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Grover A, Choi F, Wang SP. Early Cutaneous Manifestations of COVID-19: A Systematic Review and Public Health Implications. WMJ 2023; 122:349-356. [PMID: 38180923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
Abstract
INTRODUCTION Cutaneous manifestations before other symptoms have great potential for early COVID-19 diagnosis to prevent surge. METHODS We conducted a search of PubMed and Embase databases through April 11, 2021 to include 39 studies reporting skin manifestations occurring prior to any other COVID-19 symptoms in laboratory-confirmed cases. RESULTS Ninety-seven patients were included. Urticarial (24.7%) and maculopapular (22.7%) lesions were most common, followed by pernio (17.5%), vesicular (14.4%), papulosquamous (8.2%), and purpuric (5.1%) lesions. Cutaneous to systemic symptom latency ranged from 2 to 20 days in cases that reported it (26%), while skin lesions were the only presentation in 23 cases (23.7%). Skin lesions were the only COVID-19 manifestation in 58.8% of pernio, 40% of vesicular, 16.6% of urticarial, 18.2% of maculopapular, and 12.5% of papulosquamous presymptomatic cases. Although sample size is limited, all purpuric cases developed other symptom(s) later. CONCLUSIONS Pernio and purpuric lesions have been well-associated with COVID-19, but papulosquamous, vesicular, mild maculopapular, and urticarial lesions can easily be dismissed as unrelated to COVID-19. Pernio lesions are thought to be related to strong immune response and low contagiousness, while purpuric and vesicular cases are speculated to be related to higher SARS-CoV2 viral load, severity, and contagiousness. All rashes, even without other symptoms, should necessitate high level of suspicion for isolation or contact tracing.
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Affiliation(s)
- Abhinav Grover
- Department of Pathology and Laboratory Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin,
| | - Franchesca Choi
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
- DermAI, Taipei, Taiwan
| | - Sheng-Pei Wang
- DermAI, Taipei, Taiwan
- National Cheng Kung University International Research Center of Wound Repair and Regeneration, Tainan, Taiwan
- University of Southern California Department of Pathology, Los Angeles, California
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Grover A, Choi F, Pei-Wang S. 33624 Long-term cutaneous manifestations in COVID-19 patients: A systematic review. J Am Acad Dermatol 2022. [PMCID: PMC9465215 DOI: 10.1016/j.jaad.2022.06.339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mangano MC, Berlino M, Corbari L, Milisenda G, Lucchese M, Terzo S, Bosch-Belmar M, Azaza MS, Babarro JMF, Bakiu R, Broitman BR, Buschmann AH, Christofoletti R, Dong Y, Glamuzina B, Luthman O, Makridis P, Nogueira AJA, Palomo MG, Dineshram R, Sanchez-Jerez P, Sevgili H, Troell M, AbouelFadl KY, Azra MN, Britz P, Carrington E, Celić I, Choi F, Qin C, Dionísio MA, Dobroslavić T, Galli P, Giannetto D, Grabowski JH, Helmuth B, Lebata-Ramos MJH, Lim PT, Liu Y, Llorens SM, Mirto S, Pećarević M, Pita C, Ragg N, Ravagnan E, Saidi D, Schultz K, Shaltout M, Tan SH, Thiyagarajan V, Sarà G. The aquaculture supply chain in the time of covid-19 pandemic: Vulnerability, resilience, solutions and priorities at the global scale. Environ Sci Policy 2022; 127:98-110. [PMID: 34720746 PMCID: PMC8548891 DOI: 10.1016/j.envsci.2021.10.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The COVID-19 global pandemic has had severe, unpredictable and synchronous impacts on all levels of perishable food supply chains (PFSC), across multiple sectors and spatial scales. Aquaculture plays a vital and rapidly expanding role in food security, in some cases overtaking wild caught fisheries in the production of high-quality animal protein in this PFSC. We performed a rapid global assessment to evaluate the effects of the COVID-19 pandemic and related emerging control measures on the aquaculture supply chain. Socio-economic effects of the pandemic were analysed by surveying the perceptions of stakeholders, who were asked to describe potential supply-side disruption, vulnerabilities and resilience patterns along the production pipeline with four main supply chain components: a) hatchery, b) production/processing, c) distribution/logistics and d) market. We also assessed different farming strategies, comparing land- vs. sea-based systems; extensive vs. intensive methods; and with and without integrated multi-trophic aquaculture, IMTA. In addition to evaluating levels and sources of economic distress, interviewees were asked to identify mitigation solutions adopted at local / internal (i.e., farm-site) scales, and to express their preference on national / external scale mitigation measures among a set of a priori options. Survey responses identified the potential causes of disruption, ripple effects, sources of food insecurity, and socio-economic conflicts. They also pointed to various levels of mitigation strategies. The collated evidence represents a first baseline useful to address future disaster-driven responses, to reinforce the resilience of the sector and to facilitate the design reconstruction plans and mitigation measures, such as financial aid strategies.
