1
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Nasiri N, Maazi M, Mehta S, McMullen EP, Pourghadiri A, Croitoru D, Piguet V. Seasonal Trends in Hidradenitis Suppurativa: Data Analysis of the United States and Canada Google Search Patterns. J Cutan Med Surg 2024:12034754241252436. [PMID: 38708559 DOI: 10.1177/12034754241252436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Affiliation(s)
- Nima Nasiri
- Department of Electrical and Computer Engineering (ECE), University of British Columbia, Vancouver, BC, Canada
| | - Mahan Maazi
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Shanti Mehta
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Eric P McMullen
- Division of Dermatology, University of Toronto, Toronto, ON, Canada
| | - Amir Pourghadiri
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - David Croitoru
- Division of Dermatology, University of Toronto, Toronto, ON, Canada
- Division of Dermatology, Department of Medicine, University Health Network, Toronto ON, Canada
- Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, ON, Canada
| | - Vincent Piguet
- Division of Dermatology, University of Toronto, Toronto, ON, Canada
- Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, ON, Canada
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2
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Mohsen ST, Suntres E, Manzar D, Price EL, Croitoru D, Sibbald C. Population-based mortality in hidradenitis suppurativa: A systematic review. J Am Acad Dermatol 2024; 90:866-867. [PMID: 38151054 DOI: 10.1016/j.jaad.2023.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/27/2023] [Accepted: 12/20/2023] [Indexed: 12/29/2023]
Affiliation(s)
- Samiha T Mohsen
- University of Toronto, Temerty Faculty of Medicine, Toronto, Ontario
| | - Emmanuel Suntres
- University of Toronto, Temerty Faculty of Medicine, Toronto, Ontario
| | - Daud Manzar
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario
| | - Emma L Price
- University of Toronto, Temerty Faculty of Medicine, Toronto, Ontario
| | - David Croitoru
- Department of Dermatology, Women's College Hospital, Toronto, Ontario
| | - Cathryn Sibbald
- Department of Paediatrics, Dermatology, The Hospital for Sick Children, Toronto, Ontario.
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3
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Guo YX, Wang HX, Wang SS, Croitoru D, Piguet V, Gao XH, Xu XG. Treatment With Selumetinib for Café-au-Lait Macules and Plexiform Neurofibroma in Pediatric Patients With Neurofibromatosis Type 1. JAMA Dermatol 2024; 160:366-368. [PMID: 38198164 DOI: 10.1001/jamadermatol.2023.5338] [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: 01/11/2024]
Abstract
This case report describes 4 patients with a rare autosomal dominant multisystem disorder resulting from NF1 variants that leads to café-au-lait macules and neurofibromas.
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Affiliation(s)
- Ya-Xin Guo
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, Liaoning, China
- Key Laboratory of Immunodermatology, Ministry of Education and NHC, National joint Engineering Research Center for Theranostics of Immunological Skin Diseases, Shenyang, Liaoning, China
| | - He-Xiao Wang
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, Liaoning, China
- Key Laboratory of Immunodermatology, Ministry of Education and NHC, National joint Engineering Research Center for Theranostics of Immunological Skin Diseases, Shenyang, Liaoning, China
| | - Shan-Shan Wang
- Department of Radiology, The First Hospital, China Medical University, Shenyang, Liaoning, China
| | - David Croitoru
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Dermatology, Women's College Hospital, Toronto, Ontario, Canada
| | - Vincent Piguet
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Dermatology, Women's College Hospital, Toronto, Ontario, Canada
| | - Xing-Hua Gao
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, Liaoning, China
- Key Laboratory of Immunodermatology, Ministry of Education and NHC, National joint Engineering Research Center for Theranostics of Immunological Skin Diseases, Shenyang, Liaoning, China
| | - Xue-Gang Xu
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, Liaoning, China
- Key Laboratory of Immunodermatology, Ministry of Education and NHC, National joint Engineering Research Center for Theranostics of Immunological Skin Diseases, Shenyang, Liaoning, China
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4
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Seigel K, Croitoru D, Silverberg OM, Miller-Monthrope Y, Laframboise S, Joseph M. Painful plaques in a woman with recurrent squamous cell carcinoma. JAAD Case Rep 2023; 41:116-118. [PMID: 38022755 PMCID: PMC10657784 DOI: 10.1016/j.jdcr.2023.09.034] [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: 12/01/2023] Open
Affiliation(s)
- Kyle Seigel
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - David Croitoru
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Orli M. Silverberg
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Yvette Miller-Monthrope
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Dermatology, Women’s College Hospital, University of Toronto, Toronto, Ontario, Canada
- Division of Pathology, St. Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Stephane Laframboise
- Division of Gynecology & Gynecologic Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Marissa Joseph
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Dermatology, Women’s College Hospital, University of Toronto, Toronto, Ontario, Canada
- Section of Pediatric Dermatology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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5
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Cheung MW, Dayam RM, Shapiro JR, Law JC, Chao GYC, Pereira D, Goetgebuer RL, Croitoru D, Stempak JM, Acheampong L, Rizwan S, Lee JD, Jacob L, Ganatra D, Law R, Rodriguez-Castellanos VE, Kern-Smith M, Delgado-Brand M, Mailhot G, Haroon N, Inman RD, Piguet V, Chandran V, Silverberg MS, Watts TH, Gingras AC. Third and Fourth Vaccine Doses Broaden and Prolong Immunity to SARS-CoV-2 in Adult Patients with Immune-Mediated Inflammatory Diseases. J Immunol 2023:ji2300190. [PMID: 37326480 DOI: 10.4049/jimmunol.2300190] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/25/2023] [Indexed: 06/17/2023]
Abstract
Previous studies have reported impaired humoral responses after SARS-CoV-2 mRNA vaccination in patients with immune-mediated inflammatory diseases (IMIDs), particularly those treated with anti-TNF biologics. We previously reported that IMID patients diagnosed with inflammatory bowel disease, psoriasis, psoriatic arthritis, ankylosing spondylitis, or rheumatoid arthritis exhibited greater waning of Ab and T cell responses than healthy control subjects after SARS-CoV-2 vaccine dose 2. Fewer data are available on the effects of third and fourth doses. This observational cohort study collected plasma and PBMCs from healthy control subjects and untreated or treated patients with IMIDs prevaccination and after one to four doses of SARS-CoV-2 mRNA vaccine (BNT162b2 or mRNA-1273). SARS-CoV-2-specific Ab levels, neutralization, and T cell cytokine release were measured against wild-type and Omicron BA.1 and BA.5 variants of concern. Third vaccine doses substantially restored and prolonged Ab and T cell responses in patients with IMIDs and broadened responses against variants of concern. Fourth-dose effects were subtle but also prolonged Ab responses. However, patients with IMIDs treated with anti-TNF, especially patients with inflammatory bowel disease, exhibited lower Ab responses even after the fourth dose. Although T cell IFN-γ responses were maximal after one dose, IL-2 and IL-4 production increased with successive doses, and early production of these cytokines was predictive of neutralization responses at 3-4 mo postvaccination. Our study demonstrates that third and fourth doses of the SARS-CoV-2 mRNA vaccines sustain and broaden immune responses to SARS-CoV-2, supporting the recommendation for three- and four-dose vaccination regimens in patients with IMIDs.
