Pediatrics, University of California San Diego, San Diego, California
| | - Catherine C McCuaig
- Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, Quebec, Canada
| | - Julie Powell
- Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, Quebec, Canada
| | - Leslie Castelo-Soccio
- Department of Pediatrics, Section of Dermatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Moise L Levy
- Pediatric/Adolescent Dermatology, Dell Children's Medical Center, University of Texas, Austin, Texas; Departments of Pediatrics and Medicine (Dermatology), Dell Medical School, University of Texas, Austin, Texas
| | - Harper N Price
- Department of Dermatology, Phoenix Children's Hospital, Phoenix, Arizona
| | - Lawrence A Schachner
- Department of Dermatology, University of Miami Miller School of Medicine, Miami, Florida
| | - John C Browning
- Department of Pediatric Dermatology, Children's Hospital San Antonio, San Antonio, Texas
| | - Marla Jahnke
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Tor Shwayder
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Susan Bayliss
- Division of Dermatology, Department of Medicine, Washington University in St. Louis, St. Louis, Missouri
| | - Anne W Lucky
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Sharon A Glick
- Department of Dermatology, State University of New York Downstate Health Sciences University, Brooklyn, New York.
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7
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Kleitsch J, Mazori DR, Derrick KM, Uwakwe LN, Glick SA. Periorbital hypopigmentation and telangiectasias: Clues to diagnosing neonatal lupus in skin of color. Pediatr Dermatol 2021; 38 Suppl 2:135-136. [PMID: 34250633 DOI: 10.1111/pde.14674] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Neonatal lupus erythematosus (NLE) is an autoimmune disease characterized by a periorbital erythematous rash. Although post-inflammatory hypopigmentation and telangiectasias are known possible sequelae, these features may be particularly noticeable in skin of color. Herein, we describe two infants with skin of color in whom periorbital hypopigmentation and telangiectasias were clues to the diagnosis of NLE.
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Affiliation(s)
- Julianne Kleitsch
- SUNY Downstate Health Sciences University College of Medicine, Brooklyn, NY, USA
| | - Daniel R Mazori
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA
| | - Kristina M Derrick
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Laura N Uwakwe
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Sharon A Glick
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
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8
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Affiliation(s)
- Jianni Wu
- Department of Dermatology, State University of New York Downstate Health Sciences University, Brooklyn
| | - Juliana Berk-Krauss
- Department of Dermatology, State University of New York Downstate Health Sciences University, Brooklyn
| | - Sharon A Glick
- Department of Dermatology, State University of New York Downstate Health Sciences University, Brooklyn
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9
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Pithadia DJ, Kerns ML, Golden WC, Balagula Y, Glick SA, Huang A, Natsis NE, Tom WL, Cohen BA. Heterogeneous cutaneous findings associated with intrauterine HSV infection: A case series and literature review. Pediatr Dermatol 2021; 38:831-841. [PMID: 34227161 DOI: 10.1111/pde.14682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND/OBJECTIVE Herpes simplex virus (HSV) infection acquired in utero may present with non-vesicular dermatologic findings in affected newborns, which may pose a diagnostic dilemma. We aimed to describe and assess the range of non-vesiculobullous skin lesions that neonates with intrauterine HSV infection may manifest at birth. METHODS We collected a multicenter case series and conducted a literature review of neonates with intrauterine HSV infection presenting with non-vesiculobullous cutaneous lesions. RESULTS Twenty-two cases were reviewed, including six managed clinically by members of our team and 16 identified in the literature. Four (18%) were associated with twin pregnancies, and thirteen (59%) cases occurred in premature infants. Only four (18%) mothers had a documented history of HSV infection. Twelve (55%) cases resulted in poor outcomes, including long-term neurologic sequelae or death. Cutaneous manifestations included erosions, ulcerations, crusted papules or plaques, calcinosis cutis, excoriations, macules (erythematous, hypopigmented, or hyperpigmented), cutaneous atrophy, contractures, and bruising. About one-third of neonates developed new-onset vesicular lesions within a week of birth; in each of these cases, accurate diagnosis and therapy were delayed until appearance of vesicles. CONCLUSIONS The range of dermatologic findings associated with intrauterine HSV is extremely broad, and the various morphologies present at birth likely reflect different stages of the ongoing evolution of an HSV infection that began in utero. Clinicians should have a low threshold for HSV testing in premature neonates born with atypical cutaneous lesions, since early detection and treatment of HSV may reduce morbidity and mortality from systemic complications.