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Affiliation(s)
- M C Mangano
- Department of Integrated Marine Ecology, Stazione Zoologica Anton Dohrn, Sicily Marine Centre, Lungomare Cristoforo Colombo (complesso Roosevelt), 90142 Palermo, Italy
| | - M Berlino
- Laboratory of Ecology, Earth and Marine Sciences Department, University of Palermo Viale delle, Scienze Ed. 16, 90128 Palermo, Italy
- National Institute of Oceanography and Applied Geophysics - OGS, via A. Piccard 54, Trieste, 34151, Italy
| | - L Corbari
- Laboratory of Ecology, Earth and Marine Sciences Department, University of Palermo Viale delle, Scienze Ed. 16, 90128 Palermo, Italy
- Department of Engineering, University of Palermo, Viale delle Scienze, Ed. 8, 90128 Palermo, Italy
| | - G Milisenda
- Department of Integrated Marine Ecology, Stazione Zoologica Anton Dohrn, Sicily Marine Centre, Lungomare Cristoforo Colombo (complesso Roosevelt), 90142 Palermo, Italy
| | - M Lucchese
- Laboratory of Ecology, Earth and Marine Sciences Department, University of Palermo Viale delle, Scienze Ed. 16, 90128 Palermo, Italy
- National Institute of Oceanography and Applied Geophysics - OGS, via A. Piccard 54, Trieste, 34151, Italy
| | - S Terzo
- Laboratory of Ecology, Earth and Marine Sciences Department, University of Palermo Viale delle, Scienze Ed. 16, 90128 Palermo, Italy
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, Viale Fernando Stagno d'Alcontres 3, University of Messina, Messina, Italy
- Department of Marine Biotechnology, Stazione Zoologica Anton Dohrn, Villa Comunale, 80121, Naples, Italy
| | - M Bosch-Belmar
- Laboratory of Ecology, Earth and Marine Sciences Department, University of Palermo Viale delle, Scienze Ed. 16, 90128 Palermo, Italy
| | - M S Azaza
- Aquaculture Laboratory, National Institute of Marine Science and Technology, 2025 Salammbo, Tunis, Tunisia
| | - J M F Babarro
- Instituto de Investigaciones Marinas IIM-CSIC, Eduardo Cabello 6, 36208 Vigo, Spain
| | - R Bakiu
- Department of Aquaculture and Fisheries, Agricultural University of Tirana, Tirane, Albania
| | - B R Broitman
- Departamento de Ciencias, Universidad Adolfo Ibáñez, Viña del Mar Chile & Millenium Institute for Coastal Socio-Ecology (SECOS), Chile
| | - A H Buschmann
- Centro i-mar & CeBiB, Universidad de Los Lagos, Puerto Montt, Chile
| | - R Christofoletti
- Institute of Marine Sciences, Federal University of São Paulo (UNIFESP/IMar), Brazil
| | - Y Dong
- The Key Laboratory of Mariculture, Ministry of Education, Fisheries College, Ocean University of China, Qingdao 266003, China
| | - B Glamuzina
- Department of Applied Ecology, University of Dubrovnik, Ćira Carića 4, 20000 Dubrovnik, Croatia
| | - O Luthman
- School of Natural Science, Technology and Environmental Studies, Södertörn University, Alfred Nobels allé 7, 141 89 Huddinge, Sweden
| | - P Makridis
- Department of Biology, University of Patras, University Campus, Rio Achaias 26504, Greece
| | - A J A Nogueira
- Departamento de Biologia & CESAM, Universidade de Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal
| | - M G Palomo
- Laboratory of Marine Ecology, Natural History Museum of Argentina, CONICET, Argentina
| | - R Dineshram
- Biological Oceanography Division, CSIR-National Institute of Oceanography, Dona Paula, Goa 403004, India
| | - P Sanchez-Jerez
- Department of Marine Science and Applied Biology, University of Alicante. Ap.C. 99. Spain
| | - H Sevgili
