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Islam N, Korman AM, Trinidad J, Kaffenberger JA. Cross-sectional evaluation of Spanish-language care at academic dermatology clinics. Int J Dermatol 2023; 62:e450-e452. [PMID: 36416670 DOI: 10.1111/ijd.16514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 10/24/2022] [Accepted: 11/05/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Nabiha Islam
- Department of Dermatology, The Ohio State University, Columbus, OH, USA
| | - Abraham M Korman
- Department of Dermatology, The Ohio State University, Columbus, OH, USA
| | - John Trinidad
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
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2
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Hecht AL, Milani‐Nejad N, Bubic BN, Kaffenberger JA. A retrospective review of treatment response of palmoplantar psoriasis. Int J Dermatol 2022. [DOI: 10.1111/ijd.16521] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/06/2022] [Indexed: 11/25/2022]
Affiliation(s)
| | - Nima Milani‐Nejad
- Department of Internal Medicine The University of California, Los Angeles Medical Center Division of Dermatology Los Angeles CA USA
| | - Bianka N. Bubic
- The Ohio State University Department of Dermatology Columbus OH USA
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3
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Paradkar KA, Kaffenberger JA. Skin Tone Representation in Dermatologist Social Media Accounts. J Clin Aesthet Dermatol 2022; 15:40-42. [PMID: 36381184 PMCID: PMC9651156] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Skin conditions manifest differently on darker skin tones, yet lighter skin tones are usually overrepresented in dermatology educational resources. Our aim was to explore the representation of skin tones within dermatology social media posts in 2019. METHODS This is a retrospective review of posts made on Instagram, YouTube, and Twitter by the top 2019 dermatology social media influencers. Twenty-one accounts were included. Eight posts were randomly chosen per account and graded by the Fitzpatrick scale (I-VI). RESULTS Overall, Fitzpatrick Type II was the most represented skin type (53%), while Fitzpatrick Type VI was the least represented (0%). On Instagram, 79.7 percent of posts represented light skin tones (Fitzpatrick Types I-III) and 20.3 percent represented dark skin tones (Fitzpatrick Types IV-VI). On YouTube, 93.75 percent of posts represented light skin tones and 6.25 percent represented dark skin tones. On Twitter, 73.2 percent of posts represented light skin tones and 26.8 percent represented dark skin tones. LIMITATIONS This study is limited by the subjective nature of assigning Fitzpatrick skin types and by only analyzing posts from dermatology social media influencers in 2019. CONCLUSION Within the analyzed posts, darker skin tones were represented less frequently than lighter skin tones; we encourage a wider range of skin tone representation within educational resources.
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Affiliation(s)
- Komal A Paradkar
- Both authors are with The Ohio State College of Medicine in Columbus, Ohio
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4
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Nosewicz J, Sparks A, Hart PA, Roberts KM, Kaffenberger JA, Korman A, Trinidad JC, Spaccarelli N, Kaffenberger BH. The Evaluation and Management of Macronutrient Deficiency Dermatoses. J Am Acad Dermatol 2022; 87:640-647. [PMID: 35427683 DOI: 10.1016/j.jaad.2022.04.007] [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: 09/06/2021] [Revised: 03/31/2022] [Accepted: 04/03/2022] [Indexed: 10/18/2022]
Abstract
In industrialized countries, nutritional dermatoses are likely underdiagnosed and result in increased disease morbidity and utilization of hospital resources. These findings underscore the need for physicians to be able to correctly identify these deficiencies. Nutritional dermatoses may be split into micronutrient deficiencies and macronutrient deficiencies. This article is intended to serve as a supplement to a two-part review of micronutrient deficiency dermatoses and highlights cutaneous findings in patients with protein-energy malnutrition and essential fatty acid deficiency. This article reviews the evaluation, cutaneous manifestations, and management of macronutrient deficiencies.
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Affiliation(s)
- Jacob Nosewicz
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Alexander Sparks
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Phil A Hart
- Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Kristen M Roberts
- Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Jessica A Kaffenberger
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Abraham Korman
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - John C Trinidad
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Natalie Spaccarelli
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
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5
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Nosewicz J, Spaccarelli N, Roberts KM, Hart PA, Kaffenberger JA, Trinidad JC, Kaffenberger BH. Response to Falotico et al's "Biotin beware: Perils of biotin supplementation". J Am Acad Dermatol 2022; 87:497. [PMID: 35331806 DOI: 10.1016/j.jaad.2022.03.030] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Jacob Nosewicz
- Division of Dermatology, Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Natalie Spaccarelli
- Division of Dermatology, Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Kristen M Roberts
- Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Phil A Hart
- Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Jessica A Kaffenberger
- Division of Dermatology, Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - John C Trinidad
- Division of Dermatology, Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Benjamin H Kaffenberger
- Division of Dermatology, Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio.
