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Ahmed A, Wilson S, Kyllo RL, Koza E, Shi V, Haq M, Ma M, Poon E, Worley B, Harikumar V, Pearlman R, Schlessinger DI, Cahn BA, Alam M. Simulation-based Exercises to Improve the Performance of Cosmetic Consultations. J Am Acad Dermatol 2024:S0190-9622(24)00689-3. [PMID: 38705196 DOI: 10.1016/j.jaad.2024.04.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 04/21/2024] [Accepted: 04/24/2024] [Indexed: 05/07/2024]
Affiliation(s)
- Areeba Ahmed
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Sarah Wilson
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Rachel L Kyllo
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Eric Koza
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Victoria Shi
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Misha Haq
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Melissa Ma
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Emily Poon
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Brandon Worley
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Vishnu Harikumar
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Ross Pearlman
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Daniel I Schlessinger
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Brian A Cahn
- Department of Dermatology, University of Illinois at Chicago, Chicago, IL
| | - Murad Alam
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL; Department of Otolaryngology-Head and Neck Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL; Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL.
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2
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Kibbi N, Owen JL, Worley B, Wang JX, Harikumar V, Aasi SZ, Chandra S, Choi JN, Fujisawa Y, Iavazzo C, Kim JYS, Lawrence N, Leitao MM, MacLean AB, Ross JS, Rossi AM, Servaes S, Solomon MJ, Alam M. Anatomic Subtype Differences in Extramammary Paget Disease: A Meta-Analysis. JAMA Dermatol 2024; 160:417-424. [PMID: 38446447 PMCID: PMC10918581 DOI: 10.1001/jamadermatol.2024.0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 12/28/2023] [Indexed: 03/07/2024]
Abstract
Importance Extramammary Paget disease (EMPD) is a rare, highly recurrent cutaneous malignant neoplasm of unclear origin. EMPD arises most commonly on the vulvar and penoscrotal skin. It is not presently known how anatomic subtype of EMPD affects disease presentation and management. Objective To compare demographic and tumor characteristics and treatment approaches for different EMPD subtypes. Recommendations for diagnosis and treatment are presented. Data Sources MEDLINE, Embase, Web of Science Core Collection, and Cochrane Reviews CENTRAL from December 1, 1990, to October 24, 2022. Study Selection Articles were excluded if they were not in English, reported fewer than 3 patients, did not specify information by anatomic subtype, or contained no case-level data. Metastatic cases on presentation were also excluded. Data Extraction and Synthesis Abstracts of 1295 eligible articles were independently reviewed by 5 coauthors, and 135 articles retained. Reporting was in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines. The analysis was cunducted in August 2019 and updated in November 2022. Findings Most vulvar EMPD cases were asymptomatic, and diagnosis was relatively delayed (mean, 25.1 months). Although most vulvar EMPD cases were intraepidermal (1247/1773 [70.3%]), radical surgeries were still performed in almost one-third of cases. Despite this aggressive surgical approach, 481 of 1423 (34%) recurred, commonly confined to the skin and mucosa (177/198 [89.4%]). By contrast, 152 of 1101 penoscrotal EMPD cases (14%) recurred, but more than one-third of these recurrences were regional or associated with distant metastases (54 of 152 [35.5%]). Perianal EMPD cases recurred in one-third of cases (74/218 [33.9%]), with one-third of these recurrences being regional or associated with distant metastasis (20 of 74 [27.0%]). Perianal EMPD also had the highest rate of invasive disease (50% of cases). Conclusions and Relevance The diagnosis and treatment of EMPD should differ based on anatomic subtypes. Considerations for updated practice may include less morbid treatments for vulvar EMPD, which is primarily epidermal, and close surveillance for local recurrence in vulvar EMPD and metastatic recurrence in perianal EMPD. Recurrences in penoscrotal subtype were less common, and selective surveillance in this subtype may be considered. Limitations of this study include the lack of replication cohorts and the exclusion of studies that did not stratify outcomes by anatomic subtype.
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Affiliation(s)
- Nour Kibbi
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California
| | - Joshua L. Owen
- Dermatology Service, Audie L Murphy VA Medical Center, San Antonio, Texas
- Division of Dermatology, University of Texas Health San Antonio, San Antonio
| | | | - Jake X. Wang
- Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Vishnu Harikumar
- Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida
| | - Sumaira Z. Aasi
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California
| | - Sunandana Chandra
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Jennifer N. Choi
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | | - Christos Iavazzo
- Department of Gynecologic Oncology, Metaxa Cancer Hospital, Piraeus, Greece
| | - John Y. S. Kim
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Naomi Lawrence
- Division of Dermatology, Cooper Hospital, Rowan University, Camden, New Jersey
| | - Mario M. Leitao
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of OB/GYN, Weill Cornell Medical College, New York, New York
| | - Allan B. MacLean
- Department of Gynaecology, University College, London, United Kingdom
| | - Jeffrey S. Ross
- Departments of Pathology and Urology, Upstate Medical University, Syracuse, New York
- Medical Director, Foundation Medicine, Inc, Boston, Massachusetts
| | - Anthony M. Rossi
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sabah Servaes
- Department of Radiology, West Virginia University Children’s Hospital, Charleston, West Virginia
| | - Michael J. Solomon
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, Australia
| | - Murad Alam
- Department of Dermatology, Ehime University, To-on, Japan
- Department of Otolaryngology–Head and Neck Surgery and Surgery (Organ Transplantation), Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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3
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Nadir U, Yi MD, Koza E, Shi VJ, Dave L, Hisham FI, Maisel-Campbell A, Lin KA, Ibrahim SA, Kang BY, Anvery N, Dirr MA, Christensen RE, Riley JM, Kundu RV, Aylward JL, Bari O, Bhatti H, Bolotin D, Cherpelis BS, Cohen JL, Condon S, Farhang S, Firoz B, Garrett AB, Geronemus RG, Golda NJ, Humphreys TR, Hurst EA, Jacobson OH, Jiang SB, Karia PS, Kimyai-Asadi A, Kouba DJ, Council ML, Le M, MacFarlane DF, Maher IA, Miller SJ, Moioli EK, Morrow M, Neckman J, Peterson SR, Poblete-Lopez C, Prather CL, Ranario JS, Rubin AG, Swanson AM, Urban C, Xu YG, Pearlman R, Cahn BA, Yoo S, Harikumar V, Weil A, Schaeffer M, Iyengar S, Poon E, Alam M. Outcomes of cutaneous surgery for nonmelanoma skin cancer in patients with different Fitzpatrick skin types: A nationwide, multicenter, prospective study. J Am Acad Dermatol 2024:S0190-9622(24)00137-3. [PMID: 38296200 DOI: 10.1016/j.jaad.2023.11.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 11/15/2023] [Accepted: 11/20/2023] [Indexed: 02/23/2024]
Affiliation(s)
- Umer Nadir
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - Michael D Yi
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - Eric Koza
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - Victoria J Shi