- Fisheries Application and Research Center & Department of Aquaculture, Eğirdir Faculty of Fisheries, Isparta University of Applied Sciences, Çünür, Isparta, Turkey
| | - M Troell
- Stockholm Resilience Centre, Stockholm University, Kräftriket 2B, 10691 Stockholm, Sweden and Beijer Institute of Ecological Economics, Royal Swedish Academy of Sciences, SE-104 05 Stockholm, Sweden
| | - K Y AbouelFadl
- Aquatic ecology Department, Faculty of Fish and Fisheries Technology, Aswan University, Egypt
| | - M N Azra
- Institute of Marine Biotechnology, Universiti Malaysia Terengganu, 21030 Terengganu, Malaysia
| | - P Britz
- Rhodes University, Department of Ichthyology and Fisheries Science, Grahamstown, South Africa
| | - E Carrington
- Department of Biology and Friday Harbor Laboratories, University of Washington, 620 University Road, Friday Harbor, WA 98250, USA
| | - I Celić
- National Institute of Oceanography and Applied Geophysics - OGS, via A. Piccard 54, Trieste, 34151, Italy
| | - F Choi
- Northeastern University Marine Science Center, 430 Nahant Rd Nahant, MA 01908, USA
| | - C Qin
- South China Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences, China
| | - M A Dionísio
- MARE-Marine and Environmental Sciences Centre, Faculty of Science, University of Lisbon, Campo Grande, 1749-016 Lisbon, Portugal
| | - T Dobroslavić
- Department of Applied Ecology, University of Dubrovnik, Ćira Carića 4, 20000 Dubrovnik, Croatia
| | - P Galli
- Department of Earth and Environmental Sciences, University of Milano-Bicocca, Italy
| | - D Giannetto
- Department of Biology, Faculty of Science, Muğla Sıktı Koçman University, 48000 Muğla, Turkey
| | - J H Grabowski
- Northeastern University Marine Science Center, 430 Nahant Rd Nahant, MA 01908, USA
| | - B Helmuth
- Northeastern University Marine Science Center, 430 Nahant Rd Nahant, MA 01908, USA
| | - M J H Lebata-Ramos
- Aquaculture Department, Southeast Asian Fisheries Development Center, Tigbauan, Iloilo 5021, Philippines
| | - P T Lim
- Bachok Marine Research Station, Institute of Ocean and Earth Sciences, University of Malaysia, 16310 Bachok Kelantan, Malaysia
| | - Y Liu
- Faculty of Biosciences, Fisheries and Economics, UiT The Arctic University of Norway, Norway
| | - S M Llorens
- Departamento de Ciencia Animal, Universitat Politècnica de València, Spain
| | - S Mirto
- Institute of Anthropic Impact and Sustainability in Marine Environment, National Research Council (IAS-CNR), Lungomare Cristoforo Colombo 4521, 90142 Palermo, Italy
| | - M Pećarević
- Department of Applied Ecology, University of Dubrovnik, Ćira Carića 4, 20000 Dubrovnik, Croatia
| | - C Pita
- International Institute for Environment and Development (IIED), London, United Kingdom
- CESAM - Centre for Environmental and Marine Studies, Department of Environment and Planning, University of Aveiro, Aveiro, Portugal
| | - N Ragg
- Cawthron Institute, Aquaculture Group, Nelson, New Zealand
| | - E Ravagnan
- NORCE Climate&Environment, Nygårdsgaten 112, 5008 Bergen, Norway
| | - D Saidi
- Faculty of Natural Sciences and life, Department of Water and Environment, University Hassiba Benbouali of Chlef, Algeria
| | - K Schultz
- Northeastern University Marine Science Center, 430 Nahant Rd Nahant, MA 01908, USA
| | - M Shaltout
- Faculty of Science, Department of Oceanography, University of Alexandria, Alexandria, Egypt
| | - S H Tan
- Centre For Marine & Coastal Studies, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - V Thiyagarajan