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6
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Korman AM, Kaffenberger JA. Diffuse Urticarial Rash in a Pregnant Patient. Cutis 2022; 109:E29-E30. [PMID: 35180066 DOI: 10.12788/cutis.0454] [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: 11/20/2022]
Affiliation(s)
- Abraham M Korman
- Department of Internal Medicine, Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus
| | - Jessica A Kaffenberger
- Department of Internal Medicine, Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus
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7
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Noe MH, Wan MT, Mostaghimi A, Gelfand JM, Agnihothri R, Armstrong AW, Bhutani T, Bridges A, Brownstone N, Butt M, Duffin KPC, Carr C, Creadore A, DeNiro KL, Desai S, Dominguez AR, Duffy EK, Fairley JA, Femia A, Gudjonsson JE, Kaffenberger JA, Katz KL, Kirby JS, Le ST, Martinez E, Maverakis E, Myers B, Naik HB, Nelson CA, Ortega-Loayza AG, Plovanich ME, Rangel LK, Ravi V, Reddy VD, Saleh JZ, Sandhu JK, Shakshouk H, Shields BE, Sharif-Sidi Z, Smith J, Steahr A, Toussi A, Wanat KA, Wang B, Wei BM, Weinhammer A, Worswick SD, Yang A. Evaluation of a Case Series of Patients With Palmoplantar Pustulosis in the United States. JAMA Dermatol 2021; 158:68-72. [PMID: 34878495 DOI: 10.1001/jamadermatol.2021.4635] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Importance Palmoplantar pustulosis (PPP) is a is a chronic, orphan disease with limited epidemiological data. Objective To describe the clinical characteristics, treatments, longitudinal disease course, and health care utilization in adults with PPP across the US. Design, Setting, and Participants This retrospective, longitudinal case series from 20 academic dermatology practices in the US included a consecutive sample of 197 adults who met the European Rare and Severe Psoriasis Expert Network consensus definition for PPP between January 1, 2007, and December 31, 2018. Data analysis was performed June 2020 to December 2020. Main Outcomes and Measures The primary outcome was to describe the patient characteristics, associated medical comorbidities, treatment patterns, complications, and PPP-specific health care utilization. Results Of 197 patients, 145 (73.6%) were female, and the mean (SD) age at presentation was 53.0 (12.6) years, with a mean (SD) follow-up time of 22.1 (28.0) months. On initial presentation, 95 (48.2%) patients reported skin pain, and 39 (19.8%) reported difficulty using hands and/or feet. Seventy patients (35.5%) were treated with systemic treatments, and use of more than 20 different systemic therapies was reported. In patients with at least 6 months of follow-up (n = 128), a median (IQR) of 3.7 (4-10) dermatology visits per year were reported; 24 (18.8%) patients had 5 or more visits during the study period. Conclusions and Relevance In this case series, PPP was associated with persistent symptoms, continued health care utilization, and a lack of consensus regarding effective treatments, emphasizing the unmet medical need in this population. Additional research is necessary to understand treatment response in these patients.
