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Thompson LJ, Furmanchuk A, Liszewski W, Kho A, West DP, Liebovitz DM, Nardone B, Gerami P. Machine learning identification of patient clusters for cutaneous melanoma. Ital J Dermatol Venerol 2023; 158:388-394. [PMID: 37750845 DOI: 10.23736/s2784-8671.23.07631-4] [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: 09/27/2023]
Abstract
BACKGROUND Cutaneous melanoma is a cancer arising in melanocyte skin cells and is the deadliest form of skin cancer worldwide. Although some risk factors are known, accurate prediction of disease progression and probability for metastasis are difficult to ascertain, given the complexity of the disease and the absence of reliable predictive markers. Since early detection and treatment are essential to enhance survival, this study utilizing machine learning (ML) aims to further delineate additional risk factors associated with cutaneous melanoma. METHODS A Bayesian Gaussian Mixture ML model was created with data from 2056 patients diagnosed with cutaneous melanoma and then used to group the patients into six Clusters based on a Silhouette Score analysis. A t-distributed stochastic neighbor embedding (t-SNE) model was used to visualize the six Clusters. RESULTS Statistical analysis revealed that Cluster 4 showed a significantly higher rate of metastatic disease, as well as higher Breslow depth at diagnosis, compared to the other five Clusters. Compared to the other five Clusters, patients represented in Cluster 4 also had lower healthcare utilization, fewer dermatology clinic visits, fewer primary care providers, and less frequent colonoscopies and mammograms, and were more likely to smoke and less likely to have a prior diagnosis of basal cell carcinoma. CONCLUSIONS This study uncovers gaps in healthcare utilization of services among patient groups with cutaneous melanoma as well as possible implications for management of disease progression. Data-driven analyses emphasize the importance of routine clinic visits to dermatologists and/or primary care physicians (PCPs) for early detection and management of cutaneous melanoma. The findings from this study demonstrate that unsupervised ML methodology may serve to define the best candidate patients to benefit from enhanced dermatology/primary care which, in turn, is expected to improve outcomes for cutaneous melanoma.
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Affiliation(s)
- Leo J Thompson
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Institute for Augmented Intelligence in Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Al'ona Furmanchuk
- Department of Medicine (General Internal Medicine), Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Walter Liszewski
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Abel Kho
- Institute for Augmented Intelligence in Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Department of Medicine (General Internal Medicine), Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Dennis P West
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - David M Liebovitz
- Institute for Augmented Intelligence in Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Department of Medicine (General Internal Medicine), Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Beatrice Nardone
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA -
- Institute for Augmented Intelligence in Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Department of Medicine (General Internal Medicine), Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Pedram Gerami
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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2
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Kahen N, Ali Y, West DP. 35128 Cerebrovascular accident events associated with IL-23 inhibition: Pharmacovigilance analysis of the Food and Drug Administration Adverse Event Reporting System (FAERS) from the RADAR (Research on Adverse Drug Events And Reports) Program. J Am Acad Dermatol 2022. [DOI: 10.1016/j.jaad.2022.06.141] [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: 10/14/2022]
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3
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Reynolds KA, Harikumar VB, Poon E, West DP, Alam M. While Ethical Considerations Predominate, Scientific Merit Can Impact Institutional Review Board (IRB) Determinations A Cross-sectional Study. J Clin Epidemiol 2022; 150:12-17. [PMID: 35750103 DOI: 10.1016/j.jclinepi.2022.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 06/01/2022] [Accepted: 06/15/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine the most common reasons for Institutional Review Boards deferral of biomedical research proposals. STUDY DESIGN AND SETTING Cross-sectional study administered to chairs, vice-chairs, and co-chairs of IRBs at NIH-funded institutions. RESULTS Data forms were distributed to IRB chairs at 21 of 25 NIH-funded institutions (4 declined to participate), with an institutional response rate of 86% (18/21). Overall, ethical considerations were more likely than scientific merit to be a reason for protocol deferral. Common ethical considerations for deferral were inadequate informed consent, inadequate detail for risk assessment, insufficient protection of participant safety, and inadequate minimization of risks. Important elements of scientific merit were appropriate research design, adequate adverse event reporting, and the importance of knowledge to be gained. Non-sponsored, investigator-initiated proposals (including those receiving internal funding) were more likely to be deferred (66%), usually due to inadequate protocol development (43%), less external vetting and oversight (20%), and submissions from inexperienced faculty (16%). CONCLUSION Deferrals may be avoided by careful compliance with ethical considerations, and by ensuring sufficient scientific merit of the proposal, with research design optimized for participant safety. Those submitting investigator-initiated proposals may consider obtaining at least partial funding to decrease the risk of deferral.
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Affiliation(s)
- Kelly A Reynolds
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Vishnu B Harikumar
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Emily Poon
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Dennis P West
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Murad Alam
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Department of Otolaryngology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
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4
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Ghafari G, Ali Y, Tahseen D, Liszewski WJ, West DP, Nardone B. 28481 Risk for nonmelanoma second primary malignancy in malignant melanoma survivors: A nationwide report from the National Cancer Institute Surveillance, Epidemiology, and End Results program. J Am Acad Dermatol 2021. [DOI: 10.1016/j.jaad.2021.06.782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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5
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Randolph A, Ali Y, Kundu RV, West DP, Nardone B. 28478 Risk for depression after diagnosis for vitiligo in dermatology patients: Real-world evidence from a large, urban, Midwestern US, dermatology patient population study. J Am Acad Dermatol 2021. [DOI: 10.1016/j.jaad.2021.06.781] [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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6
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Nardone B, Ghafari G, Ali Y, Liszewski WJ, West DP. 28486 Cause of death after melanoma diagnosis: A US population-based analysis of current SEER data from the National Cancer Institute. J Am Acad Dermatol 2021. [DOI: 10.1016/j.jaad.2021.06.208] [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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7
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Tahseen D, Ghafari G, Liszewski WJ, West DP, Nardone B. 28484 A U.S. population–based epidemiologic analysis of head and neck and genital mucosal melanoma from the Surveillance, Epidemiology and End Results (SEER) database. J Am Acad Dermatol 2021. [DOI: 10.1016/j.jaad.2021.06.206] [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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8
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Pease DR, Martinez-Escala ME, Jimenez J, Guitart J, West DP, Nardone B. Cutaneous T-cell lymphoma after chronic exposure to hydrochlorothiazide: pharmacovigilance analysis from the RADAR (Research on Adverse Drug events And Reports) Program. J Eur Acad Dermatol Venereol 2021; 35:e106-e108. [PMID: 33480442 DOI: 10.1111/jdv.16833] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- D R Pease
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - M E Martinez-Escala
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - J Jimenez
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - J Guitart
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA
| | - D P West
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA
| | - B Nardone
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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9
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Bronckers IMGJ, Paller AS, West DP, Lara-Corrales I, Tollefson MM, Tom WL, Hogeling M, Belazarian L, Zachariae C, Mahé E, Siegfried E, Blume-Peytavi U, Szalai Z, Vleugels RA, Holland K, Murphy R, Puig L, Cordoro KM, Lambert J, Alexopoulos A, Mrowietz U, Kievit W, Seyger MMB. A Comparison of Psoriasis Severity in Pediatric Patients Treated With Methotrexate vs Biologic Agents. JAMA Dermatol 2020; 156:384-392. [PMID: 32022846 DOI: 10.1001/jamadermatol.2019.4835] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Importance Few studies have compared the use of methotrexate and biologics, the most commonly used systemic medications for treatment of moderate to severe psoriasis in children. Objective To assess the real-world, 6-month reduction in psoriasis severity and long-term drug survival (rate and duration of adherence to a specific drug) of methotrexate vs biologics in plaque psoriasis in children. Design, Setting, and Participants A retrospective medical records review was conducted at 20 European and North American centers. Treatment response was based on site-reported Psoriasis Area and Severity Index (PASI) and/or Physician Global Assessment (PGA) scores at baseline and within the first 6 months of treatment. Participants included all 234 consecutively seen children with moderate to severe psoriasis who received at least 3 months of methotrexate or biologics from December 1, 1990, to September 16, 2014, with sufficient data for analysis. Data analysis was performed from December 14, 2015, to September 1, 2016. Main Outcomes and Measures PASI, with a range from 0 to 72 (highest score indicating severe psoriasis), and/or PGA, with a scale of 0 (clear), 1 (minimal), 2 (mild), 3 (moderate), 4 (severe), and 5 (very severe). Results Of 234 pediatric patients (103 boys [44.0%]; 131 girls [56.0%]) treated with methotrexate and/or biologics, 163 patients (69.7%) exclusively received methotrexate, 47 patients (20.1%) exclusively received biologics, and 24 children (10.2%) received methotrexate and biologics sequentially. Of the latter cohort, 23 children were treated initially with methotrexate. Mean (SD) age at initiation was 11.6 (3.7) years for methotrexate and 13.3 (2.9) years for biologics (73.2% for etanercept) (P = .002). Among patients evaluated by a scoring method at 6-month follow-up, 75% or greater improvement in PASI (PASI75) was achieved in 12 of 30 patients (40.0%) receiving methotrexate and 20 of 28 patients (71.4%) receiving biologics, and PGA was clear/almost clear (PGA 0/1) in 41 of 115 patients (35.6%) receiving methotrexate and 18 of 37 patients (48.6%) receiving biologics. Achieving PASI75 and/or PGA 0/1 between baseline and 6 months was more likely with biologics than methotrexate (PASI75: odds ratio [OR], 4.56; 95% CI, 2.02-10.27; P < .001; and PGA 0/1: OR, 2.00; 95% CI, 0.98-4.00; P = .06). Decreased mean PASI and PGA scores were associated with biologics more than with methotrexate (PASI effect, -3.13; 95% CI, -4.33 to -1.94; P < .001; and PGA effect, -0.31; 95% CI, -0.56 to -0.06; P = .02). After 1, 3, and 5 years of use, overall drug survival rates for methotrexate were 77.5%, 50.3%, and 35.9%, and for biologics, the rates were 83.4%, 64.3%, and 57.1%, respectively. Biologics were associated with a better confounder-corrected drug survival than methotrexate (hazard ratio [HR], 2.23; 95% CI, 1.21-4.10; P = .01). Discontinuation owing to lack of response was comparable (HR, 1.64; 95% CI, 0.80-3.36; P = .18). Conclusions and Relevance Methotrexate and biologics appear to be associated with improvement in pediatric psoriasis, although biologics seem to be associated with greater reduction in psoriasis severity scores and higher drug survival rates than methotrexate in the real-world setting. Additional studies directly comparing these medications should be performed for confirmation.