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - Loma Dave
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | | | - Amanda Maisel-Campbell
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois; Department of Dermatology, Columbia University Irving Medical Center, New York, New York
| | - Katherine A Lin
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - Sarah A Ibrahim
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - Bianca Y Kang
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - Noor Anvery
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - McKenzie A Dirr
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | | | - Julia M Riley
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - Roopal V Kundu
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - Juliet L Aylward
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Omar Bari
- Mohs and Dermatologic Surgery Center, University of California, San Diego, San Diego, California; Division of Dermatology, University of California, Los Angeles, Los Angeles, California
| | - Hamza Bhatti
- Department of Dermatology, Rutgers Robert Wood Johnson Medical School, Somerset, New Jersey; The Skin Institute of South Florida, Coral Springs, Florida
| | - Diana Bolotin
- Section of Dermatology, University of Chicago, Chicago, Illinois
| | - Basil S Cherpelis
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida
| | - Joel L Cohen
- AboutSkin Dermatology, Denver, Colorado; Department of Dermatology, University of California, Irvine, Irvine, California
| | - Sean Condon
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio; The Center For Dermatology Care, Thousand Oaks, California
| | - Sheila Farhang
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida; Avant Dermatology and Aesthetics, Tucson, Arizona
| | - Bahar Firoz
- Department of Dermatology, Rutgers Robert Wood Johnson Medical School, Somerset, New Jersey
| | | | - Roy G Geronemus
- Ronald O. Perelman Department of Dermatology, New York University Langone Medical Center, New York, New York; Laser and Skin Surgery Center of New York, New York, New York
| | - Nicholas J Golda
- Department of Dermatology, University of Missouri School of Medicine, Columbia, Missouri
| | - Tatyana R Humphreys
- Main Line Center for Skin Surgery, Bala Cynwyd, Pennsylvania; Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Eva A Hurst
- Division of Dermatology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri; Distinctive Dermatology, Fairview Heights, Illinois
| | - Oren H Jacobson
- Revere Health Central Utah Mohs, Provo, Utah; St. George's University School of Medicine, Grenada, West Indies
| | - Shang Brian Jiang
- Mohs and Dermatologic Surgery Center, University of California, San Diego, San Diego, California
| | - Pritesh S Karia
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - David J Kouba
- Wayne State University School of Medicine, Detroit, Michigan; Toledo Clinic Facial Plastics and Dermatology, Toledo, Ohio
| | - Martha Laurin Council
- Division of Dermatology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Marilyn Le
- Main Line Center for Skin Surgery, Bala Cynwyd, Pennsylvania
| | | | - Ian A Maher
- Department of Dermatology, Saint Louis University, St. Louis, Missouri; Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
| | | | - Eduardo K Moioli
- Section of Dermatology, University of Chicago, Chicago, Illinois
| | - Meghan Morrow
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - Julia Neckman
- Laser and Skin Surgery Center of New York, New York, New York; MetroDerm, Atlanta, Georgia
| | - Samuel R Peterson
- Revere Health Central Utah Mohs, Provo, Utah; ERderm, Newport Beach, California
| | | | | | | | - Ashley G Rubin
- Mohs and Dermatologic Surgery Center, University of California, San Diego, San Diego, California; Bernardo Dermatology Medical Group, Poway, California
| | - Andrew M Swanson
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Christopher Urban
- Division of Dermatology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri; Carolina Mountain Dermatology, Arden, North Carolina
| | - Yaohui Gloria Xu
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Ross Pearlman
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - Brian A Cahn
- University of Illinois Chicago, Chicago, Illinois
| | - Simon Yoo
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - Vishnu Harikumar
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - Alexandra Weil
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - Matthew Schaeffer
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - Sanjana Iyengar
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - Emily Poon
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - Murad Alam
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois.
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4
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Harikumar V, Anvery N, Haq M, Christensen RE, Ahmed A, Koza E, Ma M, Shi V, Dirr MA, Worley B, Brieva JC, Yoo SS, Alam M. Risk factors for hospital-based surgical site infections. Arch Dermatol Res 2023; 316:43. [PMID: 38091095 DOI: 10.1007/s00403-023-02773-5] [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: 09/06/2023] [Revised: 09/06/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023]
Abstract
Surgical site infections (SSIs) contribute to morbidity and are costly to the healthcare system. To identify factors associated with SSIs. Case-control study analyzing the Nationwide Readmission Database (NRD). We identified 45,445 SSIs. Infection rates were higher in those who were obese (BMI ≥ 30) (OR: 1.39, 95% CI 1.28-1.51), tobacco users (OR: 1.08, 95% CI 1.02-1.15), diagnosed with diabetes (OR: 1.16, 95% CI 1.10-1.22), with Elixhauser Comorbidity Index ≥ 2 (OR: 1.14, 95% CI 1.09-1.20), admitted to hospital for 4-6 days (OR: 1.35, 95% CI 1.29-1.42), in medium-size hospital (OR: 1.15, 95% CI 1.05-1.26), or large-size hospital (OR: 1.43, 95% CI 1.31-1.56). In contrast, patients who were 60-79 years old (OR: 0.78, 95% CI 0.73-0.84), 80 years or older (OR: 0.66, 95% CI 0.59-0.73), female (OR: 0.95, 95% CI 0.91-0.99), underweight (BMI < 18.5) (OR: 0.14, 95% CI 0.03-0.59), in a non-metropolitan hospital (OR: 0.83, 95% CI 0.75-0.91), self-pay (OR: 0.82, 95% CI 0.74-0.91), or covered by Medicare (OR: 0.86, 95% CI 0.80-0.91) had lower odds. Initial data entry to NRD is susceptible to human error. Patients who are obese, use tobacco, have multiple comorbidities, and have long hospital stays in medium-to-large-size hospitals are at risk of SSIs. Conversely, odds of SSIs are lower in females, age ≥ 60, BMI < 18.5, self-pay or Medicare (versus private insurance), or at smaller hospitals. Understanding factors associated with SSIs may help surgeons anticipate complications.
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Affiliation(s)
- Vishnu Harikumar
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA
| | - Noor Anvery
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA
| | - Misha Haq
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA
| | - Rachel E Christensen
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA
| | - Areeba Ahmed
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA
| | - Eric Koza
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA
| | - Melissa Ma
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA
| | - Victoria Shi
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA
| | - McKenzie A Dirr
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA
| | - Brandon Worley
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA
- Florida Dermatology and Skin Cancer Centers, Lake Wales, FL, USA
| | - Joaquin C Brieva
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA
| | - Simon S Yoo
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA
| | - Murad Alam
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA.
