DeBusk L, Atanaskova-Mesinkovska N, Bartley B
… +12 more, Burshtein J, Cameron M, Daly T, Eichenfield L, Merritt D, Patel T, Rigel D, Rosenberg A, Shah M, Swanson L, Zakria D, Lebwohl M
Atopic dermatitis is a chronic inflammatory skin condition driven by immune dysregulation, with interleukin-13 playing a central role in its pathogenesis. Recent advances in targeted biologic therapies have shown promisi...Atopic dermatitis is a chronic inflammatory skin condition driven by immune dysregulation, with interleukin-13 playing a central role in its pathogenesis. Recent advances in targeted biologic therapies have shown promising results in treating moderate-to-severe atopic dermatitis. A comprehensive literature review of PubMed and Google Scholar was conducted to identify studies related to interleukin-13 inhibition in atopic dermatitis. An expert panel reviewed and graded the evidence using Strength of Recommendation Taxonomy criteria and utilized a modified Delphi process to formulate consensus statements on the role of interleukin-13 inhibitors. Based on selected literature, the panel developed 14 consensus statements, all receiving unanimous approval. Key findings include the rapid efficacy, sustained benefits, and favorable safety profiles of interleukin-13 inhibitors. Differences between available interleukin-13 inhibitors included pain of injection, speed of onset, durability of efficacy, and number of injections needed to maintain efficacy. Interleukin-13 plays a pivotal role in atopic dermatitis pathogenesis, driving inflammation, pruritus, and barrier dysfunction. Targeted therapies, including interleukin-13 inhibitors, provide rapid, durable, and safe options for managing moderate-to-severe atopic dermatitis. This consensus highlights interleukin-13 inhibition as a cornerstone in advancing atopic dermatitis treatment strategies, offering improved patient outcomes and quality of life.
eclare that the contents of this article are their own original unpublished findings. Title: Changes in public interest for Mohs micrographic surgery: a Google Trends analysis Authors: Joshua Burshtein1 MD, Milaan Shah2...eclare that the contents of this article are their own original unpublished findings. Title: Changes in public interest for Mohs micrographic surgery: a Google Trends analysis Authors: Joshua Burshtein1 MD, Milaan Shah2 MD, Danny Zakria3 MD MBA, Lauren DeBusk4 MD, Angela Rosenberg4 DO, Darrell Rigel5 MD MS Affiliations: 1Department of Dermatology, University of Illinois Chicago, Chicago, Illinois, USA, 2Department of Dermatology, Medical University of South Carolina, Charleston, South Carolina, USA, 3Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA, 4Department of Dermatology, UT Southwestern Medical Center, Dallas, Texas, USA, 5Department of Dermatology, NYU Grossman School of Medicine, New York, New York, USA Corresponding Author: Joshua Burshtein MD, 808 South Wood Street, Chicago, IL 60612, Tel: 845-596-9482, Email: jburshtein13@gmail.com.
Traumatic tattoos result from the forceful implantation of foreign material into the skin and may present a significant cosmetic burden to patients. Long-lasting or permanent skin pigmentation in traumatic tattoo may ari...Traumatic tattoos result from the forceful implantation of foreign material into the skin and may present a significant cosmetic burden to patients. Long-lasting or permanent skin pigmentation in traumatic tattoo may arise from particles of numerous materials such as fireworks, metals, gunpowder, asphalt, and dust embedded within injured skin. Our aim was to demonstrate the appropriate and beneficial use of the Q-switched alexandrite laser to treat traumatic tattoos. The patient's pigmented scars were biopsied and processed using standard histological methods to demonstrate foreign material within the scars. Following patient consent and laser tolerance testing, pigmented scars on the face were treated on two occasions with the Q-switched alexandrite laser. Progress photos were obtained before and after each treatment. The pigmented lesions responded well to treatment with the Q-switched alexandrite laser and exhibited almost complete resolution of foreign body pigmentation after just two treatments. The Q-switched alexandrite laser was used safely and effectively to treat traumatic tattoos.
