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Ali R, Connolly ID, Tang OY, Mirza FN, Johnston B, Abdulrazeq HF, Lim RK, Galamaga PF, Libby TJ, Sodha NR, Groff MW, Gokaslan ZL, Telfeian AE, Shin JH, Asaad WF, Zou J, Doberstein CE. Author Correction: Bridging the literacy gap for surgical consents: an AI-human expert collaborative approach. NPJ Digit Med 2024; 7:93. [PMID: 38609435 PMCID: PMC11015017 DOI: 10.1038/s41746-024-01099-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024] Open
Affiliation(s)
- Rohaid Ali
- Department of Neurosurgery, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA.
- Norman Prince Neurosciences Institute, Providence, RI, USA.
| | - Ian D Connolly
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA
| | - Oliver Y Tang
- Department of Neurosurgery, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Fatima N Mirza
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Benjamin Johnston
- Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Hael F Abdulrazeq
- Department of Neurosurgery, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Norman Prince Neurosciences Institute, Providence, RI, USA
| | - Rachel K Lim
- Department of Surgery & Division of Cardiothoracic Surgery, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | | | - Tiffany J Libby
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Neel R Sodha
- Department of Surgery & Division of Cardiothoracic Surgery, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Michael W Groff
- Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Ziya L Gokaslan
- Department of Neurosurgery, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Norman Prince Neurosciences Institute, Providence, RI, USA
| | - Albert E Telfeian
- Department of Neurosurgery, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Norman Prince Neurosciences Institute, Providence, RI, USA
| | - John H Shin
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA
| | - Wael F Asaad
- Department of Neurosurgery, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - James Zou
- Departments of Electrical Engineering, Biomedical Data Science, and Computer Science, Stanford University, Stanford, CA, USA
- Chan Zuckerberg Biohub, San Francisco, CA, USA
| | - Curtis E Doberstein
- Department of Neurosurgery, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Norman Prince Neurosciences Institute, Providence, RI, USA
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2
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Maymone MBC, Mirza FN, Steiner D, Ribeiro F, Landau M, Marçon C, Celidonio TC, Soon SL, Wambier CG. Comparative long-term efficacy of phenol-croton oil chemical peels for persistent melasma at varied Croton tiglium oil concentrations. J Am Acad Dermatol 2024:S0190-9622(24)00547-4. [PMID: 38574769 DOI: 10.1016/j.jaad.2024.03.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 02/15/2024] [Accepted: 03/27/2024] [Indexed: 04/06/2024]
Affiliation(s)
- Mayra B C Maymone
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Fatima N Mirza
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Denise Steiner
- Department of Dermatology, University of Mogi das Cruzes, Mogi das Cruzes, Brazil
| | - Felipe Ribeiro
- Department of Dermatology, University of Mogi das Cruzes, Mogi das Cruzes, Brazil
| | | | | | | | | | - Carlos G Wambier
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
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3
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Tran MM, Orsillo L, Wei G, Mirza FN, Yumeen S, Wisco OJ. Applications and Best Practices for Geospatial Analysis Research in Dermatology. J Invest Dermatol 2024; 144:738-747. [PMID: 38519249 DOI: 10.1016/j.jid.2024.01.016] [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: 10/31/2023] [Revised: 01/02/2024] [Accepted: 01/23/2024] [Indexed: 03/24/2024]
Abstract
Dermatologic diseases often exhibit distinct geographic patterns, underscoring the significant role of regional environmental, genetic, and sociocultural factors in driving their prevalence and manifestations. Geographic information and geospatial analysis enable researchers to investigate the spatial distribution of adverse health outcomes and their relationship with socioeconomic and environmental risk factors that are inherently geographic. Health geographers and spatial epidemiologists have developed numerous geospatial analytical tools to collect, process, visualize, and analyze geographic data. These tools help provide vital spatial context to the comprehension of the underlying dynamics behind health outcomes. By identifying areas with high rates of dermatologic disease and areas with barriers to access to quality dermatologic care, findings from studies utilizing geospatial analysis can inform the design and targeting of policy and intervention to help improve dermatologic healthcare outcomes and promote health equity. This article emphasizes the significance of geospatial data and analysis in dermatology research. We explore the common processes in data acquisition, harmonization, and geospatial analytics while conducting spatially and dermatologically relevant research. The article also highlights the practical application of geospatial analysis through instances drawn from the dermatology literature.
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Affiliation(s)
- Megan M Tran
- The Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.
| | | | - Guixing Wei
- Spatial Structures in the Social Sciences, Population Studies and Training Center, Brown University, Providence, Rhode Island, USA
| | - Fatima N Mirza
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Sara Yumeen
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Oliver J Wisco
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
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4
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Tran MM, Mirza FN, Lee AC, Goldbach HS, Libby TJ, Wisco OJ. Dermatologic findings associated with semaglutide use: A scoping review. J Am Acad Dermatol 2024:S0190-9622(24)00532-2. [PMID: 38554940 DOI: 10.1016/j.jaad.2024.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/05/2024] [Accepted: 03/12/2024] [Indexed: 04/02/2024]
Affiliation(s)
- Megan M Tran
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Fatima N Mirza
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | | | - Hayley S Goldbach
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Tiffany J Libby
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Oliver J Wisco
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
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5
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Ali R, Connolly ID, Tang OY, Mirza FN, Johnston B, Abdulrazeq HF, Lim RK, Galamaga PF, Libby TJ, Sodha NR, Groff MW, Gokaslan ZL, Telfeian AE, Shin JH, Asaad WF, Zou J, Doberstein CE. Bridging the literacy gap for surgical consents: an AI-human expert collaborative approach. NPJ Digit Med 2024; 7:63. [PMID: 38459205 PMCID: PMC10923794 DOI: 10.1038/s41746-024-01039-2] [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] [Received: 06/30/2023] [Accepted: 02/14/2024] [Indexed: 03/10/2024] Open
Abstract
Despite the importance of informed consent in healthcare, the readability and specificity of consent forms often impede patients' comprehension. This study investigates the use of GPT-4 to simplify surgical consent forms and introduces an AI-human expert collaborative approach to validate content appropriateness. Consent forms from multiple institutions were assessed for readability and simplified using GPT-4, with pre- and post-simplification readability metrics compared using nonparametric tests. Independent reviews by medical authors and a malpractice defense attorney were conducted. Finally, GPT-4's potential for generating de novo procedure-specific consent forms was assessed, with forms evaluated using a validated 8-item rubric and expert subspecialty surgeon review. Analysis of 15 academic medical centers' consent forms revealed significant reductions in average reading time, word rarity, and passive sentence frequency (all P < 0.05) following GPT-4-faciliated simplification. Readability improved from an average college freshman to an 8th-grade level (P = 0.004), matching the average American's reading level. Medical and legal sufficiency consistency was confirmed. GPT-4 generated procedure-specific consent forms for five varied surgical procedures at an average 6th-grade reading level. These forms received perfect scores on a standardized consent form rubric and withstood scrutiny upon expert subspeciality surgeon review. This study demonstrates the first AI-human expert collaboration to enhance surgical consent forms, significantly improving readability without sacrificing clinical detail. Our framework could be extended to other patient communication materials, emphasizing clear communication and mitigating disparities related to health literacy barriers.
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Affiliation(s)
- Rohaid Ali
- Department of Neurosurgery, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA.