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Affiliation(s)
- Megan H Noe
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Marilyn T Wan
- Department of Internal Medicine, Memorial Hospital West, Pembroke Pines, Florida
| | - Arash Mostaghimi
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Joel M Gelfand
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia.,Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | | | - Ritesh Agnihothri
- Department of Dermatology, University of Rochester, School of Medicine & Dentistry, Rochester, New York
| | - April W Armstrong
- Department of Dermatology, Keck Hospital of USC, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Tina Bhutani
- Department of Dermatology, UCSF Medical Center, University of California San Francisco School of Medicine
| | - Alina Bridges
- Department of Dermatology, Mayo Clinic Graduate School of Education, Rochester, Minnesota.,Richfield Laboratory of Dermatopathology, Dermpath Diagnostics, Cincinnati, Ohio
| | - Nicholas Brownstone
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco
| | - Melissa Butt
- Department of Dermatology, Penn State Hershey Medical Center, Hershey, Pennsylvania
| | | | | | - Andrew Creadore
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Boston University School of Medicine, Boston, Massachusetts
| | - Katherine L DeNiro
- Division of Dermatology, Department of Medicine, University of Washington, Seattle
| | - Sheena Desai
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Tufts University School of Medicine, Boston, Massachusetts
| | - Arturo R Dominguez
- Departments of Dermatology and Internal Medicine, University of Texas Southwestern Medical Center, Dallas
| | - Emily K Duffy
- Division of Dermatology, Department of Medicine, University of Washington, Seattle
| | - Janet A Fairley
- Department of Dermatology, University of Iowa Carver College of Medicine, Iowa City
| | - Alisa Femia
- Ronald O. Perelman Department of Dermatology, NYU Langone Hospitals, New York University Grossman School of Medicine, New York, New York
| | | | | | - Kimberly L Katz
- Department of Dermatology, Medical College of Wisconsin, Milwaukee
| | - Joslyn S Kirby
- Department of Dermatology, Penn State Hershey Medical Center, Hershey, Pennsylvania
| | - Stephanie T Le
- Department of Dermatology, University of California, Davis School of Medicine, Sacramento
| | | | - Emanual Maverakis
- Department of Dermatology, University of California, Davis School of Medicine, Sacramento
| | - Bridget Myers
- University of California San Francisco School of Medicine
| | - Haley B Naik
- Department of Dermatology, UCSF Medical Center, University of California San Francisco School of Medicine
| | - Caroline A Nelson
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Alex G Ortega-Loayza
- Department of Dermatology, Oregon Health and Science University School of Medicine, Portland
| | - Molly E Plovanich
- Department of Dermatology, University of Rochester, School of Medicine & Dentistry, Rochester, New York
| | - Lauren K Rangel
- Ronald O. Perelman Department of Dermatology, NYU Langone Hospitals, New York University Grossman School of Medicine, New York, New York
| | - Vignesh Ravi
- Department of Dermatology, Keck Hospital of USC, University of Southern California Keck School of Medicine, Los Angeles, California
| | | | - Jamal Z Saleh
- Department of Dermatology, Medical College of Wisconsin, Milwaukee
| | - Jeena K Sandhu
- Department of Dermatology, Keck Hospital of USC, University of Southern California Keck School of Medicine, Los Angeles, California.,Division of Dermatology, John H. Stroger Jr Hospital of Cook County, Chicago, Illinois
| | - Hadir Shakshouk
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | - Bridget E Shields
- Department of Dermatology, School of Medicine and Public Health, University of Wisconsin, Madison
| | | | - Jacob Smith
- Oregon Health and Science University School of Medicine, Portland
| | - Amanda Steahr
- Department of Dermatology, University of Iowa Carver College of Medicine, Iowa City
| | - Atrin Toussi
- Department of Dermatology, University of California, Davis School of Medicine, Sacramento
| | - Karolyn A Wanat
- Department of Dermatology, Medical College of Wisconsin, Milwaukee
| | - Bo Wang
- Department of Dermatology, University of Michigan, Ann Arbor
| | - Brian M Wei
- Yale School of Medicine, New Haven, Connecticut
| | - Annika Weinhammer
- Department of Dermatology, School of Medicine and Public Health, University of Wisconsin, Madison
| | - Scott D Worswick
- Department of Dermatology, Keck Hospital of USC, University of Southern California Keck School of Medicine, Los Angeles, California
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8
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Nosewicz J, Spaccarelli N, Roberts KM, Hart PA, Kaffenberger JA, Trinidad JC, Kaffenberger BH. The Epidemiology, Impact, and Diagnosis of Micronutrient Nutritional Dermatoses Part 1: Zinc, Selenium, Copper, Vitamin A, and Vitamin C. J Am Acad Dermatol 2021; 86:267-278. [PMID: 34748862 DOI: 10.1016/j.jaad.2021.07.079] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 04/11/2021] [Revised: 07/16/2021] [Accepted: 07/23/2021] [Indexed: 11/27/2022]
Abstract
Dermatologists play a critical role in diagnosing and managing nutritional deficiencies as they often present with cutaneous findings. Traditionally, nutritional dermatoses are taught in the context of developing countries, famine, population displacement, and poor healthcare access; however, in the United States, common risk factors include chronic liver disease, alcoholism, psychiatric disease, bariatric surgery, inflammatory bowel disease, and hemodialysis. Additionally, nutritional dermatoses may be underdiagnosed in the United States and result in increased morbidity and utilization of hospital resources. There is a need for providers in developed nations to identify these deficiencies, and this review aims to meet that practice gap and provide relevant context to these diseases for dermatologists. This two-part review series will focus on the epidemiology, impact, appearance, and diagnostic modalities for micronutrient deficiencies, including zinc, selenium, copper, and vitamins A and C in part one. The companion review will focus on the B-complex vitamins.