- Department of Otolaryngology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
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5
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Worley B, Harikumar V, Reynolds K, Dirr MA, Christensen RE, Anvery N, Yi MD, Poon E, Alam M. Treatment of actinic keratosis: a systematic review. Arch Dermatol Res 2022; 315:1099-1108. [DOI: 10.1007/s00403-022-02490-5] [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: 10/11/2022] [Revised: 11/14/2022] [Accepted: 11/18/2022] [Indexed: 12/05/2022]
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6
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Merkel EA, Worley B, Christensen RE, Harikumar V, Lu KQ, Evans ST, Anvery N, Dirr MA, Poon E, Alam M. In Vitro and Ex Vivo Investigation of Intralesional Sodium Thiosulfate as a Reversal Agent for Calcium Hydroxylapatite Soft Tissue Filler. J Invest Dermatol 2022; 142:3125-3127. [PMID: 35526562 PMCID: PMC9613503 DOI: 10.1016/j.jid.2022.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/04/2022] [Accepted: 04/20/2022] [Indexed: 10/31/2022]
Affiliation(s)
- Emily A Merkel
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Brandon Worley
- Florida Dermatology and Skin Cancer Centers, Lake Wales, Florida, USA
| | - Rachel E Christensen
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Vishnu Harikumar
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Kurt Q Lu
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Spencer T Evans
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Noor Anvery
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - McKenzie A Dirr
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Emily Poon
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Murad Alam
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA; Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA; Department of Otolaryngology - Head & Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA; Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
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7
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Dirr M, Christensen R, Anvery N, Merkel E, Worley B, Harikumar V, Lu K, Evans S, Poon E, Alam M. LB984 Intralesional sodium thiosulfate as a reversal agent for calcium hydroxylapatite soft tissue filler: An in vitro and ex vivo comparison. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.1008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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8
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Christensen R, Harikumar V, Dirr M, Anvery N, Brieva J, Yoo S, Alam M. 244 Risk factors for post-operative surgical site infections: A case-control study. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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9
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Maisel-Campbell A, Lin KA, Ibrahim SA, Kang BY, Anvery N, Dirr MA, Christensen RE, Aylward JL, Bari O, Bhatti H, Bolotin D, Cherpelis BS, Cohen JL, Condon S, Farhang S, Firoz B, Garrett AB, Geronemus RG, Golda NJ, Humphreys TR, Hurst EA, Jacobson OH, Jiang SB, Karia PS, Kimyai-Asadi A, Kouba DJ, Lahti JG, Council ML, Le M, MacFarlane DF, Maher IA, Miller SJ, Moioli EK, Morrow M, Neckman J, Pearson T, Peterson SR, Poblete-Lopez C, Prather CL, Ranario JS, Rubin AG, Schmults CD, Swanson AM, Urban C, Xu YG, Alam M, Yoo S, Poon E, Harikumar V, Weil A, Iyengar S, Schaeffer MR. Nonmelanoma Skin Cancer in Patients Older Than Age 85 Years Presenting for Mohs Surgery: A Prospective, Multicenter Cohort Study. JAMA Dermatol 2022; 158:770-778. [PMID: 35612849 DOI: 10.1001/jamadermatol.2022.1733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance It has been suggested that Mohs surgery for skin cancer among individuals with limited life expectancy may be associated with needless risk and discomfort, along with increased health care costs. Objective To investigate patient- and tumor-specific indications considered by clinicians for treatment of nonmelanoma skin cancer in older individuals. Design, Setting, and Participants This multicenter, prospective cohort study was conducted using data from US private practice and academic centers. Included patients were those older than age 85 years presenting for skin cancer surgery and referred for Mohs surgery, with reference groups of those younger than age 85 years receiving Mohs surgery and those older than age 85 years not receiving Mohs surgery. Data were analyzed from November 2018 through January 2019. Exposures Mohs surgery for nonmelanoma skin cancer. Main Outcomes and Measures Reason for treatment selection. Results Among 1181 patients older than age 85 years referred for Mohs surgery (724 [61.9%] men among 1169 patients with sex data; 681 individuals aged >85 to 88 years [57.9%] among 1176 patients with age data) treated at 22 sites, 1078 patients (91.3%) were treated by Mohs surgery, and 103 patients (8.7%) received alternate treatment. Patients receiving Mohs surgery were more likely to have tumors on the face (738 patients [68.5%] vs 26 patients [25.2%]; P < .001) and nearly 4-fold more likely to have high functional status (614 patients [57.0%] vs 16 patients [15.5%]; P < .001). Of 15 distinct reasons provided by surgeons for opting to proceed with Mohs surgery, the most common were patient desire for treatment with a high cure rate (712 patients [66.0%]), good or excellent patient functional status for age (614 patients [57.0%]), and high risk associated with the tumor based on histology (433 patients [40.2%]). Conclusions and Relevance This study found that older patients who received Mohs surgery often had high functional status, high-risk tumors, and tumors located on the face. These findings suggest that timely surgical treatment may be appropriate in older patients given that their tumors may be aggressive, painful, disfiguring, and anxiety provoking.