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Affiliation(s)
- Michelle W Cheung
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Roya M Dayam
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Janna R Shapiro
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Jaclyn C Law
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Gary Y C Chao
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Daniel Pereira
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Rogier L Goetgebuer
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - David Croitoru
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Joanne M Stempak
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Lily Acheampong
- Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada
| | - Saima Rizwan
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Jenny D Lee
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Liz Jacob
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Darshini Ganatra
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Ryan Law
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Melanie Delgado-Brand
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Genevieve Mailhot
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Nigil Haroon
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
- Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Robert D Inman
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
- Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Vincent Piguet
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada
| | - Vinod Chandran
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
- Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Mark S Silverberg
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Division of Gastroenterology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Tania H Watts
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Anne-Claude Gingras
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
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6
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Seigel K, Croitoru D, Lena ER, Dienes S, Alsukait S, Piguet V. Utility of Rituximab in the Treatment of Hidradenitis Suppurativa: A Systematic Review. J Cutan Med Surg 2023; 27:176-177. [PMID: 36789521 DOI: 10.1177/12034754231154261] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- Kyle Seigel
- 12366 Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - David Croitoru
- 12366 Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada
| | - Eleanor R Lena
- 12366 Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Serena Dienes
- 12366 Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sarah Alsukait
- 12366 Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Vincent Piguet
- 12366 Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada
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7
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Brooks SG, Pawluk MA, Litvinov IV, Fradette J, Chan AW, Philip A, Croitoru D, Richardson KC. Informing a Canadian Skin Science Trainee Program Based on the State of Trainee Programs Offered by International Academic Societies. J Cutan Med Surg 2022; 27:20-27. [PMID: 36408849 PMCID: PMC9902982 DOI: 10.1177/12034754221137570] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND For dermatology to effectively address the ever-growing medical needs, longstanding communication barriers across investigators working in different research pillars and practicing clinicians must be improved. To address this problem, trainee-specific programs are now evolving to align their educational landscape across basic science, translational and clinical research programs. OBJECTIVES To establish a Skin Investigation Network of Canada (SkIN Canada) training roadmap for the career and skill development of future clinicians, clinican scientists and basic scientists in Canada. This Working Group aims to strengthen and harmonize collaborations and capacity across the skin research community. METHODS The Working Group conducted a search of established international academic societies which offered trainee programs with mandates similar to SkIN Canada. Societies' program items and meetings were evaluated by use of an interview survey and/or the collection of publicly available data. Program logistics, objectives and feedback were assessed for commonalities and factors reported or determined to improve trainee experience. RESULTS Through the various factors explored, the Working Group discovered the need for increasing program accessibility, creating opportunities for soft skill development, emphasizing the importance of current challenges, collecting and responding to feedback, and improving knowledge sharing to bridge pillars of skin research. CONCLUSIONS Although improvements have been made to trainee education in recent years, a plurality of approaches exist and many of the underlying roadblocks remain unresolved. To establish fundamental clinician-basic scientist collaboration and training efforts, this Working Group highlights important factors to include and consider in building a trainee program and emphasizes the importance of trainee education.
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Affiliation(s)
- Stephanie G. Brooks
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Megan A. Pawluk
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada, International Collaboration on Repair Discoveries (ICORD), Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Ivan V. Litvinov
- SkIN Canada Training Committee, Canada, Division of Dermatology, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Julie Fradette
- Department of Surgery, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada, CHU de Québec-Université Laval Research Center, Quebec City, Quebec, Canada, Centre de Recherche en Organogénèse Expérimentale de l’Université Laval/LOEX, Québec City, Québec, Canada
| | - An-Wen Chan
- SkIN Canada Training Committee, Canada, Women’s College Research Institute, Department of Medicine, University of Toronto, Toronto, Ontario, Canada, Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Anie Philip
- SkIN Canada Training Committee, Canada, Division of Plastic Surgery, Department of Surgery, McGill University, Montreal, Quebec, Canada
| | - David Croitoru
- SkIN Canada Training Committee, Canada, Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada,David Croitoru, Women’s College Hospital, 76 Grenville St., Toronto, Ontario M5S 1B2, Canada;
| | - Katlyn C. Richardson
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada, International Collaboration on Repair Discoveries (ICORD), Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada, SkIN Canada Training Committee, Canada,Katlyn C. Richardson, ICORD Centre, Blusson Spinal Cord Centre, 818 West 10th Ave. Vancouver, BC V5Z 1M9, Canada;
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8
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Cheung MW, Dayam RM, Law JC, Goetgebuer RL, Chao GYC, Finkelstein N, Stempak JM, Pereira D, Croitoru D, Acheampong L, Rizwan S, Lee JD, Ganatra D, Law R, Delgado-Brand M, Mailhot G, Piguet V, Silverberg MS, Watts TH, Gingras AC, Chandran V. Third dose corrects waning immunity to SARS-CoV-2 mRNA vaccines in immunocompromised patients with immune-mediated inflammatory diseases. RMD Open 2022. [PMCID: PMC9471210 DOI: 10.1136/rmdopen-2022-002622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Michelle W Cheung
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Roya M Dayam
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Jaclyn C Law
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Rogier L Goetgebuer
