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Shaker N, Phelps R, Niedt G, Sangueza OP, Youngs J, Lauer S, Pradhan D. Cutaneous Syncytial Myoepithelioma: An Uncommon and Distinct Variant of Cutaneous Epithelioid Neoplasm. Am J Dermatopathol 2024:00000372-990000000-00324. [PMID: 38574041 DOI: 10.1097/dad.0000000000002691] [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: 04/06/2024]
Abstract
BACKGROUND Cutaneous syncytial myoepithelioma (CSM) is an uncommon and distinct variant of cutaneous myoepithelioma. We aim to present a case of CSM to enhance the recognition of this unique variant, encompassing its clinical characteristics, histopathological features, immunohistochemical staining, and therapeutic approaches. CASE PRESENTATION A 10-year-old girl presented with a dome-shaped nodule located on the skin of her left medial distal arm. Microscopic examination of the skin biopsy revealed a well-defined dermal nodular lesion, surrounded by an epidermal collarette. Tumor cells were composed of epithelioid to spindle-shaped cells with round-to-oval nuclei, small nucleoli, and abundant eosinophilic cytoplasm with a syncytial-like growth pattern. A moderate degree of nuclear pleomorphism was noted. Mitotic activity was not prominent. Immunohistochemical staining revealed positive staining for epithelial membrane antigen, GLUT1, collagen IV, and S100. Smooth muscle actin, CD10, and CD68 showed patchy positivity. CD31, CD34, p63, SOX10, anaplastic lymphoma kinase (ALK), glial fibrillary acidic protein, pankeratin (AE1/AE3/PCK26), Melan-A, and CD1a were negative. Fluorescence in situ hybridization targeting TFE3 and ALK genes was negative. The differential diagnosis included ALK-negative epithelioid cell histiocytoma, epithelioid perineurioma, and CSM. Based on the above findings, a diagnosis of CSM was rendered. DISCUSSION CSM is a benign cutaneous neoplasm composed of sheets of histiocytoid or short spindle cells with pale eosinophilic cytoplasm with a syncytial-like growth pattern. Clinically, CSM often presents as a painless, slow-growing nodule or plaque in a broad anatomical distribution with a preference for the distal extremities.. CSM is characteristically positive for epithelial membrane antigen (EMA) and S100 protein and negative for keratins. In challenging cases, molecular testing for EWSR1 gene rearrangement and EWSR1-PBX3 gene fusion aid in confirming the diagnosis. CONCLUSIONS The histologic features of CSM present a unique set of challenges posing a diagnostic dilemma, as they can bear resemblance to a range of benign and malignant cutaneous neoplasms including ALK-negative epithelioid cell histiocytoma, epithelioid perineurioma, malignant or nevoid melanoma, and epithelioid sarcoma. An accurate diagnosis is crucial for guiding proper clinical management considering that this entity typically demonstrates an excellent prognosis following a complete surgical excision.
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Affiliation(s)
- Nada Shaker
- Department of Pathology, The Ohio State University Wexner Medical Center/James Cancer Hospital, Columbus, OH
| | - Robert Phelps
- Departments of Dermatology and Pathology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - George Niedt
- Departments of Dermatology and Pathology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Omar P Sangueza
- Department of Pathology and Dermatology, Wake Forest University, School of Medicine, Medical Center Boulevard, Winston-Salem, NC; and
| | - Julie Youngs
- Department of Pathology & Microbiology, University of Nebraska Medical Center, Nebraska Medical Center, Omaha, NE
| | - Scott Lauer
- Department of Pathology & Microbiology, University of Nebraska Medical Center, Nebraska Medical Center, Omaha, NE
| | - Dinesh Pradhan
- Department of Pathology & Microbiology, University of Nebraska Medical Center, Nebraska Medical Center, Omaha, NE
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Shaker N, Phelps R, Niedt G, Sangueza OP, Pradhan D. Indurated Erythematous Lesions of Bilateral Breasts in a Middle-Aged Woman: Challenge. Am J Dermatopathol 2024; 46:e1-e2. [PMID: 38086091 DOI: 10.1097/dad.0000000000002586] [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] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Affiliation(s)
- Nada Shaker
- Department of Pathology, The Ohio State University, Wexner Medical Center, Columbus, OH
| | - Robert Phelps
- Icahn School of Medicine at Mount Sinai, New York, NY
- Division of Dermatopathology, Departments of Dermatology and Pathology, Mount Sinai Medical Center, New York, NY
| | - George Niedt
- Icahn School of Medicine at Mount Sinai, New York, NY
- Division of Dermatopathology, Departments of Dermatology and Pathology, Mount Sinai Medical Center, New York, NY
| | - Omar P Sangueza
- Departments of Dermatology and Pathology, Wake Forest University, School of Medicine, Medical Center Boulevard Winston-Salem, NC; and
| | - Dinesh Pradhan
- Department of Dermatopathology, The University of Nebraska Medical Center, Omaha, NE
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Shaker N, Phelps R, Niedt G, Sangueza OP, Pradhan D. Diffuse Dermal Angiomatosis of Bilateral Breasts, A Distinct Entity of Reactive Angiomatoses: A Clinicopathologic Challenge. Am J Dermatopathol 2024; 46:60-61. [PMID: 38086087 DOI: 10.1097/dad.0000000000002587] [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] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Affiliation(s)
- Nada Shaker
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Robert Phelps
- Departments of Dermatology and Pathology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - George Niedt
- Departments of Dermatology and Pathology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Omar P Sangueza
- Departments of Dermatology and Pathology, Wake Forest University, School of Medicine, Medical Center Boulevard, Winston-Salem, NC; and
| | - Dinesh Pradhan
- Department of Dermatopathology, The University of Nebraska Medical Center, Omaha, NE
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Shaker N, Phelps R, Cabala CT, Niedt G, Sangueza OP, Pradhan D. Cutaneous Involvement by Diffuse Large B-Cell Lymphoma With Dual B-Cell and T-Cell Clonality and Heavy Admixed T-Cell Infiltrate: Answer. Am J Dermatopathol 2023; 45:859-860. [PMID: 37982471 DOI: 10.1097/dad.0000000000002576] [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] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Affiliation(s)
- Nada Shaker
- Department of Pathology, The Ohio State University, Wexner Medical Center, Columbus, OH
| | - Robert Phelps
- Department of Dermatology, Mount Sinai Medical Center, New York, NY
- Department of Dermatopathology, Mount Sinai Medical Center, New York, NY
| | - Carlos Torres Cabala
- Department of Dermatopathology and Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - George Niedt
- Department of Dermatology, Mount Sinai Medical Center, New York, NY
- Department of Dermatopathology, Mount Sinai Medical Center, New York, NY
| | - Omar P Sangueza
- Department of Dermatology, Wake Forest University, School of Medicine, Medical Center BoulevardWinston-Salem, NC
- Department of Dermatopathology, Wake Forest University, School of Medicine, Medical Center BoulevardWinston-Salem, NC; and