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Affiliation(s)
- Jacob Nosewicz
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Natalie Spaccarelli
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Kristen M Roberts
- Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Phil A Hart
- Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Jessica A Kaffenberger
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - John C Trinidad
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
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9
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Nusbaum KB, Korman AM, Tyler KH, Kaffenberger JA, Trinidad JC, Dean S, Cataland S, Kaffenberger BH. In vitro diagnostics for the medical dermatologist. Part II: Hypercoagulability tests. J Am Acad Dermatol 2021; 85:301-310. [PMID: 33852929 DOI: 10.1016/j.jaad.2021.03.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
The skin often provides initial clues of hypercoagulability with features such as livedo reticularis, livedo racemosa, retiform purpura, necrosis, and ulcerations. Because these cutaneous manifestations are nonspecific, laboratory testing is often needed to evaluate for underlying causes of hypercoagulability. Importantly, these disorders are reported to be the most common mimicker, resulting in an erroneous diagnosis of pyoderma gangrenosum. Understanding inherent properties of, and indications for, available tests is necessary for appropriate ordering and interpretation of results. Additionally, ordering of these tests in an indiscriminate manner may lead to inaccurate results, complicating the interpretation and approach to management. This second article in this continuing medical education series summarizes information on methodology, test characteristics, and limitations of several in vitro laboratory tests used for the work up of hypercoagulability and vasculopathic disease as it pertains to dermatologic disease.
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Affiliation(s)
| | - Abraham M Korman
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Kelly H Tyler
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Jessica A Kaffenberger
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - John C Trinidad
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Steven Dean
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Spero Cataland
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Benjamin H Kaffenberger
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio.
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10
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Paradiso MM, Rismiller KP, Kaffenberger JA. Unconscious gender bias: A look at speaker introductions at the American Academy of Dermatology. J Am Acad Dermatol 2021; 85:1652-1653. [PMID: 33428976 DOI: 10.1016/j.jaad.2020.12.066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 12/23/2020] [Accepted: 12/25/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Michela M Paradiso
- The Ohio State University Division of Dermatology, Department of Internal Medicine, Columbus, Ohio
| | - Kyle P Rismiller
- The Ohio State University Division of Dermatology, Department of Internal Medicine, Columbus, Ohio
| | - Jessica A Kaffenberger
- The Ohio State University Division of Dermatology, Department of Internal Medicine, Columbus, Ohio.
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11
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Marsh RL, Spohn GP, Kaffenberger JA. Erosive pustular dermatosis of the scalp. Dermatol Online J 2020; 26:13030/qt8ks9j8sv. [PMID: 32941728] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 09/15/2020] [Indexed: 06/11/2023] Open
Abstract
Erosive pustular dermatosis of the scalp (EPDS) is a rare inflammatory condition commonly associated with antecedent iatrogenic insult. EPDS may be diagnostically challenging owing to a lack of pathognomonic histologic findings and cutaneous manifestations that overlap with alternative dermatologic conditions. Therefore, EPDS may be more common than previously recognized. We present a 60-year-old woman with a four-year history of non-healing scalp erosions, progressive skin atrophy, and scarring alopecia despite intravenous antibiotics and intraoperative debridement who improved with systemic glucocorticoids. Our report emphasizes the importance of early recognition of EPDS when delayed wound healing and erosive disease occur in the setting of iatrogenic injury to the scalp. Timely treatment with systemic anti-inflammatory agents is paramount to prevent cicatricial alopecia and mitigate further scalp insult in EPDS.
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Affiliation(s)
| | | | - Jessica A Kaffenberger
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH.