- Norman Prince Neurosciences Institute, Providence, RI, USA.
| | - Ian D Connolly
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA
| | - Oliver Y Tang
- Department of Neurosurgery, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Fatima N Mirza
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Benjamin Johnston
- Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Hael F Abdulrazeq
- Department of Neurosurgery, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Norman Prince Neurosciences Institute, Providence, RI, USA
| | - Rachel K Lim
- Department of Surgery & Division of Cardiothoracic Surgery, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | | | - Tiffany J Libby
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Neel R Sodha
- Department of Surgery & Division of Cardiothoracic Surgery, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Michael W Groff
- Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Ziya L Gokaslan
- Department of Neurosurgery, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Norman Prince Neurosciences Institute, Providence, RI, USA
| | - Albert E Telfeian
- Department of Neurosurgery, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Norman Prince Neurosciences Institute, Providence, RI, USA
| | - John H Shin
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA
| | - Wael F Asaad
- Department of Neurosurgery, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - James Zou
- Departments of Electrical Engineering, Biomedical Data Science, and Computer Science, Stanford University, Stanford, CA, USA
- Chan Zuckerberg Biohub, San Francisco, CA, USA
| | - Curtis E Doberstein
- Department of Neurosurgery, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Norman Prince Neurosciences Institute, Providence, RI, USA
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Mirza FN, Lim RK, Yumeen S, Wahood S, Zaidat B, Shah A, Tang OY, Kawaoka J, Seo SJ, DiMarco C, Muglia J, Goldbach HS, Wisco O, Qureshi AA, Libby TJ. Performance of Three Large Language Models on Dermatology Board Examinations. J Invest Dermatol 2024; 144:398-400. [PMID: 37541614 DOI: 10.1016/j.jid.2023.06.208] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 06/27/2023] [Indexed: 08/06/2023]
Affiliation(s)
- Fatima N Mirza
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
| | - Rachel K Lim
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA; The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Sara Yumeen
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Samer Wahood
- The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Bashar Zaidat
- Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Asghar Shah
- The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Oliver Y Tang
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - John Kawaoka
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Su-Jean Seo
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Christopher DiMarco
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Jennie Muglia
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Hayley S Goldbach
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Oliver Wisco
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Abrar A Qureshi
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Tiffany J Libby
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
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Ali R, Tang OY, Connolly ID, Abdulrazeq HF, Mirza FN, Lim RK, Johnston BR, Groff MW, Williamson T, Svokos K, Libby TJ, Shin JH, Gokaslan ZL, Doberstein CE, Zou J, Asaad WF. Demographic Representation in 3 Leading Artificial Intelligence Text-to-Image Generators. JAMA Surg 2024; 159:87-95. [PMID: 37966807 PMCID: PMC10782243 DOI: 10.1001/jamasurg.2023.5695] [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] [Received: 05/31/2023] [Accepted: 08/25/2023] [Indexed: 11/16/2023]
Abstract
Importance The progression of artificial intelligence (AI) text-to-image generators raises concerns of perpetuating societal biases, including profession-based stereotypes. Objective To gauge the demographic accuracy of surgeon representation by 3 prominent AI text-to-image models compared to real-world attending surgeons and trainees. Design, Setting, and Participants The study used a cross-sectional design, assessing the latest release of 3 leading publicly available AI text-to-image generators. Seven independent reviewers categorized AI-produced images. A total of 2400 images were analyzed, generated across 8 surgical specialties within each model. An additional 1200 images were evaluated based on geographic prompts for 3 countries. The study was conducted in May 2023. The 3 AI text-to-image generators were chosen due to their popularity at the time of this study. The measure of demographic characteristics was provided by the Association of American Medical Colleges subspecialty report, which references the American Medical Association master file for physician demographic characteristics across 50 states. Given changing demographic characteristics in trainees compared to attending surgeons, the decision was made to look into both groups separately. Race (non-White, defined as any race other than non-Hispanic White, and White) and gender (female and male) were assessed to evaluate known societal biases. Exposures Images were generated using a prompt template, "a photo of the face of a [blank]", with the blank replaced by a surgical specialty. Geographic-based prompting was evaluated by specifying the most populous countries on 3 continents (the US, Nigeria, and China). Main Outcomes and Measures The study compared representation of female and non-White surgeons in each model with real demographic data using χ2, Fisher exact, and proportion tests. Results There was a significantly higher mean representation of female (35.8% vs 14.7%; P < .001) and non-White (37.4% vs 22.8%; P < .001) surgeons among trainees than attending surgeons. DALL-E 2 reflected attending surgeons' true demographic data for female surgeons (15.9% vs 14.7%; P = .39) and non-White surgeons (22.6% vs 22.8%; P = .92) but underestimated trainees' representation for both female (15.9% vs 35.8%; P < .001) and non-White (22.6% vs 37.4%; P < .001) surgeons. In contrast, Midjourney and Stable Diffusion had significantly lower representation of images of female (0% and 1.8%, respectively; P < .001) and non-White (0.5% and 0.6%, respectively; P < .001) surgeons than DALL-E 2 or true demographic data. Geographic-based prompting increased non-White surgeon representation but did not alter female representation for all models in prompts specifying Nigeria and China. Conclusion and Relevance In this study, 2 leading publicly available text-to-image generators amplified societal biases, depicting over 98% surgeons as White and male. While 1 of the models depicted comparable demographic characteristics to real attending surgeons, all 3 models underestimated trainee representation. The study suggests the need for guardrails and robust feedback systems to minimize AI text-to-image generators magnifying stereotypes in professions such as surgery.
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Affiliation(s)
- Rohaid Ali
- Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Oliver Y. Tang
- Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Ian D. Connolly
- Department of Neurosurgery, Massachusetts General Hospital, Boston
| | - Hael F. Abdulrazeq
- Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Fatima N. Mirza
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Rachel K. Lim
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | | | - Michael W. Groff
- Department of Neurosurgery, Brigham and Women’s Hospital, Boston, Massachusetts
| | | | - Konstantina Svokos
- Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Tiffany J. Libby
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - John H. Shin
- Department of Neurosurgery, Massachusetts General Hospital, Boston
| | - Ziya L. Gokaslan
- Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Curtis E. Doberstein
- Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - James Zou
- Department of Biomedical Data Science and, by courtesy, Computer Science and Electrical Engineering, Stanford University, Stanford, California
| | - Wael F. Asaad
- Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Department of Neuroscience, Norman Prince Neurosciences Institute, Rhode Island Hospital, Providence
- Department of Neuroscience, Brown University, Providence, Rhode Island
- Department of Neuroscience, Carney Institute for Brain Science, Brown University, Providence, Rhode Island
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Omer M, Trepanowski N, Yumeen S, Mirza FN, Goldbach HS, Joshipura D, Woo SB, Nuovo GJ, Robinson-Bostom L. Focal epithelial hyperplasia associated with human papillomavirus-13 in a healthy Haitian adult. JAAD Case Rep 2023; 42:52-55. [PMID: 38053542 PMCID: PMC10694523 DOI: 10.1016/j.jdcr.2023.09.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023] Open
Affiliation(s)
- Mohamed Omer
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Department of Pathology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Nicole Trepanowski
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Boston University School of Medicine, Boston, Massachusetts
| | - Sara Yumeen
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Fatima N. Mirza
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Hayley S. Goldbach
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Deep Joshipura
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Sook-Bin Woo
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, Massachusetts
| | - Gerard J. Nuovo
- Department of Pathology, Ohio State University Medical Center, Columbus, Ohio
- GnomeDX, Powell, Ohio
| | - Leslie Robinson-Bostom
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
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Yumeen S, Mirza FN, Mirza HN, Zogg CK, Leventhal JS, Cohen JM. Malignant blue nevus: Characterization of US epidemiology and prognostic factors of a rare neoplasm with aggressive clinical course using the Surveillance, Epidemiology, and End Results Program database. J Am Acad Dermatol 2023; 89:843-846. [PMID: 37343827 DOI: 10.1016/j.jaad.2023.05.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 04/23/2023] [Accepted: 05/17/2023] [Indexed: 06/23/2023]
Affiliation(s)
- Sara Yumeen
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Fatima N Mirza
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Humza N Mirza
- University of Michigan Medical School, Ann Arbor, Michigan
| | - Cheryl K Zogg
- Yale School of Medicine, New Haven, Connecticut; Department of Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Jeffrey M Cohen
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut; Division of Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, Connecticut.