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centres, Duivendrecht, The Netherlands
| | - Gary Y C Chao
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Naomi Finkelstein
- Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
- Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Joanne M Stempak
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Daniel Pereira
- Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - David Croitoru
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lily Acheampong
- Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada
| | - Saima Rizwan
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Jenny D Lee
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Darshini Ganatra
- Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Ryan Law
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Melanie Delgado-Brand
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Geneviève Mailhot
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Vincent Piguet
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada
| | - Mark S Silverberg
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Division of Gastroenterology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Tania H Watts
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Anne-Claude Gingras
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Vinod Chandran
- Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
- Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
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9
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Croitoru D, Lu JD, Ling SC, Wales P, Levy R. Laparoscopic Detection of Malignant Atrophic Papulosis (MAP) in a Pediatric Patient. J Eur Acad Dermatol Venereol 2022; 36:e1052-e1054. [PMID: 35857385 DOI: 10.1111/jdv.18446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- David Croitoru
- Division of Dermatology, Department of Medicine, University of Toronto Ontario, Canada
| | - Justin D Lu
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Simon C Ling
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.,The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Paul Wales
- Division of General and Thoracic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.,The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Rebecca Levy
- Division of Dermatology, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.,Section of Dermatology, The Hospital for Sick Children, Toronto, Ontario, Canada
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10
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Dayam RM, Law JC, Goetgebuer RL, Chao GY, Abe KT, Sutton M, Finkelstein N, Stempak JM, Pereira D, Croitoru D, Acheampong L, Rizwan S, Rymaszewski K, Milgrom R, Ganatra D, Batista NV, Girard M, Lau I, Law R, Cheung MW, Rathod B, Kitaygorodsky J, Samson R, Hu Q, Hardy WR, Haroon N, Inman RD, Piguet V, Chandran V, Silverberg MS, Gingras AC, Watts TH. Accelerated waning of immunity to SARS-CoV-2 mRNA vaccines in patients with immune-mediated inflammatory diseases. JCI Insight 2022; 7:e159721. [PMID: 35471956 PMCID: PMC9220925 DOI: 10.1172/jci.insight.159721] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/22/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUNDLimited information is available on the impact of immunosuppressants on COVID-19 vaccination in patients with immune-mediated inflammatory diseases (IMID).METHODSThis observational cohort study examined the immunogenicity of SARS-CoV-2 mRNA vaccines in adult patients with inflammatory bowel disease, rheumatoid arthritis, ankylosing spondylitis, or psoriatic disease, with or without maintenance immunosuppressive therapies. Ab and T cell responses to SARS-CoV-2, including neutralization against SARS-CoV-2 variants, were determined before and after 1 and 2 vaccine doses.RESULTSWe prospectively followed 150 subjects, 26 healthy controls, 9 patients with IMID on no treatment, 44 on anti-TNF, 16 on anti-TNF with methotrexate/azathioprine (MTX/AZA), 10 on anti-IL-23, 28 on anti-IL-12/23, 9 on anti-IL-17, and 8 on MTX/AZA. Ab and T cell responses to SARS-CoV-2 were detected in all participants, increasing from dose 1 to dose 2 and declining 3 months later, with greater attrition in patients with IMID compared with healthy controls. Ab levels and neutralization efficacy against variants of concern were substantially lower in anti-TNF-treated patients than in healthy controls and were undetectable against Omicron by 3 months after dose 2.CONCLUSIONSOur findings support the need for a third dose of the mRNA vaccine and for continued monitoring of immunity in these patient groups.FUNDINGFunded by a donation from Juan and Stefania Speck and by Canadian Institutes of Health (CIHR)/COVID-Immunity Task Force (CITF) grants VR-1 172711 and VS1-175545 (to THW and ACG), CIHR FDN-143250 (to THW), GA2-177716 (to VC, ACG, and THW), and GA1-177703 (to ACG) and the CIHR rapid response network to SARS-CoV-2 variants, CoVaRR-Net (to ACG).
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Affiliation(s)
- Roya M. Dayam
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Jaclyn C. Law
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Rogier L. Goetgebuer
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health
| | - Gary Y.C. Chao
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Kento T. Abe
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Molecular Genetics
| | - Mitchell Sutton
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Division of Rheumatology, Department of Medicine, and
| | - Naomi Finkelstein
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Division of Rheumatology, Department of Medicine, and
| | - Joanne M. Stempak
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health
| | - Daniel Pereira
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Division of Rheumatology, Department of Medicine, and
| | - David Croitoru
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lily Acheampong
- Division of Dermatology, Department of Medicine, Women’s College Hospital, Toronto, Ontario, Canada
| | - Saima Rizwan
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health
| | - Klaudia Rymaszewski
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health
| | - Raquel Milgrom
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health
| | - Darshini Ganatra
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Division of Rheumatology, Department of Medicine, and
| | | | - Melanie Girard
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Irene Lau
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Ryan Law
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Michelle W. Cheung
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Bhavisha Rathod
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Julia Kitaygorodsky
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Molecular Genetics
| | - Reuben Samson
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Molecular Genetics
| | - Queenie Hu
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - W. Rod Hardy
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Nigil Haroon
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Division of Rheumatology, Department of Medicine, and
| | - Robert D. Inman
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Division of Rheumatology, Department of Medicine, and
| | - Vincent Piguet
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Dermatology, Department of Medicine, Women’s College Hospital, Toronto, Ontario, Canada
| | - Vinod Chandran
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Division of Rheumatology, Department of Medicine, and
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Mark S. Silverberg