A 76-year-old woman with a significant cardiac surgery and breast cancer history presented to the dermatology clinic with a three-year history of an enlarging, tender, nonhealing cutaneous nodule on her upper abdomen. A...A 76-year-old woman with a significant cardiac surgery and breast cancer history presented to the dermatology clinic with a three-year history of an enlarging, tender, nonhealing cutaneous nodule on her upper abdomen. A shave biopsy was attempted given concern for nonmelanoma skin cancer or cutaneous metastasis. The biopsy was halted after a white wire was visualized. Retrospective computed tomography (CT) imaging review revealed a hyperdense linear structure becoming superficial at the location of the nodule seen on examination. Discussion with a cardiothoracic surgeon revealed this wire was likely a retained temporary epicardial pacing wire that was placed at the time of the patient's cardiac surgery three years prior. The decision was made to excise the lesion to fully remove the wire. Given intraoperative resistance with traction, the wire was partially removed by cutting it flush to the skin's surface. The patient healed appropriately with complete resolution of her symptoms. This case is unique because the wire was fully visualized on the CT scan, and it was unable to be fully removed.
Enchondromas are frequently occurring cartilaginous tumors, accounting for 10-25% of all benign bone neoplasms. We present a distinctive case involving distal clubbing of the right third toenail with a painless, 5mm-wide...Enchondromas are frequently occurring cartilaginous tumors, accounting for 10-25% of all benign bone neoplasms. We present a distinctive case involving distal clubbing of the right third toenail with a painless, 5mm-wide red longitudinal streak. Clinical examination, nail matrix biopsy, and imaging confirmed the presence of an enchondroma in the distal phalanx. Although solitary enchondromas often present with pain or pathological fractures, asymptomatic cases like this one are quite rare. Given the low risk of malignant transformation, the patient chose regular magnetic resonance imaging (MRI) monitoring. This case highlights the need to consider enchondromas in the differential diagnosis of painless longitudinal erythronychia, an infrequent manifestation. Proper diagnosis is essential to differentiate these lesions from malignant chondrosarcomas, which have a different management approach.
Blue rubber bleb nevus syndrome (BRBNS) and familial multiple glomuvenous malformations (GVM) are genetic disorders characterized by multiple cutaneous vascular malformations. Unlike multiple GVM, BRBNS comprises a risk...Blue rubber bleb nevus syndrome (BRBNS) and familial multiple glomuvenous malformations (GVM) are genetic disorders characterized by multiple cutaneous vascular malformations. Unlike multiple GVM, BRBNS comprises a risk of systemic involvement with vascular malformations in other organs, potentially causing life-threatening bleeding. The correct distinction between these two conditions is challenging due to their clinical similarity, but it is crucial in light of the pivotal differences in prognosis and follow-up. We report a case of multiple glomuvenous malformations in a child with lower gastrointestinal bleeding that posed a thought-provoking diagnosis.
Anetoderma is commonly characterized by well-circumscribed areas of slack or baggy skin related to the loss of elastic fibers in the dermis. It has associations with some well-defined skin lesions, such as acne vulgaris...Anetoderma is commonly characterized by well-circumscribed areas of slack or baggy skin related to the loss of elastic fibers in the dermis. It has associations with some well-defined skin lesions, such as acne vulgaris and varicella. We report a 67-year-old woman with clinical and pathologically confirmed anetoderma at sites of previously documented lichen planus.
Drug-induced subacute cutaneous lupus erythematosus (DI-SCLE) is an erythematous, photodistributed, scaly, and annular cutaneous eruption that is clinically similar to subacute cutaneous lupus erythematosus. However, DI-...Drug-induced subacute cutaneous lupus erythematosus (DI-SCLE) is an erythematous, photodistributed, scaly, and annular cutaneous eruption that is clinically similar to subacute cutaneous lupus erythematosus. However, DI-SCLE is associated with medication use and generally resolves or greatly improves following discontinuation. Chemotherapeutic agents are common triggers of DI-SCLE. We report a patient with breast cancer who experienced multiple episodes of DI-SCLE associated with the use of different chemotherapeutic agents for treatment-resistant cancer. Notably, to the best of our knowledge, this case highlights the first reported association of DI-SCLE with trastuzumab deruxtecan. Additionally, this case is unique owing to a component of radiation recall dermatitis, as the rash was prominent in areas that had prior ionizing radiation. A prior history of DI-SCLE in oncology patients who continue to undergo treatment should prompt clinicians to consider DI-SCLE when faced with a new photodistributed, erythematous, annular, and scaly eruption. Early initiation of immunomodulating agents like hydroxychloroquine in patients with a history of moderate to severe DI-SCLE to chemotherapy who continue to undergo anti-cancer treatment may provide benefit and warrants further investigation.