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Türk CB, Mirza FN, Kroumpouzos G. A Screening Proposal for Zoom Dysmorphia in Virtual Settings. Life (Basel) 2023; 13:1678. [PMID: 37629535 PMCID: PMC10456071 DOI: 10.3390/life13081678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/24/2023] [Accepted: 07/31/2023] [Indexed: 08/27/2023] Open
Abstract
Zoom dysmorphia (ZD) is a facial dysmorphia that is triggered or aggravated by frequent virtual meetings. The frequent use of videoconferencing platforms has been linked to a distorted perception of facial images as individuals have an increased awareness of their appearance, given constant video feedback. As a result, dysmorphic concerns can develop. It is crucial to identify ZD as this condition interferes with an individual's life and can trigger or aggravate body dysmorphic disorder (BDD). A standardized approach for screening ZD in non-psychiatric settings has yet to be defined. We discuss the features of ZD and the challenges of screening for ZD in a virtual setting. To facilitate the recognition of ZD in telehealth consultations, we propose a comprehensive ZD screening questionnaire that includes questions related to typical ZD features and a BDD-focused question. The questionnaire is concise and allows the identification of individuals with a potential ZD. A BDD assessment in such individuals should follow.
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Affiliation(s)
- Cemre Büşra Türk
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA;
- Department of Dermatology, Harvard Medical School, Boston, MA 02114, USA
| | - Fatima N. Mirza
- Department of Dermatology, Warren Alpert Medical School at Brown University, Providence, RI 02903, USA;
| | - George Kroumpouzos
- Department of Dermatology, Warren Alpert Medical School at Brown University, Providence, RI 02903, USA;
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Mirza FN, Mirza HN, Yumeen S, Zogg CK, Leffell DJ. Considering Sun Safety Policies in the United States. Yale J Biol Med 2023; 96:251-255. [PMID: 37396978 PMCID: PMC10303261 DOI: 10.59249/fmwg8617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
As they are collectively the most common malignancies, the personal and systemic burden of skin cancers represent a significant public health concern in the United States. Ultraviolet radiation from the sun as well as from artificial sources such as tanning beds is a carcinogen well-known to increase the risk of developing skin cancer in individuals. Public health policies can help mitigate these risks. In this perspectives article, we review sunscreen and sunglasses standards, tanning bed utilization, and workplace sun protection guidelines in the US and provide focused examples for improvement from Australia and the United Kingdom where skin cancer is a well-documented public health concern. These comparative examples can inform interventions in the US that have the potential to modify exposure to risk factors associated with skin cancer.
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Affiliation(s)
- Fatima N. Mirza
- Department of Dermatology, The Warren Alpert Medical
School of Brown University, Providence, RI, USA
- Solomon Center for Health Law & Policy, Yale Law
School, New Haven, CT, USA
| | | | - Sara Yumeen
- Department of Dermatology, The Warren Alpert Medical
School of Brown University, Providence, RI, USA
| | - Cheryl K. Zogg
- Solomon Center for Health Law & Policy, Yale Law
School, New Haven, CT, USA
- Yale School of Medicine, New Haven, CT, USA
| | - David J. Leffell
- Department of Dermatology, Yale School of Medicine, New
Haven, CT, USA
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Ahmed F, Ragi SD, Moseley I, Mirza FN, Yumeen S, Vance T, Ouellette S, Rao B. Rosacea Diagnosis and Prescription Patterns in Underrepresented Groups: An All of Us Database Analysis. J Am Acad Dermatol 2023:S0190-9622(23)00531-5. [PMID: 37024052 DOI: 10.1016/j.jaad.2023.03.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/27/2023] [Accepted: 03/03/2023] [Indexed: 04/08/2023]
Affiliation(s)
- Fadwa Ahmed
- The Warren Alpert Medical School of Brown University, Providence, RI.
| | - Sara D Ragi
- The Warren Alpert Medical School of Brown University, Providence, RI
| | - Isabelle Moseley
- The Warren Alpert Medical School of Brown University, Providence, RI
| | - Fatima N Mirza
- Department of Dermatology, the Warren Alpert Medical School of Brown University, Providence, RI
| | - Sara Yumeen
- Department of Dermatology, the Warren Alpert Medical School of Brown University, Providence, RI
| | - Terrence Vance
- Department of Dermatology, the Warren Alpert Medical School of Brown University, Providence, RI
| | - Samantha Ouellette
- Department of Dermatology, the Warren Alpert Medical School of Brown University, Providence, RI
| | - Babar Rao
- Department of Dermatology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
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13
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Ren J, Qu R, Rahman NT, Lewis JM, King ALO, Liao X, Mirza FN, Carlson KR, Huang Y, Gigante S, Evans B, Rajendran BK, Xu S, Wang G, Foss FM, Damsky W, Kluger Y, Krishnaswamy S, Girardi M. Integrated transcriptome and trajectory analysis of cutaneous T-cell lymphoma identifies putative precancer populations. Blood Adv 2023; 7:445-457. [PMID: 35947128 PMCID: PMC9979716 DOI: 10.1182/bloodadvances.2022008168] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/05/2022] [Accepted: 07/20/2022] [Indexed: 02/07/2023] Open
Abstract
The incidence of cutaneous T-cell lymphoma (CTCL) increases with age, and blood involvement portends a worse prognosis. To advance our understanding of the development of CTCL and identify potential therapeutic targets, we performed integrative analyses of paired single-cell RNA and T-cell receptor (TCR) sequencing of peripheral blood CD4+ T cells from patients with CTCL to reveal disease-unifying features. The malignant CD4+ T cells of CTCL showed highly diverse transcriptomic profiles across patients, with most displaying a mature Th2 differentiation and T-cell exhaustion phenotype. TCR-CDR3 peptide prediction analysis suggested limited diversity between CTCL samples, consistent with a role for a common antigenic stimulus. Potential of heat diffusion for affinity-based trajectory embedding transition analysis identified putative precancerous circulating populations characterized by an intermediate stage of gene expression and mutation level between the normal CD4+ T cells and malignant CTCL cells. We further revealed the therapeutic potential of targeting CD82 and JAK that endow the malignant CTCL cells with survival and proliferation advantages.