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Affiliation(s)
- Deeti J Pithadia
- Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
| | - Michelle L Kerns
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - William C Golden
- Division of Neonatology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Sharon A Glick
- Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Amy Huang
- Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Nicola E Natsis
- Department of Dermatology, University of California San Diego School of Medicine, San Diego, CA, USA
| | - Wynnis L Tom
- Department of Dermatology, University of California San Diego School of Medicine, San Diego, CA, USA
| | - Bernard A Cohen
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Division of Neonatology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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10
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Cotton CH, Ahluwalia J, Balkin DM, Frieden IJ, Haggstrom AN, Castelo-Soccio LA, Liy-Wong C, Pope E, Steiner JE, Siegel DH, Fernandez-Faith E, Morel KD, Lauren CT, Garzon MC, Mancini AJ, Chamlin SL, Tollefson MM, Liang MG, Delano S, Glick SA, Hogeling M, Barrio VR. Association of Demographic Factors and Infantile Hemangioma Characteristics With Risk of PHACE Syndrome. JAMA Dermatol 2021; 157:2781293. [PMID: 34132754 PMCID: PMC8209569 DOI: 10.1001/jamadermatol.2021.1901] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 04/21/2021] [Indexed: 11/14/2022]
Abstract
Importance A 2010 prospective study of 108 infants estimated the incidence of PHACE (posterior fossa malformations, hemangioma, arterial anomalies, cardiac defects, eye anomalies) syndrome to be 31% in children with facial infantile hemangiomas (IHs) of at least 22 cm2. There is little evidence regarding the associations among IH characteristics, demographic characteristics, and risk of PHACE syndrome. Objectives To evaluate demographic characteristics and comorbidities in a large cohort of patients at risk for PHACE syndrome and assess the clinical features of large head and neck IH that may be associated with a greater risk of a diagnosis of PHACE syndrome. Design, Setting, and Participants This multicenter, retrospective cohort study assessed all patients with a facial, head, and/or neck IH who were evaluated for PHACE syndrome from August 1, 2009, to December 31, 2014, at 13 pediatric dermatology referral centers across North America. Data analysis was performed from June 15, 2017, to February 29, 2020. Main Outcomes and Measures The main outcome was presence or absence of PHACE syndrome. Data included age at diagnosis, sex, patterns of IH presentation (including size, segment location, and depth), diagnostic procedures and results, and type and number of associated anomalies. Results A total of 238 patients (mean [SD] age, 2.96 [4.71] months; 184 [77.3%] female) were included in the analysis; 106 (44.5%) met the criteria for definite (n = 98) or possible (n = 8) PHACE syndrome. A stepwise linear regression model found that a surface area of 25 cm2 or greater (odds ratio [OR] 2.99; 95% CI, 1.49-6.02) and involvement of 3 or more locations (OR, 17.96; 95% CI, 6.10-52.85) to be statistically significant risk factors for PHACE syndrome. Involvement of the parotid gland (OR, 0.39; 95% CI, 0.18-0.85) and segment S2 (OR, 0.38; 95% CI, 0.16-0.91) was associated with a lower risk. Race and ethnicity may also be associated with PHACE syndrome risk, although more studies are needed. Conclusions and Relevance This cohort study further described factors associated with both a higher and lower risk of PHACE syndrome. The presence of multiple anatomical sites and large surface area were associated with greater risk, whereas S2 or parotid IHs were associated with lower, but still potential, risk. These findings can help in counseling families and decision-making regarding evaluation of infants with large head and neck IHs.
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Affiliation(s)
- Colleen H. Cotton
- Division of Dermatology, University of Arizona, Tucson
- now with Departments of Dermatology and Pediatrics, Medical University of South Carolina, Charleston
| | | | - Daniel M. Balkin
- Department of Plastic & Oral Surgery, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ilona J. Frieden
- Department of Dermatology, School of Medicine, University of California, San Francisco
| | - Anita N. Haggstrom
- Department of Dermatology, Indiana University School of Medicine, Indianapolis
| | | | - Carmen Liy-Wong
- Section of Pediatric Dermatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Elena Pope
- Section of Pediatric Dermatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Jack E. Steiner
- Department of Dermatology, Medical College of Wisconsin, Milwaukee
| | - Dawn H. Siegel
- Department of Dermatology, Medical College of Wisconsin, Milwaukee
| | - Esteban Fernandez-Faith
- Division of Dermatology, Department of Pediatrics, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus
| | - Kimberly D. Morel
- Department of Dermatology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
- Department of Pediatrics, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
| | - Christine T. Lauren
- Department of Dermatology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
- Department of Pediatrics, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
| | - Maria C. Garzon
- Department of Dermatology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
- Department of Pediatrics, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
| | - Anthony J. Mancini
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Sarah L. Chamlin
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Megha M. Tollefson
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
- Department of Pediatrics, Mayo Clinic, Rochester, Minnesota
| | - Marilyn G. Liang
- Department of Dermatology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sophia Delano
- Department of Dermatology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sharon A. Glick
- Departments of Dermatology and Pediatrics, Kings County Medical Center, Brooklyn, New York
| | - Marcia Hogeling
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles
| | - Victoria R. Barrio
- Department of Dermatology, University of California, San Diego, Rady Children's Hospital, San Diego
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11
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Abstract
Multisystem inflammatory syndrome in children (MIS-C) is a syndrome associated with coronavirus disease 2019. Various phenotypes of MIS-C have been described including Kawasaki disease (KD). Although perineal desquamation is a known early sign of KD, to our knowledge, this rash has not yet been described in the KD phenotype of MIS-C. In this article, we report two patients in whom perineal desquamation was an early clue for the KD phenotype of MIS-C.
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Affiliation(s)
- Daniel R Mazori
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Kristina M Derrick
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Urvi Kapoor
- Department of Pediatrics, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Minoti Haribhai
- Department of Pediatrics, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Ramon E Gist
- Division of Critical Care, Department of Pediatrics, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Sharon A Glick
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
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12
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Levin LE, Shayegan LH, Lucky AW, Hook KP, Bruckner AL, Feinstein JA, Whittier S, Lauren CT, Pope E, Lara-Corrales I, Wiss K, McCuaig CC, Powell J, Eichenfield LF, Levy ML, Diaz L, Glick SA, Paller AS, Price HN, Browning JC, Morel KD. Characterization of wound microbes in epidermolysis bullosa: Results from the epidermolysis bullosa clinical characterization and outcomes database. Pediatr Dermatol 2021; 38:119-124. [PMID: 33247481 PMCID: PMC7906915 DOI: 10.1111/pde.14444] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 10/07/2020] [Accepted: 10/12/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND/OBJECTIVES Patients with epidermolysis bullosa (EB) require care of wounds that are colonized or infected with bacteria. A subset of EB patients are at risk for squamous cell carcinoma, and bacterial-host interactions have been considered in this risk. The EB Clinical Characterization and Outcomes Database serves as a repository of information from EB patients at multiple centers in the United States and Canada. Access to this resource enabled broad-scale analysis of wound cultures. METHODS A retrospective analysis of 739 wound cultures from 158 patients from 13 centers between 2001 and 2018. RESULTS Of 152 patients with a positive culture, Staphylococcus aureus (SA) was recovered from 131 patients (86%), Pseudomonas aeruginosa (PA) from 56 (37%), and Streptococcus pyogenes (GAS) from 34 (22%). Sixty-eight percent of patients had cultures positive for methicillin-sensitive SA, and 47%, methicillin-resistant SA (18 patients had cultures that grew both methicillin-susceptible and methicillin-resistant SA at different points in time). Of 15 patients with SA-positive cultures with recorded mupirocin susceptibility testing, 11 had mupirocin-susceptible SA and 6 patients mupirocin-resistant SA (2 patients grew both mupirocin-susceptible and mupirocin-resistant SA). SCC was reported in 23 patients in the entire database, of whom 10 had documented wound cultures positive for SA, PA, and Proteus species in 90%, 50%, and 20% of cases, respectively. CONCLUSIONS SA and PA were the most commonly isolated bacteria from wounds. Methicillin resistance and mupirocin resistance were reported in 47% and 40% of patients tested, respectively, highlighting the importance of ongoing antimicrobial strategies to limit antibiotic resistance.