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12
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Rzepka PV, Kaffenberger JA. A CASE OF MORBILLIFORM DRUG ERUPTION TO DULAGLUTIDE. J Clin Aesthet Dermatol 2020; 13:13. [PMID: 33144906 PMCID: PMC7605389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Polina V Rzepka
- Drs. Rzepka and Kaffenberger are with the Division of Dermatology at the Ohio State University Department of Internal Medicine in Columbus, Ohio
| | - Jessica A Kaffenberger
- Drs. Rzepka and Kaffenberger are with the Division of Dermatology at the Ohio State University Department of Internal Medicine in Columbus, Ohio
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13
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Hoffman KP, Shearer S, Chung C, Kaffenberger JA, Kaffenberger BH. Clinical and therapeutic overlap of pyoderma gangrenosum, cutaneous small vessel vasculitis, and immunoglobulin A. Int J Dermatol 2020; 59:e286-e288. [PMID: 32118287 DOI: 10.1111/ijd.14841] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 01/01/2020] [Accepted: 02/10/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Kalyn P Hoffman
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Sabrina Shearer
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Catherine Chung
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA.,Department of Pathology, The Ohio State University, Columbus, OH, USA
| | - Jessica A Kaffenberger
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Benjamin H Kaffenberger
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
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14
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15
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Abstract
The Koebner phenomenon is the development of lesions in traumatized skin, often with spontaneously occurring lesions elsewhere. We report a case of a woman in her 20 s presenting with discoid lesions superimposed on tattoos that she obtained many years ago. Although a few case reports have been published describing development of lesions on red tattoos attributed to photosensitivity, or koebnerization occurring less than a month following tattoo placement, our patient demonstrates a unique delayed development of discoid lesions years after obtaining her tattoos in non-sun exposed skin. Patients with conditions associated with the Koebner phenomenon must be counseled regarding forms of preventable trauma such as tattoos, and should be made aware that the Koebner phenomenon may not only manifest immediately, but can also present many years later.
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Affiliation(s)
- R F Wang
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - M Maher
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - C Chung
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - J A Kaffenberger
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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16
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Wang RF, Zhang M, Alloo A, Stasko T, Miller JE, Kaffenberger JA. Characterization of the 2016-2017 Dermatology Standardized Letter of Recommendation. J Clin Aesthet Dermatol 2018; 11:26-29. [PMID: 29606997 PMCID: PMC5868781] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Objective: We aimed to analyze the reformatted standard letter of recommendation (SLOR) for dermatology residents to examine trends in grading and content based on the positions of the letter writers, their backgrounds, and their relationship with the applicant, as well as to evaluate the SLOR's ability to discriminate applicants. Design: This was a retrospective characterization study of dermatology SLORs from the 2016-17 application cycle. Setting: We examined SLORs received by The Ohio State University, the University of Oklahoma, and Hofstra University Northwell Health dermatology residency programs. Participants: We included dermatology residency applicants and their letter writers from the 2016-17 application cycle. Results: A total of 141 SLORs were analyzed from 115 applicants. SLORs demonstrated grade inflation from letter writers of all backgrounds. Ratings for research potential and inquisitive nature were significantly lower than ratings for other categories. Letter writers with limited clinical and research contact graded applicants significantly lower than did writers who had more extensive contact. Word boxes were underutilized. Conclusion: The dermatology SLOR is useful in differentiating applicants, and ratings correlate with the relationships that letter writers have with their applicants. Residency programs should be aware of these findings when evaluating letters of recommendation for applicants.