| | - Dinesh Pradhan
- Department of Pathology & Microbiology, University of Nebraska Medical Center, Nebraska Medical Center, Omaha, NE
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Shaker N, Phelps R, Cabala CT, Niedt G, Sangueza OP, Pradhan D. Navigating the Complexity of Dual Clonality in Cutaneous Lymphoma: Challenge. Am J Dermatopathol 2023; 45:e103-e104. [PMID: 37982477 DOI: 10.1097/dad.0000000000002575] [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] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Affiliation(s)
- Nada Shaker
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Robert Phelps
- Departments of Dermatology and Dermatopathology, Mount Sinai Medical Center, New York, NY
| | - Carlos Torres Cabala
- Department of Dermatopathology and Pathology, The University of Texas, MD Anderson Cancer Center, Houston, TX
| | - George Niedt
- Departments of Dermatology and Dermatopathology, Mount Sinai Medical Center, New York, NY
| | - Omar P Sangueza
- Departments of Dermatology and Dermatopathology, Wake Forest University, School of Medicine, Medical Center Boulevard, Winston-Salem, NC; and
| | - Dinesh Pradhan
- Department of Pathology & Microbiology, University of Nebraska Medical Center, Nebraska Medical Center, Omaha, NE
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Jostes S, Vardabasso C, Dong J, Carcamo S, Singh R, Phelps R, Meadows A, Hasson D, Bernstein E. H2A.Z chaperones converge on histone H4 acetylation for melanoma cell proliferation. bioRxiv 2023:2023.11.26.568747. [PMID: 38076914 PMCID: PMC10705243 DOI: 10.1101/2023.11.26.568747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
High levels of H2A.Z promote melanoma cell proliferation and correlate with poor prognosis. However, the role of the two distinct H2A.Z histone chaperone complexes, SRCAP and P400-TIP60, in melanoma remains unclear. Here, we show that individual depletion of SRCAP, P400, and VPS72 (YL1) not only results in loss of H2A.Z deposition into chromatin, but also a striking reduction of H4 acetylation in melanoma cells. This loss of H4 acetylation is found at the promoters of cell cycle genes directly bound by H2A.Z and its chaperones, suggesting a highly coordinated regulation between H2A.Z deposition and H4 acetylation to promote their expression. Knockdown of each of the three subunits downregulates E2F1 and its targets, resulting in a cell cycle arrest akin to H2A.Z depletion. However, unlike H2A.Z deficiency, loss of the shared H2A.Z chaperone subunit YL1 induces apoptosis. Furthermore, YL1 is overexpressed in melanoma tissues, and its upregulation is associated with poor patient outcome. Together, these findings provide a rationale for future targeting of H2A.Z chaperones as an epigenetic strategy for melanoma treatment.
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Affiliation(s)
- Sina Jostes
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Chiara Vardabasso
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joanna Dong
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Saul Carcamo
- Bioinformatics for Next Generation Sequencing Facility, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rajendra Singh
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert Phelps
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Austin Meadows
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dan Hasson
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Bioinformatics for Next Generation Sequencing Facility, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Emily Bernstein
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Shaker N, Niedt G, Kasago I, Patel A, Phelps R, Pradhan D. Isolated Primary Langerhans Cell Histiocytosis of the Vulva: Answer. Am J Dermatopathol 2023; 45:776. [PMID: 37856743 DOI: 10.1097/dad.0000000000002545] [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] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Affiliation(s)
- Nada Shaker
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - George Niedt
- Departments of Dermatology and Dermatopathology, Mount Sinai Medical Center, New York, NY
| | - Israel Kasago
- Department of Dermatopathology, Mount Sinai Medical Center, New York, NY
| | - Ankush Patel
- Department of Pathology. Mayo Clinic Medical Center, Mayo Clinic, Rochester, MN; and
| | - Robert Phelps
- Departments of Dermatology and Dermatopathology, Mount Sinai Medical Center, New York, NY
| | - Dinesh Pradhan
- Department of Pathology & Microbiology, University of Nebraska Medical Center, Nebraska Medical Center, Omaha, NE
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Shaker N, Niedt G, Kasago I, Patel A, Phelps R, Pradhan D. A Rare Presentation of an Isolated Vulvar Lesion in an Elderly Female: Challenge. Am J Dermatopathol 2023; 45:e93-e94. [PMID: 37856747 DOI: 10.1097/dad.0000000000002544] [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] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Affiliation(s)
- Nada Shaker
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - George Niedt
- Departments of Dermatology and Dermatopathology, Mount Sinai Medical Center, New York, NY
| | - Israel Kasago
- Department of Dermatopathology, Mount Sinai Medical Center, New York, NY
| | - Ankush Patel
- Department of Pathology, Mayo Clinic, Rochester, MN
| | - Robert Phelps
- Departments of Dermatology and Dermatopathology, Mount Sinai Medical Center, New York, NY
| | - Dinesh Pradhan
- Department of Pathology & Microbiology, University of Nebraska Medical Center, Nebraska Medical Center, Omaha, NE
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9
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Shaker N, Phelps R, Niedt G, Patel A, Wu D, Aung PP, Prieto V, Church A, Pradhan D. Cutaneous Atypical Fibroxanthoma With Osteoclast-Like Giant Cell: A Rare but Diagnostic Pitfall. Am J Dermatopathol 2023; 45:704-707. [PMID: 37708369 DOI: 10.1097/dad.0000000000002508] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
BACKGROUND Atypical fibroxanthoma (AFX) is a dermal-based, low-grade neoplasm with no specific lineage of differentiation. The occurrence of AFX with osteoclast-like giant cells is exceptionally rare. Less than 20 cases have been reported in the literature. CASE PRESENTATION A 77-year-old man with a medical history of multiple basal and squamous cell carcinomas of the skin, presented with a progressively growing erythematous nodule on the sun-damaged right central parietal scalp. A shave biopsy showed a dermal spindle cell proliferation accompanied by numerous osteoclast-like multinucleated giant cells and predominant atypical mitotic figures. The immunohistochemical staining showed a diffuse positive staining for CD68 and SMA, patchy staining for CD10, and negative staining for SOX-10, pan-cytokeratin, CK5/6, S100, CD34, and desmin. The tumor was completely excised with negative margins. A subsequent follow-up over a period of 13 months showed no recurrence. CONCLUSION Distinguishing AFX with osteoclast-like giant cells from both malignant and benign skin lesions with osteoclast-like giant cells is crucial. Although AFX tumors display worrisome malignant histologic features, most cases have a favorable prognosis with a local recurrence rate below 5% and exceedingly rare metastasis.
