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Birnbach DJ, McKenty NT, Rosen LF, Arheart KL, Everett-Thomas R, Lindsey SF. Does Adherence to World Health Organization Hand Hygiene Protocols in the Operating Room Have the Potential to Produce Irritant Contact Dermatitis in Anesthesia Providers? Anesth Analg 2019; 129:e182-e184. [PMID: 31743176 DOI: 10.1213/ane.0000000000004112] [Citation(s) in RCA: 5] [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: 11/05/2022]
Abstract
Anesthesia providers have the burden of constant hand hygiene during task dense periods. The requirement for hand hygiene often demands frequent application of alcohol-based hand rub. To assess whether frequent alcohol-based hand rub use leads to skin changes or irritant contact dermatitis, volunteers cleaned their hands with alcohol-based hand rub every 15 minutes for 8 hours for 5 sequential days. They were examined by a dermatologist before and after and asked about subjective skin changes. Results suggest an increase in irritant contact dermatitis scores and subjective complaints.
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Affiliation(s)
- David J Birnbach
- From the Department of Anesthesiology, University of Miami Miller School of Medicine
- University of Miami-Jackson Memorial Hospital Center for Patient Safety, Miami, Florida
- Department of Public Health Sciences, University of Miami Miller School of Medicine
| | - Nathan T McKenty
- From the Department of Anesthesiology, University of Miami Miller School of Medicine
| | - Lisa F Rosen
- University of Miami-Jackson Memorial Hospital Center for Patient Safety, Miami, Florida
| | - Kristopher L Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine
| | | | - Scott F Lindsey
- Department of Dermatology, University of Miami Miller School of Medicine
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Lindsey SF, Aickara D, Price A, Pavlis J, Wei EX, Elgart G, Cho-Vega JH. Giant proliferating trichilemmal cyst arising from a nevus sebaceus growing for 30 years. J Cutan Pathol 2017; 44:639-642. [PMID: 28419495 DOI: 10.1111/cup.12951] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 11/14/2016] [Revised: 04/06/2017] [Accepted: 04/08/2017] [Indexed: 12/28/2022]
Abstract
Nevus sebaceus of Jadassohn, a congenital cutaneous hamartoma, has the potential to develop into various epidermal adnexal-origin neoplasms. While the most common neoplasms are trichoblastoma or syringocystadenoma, proliferating trichilemmal cysts are exceptionally rare. We report a case of a 63-year-old Cuban male with a giant proliferating trichilemmal cyst arising from a nevus sebaceus on the right shoulder which had been growing for 30 years. Proliferating trichilemmal cysts arising from nevus sebaceus cases are difficult to diagnose clinically and histologically as they are very rare and have not been defined by exact diagnostic criteria. Our case creates awareness of this particular tumor in nevus sebaceus and shares clinical and histological diagnostic information that can be used to make a proper diagnosis.
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Affiliation(s)
- Scott F Lindsey
- Department of Dermatology, Miller School of Medicine, University of Miami, Miami, Florida
| | - Divya Aickara
- College of Medicine, Florida State University, Tallahassee, Florida
| | - Alexandra Price
- Department of Dermatology, Miller School of Medicine, University of Miami, Miami, Florida
| | - Janelle Pavlis
- Department of Dermatology, Miller School of Medicine, University of Miami, Miami, Florida
| | - Erin X Wei
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Miami, Florida
| | - George Elgart
- Department of Dermatology, Miller School of Medicine, University of Miami, Miami, Florida
| | - Jeong Hee Cho-Vega
- Department of Pathology, Dermatopathology Division, Sylvester Comprehensive Cancer Center and Miller School of Medicine, University of Miami, Miami, Florida
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Affiliation(s)
- Jordan J Cole
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Eric L Maranda
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Tarek Salih
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Scott F Lindsey
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Joaquin Jimenez
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
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Abstract
The management of hair and scalp conditions is difficult in any patient, especially given the emotional and psychological implications of hair loss. This undertaking becomes even more challenging in the ethnic patient. Differences in hair care practices, hair shaft morphology, and follicular architecture add complexity to the task. It is imperative that the physician be knowledgeable about these practices and the phenotypic differences seen in ethnic hair in order to appropriately diagnose and treat these patients. In this chapter, we will discuss cultural practices and morphologic differences and explain how these relate to the specific disorders seen in ethnic populations. We will also review the most prominent of the ethnic hair conditions including acquired trichorrhexis nodosa, traction alopecia, central centrifugal cicatricial alopecia, pseudofolliculitis barbae, dissecting cellulitis, and acne keloidalis nuchae.
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Lindsey SF, Weiss J, Lee ES, Romanelli P. Treatment of severe psoriasis and psoriatic arthritis with adalimumab in an HIV-positive patient. J Drugs Dermatol 2014; 13:869-871. [PMID: 25007373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Psoriasis in HIV-infected patients poses a distinct challenge to the dermatologist due to its increased severity, tendency to be refractory to common treatment modalities, and necessity for cautious use of immunosuppressive agents. Tumor necrosis factor-α inhibitors have been shown to be safe and effective for the treatment of psoriasis in the general population, but their role in the treatment of HIV-positive patients is still unclear. The use of the tumor necrosis factor-α inhibitor adalimumab for the treatment of psoriasis in HIV-positive patients has yet to be reported. We present the case of a 49-year-old HIV-positive man with severe plaque psoriasis who has been successfully treated with adalimumab for the past 30 months with no adverse events related to treatment.
