1
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Zhang AL, Humphrey VS, Trinidad JC. Cooling Research Fever in Dermatology-The Role of Community Service. JAMA Dermatol 2024; 160:477-478. [PMID: 38381445 DOI: 10.1001/jamadermatol.2023.6096] [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: 02/22/2024]
Affiliation(s)
| | - Victoria S Humphrey
- Harvard Combined Dermatology Residency Training Program, Boston, Massachusetts
| | - John C Trinidad
- Department of Dermatology, Massachusetts General Hospital, Boston
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2
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Chiang C, Gessner N, Burli A, Liszewski W, Mansh M, Nguyen CV, Yeung H, Trinidad JC. Poppers Dermatitis: A Systematic Review on a Unique Form of Contact Dermatitis in the MSM Community. Dermatitis 2023. [PMID: 37788394 DOI: 10.1089/derm.2023.0157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
There are certain demographic characteristics that may serve as risk factors for exposure to a contact allergen. Volatile alkyl nitrites, colloquially known as "poppers," are commonly inhaled by men who have sex with men (MSM) for their psychoactive and muscle-relaxing effects. They have been reported to cause either allergic contact dermatitis (ACD) or irritant contact dermatitis (ICD), termed "poppers dermatitis." We searched PubMed, Embase, and Web of Science to understand the patient population, clinical presentation, diagnosis, and clinical course of poppers dermatitis. Our search returned 13 articles detailing 18 patients total. Most patient cases were male (n = 13/15; 87%), of whom 5 were MSM. The reports on the remaining 8 men did not disclose their sexual behaviors. The chemicals deemed responsible for adverse cutaneous side effects included amyl nitrite (6/18; 33%), butyl nitrite (3/18; 167%), isobutyl nitrite (2/18; 11%), and an unspecified alkyl nitrite (7/18, 39%). The most common diagnosis was ICD (10/18; 56%). Only 3 patients underwent alkyl nitrite patch testing, with 2 testing positive for ACD. The most commonly involved anatomic sites were perinasal (13/18; 72%) and perioral regions (10/18; 56%). Rash morphology has been described as yellow crusting, impetigo-like, eczematous, vesicular, edematous, and erythematous. Ulceration can occur with direct skin contact to concentrated nitrite solution. Poppers dermatitis was often self-limited with complete resolution. Dermatologists should consider poppers dermatitis in those presenting with a characteristic midfacial rash, especially in MSM.
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Affiliation(s)
- Chavy Chiang
- From the University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Nicholas Gessner
- The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Anuk Burli
- Department of Dermatology, Stanford University, Palo Alto, California, USA
| | - Walter Liszewski
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Matthew Mansh
- Department of Dermatology, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA
| | - Cuong V Nguyen
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Howa Yeung
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - John C Trinidad
- Department of Dermatology, Massachusetts General Hospital, Cambridge, Massachusetts, USA
- Department of Dermatology, Harvard Medical School, Cambridge, Massachusetts, USA
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3
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Zheng L, Guggina LM, Zhou XA, Wanat KA, Brieva JC, Trinidad JC, Nguyen CV. Perceptions of telehealth among inpatient consultative dermatology providers and practice patterns during COVID-19. Arch Dermatol Res 2023; 315:2449-2451. [PMID: 37184600 PMCID: PMC10184090 DOI: 10.1007/s00403-023-02637-y] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 02/19/2023] [Accepted: 05/04/2023] [Indexed: 05/16/2023]
Abstract
Use of inpatient teledermatology increased during the COVID-19 pandemic. We surveyed the Society for Dermatology Hospitalists to better characterize the impact of COVID-19 on teledermatology use by inpatient dermatology providers, particularly on provider perceptions of teledermatology. Prior to the COVID-19 pandemic, 40% (8/20) of surveyed providers had used telehealth at their institution to help perform inpatient consults, while 90% (18/20) adapted use of teledermatology during the pandemic. 80% (16/20) reported that their opinion of teledermatology changed as a result of the COVID-19 pandemic, with the vast majority (87.5%, 14/16) reporting having a more positive opinion. Benefits of teledermatology included efficiency, ability to increase access safely, and ability for clinicians to focus on complex cases. Some providers expressed concerns over the potential implications regarding the perception of dermatology within medicine, limitations of inadequate photos, and breakdowns in communication with consulting teams and patients. Robust algorithms and or utilization criteria of teledermatology may help to mitigate risk, while increasing access to inpatient dermatologic evaluation.