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Affiliation(s)
- Nada Shaker
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Robert Phelps
- Departments of Dermatology and Dermatopathology, Mount Sinai Medical Center, New York, NY
| | - George Niedt
- Departments of Dermatology and Dermatopathology, Mount Sinai Medical Center, New York, NY
| | - Ankush Patel
- Department of Pathology, Mayo Clinic, Rochester, MN
| | - Douglas Wu
- The Ohio State University Wexner Medical Center, Columbus, OH
| | - Phyu P Aung
- Department of Dermatopathology and Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Victor Prieto
- Department Chair, Department of Dermatopathology, The University of Texas MD Anderson Cancer Center, Houston, TX; and
| | - Ann Church
- Department of Dermatopathology, The University of Nebraska Medical Center, Omaha, NE
| | - Dinesh Pradhan
- Department of Dermatopathology, The University of Nebraska Medical Center, Omaha, NE
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Levine J, Liu S, Alexander M, Phelps R. HTLV-1 Presenting as an Incidental Finding after a Cosmetic Procedure. Skinmed 2023; 21:285-287. [PMID: 37771025] [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] [Indexed: 09/30/2023]
Abstract
A 44-year-old woman presented to a plastic surgeon for liposuction of the abdomen, back, and flanks, a gluteal fat transfer, and a vertical pattern breast lift and small reduction. The patient had a medical history of significantly well-controlled hypertension for 4 years treated with hydrochlorothiazide and amlodipine. She had been pregnant four times and delivered six children with two sets of twins. She was allergic to latex and denied a history of smoking. Her physical examination was unremarkable and her body mass index (BMI) was 26.1. No skin lesions were evident (Figure 1). Her preoperative laboratory findings were within normal limits, with unremarkable electrocardiogram (EKG), chest x-ray, and mammogram. The patient underwent a successful surgical procedure, and the excised breast tissue and skin were sent to pathology for routine evaluation. Surgery removed 220 g of breast tissue from the left breast and 45 g was excised from the right one. The histopathology depicted atypical T-cells in the epidermis and superficial dermis of both left and right breasts. Physical examination failed to evidence lymph-adenopathy or masses. The patient denied weight loss, night sweats, or fever; however, due to her Caribbean heritage, adult T-cell leukemia/ lymphoma was considered and submitted for further histologic workup.
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Affiliation(s)
- Jasmine Levine
- The Division of Dermatopathology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Stephanie Liu
- The Division of Dermatopathology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Melissa Alexander
- The Division of Dermatopathology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Robert Phelps
- The Division of Dermatopathology, Icahn School of Medicine at Mount Sinai, New York, NY;
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Bitterman A, Zundell MP, Psomadakis C, Kasago I, Phelps R, Niedt G, Khattri S. Halogen halos: Report of an early histopathologic finding in iododerma. J Cutan Pathol 2023; 50:806-809. [PMID: 37394806 DOI: 10.1111/cup.14489] [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: 01/18/2023] [Revised: 06/05/2023] [Accepted: 06/13/2023] [Indexed: 07/04/2023]
Abstract
Iododerma is a rare cutaneous eruption that manifests after exposure to iodine-containing compounds, with few cases reported in the literature. Previous reports of this halogenoderma have described acellular halos simulating cryptococcus on histopathological examination but there is a paucity of reports of biopsies taken early in the disease course. We present a case of a 78-year-old patient who developed a papular eruption after receiving iodinated contrast. A skin biopsy taken within 24 h of the eruption showed a neutrophilic infiltrate with cryptococcal-like acellular haloed structures, indicating that the diagnostic finding may be found early in the disease course.
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Affiliation(s)
- Avi Bitterman
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Melissa Peri Zundell
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Corinna Psomadakis
- Department of Internal Medicine, Mount Sinai Morningside, New York, New York, USA
| | - Israel Kasago
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Robert Phelps
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - George Niedt
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Saakshi Khattri
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Bronin A, Phelps R, Sidbury R. Beyond JAAD July 2021: Articles of interest to dermatologists from the nondermatologic literature. J Am Acad Dermatol 2021; 85:279-283. [PMID: 33848607 DOI: 10.1016/j.jaad.2021.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 04/05/2021] [Indexed: 10/21/2022]
Affiliation(s)
| | - Robert Phelps
- Icahn School of Medicine at Mount Sinai, New York, New York
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Aina DA, Jobarteh R, Alawadhi A, Phelps R, Silverberg N. A case of neutrophilic superficial eccrine ductitis. JAAD Case Rep 2021; 11:69-71. [PMID: 33898685 PMCID: PMC8060513 DOI: 10.1016/j.jdcr.2021.02.003] [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: 11/28/2022] Open
Affiliation(s)
- Deborah A Aina
- Saba University School of Medicine, The Bottom, Saba, Caribbean, Netherlands
| | - Ruth Jobarteh
- Department of Dermatology, Icahn School of Medicine at Mount Sinai Hospital, New York, New York
| | - Ameen Alawadhi
- Department of Pathology, Icahn School of Medicine at Mount Sinai Hospital, New York, New York
| | - Robert Phelps
- Department of Pathology, Icahn School of Medicine at Mount Sinai Hospital, New York, New York
| | - Nanette Silverberg
- Department of Dermatology, Icahn School of Medicine at Mount Sinai Hospital, New York, New York
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Affiliation(s)
- Andrew Bronin
- Department of Dermatology, Yale University, New Haven, Connecticut.
| | - Robert Phelps
- Department of Dermatopathology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Robert Sidbury
- Department of Dermatology, Seattle Children's Hospital/University of Washington School of Medicine, Seattle, Washington
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Bronin A, Phelps R, Sidbury R. Beyond JAAD January 2021. J Am Acad Dermatol 2020; 84:231-233. [PMID: 33039487 DOI: 10.1016/j.jaad.2020.10.006] [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: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Andrew Bronin
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut.
| | - Robert Phelps
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Robert Sidbury
- Division of Dermatology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington
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Bronin A, Phelps R, Sidbury R. Beyond JAAD October 2020: Articles of interest to dermatologists from the nondermatologic literature. J Am Acad Dermatol 2020; 83:1233-1236. [PMID: 32652188 PMCID: PMC7341032 DOI: 10.1016/j.jaad.2020.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 07/04/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Andrew Bronin
- Department of Dermatology, Yale Medical School, Yale University, New Haven, Connecticut.