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Affiliation(s)
| | - Amy S Paller
- Department of Dermatology, Northwestern University, Chicago, Illinois.,Department of Pediatrics, Northwestern University, Chicago, Illinois
| | - Dennis P West
- Department of Dermatology, Northwestern University, Chicago, Illinois.,Department of Pediatrics, Northwestern University, Chicago, Illinois
| | - Irene Lara-Corrales
- Department of Pediatric Medicine, Dermatology Section, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | | | - Wynnis L Tom
- Department of Dermatology, Rady Children's Hospital San Diego, University of California, San Diego.,Department of Pediatrics, Rady Children's Hospital San Diego, University of California, San Diego
| | - Marcia Hogeling
- Department of Dermatology, Phoenix Children's Hospital, Phoenix, Arizona.,now with the Department of Dermatology, UCLA (University of California, Los Angeles)
| | - Leah Belazarian
- Department of Dermatology, University of Massachusetts Medical School, Worcester
| | - Claus Zachariae
- Department of Dermatology and Allergy, Herlev-Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Emmanuel Mahé
- Department of Dermatology, Hôpital Victor Dupouy Argenteuil, Argenteuil, France
| | - Elaine Siegfried
- Department of Dermatology, St Louis University School of Medicine, St Louis, Missouri.,Department of Pediatrics, St Louis University School of Medicine, St Louis, Missouri
| | - Ulrike Blume-Peytavi
- Department of Dermatology and Allergy, Charité- Universitätsmedizin, Berlin, Germany
| | - Zsuzsanna Szalai
- Department of Dermatology, Heim Pál Children's Hospital, Budapest, Hungary
| | - Ruth Ann Vleugels
- Department of Dermatology, Boston Children's Hospital, Boston, Massachusetts
| | - Kristen Holland
- Department of Dermatology, Medical College of Wisconsin, Milwaukee.,Department of Pediatrics, Medical College of Wisconsin, Milwaukee
| | - Ruth Murphy
- Paediatric Dermatology Department, Nottingham University Hospitals, Nottingham, England
| | - Lluís Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Kelly M Cordoro
- Department of Dermatology, University of California, San Francisco Medical Center, San Francisco.,Department of Pediatrics, University of California, San Francisco Medical Center, San Francisco
| | - Jo Lambert
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | - Alex Alexopoulos
- First Department of Pediatrics, Agia Sofia Children's Hospital, University of Athens Medical School, Athens, Greece
| | - Ulrich Mrowietz
- Psoriasis Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Wietske Kievit
- Department for Health Evidence, Radboud University, Nijmegen, the Netherlands
| | - Marieke M B Seyger
- Department of Dermatology, Radboud University, Nijmegen, the Netherlands
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10
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Parker J, Gwillim E, Ali Y, Pease DR, Laumann AE, West DP, Nardone B. 16834 Risk of hemorrhagic and ischemic stroke subsequent to diagnosis for hidradenitis suppurativa: Real-world data from a large urban Midwestern US patient population. J Am Acad Dermatol 2020. [DOI: 10.1016/j.jaad.2020.06.837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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11
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Erickson MK, Pontes D, Memon R, Schlosser BJ, West DP, Nardone B. 16835 A US population-based epidemiologic study of vulvar melanoma from the Surveillance, Epidemiology, and End Results (SEER) database. J Am Acad Dermatol 2020. [DOI: 10.1016/j.jaad.2020.06.377] [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: 10/22/2022]
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12
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Memon R, Kelm RC, Erickson MK, Choi JN, Laumann AE, West DP, Nardone B. 15156 Autoimmune cutaneous disorders associated with PD-1 and PD-L1 inhibitors: Pharmacovigilance analysis of the FDA Adverse Event Reporting System from the Research on Adverse Drug Events and Reports program. J Am Acad Dermatol 2020. [DOI: 10.1016/j.jaad.2020.06.658] [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: 10/22/2022]
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13
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Lee N, Majewski S, Ali Y, Parker JJ, Amin S, Amin A, West DP, Nardone B. 16829 Risk of major cardiovascular events with interleukin-12/23 inhibition compared with tumor necrosis factor α in patients with psoriasis: Pharmacovigilance analysis within a large Midwestern US patient population from the RADAR program. J Am Acad Dermatol 2020. [DOI: 10.1016/j.jaad.2020.06.834] [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: 10/22/2022]
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14
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Kelm RC, Ali Y, Orrell K, Rangel SM, Kruse L, Wagner AM, Gerami P, West DP, Nardone B. Age and sex differences for malignant melanoma in the pediatric population-childhood versus adolescence: analysis of current nationwide data from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) program. J Am Acad Dermatol 2020; 84:862-864. [PMID: 33478777 DOI: 10.1016/j.jaad.2020.10.050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 10/06/2020] [Accepted: 10/20/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Ryan C Kelm
- Department of Dermatology, Feinberg School of Medicine, Northwestern University Chicago, Chicago, Illinois
| | - Yasmeen Ali
- Department of Dermatology, Feinberg School of Medicine, Northwestern University Chicago, Chicago, Illinois
| | - Kelsey Orrell
- Department of Dermatology, Feinberg School of Medicine, Northwestern University Chicago, Chicago, Illinois
| | - Stephanie M Rangel
- Department of Dermatology, Feinberg School of Medicine, Northwestern University Chicago, Chicago, Illinois
| | - Lacey Kruse
- Department of Dermatology, Feinberg School of Medicine, Northwestern University Chicago, Chicago, Illinois; Department of Pediatrics, Feinberg School of Medicine, Northwestern University Chicago, Chicago, Illinois
| | - Annette M Wagner
- Department of Dermatology, Feinberg School of Medicine, Northwestern University Chicago, Chicago, Illinois; Department of Pediatrics, Feinberg School of Medicine, Northwestern University Chicago, Chicago, Illinois
| | - Pedram Gerami
- Department of Dermatology, Feinberg School of Medicine, Northwestern University Chicago, Chicago, Illinois; Department of Pediatrics, Feinberg School of Medicine, Northwestern University Chicago, Chicago, Illinois; Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University Chicago, Chicago, Illinois
| | - Dennis P West
- Department of Dermatology, Feinberg School of Medicine, Northwestern University Chicago, Chicago, Illinois; Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University Chicago, Chicago, Illinois
| | - Beatrice Nardone
- Department of Dermatology, Feinberg School of Medicine, Northwestern University Chicago, Chicago, Illinois.