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Affiliation(s)
- Lida Zheng
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, 676 N St. Clair Street Suite 1600, Chicago, IL, 60654, USA.
| | - Lauren M Guggina
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Xiaolong A Zhou
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, 676 N St. Clair Street Suite 1600, Chicago, IL, 60654, USA
| | - Karolyn A Wanat
- Department of Dermatology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Joaquin C Brieva
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, 676 N St. Clair Street Suite 1600, Chicago, IL, 60654, USA
| | - John C Trinidad
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - Cuong V Nguyen
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, 676 N St. Clair Street Suite 1600, Chicago, IL, 60654, USA
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4
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Himed S, Levine E, Trinidad JC, Kaffenberger BH. Risk factors for loss of follow-up after asynchronous dermatology eConsult concerning for skin cancer. Arch Dermatol Res 2023; 315:669-672. [PMID: 36282349 DOI: 10.1007/s00403-022-02419-y] [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: 04/29/2022] [Accepted: 10/13/2022] [Indexed: 11/30/2022]
Abstract
Asynchronous electronic consultations (e-consults) can be a useful tool for the screening of cutaneous lesions, but may offer a malpractice risk. We characterized factors affecting initial eConsult office follow-up in a cohort of patients with documented neoplasm of uncertain behavior. Patients with an ICD 10 code of neoplasm with uncertain behavior (D48.5) at The Ohio State University that received an E-consult order from May 2017 to May 2021 were queried. Information collected included patient demographics, status of follow-up in-office appointment, referral status, and health care utilization. In-office follow-up appointments were defined as completed, cancelled/no-show or no-contact. 667 patients with a diagnosis of D48.5 were identified as having completed an eConsult. 427 (64%) patients had a documented phone/electronic message notifying the patient of the results of the eConsult. Year of encounter (0.88 [0.79-0.97]) and number of previously completed ambulatory visits (0.86 [0.77-0.96]) were significantly associated with documentation of phone/electronic message in the univariate and multivariate model. 429 (84%) patients had a dermatology office follow-up encounter while 82 (16%) had no appointment scheduled. Language spoken, referral status and race were significant in the univariate model, though race was the only significant variable in the multivariate model (P < 0.003). Asynchronous electronic consults to assess possible cutaneous neoplasms is an important tool for population screening of skin cancer. Dermatologists and health systems implementing an eConsult model for screening purposes should be aware of risk factors for loss of follow-up. Additional systems need to be implemented to ensure minorities and non-native English speakers are obtaining adequate dermatologic care.
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Affiliation(s)
- Sonia Himed
- University of Cincinnati College of Medicine, Cincinnati, USA
| | - Edward Levine
- Division of Gastroenterology, Medical Wexner Center, The Ohio State University, Columbus, USA
| | - John C Trinidad
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Benjamin H Kaffenberger
- Division of Dermatology, Department of Internal Medicine, Medical Wexner Center, The Ohio State University, 1328 Dublin Road, Columbus, OH, 43210, USA.
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5
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Nosewicz J, Hyde J, McGrath M, Kaffenberger BH, Trinidad JC, Chung CG. Infectious panniculitis: an inpatient cohort. Int J Dermatol 2022; 61:e483-e485. [PMID: 34813076 DOI: 10.1111/ijd.16004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/26/2021] [Accepted: 11/11/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Jacob Nosewicz
- Division of Dermatology, Department of Medicine, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Jordan Hyde
- Division of Dermatology, Department of Medicine, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Mary McGrath
- College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Benjamin H Kaffenberger
- Division of Dermatology, Department of Medicine, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - John C Trinidad
- Division of Dermatology, Department of Medicine, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Catherine G Chung
- Division of Dermatology, Department of Medicine, Wexner Medical Center, The Ohio State University, Columbus, OH, USA.,Department of Pathology, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
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6
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Mital R, Cartron AM, Trinidad JC, Spaccarelli N, Gibbons-Fideler IS, Kaffenberger BH, Chung CG. Novel cutaneous eruptions in the setting of programmed cell death protein 1 inhibitor therapy. JAAD Case Rep 2022; 31:124-127. [PMID: 36583144 PMCID: PMC9792734 DOI: 10.1016/j.jdcr.2022.11.020] [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: 11/25/2022] Open
Affiliation(s)
- Rohan Mital
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Alexander M. Cartron
- Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland
| | - John C. Trinidad
- Department of Dermatology, Massachusetts General Hospital, Cambridge, Massachusetts
| | - Natalie Spaccarelli
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | | | | | - Catherine G. Chung
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio,Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio,Correspondence to: Catherine G. Chung, MD, 2050 Kenny Rd MMT 930, Columbus, OH 43221.