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health
| | - Anne-Claude Gingras
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Molecular Genetics
| | - Tania H. Watts
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
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11
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Finkelstein N, Dayam RM, Law J, Goetgebuer R, Chao G, Abe KT, Sutton M, Stempak JM, Pereira D, Croitoru D, Acheampong L, Rizwan S, Rymaszewski K, Milgrom R, Ganatra D, Batista NV, Girard M, Lau I, Law R, Cheung M, Rathod B, Kitaygorodsky J, Samson R, Hu Q, Haroon N, Inman R, Piguet V, Silverberg M, Grigras AC, Watts TH, Chandran V. POS1217 ANTI-TNF THERAPY FOR IMMUNE MEDIATED INFLAMMATORY DISEASES MAY BE ASSOCIATED WITH LOWER ANTIBODY LEVELS AND VIRUS NEUTRALIZATION EFFICACY FOLLOWING SARS-CoV-2 mRNA VACCINATION. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundThe impact of immunosuppressants on COVID-19 vaccination response and durability in patients with immune-mediated inflammatory diseases (IMID) is yet to be fully characterized. Humoral response may be attenuated in these patients especially those on B cell depleting therapy and higher doses of corticosteroids, but data regarding other immunosuppressants are scarce.ObjectivesWe aimed to investigate antibody and T cell responses and durability to SARS-CoV-2 mRNA vaccines (BNT162b and/or mRNA 1273) in IMID patients on immunomodulatory maintenance therapy other than B-cell depleting therapy and corticosteroids.MethodsThis prospective observational cohort study examined the immunogenicity of SARS-CoV-2 mRNA vaccines in adult patients with IMIDs (psoriatic arthritis, psoriasis, inflammatory bowel disease and rheumatoid arthritis) with or without maintenance immunosuppressive therapies (anti-TNF, methotrexate/azathioprine [MTX/AZA], anti-TNF + MTX/AZA, anti IL12/23, anti-IL-17, anti-IL23) compared to healthy controls. Automated ELISA for IgGs to spike trimer, spike receptor binding domain (RBD) and the nucleocapsid (NP) and T-cell release of 9 cytokines (IFNg, IL2, IL4, IL17A, TNF) and cytotoxic molecules (sFasL, GzmA, GzmB, Perforinin) in cell culture supernatants following stimulation with spike or NP peptide arrays were conducted at 4 time points: T1=pre vaccination, T2=median 26 days after dose 1, T3=median 16 days after dose 2 and T4=median 106 days after dose 2. Neutralization assays against four SARS-CoV-2 variants (wild type, delta, beta and gamma) were conducted at T3.ResultsWe followed 150 subjects: 26 healthy controls and 124 IMID patients: 9 untreated, 44 on anti-TNF, 16 on anti-TNF with MTX/AZA, 10 on anti-IL23, 28 on anti-IL12/23, 9 on anti-IL17, 8 on MTX/AZA (Table 1). Most patients mounted antibody and T cell responses with increases from dose 1 to dose 2 (100% seroconversion at T3) and some decline by T4, with variability within groups. Antibody levels and neutralization efficacy was lower in anti-TNFgroups (anti-TNF, anti-TNF + MTX/AZA) compared to controls and waned by T4 (Figure 1). T cell responses were not consistently different between groups. Pooled data showed a higher antibody response to mRNA-1273 compared to BNT162b.Table 1.Baseline characteristics of study participantsControluntreated IMIDAnti- TNFAnti- TNF +MTX/AZAAnti-IL-23Anti -IL-12/23Anti -IL-17MTX/AZAn=26n=9n=44n=16n=10n=28n=9n=8p-valueIMID*N/A IBD9301002704 Psoriasis1318122 PA0732172 AS0830010 RA1100011Age median years [IQR]36 [26-46]33 [27-41]38 [30-51]53 [44-59]48 [45-61]34 [28-47]49 [46-61]42 [31-55]<0.001^Sex male (%)16 (62)5 (56)18 (41)8 (50)5 (50)13 (46)6 (67)4 (50)0.772~BMImedian kg/m2 [IQR]25 [23-28]26 [22-27]22 [24-26]26 [24-28]27 [24-35]22 [21-24]32 [26-34]26[25-33]0.001^Vaccine interval median days [IQR]74 [35-84]54 [31-64]60 [45-69]64 [50-72]74 [35-84]62 [49-69]65 [52-75]58 [21-97]0.372^*multiple IMIDs per patient possibleFigure 1.Antibody responses (A) Anti spike and anti RBD IgG levels at indicated time points. Blue line represents median ratio in convalescent patients. The red line is the seropositivity threshold: the median antibody level of those that pass both a 1% false positive rate and show ≥3SD from the log means of the negative controls. (B) Relative ratio of RBD, spike and NP across time. Black and gray lines indicate median and mean values, respectively. *p≤0.05, **p≤0.01, ***p≤0.001, ****p≤0.0001ConclusionFollowing 2 doses of mRNA vaccination there is 100% seroconversion in IMID patients on maintenance therapy. Antibody levels and neutralization efficacy in anti-TNF group are lower than controls, and wane substantially by 3 months after dose 2. These findings highlight the need for third dose in patients undergoing treatment with anti-TNF therapy and continued monitoring of immunity in these patient groups, taking into consideration newer variants and additional vaccine doses.AcknowledgementsThis work was funded by a donation from Juan and Stefania Speck and by grants VR-1 172711, VS1-175545, FDN-143250, GA1- 177703 and GA2- 177716, from Canadian Institutes of Health Research and COVID Immunity task force and by Sinai Health FoundationDisclosure of InterestsNaomi Finkelstein: None declared, Roya M. Dayam: None declared, Jaclyn Law: None declared, Rogier Goetgebuer: None declared, Gary Chao: None declared, Kento T. Abe: None declared, Mitchell Sutton: None declared, Joanne M. Stempak: None declared, Daniel Pereira: None declared, David Croitoru: None declared, Lily Acheampong: None declared, Saima Rizwan: None declared, Klaudia Rymaszewski: None declared, Raquel Milgrom: None declared, Darshini Ganatra: None declared, Nathalia V. Batista: None declared, Melanie Girard: None declared, Irene Lau: None declared, Ryan Law: None declared, Michelle Cheung: None declared, Bhavisha Rathod: None declared, Julia Kitaygorodsky: None declared, Reuben Samson: None declared, Queenie Hu: None declared, Nigil Haroon: None declared, Robert Inman Consultant of: AbbVie, Janssen, Lilly, Novartis., Grant/research support from: AbbVie, Novartis, Vincent Piguet Consultant of: AbbVie, Almirall, Celgene, Janssen, Kyowa Kirin Co. Ltd, LEO Pharma,Novartis, Pfizer, Sanofi, UCB, and Union Therapeutic, Grant/research support from: Unrestricted educational grants from AbbVie, Bausch Health, Celgene, Janssen, LEO Pharma, Lilly, L’Oréal, NAOS, Novartis, Pfizer, Pierre-Fabre, Sandoz, and Sanofi, Mark Silverberg Speakers bureau: AbbVie, Janssen, Takeda, Pfizer, Gilead and Amgen, Consultant of: AbbVie, Janssen, Takeda, Pfizer, Gilead and Amgen, Grant/research support from: AbbVie, Janssen, Takeda, Pfizer, Gilead and Amgen, Anne-Claude Grigras: None declared, Tania H. Watts: None declared, Vinod Chandran Consultant of: AbbVie, Amgen, BMS, Eli Lilly, Janssen, Novartis, Pfizer and UCB, Grant/research support from: AbbVie, Amgen, Eli-Lilly.
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12
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Silverberg OM, Cyrenne BM, Croitoru D, Sandre MK, Pon K. A case of recalcitrant silicone granuloma treated with adalimumab: A case report. SAGE Open Med Case Rep 2022; 10:2050313X221093444. [PMID: 35573102 PMCID: PMC9102130 DOI: 10.1177/2050313x221093444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Liquid silicone is a relatively inexpensive injectable used for soft tissue augmentation. Injection of silicone is associated with a risk of delayed granuloma formation associated with elevated levels of tumour necrosis factor-α. We report a case of recalcitrant silicone granulomas following facial injections of silicone successfully treated with tumour necrosis factor-α blockade. Our case, as well as previous reports, demonstrates the effectiveness of this therapy for the treatment of foreign body granulomas from due to silicone.