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15
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West DP, Ecklund B, Griggs RK. Continuous Temperature and Humidity Monitoring Using Sensors Within an External Male Incontinence Device over 12 Hours of Wear-time. Am J Infect Control 2020. [DOI: 10.1016/j.ajic.2020.06.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Jimenez J, Gwillim EC, Kosche C, Figueiredo A, Rauck C, Rangel SM, Choi J, West DP, Nardone B, Lacouture ME. Bullous disorders associated with PD-1 and PD-L1 inhibitors: Pharmacovigilance analysis of the United States Food and Drug Administration Adverse Event Reporting System from the Research on Adverse Drug Events And Reports Program. J Am Acad Dermatol 2020; 83:955-957. [PMID: 32014533 DOI: 10.1016/j.jaad.2020.01.059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 01/17/2020] [Accepted: 01/26/2020] [Indexed: 10/25/2022]
Affiliation(s)
- Javier Jimenez
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Eran C Gwillim
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Cory Kosche
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Anna Figueiredo
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Corrine Rauck
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Stephanie M Rangel
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Jennifer Choi
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Dennis P West
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Beatrice Nardone
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
| | - Mario E Lacouture
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
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17
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Vakharia PP, Kelm RC, Orrell KA, Patel KR, Singam V, Ali Y, Rastogi S, Yousif R, Rangel SM, West DP, Nardone B. Risks for noncutaneous second primary malignancy in cutaneous malignant melanoma survivors: an analysis of data from the Surveillance, Epidemiology, and End Results (SEER) program. Int J Dermatol 2020; 59:463-468. [DOI: 10.1111/ijd.14781] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 11/26/2019] [Accepted: 12/23/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Paras P. Vakharia
- Department of Dermatology Northwestern University Feinberg School of Medicine Chicago IL USA
- Department of Dermatology University of Texas Southwestern Dallas TX USA
| | - Ryan C. Kelm
- Department of Dermatology Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Kelsey A. Orrell
- Department of Dermatology Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Kevin R. Patel
- Department of Dermatology Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Vivek Singam
- Department of Dermatology Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Yasmeen Ali
- Department of Dermatology Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Supriya Rastogi
- Department of Dermatology Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Rame Yousif
- Department of Dermatology Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Stephanie M. Rangel
- Department of Dermatology Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Dennis P. West
- Department of Dermatology Northwestern University Feinberg School of Medicine Chicago IL USA
- Robert H. Lurie Comprehensive Cancer Center Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Beatrice Nardone
- Department of Dermatology Northwestern University Feinberg School of Medicine Chicago IL USA
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18
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Alam M, Hughart R, Champlain A, Geisler A, Paghdal K, Whiting D, Hammel JA, Maisel A, Rapcan MJ, West DP, Poon E. Effect of Platelet-Rich Plasma Injection for Rejuvenation of Photoaged Facial Skin: A Randomized Clinical Trial. JAMA Dermatol 2019; 154:1447-1452. [PMID: 30419125 DOI: 10.1001/jamadermatol.2018.3977] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance There remains little experimental evidence and no randomized clinical trial to date to confirm the benefit of platelet-rich plasma (PRP) for facial rejuvenation. Objective To investigate whether PRP injection improves the visual appearance, including texture and color, of photodamaged facial skin. Design, Setting, and Participants In this randomized clinical trial, participants and raters were masked to groupings. The setting was an academic-based, urban outpatient dermatology practice in Chicago, Illinois. Participants were adults aged 18 to 70 years with bilateral cheek rhytids of Glogau class II or greater. The duration of the study was August 21, 2012, to February 16, 2016. Interventions Each participant received 3 mL intradermal injections of PRP to one cheek and sterile normal saline to the contralateral cheek. Main Outcomes and Measures Primary outcomes were photoaging scores (with subscores for fine lines, mottled pigmentation, roughness, and sallowness) as rated by 2 masked dermatologists. Secondary outcomes included participant self-assessment scores of improvement on a 5-point scale (worsening, no change, mild improvement, moderate improvement, or significant improvement), participant overall satisfaction scores on a 4-point scale (not satisfied, slightly satisfied, moderately satisfied, or very satisfied), and participant-reported or investigator-observed adverse events. Results Of 27 enrolled participants, 19 (mean [SD] age, 46.37 [10.88] years; 17 female) were analyzed. Reported adverse events, which were not associated with the study agent, included redness (n = 18), swelling (n = 16), bruising (n = 14), pruritus (n = 1), skin scaling (n = 1), and dryness of skin (n = 1). No participants reported any adverse events at 12 months. Mean (SD) photoaging scores rated by 2 dermatologists showed no significant difference between PRP and normal saline for fine lines (baseline, 1.00 [0.75] vs 1.05 [0.78]; 2 weeks, 0.95 [0.71] vs 0.95 [0.71]; 3 months, 0.95 [0.71] vs 0.95 [0.71]; 6 months, 0.95 [0.71] vs 0.95 [0.71]), mottled pigmentation (baseline, 1.21 [0.53] vs 1.21 [0.54]; 2 weeks, 1.16 [0.60] vs 1.16 [0.60]; 3 months, 1.00 [0.47] vs 1.11 [0.46]; 6 months, 1.16 [0.69] vs 1.16 [0.69]), skin roughness (baseline, 0.47 [0.61] vs 0.47 [0.61]; 2 weeks, 0.47 [0.61] vs 0.47 [0.61]; 3 months, 0.47 [0.61] vs 0.47 [0.61]; 6 months, 0.37 [0.60] vs 0.37 [0.68]), and skin sallowness (baseline, 1.11 [0.88] vs 1.11 [0.88]; 2 weeks, 0.95 [0.85] vs 0.95 [0.85]; 3 months, 0.58 [0.61] vs 0.58 [0.61]; 6 months, 0.37 [0.68] vs 0.37 [0.68]). At 6 months after a single treatment, participants rated the PRP-treated side as significantly more improved compared with normal saline for texture (mean [SD] self-assessment score, 2.00 [1.20] vs 1.21 [0.54]; P = .02) and wrinkles (mean [SD] self-assessment score, 1.74 [0.99] vs 1.21 [0.54]; P = .03). Conclusions and Relevance Masked participants noted that both fine and coarse texture improved significantly more with a single treatment of PRP than with normal saline. Both participants and raters found PRP to be nominally but not significantly superior to normal saline. Trial Registration ClinicalTrials.gov Identifier: NCT01372566.
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Affiliation(s)
- Murad Alam
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Rosemara Hughart
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Amanda Champlain
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Amelia Geisler
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Kapila Paghdal
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Dennis Whiting
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Josh A Hammel
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Amanda Maisel
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Matthew J Rapcan
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Dennis P West
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Emily Poon
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Alam M, Hughart R, Geisler A, Paghdal K, Maisel A, Weil A, West DP, Veledar E, Poon E. Effectiveness of Low Doses of Hyaluronidase to Remove Hyaluronic Acid Filler Nodules: A Randomized Clinical Trial. JAMA Dermatol 2019; 154:765-772. [PMID: 29710212 DOI: 10.1001/jamadermatol.2018.0515] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Importance Although hyaluronidase is known to remove hyaluronic acid fillers, use of low doses has not been well studied. Objective To assess the effectiveness and dose-related effect of small quantities of hyaluronidase to treat hyaluronic acid filler nodules. Design, Setting, and Participants Split-arm, parallel-group, randomized clinical trial at an urban academic center. Participants were 9 healthy women. Recruitment and follow-up occurred from February 2013 to March 2014; data analysis occurred from February to July 2016. Interventions Each participant received aliquots (buttons) of either of 2 types of hyaluronic acid fillers into bilateral upper inner arms, respectively. At 1, 2, and 3 weeks each button was treated with a constant volume (0.1 mL) of variable-dose hyaluronidase (1.5, 3.0, or 9.0 U per 0.1 mL) or saline control. Main Outcomes and Measures Both a blinded dermatologist and the participant independently assessed detectability. Results Seventy-two treatment sites on 9 women (mean [SD] age, 45.8 [15.7] years) received all interventions and were analyzed. There was a significant difference in physician rater assessment between saline and hyaluronidase at 4 weeks (visual detection: mean difference = 1.15; 95% CI, 0.46-1.80; P < .001; palpability: mean difference = 1.22; 95% CI, 0.61-1.83; P < .001) and 4 months (visual detection: mean difference = 0.77; 95% CI, 0.33-1.26; P = .001; palpability: mean difference = 0.82; 95% CI, 0.38-1.25; P < .001) that was mirrored by participant self-assessment at 4 weeks (visual detection: mean difference = 0.87; 95% CI, 0.26-1.48; P = .006; palpability: mean difference = 1.59; 95% CI, 1.41-1.77; P < .001) and 4 months (visual detection: mean difference = 1.31; 95% CI, 1.09-1.53; P < .001; palpability: mean difference = 1.52; 95% CI, 1.03-2.01; P < .001), and hyaluronidase was associated with greater resolution of buttons compared with normal saline. The 9.0-unit hyaluronidase injection sites were significantly less palpable than the 1.5-unit sites at both 4 weeks (mean difference = 0.50; 95% CI, 0.01-.99; P = .045) and 4 months (mean difference = 0.47; 95% CI, 0.14-0.81; P = .007). Dose dependence was more notable for Restylane-L. Conclusions and Relevance Although very small doses of hyaluronidase can remove hyaluronic acid fillers from patient skin, slightly higher doses often result in more rapid resolution. Trial Registration clinicaltrials.gov Identifier: NCT01722916.
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Affiliation(s)
- Murad Alam
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Department of Otolaryngology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Rosemara Hughart
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Amelia Geisler
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Kapila Paghdal
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Amanda Maisel
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Alexandra Weil
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Dennis P West
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Emir Veledar
- Center for Research and Grants, Baptist Health South Florida, Coral Gables.,Rollins School of Public Health, Department of Epidemiology, Emory University, Atlanta, Georgia.,School of Medicine, Department of Medicine, Emory University, Atlanta, Georgia.,Robert Stempel College of Public Health and Social Work, Department of Biostatistics, Florida International University, Miami
| | - Emily Poon
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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20
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Kosche C, Para A, Brieva J, West DP, Palella FJ, Nardone B. Incidence of cutaneous adverse events after exposure to tenofovir-emtricitabine in HIV-uninfected vs HIV-infected patients: pharmacovigilance within a large Midwestern U.S. patient population from the Research on Adverse Drug events And Reports program. J Eur Acad Dermatol Venereol 2019; 33:e470-e471. [PMID: 31301245 DOI: 10.1111/jdv.15799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- C Kosche
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - A Para
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - J Brieva
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - D P West
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - F J Palella
- Department of Medicine, Division of Infectious Diseases, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - B Nardone
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
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21
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Majewski S, Bhattacharya T, Asztalos M, Bohaty B, Durham KC, West DP, Hebert AA, Paller AS. Sodium hypochlorite body wash in the management of Staphylococcus aureus-colonized moderate-to-severe atopic dermatitis in infants, children, and adolescents. Pediatr Dermatol 2019; 36:442-447. [PMID: 30983053 PMCID: PMC6767696 DOI: 10.1111/pde.13842] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES A cleansing body wash containing diluted sodium hypochlorite (0.006% NaOCl) was evaluated for management of moderate-to-severe Staphylococcus aureus-colonized, atopic dermatitis in children. METHODS A 6-week, prospective, open-label study was conducted with 50 evaluable participants (ages 6 months to 17 years) who had moderate-to-severe atopic dermatitis with S aureus skin colonization documented by culture. Participants were instructed to continue using their current medications while using the study product, 0.006% NaOCl body wash, once daily to affected areas for 6 weeks. Primary outcome measures were Investigator's Global Assessment, Eczema Area and Severity Index, and Body Surface Area scores. Secondary outcome measures were the Visual Analog Scale for pruritus, Family Dermatology Life Quality Index, and Patient Satisfaction Questionnaire for Problem Areas. A subject daily diary and a six-item subject questionnaire that provided information on preferences for bleach bath vs body wash were secondary outcome measures. RESULTS Daily use of the 0.006% NaOCl body wash led to improvement for all outcome measures comparing baseline to 2-week and to 6-week evaluations. Of the 50 skin S aureus-positive subjects, 32/50 (64%) were still positive at 2 weeks. A 36.5% decrease in subject's daily record of topical corticosteroid application at end of study compared to baseline was found. Participant surveys indicated preferences for the body wash over bleach baths. CONCLUSIONS Sodium hypochlorite (NaOCl) body wash improved all outcome measures for moderate-to-severe S aureus-colonized AD in infants, children, and adolescents. The limited reduction in S aureus further suggests that sodium hypochlorite has ameliorative effects other than antimicrobial actions.
