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Gordon ER, Chen C, Trager MH, Adeuyan O, Lapolla BA, Fahmy LM, Schreidah CM, Wetter DA, Geskin LJ. Gammopathic dermopathy: characterization of cutaneous MGUS. Leuk Lymphoma 2024:1-8. [PMID: 38581379 DOI: 10.1080/10428194.2024.2336046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 03/24/2024] [Indexed: 04/08/2024]
Abstract
Monoclonal Gammopathy of Undetermined Significance (MGUS) is a clonal plasma cell disorder that is considered preneoplastic, asymptomatic, and only requiring observation. However, MGUS may result in cutaneous complications, which are poorly understood, causing treatment delays and patient suffering. We present 30 patients with cutaneous findings associated with MGUS, characterizing clinical presentations, isoforms, treatments, and outcomes. These included: MGUS-associated 'rashes' (pruritic eczematous rashes), reactive and mucin-depositional conditions (pyoderma gangrenosum, scleromyxedema), M-protein-related deposition disorders (POEMS syndrome, Waldenstrom macroglobulinemia), and cutaneous lymphomas. Twelve of 30 (40%) patients received multiple myeloma drugs (MMDs). Eleven (92%) patients improved, and those not receiving MMDs rarely improved, suggesting that MMDs have efficacy for cutaneous manifestations of MGUS. Therefore, trialing MMDs may be warranted for patients with MGUS not responding to other therapies. Moreover, evaluation for monoclonal gammopathy in elderly patients with intractable pruritus or other chronic skin conditions that are non-responsive to skin-directed therapies should be considered.
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Affiliation(s)
- Emily R Gordon
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Caroline Chen
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Megan H Trager
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA
| | - Oluwaseyi Adeuyan
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Brigit A Lapolla
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA
| | - Lauren M Fahmy
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Celine M Schreidah
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - David A Wetter
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Larisa J Geskin
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA
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2
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Tran MM, Mirza FN, Lee AC, Goldbach HS, Libby TJ, Wisco OJ. Dermatologic findings associated with semaglutide use: A scoping review. J Am Acad Dermatol 2024:S0190-9622(24)00532-2. [PMID: 38554940 DOI: 10.1016/j.jaad.2024.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/05/2024] [Accepted: 03/12/2024] [Indexed: 04/02/2024]
Affiliation(s)
- Megan M Tran
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Fatima N Mirza
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | | | - Hayley S Goldbach
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Tiffany J Libby
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Oliver J Wisco
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
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3
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Gordon ER, Chen C, Adeuyan O, Lapolla BA, Trager MH, Fahmy LM, Schreidah CM, Wetter DA, Geskin LJ. Retrospective analysis of multiple myeloma drug use in cutaneous toxicity of monoclonal gammopathy of undetermined significance. J Am Acad Dermatol 2024:S0190-9622(24)00483-3. [PMID: 38479611 DOI: 10.1016/j.jaad.2024.02.050] [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: 11/01/2023] [Revised: 02/16/2024] [Accepted: 02/28/2024] [Indexed: 04/05/2024]
Affiliation(s)
- Emily R Gordon
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Caroline Chen
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Oluwaseyi Adeuyan
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Brigit A Lapolla
- Department of Dermatology, Columbia University Irving Medical Center, New York, New York
| | - Megan H Trager
- Department of Dermatology, Columbia University Irving Medical Center, New York, New York
| | - Lauren M Fahmy
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Celine M Schreidah
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - David A Wetter
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | - Larisa J Geskin
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York; Department of Dermatology, Columbia University Irving Medical Center, New York, New York.
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4
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Diaconeasa A, Voicu C, Ivaniciuc M, Miulescu R, Birsan C, Chiriac AE, Chiriac A, Schönlebe J, Wollina U. Cutaneous borreliosis in children - a challenging problem. Eur J Dermatol 2024; 34:18-25. [PMID: 38557454 DOI: 10.1684/ejd.2024.4611] [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] [Indexed: 04/04/2024]
Abstract
Borreliosis, also known as Lyme disease, is a vector-borne disease caused by different species of the Borrelia burgdorferi complex. It is frequent in Europe and Northern America. The major vectors are ixodoid ticks. Paediatric borreliosis is common and peaks in children between five to nine years. In Europe, the leading symptom of early infection is erythema migrans, in contrast to Northern America where arthritis is the dominating clinical finding. In this review, we focus on Europe, where cutaneous borreliosis is mainly caused by infection with B. afzelii. The cutaneous symptoms include erythema migrans, lymphocytoma, chronic atrophic dermatitis and juxta-articular nodules. In children, lymphocytoma is very common but chronic atrophic dermatitis is rare. Clinical symptoms, diagnosis, peculiarities of childhood disease and treatment are also reviewed. It is important to note that after haematogeneic spread, signs of infection may be non-specific, and this is a challenge for diagnosis.