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Affiliation(s)
- Amanda Maisel-Campbell
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois.,Department of Dermatology, Columbia University Medical Center, New York, New York
| | - Katherine A Lin
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - Sarah A Ibrahim
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - Bianca Y Kang
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - Noor Anvery
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - McKenzie A Dirr
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | | | - Juliet L Aylward
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison
| | - Omar Bari
- Mohs and Dermatologic Surgery Center, University of California, San Diego.,Division of Dermatology, University of California, Los Angeles
| | - Hamza Bhatti
- Department of Dermatology, Rutgers Robert Wood Johnson Medical School, Somerset, New Jersey.,The Skin Institute of South Florida, Coral Springs
| | - Diana Bolotin
- Section of Dermatology, University of Chicago, Chicago, Illinois
| | - Basil S Cherpelis
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa
| | - Joel L Cohen
- AboutSkin Dermatology, Denver, Colorado.,Department of Dermatology, University of California Irvine
| | - Sean Condon
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio.,The Center For Dermatology Care, Thousand Oaks, California
| | - Sheila Farhang
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa.,Avant Dermatology and Aesthetics, Tucson, Arizona
| | - Bahar Firoz
- Department of Dermatology, Rutgers Robert Wood Johnson Medical School, Somerset, New Jersey
| | | | - Roy G Geronemus
- Ronald O. Perelman Department of Dermatology, New York University Langone Medical Center, New York, New York.,Laser and Skin Surgery Center of New York, New York, New York
| | - Nicholas J Golda
- Department of Dermatology, University of Missouri School of Medicine, Columbia
| | - Tatyana R Humphreys
- Main Line Center for Skin Surgery, Bala Cynwyd, Pennsylvania.,Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Eva A Hurst
- Division of Dermatology, Department of Medicine, Washington University School of Medicine, St Louis, Missouri.,Distinctive Dermatology, Fairview Heights, Illinois
| | - Oren H Jacobson
- Revere Health Central Utah Mohs, Provo.,St George's University School of Medicine, Grenada, West Indies
| | - S Brian Jiang
- Mohs and Dermatologic Surgery Center, University of California, San Diego
| | - Pritesh S Karia
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - David J Kouba
- Wayne State University School of Medicine, Detroit, Michigan.,Toledo Clinic Facial Plastics and Dermatology, Toledo, Ohio
| | - James G Lahti
- Dermatology Partners of North Shore, Northbrook, Illinois
| | - Martha Laurin Council
- Division of Dermatology, Department of Medicine, Washington University School of Medicine, St Louis, Missouri
| | - Marilyn Le
- Main Line Center for Skin Surgery, Bala Cynwyd, Pennsylvania
| | | | - Ian A Maher
- Department of Dermatology, St Louis University, St Louis, Missouri.,Department of Dermatology, University of Minnesota, Minneapolis
| | | | - Eduardo K Moioli
- Section of Dermatology, University of Chicago, Chicago, Illinois
| | - Meghan Morrow
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - Julia Neckman
- Laser and Skin Surgery Center of New York, New York, New York.,Metroderm, Atlanta, Georgia
| | - Timothy Pearson
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio.,Anne Arundel Dermatology, Berlin, Maryland
| | - Samuel R Peterson
- Revere Health Central Utah Mohs, Provo.,ERderm, Newport Beach, California
| | | | | | - Jennifer S Ranario
- Department of Dermatology, MD Anderson Cancer Center, Houston, Texas.,US Dermatology Partners, Austin, Texas
| | - Ashley G Rubin
- Mohs and Dermatologic Surgery Center, University of California, San Diego.,Bernardo Dermatology Medical Group, Poway, California
| | - Chrysalyne D Schmults
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Andrew M Swanson
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison
| | - Christopher Urban
- Division of Dermatology, Department of Medicine, Washington University School of Medicine, St Louis, Missouri.,Carolina Mountain Dermatology, Arden, North Carolina
| | - Y Gloria Xu
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison
| | - Murad Alam
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | | | - Simon Yoo
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - Emily Poon
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - Vishnu Harikumar
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - Alexandra Weil
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois
| | - Sanjana Iyengar
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois.,Department of Dermatology, West Virginia University, Morgantown
| | - Matthew R Schaeffer
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois.,Department of Surgery, Wright State University, Boonshoft School of Medicine, Dayton, Ohio
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10
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Kibbi N, Owen JL, Worley B, Wang JX, Harikumar V, Downing MB, Aasi SZ, Aung PP, Barker CA, Bolotin D, Bordeaux JS, Cartee TV, Chandra S, Cho NL, Choi JN, Chung KY, Cliby WA, Dorigo O, Eisen DB, Fujisawa Y, Golda N, Halfdanarson TR, Iavazzo C, Jiang SIB, Kanitakis J, Khan A, Kim JYS, Kuzel TM, Lawrence N, Leitao MM, MacLean AB, Maher IA, Mittal BB, Nehal KS, Ozog DM, Pettaway CA, Ross JS, Rossi AM, Servaes S, Solomon MJ, Thomas VD, Tolia M, Voelzke BB, Waldman A, Wong MK, Zhou Y, Arai N, Brackett A, Ibrahim SA, Kang BY, Poon E, Alam M. Evidence-Based Clinical Practice Guidelines for Extramammary Paget Disease. JAMA Oncol 2022; 8:618-628. [PMID: 35050310 DOI: 10.1001/jamaoncol.2021.7148] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
IMPORTANCE Extramammary Paget disease (EMPD) is a frequently recurring malignant neoplasm with metastatic potential that presents in older adults on the genital, perianal, and axillary skin. Extramammary Paget disease can precede or occur along with internal malignant neoplasms. OBJECTIVE To develop recommendations for the care of adults with EMPD. EVIDENCE REVIEW A systematic review of the literature on EMPD from January 1990 to September 18, 2019, was conducted using MEDLINE, Embase, Web of Science Core Collection, and Cochrane Libraries. Analysis included 483 studies. A multidisciplinary expert panel evaluation of the findings led to the development of clinical care recommendations for EMPD. FINDINGS The key findings were as follows: (1) Multiple skin biopsies, including those of any nodular areas, are critical for diagnosis. (2) Malignant neoplasm screening appropriate for age and anatomical site should be performed at baseline to distinguish between primary and secondary EMPD. (3) Routine use of sentinel lymph node biopsy or lymph node dissection is not recommended. (4) For intraepidermal EMPD, surgical and nonsurgical treatments may be used depending on patient and tumor characteristics, although cure rates may be superior with surgical approaches. For invasive EMPD, surgical resection with curative intent is preferred. (5) Patients with unresectable intraepidermal EMPD or patients who are medically unable to undergo surgery may receive nonsurgical treatments, including radiotherapy, imiquimod, photodynamic therapy, carbon dioxide laser therapy, or other modalities. (6) Distant metastatic disease may be treated with chemotherapy or individualized targeted approaches. (7) Close follow-up to monitor for recurrence is recommended for at least the first 5 years. CONCLUSIONS AND RELEVANCE Clinical practice guidelines for EMPD provide guidance regarding recommended diagnostic approaches, differentiation between invasive and noninvasive disease, and use of surgical vs nonsurgical treatments. Prospective registries may further improve our understanding of the natural history of the disease in primary vs secondary EMPD, clarify features of high-risk tumors, and identify superior management approaches.