| | - Robert Phelps
- Icahn School of Medicine at Mount Sinai, New York, New York
| | - Robert Sidbury
- Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington
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Gruber CN, Calis JJA, Buta S, Evrony G, Martin JC, Uhl SA, Caron R, Jarchin L, Dunkin D, Phelps R, Webb BD, Saland JM, Merad M, Orange JS, Mace EM, Rosenberg BR, Gelb BD, Bogunovic D. Complex Autoinflammatory Syndrome Unveils Fundamental Principles of JAK1 Kinase Transcriptional and Biochemical Function. Immunity 2020; 53:672-684.e11. [PMID: 32750333 PMCID: PMC7398039 DOI: 10.1016/j.immuni.2020.07.006] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/02/2020] [Accepted: 07/08/2020] [Indexed: 01/08/2023]
Abstract
Autoinflammatory disease can result from monogenic errors of immunity. We describe a patient with early-onset multi-organ immune dysregulation resulting from a mosaic, gain-of-function mutation (S703I) in JAK1, encoding a kinase essential for signaling downstream of >25 cytokines. By custom single-cell RNA sequencing, we examine mosaicism with single-cell resolution. We find that JAK1 transcription was predominantly restricted to a single allele across different cells, introducing the concept of a mutational “transcriptotype” that differs from the genotype. Functionally, the mutation increases JAK1 activity and transactivates partnering JAKs, independent of its catalytic domain. S703I JAK1 is not only hypermorphic for cytokine signaling but also neomorphic, as it enables signaling cascades not canonically mediated by JAK1. Given these results, the patient was treated with tofacitinib, a JAK inhibitor, leading to the rapid resolution of clinical disease. These findings offer a platform for personalized medicine with the concurrent discovery of fundamental biological principles. Janus kinase (JAK1) mutation underlies monogenic autoinflammatory disease S703I mutation enhances downstream signaling by transactivation of partnering JAKs Mosaicism and monoallelic expression shape JAK1 transcription patterns JAK inhibitor therapy resolves clinical disease
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Affiliation(s)
- Conor N Gruber
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Jorg J A Calis
- Program in Immunogenomics, The Rockefeller University, New York, NY 10065, USA; Laboratory of Virology and Infectious Disease, The Rockefeller University, New York, NY 10065, USA; Center for Translational Immunology, Department of Pediatric Immunology & Rheumatology, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands
| | - Sofija Buta
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Gilad Evrony
- Center for Genetics and Genomics, New York University Grossman School of Medicine, New York, NY, USA
| | - Jerome C Martin
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Université de Nantes, Inserm, CHU Nantes, Centre de Recherche en Transplantation et Immunologie, UMR 1064, ITUN, 44000 Nantes, France; CHU Nantes, Laboratoire d'Immunologie, Center for Immuno Monitoring Nantes-Atlantique (CIMNA), 44000 Nantes, France
| | - Skyler A Uhl
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Rachel Caron
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Lauren Jarchin
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - David Dunkin
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Robert Phelps
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Bryn D Webb
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Jeffrey M Saland
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Miriam Merad
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Jordan S Orange
- Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Emily M Mace
- Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Brad R Rosenberg
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Bruce D Gelb
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Dusan Bogunovic
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
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Bronin A, Phelps R, Sidbury R. Beyond JAAD July 2020: Articles of interest to dermatologists from the nondermatologic literature. J Am Acad Dermatol 2020; 83:310-313. [DOI: 10.1016/j.jaad.2020.04.036] [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] [Received: 04/06/2020] [Accepted: 04/06/2020] [Indexed: 10/24/2022]
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19
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Chang LW, Iqbal R, Badal B, Bernstein D, Mendelson K, Solovyov A, Friedlander P, Phelps R, Goodheart H, Desman G, Greenbaum BD, Tok Celebi J. Genomic analysis of metastatic melanoma in an adult with giant congenital melanocytic nevus. Pigment Cell Melanoma Res 2020; 33:633-636. [PMID: 32096295 DOI: 10.1111/pcmr.12872] [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] [Indexed: 11/30/2022]
Affiliation(s)
- Li-Wei Chang
- Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Ramiz Iqbal
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Brateil Badal
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Daniel Bernstein
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Karen Mendelson
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Alexander Solovyov
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York.,Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.,Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.,Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Philip Friedlander
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.,Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Robert Phelps
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York.,Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Herbert Goodheart
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Garrett Desman
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Benjamin D Greenbaum
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York.,Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.,Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.,Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Julide Tok Celebi
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York.,Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.,Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.,Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
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Abstract
Lichen myxedematosus (LM) is an idiopathic cutaneous mucinosis, commonly described as localized scleromyxedema. In contrast to scleromyxedema, there is typically no systemic involvement. Treatment options are limited and spontaneous resolution has been reported. We present the case of a 66-year-old Hispanic male referred by his primary care physician for evaluation of asymptomatic dark spots on his trunk and extremities present for about one-year. Physical exam revealed smooth, brown hyperpigmented papules coalescing into plaques on the trunk. Multiple well-demarcated oval dark brown plaques measuring 3 cm in size were located on the upper back, peri-umbilical area, bilateral lower extremities, and buttocks. A diagnosis of lichen myxedematosus was made based on histologic features observed in the dermis. There are 5 subtypes of LM: a discrete papular form, acral persistent papular mucinosis, self-healing papular mucinosis, papular mucinosis of infancy, and a pure nodular form. Occasional patients with LM have atypical features or features intermediate between scleromyxedema and localized LM. We present a case of atypical LM with mixed features of the different subtypes. Herein we will review the varied clinical presentations of LM and highlight the distinguishing features of scleromyxedema. J Drugs Dermatol. 2020;19(3): 320-322 doi:10.36849/JDD.2020.4864.
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21
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Bronin A, Phelps R, Sidbury R. Beyond JAAD January 2020: Articles of interest to dermatologists from the nondermatologic literature. J Am Acad Dermatol 2020; 82:263-266. [DOI: 10.1016/j.jaad.2019.10.031] [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] [Received: 10/13/2019] [Accepted: 10/14/2019] [Indexed: 10/25/2022]
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22
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Kulkarni PM, Robinson EJ, Sarin Pradhan J, Gartrell-Corrado RD, Rohr BR, Trager MH, Geskin LJ, Kluger HM, Wong PF, Acs B, Rizk EM, Yang C, Mondal M, Moore MR, Osman I, Phelps R, Horst BA, Chen ZS, Ferringer T, Rimm DL, Wang J, Saenger YM. Deep Learning Based on Standard H&E Images of Primary Melanoma Tumors Identifies Patients at Risk for Visceral Recurrence and Death. Clin Cancer Res 2019; 26:1126-1134. [PMID: 31636101 PMCID: PMC8142811 DOI: 10.1158/1078-0432.ccr-19-1495] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 08/09/2019] [Accepted: 10/16/2019] [Indexed: 12/22/2022]
Abstract
PURPOSE Biomarkers for disease-specific survival (DSS) in early-stage melanoma are needed to select patients for adjuvant immunotherapy and accelerate clinical trial design. We present a pathology-based computational method using a deep neural network architecture for DSS prediction. EXPERIMENTAL DESIGN The model was trained on 108 patients from four institutions and tested on 104 patients from Yale School of Medicine (YSM, New Haven, CT). A receiver operating characteristic (ROC) curve was generated on the basis of vote aggregation of individual image sequences, an optimized cutoff was selected, and the computational model was tested on a third independent population of 51 patients from Geisinger Health Systems (GHS). RESULTS Area under the curve (AUC) in the YSM patients was 0.905 (P < 0.0001). AUC in the GHS patients was 0.880 (P < 0.0001). Using the cutoff selected in the YSM cohort, the computational model predicted DSS in the GHS cohort based on Kaplan-Meier (KM) analysis (P < 0.0001). CONCLUSIONS The novel method presented is applicable to digital images, obviating the need for sample shipment and manipulation and representing a practical advance over current genetic and IHC-based methods.
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Affiliation(s)
- Prathamesh M Kulkarni
- Department of Psychiatry, School of Medicine, NYU School of Medicine, New York, New York
| | - Eric J Robinson
- Department of Anesthesiology, Perioperative Care and Pain Medicine, NYU School of Medicine, New York, New York
| | - Jaya Sarin Pradhan
- Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | | | - Bethany R Rohr
- Department of Pathology, Geisinger Health System, Danville, Pennsylvania
| | - Megan H Trager
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Larisa J Geskin
- Department of Dermatology, Columbia University Irving Medical Center, New York, New York
| | - Harriet M Kluger
- Department of Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Pok Fai Wong
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut
| | - Balazs Acs
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut
- Department of Oncology and Pathology, Karolinska Institute, Stockholm, Sweden
| | - Emanuelle M Rizk
- Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Chen Yang
- Department of Medicine, Jiaotong University School of Medicine, Shanghai, China
| | - Manas Mondal
- Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Michael R Moore
- Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Iman Osman
- Departments of Dermatology, Medicine, and Urology, NYU School of Medicine, New York, New York
| | - Robert Phelps
- Departments of Pathology and Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Basil A Horst
- Department of Pathology, University of British Columbia, Vancouver, Canada
| | - Zhe S Chen
- Department of Psychiatry, School of Medicine, NYU School of Medicine, New York, New York
- Department of Neuroscience and Physiology, NYU School of Medicine, New York, New York
| | - Tammie Ferringer
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - David L Rimm
- Department of Dermatology, Columbia University Irving Medical Center, New York, New York
| | - Jing Wang
- Department of Anesthesiology, Perioperative Care and Pain Medicine, NYU School of Medicine, New York, New York.