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Affiliation(s)
- Adriana Diaconeasa
- Dermatology Ambulatory Care Center, "Grigore Alexandrescu" Clinical Emergency Hospital for Children, Bucharest, Romania
| | - Cristiana Voicu
- Department of Dermatology, MedLife Medical System, Bucharest, Romania
| | | | | | - Cristina Birsan
- Nicolina Medical Center, Department of Dermatology, Iasi, Romania
| | - Anca E Chiriac
- Nicolina Medical Center, Department of Dermatology, Iasi, Romania
| | - Anca Chiriac
- Nicolina Medical Center, Department of Dermatology, Iasi, Romania, P. Poni Institute of Macromolecular Chemistry, Romanian Academy
| | | | - Uwe Wollina
- Department of Dermatology and Allergology, Municipal Hospital Dresden, Dresden, Germany
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Gordon ER, Trager MH, Adeuyan O, Schreidah CM, Fahmy LM, Lapolla BA, Husain S, Coromilas AJ, Geskin LJ. Alone on a collagen island: Unique findings of osseous sclerotic bodies in nephrogenic systemic fibrosis. JAAD Case Rep 2023; 40:117-119. [PMID: 37766735 PMCID: PMC10520489 DOI: 10.1016/j.jdcr.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023] Open
Affiliation(s)
- Emily R. Gordon
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Megan H. Trager
- Department of Dermatology, Columbia University Irving Medical Center, New York, New York
| | - Oluwaseyi Adeuyan
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Celine M. Schreidah
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Lauren M. Fahmy
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Brigit A. Lapolla
- Department of Dermatology, Columbia University Irving Medical Center, New York, New York
| | - Sameera Husain
- Department of Dermatology, Columbia University Irving Medical Center, New York, New York
| | - Alexandra J. Coromilas
- Department of Dermatology, Columbia University Irving Medical Center, New York, New York
| | - Larisa J. Geskin
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York
- Department of Dermatology, Columbia University Irving Medical Center, New York, New York
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Sarac G, Ozcan KN, Baskiran A, Cenk H, Sarac M, Sener S, Yilmaz S. Dermatological signs in liver transplant recipients. J Cosmet Dermatol 2021; 20:2969-2974. [PMID: 33480152 DOI: 10.1111/jocd.13944] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 12/21/2020] [Accepted: 01/06/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND In recent years, the number of liver transplantations for advanced-stage liver diseases has considerably increased and the patients have a wide range of dermatologic manifestations. AIM This study aims to reveal cutaneous, mucosal, and nail lesions in liver transplant recipients in quite large patient series. PATIENTS/METHODS The study included 520 patients in the Inonu University Liver Transplantation Institute. New and followed-up patients attended to the study between May and October 2019. The patients were examined by a dermatologist, and their data were recorded. RESULTS The study included 163 female and 357 male patients with the main age of 44.20 ± 18.18 (range: 1-83 years), and 465 livers (89.4%) were taken from live donors, while 54 livers (10.4%) were taken from cadavers. A total of 314 (60.4%) patients had dermatophyte infections, 174 (33.4%) patients had pathological nail changes, and 427 (82.1%) patients had oral mucosal lesions. Graft-versus-host disease (GVHD) developed in 9 (1.73%) patients after the transplantation, and 5 patients died of GVHD. Four patients had cutaneous malignancies. CONCLUSIONS Tumoral and nontumoral dermatological diseases may be encountered following the transplantation depending on underlying liver disease, immunosuppressive treatment, the graft itself, or any primary cutaneous disease. Liver transplantation recipients require a multidisciplinary clinical approach, and dermatological care must be an integral part of this approach.
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Affiliation(s)
- Gulbahar Sarac
- Department of Dermatology, Turgut Ozal Medical Center, Inonu University, Malatya, Turkey
| | - Kubra Nur Ozcan
- Department of Dermatology, Turgut Ozal Medical Center, Inonu University, Malatya, Turkey
| | - Adil Baskiran
- Department of General Surgery, Turgut Ozal Medical Center, Liver Transplantation Institute, Inonu University, Malatya, Turkey
| | - Hulya Cenk
- Department of Dermatology, Malatya Training and Research Hospital, Malatya, Turkey
| | - Mehmet Sarac
- Department of General Surgery, Malatya Training and Research Hospital, Malatya, Turkey
| | - Serpil Sener
- Department of Dermatology, Turgut Ozal Medical Center, Inonu University, Malatya, Turkey
| | - Sezai Yilmaz
- Department of General Surgery, Turgut Ozal Medical Center, Liver Transplantation Institute, Inonu University, Malatya, Turkey
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Duygu F, Sari T, Gunal O, Barut S, Atay A, Aytekin F. Cutaneous Findings of Crimean-Congo Hemorrhagic Fever: a Study of 269 Cases. Jpn J Infect Dis 2018; 71:408-412. [PMID: 29962486 DOI: 10.7883/yoken.jjid.2018.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic viral disease. We aimed to investigate the cutaneous manifestations of CCHF and reveal their associations with fatality. Two hundred and sixty-nine patients diagnosed with CCHF were assessed. Skin findings were observed in 170 (63.2%) patients. A facial rash was the most common cutaneous finding (n = 82, 30.5%). In severe cases, hemorrhagic cutaneous manifestations (petechiae and ecchymoses) were recognized. A statistically significant correlation was obtained between cutaneous manifestations and fatality, and it was determined that there was a strong positive correlation between fatality and ecchymosis (r = 567, p < 0.001). In addition, a logistic regression analysis was performed, and death occurred 4.69 times more in those with skin signs than in those without. We hypothesize that CCHF patients with ecchymosis are at the highest risk and that cutaneous findings can contribute to the prognosis of CCHF.
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Affiliation(s)
- Fazilet Duygu
- Department of Infectious Diseases and Clinical Microbiology, Ankara Oncology Training and Research Hospital
| | - Tugba Sari
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Pamukkale University
| | - Ozgur Gunal
- Department of Infectious Diseases and Clinical Microbiology, Samsun Training and Research Hospital
| | - Sener Barut
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Gaziosmanpasa University
| | - Ayfer Atay
- Department of Infectious Diseases and Clinical Microbiology, Bakirköy Dr. Sadi Konuk Training and Research Hospital
| | - Feyza Aytekin
- Department of Infectious Diseases and Clinical Microbiology, Ministry of Health-Giresun University Dr. A. Ilhan Ozdemir Training and Research Hospital
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