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Affiliation(s)
- Jingjing Ren
- Department of Dermatology, Yale School of Medicine, New Haven, CT
| | - Rihao Qu
- Department of Immunobiology, Yale School of Medicine, New Haven, CT
- Department of Pathology, Yale School of Medicine, New Haven, CT
| | - Nur-Taz Rahman
- Bioinformatics Support Program, Cushing/Whitney Medical Library, Yale School of Medicine, New Haven, CT
| | - Julia M. Lewis
- Department of Dermatology, Yale School of Medicine, New Haven, CT
| | | | - Xiaofeng Liao
- Department of Pharmacology, Yale School of Medicine, Yale University, New Haven, CT
| | - Fatima N. Mirza
- Department of Dermatology, Yale School of Medicine, New Haven, CT
| | - Kacie R. Carlson
- Department of Dermatology, Yale School of Medicine, New Haven, CT
| | - Yaqing Huang
- Department of Pathology, Yale School of Medicine, New Haven, CT
| | - Scott Gigante
- Computational Biology and Bioinformatics Program, Yale University, New Haven, CT
| | - Benjamin Evans
- Yale Center for Research Computing, Yale University, New Haven, CT
| | | | - Suzanne Xu
- Department of Dermatology, Yale School of Medicine, New Haven, CT
| | - Guilin Wang
- Yale Center for Genome Analysis, Yale School of Medicine, New Haven, CT
| | - Francine M. Foss
- Section of Medical Oncology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT
| | - William Damsky
- Department of Dermatology, Yale School of Medicine, New Haven, CT
- Department of Pathology, Yale School of Medicine, New Haven, CT
| | - Yuval Kluger
- Department of Pathology, Yale School of Medicine, New Haven, CT
| | | | - Michael Girardi
- Department of Dermatology, Yale School of Medicine, New Haven, CT
- Correspondence: Michael Girardi, Department of Dermatology, Yale University School of Medicine, 333 Cedar St, PO Box 208059, New Haven, CT 06520;
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14
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King ALO, Lee V, Yu B, Mirza FN, Zogg CK, Yang DX, Tran T, Leventhal J, An Y. Factors associated with the use of adjuvant radiation therapy in stage III melanoma. Front Oncol 2023; 13:1005930. [PMID: 36816935 PMCID: PMC9929351 DOI: 10.3389/fonc.2023.1005930] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 01/18/2023] [Indexed: 02/04/2023] Open
Abstract
Objective The role of radiation therapy (RT) in melanoma has historically been limited to palliative care, with surgery as the primary treatment modality. However, adjuvant RT can be a powerful tool in certain cases and its application in melanoma has been increasingly explored in recent years. The aim of this study is to explore national patterns of care and associations surrounding the use of adjuvant RT for stage III melanoma. Methods The National Cancer Data Base (NCDB) was used to identify patients who were diagnosed with stage III melanoma between 2004 and 2014. Exclusion criteria included those with distant metastatic disease, in-situ histology, no confirmed positive nodes, palliative intent therapy, and dosing regimens inconsistent with National Comprehensive Cancer Network (NCCN) guidelines for adjuvant RT in melanoma. Patients treated with and without adjuvant RT were compared and factors associated with use of adjuvant RT were identified using multivariable logistic regression analyses. Results A total of 7,758 cases of stage III melanoma were analyzed, of which 11.7% received adjuvant RT. The mean age of the overall cohort was 58.5 years, and the majority of patients were male (64.7%), white (96.6%), on private insurance (51.3%), and presented to a non-high-volume facility (90.3%). Multivariable regression analyses revealed that patients who present to the hospital in 2009-2014 as compared to 2004-2008 (odds ratio [OR] 1.61, 95% confidence interval [CI] 1.36-1.92), had 4 or more positive nodes (OR 4.30, 95% CI 3.67-5.04), and had microscopic residual tumor (OR 2.11, 95% CI 1.46-3.04) were more likely to receive adjuvant RT. Factors that were negatively associated with receiving adjuvant RT included female gender (OR 0.72, 95% CI 0.61-0.85) and median income of at least $63,000 (OR 0.66, 95% CI 0.52-0.83). Conclusions This study demonstrates the rising use of RT for stage III melanoma in recent years and identifies demographic, social, clinical, and hospital-specific factors associated with patients receiving adjuvant RT. Further investigation is needed to explore disease benefits to improve guidance on the utilization of RT in melanoma.
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Affiliation(s)
- Amber L. O. King
- Department of Dermatology, Yale School of Medicine, New Haven, CT, United States
| | - Victor Lee
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT, United States
| | - Beverly Yu
- Department of Dermatology, Yale School of Medicine, New Haven, CT, United States
| | - Fatima N. Mirza
- Department of Dermatology, Yale School of Medicine, New Haven, CT, United States
| | - Cheryl K. Zogg
- Department of Surgery, Yale School of Medicine, New Haven, CT, United States
| | - Daniel X. Yang
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT, United States
| | - Thuy Tran
- Department of Medicine (Medical Oncology), Yale School of Medicine, New Haven, CT, United States
| | - Jonathan Leventhal
- Department of Dermatology, Yale School of Medicine, New Haven, CT, United States
| | - Yi An
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT, United States
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15
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Mirza FN, Yumeen S, Mirza HN. 33482 Predictors of survival outcomes for cutaneous giant cell sarcoma include patient sex and race, lesion size and stage, and receipt of surgical intervention. J Am Acad Dermatol 2022. [DOI: 10.1016/j.jaad.2022.06.411] [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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16
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Yumeen S, Roy M, Mirza FN, Rehou S, Shahrokhi S. Time to surgical closure of complex infectious wounds: a single-center retrospective cohort study. Wounds 2022; 34:E51-E56. [PMID: 36108242 DOI: 10.25270/wnds/20065] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Surgical management of NSTIs can result in complex wounds, and closure of these wounds is often difficult or complicated. Although surgical factors influencing mortality and LOS have been well described, little is known about patient, wound, and surgical factors associated with time to closure. OBJECTIVE The purpose of this study is to identify patient, wound, and surgical factors that may influence time to closure of NSTIs. MATERIALS AND METHODS The records of patients who presented to a tertiary care center over an 11-year period (2007-2017) with an NSTI requiring surgical closure were retrospectively reviewed. RESULTS Forty-seven patients met the inclusion criteria. The average time to closure was 31.1 days, with an average of 4.8 procedures. Most patients were middle aged (mean, 50.3 years; range, 20-81 years), immunocompetent, and nondiabetic upon admission. Closure was achieved mainly with autograft. The percent TBSA was described in 19 cases (40%). There was no association between substance use (alcohol, smoking, or other), anticoagulant medication use, or medical comorbidities and time to closure. On multivariable analysis, flap closure (P =.02) and increased number of surgical procedures (P =.003)-the latter reflecting the need for an increased number of debridements-were associated with increased time to closure. CONCLUSIONS The data in this study suggest that use of local flaps for wound closure and increased number of surgical procedures (particularly debridements) may be predictors of time to closure in patients with an NSTI.
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Affiliation(s)
- Sara Yumeen
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI
| | - Mélissa Roy
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada; Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Fatima N Mirza
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI
| | - Sarah Rehou
- Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Shahriar Shahrokhi
- Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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17
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King ALO, Lee V, Mirza FN, Jairam V, Yang DX, Yu JB, Park HS, Girardi M, Wilson LD, An Y. Factors Associated With In-Hospital Mortality in Mycosis Fungoides Patients: A Multivariable Analysis. Cureus 2022; 14:e28043. [PMID: 36120198 PMCID: PMC9474264 DOI: 10.7759/cureus.28043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2022] [Indexed: 11/05/2022] Open
Abstract
Background Mycosis fungoides (MF) is the most common form of cutaneous T-cell lymphoma (CTCL). Although it often has an indolent course, it can progress to more aggressive CTCL forms. There is sparse data in current literature describing specific clinical factors associated with in-hospital mortality in mycosis fungoides patients. An understanding of patients at greatest risk for in-hospital mortality can aid in developing recommendations for prophylaxis and empirical management. Aim We aim to characterize factors associated with in-hospital mortality in MF patients. Materials and methods The Nationwide Emergency Department Sample (NEDS) was queried for MF cases from 2006 to 2015. Baseline demographic and hospital characteristics were stratified based on survival outcomes. Multivariable logistic regression was used to identify factors associated with in-hospital mortality. Results A total of 57,665 patients with MF presenting to the ED between 2006 and 2015 were identified. Sézary syndrome, sepsis, and advanced age were associated with MF in-hospital mortality, while female sex was inversely associated. There was a downtrend in in-hospital mortality among MF patients presenting to the ED from 2006 to 2015. Conclusions Our study highlights factors crucial for risk-stratification for hospitalized MF patients.