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Affiliation(s)
- Laura E Levin
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA
| | - Leila H Shayegan
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Anne W Lucky
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Kristen P Hook
- Department of Dermatology, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Anna L Bruckner
- Departments of Dermatology and Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - James A Feinstein
- Departments of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Susan Whittier
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY, USA
| | - Christine T Lauren
- Departments of Pediatrics and Dermatology, Columbia University Irving Medical Center, New York, NY, USA
| | - Elena Pope
- Section of Dermatology, Division of Paediatric Medicine, Hospital for Sick Children, Toronto, ON, Canada
| | - Irene Lara-Corrales
- Section of Dermatology, Division of Paediatric Medicine, Hospital for Sick Children, Toronto, ON, Canada
| | - Karen Wiss
- Division of Dermatology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Catherine C McCuaig
- Departments of Pediatrics and Dermatology, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada
| | - Julie Powell
- Department of Dermatology, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada
| | - Lawrence F Eichenfield
- Departments of Pediatrics and Dermatology, University of California San Diego, San Diego, CA, USA
| | - Moise L Levy
- Departments of Pediatrics and Dermatology, Dell Children's Medical Center, Austin, TX, USA
| | - Lucia Diaz
- Department of Dermatology, Dell Children's Medical Center, Austin, TX, USA
| | - Sharon A Glick
- Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Amy S Paller
- Departments of Pediatrics and Dermatology, Northwestern University, Chicago, IL, USA
| | - Harper N Price
- Department of Dermatology, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - John C Browning
- Department of Dermatology, The Children's Hospital of San Antonio, San Antonio, TX, USA
| | - Kimberly D Morel
- Departments of Pediatrics and Dermatology, Columbia University Irving Medical Center, New York, NY, USA
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13
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Derrick KM, Mazori DR, Heilman ER, Glick SA. Prurigo pigmentosa and new-onset type 1 diabetes in a black female patient testing positive for SARS-CoV-2 IgG. Br J Dermatol 2020; 184:e5. [PMID: 33103238 PMCID: PMC9214012 DOI: 10.1111/bjd.19568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/18/2020] [Accepted: 09/21/2020] [Indexed: 11/27/2022]
Affiliation(s)
- K M Derrick
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.,NYC Health + Hospitals/Kings County, Brooklyn, NY, USA
| | - D R Mazori
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.,NYC Health + Hospitals/Kings County, Brooklyn, NY, USA
| | - E R Heilman
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.,NYC Health + Hospitals/Kings County, Brooklyn, NY, USA
| | - S A Glick
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.,NYC Health + Hospitals/Kings County, Brooklyn, NY, USA
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14
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Abstract
Reactive infectious mucocutaneous eruption (RIME) was recently proposed to replace the term Mycoplasma pneumoniae (MP)-induced rash and mucositis to account for the fact that non-MP pathogens may also cause rash and mucositis. In this report, we describe a unique case of recurrent RIME featuring a total of three episodes. As two of the episodes demonstrated contemporaneous infection with MP and group A streptococcus or influenza B, this case lends further support to use of the term RIME. In addition, although RIME typically involves at least two mucous membranes, this case shows that recurrent episodes may fall into the rare exception in which mucositis is limited to one site.
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Affiliation(s)
- Daniel R Mazori
- Department of Dermatology, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, New York
| | - Sairaman Nagarajan
- Department of Medicine, Division of Allergy and Immunology, SUNY Downstate Health Sciences University, Brooklyn, New York
| | - Sharon A Glick
- Department of Dermatology, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, New York
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15
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Shayegan LH, Levin LE, Galligan ER, Lucky AW, Bruckner AL, Pope E, Lara-Corrales I, Wiss K, McCuaig CC, Garzon MC, Eichenfield LF, Hook KP, Browning JC, Schachner LA, Perman MJ, Castelo-Soccio L, Levy ML, Glick SA, Morel KD. Skin cleansing and topical product use in patients with epidermolysis bullosa: Results from a multicenter database. Pediatr Dermatol 2020; 37:326-332. [PMID: 31944391 DOI: 10.1111/pde.14102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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] [Indexed: 10/25/2022]
Abstract
BACKGROUND/OBJECTIVES Epidermolysis bullosa (EB) comprises a group of inherited skin blistering diseases. There is currently no cure, and management includes skin protection and prevention of infection. To date, there has been no systematic investigation of home skin care practices among EB patients on a multicenter scale. METHODS This cross-sectional, observational study included data collected from patients with EB enrolled in the Epidermolysis Bullosa Characterization and Clinical Outcomes Database (EBCCOD) who provided answers to a patient-directed questionnaire between January 1, 2017, and December 31, 2017. RESULTS Of 202 respondents, 130 (64.4%) had dystrophic EB, 51 (25.2%) had EB simplex, 21 (7.4%) had junctional EB, 3 (1.5%) had Kindler syndrome, and 3 (1.5%) had an unspecified subtype. Seventy-eight patients reported cleansing in plain water only (39%). Of those who used an additive in their cleansing water, 75 (57%) added salt, 71 (54%) added bleach, 36 (27%) added vinegar, and 34 (26%) endorsed the use of an "other" additive (multiple additives possible). Reported concentrations of additives ranged widely from 0.002% sodium hypochlorite and 0.002% acetic acid solutions, which are thought to have negligible effects on microbes, to 0.09% sodium hypochlorite and 0.156% acetic acid, concentrations shown to be cytotoxic. One hundred eighty-eight patients answered questions regarding topical product use (93%). Of those, 131 reported topical antimicrobial use (70%). Mupirocin and bacitracin were the most commonly reported topical antibiotics (59, 58 [31.4%, 30.9%], respectively). CONCLUSIONS These findings highlight the variety of skin care routines and frequent use of topical antimicrobials among EB patients and have potential implications for antibiotic resistance. The reported range of bleach and vinegar additives to cleansing water, including cytotoxic concentrations, emphasizes the need for clear and optimized skin cleansing recommendations.