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Affiliation(s)
- Orli M Silverberg
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Benoit M Cyrenne
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Division of Dermatology, Women's College Hospital, Toronto, ON, Canada
| | - David Croitoru
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Matthew K Sandre
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kucy Pon
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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13
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Croitoru D, Seigel K, Nathanielsz N, Elsawi R, Silverberg MS, Piguet V, Sibbald C. Treatment of Severe Hidradenitis Suppurativa and Fistulizing Crohn’s Disease with Guselkumab. J Eur Acad Dermatol Venereol 2022; 36:e563-e565. [DOI: 10.1111/jdv.18033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/24/2022] [Accepted: 02/23/2022] [Indexed: 11/28/2022]
Affiliation(s)
- David Croitoru
- Division of Dermatology Department of Medicine University of Toronto Toronto Ontario Canada
| | - Kyle Seigel
- Temerty Faculty of Medicine University of Toronto Toronto Ontario Canada
| | - Nikki Nathanielsz
- Temerty Faculty of Medicine University of Toronto Toronto Ontario Canada
| | - Rawaan Elsawi
- Temerty Faculty of Medicine University of Toronto Toronto Ontario Canada
| | - Mark S Silverberg
- Division of Gastroenterology Department of Medicine Mount Sinai Hospital University of Toronto Toronto Ontario Canada
| | - Vincent Piguet
- Division of Dermatology Department of Medicine University of Toronto Toronto Ontario Canada
- Division of Dermatology Department of Medicine Women’s College Hospital Toronto Ontario Canada
| | - Cathryn Sibbald
- Division of Dermatology Department of Medicine University of Toronto Toronto Ontario Canada
- Section of Dermatology Department of Pediatrics The Hospital for Sick Children Toronto Ontario Canada
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14
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Seigel K, Croitoru D, Nathanielsz N, Elsawi R, Silverberg MS, Sibbald C, Piguet V. Clinical Features and Treatment Outcomes in Hidradenitis Suppurativa With Fistulizing Crohn’s Disease: A Systematic Review. J Cutan Med Surg 2022; 26:426-427. [DOI: 10.1177/12034754221083980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Kyle Seigel
- Temerty Faculty of Medicine, University of Toronto, ON, Canada
| | - David Croitoru
- Division of Dermatology, Department of Medicine, University of Toronto, ON, Canada
| | | | - Rawaan Elsawi
- Temerty Faculty of Medicine, University of Toronto, ON, Canada
| | - Mark S. Silverberg
- Division of Gastroenterology, Department of Medicine, Mount Sinai Hospital, University of Toronto, ON, Canada
| | - Cathryn Sibbald
- Division of Dermatology, Department of Medicine, University of Toronto, ON, Canada
- Section of Dermatology, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Vincent Piguet
- Division of Dermatology, Department of Medicine, University of Toronto, ON, Canada
- Division of Dermatology, Department of Medicine, Women’s College Hospital, Toronto, ON, Canada
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15
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Zipursky JS, Croitoru D. Urticaire et angio-œdème associés à l’infection par le SRAS-CoV-2. CMAJ 2021; 193:E1752-E1753. [PMID: 34782386 PMCID: PMC8594547 DOI: 10.1503/cmaj.211087-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Jonathan S Zipursky
- Département de médecine (Zipursky, Croitoru), Université de Toronto; Département de médecine (Zipursky), Centre des sciences de la santé Sunnybrook; Division de pharmacologie clinique et de toxicologie (Zipursky) et l'Institut des politiques, de la gestion et de l'évaluation de la santé (Zipursky) et Division de dermatologie (Croitoru), Université de Toronto, Toronto, Ont.
| | - David Croitoru
- Département de médecine (Zipursky, Croitoru), Université de Toronto; Département de médecine (Zipursky), Centre des sciences de la santé Sunnybrook; Division de pharmacologie clinique et de toxicologie (Zipursky) et l'Institut des politiques, de la gestion et de l'évaluation de la santé (Zipursky) et Division de dermatologie (Croitoru), Université de Toronto, Toronto, Ont
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16
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Brooks SG, Alhusayen R, Piguet V, Croitoru D. Pfizer/BioNTech-associated perniosis in two young adults with re-challenge evidence. J Eur Acad Dermatol Venereol 2021; 36:e84-e85. [PMID: 34606671 PMCID: PMC8657532 DOI: 10.1111/jdv.17719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S G Brooks
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - R Alhusayen
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Division of Dermatology, Sunnybrook Hospital, Toronto, ON, Canada
| | - V Piguet
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Division of Dermatology, Women's College Hospital, Toronto, ON, Canada
| | - D Croitoru
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada
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17
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Elsawi R, Brooks SG, Georgakopolous JR, Lansang P, Piguet V, Croitoru D. The Utility of IL-17 Inhibitors in Neutrophilic Dermatoses: A Systematic Review. J Cutan Med Surg 2021; 26:210-211. [PMID: 34498508 DOI: 10.1177/12034754211045389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Rawaan Elsawi
- 12366 Temerty Faculty of Medicine, University of Toronto, ON, Canada
| | | | - Jorge R Georgakopolous
- 12366 Temerty Faculty of Medicine, University of Toronto, ON, Canada.,12366 Division of Dermatology, Department of Medicine, University of Toronto, ON, Canada
| | - Perla Lansang
- 12366 Temerty Faculty of Medicine, University of Toronto, ON, Canada.,12366 Division of Dermatology, Department of Medicine, University of Toronto, ON, Canada.,Division of Dermatology, Sunnybrook Hospital, Toronto, ON, Canada
| | - Vincent Piguet
- 12366 Temerty Faculty of Medicine, University of Toronto, ON, Canada.,12366 Division of Dermatology, Department of Medicine, University of Toronto, ON, Canada.,Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, ON, Canada
| | - David Croitoru
- 12366 Temerty Faculty of Medicine, University of Toronto, ON, Canada.,12366 Division of Dermatology, Department of Medicine, University of Toronto, ON, Canada
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18
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Affiliation(s)
- Jonathan S Zipursky
- Department of Medicine (Zipursky, Croitoru), University of Toronto; Department of Medicine (Zipursky), Sunnybrook Health Sciences Centre; Division of Clinical Pharmacology and Toxicology (Zipursky) and Institute of Health Policy, Management and Evaluation (Zipursky) and Division of Dermatology (Croitoru), University of Toronto, Toronto, Ont.