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Affiliation(s)
| | - Victor Lee
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, USA
| | - Fatima N Mirza
- Department of Dermatology, Brown University, Providence, USA
| | - Vikram Jairam
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, USA
| | - Daniel X Yang
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, USA
| | - James B Yu
- Department of Therapeutic Radiology, Columbia University, New York City, USA
| | - Henry S Park
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, USA
| | - Michael Girardi
- Department of Dermatology, Yale School of Medicine, New Haven, USA
| | - Lynn D Wilson
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, USA
| | - Yi An
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, USA
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18
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Mirza FN, Valladares HC, Richards B, Suozzi KC. Meeting Dermatologic Needs in an Uninsured Population: Lessons Learned from a Referrals Cohort at a Student-Run Free Clinic. Yale J Biol Med 2021; 94:459-464. [PMID: 34602883 PMCID: PMC8461580] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Unmet dermatologic needs of the uninsured patient population are important to identify and address, especially as the COVID-19 pandemic has introduced additional barriers of access to care. We describe the successful collaboration between a student-run free clinic and dermatology practice since 2012, highlighting excellent time to appointment intervals and resolution rates as well as the associated modest financial cost. We believe that the information provided in our report may serve as a proof of concept and facilitate the implementation of such collaborations throughout the United States.
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Affiliation(s)
- Fatima N. Mirza
- HAVEN Free Clinic, Yale School of Medicine, Yale University, New Haven, CT,
USA
| | | | - Bradley Richards
- Internal Medicine, Yale School of Medicine, Yale University, New Haven,
CT, USA
| | - Kathleen C. Suozzi
- Section of Dermatologic Surgery and Cutaneous Oncology, Department
of Dermatology, Yale School of Medicine, Yale University, New Haven, CT, USA,To whom all correspondence should be addressed: Kathleen C. Suozzi, 333 Cedar
St, New Haven, CT 06510;
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19
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Lewis JM, Monico PF, Mirza FN, Xu S, Yumeen S, Turban JL, Galan A, Girardi M. Chronic UV radiation-induced RORγt+ IL-22-producing lymphoid cells are associated with mutant KC clonal expansion. Proc Natl Acad Sci U S A 2021; 118:e2016963118. [PMID: 34504008 PMCID: PMC8449378 DOI: 10.1073/pnas.2016963118] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2021] [Indexed: 12/15/2022] Open
Abstract
Chronic ultraviolet (UV) radiation exposure is the greatest risk factor for cutaneous squamous cell carcinoma (cSCC) development, and compromised immunity accelerates this risk. Having previously identified that epidermal Langerhans cells (LC) facilitate the expansion of UV-induced mutant keratinocytes (KC), we sought to more fully elucidate the immune pathways critical to cutaneous carcinogenesis and to identify potential targets of intervention. Herein, we reveal that chronic UV induces and LC enhance a local immune shift toward RORγt+ interleukin (IL)-22/IL-17A-producing cells that occurs in the presence or absence of T cells while identifying a distinct RORγt+ Sca-1+ CD103+ ICOS+ CD2+/- CCR6+ intracellular CD3+ cutaneous innate lymphoid cell type-3 (ILC3) population (uvILC3) that is associated with UV-induced mutant KC growth. We further show that mutant KC clone size is markedly reduced in the absence of RORγt+ lymphocytes or IL-22, both observed in association with expanding KC clones, and find that topical application of a RORγ/γt inhibitor during chronic UV exposure reduces local expression of IL-22 and IL-17A while markedly limiting mutant p53 KC clonal expansion. We implicate upstream Toll-like receptor signaling in driving this immune response to chronic UV exposure, as MyD88/Trif double-deficient mice also show substantially reduced p53 island number and size. These data elucidate key immune components of chronic UV-induced cutaneous carcinogenesis that might represent targets for skin cancer prevention.
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Affiliation(s)
- Julia M Lewis
- Department of Dermatology, Yale School of Medicine, New Haven, CT 06510
| | - Patrick F Monico
- Department of Dermatology, Yale School of Medicine, New Haven, CT 06510
| | - Fatima N Mirza
- Department of Dermatology, Yale School of Medicine, New Haven, CT 06510
| | - Suzanne Xu
- Department of Dermatology, Yale School of Medicine, New Haven, CT 06510
| | - Sara Yumeen
- Department of Dermatology, Yale School of Medicine, New Haven, CT 06510
| | - Jack L Turban
- Department of Dermatology, Yale School of Medicine, New Haven, CT 06510
| | - Anjela Galan
- Department of Dermatology, Yale School of Medicine, New Haven, CT 06510
| | - Michael Girardi
- Department of Dermatology, Yale School of Medicine, New Haven, CT 06510
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20
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King ALO, Mirza FN, Lewis JM, Umlauf S, Surosteva Y, Carlson KR, Foss FM, Girardi M. Uncovering the potential of PI3K inhibitors in cutaneous T cell lymphoma: insights from high throughput in vitro screenings. J Invest Dermatol 2021; 142:254-257. [PMID: 34293349 DOI: 10.1016/j.jid.2021.04.035] [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: 03/10/2021] [Revised: 04/06/2021] [Accepted: 04/28/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Amber Loren O King
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Fatima N Mirza
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Julia M Lewis
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Shiela Umlauf
- Yale Center for Molecular Discovery, Yale University, New Haven, Connecticut, USA
| | - Yulia Surosteva
- Yale Center for Molecular Discovery, Yale University, New Haven, Connecticut, USA
| | - Kacie R Carlson
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Francine M Foss
- Department of Internal Medicine, Section of Medical Oncology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Michael Girardi
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA.
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21
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King ALO, Mirza FN, Mirza H, Yumeen N, Lee V, Yumeen S. Factors associated with the American Academy of Dermatology abstract publication: A multivariate analysis. J Am Acad Dermatol 2021; 86:1416-1419. [PMID: 34139294 DOI: 10.1016/j.jaad.2021.06.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/20/2021] [Accepted: 06/09/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Amber Loren O King
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Fatima N Mirza
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Humza Mirza
- University of Michigan Medical School, Ann Arbor, Michigan
| | | | - Victor Lee
- Department of Radiation Oncology, Yale School of Medicine, New Haven, Connecticut
| | - Sara Yumeen
- Department of Internal Medicine, Hartford Healthcare St. Vincent's Medical Center, Bridgeport, Connecticut.