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Affiliation(s)
- Nour Kibbi
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California
| | - Joshua L Owen
- Dermatology Service, South Texas Veterans Health Care System, San Antonio
| | | | - Jake X Wang
- Department of Dermatology, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Vishnu Harikumar
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | | - Sumaira Z Aasi
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California
| | - Phyu P Aung
- Department of Pathology (Dermatopathology), The University of Texas MD Anderson Cancer Center, Houston
| | - Christopher A Barker
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Diana Bolotin
- Section of Dermatology, University of Chicago, Chicago, Illinois
| | - Jeremy S Bordeaux
- University Hospitals Cleveland Medical Center, Department of Dermatology, Case Western Reserve University, Cleveland, Ohio
| | - Todd V Cartee
- Division of Dermatology, Pennsylvania State College of Medicine, Hershey
| | - Sunandana Chandra
- Division of Oncology, Department of Medicine, Northwestern University Medical Center, Chicago, Illinois
| | - Nancy L Cho
- Department of Surgery, Brigham and Women's Hospital, Harvard University, Boston, Massachusetts
| | - Jennifer N Choi
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Kee Yang Chung
- Department of Dermatology, Yonsei University College of Medicine, Seoul, South Korea
| | - William A Cliby
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota
| | - Oliver Dorigo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Stanford Women's Cancer Center, Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Daniel B Eisen
- Department of Dermatology, University of California Davis, Sacramento
| | | | - Nicholas Golda
- Department of Dermatology, University of Missouri School of Medicine, Columbia
| | | | - Christos Iavazzo
- Department of Gynecologic Oncology, Metaxa Cancer Hospital, Piraeus, Greece
| | | | - Jean Kanitakis
- Department of Dermatology, Ed. Herriot Hospital Group (Pav. R), Lyon, France
| | - Ashraf Khan
- Department of Pathology, University of Massachusetts Medical School-Baystate, Baystate Health, Springfield
| | - John Y S Kim
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Timothy M Kuzel
- Division of Hematology, Oncology and Cell Therapy, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Naomi Lawrence
- Division of Dermatology, Cooper Hospital, Rowan University, Camden, New Jersey
| | - Mario M Leitao
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, New York
| | - Allan B MacLean
- Department of Gynaecology, University College, London, United Kingdom
| | - Ian A Maher
- Department of Dermatology, University of Minnesota, Minneapolis
| | - Bharat B Mittal
- Department of Radiation Oncology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Kishwer S Nehal
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - David M Ozog
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Curtis A Pettaway
- Division of Surgery, Department of Urology, The University of Texas MD Anderson Cancer Center, Houston
| | - Jeffrey S Ross
- Department of Pathology, Upstate Medical University, Syracuse, New York
- Department of Urology, Upstate Medical University, Syracuse, New York
| | - Anthony M Rossi
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sabah Servaes
- Department of Radiology, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia
| | - Michael J Solomon
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, Australia
| | - Valencia D Thomas
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston
| | - Maria Tolia
- Department of Radiotherapy, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | | | - Abigail Waldman
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Michael K Wong
- Division of Cancer Medicine, Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston
| | - Youwen Zhou
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nobuo Arai
- Electrical Engineering, Kanagawa University, Kanagawa-ku, Yokohama, Japan
| | - Alexandria Brackett
- Cushing/Whitney Medical Library, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Sarah A Ibrahim
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Bianca Y Kang
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Emily Poon
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Murad Alam
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Department of Otolaryngology-Head and Neck Surgery and Surgery (Organ Transplantation), Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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11
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Labadie JG, Compres E, Sunshine JC, Alam M, Gerami P, Harikumar V, Poon E, Arndt KA, Dover JS. Actinic Keratosis Color and Its Associations: A Retrospective Photographic, Dermoscopic, and Histologic Evaluation. Dermatol Surg 2022; 48:57-60. [PMID: 34812188 DOI: 10.1097/dss.0000000000003281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVE Actinic keratoses (AKs) have been described with varying color and morphology; however, no reports have demonstrated associations between color, vasculature, and inflammation. In this retrospective study, we analyze the clinical, dermoscopic, and histopathologic features of AKs to elucidate this relationship. METHODS A retrospective search for patients diagnosed with AK between January 2018 and October 2019 was performed. Clinical and dermoscopic photographs and pathology slides for all included subjects were reviewed. RESULTS Forty-nine images and histopathology slides were analyzed. Dermoscopy of white AKs demonstrated scale and absence of erythema with corresponding absence of inflammation on histopathology. Dermoscopy of brown AKs revealed pseudonetwork, absent scale, and a variable vessel pattern with pigment incontinence and absence of inflammation on histopathology. Red AKs had a distinct polymorphous vessel pattern and presence of erythema on dermoscopy. On histopathology, about half of samples showed increased vascularity and variable inflammation. Pink AK dermoscopy revealed a presence of erythema with corresponding presence of inflammation on histopathology. CONCLUSION This report adds to our understanding of AKs and confirms that, in general, the pinker or redder the AK, the more prominent the inflammatory infiltrate and vasculature, respectively. Dermatologists should continue to use their diagnostic skills to successfully diagnose and triage AKs.
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Affiliation(s)
- Jessica G Labadie
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Elsy Compres
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Joel C Sunshine
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Department of Dermatopathology, Northwestern University, Chicago, Illinois
| | - Murad Alam
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Pedram Gerami
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Department of Dermatopathology, Northwestern University, Chicago, Illinois
| | - Vishnu Harikumar
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Emily Poon
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Kenneth A Arndt
- SkinCare Physicians, Chestnut Hill, Massachusetts
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Jeffrey S Dover
- SkinCare Physicians, Chestnut Hill, Massachusetts
- Yale University School of Medicine, New Haven, Connecticut
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
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12
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Suozzi KC, Kibbi N, Lee KC, Worley B, Furlan KC, Kang BY, Ibrahim SA, Poon E, Alam M, Harikumar V, Keimig EL, Alster TS, Bolotin D, Dover JS, Galadari H, Goodman GJ, Hexsel D, Kaminer MS, Kim JYS, Karen J, Lask G, Lewis AB, Maher IA, Paul BC, Negishi K, Touma DJ, Waldman A, Beer K, Bertucci V, Burgess CM, Casabona G, De Boulle KL, Fitzgerald R, Green JB, Goldman MP, Humphrey S, Ibrahim SF, Ibrahimi OA, Jagdeo J, Kim HS, Lawrence N, Marmur E, Matarasso SL, McDonald M, Obagi S, Ortiz AE, Philipp-Dormston WG, Rossi AM, Solish N, Taylor SC, Trindade de Almeida AR, Weinkle SH. Development of Objective Structured Assessment of Technical Skills in Facial Cosmetic Procedures: Botulinum Toxin Neuromodulator and Soft Tissue Filler Injection. J Am Acad Dermatol 2021; 86:463-467. [PMID: 34499988 DOI: 10.1016/j.jaad.2021.08.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Kathleen C Suozzi