| | - David Croitoru
- Department of Medicine (Zipursky, Croitoru), University of Toronto; Department of Medicine (Zipursky), Sunnybrook Health Sciences Centre; Division of Clinical Pharmacology and Toxicology (Zipursky) and Institute of Health Policy, Management and Evaluation (Zipursky) and Division of Dermatology (Croitoru), University of Toronto, Toronto, Ont
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19
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Ramirez-GarciaLuna J, Wang SC, Allport J, Croitoru D, Brar R, Alavi A. 27591 Quantification of the area of affection and inflammation of hidradenitis suppurativa using a dedicated mobile app. J Am Acad Dermatol 2021. [DOI: 10.1016/j.jaad.2021.06.626] [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: 10/20/2022]
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20
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Croitoru D, Sibbald C, Alavi A, Brooks S, Piguet V. Challenging the association of hepatitis C and pyoderma gangrenosum. Br J Dermatol 2021; 185:1047-1048. [PMID: 34105770 DOI: 10.1111/bjd.20566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/02/2021] [Accepted: 06/07/2021] [Indexed: 11/30/2022]
Affiliation(s)
- D Croitoru
- Faculty of Medicine, University of Toronto, Toronto, Canada.,Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada
| | - C Sibbald
- Faculty of Medicine, University of Toronto, Toronto, Canada.,Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada.,Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Canada.,Hospital for Sick Children, Section␣of Dermatology, Toronto, Canada
| | - A Alavi
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - S Brooks
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | - V Piguet
- Faculty of Medicine, University of Toronto, Toronto, Canada.,Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada.,Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Canada
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21
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Lu JD, Sachdeva M, Silverberg OM, Shapiro L, Croitoru D, Levy R. Clinical and laboratory prognosticators of atrophic papulosis (Degos disease): a systematic review. Orphanet J Rare Dis 2021; 16:203. [PMID: 33957947 PMCID: PMC8101154 DOI: 10.1186/s13023-021-01819-z] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 04/06/2021] [Indexed: 12/14/2022] Open
Abstract
Background Degos disease is a rare vascular disorder with a cutaneous-limited form, benign atrophic papulosis (BAP), and a systemic variant, malignant atrophic papulosis (MAP). Despite the poor prognosis of MAP, no study has established features associated with systemic disease. Objectives The aims of this systematic review were to: (1) summarize clinical features and treatments implemented for patients with MAP and BAP (2) identify clinical and laboratory factors associated with the development of MAP, compared to BAP. Methods We systematically searched MEDLINE and Embase from inception to April 2020. Demographic and clinical features of Degos patients were presented descriptively; multivariable logistic regression was performed to identify associations with MAP. Results We identified 99 case studies, comprising 105 patients. MAP (64%) had a 2.15 year median survival time from cutaneous onset, most often with gastrointestinal or central nervous system involvement. We found that elevations in either of erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) were associated with systemic involvement (OR 2.27, p = 0.023). Degos secondary to an autoimmune connective tissue disease was found to be inversely associated with MAP (OR 0.08, p = 0.048). Conclusions Elevated ESR or CRP is associated with MAP and may be a predictor of systemic involvement for patients with Degos disease. In addition, secondary Degos disease is associated with a favourable prognosis. Clinicians should be aware of the differences between primary and secondary Degos and the utility of ESR or CRP in identifying disease evolution to systemic involvement. The utility of ESR and CRP to identify systemic involvement should be further explored. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-021-01819-z.
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Affiliation(s)
- Justin D Lu
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | | | | | - Lee Shapiro
- Department of Medicine, Division of Rheumatology, Albany Medical College, Albany, NY, USA
| | - David Croitoru
- Division of Dermatology, Department of Medicine, Women's College Hospital, 76 Grenville St, 3rd Floor, Toronto, ON, M5S 1B2, Canada.
| | - Rebecca Levy
- Department of Dermatology, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Pediatrics, University of Toronto, Toronto, ON, Canada
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22
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Yang Y, Zhang L, Zhang Y, Huo W, Qi R, Guo H, Li X, Wu X, Bai F, Liu K, Qiao Y, Piguet V, Croitoru D, Chen HD, Gao XH. Local hyperthermia at 44 ºC is effective to clear cervical high-risk HPVs: a proof of concept, randomized, controlled clinical trial. Clin Infect Dis 2021; 73:1642-1649. [PMID: 33905482 DOI: 10.1093/cid/ciab369] [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: 01/25/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Persistent infection by high risk human papillomavirus (HPV) is the leading cause of cervical intraepithelial neoplasia and cervical carcinoma. Local hyperthermia at 44ºC has been proven efficacious to clear cutaneous or anogenital warts caused by HPV infection. This study aims to assess the effect of hyperthermia at 44ºC on the clearance of high-risk HPV. METHODS A randomized, patient blind, sham treatment-controlled trial was conducted in four medical centers. We enrolled patients with positive high-risk HPVs and normal or insignificant cytological findings (Negative/ASCUS/LSIL). Participants were randomly assigned (1:1) to receive either hyperthermia at 44 ºC or 37 ºC, for 30mins in each session. Patients in both groups received treatment once a day for three consecutive days, plus two more sessions 10 ± 3 days later. The primary outcome was clearance rate of HPV three months after the treatment. RESULTS After a 3-month follow-up, hyperthermia treatment at 44 ºC and 37 ºC achieved HPV clearance rates of 85.19% (23/27) and 50% (13/26), respectively (p=0.014). There was no significant difference of treatment response between patients with single and multiple type of HPV by 44 ºC hyperthermia treatment. There were no significant adverse events recorded during the treatment period in both groups. CONCLUSIONS Local hyperthermia at 44 ºC safely and significantly aids in clearing cervical high-risk HPVs, the effect of which helps halting the progression of cervical transformation and transmission of the virus.