- The Swire Institute of Marine Science and School of Biological Sciences, The University of Hong Kong, Pokfulam Road, Hong Kong
| | - G Sarà
- Laboratory of Ecology, Earth and Marine Sciences Department, University of Palermo Viale delle, Scienze Ed. 16, 90128 Palermo, Italy
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Sung CT, Chao T, Lee A, Foulad DP, Choi F, Juhasz M, Dobry A, Mesinkovska NA. Oral Metformin for Treating Dermatological Diseases: A Systematic Review. J Drugs Dermatol 2021; 19:713-720. [PMID: 32845585 DOI: 10.36849/jdd.2020.4874] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction:Metformin is an antihyperglycemic medication most commonly used to treat Type II Diabetes Mellitus with promising off-label application for the treatment of hidradenitis suppurativa, psoriasis, acne, acanthosis nigricans, and hirsutism. Objective: To comprehensively assess evidence regarding the use of metformin for treating primary cutaneous disorders. Materials and Methods: A systematic literature search was conducted through PubMed, Cochrane, Web of Science, and CINAHL to identify the role of metformin in primary skin disease. Results: Sixty-four studies met inclusion criteria. Metformin demonstrates promising clinical response and favorable safety profile for treatment of HS, with most patients experiencing a decrease in frequency or severity of HS flares, and some experiencing full resolution of HS lesions. Patients with psoriasis treated with metformin experienced quantifiable clinical responses. Application of metformin on polycystic ovarian disease (PCOS) related acne, acanthosis nigricans, and hirsutism yielded mixed clinical results. No serious adverse effects were reported. Conclusion: Metformin is safe and efficacious and may be considered as an adjunctive therapy for the treatment of psoriasis and hidradenitis suppurativa in addition to first line therapies as well as PCOS related acne, acanthosis nigricans, and hirsutism. J Drugs Dermatol. 2020;19(8): doi:10.36849/JDD.2020.4874.
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Lehmer L, Choi F, Kraus C, Shiu J, de Feraudy S, Elsensohn A. Histopathologic PD-L1 Tumor Expression and Prognostic Significance in Nonmelanoma Skin Cancers: A Systematic Review. Am J Dermatopathol 2021; 43:321-330. [PMID: 33910221 DOI: 10.1097/dad.0000000000001772] [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: 11/26/2022]
Abstract
ABSTRACT PD-L1 and PD-1 inhibitors are being increasingly used to treat a variety of nonmelanoma skin cancers (NMSCs). This systematic review summarizes PD-L1 expression in NMSCs and determines its use for prognosis using targeted immunotherapy. A primary search of peer-reviewed English-language medical literature was conducted for studies on PD-L1 tumor expression in biopsied or excised NMSCs. Fifty-nine articles met criteria for inclusion. PD-L1 expression in advanced NMSCs ranged from 22%-89% for basal cell carcinomas, 42%-50% for Merkel cell carcinomas, and 26%-100% for squamous cell carcinomas. Study limitations included clone heterogeneity across studies, complicating comparison of PD-L1 expression. Differences were also noted in the selection of tumor reactivity threshold. We conclude that there is insufficient evidence to determine the prognostic significance of PD-L1 expression in NMSCs as a whole, but this remains a promising area. More investigation into the role of tumor PD-L1 as a biomarker for predicting clinical response to PD-L1 and PD-1 inhibitors in NMSCs is needed.