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Lindsey SF, Reiders B, Mechaber HF. Life-threatening pharyngeal edema after sclerotherapy of oral venous malformations in a patient with blue rubber bleb nevus syndrome. J Dermatol Case Rep 2013; 7:74-6. [PMID: 24133559 DOI: 10.3315/jdcr.2013.1145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 06/10/2013] [Indexed: 11/11/2022]
Abstract
BACKGROUND Blue rubber bleb nevus syndrome (BRBNS) is a rare vascular disorder characterized by multiple venous malformations of the skin and internal organs. Oral lesions are very common and occur in over half of the patients with this condition. Sclerotherapy is currently the first-line treatment modality of symptomatic cases due to its high efficacy and low rate of complications. MAIN OBSERVATIONS We report the case of a 68-year-old male with BRBNS who presented with dysphagia and difficulty with speech due to prominent oral venous malformations. After the use of sclerotherapy with ethanolamine oleate to control his symptoms, the patient exhibited severe edema of the tongue and posterior pharyngeal wall which caused constriction of his airway. The patient was intubated, and remained so for 72 hours until his edema resolved. In addition to his oral lesions, the patient also exhibited other features of BRBNS including cutaneous, soft-tissue, gastrointestinal, and neurological manifestations of disease. CONCLUSION Physicians should be aware of the potentially life-threatening complication of severe tongue and pharyngeal edema when using sclerotherapy for the treatment of oral vascular malformations. Additionally, dermatologists should be familiar with the many systemic manifestations which can be present in patients with BRBNS, as illustrated in this case.
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Affiliation(s)
- Scott F Lindsey
- University of Miami Miller School of Medicine, Department of Dermatology, Miami, FL 33136, USA
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Denzler KL, Rice AD, MacNeill AL, Fukushima N, Lindsey SF, Wallace G, Burrage AM, Smith AJ, Manning BR, Swetnam DM, Gray SA, Moyer RW, Jacobs BL. The NYCBH vaccinia virus deleted for the innate immune evasion gene, E3L, protects rabbits against lethal challenge by rabbitpox virus. Vaccine 2011; 29:7659-69. [PMID: 21840358 PMCID: PMC3190037 DOI: 10.1016/j.vaccine.2011.07.140] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [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: 05/14/2011] [Revised: 07/28/2011] [Accepted: 07/31/2011] [Indexed: 11/29/2022]
Abstract
Vaccinia virus deleted for the innate immune evasion gene, E3L, has been shown to be highly attenuated and yet induces a protective immune response against challenge by homologous virus in a mouse model. In this manuscript the NYCBH vaccinia virus vaccine strain was compared to NYCBH vaccinia virus deleted for E3L (NYCBHΔE3L) in a rabbitpox virus (RPV) challenge model. Upon scarification, both vaccines produced a desired skin lesion, although the lesion produced by NYCBHΔE3L was smaller. Both vaccines fully protected rabbits against lethal challenge by escalating doses of RPV, from 10LD(50) to 1000LD(50). A single dose of NYCBHΔE3L protected rabbits from weight loss, fever, and clinical symptoms following the lowest dose challenge of 10LD(50), however it allowed a moderate level of RPV replication at the challenge site, some spread to external skin and mucosal surfaces, and increased numbers of secondary lesions as compared to vaccination with NYCBH. Alternately, two doses of NYCBHΔE3L fully protected rabbits from weight loss, fever, and clinical symptoms, following challenge with 100-1000LD(50) RPV, and it prevented development of secondary lesions similar to protection seen with NYCBH. Finally, vaccination with either one or two doses of NYCBHΔE3L resulted in similar neutralizing antibody titers following RPV challenge as compared to titers obtained by vaccination with NYCBH. These results support the efficacy of the attenuated NYCBHΔE3L in protection against an orthologous poxvirus challenge.