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Affiliation(s)
- Rebecca F Wang
- Ms. Wang and Drs. Zhang and Kaffenberger are with the Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center in Columbus, Ohio
- Dr. Alloo is with the Department of Dermatology at Hofstra Northwell School of Medicine in New Hyde Park, New York
- Dr. Stasko and Mr. Miller are with the Department of Dermatology at the University of Oklahoma in Oklahoma City, Oklahoma
| | - Myron Zhang
- Ms. Wang and Drs. Zhang and Kaffenberger are with the Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center in Columbus, Ohio
- Dr. Alloo is with the Department of Dermatology at Hofstra Northwell School of Medicine in New Hyde Park, New York
- Dr. Stasko and Mr. Miller are with the Department of Dermatology at the University of Oklahoma in Oklahoma City, Oklahoma
| | - Allireza Alloo
- Ms. Wang and Drs. Zhang and Kaffenberger are with the Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center in Columbus, Ohio
- Dr. Alloo is with the Department of Dermatology at Hofstra Northwell School of Medicine in New Hyde Park, New York
- Dr. Stasko and Mr. Miller are with the Department of Dermatology at the University of Oklahoma in Oklahoma City, Oklahoma
| | - Thomas Stasko
- Ms. Wang and Drs. Zhang and Kaffenberger are with the Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center in Columbus, Ohio
- Dr. Alloo is with the Department of Dermatology at Hofstra Northwell School of Medicine in New Hyde Park, New York
- Dr. Stasko and Mr. Miller are with the Department of Dermatology at the University of Oklahoma in Oklahoma City, Oklahoma
| | - Jordan E Miller
- Ms. Wang and Drs. Zhang and Kaffenberger are with the Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center in Columbus, Ohio
- Dr. Alloo is with the Department of Dermatology at Hofstra Northwell School of Medicine in New Hyde Park, New York
- Dr. Stasko and Mr. Miller are with the Department of Dermatology at the University of Oklahoma in Oklahoma City, Oklahoma
| | - Jessica A Kaffenberger
- Ms. Wang and Drs. Zhang and Kaffenberger are with the Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center in Columbus, Ohio
- Dr. Alloo is with the Department of Dermatology at Hofstra Northwell School of Medicine in New Hyde Park, New York
- Dr. Stasko and Mr. Miller are with the Department of Dermatology at the University of Oklahoma in Oklahoma City, Oklahoma
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Wang RF, Kaffenberger BH, Kaffenberger JA. A Retrospective Review of New-onset Dermatitis in Patients Aged 60 Years or Older. J Clin Aesthet Dermatol 2018; 11:19-20. [PMID: 29410725 PMCID: PMC5788263] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Background: New-onset dermatitis in the elderly can be attributed to a variety of disease processes. We defined new-onset dermatitis in which the etiology is attributed solely to age-related processes as "dermatitis of immune senescence"-a diagnosis of exclusion based on clinical presentation and further diagnostic testing. Objective: Retrospective cohort of elderly patients with new-onset dermatitis to examine the differences in demographics, work-up, and treatments between patients with dermatitis of immune senescence and those patients ultimately given more specific diagnoses. Methods: Four hundred and thirty-three patients aged 60 years and older with new-onset dermatitis from 2011 to 2016 at Ohio State University were identified by chart review and categorized as "dermatitis of immune senescence" or "alternate diagnosis" based on patch testing, biopsy, and physician documentation. Results: In this subset of patients, 10.2 percent (44/433) underwent patch testing and 16.2 percent (70/433) underwent biopsy. Furthermore, 86.4 percent of patients who underwent patch testing (38/44) and 57.1 percent who underwent biopsy (40/70) were given a more specific diagnosis following their test. Use of intramuscular steroids (p<.001), oral steroids (p=.004), and antihistamines (p=.002) were significantly higher in the alternate diagnosis group. Conclusion: The low rate of patch testing and biopsy and the high rate of diagnosis change post-procedure demonstrate an underutilization of diagnostic testing in this population.
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Affiliation(s)
- Rebecca F Wang
- Ms. Wang and Drs. B. Kaffenberger and J. Kaffenberger are with the Department of Internal Medicine, Division of Dermatology, at The Ohio State University Wexner Medical Center in Columbus, Ohio
| | - Benjamin H Kaffenberger
- Ms. Wang and Drs. B. Kaffenberger and J. Kaffenberger are with the Department of Internal Medicine, Division of Dermatology, at The Ohio State University Wexner Medical Center in Columbus, Ohio
| | - Jessica A Kaffenberger
- Ms. Wang and Drs. B. Kaffenberger and J. Kaffenberger are with the Department of Internal Medicine, Division of Dermatology, at The Ohio State University Wexner Medical Center in Columbus, Ohio
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Wang RF, Zhang M, Kaffenberger JA. Does the dermatology standardized letter of recommendation alter applicants' chances of matching into residency? J Am Acad Dermatol 2017; 77:e139-e140. [DOI: 10.1016/j.jaad.2017.05.058] [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: 05/21/2017] [Accepted: 05/28/2017] [Indexed: 10/18/2022]
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Yanes DA, Kaffenberger JA, Carr DR. Erythema multiforme as a reaction to imiquimod 5% cream. Dermatol Online J 2017; 23:13030/qt0r2992mq. [PMID: 28329504] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 02/16/2017] [Indexed: 06/06/2023] Open
Abstract
We describe a patient with erythema multiformefollowing a local site reaction after the use of topicalimiquimod 5% cream and review the literature forprevious reports of this cutaneous adverse effect.