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Affiliation(s)
- Larisa Lehmer
- Resident, Department of Dermatology, University of California Irvine, Irvine, CA
| | - Franchesca Choi
- Research Fellow and Resident, School of Medicine, University of California Irvine, Irvine, CA
- Research Fellow and Resident, Department of Pathology, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Christina Kraus
- Assistant Professor, Department of Dermatology, University of California Irvine, Irvine, CA
| | - Jessica Shiu
- Assistant Professor, Department of Dermatology, University of California Irvine, Irvine, CA
| | - Sebastien de Feraudy
- Dermatopathologist, Kaiser Regional Dermatopathology Service, Kaiser Permanente, San Francisco, CA; and
| | - Ashley Elsensohn
- Fellow, Dermatopathology Section, Geisinger Medical Center, Danville, PA
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Nikoo M, Kianpoor K, Nikoo N, Javidanbardan S, Kazemi A, Choi F, Vogel M, Gholami A, Tavakoli S, Wong J, Moazen‐Zadeh E, Givaki R, Jazani M, Mohammadian F, Moghaddam NM, Schütz C, Jang K, Akhondzadeh S. Opium tincture for opioid substitution treatment. Eur Psychiatry 2021. [PMCID: PMC9471765 DOI: 10.1192/j.eurpsy.2021.455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Opium tincture (OT) is widely used for opioid substitution treatment (OST) in Iran. Objectives To determine if OT is a safe and effective medication for OST. Methods Opium Trial was a multicenter, double‐blind, noninferiority randomized controlled trial, with 204 participants with opioid dependence in Iran. Participants were then randomized to OT or methadone arms with an allocation ratio of 1:1 and were followed for 12 weeks. The primary outcome was retention in treatment, compared between the two groups using both intention-To-Treat (ITT) and Per-Protocol (PP) analyses. Results A total of 70 participants (IT: 68.6%, PP: 69.3%) in methadone arm and 61 participants (ITT: 59.8%, PP: 60.4%) in OT arm remained in the treatment. The relative retention rate was 1.15 (0.97, 1.36) in both analyses in favour of methadone. A total of 46 out of 152 (30.3%) participants in OT arm and 83 out of 168 (49.4%) participants in methadone arm reported opioid use outside the treatment. The difference in these two proportions (OT - methadone) was 19%: (10%, 28%) in favour of OT. The proportion of patients with adverse events were not different between the two arms (P = 0.06). There was no serious AE in OT arm. Conclusions Opium tincture is a clinically effective and safe medication, but this study could not conclude if it was as equally effective as methadone in retaining participants in treatment, but it showed that OT was superior to methadone in reducing opioid use outside the treatment. Disclosure No significant relationships.
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Ekelem C, Juhasz M, Yu J, Hosking AM, Csuka E, Choi F, Pham CT, Heidari AE, Valdebran M, Rapaport JA, Chen Z, Mesinkovska NA. Monitoring Response to Platelet-Rich Plasma in Patients with Alopecia Areata with Optical Coherence Tomography: A Case Series. J Investig Dermatol Symp Proc 2020; 20:S50-S54. [PMID: 33099385 DOI: 10.1016/j.jisp.2020.05.008] [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: 10/23/2022]
Abstract
Alopecia areata (AA) is an autoimmune hair loss condition that is difficult to treat and frequently disruptive to the psychosocial well-being of patients. Platelet-rich plasma (PRP) is an innovative therapy that provides concentrated GFs that impart anti-inflammatory effects. Optical coherence tomography (OCT) is a noninvasive imaging modality with the potential for providing quantitative monitoring of AA response to PRP. Our objective is to share our experience using OCT to monitor the therapeutic progress of patients with AA treated with PRP. Two patients with patchy AA and one with alopecia universalis were treated with PRP three times at 6-week intervals as part of a larger clinical trial. Patients were followed from baseline to week 24 with OCT imaging. OCT demonstrates an increase in hair density associated with improvement in inflammation at week 24. Conversely, the patient with alopecia universalis did not experience any significant change in follicular activity. This case series exemplifies the potential of PRP in inflammatory regulation as well as hair regrowth in patchy AA, whereas there is no notable advantage in alopecia universalis. Our findings add evidence on the possible value of OCT in quantitatively assessing hair growth progress throughout a treatment course.
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Affiliation(s)
- Chloe Ekelem
- Department of Dermatology, University of California Irvine, Irvine, California, USA.