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Affiliation(s)
- Sara Majewski
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Tanya Bhattacharya
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Manuela Asztalos
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Benjamin Bohaty
- Department of Dermatology, The UTHealth McGovern Medical School-Houston, Houston, Texas
| | - Katherine C Durham
- Department of Dermatology, The UTHealth McGovern Medical School-Houston, Houston, Texas
| | - Dennis P West
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Adelaide A Hebert
- Department of Dermatology, The UTHealth McGovern Medical School-Houston, Houston, Texas
| | - Amy S Paller
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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22
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Thiede RM, Rastogi S, Nardone B, Sadowsky LM, Rangel SM, West DP, Schlosser BJ. Hyperkalemia in women with acne exposed to oral spironolactone: A retrospective study from the RADAR (Research on Adverse Drug Events and Reports) program. Int J Womens Dermatol 2019; 5:155-157. [PMID: 31360748 PMCID: PMC6637080 DOI: 10.1016/j.ijwd.2019.04.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/11/2019] [Accepted: 04/14/2019] [Indexed: 11/19/2022] Open
Abstract
Purpose The necessity of serum potassium monitoring for healthy women who are prescribed spironolactone for acne has been debated. The aim of this study was to compare the incidence of hyperkalemia in women 18 to 45 years of age to that in women 46 to 65 years of age, when treated with oral spironolactone for acne. Methods and materials Data for all women 18 to 65 years of age who were prescribed oral spironolactone by a dermatologist for acne between January 2006 and October 2016 were extracted for analysis. Retrospective data were included for women who exhibited baseline serum potassium within the normal limits and who had repeat serum potassium monitoring within 12 months after initiation of spironolactone. The rate of incident hyperkalemia was determined. Results Of 618 women who received spironolactone for acne, 133 had serum potassium monitoring both before and after spironolactone initiation. Nine were excluded due to confounding comorbidities. Of the remaining 124 women, the mean age at initiation of spironolactone was 32 years (range, 18-57 years); 112 women were in the 18 to 45 years age group, and 12 were in the 46 to 65 years age group. All women had serum potassium within normal limits at baseline. Women in the 46 to 65 years age group had a significantly higher rate of incident hyperkalemia after spironolactone initiation compared with women 18 to 45 years of age (2 of 12 women [16.7%] vs. 1 of 112 women [< 1%]; p = .0245). Conclusions Although controversy surrounds the clinical utility of serum potassium monitoring in healthy women exposed to spironolactone for acne, based on the findings from this large patient population, monitoring of serum potassium is warranted for women over 45 years of age given an age-related greater risk of hyperkalemia.
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Affiliation(s)
- Rebecca M. Thiede
- Division of Dermatology, University of Arizona College of Medicine-Tucson, Tucson, Arizona
| | - Supriya Rastogi
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Beatrice Nardone
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Lauren M. Sadowsky
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Stephanie M. Rangel
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Dennis P. West
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Bethanee J. Schlosser
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Corresponding author.
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23
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Rastogi S, Patel KR, Singam V, Ali Y, Gao J, Amin A, Schlosser BJ, West DP, Nardone B. Vulvar cancer association with groin hidradenitis suppurativa: A large, urban, midwestern US patient population study. J Am Acad Dermatol 2019; 80:808-810. [DOI: 10.1016/j.jaad.2018.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 10/03/2018] [Accepted: 10/07/2018] [Indexed: 10/28/2022]
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24
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Alam M, Geisler A, Warycha M, Paghdal K, Roongpisuthipong W, Schlessinger DI, Chen BR, Reynolds KA, West DP, Poon E. Effect of postinjection facial exercise on time of onset of botulinum toxin for glabella and forehead wrinkles: A randomized, controlled, crossover clinical trial. J Am Acad Dermatol 2019; 80:1144-1147. [PMID: 30617028 DOI: 10.1016/j.jaad.2018.10.013] [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: 03/14/2018] [Revised: 08/28/2018] [Accepted: 10/01/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Murad Alam
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Department of Otolaryngology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
| | - Amelia Geisler
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | | - Kapila Paghdal
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Wanjarus Roongpisuthipong
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Division of Dermatology, Department of Medicine, Vajira Hospital, Navamindrahiraj University, Bangkok, Thailand
| | - Daniel I Schlessinger
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Brian R Chen
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | | - Dennis P West
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Emily Poon
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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25
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Kelm RC, Hagstrom EL, Mathieu RJ, Orrell KA, Serrano L, Mueller KA, Laumann AE, West DP, Nardone B. Melanoma subsequent to natalizumab exposure: A report from the RADAR (Research on Adverse Drug events And Reports) program. J Am Acad Dermatol 2018; 80:820-821. [PMID: 30395915 DOI: 10.1016/j.jaad.2018.10.052] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 10/22/2018] [Accepted: 10/25/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Ryan C Kelm
- Department of Dermatology, Northwestern University, Chicago, Illinois
| | - Erika L Hagstrom
- Department of Dermatology, Northwestern University, Chicago, Illinois
| | - Regine J Mathieu
- Department of Dermatology, Northwestern University, Chicago, Illinois
| | - Kelsey A Orrell
- Department of Dermatology, Northwestern University, Chicago, Illinois
| | - Linda Serrano
- Department of Dermatology, Northwestern University, Chicago, Illinois
| | - Kelly A Mueller
- Department of Dermatology, Northwestern University, Chicago, Illinois
| | - Anne E Laumann
- Department of Dermatology, Northwestern University, Chicago, Illinois
| | - Dennis P West
- Department of Dermatology, Northwestern University, Chicago, Illinois; Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois
| | - Beatrice Nardone
- Department of Dermatology, Northwestern University, Chicago, Illinois.
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26
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Ibler E, Tran G, Orrell KA, Serrano L, Majewski S, Sable KA, Thiede R, Laumann AE, West DP, Nardone B. Inverse association for diagnosis of Alzheimer's disease subsequent to both melanoma and non-melanoma skin cancers in a large, urban, single-centre, Midwestern US patient population. J Eur Acad Dermatol Venereol 2018; 32:1893-1896. [PMID: 29573497 PMCID: PMC6153078 DOI: 10.1111/jdv.14952] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 02/28/2018] [Indexed: 01/25/2023]
Abstract
BACKGROUND Although literature demonstrates a decreased risk of Alzheimer's disease (AD) in individuals with various cancers, including squamous cell cancers (SCC) and basal cell cancers (BCC) comprising non-melanoma skin cancers (NMSC), there is a paucity of literature to substantiate an association between malignant melanoma (MM) and AD. OBJECTIVE The aim of this study was to determine whether an association exists between MM and AD as well as for NMSC and AD. METHODS A large urban, Midwestern, US, single-centre, medical record (EMR) data repository was searched between January 2001 and December 2015, to identify all patients at age ≥60 and <89 years with a clinic follow-up of at least 1 year and no diagnosis for AD, MM or NMSC at the time of the study entry. Data collected included age, gender, race and duration of follow-up. MM and NMSC were detected by ICD-9 codes and ICD-10 codes. Incident diagnosis of AD was also detected by ICD-9 and ICD-10 codes. Logistic regression analysis was utilized to obtain crude and adjusted odds ratios (ORs). RESULTS Data for a total of 82 925 patients with known race and gender and were detected. After adjusting for confounding factors (race, gender, age, cerebrovascular disease, peripheral vascular disease and diabetes), there was a significant decreased risk of subsequent AD in patients with MM (OR: 0.39; 95% CI: 0.16-0.96; P = 0.042) as well as in patients with BCC (OR: 0.18; 95% CI: 0.08-0.45; P < 0.0001) and for patients with SCC (OR: 0.08; 95% CI: 0.01-0.56; P = 0.013). CONCLUSION These findings add to the growing body of evidence for a decreased risk of AD in patients with various cancers and highlight the need for ongoing research to elucidate both neurologic and biologic mechanisms that may underlie this apparent inverse association.