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Affiliation(s)
- Yang Yang
- Department of Dermatology, The First Hospital of China Medical University and National joint Engineering Research Center for Theranostics of Immunological Skin Diseases, The First Hospital of China Medical University and Key Laboratory of Immunodermatology, Ministry of Health and Ministry of Education, Shenyang, China
| | - Lan Zhang
- Department of Dermatology, The First Hospital of China Medical University and National joint Engineering Research Center for Theranostics of Immunological Skin Diseases, The First Hospital of China Medical University and Key Laboratory of Immunodermatology, Ministry of Health and Ministry of Education, Shenyang, China
| | - Yuqing Zhang
- GCP Center, The First Hospital of China Medical University, Shenyang, China
| | - Wei Huo
- Department of Dermatology, The First Hospital of China Medical University and National joint Engineering Research Center for Theranostics of Immunological Skin Diseases, The First Hospital of China Medical University and Key Laboratory of Immunodermatology, Ministry of Health and Ministry of Education, Shenyang, China
| | - Ruiqun Qi
- Department of Dermatology, The First Hospital of China Medical University and National joint Engineering Research Center for Theranostics of Immunological Skin Diseases, The First Hospital of China Medical University and Key Laboratory of Immunodermatology, Ministry of Health and Ministry of Education, Shenyang, China
| | - Hao Guo
- Department of Dermatology, The First Hospital of China Medical University and National joint Engineering Research Center for Theranostics of Immunological Skin Diseases, The First Hospital of China Medical University and Key Laboratory of Immunodermatology, Ministry of Health and Ministry of Education, Shenyang, China
| | - Xiaodong Li
- Department of Dermatology, Central Hospital Affiliated to Shenyang Medical College, Shenyang, China
| | - Xin Wu
- Department of Obstetrics and Gynecology,The First Hospital of China Medical University, Shenyang, China
| | - Feng Bai
- Department of Obstetrics and Gynecology, Liaoning Province People's Republic of China, Shenyang, China
| | - Kuiran Liu
- Department of Obstetrics and Gynecology, Shengjing Hospital affiliated to China Medical University, Shenyang, China
| | - Youlin Qiao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking, China
| | - Vincent Piguet
- Division of Dermatology, Women's College Hospital, Toronto, Ontario, Canada.,Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - David Croitoru
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Hong-Duo Chen
- Department of Dermatology, The First Hospital of China Medical University and National joint Engineering Research Center for Theranostics of Immunological Skin Diseases, The First Hospital of China Medical University and Key Laboratory of Immunodermatology, Ministry of Health and Ministry of Education, Shenyang, China
| | - Xing-Hua Gao
- Department of Dermatology, The First Hospital of China Medical University and National joint Engineering Research Center for Theranostics of Immunological Skin Diseases, The First Hospital of China Medical University and Key Laboratory of Immunodermatology, Ministry of Health and Ministry of Education, Shenyang, China
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23
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Croitoru D, Lu JD, Lara-Corrales I, Kannu P, Pope E. ELOVL4 with erythrokeratoderma: A pediatric case and emerging genodermatosis. Am J Med Genet A 2021; 185:1619-1623. [PMID: 33655653 DOI: 10.1002/ajmg.a.62136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 01/21/2021] [Accepted: 01/30/2021] [Indexed: 11/12/2022]
Affiliation(s)
- David Croitoru
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Justin D Lu
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Irene Lara-Corrales
- Section of Pediatric Dermatology, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.,Section of Dermatology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Peter Kannu
- Section of Genetics, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Elena Pope
- Section of Pediatric Dermatology, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.,Section of Dermatology, The Hospital for Sick Children, Toronto, Ontario, Canada
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24
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Naderi-Azad S, Croitoru D, Khalili S, Eder L, Piguet V. Research Techniques Made Simple: Experimental Methodology for Imaging Mass Cytometry. J Invest Dermatol 2021; 141:467-473.e1. [PMID: 33618801 DOI: 10.1016/j.jid.2020.11.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 11/14/2020] [Accepted: 11/17/2020] [Indexed: 10/22/2022]
Abstract
Technological advances in flow cytometry and the development of mass cytometry by time-of-flight (CyTOF) have led to progressive increases in the number of proteins and biochemical processes that can be simultaneously measured. The most recent development of these platforms, imaging mass cytometry (IMC), allows for the visualization of up to 40 unique cellular markers and also employs rare metal isotopes conjugated to antibodies. However, IMC also adds the important benefit of preserving two-dimensional (2D) tissue architecture; this is accomplished by staining in situ and direct tissue vaporization followed by generation of a 2D spectral reconstruction using CyTOF-captured events. We review the experimental methodology for IMC that enables high-resolution multilayer images depicting protein expression, cellular localization, and interaction in situ in dermatology research.
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Affiliation(s)
| | - David Croitoru
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Saeed Khalili
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lihi Eder
- Division of Rheumatology, Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada; Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Vincent Piguet
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada.
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25
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Georgakopoulos JR, Croitoru D, Felfeli T, Alhusayen R, Lansang P, Shear NH, Yeung J, Walsh S. Long-term dupilumab treatment for chronic refractory generalized prurigo nodularis: A retrospective cohort study. J Am Acad Dermatol 2021; 85:1049-1051. [PMID: 33617911 DOI: 10.1016/j.jaad.2021.02.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/11/2021] [Accepted: 02/14/2021] [Indexed: 01/08/2023]
Affiliation(s)
- Jorge R Georgakopoulos
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - David Croitoru
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Tina Felfeli
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Raed Alhusayen
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Perla Lansang
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Neil H Shear
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Women's College Hospital, Toronto, Ontario, Canada
| | - Jensen Yeung
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Women's College Hospital, Toronto, Ontario, Canada; Probity Medical Research Inc, Waterloo, Ontario, Canada
| | - Scott Walsh
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Women's College Hospital, Toronto, Ontario, Canada.
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Abstract
We describe a case of a young man, taking no other routine medications, presenting with erythema multiforme and cetirizine-induced psychosis with re-challenge evidence. On retrospective elicitation of history, it was found that he had been involved in a motor vehicle collision 4 months prior and was a daily cannabis user; there were no objective abnormalities by MRI and neurological evaluations. Although rare, cetirizine-induced psychosis is an important adverse drug reaction that warrants the attention of healthcare practitioners.
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Affiliation(s)
- David Croitoru
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Vincent Piguet
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada
| | - Lindsey MacGillivray
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University Health Network, Toronto, Ontario, Canada
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Abstract
Significance: Pyoderma gangrenosum (PG) is a rare neutrophilic ulcerative dermatosis that poses a high burden of morbidity due to underdiagnosis, resistance to therapy, and limited therapeutic options. Optimization of wound care strategies and multimodal anti-inflammatory approaches are necessary to mitigate multiple converging pathways of inflammation leading to delayed healing, which is further complicated by additional factors such as pathergy. Recent Advances: PG treatment typically involves reducing inflammation, controlling pain, promoting wound healing, and treating the underlying etiology. Recent advances have been made with regard to targeted therapies for PG with topical, intralesional, and systemic medications. Wound management includes gentle cleansing without sharp debridement, limited topical antibacterial use, and maintenance of a moist environment to promote epithelial migration. Critical Issues: Wound dressings and compression therapy, in particular, introduce a wide variety of therapeutic options. Dressings should aim to target the specific PG wound type, depending on the depth and exudative nature of the wound, as well as local secondary factors. Superficial wounds, eschar, exudative wounds, granulating wounds, and colonized wounds are managed with variable approaches to the same underlying principles of pathergy avoidance, moisture balance, and reduction of immunogenic inflammatory stimuli. The importance of compression therapy to decrease edema and overgranulation fits within this treatment paradigm. Future Directions: As each of these treatment modalities offers a complex mixture of advantages and limitations, development of a systematic treatment algorithm in the future can help direct a more tailored path toward wound healing.