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Affiliation(s)
- Leila H Shayegan
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Laura E Levin
- Department of Dermatology, Columbia University Irving Medical Center, New York, New York
| | - Eloise R Galligan
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Anne W Lucky
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Anna L Bruckner
- Departments of Dermatology and Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Elena Pope
- Section of Dermatology, Division of Paediatric Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Irene Lara-Corrales
- Section of Dermatology, Division of Paediatric Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Karen Wiss
- Division of Dermatology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
| | | | - Maria C Garzon
- Departments of Dermatology and Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Lawrence F Eichenfield
- Departments of Pediatrics and Dermatology, University of California San Diego, San Diego, California
| | - Kristen P Hook
- Department of Dermatology, University of Minnesota Medical School, Minneapolis, Minnesota
| | - John C Browning
- Department of Pediatric Dermatology, Children's Hospital San Antonio, San Antonio, Texas
| | - Lawrence A Schachner
- Department of Dermatology, University of Miami Miller School of Medicine, Miami, Florida
| | - Marissa J Perman
- Section of Pediatric Dermatology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Leslie Castelo-Soccio
- Section of Pediatric Dermatology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Moise L Levy
- Departments of Pediatrics and Medicine (Dermatology), Dell Medical School, University of Texas, Austin, Texas
- Department of Pediatric Dermatology, Dell Children's Medical Center, Austin, Texas
| | - Sharon A Glick
- Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, New York
| | - Kimberly D Morel
- Departments of Dermatology and Pediatrics, Columbia University Irving Medical Center, New York, New York
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16
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Feinstein JA, Jambal P, Peoples K, Lucky AW, Khuu P, Tang JY, Lara-Corrales I, Pope E, Wiss K, Hook KP, Levin LE, Morel KD, Paller AS, McCuaig CC, Powell J, Eichenfield LF, Price H, Levy ML, Schachner LA, Browning JC, Bayliss S, Jahnke M, Shwayder T, Glick SA, Bruckner AL. Assessment of the Timing of Milestone Clinical Events in Patients With Epidermolysis Bullosa From North America. JAMA Dermatol 2019; 155:196-203. [PMID: 30586139 DOI: 10.1001/jamadermatol.2018.4673] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Importance Children with epidermolysis bullosa (EB) comprise a rare population with high morbidity and mortality. An improved understanding of the clinical trajectory of patients with EB, including age at time of clinical diagnosis and major clinical events, is needed to refine best practices and improve quality of life and clinical outcomes for patients with EB. Objectives To describe demographics, clinical characteristics, milestone diagnostic and clinical events (such as initial esophageal dilation), and outcomes in patients with EB using the Epidermolysis Bullosa Clinical Characterization and Outcomes Database and to determine what characteristics may be associated with overall EB severity and/or disease progression. Design, Setting, and Participants This cohort study included data on patients with EB who were enrolled in the Epidermolysis Bullosa Clinical Characterization and Outcomes Database from January 1, 2011, to June 30, 2017; 17 participating EB centers in the United States and Canada contributed data to this study. Exposures Type of EB, including recessive dystrophic epidermolysis bullosa (RDEB), junctional epidermolysis bullosa (JEB), dominant dystrophic epidermolysis bullosa (DDEB), and epidermolysis bullosa simplex (EBS). Main Outcomes and Measures Demographic information, clinical characteristics (including age at onset of signs of EB and subsequent clinical diagnosis), types of diagnostic testing performed, and milestone clinical events for patients with RDEB. Results Of 644 enrolled patients from 17 sites included in this study, 323 were male (50.2%), with a mean (SD) age of 14.4 (11.7) years; 283 (43.9%) had RDEB, 194 (30.1%) had EBS, 104 (16.2%) had DDEB, and 63 (9.8%) had JEB. Signs of disease were present at birth in 202 patients with RDEB (71.4%), 39 with JEB (61.9%), 60 with DDEB (57.7%), and 74 with EBS (38.1%). For those with signs of disease at birth, a clinical diagnosis was made at the time of birth in 135 patients with RDEB (67.0%), 31 with DDEB (52.6%), 35 with EBS, (47.3%) and 18 with JEB (46.2%). Patients with JEB had the highest rate of any confirmatory testing (51 of 63 [81.0%]), followed by RDEB (218 of 283 [77.0%]), DDEB (71 of 104 [68.3%]), and EBS (100 of 194 [51.5%]). For all types of EB, both electron microscopy and immunofluorescence microscopy were performed at younger ages than genetic analysis. Among 283 patients with RDEB, 157 (55.5%) had esophageal dilation, 104 (36.7%) had gastrostomy tube placement, 62 (21.9%) had hand surgery, 18 (6.4%) developed squamous cell carcinoma, and 19 (6.7%) died. Conclusions and Relevance The findings suggest that diagnostic testing for EB is more common for patients with severe phenotypes. Earlier diagnostic testing may enable improved characterizations of patients so that appropriate counseling and clinical care may be offered, especially pertaining to milestone events for those with RDEB.