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Affiliation(s)
- Erin Ibler
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Gary Tran
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Kelsey A. Orrell
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Linda Serrano
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Sara Majewski
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Kimberly A. Sable
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Rebecca Thiede
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Anne E. Laumann
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Dennis P. West
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA
| | - Beatrice Nardone
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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Alam M, Pongprutthipan M, Nanda S, Kim NA, Swary JH, Roongpisuthipong W, Kauvar AN, Weil A, Iyengar S, Chen BR, Vasic J, Maisel A, West DP, Nodzenksi M, Veledar E, Poon E. Quantitative evaluation of skin shrinkage associated with non-invasive skin tightening: a simple method for reproducible linear measurement using microtattoos. Lasers Med Sci 2018; 34:703-709. [PMID: 30280300 DOI: 10.1007/s10103-018-2646-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 05/30/2018] [Accepted: 09/18/2018] [Indexed: 10/28/2022]
Abstract
Non-invasive skin-tightening devices can induce thermal denaturation and skin shrinkage via externally applied radiofrequency emissions or high-frequency ultrasound. Therefore, the purpose of this study is to develop and test a method for measurement of skin reduction associated with application of such energy devices. Twenty-five healthy participants with mild to moderate skin laxity of the arms were enrolled. Pinpoint microtattoos were placed at each of the treatment sites to delineate two 6 × 12 cm rectangles per subject. A non-stretchable filament, tape and marking pen apparatus was used to measure the size of each rectangle before treatment and at follow-up visit by two blinded investigators. After randomization, one side received a single pass with a radiofrequency device (6.78 MHz), while the contralateral side received multiple passes. Participants underwent two treatment sessions to each side 2 weeks apart, and returned for follow-up 4 weeks after the second treatment. Length and area measurement were analyzed to assess precision and accuracy of measurements and to compare efficacy of treatment between pre- and post-treatment. Concordance correlation coefficients (CCC) demonstrated substantial inter-investigator reliability and precision in length measurements (CCC, 0.94 to 0.98 in pre-treatment; 0.95 to 0.98 in post-treatment). Measurements at the 6-week post-treatment follow-up demonstrated a statistically significant skin reduction in all six of the measured parameters. A simple skin measurement method requiring minimal instrumentation can quantitatively evaluate skin shrinkage associated with non-invasive skin-tightening devices.
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Affiliation(s)
- Murad Alam
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA. .,Department of Otolaryngology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. .,Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
| | - Marisa Pongprutthipan
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA.,Division of Dermatology, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
| | - Shivani Nanda
- Department of Dermatology, Henry Ford Health System, West Bloomfield Township, MI, USA
| | - Natalie A Kim
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA
| | - Jillian H Swary
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA
| | - Wanjarus Roongpisuthipong
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA.,Division of Dermatology, Department of Medicine, Vajira Hospital, Navamindrahiraj University, Bangkok, Thailand
| | - Arielle N Kauvar
- Division of Pulmonary, Allergy and Critical Care Medicine, New York Laser and Skin Care, New York, NY, USA
| | - Alexandra Weil
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA
| | - Sanjana Iyengar
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA
| | - Brian R Chen
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA
| | - Jelena Vasic
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA
| | - Amanda Maisel
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA
| | - Dennis P West
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA
| | - Michael Nodzenksi
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA
| | - Emir Veledar
- Emory University School of Medicine, Atlanta, GA, USA.,Baptist Health South Florida, Miami, FL, USA
| | - Emily Poon
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA
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28
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Orrell KA, Murphrey M, Kelm RC, Lee HH, Pease DR, Laumann AE, West DP, Nardone B. Inflammatory bowel disease events after exposure to interleukin 17 inhibitors secukinumab and ixekizumab: Postmarketing analysis from the RADAR (“Research on Adverse Drug events And Reports”) program. J Am Acad Dermatol 2018; 79:777-778. [DOI: 10.1016/j.jaad.2018.06.024] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/05/2018] [Accepted: 06/12/2018] [Indexed: 12/01/2022]
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29
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Alam M, Sadhwani D, Geisler A, Aslam I, Makin IRS, Schlessinger DI, Disphanurat W, Pongprutthipan M, Voravutinon N, Weil A, Chen BR, West DP, Veledar E, Poon E. Subcutaneous infiltration of carbon dioxide (carboxytherapy) for abdominal fat reduction: A randomized clinical trial. J Am Acad Dermatol 2018; 79:320-326. [DOI: 10.1016/j.jaad.2018.04.038] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 03/15/2018] [Accepted: 04/15/2018] [Indexed: 11/25/2022]
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Siegfried EC, Jaworski JC, Eichenfield LF, Paller A, Hebert AA, Simpson EL, Altman E, Arena C, Blauvelt A, Block J, Boguniewicz M, Chen S, Cordoro K, Hanna D, Horii K, Hultsch T, Lee J, Leung DY, Lio P, Milner J, Omachi T, Schneider C, Schneider L, Sidbury R, Smith T, Sugarman J, Taha S, Tofte S, Tollefson M, Tom WL, West DP, Whitney L, Zane L. Developing drugs for treatment of atopic dermatitis in children (≥3 months to <18 years of age): Draft guidance for industry. Pediatr Dermatol 2018; 35:303-322. [PMID: 29600515 DOI: 10.1111/pde.13452] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Atopic dermatitis is the most common chronic skin disease, and it primarily affects children. Although atopic dermatitis (AD) has the highest effect on burden of skin disease, no high-level studies have defined optimal therapy for severe disease. Corticosteroids have been used to treat AD since the 1950s and remain the only systemic medication with Food and Drug Administration approval for this indication in children, despite published guidelines of care that recommend against this option. Several clinical trials with level 1 evidence have supported the use of topical treatments for mild to moderate atopic dermatitis in adults and children, but these trials have had little consistency in protocol design. Consensus recommendations will help standardize clinical development and trial design for children. The Food and Drug Administration issues guidance documents for industry as a source for "the Agency's current thinking on a particular subject." Although they are nonbinding, industry considers these documents to be the standard for clinical development and trial design. Our consensus group is the first to specifically address clinical trial design in this population. We developed a draft guidance document for industry, Developing Drugs for Treatment of Atopic Dermatitis in Children (≥3 months to <18 years of age). This draft guidance has been submitted to the Food and Drug Administration based on a provision in the Federal Register (Good Guidance Practices).
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Affiliation(s)
- Elaine C Siegfried
- Department of Pediatrics, Saint Louis University and Cardinal Glennon Children's Hospital, St. Louis, MO, USA
| | | | - Lawrence F Eichenfield
- Department of Dermatology, School of Medicine, University of California, and Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital-San Diego, San Diego, CA, USA
| | - Amy Paller
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Division of Dermatology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Adelaide A Hebert
- Department of Dermatology, UTHealth McGovern Medical School at Houston, Houston, TX, USA
| | - Eric L Simpson
- Department of Dermatology, Oregon Health & Science University, Portland, OR, USA
| | | | - Charles Arena
- Clinical Development & Medical Affairs, Regeneron Pharmaceuticals, Tarrytown, NY, USA
| | | | - Julie Block
- National Eczema Association, San Rafael, CA, USA
| | - Mark Boguniewicz
- Department of Pediatrics, National Jewish Health and Division of Pediatric Allergy-Immunology, University of Colorado School of Medicine, Denver, CO, USA
| | - Suephy Chen
- Department of Dermatology, Emory University, and Division of Dermatology, Atlanta Veterans Affairs Medical Center, Atlanta, GA, USA
| | - Kelly Cordoro
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Diane Hanna
- Medical Affairs, Regeneron Pharmaceuticals, Tarrytown, NY, USA
| | - Kimberly Horii
- Division of Dermatology, Children's Mercy and University of Missouri, Kansas City, MO, USA
| | - Thomas Hultsch
- Translational Medicine, Sanofi-Genzyme, Cambridge, MA, USA
| | - James Lee
- Dermavant Sciences, Raleigh-Durham, NC, USA
| | - Donald Y Leung
- Department of Pediatrics, National Jewish Health and Division of Pediatric Allergy-Immunology, University of Colorado School of Medicine, Denver, CO, USA
| | - Peter Lio
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Joshua Milner
- Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - Theodore Omachi
- Immunology/Respiratory, Genentech, Inc., San Francisco, CA, USA
| | | | - Lynda Schneider
- Department of Pediatrics, Harvard Medical School and Division of Allergy and Immunology, Boston Children's Hospital, Boston, MA, USA
| | - Robert Sidbury
- Division of Dermatology, Seattle Children's Hospital and Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | | | - Jeffrey Sugarman
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Sharif Taha
- National Eczema Association, San Rafael, CA, USA
| | - Susan Tofte
- Department of Dermatology, Oregon Health & Science University, Portland, OR, USA
| | | | - Wynnis L Tom
- Department of Dermatology, School of Medicine, University of California, and Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital-San Diego, San Diego, CA, USA
| | - Dennis P West
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Lucinda Whitney
- School of Nursing, University of Kansas Medical Center, Kansas City, KS, USA
| | - Lee Zane
- Anacor Pharmaceuticals, Palo Alto, CA, USA
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31
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Grushchak S, Mathieu RJ, Orrell KA, Hagstrom EL, Laumann AE, West DP, Nardone B. Malignant melanoma association with systemic lupus erythematosus in a large midwestern U.S. patient population: a retrospective study. Int J Dermatol 2018; 57:e34-e36. [PMID: 29676462 DOI: 10.1111/ijd.13979] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 02/11/2018] [Accepted: 02/24/2018] [Indexed: 12/23/2022]
Affiliation(s)
- Solomiya Grushchak
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Regine J Mathieu
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Kelsey A Orrell
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Erika L Hagstrom
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Anne E Laumann
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Dennis P West
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA
| | - Beatrice Nardone
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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32
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Bronckers IMGJ, Seyger MMB, West DP, Lara-Corrales I, Tollefson M, Tom WL, Hogeling M, Belazarian L, Zachariae C, Mahé E, Siegfried E, Philipp S, Szalai Z, Vleugels RA, Holland K, Murphy R, Baselga E, Cordoro K, Lambert J, Alexopoulos A, Mrowietz U, Kievit W, Paller AS. Safety of Systemic Agents for the Treatment of Pediatric Psoriasis. JAMA Dermatol 2017; 153:1147-1157. [PMID: 28903160 DOI: 10.1001/jamadermatol.2017.3029] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Importance Use of systemic therapies for moderate to severe psoriasis in children is increasing, but comparative data on their use and toxicities are limited. Objective To assess patterns of use and relative risks of systemic agents for moderate to severe psoriasis in children. Design, Setting, and Participants A retrospective review was conducted at 20 centers in North America and Europe, and included all consecutive children with moderate to severe psoriasis who used systemic medications or phototherapy for at least 3 months from December 1, 1990, to September 16, 2014. Main Outcomes and Measures The minimal core data set included age, sex, severity of psoriasis, systemic interventions, monitoring, adverse events (AEs), and reason for discontinuation. Results For 390 children (203 girls and 187 boys; mean [SD] age at diagnosis, 8.4 [3.7] years) with psoriasis who used 1 or more systemic medications, the mean interval between diagnosis and starting systemic therapy was 3.0 years. Methotrexate was used by 270 patients (69.2%), biologic agents (primarily etanercept) by 106 (27.2%), acitretin by 57 (14.6%), cyclosporine by 30 (7.7%), fumaric acid esters by 19 (4.9%), and more than 1 medication was used by 73 (18.7%). Of 270 children taking methotrexate, 130 (48.1%) reported 1 or more AEs associated with methotrexate, primarily gastrointestinal (67 [24.8%]). Folic acid 6 days per week (odds ratio, 0.16; 95% CI, 0.06-0.41; P < .001) or 7 days per week (OR, 0.21; 95% CI, 0.08-0.58; P = .003) protected against gastrointestinal AEs more than once-weekly folic acid, regardless of the total weekly dosage. Methotrexate-associated hepatic transaminase elevations were associated with obesity (35 of 270 patients [13.0%]), but a folic acid regimen was not. Injection site reactions occurred in 20 of 106 patients (18.9%) treated with tumor necrosis factor inhibitors, but did not lead to discontinuation of treatment. Having 1 or more AEs related to medication, gastrointestinal AE, laboratory abnormality, or AE leading to discontinuation of the drug was more likely with methotrexate than tumor necrosis factor inhibitors, but having 1 or more infections related to medication (predominantly upper airway) was less likely. Six patients developed a serious treatment-related AE (methotrexate, 3; fumaric acid esters, 2; and adalimumab, 1), but methotrexate and biologic agents were taken for a mean duration that was 2-fold greater than the mean duration for cyclosporine or fumaric acid esters. No patient developed tuberculosis or a malignant neoplasm. Conclusions and Relevance Medication-related AEs occur less often with tumor necrosis factor inhibitors than with methotrexate. Folic acid administration 6 or 7 times per week protected more against methotrexate-induced gastrointestinal AEs than did weekly administration. A prospective registry is needed to track the long-term risks of systemic agents for pediatric psoriasis.