| | - Margit Juhasz
- Department of Dermatology, University of California Irvine, Irvine, California, USA
| | - Junxiao Yu
- Beckman Laser Institute, University of California Irvine, Irvine, California, USA
| | - Anna-Marie Hosking
- Department of Dermatology, University of California Irvine, Irvine, California, USA
| | - Ella Csuka
- Department of Dermatology, University of California Irvine, Irvine, California, USA
| | - Franchesca Choi
- Department of Dermatology, University of California Irvine, Irvine, California, USA
| | - Christine T Pham
- Department of Dermatology, University of California Irvine, Irvine, California, USA
| | - Andrew Emon Heidari
- Beckman Laser Institute, University of California Irvine, Irvine, California, USA
| | - Manuel Valdebran
- Department of Dermatology, University of California Irvine, Irvine, California, USA
| | | | - Zhongping Chen
- Beckman Laser Institute, University of California Irvine, Irvine, California, USA
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Urban G, Feil N, Csuka E, Hashemi K, Ekelem C, Choi F, Mesinkovska NA, Baldi P. Combining Deep Learning With Optical Coherence Tomography Imaging to Determine Scalp Hair and Follicle Counts. Lasers Surg Med 2020; 53:171-178. [PMID: 32960994 DOI: 10.1002/lsm.23324] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 06/16/2020] [Revised: 08/27/2020] [Accepted: 09/09/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND OBJECTIVES One of the challenges in developing effective hair loss therapies is the lack of reliable methods to monitor treatment response or alopecia progression. In this study, we propose the use of optical coherence tomography (OCT) and automated deep learning to non-invasively evaluate hair and follicle counts that may be used to monitor the success of hair growth therapy more accurately and efficiently. STUDY DESIGN/MATERIALS AND METHODS We collected 70 OCT scans from 14 patients with alopecia and trained a convolutional neural network (CNN) to automatically count all follicles present in the scans. The model is based on a dual approach of both detecting hair follicles and estimating the local hair density in order to give accurate counts even for cases where two or more adjacent hairs are in close proximity to each other. RESULTS We evaluate our system on 70 OCT manually labeled scans taken at different scalp locations from 14 patients, with 20 of those redundantly labeled by two human expert OCT operators. When comparing the individual human predictions and considering the exact locations of hair and follicle predictions, we find that the two human raters disagree with each other on approximately 22% of hairs and follicles. Overall, the deep learning (DL) system predicts the number of follicles with an error rate of 11.8% and the number of hairs with an error rate of 18.7% on average on the 70 scans. The OCT system can capture one scalp location in three seconds, and the DL model can make all predictions in less than a second after processing the scan, which takes half a minute using an unoptimized implementation. CONCLUSION This approach is well-positioned to become the standard for non-invasive evaluation of hair growth treatment progress in patients, saving significant amounts of time and effort compared with manual evaluation. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.
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Affiliation(s)
- Gregor Urban
- Department of Computer Science, University of California, Irvine, California, 92697
| | - Nate Feil
- Department of Dermatology, School of Medicine, University of California, Irvine, California, 92697
| | - Ella Csuka
- Department of Dermatology, School of Medicine, University of California, Irvine, California, 92697
| | - Kiana Hashemi
- Department of Dermatology, School of Medicine, University of California, Irvine, California, 92697
| | - Chloe Ekelem
- Department of Dermatology, School of Medicine, University of California, Irvine, California, 92697.,Department of Dermatology, School of Medicine, University of Utah, 30 North 1900 East, 4A330, Salt Lake City, Utah, 84132
| | - Franchesca Choi
- Department of Computer Science, University of California, Irvine, California, 92697
| | - Natasha A Mesinkovska
- Department of Dermatology, School of Medicine, University of California, Irvine, California, 92697.,Beckman Laser Institute, Irvine, California, 92697
| | - Pierre Baldi
- Department of Computer Science, University of California, Irvine, California, 92697
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Ekelem C, Feil N, Csuka E, Juhasz M, Lin J, Choi F, Asghari A, Heydarlou D, Mesinkovska NA. Optical Coherence Tomography in the Evaluation of the Scalp and Hair: Common Features and Clinical Utility. Lasers Surg Med 2020; 53:129-140. [PMID: 32253781 DOI: 10.1002/lsm.23243] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 03/22/2020] [Accepted: 03/23/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVE Early diagnosis and treatment of hair loss disorders is vital in providing patients with improved psychological outcomes. Non-invasive imaging with optical coherence tomography (OCT) may be useful in characterizing and managing alopecia. Despite expanding clinical applications of OCT in dermatology, guidelines demonstrating in vivo features of normal and alopecic scalp images remain scant. This pilot study aims to provide an atlas of OCT findings of healthy and alopecia subjects, explore diagnostic quantitative endpoints of alopecia, and compare epidermal thickness and follicular density between scalp regions. STUDY DESIGN/MATERIALS AND METHODS A total of 32 patients (19-76 years old) were enrolled in the study, including healthy patients (n = 6), and patients with scarring alopecia (n = 12) or non-scarring alopecia (n = 14). An in-line fiber-based swept source OCT was used to image five scalp locations at baseline and 6-month visits. Three investigators evaluated each image for gross features, epidermal thickness, and follicular density. RESULTS Only data from baseline imaging analysis is discussed in this manuscript. Qualitative differences of OCT images are identified in sample images from healthy scalp and each subtype of alopecia studied. Scarring alopecia is characterized by significantly increased epidermal thickness (average Image J pixel units 32 ± 2 compared with non-scarring alopecia [average 28 ± 3] and control [average 27 ± 3]) (P = 0.022) and decreased follicle count (average 35 ± 5 in a 5 × 7 mm2 area compared with control (50 ± 3) and non-scarring patients (47 ± 6)) (P = 0.0052). Scalp location had no impact on epidermal thickness (P = 0.861) or follicular density (P = 0.15). CONCLUSION OCT holds promise as a non-invasive technique to further characterize and objectively measure alopecia. Larger sample sizes and longitudinal data are needed to improve reliability and determine if additional distinction between alopecia subtypes and treatment monitoring is possible. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.