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7
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Gilkey TW, Amigo MA, Himed S, Rojek NW, Milani-Nejad N, Korman AM, Trinidad JC, Kaffenberger BH. Oblique Earlobe Crease as a Novel Physical Examination Finding in Drug Reaction with Eosinophilia and Systemic Symptoms: a retrospective study. J Eur Acad Dermatol Venereol 2022; 36:e739-e740. [PMID: 35617202 DOI: 10.1111/jdv.18270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 05/18/2022] [Indexed: 11/27/2022]
Affiliation(s)
- T W Gilkey
- The Ohio State University College of Medicine
| | - M A Amigo
- Division of Dermatology, Department of Internal Medicine, OhioHealth Riverside Methodist Hospital
| | - S Himed
- University of Cincinnati, College of Medicine
| | - N W Rojek
- Department of Dermatology, University of California, Irvine
| | - N Milani-Nejad
- Department of Dermatology, University of California, Los Angeles
| | - A M Korman
- Department of Internal Medicine, Division of Dermatology, The Ohio State University, Wexner Medical Center
| | - J C Trinidad
- Department of Internal Medicine, Division of Dermatology, The Ohio State University, Wexner Medical Center
| | - B H Kaffenberger
- Department of Internal Medicine, Division of Dermatology, The Ohio State University, Wexner Medical Center
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8
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Nosewicz J, Sparks A, Hart PA, Roberts KM, Kaffenberger JA, Korman A, Trinidad JC, Spaccarelli N, Kaffenberger BH. The Evaluation and Management of Macronutrient Deficiency Dermatoses. J Am Acad Dermatol 2022; 87:640-647. [PMID: 35427683 DOI: 10.1016/j.jaad.2022.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 03/31/2022] [Accepted: 04/03/2022] [Indexed: 10/18/2022]
Abstract
In industrialized countries, nutritional dermatoses are likely underdiagnosed and result in increased disease morbidity and utilization of hospital resources. These findings underscore the need for physicians to be able to correctly identify these deficiencies. Nutritional dermatoses may be split into micronutrient deficiencies and macronutrient deficiencies. This article is intended to serve as a supplement to a two-part review of micronutrient deficiency dermatoses and highlights cutaneous findings in patients with protein-energy malnutrition and essential fatty acid deficiency. This article reviews the evaluation, cutaneous manifestations, and management of macronutrient deficiencies.
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Affiliation(s)
- Jacob Nosewicz
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Alexander Sparks
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Phil A Hart
- Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Kristen M Roberts
- Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Jessica A Kaffenberger
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Abraham Korman
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - John C Trinidad
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Natalie Spaccarelli
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
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9
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Nosewicz J, Spaccarelli N, Roberts KM, Hart PA, Kaffenberger JA, Trinidad JC, Kaffenberger BH. Response to Falotico et al's "Biotin beware: Perils of biotin supplementation". J Am Acad Dermatol 2022; 87:497. [PMID: 35331806 DOI: 10.1016/j.jaad.2022.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Jacob Nosewicz
- Division of Dermatology, Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Natalie Spaccarelli
- Division of Dermatology, Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Kristen M Roberts
- Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Phil A Hart
- Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Jessica A Kaffenberger
- Division of Dermatology, Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - John C Trinidad
- Division of Dermatology, Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Benjamin H Kaffenberger
- Division of Dermatology, Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio.