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Affiliation(s)
| | - Marieke M B Seyger
- Department of Dermatology, Radboud University, Nijmegen, the Netherlands
| | - Dennis P West
- Department of Dermatology, Northwestern University, Chicago, Illinois.,Department of Pediatrics, Northwestern University, Chicago, Illinois
| | - Irene Lara-Corrales
- Department of Pediatric Medicine, Dermatology Section, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Megha Tollefson
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | - Wynnis L Tom
- Department of Dermatology, Rady Children's Hospital San Diego, University of California, San Diego.,Department of Pediatrics, Rady Children's Hospital San Diego, University of California, San Diego
| | - Marcia Hogeling
- Department of Dermatology, Phoenix Children's Hospital, Phoenix, Arizona.,now with the Department of Dermatology, University of California, Los Angeles
| | - Leah Belazarian
- Department of Dermatology, University of Massachusetts Medical School, Worcester
| | - Claus Zachariae
- Department of Dermatology and Allergy, Herlev-Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Emmanuel Mahé
- Department of Dermatology, Hôpital Victor Dupouy Argenteuil, Argenteuil, France
| | - Elaine Siegfried
- Department of Dermatology, St Louis University School of Medicine, St Louis, Missouri.,Department of Pediatrics, St Louis University School of Medicine, St Louis, Missouri
| | - Sandra Philipp
- Psoriasis Research and Treatment Center, Charité-Universitäts-Medizin, Berlin, Germany
| | - Zsuzsanna Szalai
- Department of Dermatology, Heim Pál Children's Hospital, Budapest, Hungary
| | - Ruth Ann Vleugels
- Department of Dermatology, Boston Children's Hospital, Boston, Massachusetts
| | - Kristen Holland
- Department of Dermatology, Medical College of Wisconsin, Milwaukee.,Department of Pediatrics, Medical College of Wisconsin, Milwaukee
| | - Ruth Murphy
- Paediatric Dermatology Department, Nottingham University Hospitals, Nottingham, England
| | - Eulalia Baselga
- Department of Dermatology, Hospital de la Sanat Creu i Sant Pau, Barcelona, Spain
| | - Kelly Cordoro
- Department of Dermatology, University of California, San Francisco Medical Center, San Francisco.,Department of Pediatrics, University of California, San Francisco Medical Center, San Francisco
| | - Jo Lambert
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | - Alex Alexopoulos
- First Department of Pediatrics, Agia Sofia Children's Hospital, University of Athens Medical School, Athens, Greece
| | - Ulrich Mrowietz
- Psoriasis Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Wietske Kievit
- Department for Health Evidence, Radboud University, Nijmegen, the Netherlands
| | - Amy S Paller
- Department of Dermatology, Northwestern University, Chicago, Illinois.,Department of Pediatrics, Northwestern University, Chicago, Illinois
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Verzi AE, Quan VL, Walton KE, Martini MC, Marghoob AA, Garfield EM, Kong BY, Isales MC, VandenBoom T, Zhang B, West DP, Gerami P. The diagnostic value and histologic correlate of distinct patterns of shiny white streaks for the diagnosis of melanoma: A retrospective, case-control study. J Am Acad Dermatol 2017; 78:913-919. [PMID: 29138058 DOI: 10.1016/j.jaad.2017.11.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 09/18/2017] [Revised: 10/24/2017] [Accepted: 11/02/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Shiny white streaks (SWSs) are best visualized with polarized dermoscopy and correlate with dermal fibroplasia histopathologically. SWSs have been described at higher frequencies in melanomas than in benign nevi. OBJECTIVE We assessed the diagnostic value of different patterns of SWSs and their histologic correlate in melanocytic lesions. METHODS Polarized dermoscopic images of 1507 histopathologically diagnosed melanocytic neoplasms were analyzed for presence and pattern of SWSs. Histology was also reviewed for correlation. RESULTS Among 1507 melanocytic neoplasms, SWSs were observed in 31 of 144 melanomas (22%) and 22 of 1363 benign neoplasms (1.6%) (P < .001). The sensitivity and specificity of SWSs for melanoma were 22% and 98%, respectively. Diffuse SWSs exhibited the greatest diagnostic value for melanoma, with sensitivity of 11.8% and specificity of 99.5%. Focal central and peripheral SWSs were comparable in diagnostic significance. The presence of SWSs was highly uncommon in dysplastic nevi, whereas in certain benign subgroups of nevi such as Spitz nevi and atypical genital special site nevi, SWSs were not uncommon. Diffuse SWSs correlated with greater breadth of deep fibroplasia than focal SWSs (P = .009), and SWSs correlated with greater Breslow depth among melanomas (P = .007). LIMITATIONS This study was retrospective. CONCLUSION Polarized dermoscopy is a valuable diagnostic tool in the identification of SWSs, a feature that is highly specific for melanoma.
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Affiliation(s)
- Anna Eliza Verzi
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Victor L Quan
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Kara E Walton
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Mary C Martini
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Ashfaq A Marghoob
- Dermatology Service, Memorial Sloan Kettering Cancer Center, Hauppage, New York, New York
| | - Erin M Garfield
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Betty Y Kong
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Maria Cristina Isales
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Timothy VandenBoom
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Bin Zhang
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Dennis P West
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Pedram Gerami
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
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Vakharia P, Nardone B, Budris W, Hoshizaki K, Frankfurt O, West DP. Blinatumomab and pancreatitis: an analysis of FAERS, EudraVigilance, and a large urban U.S. patient population data. Leuk Lymphoma 2017; 59:1759-1761. [PMID: 29115884 DOI: 10.1080/10428194.2017.1397667] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Paras Vakharia
- a Department of Dermatology , Northwestern University Feinberg School of Medicine , Chicago , IL , USA
| | - Beatrice Nardone
- a Department of Dermatology , Northwestern University Feinberg School of Medicine , Chicago , IL , USA
| | - William Budris
- b Department of Pharmacy , Northwestern Medicine , Chicago , IL , USA
| | - Kevin Hoshizaki
- b Department of Pharmacy , Northwestern Medicine , Chicago , IL , USA
| | - Olga Frankfurt
- c Robert H. Lurie Comprehensive Cancer Center, Northwestern University , Chicago , IL , USA.,d Department of Internal Medicine, Division of Hematology/Oncology , Northwestern University Feinberg School of Medicine , Chicago , IL , USA
| | - Dennis P West
- a Department of Dermatology , Northwestern University Feinberg School of Medicine , Chicago , IL , USA.,c Robert H. Lurie Comprehensive Cancer Center, Northwestern University , Chicago , IL , USA
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35
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Nardone B, Orrell KA, Vakharia PP, West DP. Skin cancer associated with commonly prescribed drugs: tumor necrosis factor alpha inhibitors (TNF-αIs), angiotensin-receptor blockers (ARBs), phosphodiesterase type 5 inhibitors (PDE5Is) and statins -weighing the evidence. Expert Opin Drug Saf 2017; 17:139-147. [DOI: 10.1080/14740338.2018.1400530] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Beatrice Nardone
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kelsey A. Orrell
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Paras P. Vakharia
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Dennis P. West
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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36
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Verzì AE, Bubley JA, Haugh AM, Zhang B, Wagner A, Kruse L, West DP, Wayne J, Guitart J, Gerami P. A single-institution assessment of superficial spreading melanoma (SSM) in the pediatric population: Molecular and histopathologic features compared with adult SSM. J Am Acad Dermatol 2017; 77:886-892. [PMID: 28754310 DOI: 10.1016/j.jaad.2017.05.051] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 05/26/2017] [Accepted: 05/31/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND The epidemiology of pediatric melanoma is distinct from that seen in adults. This is more distinguishable when pediatric patients are separated into prepubertal and adolescent groups. OBJECTIVE In this study, we compared epidemiologic, clinical, histologic, and molecular characteristics of pediatric superficial spreading melanoma (SSM) in prepubertal and adolescent patients to that in adults. METHOD We reviewed our database for pediatric melanomas, comparing SSM data between pediatric and adult cases for pathologic stage at presentation, ratio of radial to vertical growth phase, average Breslow depth and mitotic index, and frequency of fluorescence in situ hybridization (FISH) positivity. RESULTS Of 84 pediatric melanomas, 38 were SSM, and 5 of the latter (6%) were prepubertal. There were no significant differences when pediatric and adult SSM were compared for stage at presentation, ratio of radial to vertical growth phase, average Breslow depth and mitotic count, or frequency of FISH positivity. A significant difference was detected for SSM arising from a precursor nevus (80% of pediatric cases versus 30% of adult cases). LIMITATIONS Follow-up time was limited for both cohorts. CONCLUSIONS SSM melanoma is infrequent in childhood, particularly in the prepubertal years. Features such as tumor stage, Breslow depth, mitotic activity, and FISH positivity suggest morphologic and molecular characteristics similar to those of adult SSM.