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Affiliation(s)
- Chloe Ekelem
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
| | - Nate Feil
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
| | - Ella Csuka
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
| | - Margit Juhasz
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
| | - Jessica Lin
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
| | - Franchesca Choi
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697.,School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, 807
| | - Arya Asghari
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
| | - Dorsa Heydarlou
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
| | - Natasha A Mesinkovska
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
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Choi F, Lehmer L, Ekelem C, Mesinkovska NA. Dietary and metabolic factors in the pathogenesis of hidradenitis suppurativa: a systematic review. Int J Dermatol 2019; 59:143-153. [PMID: 31651051 DOI: 10.1111/ijd.14691] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 08/10/2019] [Accepted: 09/20/2019] [Indexed: 12/13/2022]
Abstract
Hidradenitis suppurativa (HS) is a systemic recalcitrant inflammatory condition characterized by debilitating lesions with high morbidity. Its known association with obesity and smoking indicate correlation with other environmental factors, such as diet, suggesting a larger role for lifestyle modifications in disease treatment. This study seeks to assess the contribution of weight loss and dietary intake in HS management. A primary literature search was conducted using PubMed, Web of Science, and CINAHL in November 2018 to include association and intervention studies on the influence of diet and weight on HS. Twenty-five articles were included. Meta-analysis of nine case-control studies across Asia, Europe, and the United States showed that HS patients are four times more likely to be obese compared to the general population; random effects pooled odds ratio 4.022 (2.667-6.065), P < 0.001. Five articles assessed weight-loss interventions and revealed mixed findings. The remaining articles included three association studies on micronutrient levels, eight dietary intervention studies, and one article analyzing both micronutrient association and dietary intervention. Included articles in this systematic review reveal that low serum zinc and vitamin D levels are associated with increased lesion count in HS. Supplementation of zinc, vitamin D, vitamin B12, or exclusion of dairy or brewer's yeast can be effective in partial or complete lesion resolution. Reviewed data show that weight loss from bariatric surgery may lead to HS improvement but often results in more severe malnutrition that worsens or even leads to new onset HS post bariatric surgery. Future reporting is needed to conclusively determine the role of diet in HS.
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Affiliation(s)
- Franchesca Choi
- Department of Dermatology, University of California, Irvine, Irvine, CA, USA.,Kaohsiung Medical University, School of Medicine, Kaohsiung, Taiwan
| | - Larisa Lehmer
- Department of Dermatology, University of California, Irvine, Irvine, CA, USA
| | - Chloe Ekelem
- Department of Dermatology, University of California, Irvine, Irvine, CA, USA
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Sung CT, Lee A, Choi F, Juhasz M, Mesinkovska NA. Non-Submental Applications of Injectable Deoxycholic Acid: A Systematic Review. J Drugs Dermatol 2019; 18:675-680. [PMID: 31334926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Introduction: Injectable deoxycholic acid (DCA; Kybella; Allergan, Irvine, CA) is currently approved only for treatment of persistent submental fat (SMF). Many cosmetic surgeons use DCA off-label to treat fat tissue in other areas of the body. There is no review summarizing the off-label uses of injectable DCA. Methods: A systematic literature search was conducted through PubMed, Cochrane, CINAHL, and Web of Science databases using search terms “ATX-101 OR Kybella OR deoxycholic OR deoxycholate NOT amphotericin NOT bile” in accordance to PRISMA guidelines to identify off-label uses for injectable DCA or ATX-101. Results: Ten pertinent articles were identified for review. Anatomic areas treated include the face, brassiere line, foot, and gluteotrochanteric region. Indications include facial contouring, paradoxical adipose hyperplasia, HIV/HAART-associated buccal fat pad lipodystrophy, and reduction of lipomatous tumors. DCA is efficacious at causing lipolysis and safe with minimal side effects. Most patients treated for cosmetic indications reported high patient satisfaction. Conclusion: Off-label use of injectable DCA demonstrate a similar safety profile, effectiveness, and overall patient satisfaction compared to FDA-approved use for persistent SMF. DCA appears to be a safe and efficacious alternative to surgical reduction of unwanted adipose tissue in non-submental areas. Larger-scale studies are warranted to explore further cosmetic and potential medical applications. J Drugs Dermatol. 2019;18(7):675-680.