- Department of Neuroscience and Physiology, NYU School of Medicine, New York, New York
| | - Yvonne M Saenger
- Department of Medicine, Columbia University Irving Medical Center, New York, New York.
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Liu S, Aldarragi A, Mullen L, Chaudhry I, Arti B, Phelps R. Persistent cheek lesion with surrounding clusters. J Clin Pathol 2019; 73:362. [PMID: 31600133 DOI: 10.1136/jclinpath-2019-206165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 09/14/2019] [Indexed: 11/04/2022]
Affiliation(s)
- Stephanie Liu
- Pathology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | | | - Linda Mullen
- Pathology, Royal Liverpool University Hospital, Liverpool, UK
| | | | - Bakshi Arti
- Pathology, Royal Liverpool University Hospital, Liverpool, UK
| | - Robert Phelps
- Pathology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
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24
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Bronin A, Phelps R, Sidbury R. Beyond JAAD October 2019: Articles of interest to dermatologists from the nondermatologic literature. J Am Acad Dermatol 2019; 81:1033-1036. [DOI: 10.1016/j.jaad.2019.07.010] [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] [Received: 07/07/2019] [Accepted: 07/07/2019] [Indexed: 11/30/2022]
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25
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Bronin A, Phelps R, Sidbury R. Beyond JAAD July 2019: Articles of interest to dermatologists from the nondermatologic literature. J Am Acad Dermatol 2019; 81:306-309. [DOI: 10.1016/j.jaad.2019.04.016] [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] [Received: 04/05/2019] [Accepted: 04/06/2019] [Indexed: 11/29/2022]
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26
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Robinson E, Kulkarni PM, Pradhan JS, Gartrell RD, Yang C, Rizk EM, Acs B, Rohr B, Phelps R, Ferringer T, Horst B, Rimm DL, Wang J, Saenger YM. Prediction of distant melanoma recurrence from primary tumor digital H&E images using deep learning. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.9577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9577 Background: Patients with resected melanoma are at high risk for systemic recurrence. Quantifying the risk of recurrence can help identify the need for adjuvant immunotherapies, and accelerate the acquisition of survival statistics in clinical trials. Methods: 75 patients with stages I, II, and III melanoma seen at Columbia University Medical Center between 2001 and 2014 and The Icahn School of Medicine at Mount Sinai between 2000 and 2010 were included based on availability of tissue and 24 months of clinical follow-up. Images were scanned into tiff files (Aperio Biosystems). Deep neural net (DNN) architecture was designed consisting of convolutional and recurrent neural networks (CNN, RNN). Using QuPath open source software for nuclear segmentation and cell classification, we generated cell location, density, and clustering features to identify tissue areas for training of network parameters. DNN analyzes image and feature information locally within an H&E image, generating a prediction vote per region, and votes are averaged. Results: The model was validated on two independent external sets of stage I-III primary melanomas. Cohort 1 (Yale Medical Center), had n = 86 patients, of whom 49 were alive or had no evidence of disease at death (no DMR) and 37 died from melanoma. The second set, Cohort 2 (Geisnger Health Systems), had n = 29 patients, 15 without DMR and 14 with DMR. Prediction scores correlated with DMR status in both sets (AUC = 0.94 and 0.77 for Cohorts 1 and 2, respectively). A multivariable Cox proportional hazard model showed DNN recurrence prediction to be an independent prognostic factor for both Cohort 1 (HR = 2.54, 95% CI: 1.54-4.19, p = .0004***) and Cohort 2 (HR = 8.43, 95% CI: 2.58-27.51, p = .001**). Conclusions: We designed a DNN for quantitative prediction of melanoma recurrence from a H&E stained tissue. The prediction score warrants further study in larger patient cohorts and may constitute a novel digital pathology tool for the selection of melanoma patients for adjuvant immunotherapy. [Table: see text]
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Affiliation(s)
- Eric Robinson
- New York University Department of Anesthesiology, Perioperative Care and Pain Medicine, New York, NY
| | | | | | | | - Chen Yang
- Jiaotong University School of Medicine, Shanghai, China
| | | | | | - Bethany Rohr
- Department of Pathology, Geisinger Health Systems, Danville, PA
| | | | | | - Basil Horst
- Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada
| | | | - Jing Wang
- New York University Department of Anesthesiology, Perioperative Care and Pain Medicine, New York, NY
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Bronin A, Phelps R, Sidbury R. Beyond JAAD April 2019: Articles of interest to dermatologists from the nondermatologic literature. J Am Acad Dermatol 2019; 80:1175-1178. [DOI: 10.1016/j.jaad.2018.12.061] [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] [Received: 12/30/2018] [Accepted: 12/31/2018] [Indexed: 11/28/2022]
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28
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Upadhyay A, Kaushik S, Routt E, Phelps R. Pustular vasculitis: Different names for same entity? Indian Dermatol Online J 2019; 10:721-723. [PMID: 31807459 PMCID: PMC6859773 DOI: 10.4103/idoj.idoj_415_18] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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29
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Bronin A, Phelps R, Sidbury R. Beyond JAAD January 2019: Articles of interest to dermatologists from the nondermatologic literature. J Am Acad Dermatol 2018; 80:296-300. [PMID: 30287308 DOI: 10.1016/j.jaad.2018.09.028] [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] [Received: 09/25/2018] [Accepted: 09/26/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Andrew Bronin
- Department of Dermatology, Yale Medical School, Yale University, New Haven, Connecticut.
| | - Robert Phelps
- Icahn School of Medicine at Mount Sinai, New York, New York
| | - Robert Sidbury
- Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington
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Bronin A, Phelps R, Sidbury R. Beyond JAAD October 2018: Articles of interest to dermatologists from the nondermatologic literature. J Am Acad Dermatol 2018; 79:785-788. [DOI: 10.1016/j.jaad.2018.06.066] [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] [Received: 06/28/2018] [Accepted: 06/30/2018] [Indexed: 10/28/2022]
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31
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Doktor V, Hadi A, Hadi A, Phelps R, Goodheart H. Erythema elevatum diutinum: a case report and review of literature. Int J Dermatol 2018; 58:408-415. [PMID: 30074624 DOI: 10.1111/ijd.14169] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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: 06/30/2017] [Revised: 07/04/2018] [Accepted: 07/07/2018] [Indexed: 01/19/2023]
Abstract
Erythema elevatum diutinum (EED) is a rare cutaneous leukocytoclastic vasculitis thought to be related to increased levels of circulating antibodies. It has been shown to be associated with HIV infection, tuberculosis, as well as various autoimmune diseases. A retrospective review of all cases of EED indexed in PubMed between 1990 and 2014 was performed. Inclusion criteria for articles was availability of full text in English and a biopsy-confirmed diagnosis of EED. All other articles were excluded. Cases were stratified by age and anatomic location of the lesions. Treatment response was coded as "complete," "partial," and "none." A total of 133 cases of EED with 381 lesions detailed in case reports and case series were included. Twenty-one cases were associated with HIV. Of 47 patients with reported paraproteinemias, IgA paraproteinemia was found in 57.45%, IgG paraproteinemia in 29.8%, IgM paraproteinemia in 10.6%, and IgD paraproteinemia in 2.1% of cases. Of 40 (30.1%) patients with reported comorbid autoimmune disease, rheumatoid arthritis was associated with 10 cases. Cancer was found to be associated with 9.77% of cases. Seventy-five patients were treated with dapsone, with 36 (48%) achieving complete treatment response, 24 (32%) achieving partial response, and seven (9.3%) achieving no response. Keeping the clinical associations of EED in mind, especially malignancy, is critical in management of the disease. More structured studies need to take place in order to fully define the mechanisms and strength of these associations.