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Affiliation(s)
- James A Feinstein
- Department of Pediatrics, University of Colorado School of Medicine, Aurora.,Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado, Aurora.,Children's Hospital Colorado, Aurora
| | - Purevsuren Jambal
- Department of Dermatology, University of Colorado School of Medicine, Aurora
| | | | - Anne W Lucky
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Phuong Khuu
- Department of Dermatology, Stanford University School of Medicine, Stanford, California
| | - Jean Y Tang
- Department of Dermatology, Stanford University School of Medicine, Stanford, California
| | - Irene Lara-Corrales
- Section of Dermatology, Division of Paediatric Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Elena Pope
- Section of Dermatology, Division of Paediatric Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Karen Wiss
- Division of Dermatology, Department of Medicine, University of Massachusetts Medical School, Worcester
| | - Kristen P Hook
- Department of Dermatology, University of Minnesota Medical School, Minneapolis
| | - Laura E Levin
- Department of Dermatology, Columbia Irving Medical Center, New York, New York
| | - Kimberly D Morel
- Department of Dermatology, Columbia Irving Medical Center, New York, New York.,Department of Pediatrics, Columbia Irving Medical Center, New York, New York
| | - Amy S Paller
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois.,Department of Dermatology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | | | - Julie Powell
- CHU Sainte-Justine, University of Montreal, Montreal, Quebec, Canada
| | - Lawrence F Eichenfield
- Department of Dermatology, University of California San Diego, San Diego.,Department of Pediatrics, University of California San Diego, San Diego.,Department of Pediatric and Adolescent Dermatology, Rady Children's Hospital, San Diego, California
| | - Harper Price
- Department of Dermatology, Phoenix Children's Hospital, Phoenix, Arizona
| | - Moise L Levy
- Departments of Internal Medicine, Dell Medical School, University of Texas, Austin.,Departments of Pediatrics, Dell Medical School, University of Texas, Austin.,Department of Pediatric Dermatology, Dell Children's Medical Center, Austin, Texas
| | - Lawrence A Schachner
- Department of Dermatology, University of Miami Miller School of Medicine, Miami, Florida
| | - John C Browning
- Department of Pediatric Dermatology, Children's Hospital San Antonio, San Antonio, Texas
| | - Susan Bayliss
- Division of Dermatology, Department of Medicine, Washington University in St Louis, St Louis, Missouri
| | - Marla Jahnke
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Tor Shwayder
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Sharon A Glick
- Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn
| | - Anna L Bruckner
- Department of Pediatrics, University of Colorado School of Medicine, Aurora.,Children's Hospital Colorado, Aurora.,Department of Dermatology, University of Colorado School of Medicine, Aurora.,Associate Editor
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17
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Mazori DR, Leonard A, Alexander JB, Glick SA. The spectrum of staphylococcal scalded skin syndrome: a case series in children. Clin Exp Dermatol 2019; 45:333-336. [PMID: 31587342 DOI: 10.1111/ced.14116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 09/28/2019] [Accepted: 10/03/2019] [Indexed: 11/28/2022]
Abstract
Staphylococcal scalded skin syndrome (SSSS) is a disease caused by certain toxigenic strains of Staphylococcus aureus. While the classic severe phenotype is widely recognized in children, SSSS in fact exists on a spectrum with mild and moderate variants. Misunderstanding the phenotypic spectrum of SSSS may result in misdiagnosis of an otherwise treatable condition. To increase awareness of the heterogeneity of SSSS, we report four cases that together represent a range of clinical presentations.
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Affiliation(s)
- D R Mazori
- Department of Dermatology, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | - A Leonard
- Department of Dermatology, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | - J B Alexander
- Department of Dermatology, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | - S A Glick
- Department of Dermatology, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
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18
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Carrington AE, Vatanchi M, Glick SA. Overcoming vascular overgrowth in the 19th Century: The story of Grace McDaniels. Int J Womens Dermatol 2019; 5:272-273. [PMID: 31700987 PMCID: PMC6831758 DOI: 10.1016/j.ijwd.2019.04.027] [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] [Received: 02/01/2019] [Revised: 04/15/2019] [Accepted: 04/21/2019] [Indexed: 11/25/2022] Open
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19
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Weiler N, Mayer EF, Kazlouskaya V, Bamgbola OF, Banniettis N, Heilman E, Glick SA. Infective dermatitis associated with HTLV-1 infection in a girl from Trinidad: Case report and review of literature. Pediatr Dermatol 2019; 36:e12-e16. [PMID: 30338553 DOI: 10.1111/pde.13702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Infective dermatitis (ID) associated with Human T-cell leukemia virus type-1 (HTLV-1) is a rare form of severe superinfected eczema seen mostly in the Caribbean islands and Latin America. Although rapid response to antibiotic treatment is observed, patients should be monitored for development of complications associated with this retroviral infection, including T-cell leukemia/lymphoma (ATLL) and HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). Infective dermatitis is rarely seen in the United States and therefore may be under-recognized by physicians unfamiliar with this condition. Herein, we present an additional case report of an ID associated with HTLV-1 in an 11-year-old girl from Trinidad.
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Affiliation(s)
- Nicole Weiler
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Erick F Mayer
- Department of Pediatric Infectious Diseases, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | | | - Oluwatoyin F Bamgbola
- Department of Pediatric Nephrology, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Natalie Banniettis
- Department of Pediatric Infectious Diseases, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Edward Heilman
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Sharon A Glick
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York, USA
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20
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Abstract
A 15-month-old boy presented with 1-4 cm, pink edematous plaques with overlying round erosions and hemorrhagic bullae in the setting of a gastrointestinal illness and was ultimately diagnosed with bullous-type Sweet syndrome. Despite appropriate treatment with oral steroids, the patient's cutaneous lesions healed with secondary anetoderma. This case should prompt practitioners to be aware of bullous-type Sweet syndrome and the possibility of lesions healing with postinflammatory scarring.
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Affiliation(s)
- Jameson Loyal
- University of Vermont College of Medicine, Burlington, Vermont
| | - Devorah R Shagalov
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York
| | - Marjon Vatanchi
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York
| | - Jaimie B Glick
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York
| | - Georgina M Ferzli
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York
| | - Edward Heilman
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York
| | - Sharon A Glick
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York
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21
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Mori S, Adar T, Kazlouskaya V, Alexander JB, Heilman E, Glick SA. Cutaneous Langerhans cell histiocytosis presenting with hypopigmented lesions: Report of two cases and review of literature. Pediatr Dermatol 2018; 35:502-506. [PMID: 29691886 DOI: 10.1111/pde.13509] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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] [Indexed: 12/27/2022]
Abstract
Langerhans cell histiocytosis is a rare group of disorders that results from the abnormal proliferation and accumulation of dendritic-derived cells in various organs of the body, such as the skin and bones. Hypopigmented macules are a rare cutaneous presentation of Langerhans cell histiocytosis that may pose a diagnostic dilemma when no other findings of Langerhans cell histiocytosis are present at the time of examination. We present 2 cases of the hypopigmented variant of Langerhans cell histiocytosis, including a case with histopathologic features of regression, and a review of the literature. These cases highlight the importance of including Langerhans cell histiocytosis in the differential diagnosis of an infant with hypopigmented macules and papules.