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10
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Goldenberg M, Krishna SG, Milani-Nejad N, Trinidad JC, Kaffenberger BH. Response to 'Validation of Generalized Drug-Related Rash Diagnoses Using ICD-9 and ICD-10 Codes': reply from authors. Br J Dermatol 2021; 186:911. [PMID: 34951478 DOI: 10.1111/bjd.20965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | - Somashekar G Krishna
- Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Nima Milani-Nejad
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - John C Trinidad
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Benjamin H Kaffenberger
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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11
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Nosewicz J, Spaccarelli N, Roberts KM, Hart PA, Kaffenberger JA, Trinidad JC, Kaffenberger BH. The Epidemiology, Impact, and Diagnosis of Micronutrient Nutritional Dermatoses Part 1: Zinc, Selenium, Copper, Vitamin A, and Vitamin C. J Am Acad Dermatol 2021; 86:267-278. [PMID: 34748862 DOI: 10.1016/j.jaad.2021.07.079] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 07/16/2021] [Accepted: 07/23/2021] [Indexed: 11/27/2022]
Abstract
Dermatologists play a critical role in diagnosing and managing nutritional deficiencies as they often present with cutaneous findings. Traditionally, nutritional dermatoses are taught in the context of developing countries, famine, population displacement, and poor healthcare access; however, in the United States, common risk factors include chronic liver disease, alcoholism, psychiatric disease, bariatric surgery, inflammatory bowel disease, and hemodialysis. Additionally, nutritional dermatoses may be underdiagnosed in the United States and result in increased morbidity and utilization of hospital resources. There is a need for providers in developed nations to identify these deficiencies, and this review aims to meet that practice gap and provide relevant context to these diseases for dermatologists. This two-part review series will focus on the epidemiology, impact, appearance, and diagnostic modalities for micronutrient deficiencies, including zinc, selenium, copper, and vitamins A and C in part one. The companion review will focus on the B-complex vitamins.
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Affiliation(s)
- Jacob Nosewicz
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Natalie Spaccarelli
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Kristen M Roberts
- Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Phil A Hart
- Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Jessica A Kaffenberger
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - John C Trinidad
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
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12
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Goldenberg M, Amigo M, Krishna SG, Milani-Nejad N, Trinidad JC, Kaffenberger BH. Validation of generalized drug-related rash diagnoses using International Classification of Diseases 9th and 10th Revision codes. Br J Dermatol 2021; 186:583-585. [PMID: 34726268 DOI: 10.1111/bjd.20868] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/02/2021] [Accepted: 10/29/2021] [Indexed: 11/28/2022]
Affiliation(s)
- M Goldenberg
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - M Amigo
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - S G Krishna
- Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - N Milani-Nejad
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - J C Trinidad
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - B H Kaffenberger
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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13
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Nusbaum KB, Adame S, Shipp D, Trinidad JC. Skin of color in dermatology: analysis of representation in dermatologic journals. Int J Dermatol 2021; 61:e350-e351. [PMID: 34411282 DOI: 10.1111/ijd.15828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/17/2021] [Accepted: 07/20/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Kelsey B Nusbaum
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Stephanie Adame
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Desmond Shipp
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - John C Trinidad
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
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14
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Nusbaum KB, Korman AM, Tyler KH, Kaffenberger JA, Trinidad JC, Dean S, Cataland S, Kaffenberger BH. In vitro diagnostics for the medical dermatologist. Part II: Hypercoagulability tests. J Am Acad Dermatol 2021; 85:301-310. [PMID: 33852929 DOI: 10.1016/j.jaad.2021.03.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
The skin often provides initial clues of hypercoagulability with features such as livedo reticularis, livedo racemosa, retiform purpura, necrosis, and ulcerations. Because these cutaneous manifestations are nonspecific, laboratory testing is often needed to evaluate for underlying causes of hypercoagulability. Importantly, these disorders are reported to be the most common mimicker, resulting in an erroneous diagnosis of pyoderma gangrenosum. Understanding inherent properties of, and indications for, available tests is necessary for appropriate ordering and interpretation of results. Additionally, ordering of these tests in an indiscriminate manner may lead to inaccurate results, complicating the interpretation and approach to management. This second article in this continuing medical education series summarizes information on methodology, test characteristics, and limitations of several in vitro laboratory tests used for the work up of hypercoagulability and vasculopathic disease as it pertains to dermatologic disease.
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Affiliation(s)
| | - Abraham M Korman
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Kelly H Tyler
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Jessica A Kaffenberger
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - John C Trinidad
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Steven Dean
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Spero Cataland
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Benjamin H Kaffenberger
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio.