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Affiliation(s)
- Vladyslava Doktor
- Dermatology Department, St. John's Episcopal Hospital, Far Rockaway, NY, USA
| | - Ahmed Hadi
- The Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ali Hadi
- The Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert Phelps
- The Kimberly and Eric J. Waldman Department of Dermatology and Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Herbert Goodheart
- The Kimberly and Eric J. Waldman Department of Dermatology and Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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32
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Bronin A, Phelps R, Sidbury R. Beyond JAAD July 2018: Articles of interest to dermatologists from the nondermatologic literature. J Am Acad Dermatol 2018; 79:178-181. [DOI: 10.1016/j.jaad.2018.04.030] [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] [Received: 04/09/2018] [Accepted: 04/09/2018] [Indexed: 10/17/2022]
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33
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Bronin A, Phelps R, Sidbury R. Beyond JAAD April 2018: Articles of interest to dermatologists from the nondermatologic literature. J Am Acad Dermatol 2018; 78:835-838. [DOI: 10.1016/j.jaad.2018.01.010] [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] [Received: 01/07/2018] [Accepted: 01/07/2018] [Indexed: 11/24/2022]
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34
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Bronin A, Phelps R, Sidbury R. Beyond JAAD January 2018: Articles of interest to dermatologists from the nondermatologic literature. J Am Acad Dermatol 2018; 78:231-234. [DOI: 10.1016/j.jaad.2017.10.027] [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] [Received: 10/03/2017] [Revised: 10/24/2017] [Accepted: 10/25/2017] [Indexed: 10/18/2022]
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35
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Bronin A, Phelps R, Sidbury R. Beyond JAAD October 2017: Articles of interest to dermatologists from the nondermatologic literature. J Am Acad Dermatol 2017; 77:790-793. [DOI: 10.1016/j.jaad.2017.07.015] [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] [Received: 07/07/2017] [Accepted: 07/07/2017] [Indexed: 11/29/2022]
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Badal B, Solovyov A, Di Cecilia S, Chan JM, Chang LW, Iqbal R, Aydin IT, Rajan GS, Chen C, Abbate F, Arora KS, Tanne A, Gruber SB, Johnson TM, Fullen DR, Raskin L, Phelps R, Bhardwaj N, Bernstein E, Ting DT, Brunner G, Schadt EE, Greenbaum BD, Celebi JT. Transcriptional dissection of melanoma identifies a high-risk subtype underlying TP53 family genes and epigenome deregulation. JCI Insight 2017; 2:92102. [PMID: 28469092 PMCID: PMC5414564 DOI: 10.1172/jci.insight.92102] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 03/07/2017] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Melanoma is a heterogeneous malignancy. We set out to identify the molecular underpinnings of high-risk melanomas, those that are likely to progress rapidly, metastasize, and result in poor outcomes. METHODS We examined transcriptome changes from benign states to early-, intermediate-, and late-stage tumors using a set of 78 treatment-naive melanocytic tumors consisting of primary melanomas of the skin and benign melanocytic lesions. We utilized a next-generation sequencing platform that enabled a comprehensive analysis of protein-coding and -noncoding RNA transcripts. RESULTS Gene expression changes unequivocally discriminated between benign and malignant states, and a dual epigenetic and immune signature emerged defining this transition. To our knowledge, we discovered previously unrecognized melanoma subtypes. A high-risk primary melanoma subset was distinguished by a 122-epigenetic gene signature ("epigenetic" cluster) and TP53 family gene deregulation (TP53, TP63, and TP73). This subtype associated with poor overall survival and showed enrichment of cell cycle genes. Noncoding repetitive element transcripts (LINEs, SINEs, and ERVs) that can result in immunostimulatory signals recapitulating a state of "viral mimicry" were significantly repressed. The high-risk subtype and its poor predictive characteristics were validated in several independent cohorts. Additionally, primary melanomas distinguished by specific immune signatures ("immune" clusters) were identified. CONCLUSION The TP53 family of genes and genes regulating the epigenetic machinery demonstrate strong prognostic and biological relevance during progression of early disease. Gene expression profiling of protein-coding and -noncoding RNA transcripts may be a better predictor for disease course in melanoma. This study outlines the transcriptional interplay of the cancer cell's epigenome with the immune milieu with potential for future therapeutic targeting. FUNDING National Institutes of Health (CA154683, CA158557, CA177940, CA087497-13), Tisch Cancer Institute, Melanoma Research Foundation, the Dow Family Charitable Foundation, and the Icahn School of Medicine at Mount Sinai.