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Affiliation(s)
- Shoko Mori
- Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Tony Adar
- Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Viktoryia Kazlouskaya
- Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Jaime B Alexander
- Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Edward Heilman
- Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Sharon A Glick
- Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, NY, USA
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22
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Kaplan L, Kazlouskaya V, Ugorji R, Heilman E, Siegel DM, Glick SA. Folliculocystic and collagen hamartoma of tuberous sclerosis: A new case in a female patient and review of literature. J Cutan Pathol 2017; 45:67-70. [DOI: 10.1111/cup.13056] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 09/26/2017] [Accepted: 10/05/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Laura Kaplan
- Department of Dermatology; SUNY Downstate Medical Center; Brooklyn New York
| | | | - Rex Ugorji
- Department of Dermatology; SUNY Downstate Medical Center; Brooklyn New York
| | - Edward Heilman
- Department of Dermatology; SUNY Downstate Medical Center; Brooklyn New York
| | - Daniel M. Siegel
- Department of Dermatology; SUNY Downstate Medical Center; Brooklyn New York
| | - Sharon A. Glick
- Department of Dermatology; SUNY Downstate Medical Center; Brooklyn New York
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23
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Huang A, Fiadorchanka N, Brar K, Balderacchi JL, Glick SA. In utero presentation of aggressive systemic mastocytosis in a neonate. Br J Dermatol 2017; 177:1439-1441. [PMID: 28369700 DOI: 10.1111/bjd.15506] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2017] [Indexed: 11/28/2022]
Abstract
Mastocytosis is a clinically heterogenous disease characterized by mast cell hyperplasia in skin, bone marrow and/or visceral organs. Cutaneous mastocytosis is more frequently observed in children, whereas indolent systemic mastocytosis is more commonly observed in adults. Aggressive systemic presentation, particularly of the neonate, is exceptionally rare. We present a rare case of congenital aggressive systemic mastocytosis. The patient was a 37-week-old male, born by caesarean section owing to hepatosplenomegaly and ascites diagnosed in utero, who exhibited extensive cutaneous and systemic manifestations of mastocytosis at birth. Mutation analysis of c-KIT identified D816V mutation in exon 17. Although initial bilateral bone marrow aspirates demonstrated no mast-cell infiltrates or haematological neoplasm, subsequent bone-marrow biopsies postmortem exhibited multifocal mast-cell aggregates. Clinical course was complicated by bacteraemia and cardiorespiratory failure, leading to death at 10 weeks.
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Affiliation(s)
- A Huang
- Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, NY, U.S.A
| | - N Fiadorchanka
- Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, NY, U.S.A
| | - K Brar
- Department of Pediatrics, National Jewish Health, Denver, CO, U.S.A
| | - J L Balderacchi
- Department of Pathology, Maimonides Medical Center, Brooklyn, NY, U.S.A
| | - S A Glick
- Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, NY, U.S.A
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Mathieu RJ, Vatanchi M, Heilman ER, Glick SA. A pediatric case of unusual melanocytic proliferation of the nail. Dermatol Online J 2017; 23:13030/qt3s54b25d. [PMID: 29469703] [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: 07/20/2017] [Accepted: 07/20/2017] [Indexed: 06/08/2023] Open
Abstract
Pigmentation of the nail plate, or melanonychia, is typically a benign condition caused by melanocyte activation. Although rare, melanonychia may be the initial presentation of melanoma, thus all cases require an in-depth examination. Evaluation in pediatric patients can prove especially difficult as benign cases have a higher prevalence of atypia compared to adults. Lack of specific treatment guidelines in the pediatric population can make diagnosis and treatment challenging. We report a pediatric patient with melanonychia with atypical features that required significant evaluations and collaboration to ultimately reach a treatment plan.
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Affiliation(s)
- Gregory S. Phillips
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York
| | - Marjon Vatanchi
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York
| | - Sharon A. Glick
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York
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26
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Mounessa JS, Shagalov D, Levine A, Glick SA. A clinical variant of a rare hyperkeratotic disease. Clin Exp Dermatol 2017; 42:690-692. [PMID: 28543889 DOI: 10.1111/ced.13120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2016] [Indexed: 11/30/2022]
Affiliation(s)
- J S Mounessa
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - D Shagalov
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - A Levine
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - S A Glick
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY, USA
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Abstract
Distinguishing benign acral nevi from small early acral melanomas may be challenging in certain cases. Dermoscopy is a noninvasive imaging technique that can help clinicians better visualize deeper lesion structures and thus more easily differentiate benign nevi from melanoma. We report the case of a 13-year-old girl with a changing dark brown to black macule with a central papular component on the volar surface of the right third finger. Dermoscopy revealed asymmetrically distributed irregular black blotches on a bluish-black background. Histopathology revealed a traumatized compound melanocytic nevus. Certain melanocytic nevi, although histologically benign, may not conform to the limited selection of reassuring benign dermoscopic patterns. Nevi in children are often dynamic and have a high likelihood of dermoscopic change.