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Sung CT, Choi F, Wang SH, Jacobs N, Maguire GA. Nonantipsychotic therapies for delusions of parasitosis. Ital J Dermatol Venerol 2019; 156:95-96. [PMID: 30762031 DOI: 10.23736/s2784-8671.19.06163-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Calvin T Sung
- Riverside School of Medicine, University of California, Riverside, CA, USA.,Department of Dermatology, University of California, Irvine, CA, USA
| | - Franchesca Choi
- Department of Dermatology, University of California, Irvine, CA, USA.,Taipei Medical University Hospital, Taipei, Taiwan
| | - Spencer H Wang
- Riverside School of Medicine, University of California, Riverside, CA, USA
| | - Natasha Jacobs
- Riverside School of Medicine, University of California, Riverside, CA, USA
| | - Gerald A Maguire
- Riverside School of Medicine, University of California, Riverside, CA, USA - .,Department of Psychiatry, Riverside School of Medicine, University of California, Riverside, CA, USA
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Chan O, Lam K, Li J, Choi F, Wong C, Chang A, Mo F, Wang K, Yeung R, Mok T. OA07.02 ATOM: A Phase II Study to Assess Efficacy of Preemptive Local Ablative Therapy to Residual Oligometastases After EGFR TKI. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.270] [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: 10/28/2022]
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Choi F, Chen W, Hu SC. Cutaneous epidermotropic metastasis of an oesophageal squamous cell carcinoma: Wound healing and transepidermal elimination as possible mechanisms for epidermotropism. Australas J Dermatol 2018; 60:e151-e152. [DOI: 10.1111/ajd.12919] [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: 11/28/2022]
Affiliation(s)
- Franchesca Choi
- School of Post‐Baccalaureate Medicine College of Medicine Kaohsiung Medical UniversityKaohsiung Taiwan
| | - Wan‐Tzu Chen
- Department of Pathology Kaohsiung Medical University HospitalKaohsiung Taiwan
| | - Stephen Chu‐Sung Hu
- Department of Dermatology College of Medicine Kaohsiung Medical University Kaohsiung Taiwan
- Department of Dermatology Kaohsiung Medical University Hospital Kaohsiung Taiwan
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Cheung F, Chang A, Wong T, Choi F, Chan M, Soong I, Law A, Lee M, Yeung R. EP-1981: Comparing MRI vs CT based applicator reconstruction and plng techniques for adaptive cervix cancer BT. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)33232-7] [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: 10/21/2022]
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16
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Bhatia K, Mok G, Lin K, Choi F. A diffuse branching pattern of biliary FDG activity: Infective or neoplastic? Rev Esp Med Nucl Imagen Mol 2012. [DOI: 10.1016/j.remnie.2011.08.002] [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: 10/28/2022]
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Bhatia K, Mok G, Lin K, Choi F. A diffuse branching pattern of biliary FDG activity: infective or neoplastic? Rev Esp Med Nucl Imagen Mol 2011; 31:165-6. [PMID: 22056001 DOI: 10.1016/j.remn.2011.08.006] [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: 07/12/2011] [Revised: 08/02/2011] [Accepted: 08/26/2011] [Indexed: 11/16/2022]
Affiliation(s)
- K Bhatia
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, New Territories, Hong Kong, People's Republic of China.
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Lev S, Gasparich G, Choi F, King L, Moore J, Zimmerman S. Establishing the detection threshold for Bacillus subtilis in a complex matrix using an inorganic fingerprint approach. Talanta 2011; 85:1734-7. [DOI: 10.1016/j.talanta.2011.06.072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Revised: 06/24/2011] [Accepted: 06/27/2011] [Indexed: 10/18/2022]
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Affiliation(s)
- N Rhind
- Hong Kong Family Welfare Society
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Cheng G, Choi F, Wong L. Failure to detect potent anti-H in Parabombay patients with the gel system. Clin Lab Haematol 1996; 18:63-4. [PMID: 9118612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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