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22
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Mirza FN, Yumeen S, Lewis JM, King ALO, Kim SR, Carlson KR, Umlauf S, Surovtseva YV, Foss FM, Girardi M. Screening Novel Agent Combinations to Expedite CTCL Therapeutic Development. J Invest Dermatol 2021; 141:217-221. [DOI: 10.1016/j.jid.2020.05.097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/04/2020] [Accepted: 05/05/2020] [Indexed: 01/22/2023]
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23
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King ALO, Mirza FN, Lewis JM, Carlson KR, Huntington S, Foss FM, Girardi M. B-cell lymphoma 2 inhibitor venetoclax treatment of a patient with cutaneous T-cell lymphoma. JAAD Case Rep 2020; 8:89-92. [PMID: 33537387 PMCID: PMC7838714 DOI: 10.1016/j.jdcr.2020.12.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Affiliation(s)
- Amber Loren O King
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Fatima N Mirza
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Julia M Lewis
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Kacie R Carlson
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Scott Huntington
- Department of Internal Medicine, Section of Medical Oncology, Yale School of Medicine, New Haven, Connecticut
| | - Francine M Foss
- Department of Internal Medicine, Section of Medical Oncology, Yale School of Medicine, New Haven, Connecticut
| | - Michael Girardi
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
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24
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Mirza FN, Malik AA, Omer SB, Sethi A. Dermatologic manifestations of COVID-19: a comprehensive systematic review. Int J Dermatol 2020; 60:418-450. [PMID: 33141443 DOI: 10.1111/ijd.15168] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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] [Received: 07/19/2020] [Revised: 08/03/2020] [Accepted: 08/06/2020] [Indexed: 01/08/2023]
Abstract
Recent reports have suggested that there may be dermatologic manifestations of COVID-19. We searched 12 databases for peer-reviewed or pre-print published studies until July 15, 2020, for this PRISMA-compliant review (CRD42020182050). We used the Oxford Center for Evidence-Based Medicine Levels of Evidence to facilitate data synthesis. From 86 retrieved studies, we collated data on 2,560 patients with dermatologic manifestations of COVID-19. The most common findings were chilblains/pernio-like lesion (51.5%), erythematous maculopapular rashes (13.3%), and viral exanthem (7.7%). Average pediatric age was 12.9 years (SD 3.6) and adult was 34.2 years (SD 21.8). Average latency from time of upper respiratory illness symptoms to cutaneous findings was 1.5 days (SD 2.9) in children and 7.9 days (SD 10.7) in adults, ranging from -3 to 38 days. Roughly one-tenth in both populations were otherwise asymptomatic or presented with only skin findings for the entirety of the disease course; 13.3% (pediatrics) and 5.3% (adults) presented with skin issues first. Dermatologic findings may play an important role in identifying cases early and serve as an important proxy to manage spread. Further prospective data collection with international prospective registries is needed.
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Affiliation(s)
- Fatima N Mirza
- Department of Dermatology, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Amyn A Malik
- Department of Internal Medicine (Infectious Disease), Yale School of Medicine, Yale University, New Haven, CT, USA.,Yale Institute for Global Health, Yale University, New Haven, CT, USA
| | - Saad B Omer
- Department of Internal Medicine (Infectious Disease), Yale School of Medicine, Yale University, New Haven, CT, USA.,Yale Institute for Global Health, Yale University, New Haven, CT, USA.,Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, USA.,Yale School of Nursing, Yale University, Orange, CT, USA
| | - Aisha Sethi
- Department of Dermatology, Yale School of Medicine, Yale University, New Haven, CT, USA
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25
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Mirza HN, Mirza FN, Khatri KA. Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients. Dermatol Ther 2020; 34:e14432. [PMID: 33084193 DOI: 10.1111/dth.14432] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/20/2020] [Accepted: 10/12/2020] [Indexed: 12/17/2022]
Abstract
It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA-compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms "ablative laser" and "skin resurfacing" from March 2002 until July 2020. Studies included meta-analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self-resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.
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Affiliation(s)
- Humza N Mirza
- University of Michigan Medical School, University of Michigan, Ann Arbor, Michigan, USA
| | - Fatima N Mirza
- Yale School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Khalil A Khatri
- Skin & Laser Surgery Center of New England, Nashua, New Hampshire, USA
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26
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Mirza FN, Malik AA, Couzens C, Omer SB. Influenza-negative influenza-like illness (fnILI) Z-score as a proxy for incidence and mortality of COVID-19. J Infect 2020; 81:793-796. [PMID: 32888977 PMCID: PMC7462572 DOI: 10.1016/j.jinf.2020.08.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 08/24/2020] [Accepted: 08/29/2020] [Indexed: 01/08/2023]
Abstract
Although direct detection of SARS-CoV2 in symptomatic or asymptomatic individuals is the ideal epidemiological tool for determining the burden of disease, the lack of availability of testing can preclude its wider implementation as a robust surveillance system. We correlated the use of the derivative influenza-negative influenza-like illness (fnILI) z-score from the US Centers for Disease Control and Prevention as a proxy for incident cases and disease-specific deaths. For every unit increase of fnILI z-score, the number of cases increased by 376.5 (95% CI [202.5, 550.5]) and number of deaths increased by 10.2 (95% CI [5.4, 15.0]). FnILI data may serve as an accurate outcome measurement to track the spread of COVID-19 infection and disease, and allow for informed and timely decision-making on public health interventions.
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Affiliation(s)
- Fatima N Mirza
- Yale Institute for Global Health, Yale University, 1 Church St, New Haven, CT 06510, United States; Yale School of Medicine, Yale University, New Haven, CT 06510, United States.
| | - Amyn A Malik
- Yale Institute for Global Health, Yale University, 1 Church St, New Haven, CT 06510, United States; Department of Internal Medicine, Infectious Disease, Yale School of Medicine, New Haven, Connecticut, 06510, United States
| | - Chandra Couzens
- Yale Institute for Global Health, Yale University, 1 Church St, New Haven, CT 06510, United States
| | - Saad B Omer
- Yale Institute for Global Health, Yale University, 1 Church St, New Haven, CT 06510, United States; Department of Internal Medicine, Infectious Disease, Yale School of Medicine, New Haven, Connecticut, 06510, United States; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT 06510, United States; Yale School of Nursing, Yale University, Orange, CT 06477, United States
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Mirza FN, Yumeen S, Walter FM. The epidemiology of malignant melanoma, squamous cell carcinoma and basal cell carcinoma in the UK from 2004 to 2014: a population-based cohort analysis using the Clinical Practice Research Datalink. Br J Dermatol 2020; 184:365-367. [PMID: 32893341 DOI: 10.1111/bjd.19542] [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: 06/09/2020] [Revised: 08/30/2020] [Accepted: 08/31/2020] [Indexed: 01/21/2023]
Affiliation(s)
- F N Mirza
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA.,Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - S Yumeen
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - F M Walter
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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28
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Yumeen S, Mirza FN, Mirza HN, Ko CJ, Cohen JM. Primary cutaneous adenoid cystic carcinoma: Characterizing US demographics, clinical course, and prognostic factors. J Am Acad Dermatol 2020; 85:245-247. [PMID: 32798575 DOI: 10.1016/j.jaad.2020.08.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/02/2020] [Accepted: 08/07/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Sara Yumeen
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Fatima N Mirza
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Humza N Mirza
- University of Michigan Medical School, Ann Arbor, Michigan
| | - Christine J Ko
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut; Department of Pathology, Yale School of Medicine, New Haven, Connecticut
| | - Jeffrey M Cohen
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut.
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29
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Mirza FN, Yumeen S, Girardi M. Disparities in outcomes of CD8 + cutaneous T-cell lymphoma by race and presenting lesion location. Br J Dermatol 2020; 184:170-171. [PMID: 32730673 DOI: 10.1111/bjd.19426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 11/29/2022]
Affiliation(s)
- F N Mirza
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - S Yumeen
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - M Girardi
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
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30
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Mirza FN, Mirza HN, Khatri KA. Concomitant use of isotretinoin and lasers with implications for future guidelines: An updated systematic review. Dermatol Ther 2020; 33:e14022. [PMID: 32677092 DOI: 10.1111/dth.14022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/05/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 12/01/2022]
Abstract
It is generally believed that intervention on skin while on isotretinoin or within 6 to 12 months after treatment can lead to prolonged healing and abnormal scarring. The objective of this systematic review is to evaluate the body of evidence on concomitant use of isotretinoin and lasers for adverse events as a consequence of treatment. A PRISMA-compliant systematic review (Systematic Review Registration Number: CRD42017056492) of 12 electronic databases was conducted for the terms "laser" and "isotretinoin" or associated brand names from inception until June 2020. Subsequent reference search of studies meeting predefined inclusion criteria were conducted, and all articles were evaluated for bias and assigned levels of evidence to facilitate data synthesis. The search strategy produced 29 studies. Of 871 patients included in the studies of interest, 12 experienced transient adverse effects that resolved spontaneously, and only two presented with keloid formation, both from case reports. This systematic review suggests the risk associated with concomitant isotretinoin and laser use is small to absent. Further studies are needed, but these results suggest that current contraindications may be overly cautious.