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Affiliation(s)
- Tracey N Liebman
- Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY
| | - Marla N Diakow
- Department of Dermatology, Downstate Medical Center, State University of New York, Brooklyn, New York
| | - Sharon A Glick
- Department of Dermatology, Downstate Medical Center, State University of New York, Brooklyn, New York
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28
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Abstract
BACKGROUND/OBJECTIVES The past several decades have witnessed unprecedented advances in genomic technology, bringing genetic testing to the forefront of medical practice and moving us towards the practice of personalized medicine. Genetic testing has become an important aspect in preempting and successfully treating diseases in dermatology, yet difficulty remains in regards to obtaining genetic testing for patients. We conducted a survey for pediatric dermatologists in order to try to gauge and understand where difficulties lie in obtaining genetic testing and to analyze how best these issues can be resolved. METHODS An 18-question survey was emailed to 480 dermatologists who have attended at least one of the last three annual Society for Pediatric Dermatology (SPD) meetings. RESULTS Virtually all providers encountered at least one situation in which they required genetic testing for a patient (97.3% [n = 108]) and 37.4% indicated needing genetic testing more than six times per year. Of the respondents who had attempted to obtain genetic testing, half were unsuccessful in obtaining coverage more than 75% of the time (45% [n = 32]) and only 7.0% (n = 5) achieved success 75% to 100% of the time. The most common reasons for obtaining genetic testing included the need to provide an accurate diagnosis, followed by the need to provide prognostic information and appropriate medical management. CONCLUSION The role of genetic testing in the practice of dermatology is expanding, yet obtaining coverage for genetic testing remains a challenge. We propose several solutions as to how this can be remedied.
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Affiliation(s)
- Devorah R Shagalov
- Dermatology, State University of New York Downstate Medical Center, Brooklyn, New York
| | - Georgina M Ferzli
- Dermatology, State University of New York Downstate Medical Center, Brooklyn, New York
| | | | - Sharon A Glick
- Dermatology, State University of New York Downstate Medical Center, Brooklyn, New York
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29
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Glick JB, Craiglow BG, Choate KA, Kato H, Fleming RE, Siegfried E, Glick SA. Improved Management of Harlequin Ichthyosis With Advances in Neonatal Intensive Care. Pediatrics 2017; 139:peds.2016-1003. [PMID: 27999114 DOI: 10.1542/peds.2016-1003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/05/2016] [Indexed: 11/24/2022] Open
Abstract
Harlequin ichthyosis (HI) is the most severe phenotype of the autosomal recessive congenital ichthyoses. HI is caused by mutations in the lipid transporter adenosine triphosphate binding cassette A 12 (ABCA12). Neonates are born with a distinct clinical appearance, encased in a dense, platelike keratotic scale separated by deep erythematous fissures. Facial features are distorted by severe ectropion, eclabium, flattened nose, and rudimentary ears. Skin barrier function is markedly impaired, which can lead to hypernatremic dehydration, impaired thermoregulation, increased metabolic demands, and increased risk of respiratory dysfunction and infection. Historically, infants with HI did not survive beyond the neonatal period; however, recent advances in neonatal intensive care and coordinated multidisciplinary management have greatly improved survival. In this review, the authors combine the growing HI literature with their collective experiences to provide a comprehensive review of the management of neonates with HI.
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Affiliation(s)
- Jaimie B Glick
- Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, New York
| | | | - Keith A Choate
- Departments of Dermatology.,Genetics, and.,Pathology, Yale University School of Medicine, New Haven, Connecticut; and
| | | | | | - Elaine Siegfried
- Departments of Pediatrics and.,Dermatology, Saint Louis University School of Medicine, St Louis, Missouri
| | - Sharon A Glick
- Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, New York;
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30
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Mathieu RJ, Vatanchi M, Heilman ER, Glick SA. A pediatric case of unusual melanocytic proliferation of the nail. Dermatol Online J 2017. [DOI: 10.5070/d3237035749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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31
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Affiliation(s)
- Amy Huang
- State University of New York Downstate Medical Center, Brooklyn
| | - Sharon A. Glick
- State University of New York Downstate Medical Center, Brooklyn
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32
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Xu M, Flamm A, Shagalov D, Hsu E, Glick SA. Incontinentia Pigmenti presenting as a newborn eruption: two case presentations. Dermatol Online J 2016; 22:13030/qt6ph9f9c8. [PMID: 27617597] [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: 06/17/2016] [Accepted: 06/17/2016] [Indexed: 06/06/2023] Open
Abstract
Linear vesicles or papules in a newborn can be a presenting sign of incontinentia pigmenti (IP). In this report, we present two cases of neonates with cutaneous manifestations of incontinentia pigmenti. In one case, mild peripheral eosinophilia was noted. No extra-cutaneous manifestations were noted otherwise in both cases after complete ophthalmological and neurological evaluations. These cases serve as a reminder for clinicians to consider IP in newborns presenting with linear vesicles or papules.
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Affiliation(s)
- Michelle Xu
- SUNY Downstate College of Medicine, Brooklyn, New York.
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33
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Xu M, Flamm A, Shagalov D, Hsu E, Glick SA. Incontinentia Pigmenti presenting as a newborn eruption: two case presentations. Dermatol Online J 2016. [DOI: 10.5070/d3226031314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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34
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Serravallo M, Jagdeo J, Glick SA, Siegel DM, Brody NI. Sirtuins in dermatology: applications for future research and therapeutics. Arch Dermatol Res 2013; 305:269-82. [PMID: 23377138 DOI: 10.1007/s00403-013-1320-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [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: 12/09/2012] [Revised: 01/13/2013] [Accepted: 01/21/2013] [Indexed: 12/31/2022]
Abstract
Sirtuins are a family of seven proteins in humans (SIRT1-SIRT7) that are involved in multiple cellular processes relevant to dermatology. The role of sirtuins in other organ systems is established. However, the importance of these proteins in dermatology is less defined. Recently, sirtuins gained international attention because of their role as "longevity proteins" that may extend and enhance human life. Sirtuins function in the cell via histone deacetylase and/or adenosine diphosphate ribosyltransferase enzymatic activity that target histone and non-histone substrates, including transcription regulators, tumor suppressors, structural proteins, DNA repair proteins, cell signaling proteins, transport proteins, and enzymes. Sirtuins are involved in cellular pathways related to skin structure and function, including aging, ultraviolet-induced photoaging, inflammation, epigenetics, cancer, and a variety of cellular functions including cell cycle, DNA repair and proliferation. This review highlights sirtuin-related cellular pathways, therapeutics and pharmacological targets in atopic dermatitis, bullous dermatoses, collagen vascular disorders, psoriasis, systemic lupus erythematosus, hypertrophic and keloid scars, cutaneous infections, and non-melanoma and melanoma skin cancer. Also discussed is the role of sirtuins in the following genodermatoses: ataxia telangiectasia, Cowden's syndrome, dyskeratosis congenita, Rubenstein-Taybi, Werner syndrome, and xeroderma pigmentosum. The pathophysiology of these inherited diseases is not well understood, and sirtuin-related processes represent potential therapeutic targets for diseases lacking suitable alternative treatments. The goal of this review is to bring attention to the dermatology community, physicians, and scientists, the importance of sirtuins in dermatology and provide a foundation and impetus for future discussion, research and pharmacologic discovery.