Ovarian carcinoma ranks among the top causes of cancer-related fatalities among women in the United States [1]. In the spectrum of ovarian carcinomas, low-grade serous ovarian carcinoma (LGSOC) is a relatively rare form,...Ovarian carcinoma ranks among the top causes of cancer-related fatalities among women in the United States [1]. In the spectrum of ovarian carcinomas, low-grade serous ovarian carcinoma (LGSOC) is a relatively rare form, constituting only 2-5% of all ovarian carcinomas [2]. Although metastasis to the peritoneum and other organs is frequently observed, cutaneous metastasis of ovarian carcinoma is uncommon, occurring in less than 4% of cases and occurring even less often in the serous subtype [3]. Owing to its rare and variable presentation, cutaneous involvement in ovarian carcinoma is particularly challenging to recognize. Patients presenting with skin lesions in the setting of a history of ovarian carcinoma should raise suspicion for cutaneous metastasis. We present a rare case of LGSOC with non-nodular cutaneous involvement presenting as asymptomatic erythematous papules and hyperpigmented patches on the upper chest, abdomen, and lower back.
Erlotinib is one of the epithelial growth factor receptor tyrosine kinase inhibitors that have been developed and extensively employed in the treatment of non-small cell lung cancer, particularly in individuals with acti...Erlotinib is one of the epithelial growth factor receptor tyrosine kinase inhibitors that have been developed and extensively employed in the treatment of non-small cell lung cancer, particularly in individuals with activating epithelial growth factor receptor mutations. This report presents a case of erlotinib induced eyelash trichomegaly and irritation, a rare side effect in a woman who received erlotinib for lung adenocarcinoma. Following the detection of an epithelial growth factor receptor mutation in tumor tissue from a non-small cell lung cancer in a nonsmoking woman, the patient was initiated on erlotinib therapy. After several months, she experienced significant overgrowth of both eyelashes, leading to vision problems. Dermoscopy findings revealed an increase in the length and thickness of the eyelashes associated with inflammation of the eyelid's edges. It has been hypothesized that the inhibition of epithelial growth factor receptor signaling by epithelial growth factor receptor tyrosine kinase inhibitors could alter the growth pattern of hair, potentially leading to the induction of abnormal hair growth, such as trichomegaly, which has been reported only in a small number of case reports.
Given the rise of radiation based medical procedures, cutaneous radiation reactions are increasing in frequency. Diagnosis of fluoroscopic radiation-related cutaneous injuries are challenging, as patients are often unawa...Given the rise of radiation based medical procedures, cutaneous radiation reactions are increasing in frequency. Diagnosis of fluoroscopic radiation-related cutaneous injuries are challenging, as patients are often unaware of or cannot recall radiation exposure. It is important to maintain clinical suspicion of radiation induced skin injuries in patients with persistent morpheaform areas and localized areas of dermatitis or ulceration. Several cutaneous radiation induced injuries have overlapping clinical presentations. Histopathology may be required to help differentiate between these distinct disorders. Treatment of cutaneous radiation reactions may vary, dictated by a variety of factors, including the disease process, the severity of the lesions, and the presence of comorbidities. Herein, we present two cases to highlight the spectrum of fluoroscopic radiation induced cutaneous injuries.
Angiomatoid melanoma is a rare variant of malignant melanoma not currently recognized by the World Health Organization classification system. In this study, we present a case of primary angiomatoid melanoma in a 57-year-...Angiomatoid melanoma is a rare variant of malignant melanoma not currently recognized by the World Health Organization classification system. In this study, we present a case of primary angiomatoid melanoma in a 57-year-old man who presented to clinic with a complaint of a growing lesion on the frontal scalp for four months. Microscopic examination of the lesion revealed cavernous spaces filled with extravasated red blood cells. Immunohistochemical markers were positive for melanoma and negative for vascular endothelium. We also review the literature on angiomatoid melanoma, finding distinct morphological differences in previously reported cases. Owing to these differences, we propose new diagnostic criteria and offer a mechanism for formation of blood-filled cavernous spaces while cautioning against misinterpretation of CD31 expression by macrophages in zones of immune regression. Angiomatoid melanoma is a diagnostic challenge because of its rarity, signaling a need for further histopathological evaluation and more complete awareness of its features.