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Affiliation(s)
- Brateil Badal
- Department of Pathology.,Department of Dermatology.,Department of Oncological Sciences, and
| | - Alexander Solovyov
- Department of Pathology.,Department of Oncological Sciences, and.,Department of Hematology and Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Serena Di Cecilia
- Department of Pathology.,Department of Dermatology.,Department of Oncological Sciences, and
| | - Joseph Minhow Chan
- Department of Pathology.,Department of Dermatology.,Department of Oncological Sciences, and
| | - Li-Wei Chang
- Department of Pathology.,Department of Dermatology.,Department of Oncological Sciences, and
| | - Ramiz Iqbal
- Department of Pathology.,Department of Dermatology.,Department of Oncological Sciences, and
| | - Iraz T Aydin
- Department of Pathology.,Department of Dermatology.,Department of Oncological Sciences, and
| | - Geena S Rajan
- Department of Pathology.,Department of Dermatology.,Department of Oncological Sciences, and
| | | | - Franco Abbate
- Department of Pathology.,Department of Dermatology.,Department of Oncological Sciences, and
| | - Kshitij S Arora
- Department of Medicine, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Antoine Tanne
- Department of Hematology and Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Stephen B Gruber
- Department of Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | | | - Douglas R Fullen
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Leon Raskin
- Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA
| | | | - Nina Bhardwaj
- Department of Hematology and Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Emily Bernstein
- Department of Dermatology.,Department of Oncological Sciences, and.,Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - David T Ting
- Department of Medicine, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Georg Brunner
- Department of Cancer Research, Fachklinik Hornheide, Munster, Germany
| | - Eric E Schadt
- Department of Genetic and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Benjamin D Greenbaum
- Department of Pathology.,Department of Oncological Sciences, and.,Department of Hematology and Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Julide Tok Celebi
- Department of Pathology.,Department of Dermatology.,Department of Oncological Sciences, and.,Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Bronin A, Phelps R, Sidbury R. Beyond JAAD April 2017: Articles of interest to dermatologists from the nondermatologic literature. J Am Acad Dermatol 2017; 76:774-776. [DOI: 10.1016/j.jaad.2017.01.010] [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] [Received: 01/03/2017] [Revised: 01/04/2017] [Accepted: 01/04/2017] [Indexed: 10/19/2022]
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Bronin A, Phelps R, Sidbury R. Beyond JAAD January 2017: Articles of interest from the nondermatologic literature. J Am Acad Dermatol 2017; 76:186-188. [DOI: 10.1016/j.jaad.2016.10.008] [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] [Received: 10/04/2016] [Accepted: 10/06/2016] [Indexed: 10/20/2022]
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Melamed RD, Aydin IT, Rajan GS, Phelps R, Silvers DN, Emmett KJ, Brunner G, Rabadan R, Celebi JT. Genomic Characterization of Dysplastic Nevi Unveils Implications for Diagnosis of Melanoma. J Invest Dermatol 2016; 137:905-909. [PMID: 27890785 DOI: 10.1016/j.jid.2016.11.017] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 11/03/2016] [Accepted: 11/05/2016] [Indexed: 10/20/2022]
Abstract
A well-defined risk factor and precursor for cutaneous melanoma is the dysplastic nevus. These benign tumors represent clonal hyperproliferation of melanocytes that are in a senescent-like state, but with occasional malignant transformation events. To portray the mutational repertoire of dysplastic nevi in patients with the dysplastic nevus syndrome and to determine the discriminatory profiles of melanocytic nevi (including dysplastic nevi) from melanoma, we sequenced exomes of melanocytic nevi including dysplastic nevi (n = 19), followed by a targeted gene panel (785 genes) characterization of melanocytic nevi (n = 46) and primary melanomas (n = 42). Exome sequencing revealed that dysplastic nevi harbored a substantially lower mutational load than melanomas (21 protein-changing mutations versus >100). Known "driver" mutations in genes for melanoma, including CDKN2A, TP53, NF1, RAC1, and PTEN, were not found among any melanocytic nevi sequenced. Additionally, melanocytic nevi including dysplastic nevi showed a significantly lower frequency and a different UV-associated mutational signature. These results show that although melanocytic nevi and dysplastic nevi harbor stable genomes with relatively few alterations, progression into melanomas requires additional mutational processes affecting key tumor suppressors. This study identifies molecular parameters that could be useful for diagnostic platforms.
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Affiliation(s)
- Rachel D Melamed
- Department of Systems Biology and Department of Biomedical Informatics, Columbia University, New York, New York, USA; Institute for Genomics and Systems Biology, University of Chicago, Chicago, Illinois, USA
| | - Iraz T Aydin
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Geena Susan Rajan
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Robert Phelps
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - David N Silvers
- Department of Dermatology, Columbia University, New York, New York, USA
| | - Kevin J Emmett
- Department of Systems Biology and Department of Biomedical Informatics, Columbia University, New York, New York, USA
| | - Georg Brunner
- Department of Cancer Research, Skin Cancer Center Hornheide, Munster, Germany
| | - Raul Rabadan
- Department of Systems Biology and Department of Biomedical Informatics, Columbia University, New York, New York, USA.
| | - Julide Tok Celebi
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
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Bronin A, Phelps R, Sidbury R. Beyond JAAD October 2016: Articles of interest from the nondermatologic literature. J Am Acad Dermatol 2016; 75:851-853. [DOI: 10.1016/j.jaad.2016.06.059] [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] [Received: 06/30/2016] [Accepted: 06/30/2016] [Indexed: 11/30/2022]
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41
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Bronin A, Phelps R, Sidbury R. Beyond JAAD April 2016: Articles of interest from the nondermatologic literature. J Am Acad Dermatol 2016. [DOI: 10.1016/j.jaad.2016.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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42
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Bronin A, Phelps R, Sidbury R. Beyond JAAD January 2016: Articles of interest from the nondermatologic literature. J Am Acad Dermatol 2016; 74:193-5. [DOI: 10.1016/j.jaad.2015.10.008] [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] [Received: 10/05/2015] [Revised: 10/16/2015] [Accepted: 10/16/2015] [Indexed: 11/25/2022]
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43
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Bronin A, Phelps R, Sidbury R. Beyond JAAD October 2015: Articles of interest from the nondermatologic literature. J Am Acad Dermatol 2015; 73:717-9. [DOI: 10.1016/j.jaad.2015.06.055] [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] [Received: 06/15/2015] [Revised: 06/17/2015] [Accepted: 06/20/2015] [Indexed: 10/23/2022]
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Affiliation(s)
| | | | | | - Robert Phelps
- Correspondence to: Robert Phelps, MD, Icahn School of Medicine at Mount Sinai, Annenberg Bldg Room 308, 1468 Madison Ave, New York, NY 10029.