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Affiliation(s)
- Melissa Serravallo
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY 11203, USA
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35
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36
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37
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Mahindra P, Guillen C, Glick SA. A 5-year-old girl with scarring. Pediatr Ann 2009; 38:359-60, 362-4. [PMID: 19685654 DOI: 10.3928/00904481-20090622-03] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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38
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Abstract
Zygomycosis, often referred to as ''mucormycosis'' or ''phycomycosis,'' is a rapidly progressive fungal infection which usually occurs in immunocompromised individuals, and is characterized by soft tissue destruction and invasion of blood vessels. The rare and easily misdiagnosed primary cutaneous form may present as a superficial erosion with a painless, gradual onset and slow progression of symptoms or a gangrenous, necrotic ulceration due to rapid tissue and vascular invasion. With the latter form, the mortality rate among affected individuals is high even after aggressive surgical debridement and amphotericin B administration, emphasizing the importance of early recognition and proper diagnosis. We present two instances of gangrenous cutaneous zygomycosis in immunocompromised children and review the literature with regard to etiology, diagnosis and treatment, highlighting the pediatric population.
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39
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Sherer DM, Perenyi AR, Glick SA, Dalloul M, Zigalo A, Gupta R, Abulafia O. Prenatal sonographic findings of extensive low-flow mixed lymphatic and venous malformations. J Ultrasound Med 2006; 25:1469-73. [PMID: 17060437 DOI: 10.7863/jum.2006.25.11.1469] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Affiliation(s)
- David M Sherer
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, Brooklyn, NY 11203-2098 USA.
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40
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Abstract
Rosacea is a condition most commonly associated with adults; however, various forms exist in the pediatric population and need to be considered when a child presents with a facial rash. Acne rosacea, steroid rosacea, granulomatous periorificial dermatitis, and other variants of rosacea are presented here and are distinguished from their numerous mimickers. Various topical and systemic therapeutic options exist for the treatment of rosacea with several adjustments and considerations that must be taken into account when treating a child.
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Affiliation(s)
- Daniela Kroshinsky
- SUNY Downstate Department of Dermatology, Brooklyn, New York 11203, USA.
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41
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Abstract
Acne is a disease that can be seen in the first year of life, early childhood, prepubertal age, and puberty. The purpose of this article is to review the clinical presentation and pathogenesis of the various forms of prepubertal acne and to propose guidelines regarding its evaluation and treatment. The early clinical recognition of the disease and prompt initiation of therapy in these age groups will help prevent the sequelae of emotional distress and severe scarring in both the child and parents.
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42
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Abstract
Turner's syndrome (TS) is a common genetic disorder of girls and women, for which the defining clinical triad is short stature, impaired sexual development, and infertility. Although classically known as monosomy X, genetic heterogeneity is frequent in TS, with mosaicism conferring a survival advantage. Several genetic loci have been implicated in TS including the short stature homeobox gene. TS effects many organs, with cutaneous stigmata providing critical clues for early detection of TS. The presence of lymphedema and its cutaneous sequelae are predictive of other systemic disorders, such as cardiac disease. Although an increased number of benign nevi have been reported in TS, the decreased melanoma rate in this population suggests some protective factor is active. Keloids were thought to be prevalent in TS, but recent data suggest otherwise. Autoimmune diseases are common in TS, with a possible increased prevalence of alopecia areata and vitiligo. The following review discusses new insights into the genetics and pathogenesis of this complex disorder, summarizes the major systemic effects, and reviews skin manifestations of TS and their implications.
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Affiliation(s)
- Eve J Lowenstein
- Department of Dermatology, State University New York Health Science Center at Brooklyn, Brooklyn, New York 11203, USA.
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43
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Zysman AG, Anderson DN, Glick SA, Lynfield Y. Hypopigmented mycosis fungoides in children. J Am Acad Dermatol 2004. [DOI: 10.1016/j.jaad.2003.10.459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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44
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Kim KH, Teebor S, Crandell CM, Glick SA. Umbilical nodule in an elderly woman. ACTA ACUST UNITED AC 2003; 139:1497-502. [PMID: 14623713 DOI: 10.1001/archderm.139.11.1497-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Karen H Kim
- State University of New York Downstate Medical Center, Brooklyn, USA
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45
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Abstract
Glomangiomas, or multiple glomus tumors, occur in disseminated, localized, or congenital plaquelike forms. The first two cases of congenital plaquelike glomangioma were described in 1990. We report a 9-year-old girl with a congenital, violaceous, 75-cm2 indurated plaque of the left abdomen that showed the classic histologic findings of glomangioma. In our review of the world literature, we found 11 additional, well-documented cases of glomangioma present at birth. Ten of these patients had violaceous indurated plaques, and the other two had clusters of discrete nodules. The majority of lesions were painless and enlarged with body growth. Many patients developed satellite lesions at sites distant from the original glomangiomas later in life. Family history of glomangioma was positive in 4 of the 12 patients.
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Affiliation(s)
- S A Glick
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut 06510, USA
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46
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Abstract
The lines of Blaschko represent a pattern followed by many skin disorders. We review the clinical and histologic features of X-linked, congenital/nevoid, and acquired skin diseases that follow these lines. We also include cutaneous disorders that have a linear distribution but do not follow Blaschko's lines. Finally, we differentiate Blaschko's lines from other patterns on the skin such as dermatomes and Langer's lines.
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Affiliation(s)
- J L Bolognia
- Department of Dermatology, Yale University School of Medicine, New Haven, CT
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47
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Affiliation(s)
- G S Morganroth
- Department of Dermatology, Yale University School of Medicine, New Haven, CT 06510
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