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Affiliation(s)
- Daniel A Yanes
- College of Medicine, The Ohio State University, Columbus
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Kaffenberger JA, Mosser J, Lee G, Pootrakul L, Harfmann K, Fabbro S, Faith EF, Carr D, Plotner A, Zirwas M, Kaffenberger BH. A Retrospective Analysis Comparing the New Standardized Letter of Recommendation in Dermatology with the Classic Narrative Letter of Recommendation. J Clin Aesthet Dermatol 2016; 9:36-42. [PMID: 27878060 PMCID: PMC5110327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Background: In an effort to avoid numerous problems associated with narrative letters of recommendation, a dermatology standardized letter of recommendation was utilized in the 2014-2015 resident application cycle. Objective: A comparison of the standardized letter of recommendation and narrative letters of recommendation from a single institution and application cycle to determine if the standardized letter of recommendation met its original goals of efficiency, applicant stratification, and validity. Methods: Eight dermatologists assessed all standardized letters of recommendation/narrative letters of recommendation pairs received during the 2014-2015 application cycle. Five readers repeated the analysis two months later. Each letter of recommendation was evaluated based on a seven question survey. Letter analysis and survey completion for each letter was timed. Results: Compared to the narrative letters of recommendation, the standardized letter of recommendation is easier to interpret (p<0.0001), has less exaggeration of applicants' positive traits (p<0.001), and has higher inter-rater and intrarater reliability for determining applicant traits including personality, reliability, work-ethic, and global score. Standardized letters of recommendation are also faster to interpret (p<0.0001) and provide more information about the writer's background or writer-applicant relationship than narrative letters of recommendation (p<0.001). Limitations: This study was completed at a single institution. Conclusions: The standardized letter of recommendation appears to be meeting its initial goals of 1) efficiency, 2) applicant stratification, and 3) validity. (J Clin Aesthet Dermatol. 2016;9(9):36-2.).
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Affiliation(s)
- Jessica A Kaffenberger
- Department of Internal Medicine, Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Joy Mosser
- Department of Pediatrics, Division of Pediatric Dermatology, The Ohio State University and Nationwide Children's Hospital, Columbus, Ohio
| | - Grace Lee
- Department of Internal Medicine, Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Llana Pootrakul
- Department of Internal Medicine, Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Katya Harfmann
- Department of Pediatrics, Division of Pediatric Dermatology, The Ohio State University and Nationwide Children's Hospital, Columbus, Ohio
| | - Stephanie Fabbro
- Department of Internal Medicine, Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Esteban Fernandez Faith
- Department of Pediatrics, Division of Pediatric Dermatology, The Ohio State University and Nationwide Children's Hospital, Columbus, Ohio
| | - David Carr
- Department of Internal Medicine, Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Alisha Plotner
- Department of Internal Medicine, Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Matthew Zirwas
- Department of Internal Medicine, Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Benjamin H Kaffenberger
- Department of Internal Medicine, Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
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Kaffenberger BH, Kaffenberger JA, Wong H, Jarjour W, Levin D, Bechtel MA. Magnetic resonance elastography and transient elastography as non-invasive analyses for liver fibrosis: can they obviate the need for liver biopsy in psoriasis patients treated with methotrexate? Int J Dermatol 2016; 54:752-6. [PMID: 26108262 DOI: 10.1111/ijd.12923] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The liver biopsy has been regarded as the reference standard method of monitoring hepatic fibrosis in psoriasis patients treated with methotrexate. It has also been subject to concerns over sampling error, internal and external variability, and potential for morbidity and mortality. During the past two decades, two imaging techniques, magnetic resonance elastography and transient elastography, have been developed and approved by the US Food and Drug Administration (FDA) for the assessment of hepatic fibrosis. Although high-quality, psoriasis-specific data are lacking, both methods have been shown to have outstanding efficacy in the detection of hepatic fibrosis, particularly the more advanced stages which may warrant the choice of a therapeutic alternative to methotrexate. Dermatologists should be aware of the availability of these tests and understand their limitations. Prospective studies in psoriasis and methotrexate management using these techniques are needed.
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Affiliation(s)
| | - Jessica A Kaffenberger
- Department of Dermatology, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Henry Wong
- Department of Dermatology, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Wael Jarjour
- Department of Rheumatology, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Douglas Levin
- Department of Gastroenterology, Hepatology and Nutrition, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Mark A Bechtel
- Department of Dermatology, Ohio State University Wexner Medical Center, Columbus, OH, USA
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