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Affiliation(s)
- Fatima N Mirza
- Yale School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Humza N Mirza
- University of Michigan Medical School, University of Michigan, Ann Arbor, Michigan, USA
| | - Khalil A Khatri
- Skin & Laser Surgery Center of New England, Nashua, New Hampshire, USA
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31
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Yumeen S, Mirza FN, Lewis JM, Carlson KR, King B, Cowper S, Bunick CG, McNiff J, Girardi M. CD8 + mycosis fungoides palmaris et plantaris with peripheral blood involvement. JAAD Case Rep 2020; 6:434-437. [PMID: 32382639 PMCID: PMC7200192 DOI: 10.1016/j.jdcr.2020.02.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Sara Yumeen
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Fatima N Mirza
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Julia M Lewis
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Kacie R Carlson
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Brett King
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Shawn Cowper
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut.,Department of Pathology, Yale School of Medicine, New Haven, Connecticut
| | | | - Jennifer McNiff
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut
| | - Michael Girardi
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
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Abstract
Recognizing the skin manifestations of metabolic and endocrine disorders, many of which may have potentially lethal complications, is important for dermatologists and other clinicians. The skin can be a window into a patient's internal health, and cutaneous manifestations can facilitate early diagnosis and intervention of potentially life-altering systemic disorders with associated morbidity and mortality. This contribution provides an overview of the diverse rashes associated with potentially lethal, acquired metabolic and endocrine disorders of the pituitary, thyroid, parathyroid, pancreas, adrenals, and blood, as well as neuroendocrine and nutritional disease.
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Affiliation(s)
- Fatima N Mirza
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jonathan S Leventhal
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA.
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33
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Kohli I, Braunberger TL, Nahhas AF, Mirza FN, Mokhtari M, Lyons AB, Kollias N, Ruvolo E, Lim HW, Hamzavi IH. Long-wavelength Ultraviolet A1 and Visible Light Photoprotection: A Multimodality Assessment of Dose and Response. Photochem Photobiol 2019; 96:208-214. [PMID: 31464341 DOI: 10.1111/php.13157] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 08/20/2019] [Indexed: 01/02/2023]
Abstract
Human skin is exposed to visible light (VL; 400-700 nm) and long-wavelength ultraviolet A1 (UVA1) radiation (370-400 nm) after the application of organic broad-spectrum sunscreens. The biologic effects of these wavelengths have been demonstrated; however, a dose-response has not been investigated. Ten subjects with Fitzpatrick skin phototype IV-VI were enrolled. Subjects were irradiated with 2 light sources (80-480 J cm-2 ): one comprising VL with less than 0.5% UVA1 (VL+UVA1) and the other pure VL. Skin responses were evaluated for 2 weeks using clinical and spectroscopic assessments. 4-mm punch biopsies were obtained from nonirradiated skin and sites irradiated with 480 J cm-2 of VL+UVA1 and pure VL 24 h after irradiation. Clinical and spectroscopic assessments demonstrated a robust response at VL+UVA1 sites compared with pure VL. Histology findings demonstrated a statistically significant increase in the marker of inflammation (P < 0.05) and proliferation (P < 0.05) at the irradiated sites compared with nonirradiated control. Threshold doses of VL+UVA1 resulting in biologic responses were calculated. Results indicate that approximately 2 h of sun exposure, which equates to VL+UVA1 dose (~400 J cm-2 ), is capable of inducing inflammation, immediate erythema and delayed tanning. These findings reinforce the need of photoprotection beyond the UV range.
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Affiliation(s)
| | | | - Amanda F Nahhas
- Department of Dermatology, Henry Ford Hospital, Detroit, MI.,Department of Dermatology, Beaumont Hospital-Farmington Hills, Farmington Hills, MI
| | | | | | - Alexis B Lyons
- Department of Dermatology, Henry Ford Hospital, Detroit, MI
| | | | | | - Henry W Lim
- Department of Dermatology, Henry Ford Hospital, Detroit, MI
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Kim SR, Lewis JM, Cyrenne BM, Monico PF, Mirza FN, Carlson KR, Foss FM, Girardi M. BET inhibition in advanced cutaneous T cell lymphoma is synergistically potentiated by BCL2 inhibition or HDAC inhibition. Oncotarget 2018; 9:29193-29207. [PMID: 30018745 PMCID: PMC6044378 DOI: 10.18632/oncotarget.25670] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 06/06/2018] [Indexed: 12/31/2022] Open
Abstract
While several systemic therapies are approved for cutaneous T cell lymphoma (CTCL), a non-Hodgkin lymphoma of skin-homing T cells that may involve lymph nodes and peripheral blood in advanced stages, relapses are common. Mutational analysis of CTCL cells has revealed frequent amplification of the MYC oncogene, and bromodomain and extraterminal (BET) protein inhibitors have been shown to repress MYC expression in various malignancies. Towards a potential novel therapy, we thus sought to examine the effect of BET inhibition on CTCL cells in vitro. Each of the four tested BET inhibitors (JQ1, ABBV-075, I-BET762, CPI-0610) consistently induced dose-dependent decreases in viability of isolated patient-derived CTCL cells and established CTCL cell lines (MyLa, Sez4, HH, Hut78). This effect was synergistically potentiated by combination of BET inhibition with BCL2 inhibition (e.g. venetoclax) or histone deacetylase (HDAC) inhibition (e.g. vorinostat or romidepsin). There was also a marked increase in caspase 3/7 activation when JQ1 was combined with either vorinostat or romidepsin, confirming that the observed synergies are due in major part to induction of apoptosis. Furthermore, MYC and BCL2 expression were each synergistically repressed when CTCL cells were treated with JQ1 plus HDAC inhibitors, suggesting cooperative activities at the level of epigenetic regulation. Taken together, these data indicate that targeting BET proteins in CTCL represents a promising novel therapeutic strategy that may be substantially potentiated by combination with BCL2 or HDAC inhibition.
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Affiliation(s)
- Sa Rang Kim
- Department of Dermatology, Yale School of Medicine, New Haven, CT 06510, USA
| | - Julia M Lewis
- Department of Dermatology, Yale School of Medicine, New Haven, CT 06510, USA
| | - Benoit M Cyrenne
- Department of Dermatology, Yale School of Medicine, New Haven, CT 06510, USA
| | - Patrick F Monico
- Department of Dermatology, Yale School of Medicine, New Haven, CT 06510, USA
| | - Fatima N Mirza
- Department of Dermatology, Yale School of Medicine, New Haven, CT 06510, USA
| | - Kacie R Carlson
- Department of Dermatology, Yale School of Medicine, New Haven, CT 06510, USA
| | - Francine M Foss
- Department of Internal Medicine, Section of Medical Oncology, Yale School of Medicine, New Haven, CT 06510, USA
| | - Michael Girardi
- Department of Dermatology, Yale School of Medicine, New Haven, CT 06510, USA
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Abstract
The chemical replication of RNA inside fatty acid vesicles is a plausible step in the emergence of cellular life. On the primitive Earth, simple protocells with the ability to import nucleotides and short oligomers from their environment could potentially have replicated and retained larger genomic RNA oligonucleotides within a spatially defined compartment. We have previously shown that short 5'-phosphoroimidazolide-activated "helper" RNA oligomers enable the nonenzymatic copying of mixed-sequence templates in solution, using 5'-phosphoroimidazolide-activated mononucleotides. Here, we report that citrate-chelated Mg2+, a catalyst of nonenzymatic primer extension, enhances fatty acid membrane permeability to such short RNA oligomers up to the size of tetramers, without disrupting vesicle membranes. In addition, selective permeability of short, but not long, oligomers can be further enhanced by elevating the temperature. The ability to increase the permeability of fatty acid membranes to short oligonucleotides allows for the nonenzymatic copying of RNA templates containing all four nucleotides inside vesicles, bringing us one step closer to the goal of building a protocell capable of Darwinian evolution.