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - Nour Kibbi
- Department of Dermatology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Kachiu C Lee
- Main Line Center for Laser Surgery, Philadelphia, PA, USA
| | - Brandon Worley
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Karina C Furlan
- Department of Pathology, Rush University Medical Center, Chicago, IL, USA
| | - Bianca Y Kang
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Sarah A Ibrahim
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Emily Poon
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Murad Alam
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Department of Otolaryngology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
| | | | - Vishnu Harikumar
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Emily L Keimig
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Tina S Alster
- Washington Institute of Dermatologic Laser Surgery, Washington, DC, USA
| | - Diana Bolotin
- Section of Dermatology, The University of Chicago, Chicago, IL, USA
| | - Jeffrey S Dover
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA; Department of Dermatology, Alpert Medical School, Brown University, Providence, RI, USA; SkinCare Physicians, Chestnut Hill, MA, USA
| | - Hassan Galadari
- College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
| | - Greg J Goodman
- Monash University, Melbourne, AUA; University College of London, London, UK
| | - Doris Hexsel
- Brazilian Center for Studies in Dermatology, Porto Alegre, GBR
| | - Michael S Kaminer
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA; SkinCare Physicians, Chestnut Hill, MA, USA
| | - John Y S Kim
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Gary Lask
- Department of Dermatology, University of California Los Angeles, Los Angeles, CA, USA; Department of Dermatology, University of Southern California, Los Angeles, CA, USA
| | | | - Ian A Maher
- Department of Dermatology, University of Minnesota Medical School, Minneapolis, MN, USA
| | | | - Kei Negishi
- Institute of Geriatrics, Tokyo Women's Medical University, Tokyo, JPN
| | | | - Abigail Waldman
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Vince Bertucci
- Division of Dermatology, University of Toronto, Toronto, ON, CAN
| | - Cheryl M Burgess
- Center for Dermatology and Dermatologic Surgery, Washington, DC, USA
| | | | | | | | - Jeremy B Green
- Skin Associates of South Florida, Skin Research Institute, Coral Gables, FL, USA
| | - Mitchel P Goldman
- Cosmetic Laser Dermatology, A West Dermatology Company, San Diego, CA, USA
| | - Shannon Humphrey
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, CAN
| | - Sherrif F Ibrahim
- Department of Dermatology, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Jared Jagdeo
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, NY, USA; Dermatology Service, VA New York Harbor Healthcare System-Brooklyn Campus, Brooklyn, NY, USA
| | - Hei Sung Kim
- Department of Dermatology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, KOR
| | - Naomi Lawrence
- Division of Dermatology, Section of Procedural Dermatology, Cooper Hospital, Rowan University, Camden, NJ, USA
| | - Ellen Marmur
- Marmur Medical, Dermatology, New York, NY, USA; Department of Dermatology, The Mount Sinai Medical Center, New York, NY, USA
| | - Seth L Matarasso
- Department of Dermatology, University of California, San Francisco School of Medicine, San Francisco, CA, USA
| | - Michel McDonald
- Department of Dermatology, Vanderbilt University, Nashville, TN, USA
| | - Suzan Obagi
- Cosmetic Surgery & Skin Health Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Arisa E Ortiz
- Department of Dermatology, University of California, San Diego Health, La Jolla, CA, USA
| | - Wolfgang G Philipp-Dormston
- Faculty of Health, University Witten/Herdecke, Witten, DEU; Hautzentrum Koeln, Klinik Links vom Rhein, Cologne, DEU
| | - Anthony M Rossi
- Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA
| | - Nowell Solish
- Division of Dermatology, University of Toronto, Toronto, ON, CAN
| | - Susan C Taylor
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | | | - Susan H Weinkle
- Department of Dermatology and Cutaneous Surgery, University of South Florida, Tampa, FL, USA
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13
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Kang BY, Jain-Poster K, Harikumar V, Reynolds KA, Ibrahim SA, Poon E, Alam M. 27905 Factors affecting outcomes with Mohs surgery for rare tumors of the skin. J Am Acad Dermatol 2021. [DOI: 10.1016/j.jaad.2021.06.681] [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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14
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Alam M, Kakar R, Dover JS, Harikumar V, Kang BY, Wan HT, Poon E, Jones DH. Rates of Vascular Occlusion Associated With Using Needles vs Cannulas for Filler Injection. JAMA Dermatol 2021; 157:174-180. [PMID: 33377939 DOI: 10.1001/jamadermatol.2020.5102] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Importance Soft-tissue augmentation with skin fillers can be delivered with needles or microcannulas, but unwanted vascular occlusions are possible. Objective To determine whether filler-associated vascular occlusion events of the face occur more often with injections performed with needles than with microcannulas. Design, Setting, and Participants This retrospective cohort study included a random sample of board-certified dermatologists deemed eligible based on membership in relevant professional societies and attendance at relevant national professional meetings. Participants completed detailed forms in which they could enter deidentified data and volume statistics pertaining to patients undergoing filler procedures in their practices. Data were collected from August 2018 to August 2019. Exposures Injectable fillers approved by the US Food and Drug Administration delivered via needles or microcannulas. Main Outcomes and Measures The primary outcome measure was intravascular occlusion. Occlusion events were graded by severity (no sequelae, scar, and ocular injury or blindness). Results A total of 370 dermatologists (mean [SD] years in practice, 22.3 [11.1] years) participated and reported 1.7 million syringes injected. The risk of occlusion with any particular filler type using needle or cannula never exceeded 1 per 5000 syringes injected. Overall, 1 occlusion per 6410 per 1-mL syringe injections was observed with needles and 1 per 40 882 with cannulas (P < .001). Of the 370 participants, 106 (28.6%) reported at least 1 occlusion. Multivariate analysis found that injections with cannula had 77.1% lower odds of occlusion compared with needle injections. Participants injecting fillers for more than 5 years had 70.7% lower odds of occlusion than those who were less experienced. For each additional injection per week, the odds of occlusion decreased by 1%, and 85% of occlusions had no long-term sequelae. Nasolabial folds and lips were most likely to be occluded, with mean severity level of occlusions highest at the glabella. Conclusions and Relevance In this cohort study, filler injections with either needles or cannulas were associated with a very low risk of intravascular occlusion events. Moreover, the vast majority of such events were minor and resolved without scar or other injury. Injections with microcannulas were less often associated with occlusion events than injections with needles. Occlusion risk per syringe appeared decreased after the first few years of clinical practice and was also lower among those who more frequently inject fillers. Whether a needle or cannula is most appropriate for injection may depend on patient factors, anatomic site, and the type of defect being treated.