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Affiliation(s)
- Anna Elisa Verzì
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Jeffrey A Bubley
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Alexandra M Haugh
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Bin Zhang
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Annette Wagner
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Ann and Robert H. Lurie Children's Hospital, Chicago, Illinois
| | - Lacey Kruse
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Ann and Robert H. Lurie Children's Hospital, Chicago, Illinois
| | - Dennis P West
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Jeffrey Wayne
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Joan Guitart
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Pedram Gerami
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Robert H. Lurie Cancer Center, Northwestern University, Chicago, Illinois.
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37
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Vakharia PP, Nardone B, Schlosser BJ, Lee D, Serrano L, West DP. Reply to-chronic exposure to tetracyclines and subsequent diagnosis for non-melanoma skin cancer in a large Midwestern US population. J Eur Acad Dermatol Venereol 2017; 32:e159-e160. [PMID: 29080313 DOI: 10.1111/jdv.14662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- P P Vakharia
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N. Saint Clair Street, Suite 1600, Chicago, 60611, IL, USA
| | - B Nardone
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N. Saint Clair Street, Suite 1600, Chicago, 60611, IL, USA
| | - B J Schlosser
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N. Saint Clair Street, Suite 1600, Chicago, 60611, IL, USA
| | - D Lee
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N. Saint Clair Street, Suite 1600, Chicago, 60611, IL, USA
| | - L Serrano
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N. Saint Clair Street, Suite 1600, Chicago, 60611, IL, USA
| | - D P West
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N. Saint Clair Street, Suite 1600, Chicago, 60611, IL, USA.,Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, 676 N. Saint Clair Street, Suite 1600, Chicago, 60611, IL, USA
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38
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Florek AG, Nardone B, Thareja S, Tran G, Giles FJ, West DP. Malignancies and ustekinumab: an analysis of the U.S. Food and Drug Administration Adverse Event Reporting System and the European Union Drug Regulating Authorities Pharmacovigilance database. Br J Dermatol 2017. [PMID: 28646575 DOI: 10.1111/bjd.15752] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A G Florek
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, 676 N. Saint Clair Street, Suite 1600, Chicago, IL, 60611, U.S.A
| | - B Nardone
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, 676 N. Saint Clair Street, Suite 1600, Chicago, IL, 60611, U.S.A
| | - S Thareja
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, 676 N. Saint Clair Street, Suite 1600, Chicago, IL, 60611, U.S.A
| | - G Tran
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, 676 N. Saint Clair Street, Suite 1600, Chicago, IL, 60611, U.S.A
| | - F J Giles
- Developmental Therapeutics Program, Division of Hematology Oncology, Northwestern University, Feinberg School of Medicine, 676 N. Saint Clair Street, Suite 1600, Chicago, IL, 60611, U.S.A.,Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, U.S.A
| | - D P West
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, 676 N. Saint Clair Street, Suite 1600, Chicago, IL, 60611, U.S.A.,Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, U.S.A
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Affiliation(s)
- B Nardone
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, U.S.A
| | - D P West
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, U.S.A.,Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, U.S.A
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Mueller K, Verzi AE, Bhatt K, Orrell K, Hagstorm E, Flood K, Schlosser B, Nardone B, West DP. Melanoma and chronic exposure to contraceptives containing microdoses of ethinylestradiol in young women: a retrospective study from the Research on Adverse Drug Events and Reports (RADAR) project comprising a large Midwestern U.S. patient population. J Eur Acad Dermatol Venereol 2017; 32:e87-e88. [PMID: 28833586 DOI: 10.1111/jdv.14534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- K Mueller
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - A E Verzi
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - K Bhatt
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - K Orrell
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - E Hagstorm
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - K Flood
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - B Schlosser
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - B Nardone
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - D P West
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA
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Carneiro C, Bloom R, Ibler E, Majewski S, Sable KA, Guido NJ, Day J, Nocadello S, Florek AG, West DP, Nardone B. Rate of serious infection in patients who are prescribed systemic biologic or nonbiologic agents for psoriasis: A large, single center, retrospective, observational cohort study. Dermatol Ther 2017; 30. [PMID: 28796405 DOI: 10.1111/dth.12529] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 06/13/2017] [Accepted: 07/12/2017] [Indexed: 02/01/2023]
Abstract
BACKGROUND Systemic biologic and nonbiologic agents used to treat psoriasis may or may not contribute to serious infection (SI) risk. Safety data, particularly for biologic agents, and associated risk for SI, are scarce. The study's aim was to explore the risk for SI in psoriasis patients exposed to systemic biologic or nonbiologic agents. METHODS A large, single-center electronic medical record repository was searched between January 2010 and December 2014. Records for patients prescribed a systemic agent for psoriasis (SAP) with psoriasis or psoriatic arthritis diagnoses were included (ICD-9 codes 696.1 and 696.0, respectively). SIs were those who required hospitalization, and/or injectable antibacterial, antiviral or antifungal therapy. SIs occurring within 120 days after exposure to a SAP, were included for study. RESULTS A total of 1,346 patients were exposed to a SAP between January 2010 and December 2014; 27 (2%) had a SI. Comparing biologic and nonbiologic agent exposure, no statistically significant difference for risk of SI was detectable (p = .83). CONCLUSION In this population, the SI rate for biologic and nonbiologic systemic agents was clinically indistinguishable, thereby supporting consideration of the entire spectrum of available systemic therapeutic agents, both biologic and nonbiologic agents, for management of moderate to severe psoriasis.
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Affiliation(s)
- Chantelle Carneiro
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Romi Bloom
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,NorthShore University Health System, Evanston, Illinois
| | - Erin Ibler
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Sara Majewski
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Kimberly A Sable
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Nicholas J Guido
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Jennifer Day
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Salvatore Nocadello
- Center for Structural Genomics of Infectious Diseases, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Aleksandra G Florek
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Dennis P West
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Beatrice Nardone
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Vakharia PP, Nardone B, Schlosser BJ, Lee D, Serrano L, West DP. Chronic exposure to tetracyclines and subsequent diagnosis for non-melanoma skin cancer in a large Midwestern U.S. patient population. J Eur Acad Dermatol Venereol 2017; 31:e534-e536. [PMID: 28609551 DOI: 10.1111/jdv.14399] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- P P Vakharia
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - B Nardone
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - B J Schlosser
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - D Lee
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - L Serrano
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - D P West
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Sorrell J, Anthony L, Rademaker A, Belknap SM, Callahan S, West DP, Paller AS. Score of Toxic Epidermal Necrosis Predicts the Outcomes of Pediatric Epidermal Necrolysis. Pediatr Dermatol 2017; 34:433-437. [PMID: 28508417 DOI: 10.1111/pde.13172] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND/OBJECTIVES Epidermal necrolysis (Stevens-Johnson syndrome and toxic epidermal necrolysis) includes immune-mediated, life-threatening inflammatory blistering disorders that can affect children. The Score of Toxic Epidermal Necrosis (SCORTEN) tool has accurately predicted the outcome of these disorders in adults but has not been tested in children. METHODS We performed a retrospective chart review to compare the accuracy of the adult SCORTEN tool with that of two modifications tailored to children in predicting disease outcome. RESULTS The longer the patient's median length of hospital stay was, the higher the adult and two proposed pediatric SCORTENs were. In addition, all patients who died had SCORTENs greater than 4. CONCLUSION The pediatric-modified tools were not superior to the adult SCORTEN, which accurately predicted outcome.