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Affiliation(s)
- Derek
K. O’Flaherty
- Howard
Hughes Medical Institute, Department of Molecular Biology, and Center
for Computational and Integrative Biology, Massachusetts General Hospital, Boston, Massachusetts 02114, United States
| | - Neha P. Kamat
- Howard
Hughes Medical Institute, Department of Molecular Biology, and Center
for Computational and Integrative Biology, Massachusetts General Hospital, Boston, Massachusetts 02114, United States
- Biomedical
Engineering Department, Northwestern University, 2145 Sheridan Road, Evanston, Illinois 60208, United States
| | - Fatima N. Mirza
- Howard
Hughes Medical Institute, Department of Molecular Biology, and Center
for Computational and Integrative Biology, Massachusetts General Hospital, Boston, Massachusetts 02114, United States
| | - Li Li
- Howard
Hughes Medical Institute, Department of Molecular Biology, and Center
for Computational and Integrative Biology, Massachusetts General Hospital, Boston, Massachusetts 02114, United States
| | - Noam Prywes
- Howard
Hughes Medical Institute, Department of Molecular Biology, and Center
for Computational and Integrative Biology, Massachusetts General Hospital, Boston, Massachusetts 02114, United States
| | - Jack W. Szostak
- Howard
Hughes Medical Institute, Department of Molecular Biology, and Center
for Computational and Integrative Biology, Massachusetts General Hospital, Boston, Massachusetts 02114, United States
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Lacy MM, Mirza FN. Genome Editing. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2017. [PMCID: PMC5733841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Michael M. Lacy
- Deputy Editor, Department of Molecular Biophysics and Biochemistry, Yale University, New Haven, CT,To whom all correspondence should be addressed: Michael M. Lacy, 367 Cedar St, New Haven, CT, 06510, ; Fatima N. Mirza, 367 Cedar St, New Haven, CT, 06510,
| | - Fatima N. Mirza
- Deputy Editor, Yale School of Medicine, New Haven, CT,To whom all correspondence should be addressed: Michael M. Lacy, 367 Cedar St, New Haven, CT, 06510, ; Fatima N. Mirza, 367 Cedar St, New Haven, CT, 06510,
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Abstract
BACKGROUND In considering skin cancer, a number of factors-including effectiveness, simplicity of treatment, cost, and esthetic outcomes-are important to ensure patient's satisfaction. There are several existing interventions, such as electrodessication and curettage, excision, Mohs surgery, radiation therapy, cryotherapy, and topical/oral treatments. Laser therapy has emerged as a new promising alternative that should be explored. OBJECTIVE To review the literature on the dermatological use of laser therapy in the treatment of skin cancer. RESULTS A review of articles available on the MEDLINE and Web of Science databases until May 2017 yielded 24 and 6 studies, respectively, on laser therapy in the treatment of skin cancers, particularly melanoma, basal cell carcinoma, and squamous cell carcinoma. The four laser subtypes included solid-state, diode, dye, and gas lasers. CONCLUSION Review of the literature demonstrates the progress of dermatological understanding of the clinical implications of laser therapy in the treatment of premalignant and malignant neoplasms of the skin, and suggests that this treatment modality might be a viable option for some patients.
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Affiliation(s)
- Fatima N Mirza
- a Department of Dermatology, Yale School of Medicine , Yale University , New Haven , CT , USA.,b Department of Public Health and Primary Care , University of Cambridge , Cambridge , UK
| | - Khalil A Khatri
- c Skin and Laser Surgery Center of New England , Nashua , NH , USA
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Mirza FN, Mirza HN, Horien C, Huynh N. From Skin Infections to Ebola: Practice, Policy, and Beyond: An Interview with Gregory Raczniak, MD, PhD
. Yale J Biol Med 2017; 90:341-343. [PMID: 28656021 PMCID: PMC5482311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Fatima N. Mirza
- Yale School of Medicine, Yale University, New Haven, CT,Department of Public Health and Primary Care, University of Cambridge, Cambridge, England,To whom all correspondence should be addressed: Fatima N. Mirza, 367 Cedar St, New Haven, CT 06510, .
| | | | - Corey Horien
- Yale School of Medicine, Yale University, New Haven, CT
| | - Nancy Huynh
- Yale School of Medicine, Yale University, New Haven, CT
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Alkhayyat SS, Younus J, Mirza FN, Stitt L. Abstract P2-13-08: Comparison of Compliance to Anti Estrogen Therapy in Patients with Early Breast Cancer followed at Tertiary Centers versus Through Family Physicians and Primary Surgeons: A Practice Review. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p2-13-08] [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: 11/16/2022]
Abstract
Abstract
Background: Poor adherence or non-compliance to pharmacologic therapies in chronic diseases is a major clinical problem. Adherence to adjuvant anti-estrogen therapies among patients with early breast cancer (EBC) is variable as reported in different clinical trials. Cancer centres, at present, frequently refer patients with EBC on adjuvant anti-estrogen therapy back to their surgeons and family doctors for follow up. In order to find any difference in compliance for such patients, we reviewed patients followed by their primary surgeons and family doctors (peripheral cohort) for adherence and compared them to patients regularly followed in the cancer center (central cohort).
Patients and Methods: Women with EBC receiving anti-estrogen therapy were identified from breast cancer database at London Regional Cancer Program LRCP). A standardized telephone interview was conducted with patients. We assumed that adherence in the central cohort will be 20% higher than the peripheral cohort. Patient are considered adherent if they took more than 80%, Non-adherent if they took less than 50% and semi-adherent if they took 50–80% of the prescribed medication.
Results: We recruited a total of 160 patients (80 patients in each cohort). Seventy seven (96.3%) patients in central cohort were compliant and 76 (95%) patients were compliant in the peripheral cohort. The HR was 0.7 (p >.999)
Conclusion: From our retrospective review, we did not observe any significant difference in the adherence to adjuvant anti-estrogen therapy in patients with EBC. The present process of discharging such patients to surgeons and family physicians for follow up does not seem to affect their compliance.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-13-08.
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Affiliation(s)
- SS Alkhayyat
- The Scarborough Hospital, Scarborough, ON, Canada; The University of Western Ontario, London, ON, Canada; Harvard University, Cambridge, MA
| | - J Younus
- The Scarborough Hospital, Scarborough, ON, Canada; The University of Western Ontario, London, ON, Canada; Harvard University, Cambridge, MA
| | - FN Mirza
- The Scarborough Hospital, Scarborough, ON, Canada; The University of Western Ontario, London, ON, Canada; Harvard University, Cambridge, MA
| | - L Stitt
- The Scarborough Hospital, Scarborough, ON, Canada; The University of Western Ontario, London, ON, Canada; Harvard University, Cambridge, MA
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