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Bornstein J, McCullough K, Combe C, Bieber B, Jadoul M, Pisoni R, Mariani L, Robinson B, Saito A, Sen A, Tentori F, Guinsburg A, Marelli C, Marcelli D, Usvyat L, Maddux D, Canaud B, Kotanko P, Hwang SJ, Hsieh HM, Chen HF, Mau LW, Lin MY, Hsu CC, Yang WC, Pitcher D, Rao A, Phelps R, Canaud B, Barbieri C, Marcelli D, Bellocchio F, Bowry S, Mari F, Amato C, Gatti E, Zitt E, Hafner-Giessauf H, Wimmer B, Herr A, Horn S, Friedl C, Sprenger-Maehr H, Kramar R, Rosenkranz AR, Lhotta K, Ferris M, Marcelli D, Marelli C, Etter M, Xu X, Grassmann A, Von Gersdorff GD, Pecoits-Filho R, Sylvestre L, Kotanko P, Usvyat L, Consortium M, Dzekova-Vidimliski P, Nikolov I, Trajceska L, Selim G, Gelev S, Matevska Geshkovska N, Dimovski A, Sikole A, Suleymanlar G, Utas C, Ecder T, Ates K, Bieber B, Robinson BM, Pisoni RL, Laplante S, Liu FX, Culleton B, Tomilina N, Bikbov B, Andrusev A, Zemchenkov A, Bieber B, Robinson BM, Pisoni RL, Bikbov B, Tomilina N, Kotenko O, Andrusev A, Panaye M, Jolivot A, Lemoine S, Guebre-Egziabher F, Doret M, Juillard L, Filiopoulos V, Hadjiyannakos D, Papakostoula A, Takouli L, Biblaki D, Dounavis A, Vlassopoulos D, Bikbov B, Tomilina N, Al Wakeel J, Bieber B, Al Obaidli AA, Ahmed Almaimani Y, Al-Arrayed S, Alhelal B, Fawzy A, Robinson BM, Pisoni RL, Aucella F, Girotti G, Gesuete A, Cicchella A, Seresin C, Vinci C, Scaparrotta G, Naso A, Pilotto A, Hoffmann TR, Flusser V, Santoro LF, Almeida FA, Aucella F, Girotti G, Gesuete A, Cicchella A, Seresin C, Vinci C, Scaparrotta G, Ganugi S, Gnerre T, Russo GE, Amato M, Naso A, Pilotto A, Trigka K, Douzdampanis P, Chouchoulis K, Mpimpi A, Kaza M, Pipili C, Kyritsis I, Fourtunas C, Ortalda V, Tomei P, Ybarek T, Lupo A, Torreggiani M, Esposito V, Catucci D, Arazzi M, Colucci M, Montagna G, Semeraro L, Efficace E, Piazza V, Picardi L, Esposito C, Hekmat R, Mohebi M, Ahmadzadehhashemi S, Park J, Hwang E, Jang M, Park S, Resende LL, Dantas MA, Martins MTS, Lopes GB, Lopes AA, Engelen W, Elseviers M, Gheuens E, Colson C, Muyshondt I, Daelemans R, He Y, Chen J, Luan S, Wan Q, Cuoghi A, Bellei E, Monari E, Bergamini S, Tomasi A, Atti M, Caiazzo M, Palladino G, Bruni F, Tekce H, Ozturk S, Aktas G, Kin Tekce B, Erdem A, Uyeturk U, Ozyasar M, Taslamacioglu Duman T, Yazici M, Schaubel DE, McCullough KP, Morgenstern H, Gallagher MP, Hasegawa T, Pisoni RL, Robinson BM, Nacak H, Van Diepen M, Suttorp MM, Hoorn EJ, Rotmans JI, Dekker FW, Speyer E, Beauger D, Gentile S, Isnard Bagnis C, Caille Y, Baudelot C, Mercier S, Jacquelinet C, Briancon S, Sosorburam T, Baterdene B, Delger A, Daelemans R, Gheuens E, Engelen W, De Boeck K, Marynissen J, Bouman K, Mann M, Exner DV, Hemmelgarn BR, Hanley D, Ahmed SB. DIALYSIS. EPIDEMIOLOGY, OUTCOME RESEARCH, HEALTH SERVICES 2. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu178] [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] [Indexed: 11/12/2022] Open
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Emer J, Pandey S, Marciniak BJ, Sidhu H, Phelps R. Hyperpigmented follicular papules and bullae in an immunocompromised infant. J Clin Aesthet Dermatol 2014; 7:44-47. [PMID: 24563697 PMCID: PMC3930541] [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: 06/03/2023]
Affiliation(s)
- Jason Emer
- Dr. Emer, Ms. Pandey, and Mr. Marciniak are from Mount Sinai School of Medicine, Department of Dermatology, New York, New York. Drs. Sidhu and Phelps are from Mount Sinai School of Medicine, Department of Pathology, New York, New York. Disclosure: The authors report no relevant conflicts of interest
| | - Shaily Pandey
- Dr. Emer, Ms. Pandey, and Mr. Marciniak are from Mount Sinai School of Medicine, Department of Dermatology, New York, New York. Drs. Sidhu and Phelps are from Mount Sinai School of Medicine, Department of Pathology, New York, New York. Disclosure: The authors report no relevant conflicts of interest
| | - Brian J Marciniak
- Dr. Emer, Ms. Pandey, and Mr. Marciniak are from Mount Sinai School of Medicine, Department of Dermatology, New York, New York. Drs. Sidhu and Phelps are from Mount Sinai School of Medicine, Department of Pathology, New York, New York. Disclosure: The authors report no relevant conflicts of interest
| | - Harleen Sidhu
- Dr. Emer, Ms. Pandey, and Mr. Marciniak are from Mount Sinai School of Medicine, Department of Dermatology, New York, New York. Drs. Sidhu and Phelps are from Mount Sinai School of Medicine, Department of Pathology, New York, New York. Disclosure: The authors report no relevant conflicts of interest
| | - Robert Phelps
- Dr. Emer, Ms. Pandey, and Mr. Marciniak are from Mount Sinai School of Medicine, Department of Dermatology, New York, New York. Drs. Sidhu and Phelps are from Mount Sinai School of Medicine, Department of Pathology, New York, New York. Disclosure: The authors report no relevant conflicts of interest
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Nolan KA, Kling M, Birge M, Kling A, Fishman S, Phelps R. Melanoma arising in a tattoo: case report and review of the literature. Cutis 2013; 92:227-230. [PMID: 24343207] [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] [Indexed: 06/03/2023]
Abstract
Various benign and malignant lesions have been described in relation to tattoos including melanoma. Few cases of malignant melanoma (MM) arising in tattoos have been reported in the literature. We report a 79-year-old man with an MM that arose in a tattoo he had for 60 years on the inferior aspect of the left arm. This case underscores the need for careful examination of tattoos to insure that dysplastic or malignant pigmented lesions are not overlooked. We also discuss the possibility of a pathogenic relationship between MM and tattoos.
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Affiliation(s)
- Katherine A Nolan
- Department of Dermatology, Mount Sinai School of Medicine, Annenberg Bldg, Room 308, 1468 Madison Ave, New York, NY 10029, USA.
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Emer J, Roberts D, Sidhu H, Phelps R, Goodheart H. Generalized Anetoderma after Intravenous Penicillin Therapy for Secondary Syphilis in an HIV Patient. J Clin Aesthet Dermatol 2013; 6:23-28. [PMID: 24003347 PMCID: PMC3760601] [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: 06/02/2023]
Abstract
Anetoderma is a rare, benign disorder characterized microscopically by the pan-dermal loss of elastic fibers in the dermis and presenting clinically as circumscribed, skin-colored or grey-white atrophic macules and/or patches on the trunk and/or extremities. Lesions are described as having a "sac-like" appearance, since they bulge or herniate upon palpation. Although the clinical picture is characteristic, a definitive diagnosis requires histological confirmation in order to differentiate this disorder from other conditions of elastolysis, such as cutis laxa and mid-dermal elastolysis. Little is known concerning the pathogenesis of this condition, and treatment attempts have been both diverse and unsuccessful. This article will review a case of generalized anetoderma in a patient with secondary syphilis after being treated with intravenous penicillin, along with a concise literature review.
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Affiliation(s)
- Jason Emer
- Mount Sinai School of Medicine, Departments of Dermatology and Pathology, New York, New York
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Emer J, Luber A, Gropper J, Sidhu H, Phelps R. A patch of hair loss on the scalp. J Clin Aesthet Dermatol 2013; 6:45-49. [PMID: 23882315 PMCID: PMC3718756] [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: 06/02/2023]
Affiliation(s)
- Jason Emer
- The authors are from Mount Sinai School of Medicine, Departments of Dermatology and Dermatopathology, New York, New York
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Emer J, Luber A, Yazdani M, Marciniak B, Sidhu H, Phelps R. Neonate with annular plaques of the scalp. J Clin Aesthet Dermatol 2013; 6:43-47. [PMID: 23882309 PMCID: PMC3718750] [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: 06/02/2023]
Affiliation(s)
- Jason Emer
- Dr. Emer, Mr. Luber, and Mr. Marciniak are from Mount Sinai School of Medicine, Department of Dermatology, New York, New York. Ms. Yazdani is from Liaquat National Medical College, Karachi, Pakistan. Dr. Sidhu is from Mount Sinai School of Medicine, Department of Pathology
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