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Affiliation(s)
- Murad Alam
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Department of Otolaryngology-Head & Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Rohit Kakar
- Skin Care and Laser Physicians of Beverly Hills, Los Angeles, California
| | - Jeffrey S Dover
- Department of Dermatology, Yale School of Medicine, Yale University, New Haven, Connecticut.,Department of Dermatology, Alpert Medical School, Brown University, Providence, Rhode Island.,SkinCare Physicians, Chestnut Hill, Massachusetts
| | - Vishnu Harikumar
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,University of Missouri-Kansas City School of Medicine, Kansas City
| | - Bianca Y Kang
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Hoi Ting Wan
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Emily Poon
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Derek H Jones
- Skin Care and Laser Physicians of Beverly Hills, Los Angeles, California
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15
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Krishna Muppalla JN, Harikumar V, Sarathchandra P, Reddy SJ, Rajani P. Effect of modulated photoactivation of bulkfill composite on microleakage in fluorosed and nonfluorosed teeth: A confocal laser scanning microscopy study. J Conserv Dent 2021; 23:180-184. [PMID: 33384492 PMCID: PMC7720755 DOI: 10.4103/jcd.jcd_112_20] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 06/28/2020] [Accepted: 08/06/2020] [Indexed: 11/17/2022] Open
Abstract
Aim: The aim of this study is to compare the microleakage of bulkfill composite activated by modulated photoactivation between fluorosed and nonfluorosed teeth using the confocal laser scanning microscope. Methodology: One hundred and twenty intact human premolar teeth with Thylstrup and Fejerskov index fluorosis index 0–4 were stored in 0.5% thymol at the room temperature until further use. Standardized Class V preparations of 2 mm depth, 3 mm width, and 2 mm height were prepared on the buccal surface. The cavities were etched with 37% phosphoric acid, rinsed and primed with Tetric N bond, cured for 20 s with Quartz Tungsten Halogen (QTH) variable intensity light-curing unit spectrum-800 operating at 450 mW/cm2. Later, bulk fill composite was placed in the cavity and cured. Depending on the curing mode used, all the fluorosed and nonfluorosed teeth were divided into three subgroups each (n = 20) – Conventional light curing, stepped curing, and pulse delayed curing. All samples were stored in distilled water at the room temperature for 24 h and subjected to 500 thermocycles. The prepared teeth were placed in 0.6% rhodamine solution for 48 h; sectioned longitudinally using a hard-tissue microtome and scanned under a confocal laser scanning electron microscope. Data were analyzed using the one-way ANNOVA, Wilcoxson signed-rank test, and Kruskal–Wallis test. Results: Significant differences were observed between fluorosed and nonfluorosed groups. Intragroup comparisons showed significant differences between fluorosed step and conventional subgroups. Conclusion: Fluorosed teeth had higher microleakage values than nonfluorosed teeth. Pulse-delayed subgroup had the least microleakage to that of conventional and stepped curing subgroups, in both fluorosed and nonfluorosed groups.
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Affiliation(s)
- J N Krishna Muppalla
- Department of Conservative Dentistry and Endodontics, Kamineni Institute of Dental Sciences, Nalgonda, Telangana, India
| | - V Harikumar
- Department of Conservative Dentistry and Endodontics, Kamineni Institute of Dental Sciences, Nalgonda, Telangana, India
| | - P Sarathchandra
- Department of Conservative Dentistry and Endodontics, Kamineni Institute of Dental Sciences, Nalgonda, Telangana, India
| | - S Jayaprada Reddy
- Department of Conservative Dentistry and Endodontics, Kamineni Institute of Dental Sciences, Nalgonda, Telangana, India
| | - P Rajani
- Department of Conservative Dentistry and Endodontics, Kamineni Institute of Dental Sciences, Nalgonda, Telangana, India
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Alam M, Harikumar V, Kang BY, Ibrahim SA, Kibbi N, Owen JL, Maher IA, Cartee TV, Sobanko JF, Reynolds KA, Bolotin D, Waldman AH, Minkis K, Petersen B, Council ML, Nehal KS, Xu YG, Jiang SB, Somani AK, Bichakjian CK, Huang CC, Eisen DB, Ozog DM, Lee EH, Samie FH, Neuhaus IM, Bordeaux JS, Wang JV, Leitenberger JJ, Mann MW, Lawrence N, Zeitouni NC, Golda N, Behshad R, Ibrahim SF, Yu SS, Shin TM, Stebbins WG, Worley B. Development of international clinical practice guidelines: benefits, limitations, and alternative forms of international collaboration. Arch Dermatol Res 2020; 314:483-486. [PMID: 33216212 DOI: 10.1007/s00403-020-02166-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 10/30/2020] [Accepted: 11/03/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Murad Alam
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N St Clair St, Suite 1600, Chicago, IL, 60611, USA.
| | - Vishnu Harikumar
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N St Clair St, Suite 1600, Chicago, IL, 60611, USA
| | - Bianca Y Kang
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N St Clair St, Suite 1600, Chicago, IL, 60611, USA
| | - Sarah A Ibrahim
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N St Clair St, Suite 1600, Chicago, IL, 60611, USA
| | - Nour Kibbi
- Department of Dermatology, Stanford University School of Medicine, Redwood, CA, USA
| | - Joshua L Owen
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N St Clair St, Suite 1600, Chicago, IL, 60611, USA.,South Texas Skin Cancer Center, San Antonio, TX, USA
| | - Ian A Maher
- Department of Dermatology, University of Minnesota, Minneapolis, MN, USA
| | - Todd V Cartee
- Department of Dermatology, Penn State College of Medicine, Hershey, PA, USA
| | - Joseph F Sobanko
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Kelly A Reynolds
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N St Clair St, Suite 1600, Chicago, IL, 60611, USA
| | - Diana Bolotin
- Section of Dermatology, The University of Chicago, Chicago, IL, USA
| | - Abigail H Waldman
- Brigham and Women's Hospital Department of Dermatology, Harvard Medical School, Boston, MA, USA
| | - Kira Minkis
- Department of Dermatology, Weill-Cornell Medical College, New York, NY, USA
| | - Brian Petersen
- Department of Dermatology, Colorado Permanente Medical Group, Denver, CO, USA
| | - M Laurin Council
- Division of Dermatology, Center for Dermatologic and Cosmetic Surgery, Washington University in Saint Louis, Saint Louis, MO, USA
| | - Kishwer S Nehal
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Y Gloria Xu
- Department of Dermatology, University of Wisconsin-Madison, Madison, WI, USA
| | - S Brian Jiang
- Department of Dermatology, University of California San Diego, San Diego, CA, USA
| | - Ally-Khan Somani
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Conway C Huang
- Department of Dermatology, University of Alabama, Birmingham, AL, USA
| | - Daniel B Eisen
- Department of Dermatology, University of California Davis, Sacramento, CA, USA
| | - David M Ozog
- Department of Dermatology, Henry Ford Hospital, Detroit, MI, USA
| | - Erica H Lee
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Faramarz H Samie
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA
| | - Isaac M Neuhaus
- Department of Dermatology, University of California At San Francisco, San Francisco, CA, USA
| | - Jeremy S Bordeaux
- Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Jordan V Wang
- Laser and Skin Surgery Center of New York, New York, NY, USA
| | | | - Margaret W Mann
- Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Innova Dermatology, Hendersonville, TN, USA
| | - Naomi Lawrence
- Division of Dermatology, Section of Procedural Dermatology, Cooper Hospital, Rowan University, Camden, NJ, USA
| | | | - Nicholas Golda
- Department of Dermatology, University of Missouri School of Medicine, Columbia, MO, USA
| | - Ramona Behshad
- Department of Dermatology, Saint Louis University School of Medicine, Saint Louis, MO, USA
| | - Sherrif F Ibrahim
- Department of Dermatology, University of Rochester, Rochester, NY, USA
| | - Siegrid S Yu
- Department of Dermatology, University of California At San Francisco, San Francisco, CA, USA
| | - Thuzar M Shin
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - William G Stebbins
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Brandon Worley
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N St Clair St, Suite 1600, Chicago, IL, 60611, USA
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17
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Alam M, Harikumar V, Ibrahim SA, Kang BY, Maher IA, Cartee TV, Sobanko JF, Kibbi N, Owen JL, Reynolds KA, Bolotin D, Waldman AH, Minkis K, Petersen B, Council ML, Nehal KS, Xu YG, Jiang SB, Somani AK, Bichakjian CK, Huang CC, Eisen DB, Ozog DM, Lee EH, Samie FH, Neuhaus IM, Bordeaux JS, Wang JV, Leitenberger JJ, Mann MW, Lawrence N, Zeitouni NC, Golda N, Behshad R, Ibrahim SF, Yu SS, Shin TM, Stebbins WG, Worley B. Principles for developing and adapting clinical practice guidelines and guidance for pandemics, wars, shortages, and other crises and emergencies: the PAGE criteria. Arch Dermatol Res 2020; 314:393-398. [PMID: 33206210 DOI: 10.1007/s00403-020-02167-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 10/30/2020] [Accepted: 11/03/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Murad Alam
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N St Clair St, Suite 1600, Chicago, IL, 60611, USA.