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Affiliation(s)
- Karen L Denzler
- Biodesign Institute, Arizona State University, Tempe, AZ 85287-5401, USA
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Rice AD, Adams MM, Wallace G, Burrage AM, Lindsey SF, Smith AJ, Swetnam D, Manning BR, Gray SA, Lampert B, Foster S, Lanier R, Robertson A, Painter G, Moyer RW. Efficacy of CMX001 as a post exposure antiviral in New Zealand White rabbits infected with rabbitpox virus, a model for orthopoxvirus infections of humans. Viruses 2011; 3:47-62. [PMID: 21373379 PMCID: PMC3046869 DOI: 10.3390/v3010047] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Revised: 01/04/2011] [Accepted: 01/05/2011] [Indexed: 11/30/2022] Open
Abstract
CMX001, a lipophilic nucleotide analog formed by covalently linking 3-(hexdecyloxy)propan-1-ol to cidofovir (CDV), is being developed as a treatment for smallpox. In the absence of human cases of smallpox, new treatments must be tested for efficacy in animal models. Previously, we demonstrated the efficacy of CMX001 in protecting New Zealand White rabbits from mortality following intradermal infection with rabbitpox virus as a model for smallpox, monkeypox and for treatment of adverse reactions to smallpox vaccination. Here we extend these studies by exploring different dosing regimens and performing randomized, blinded, placebo-controlled studies. In addition, because rabbitpox virus can be transmitted via naturally generated aerosols (animal to animal transmission), we report on studies to test the efficacy of CMX001 in protecting rabbits from lethal rabbitpox virus disease when infection occurs by animal to animal transmission. In all cases, CMX001 treatment was initiated at the onset of observable lesions in the ears to model the use of CMX001 as a treatment for symptomatic smallpox. The results demonstrate that CMX001 is an effective treatment for symptomatic rabbitpox virus infection. The rabbitpox model has key similarities to human smallpox including an incubation period, generalized systemic disease, the occurrence of lesions which may be used as a trigger for initiating therapy, and natural animal to animal spread, making it an appropriate model.
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Affiliation(s)
- Amanda D. Rice
- Department of Molecular Genetics and Microbiology, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32610, USA; E-Mails: (A.D.R.); (M.M.A.); (G.W.); (A.M.B.); (S.F.L.); (A.J.S.); (D.S.); (B.R.M.); (S.A.G.)
| | - Mathew M. Adams
- Department of Molecular Genetics and Microbiology, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32610, USA; E-Mails: (A.D.R.); (M.M.A.); (G.W.); (A.M.B.); (S.F.L.); (A.J.S.); (D.S.); (B.R.M.); (S.A.G.)
| | - Greg Wallace
- Department of Molecular Genetics and Microbiology, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32610, USA; E-Mails: (A.D.R.); (M.M.A.); (G.W.); (A.M.B.); (S.F.L.); (A.J.S.); (D.S.); (B.R.M.); (S.A.G.)
| | - Andrew M. Burrage
- Department of Molecular Genetics and Microbiology, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32610, USA; E-Mails: (A.D.R.); (M.M.A.); (G.W.); (A.M.B.); (S.F.L.); (A.J.S.); (D.S.); (B.R.M.); (S.A.G.)
| | - Scott F. Lindsey
- Department of Molecular Genetics and Microbiology, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32610, USA; E-Mails: (A.D.R.); (M.M.A.); (G.W.); (A.M.B.); (S.F.L.); (A.J.S.); (D.S.); (B.R.M.); (S.A.G.)
| | - Andrew J. Smith
- Department of Molecular Genetics and Microbiology, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32610, USA; E-Mails: (A.D.R.); (M.M.A.); (G.W.); (A.M.B.); (S.F.L.); (A.J.S.); (D.S.); (B.R.M.); (S.A.G.)
| | - Daniele Swetnam
- Department of Molecular Genetics and Microbiology, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32610, USA; E-Mails: (A.D.R.); (M.M.A.); (G.W.); (A.M.B.); (S.F.L.); (A.J.S.); (D.S.); (B.R.M.); (S.A.G.)
| | - Brandi R. Manning
- Department of Molecular Genetics and Microbiology, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32610, USA; E-Mails: (A.D.R.); (M.M.A.); (G.W.); (A.M.B.); (S.F.L.); (A.J.S.); (D.S.); (B.R.M.); (S.A.G.)
| | - Stacey A. Gray
- Department of Molecular Genetics and Microbiology, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32610, USA; E-Mails: (A.D.R.); (M.M.A.); (G.W.); (A.M.B.); (S.F.L.); (A.J.S.); (D.S.); (B.R.M.); (S.A.G.)
| | - Bernhard Lampert
- Chimerix, Inc., 2505 Meridian Parkway Suite, 340 Durham, NC 27713, USA; E-Mails: (B.L.); (S.F.); (R.L.); (A.R.); (G.P.)
| | - Scott Foster
- Chimerix, Inc., 2505 Meridian Parkway Suite, 340 Durham, NC 27713, USA; E-Mails: (B.L.); (S.F.); (R.L.); (A.R.); (G.P.)
| | - Randall Lanier
- Chimerix, Inc., 2505 Meridian Parkway Suite, 340 Durham, NC 27713, USA; E-Mails: (B.L.); (S.F.); (R.L.); (A.R.); (G.P.)
| | - Alice Robertson
- Chimerix, Inc., 2505 Meridian Parkway Suite, 340 Durham, NC 27713, USA; E-Mails: (B.L.); (S.F.); (R.L.); (A.R.); (G.P.)
| | - George Painter
- Chimerix, Inc., 2505 Meridian Parkway Suite, 340 Durham, NC 27713, USA; E-Mails: (B.L.); (S.F.); (R.L.); (A.R.); (G.P.)
| | - Richard W. Moyer
- Department of Molecular Genetics and Microbiology, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32610, USA; E-Mails: (A.D.R.); (M.M.A.); (G.W.); (A.M.B.); (S.F.L.); (A.J.S.); (D.S.); (B.R.M.); (S.A.G.)
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