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Affiliation(s)
- David Croitoru
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Muskaan Sachdeva
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Vincent Piguet
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Women's College Hospital, Division of Dermatology, University of Toronto, Toronto, Ontario, Canada
| | - Afsaneh Alavi
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Women's College Hospital, Division of Dermatology, University of Toronto, Toronto, Ontario, Canada
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28
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Landry JS, Croitoru D, Menzies D. Validation of ICD-9 diagnostic codes for bronchopulmonary dysplasia in Quebec's provincial health care databases. Chronic Dis Inj Can 2012; 33:47-52. [PMID: 23294921] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Bronchopulmonary dysplasia (BPD) is a chronic respiratory disease caused by neonatal lung injury. The aim of this study was to validate the use of ICD-9 diagnostic codes for BPD in administrative databases to allow for their use in health care utilization analyses. METHODS The validation process used a retrospective cohort composed of preterm infants, with or without respiratory complications, admitted to the Montréal Children's Hospital, Montréal, Quebec, between 1983 and 1992. BPD subjects were identified using ICD-9 diagnostic codes in the provincial administrative databases (medical services and MED-ECHO) and then matched with subjects with confirmed BPD from the validation cohort. We examined concordance and estimated sensitivity and specificity associated with the use of these diagnostic codes for BPD. RESULTS True positive and false negative BPD subjects did not differ significantly according to gestational age, birth weight and Apgar scores. False positive BPD subjects were found to have significantly lower gestational age than true negative subjects. The use of the ICD-9 diagnostic codes for BPD was associated with a specificity between 97.6% and 98.0%. The sensitivity was lower at 45.0% and 52.4% for the medical services and MED-ECHO databases, respectively. Milder cases of BPD tended to be missed more frequently than more severe cases. CONCLUSION The specificity of the use of ICD-9 diagnostic codes for BPD in the Quebec provincial health care databases is adequate to allow its routine use. Its lower sensitivity for milder cases will likely result in an underestimation of the impacts of BPD on the long-term health care utilization of preterm infants.
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Affiliation(s)
- J S Landry
- Respiratory Epidemiology and Clinical Research Unit, McGill University, Montréal, Quebec, Canada.
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Landry JS, Croitoru D, Menzies D. Validation of ICD-9 diagnostic codes for bronchopulmonary dysplasia in Quebec's provincial health care databases. ACTA ACUST UNITED AC 2012. [DOI: 10.24095/hpcdp.33.1.06] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction
Bronchopulmonary dysplasia (BPD) is a chronic respiratory disease caused by neonatal lung injury. The aim of this study was to validate the use of ICD-9 diagnostic codes for BPD in administrative databases to allow for their use in health care utilization analyses.
Methods
The validation process used a retrospective cohort composed of preterm infants, with or without respiratory complications, admitted to the Montréal Children's Hospital, Montréal, Quebec, between 1983 and 1992. BPD subjects were identified using ICD-9 diagnostic codes in the provincial administrative databases (medical services and MED-ECHO) and then matched with subjects with confirmed BPD from the validation cohort. We examined concordance and estimated sensitivity and specificity associated with the use of these diagnostic codes for BPD.
Results
True positive and false negative BPD subjects did not differ significantly according to gestational age, birth weight and Apgar scores. False positive BPD subjects were found to have significantly lower gestational age than true negative subjects. The use of the ICD-9 diagnostic codes for BPD was associated with a specificity between 97.6% and 98.0%. The sensitivity was lower at 45.0% and 52.4% for the medical services and MED-ECHO databases, respectively. Milder cases of BPD tended to be missed more frequently than more severe cases.
Conclusion
The specificity of the use of ICD-9 diagnostic codes for BPD in the Quebec provincial health care databases is adequate to allow its routine use. Its lower sensitivity for milder cases will likely result in an underestimation of the impacts of BPD on the long-term health care utilization of preterm infants.
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Affiliation(s)
- JS Landry
- Respiratory Epidemiology and Clinical Research Unit, McGill University, Montréal, Quebec, Canada
- Respiratory Division, Department of Medicine, McGill University Health Centre, Montréal, Quebec, Canada
| | - D Croitoru
- Respiratory Epidemiology and Clinical Research Unit, McGill University, Montréal, Quebec, Canada
| | - D Menzies
- Respiratory Epidemiology and Clinical Research Unit, McGill University, Montréal, Quebec, Canada
- Respiratory Division, Department of Medicine, McGill University Health Centre, Montréal, Quebec, Canada
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Abstract
Three cases of pyloric stenosis associated with malrotation are presented. In one case, the diagnosis was made synchronously, and in two cases, pyloric stenosis was noted following correction of malrotation. All three patients underwent pyloromyotomy and Ladd's procedure. These cases differ from the few reported hereditary cases of pyloric stenosis associated with malrotation, which have congenitally shortened bowel, functional obstruction, and poor prognosis. The unusual finding of pyloric stenosis and malrotation occurring together in the first patient was diagnosed with upper gastrointestinal series, obtained because of a high index of suspicion despite a palpable pyloric tumor and positive ultrasound examination. The second and third cases illustrate that vomiting following Ladd's procedure may be due to pyloric stenosis. When clinical findings do not support the presumed diagnosis, further investigation prior to operation is recommended so that rare concommitant pathology can be corrected.
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Affiliation(s)
- D Croitoru
- Department of Surgery, Montreal Children's Hospital, Quebec, Canada
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Abstract
Laparoscopic cholecystectomy was performed safely in two children ages 7 and 15 years. Special considerations were required in the younger child because of the discrepancy between the length of the instruments and the size of the peritoneal cavity. Both children remained in hospital less than 24 hours and were able to resume normal diet and activity quickly. Pediatric surgeons with special training in laparoscopic surgery may want to use this treatment modality for children with biliary tract disease.
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Affiliation(s)
- H H Sigman
- Division of General Surgery, Sir Mortimer B. Davis, Jewish General Hospital, Montreal, Quebec, Canada
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Bărar A, Cristina V, Brumaru G, Lupşa C, Iacob M, Croitoru D. [An experimental model of data base organization in glaucoma with computer processing (a preliminary note)]. Rev Chir Oncol Radiol O R L Oftalmol Stomatol Ser Oftalmol 1989; 33:123-32. [PMID: 2529593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The authors report on an experimental model of data base set up for glaucoma with possibilities of statistical-mathematical processing. The application is designed for miniprocessors of the INDEPENDENT or CORAL type in FORTRAN 77. The paper presents the level structure of the display, and the ways of using the information under the form of assisted diagnosis and prognosis, according to which the attention is then directed to the rhythm and detailed content of the future examination.
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Croitoru D, Dobre M. [Some risk factors in cardiovascular diseases]. Viata Med Rev Inf Prof Stiint Cadrelor Medii Sanit 1985; 33:193-4. [PMID: 3938902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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