| | - Vishnu Harikumar
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N St Clair St, Suite 1600, Chicago, IL, 60611, USA
| | - Sarah A Ibrahim
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N St Clair St, Suite 1600, Chicago, IL, 60611, USA
| | - Bianca Y Kang
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N St Clair St, Suite 1600, Chicago, IL, 60611, USA
| | - Ian A Maher
- Department of Dermatology, University of Minnesota, Minneapolis, MN, USA
| | - Todd V Cartee
- Department of Dermatology, Penn State College of Medicine, Hershey, PA, USA
| | - Joseph F Sobanko
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Nour Kibbi
- Department of Dermatology, Stanford University School of Medicine, Redwood City, CA, USA
| | - Joshua L Owen
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N St Clair St, Suite 1600, Chicago, IL, 60611, USA.,South Texas Skin Cancer Center, San Antonio, TX, USA
| | - Kelly A Reynolds
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N St Clair St, Suite 1600, Chicago, IL, 60611, USA
| | - Diana Bolotin
- Section of Dermatology, The University of Chicago, Chicago, IL, USA
| | - Abigail H Waldman
- Brigham and Women's Hospital Department of Dermatology, Harvard Medical School, Boston, MA, USA
| | - Kira Minkis
- Department of Dermatology, Weill-Cornell Medical College, New York, NY, USA
| | - Brian Petersen
- Department of Dermatology, Colorado Permanente Medical Group, Denver, CO, USA
| | - M Laurin Council
- Division of Dermatology, Center for Dermatologic and Cosmetic Surgery, Washington University in Saint Louis, Saint Louis, MO, USA
| | - Kishwer S Nehal
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Y Gloria Xu
- Department of Dermatology, University of Wisconsin-Madison, Madison, WI, USA
| | - S Brian Jiang
- Department of Dermatology, University of California San Diego, San Diego, CA, USA
| | - Ally-Khan Somani
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Conway C Huang
- Department of Dermatology, University of Alabama, Birmingham, AL, USA
| | - Daniel B Eisen
- Department of Dermatology, University of California Davis, Sacramento, CA, USA
| | - David M Ozog
- Department of Dermatology, Henry Ford Hospital, Detroit, MI, USA
| | - Erica H Lee
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Faramarz H Samie
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA
| | - Isaac M Neuhaus
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, USA
| | - Jeremy S Bordeaux
- Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Jordan V Wang
- Laser and Skin Surgery Center of New York, New York, NY, USA
| | | | - Margaret W Mann
- Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Naomi Lawrence
- Division of Dermatology, Section of Procedural Dermatology, Cooper Hospital, Rowan University, Camden, NJ, USA
| | | | - Nicholas Golda
- Department of Dermatology, University of Missouri School of Medicine, Columbia, MO, USA
| | - Ramona Behshad
- Department of Dermatology, Saint Louis University School of Medicine, Saint Louis, MO, USA
| | - Sherrif F Ibrahim
- Department of Dermatology, University of Rochester, Rochester, NY, USA
| | - Siegrid S Yu
- Department of Dermatology, University of California at San Francisco, San Francisco, CA, USA
| | - Thuzar M Shin
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - William G Stebbins
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Brandon Worley
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N St Clair St, Suite 1600, Chicago, IL, 60611, USA
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18
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Harikumar V, Reynolds K, Hsu D, Chen B, Lazaroff J, Gwillim E, Poon E, Alam M. LB927 Predictors of post-operative wound dehiscence: An analysis of the northwestern medicine enterprise data warehouse (nmedw). J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Chandra PVR, Harikumar V, Ramkiran D, Krishna MJN, Gouda MV. Microleakage of class V resin composites using various self-etching adhesives: an in vitro study. J Contemp Dent Pract 2013; 14:51-5. [PMID: 23579893 DOI: 10.5005/jp-journals-10024-1269] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS Microleakage has been identified as a significant problem with composite restorations because of interfacial gap formation which can result in tooth discoloration, recurrent caries, possible pulpal involvement and restoration replacement. Aim of this study is to evaluate the microleakage of self-etch adhesive system at the coronal and apical margins of class V resin composite restorations under stereomicroscope at 20× magnification. MATERIALS AND METHODS Class V cavities were prepared on the facial surfaces of 48 human premolars with coronal margins located in enamel and apical margins located in dentin. Teeth were divided into four groups: Group one-Xeno V; group two- G-Bond; group three-Clearfil S(3) Bond; group four-control. After application of bonding agent and restoration, the teeth were subjected to thermocycling. The teeth were then immersed in 1% aqueous solution of methylene blue dye for 24 hours and sectioned to allow the assessment of microleakage under microscope. RESULTS Coronal and apical margins were scored separately using a 0-3 ordinal ranking system and the recorded values were statistically analyzed using Kruskal-Wallis, Mann- Whitney U-test and Wilcoxon signed rank test. Statistical analysis showed that there was less microleakage in Xeno V at coronal region and Clearfil S(3) Bond in apical region, overall Clearfil S(3) Bond showed less marginal permeability in both coronal and apical regions. CONCLUSION Specimens restored with the Xeno V and Clearfil S(3) Bond adhesive systems revealed reduced leakage at the coronal margin. At the apical margin, Xeno V showed greater leakage than the other groups, except the control. CLINICAL SIGNIFICANCE In class V restorations restored with composite resin, the choice of material affects the microleakage and retention of the restoration. This study theorizes that the self-etch adhesives show less microleakage in the coronal area than the apical margin.
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Affiliation(s)
- P V Ravi Chandra
- Department of Conservative Dentistry and Endodontics, Kamineni Institute of Dental Sciences, Hyderabad, Andhra Pradesh, India.
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