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Affiliation(s)
- Jennifer Sorrell
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Lisa Anthony
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Alfred Rademaker
- Department of Preventative Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Steven M Belknap
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Division of General Internal Medicine and Geriatrics, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Shields Callahan
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Dennis P West
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Amy S Paller
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Carneiro C, Nardone B, Kiguradze T, Posligua A, West DP, Rani M. Investigating the potential for protective effect against non-melanoma skin cancer in cancer patients receiving oral niacin. Ital J Dermatol Venerol 2017. [DOI: 10.23736/s0392-0488.16.05318-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Lee DE, Serrano L, Martinez-Escala E, Kaplan JB, Pro B, Guitart J, Temps WH, West DP, Belknap SM. Hypomagnesemia and exposure to romidepsin: A Research on Adverse Drug events and Reports (RADAR) project. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e14072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e14072 Background: Romidepsin (R) is indicated for cutaneous T-cell lymphoma (CTCL) and peripheral T-cell lymphoma. Hypomagnesemia (HM) is common in these patients and is also listed in the Full Prescribing Information (FPI) for R. Moreover, since cardiac arrhythmias are associated with HM, patients exposed to R may be at higher risk. This study assessed whether HM was causally related to R exposure and to what extent magnesium (M) supplementation was undertaken in those with HM. Methods: We searched a large, U.S. patient data repository to detect all patients (aged 20-94 years) exposed to R (10/2010-01/2017). For these patients, serum M, as well as M supplementation data, was collected. Baseline M was assessed at initial R exposure, and HM was defined as either, a decline in M to < 1.8 mg/dL after R exposure or, in those with baseline M < 1.8 mg/dL, a decline in M by ≥0.1 mg/dL after R exposure. For each patient with HM after R exposure, the validated Naranjo Adverse Drug Reaction Probability Scale (NADRPS) was used to determine the probability that HM was caused by R. Results: Of 51 R-exposed CTCL (or other lymphoma) patients, 25 (49.0%) had HM. Of these 25, NADRPS scores yielded: 1 doubtful, 16 possible, 8 probable and 0 definite. Additionally, 24 of 25 patients with HM had documentation for presence or absence of M supplementation: 9 (37.5%) had supplementation with M agents considered to be bioavailable, 12 (50%) received M agents considered to have low bioavailability, and 3 (12.5%) had no M supplementation. Conclusions: In this study population, 25 of 51 (49.0%) patients had HM after R exposure, which appears to nearly double the percentage of patients described in the FPI. Moreover, 8 of 25 (32%) patients with HM had causality attributed to R exposure. In addition, 15 of 24 (63%) patients with HM received M supplementation with agents considered to have low bioavailability or received no M supplementation. These findings support the need for ongoing monitoring of R-exposed patients with low M, as well as the importance of repleting M with agents considered to be adequately bioavailable. Also, given that HM appears to be more frequent in this study population compared to pre-marketing data in the FPI, further studies are warranted.
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Affiliation(s)
- Dylan E. Lee
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Linda Serrano
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Estela Martinez-Escala
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Jason B. Kaplan
- Department of Medicine, Division of Hematology/Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Barbara Pro
- Department of Medicine, Division of Hematology/Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Joan Guitart
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - William H. Temps
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Dennis P. West
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Steven M. Belknap
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL
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Vakharia PP, Orrell KA, Lee D, Rangel SM, Lund E, Laumann AE, West DP, Nardone B. Apremilast and suicidality - a retrospective analysis of three large databases: the FAERS, EudraVigilance and a large single-centre US patient population. J Eur Acad Dermatol Venereol 2017; 31:e463-e464. [PMID: 28380251 DOI: 10.1111/jdv.14256] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- P P Vakharia
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N. Saint Clair Street, Suite 1600, Chicago, IL, 60611, USA
| | - K A Orrell
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N. Saint Clair Street, Suite 1600, Chicago, IL, 60611, USA
| | - D Lee
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N. Saint Clair Street, Suite 1600, Chicago, IL, 60611, USA
| | - S M Rangel
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N. Saint Clair Street, Suite 1600, Chicago, IL, 60611, USA
| | - E Lund
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N. Saint Clair Street, Suite 1600, Chicago, IL, 60611, USA
| | - A E Laumann
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N. Saint Clair Street, Suite 1600, Chicago, IL, 60611, USA
| | - D P West
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N. Saint Clair Street, Suite 1600, Chicago, IL, 60611, USA
| | - B Nardone
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N. Saint Clair Street, Suite 1600, Chicago, IL, 60611, USA
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Kwa MC, Ardalan K, Laumann AE, Nardone B, West DP, Silverberg JI. Validation of International Classification of Diseases Codes for the Epidemiologic Study of Dermatomyositis. Arthritis Care Res (Hoboken) 2017; 69:753-757. [DOI: 10.1002/acr.23010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 07/31/2016] [Accepted: 08/09/2016] [Indexed: 11/10/2022]
Affiliation(s)
- Michael C. Kwa
- Northwestern University Feinberg School of Medicine; Chicago Illinois
| | - Kaveh Ardalan
- Ann and Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine; Chicago Illinois
| | - Anne E. Laumann
- Northwestern University Feinberg School of Medicine; Chicago Illinois
| | - Beatrice Nardone
- Northwestern University Feinberg School of Medicine; Chicago Illinois
| | - Dennis P. West
- Northwestern University Feinberg School of Medicine; Chicago Illinois
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Kiguradze T, Bruins FM, Guido N, Bhattacharya T, Rademaker A, Florek AG, Posligua A, Amin S, Laumann AE, West DP, Nardone B. Evidence for the association of Hashimoto's thyroiditis with psoriasis: a cross-sectional retrospective study. Int J Dermatol 2017; 56:553-556. [PMID: 28217937 DOI: 10.1111/ijd.13459] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 06/30/2016] [Accepted: 08/22/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND Current information indicates that psoriasis is a metabolic disorder with systemic manifestations. Reports have revealed an association between psoriasis and several chronic autoimmune disorders. For one of these disorders, Hashimoto's thyroiditis (HT), there are scarce, and relatively unconfirmed, reports of an association with psoriasis. We sought to determine if such an association is detectable in a large medical record data repository. METHODS We searched one institution's electronic medical record data repository from January 2010 to December 2013. Patients were identified by ICD-9 codes (psoriasis: 696.0; 696.1, HT: 245.2). Only data from patients with laboratory-confirmed HT (anti-thyroid peroxidase [anti-TPO] antibodies; thyroglobulin antibodies; serum thyroid-stimulating hormone; and free T3) were eligible for inclusion. Logistic regression analysis was used to obtain an odds ratio (OR) to establish an association between psoriasis and HT. Stratified analyses were performed to test for confounding variable and effect modification. RESULTS Medical records for 856,615 individuals with documented encounters between January 1, 2010, and December 31, 2013, were detected. A total of 9654 had a diagnosis of psoriasis, and 1745 had a diagnosis of HT. Of these, 41 subjects were diagnosed with both conditions. A significant association existed for psoriasis and HT, even after adjusting for confounding variables that included gender, age, psoriatic arthropathy, and the use of systemic anti-psoriatic agents (OR = 2.49; 95% CI 1.79-3.48; P < 0.0001). CONCLUSIONS This association has broad clinical impact and deserves further attention with regard to patient care, clinical research, and developmental therapeutics.
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Affiliation(s)
- Tina Kiguradze
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Finola M Bruins
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Nicholas Guido
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Tanya Bhattacharya
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Alfred Rademaker
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Aleksandra G Florek
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Alba Posligua
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Shatil Amin
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Anne E Laumann
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Dennis P West
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Beatrice Nardone
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Cices A, Ibler E, Majewski S, Huynh T, Sable KA, Brieva J, West DP, Nardone B. Hidradenitis suppurativa association at the time of, or subsequent to, diagnosis of inflammatory bowel disease in a large U.S. patient population. J Eur Acad Dermatol Venereol 2017; 31:e311-e312. [PMID: 28000245 DOI: 10.1111/jdv.14097] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 12/14/2016] [Indexed: 11/29/2022]
Affiliation(s)
- A Cices
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - E Ibler
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - S Majewski
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - T Huynh
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - K A Sable
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - J Brieva
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - D P West
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - B Nardone
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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50
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Webb KC, Lyon S, Nardone B, West DP, Kundu RV. Influence of Pregnancy on Vitiligo Activity. J Clin Aesthet Dermatol 2016; 9:21-25. [PMID: 28210395 PMCID: PMC5300723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Background: Vitiligo vulgaris, an acquired disease related to autoimmune activity directed against melanocytes, is a common disorder of pigmentation affecting up to one percent of the population. Several autoimmune disorders are reported to improve during pregnancy-a state of relative immunosuppression. Objectives: To assess self-reported changes in vitiligo disease activity that occurred during pregnancy. Methods: A survey of 24 subjects with vitiligo was conducted by telephone using questions that pertained to vitiligo history, pregnancy history, and vitiligo disease activity prior to, during, and after pregnancy. Additional questions pertained to demographics, history of other autoimmune disease, and family history of vitiligo. Results: 18 of 24 subjects (75%) reported stable or improvement in vitiligo activity during pregnancy. Of these 18 subjects, five (27%) had discontinued vitiligo therapy during their pregnancies. Conclusion: The majority of patients surveyed reported either stable or improved vitiligo activity during pregnancy. These results support a protective effect exerted by the state of pregnancy against changing or progressing depigmentation characteristic of vitiligo vulgaris in the non-pregnant state.
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Affiliation(s)
- Kirsten C. Webb
- Department of Dermatology, Loyola University, Stritch School of Medicine, Maywood, Illinois
| | - Sarah Lyon
- Department of Dermatology, University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Beatrice Nardone
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Dennis P. West
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Roopal V. Kundu
- Department of Dermatology, Loyola University, Stritch School of Medicine, Maywood, Illinois
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