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15
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Nusbaum KB, Kaffenberger BH, Paradiso Bs MM, Sopkovich JA, Daou H, Seminario-Vidal L, Trinidad JC. Dupilumab for treatment of atopic dermatitis in patients living with HIV: a case series. Int J Dermatol 2021; 60:e344-e346. [PMID: 33661522 DOI: 10.1111/ijd.15471] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/29/2020] [Accepted: 02/03/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Kelsey B Nusbaum
- University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Benjamin H Kaffenberger
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Michela M Paradiso Bs
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Jennifer A Sopkovich
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Hala Daou
- Department of Dermatology, University of South Florida, Tampa, Florida, USA
| | | | - John C Trinidad
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
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16
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Perry T, Rosen H, Pettit C, Trinidad JC. Pressure-induced alopecia due to proning in COVID-19. Dermatol Ther 2021; 34:e14764. [PMID: 33405325 PMCID: PMC7883060 DOI: 10.1111/dth.14764] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/28/2020] [Accepted: 12/31/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Thomas Perry
- The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Havi Rosen
- The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Cory Pettit
- The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - John C Trinidad
- The Ohio State University College of Medicine, Columbus, Ohio, USA
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Cartron AM, Boettler M, Chung C, Trinidad JC. Crusted scabies in an elderly woman. Dermatol Online J 2020; 26:13030/qt4c36775g. [PMID: 33147672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 10/27/2020] [Indexed: 06/11/2023] Open
Abstract
Crusted scabies is a highly contagious variant of classic scabies. Affected individuals are often elderly or immunocompromised and disease is associated with significant morbidity and mortality. Herein, we report an elderly woman residing in an assisted living facility who presented with diffuse sand-on-skin scale on her trunk, proximal extremities, scalp, hands, and feet. She was diagnosed with crusted scabies, isolated from other patients, and subsequently treated with permethrin 5% lotion and ivermectin. She died two weeks after initial presentation owing to sepsis.
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Affiliation(s)
| | | | | | - John C Trinidad
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH.
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19
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Cartron AM, Trinidad JC. Human Papillomavirus Vaccination in LGBTQ Patients: The Need for Dermatologists on the Front Lines. Cutis 2020; 106:159-161. [DOI: 10.12788/cutis.0084] [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: 11/20/2022]
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20
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Hadavand MA, Kaffenberger B, Cartron AM, Trinidad JC. Clinical Presentation and Management of Atypical and Recalcitrant Acute Generalized Exanthematous Pustulosis (AGEP). J Am Acad Dermatol 2020; 87:632-639. [PMID: 32926975 DOI: 10.1016/j.jaad.2020.09.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/31/2020] [Accepted: 09/03/2020] [Indexed: 10/23/2022]
Abstract
Acute generalized exanthematous pustulosis (AGEP) is a severe cutaneous adverse reaction (SCAR) characterized by sterile non-follicular pustules on an erythematous base that form rapidly after drug exposure. AGEP is mediated by numerous cytokines produced by drug specific T-cells that mediate neutrophilic intracorneal, subcorneal, and/or intraepidermal pustule development. Though genetic susceptibility is not fully understood, individuals with mutations in IL-36RN may be at increased risk of AGEP development. AGEP commonly presents with leukocytosis and fever in the acute pustular phase and follows a self-limited desquamative recovery phase upon removal of offending drug. Severe cases of AGEP may have multisystem organ involvement. Atypical presentations of AGEP include localized eruptions and cases with overlapping clinical and histopathological features associated with Stevens-Johnson syndrome/toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms, and generalized pustular psoriasis. Most cases of AGEP clear rapidly with systemic corticosteroids, but severe or recalcitrant cases may require other systemic therapies such as cyclosporine, and intravenous immunoglobulin.
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Affiliation(s)
| | - Benjamin Kaffenberger
- Division of Dermatology, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | | | - John C Trinidad
- Division of Dermatology, The Ohio State University College of Medicine, Columbus, Ohio, USA.
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21
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Cartron AM, Raiciulescu S, Trinidad JC. Culturally Competent Care for LGBT Patients in Dermatology Clinics. J Drugs Dermatol 2020; 19:786-787. [PMID: 32726107] [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: 06/11/2023]
Abstract
Lesbian, gay, bisexual, and transgender (LGBT) patients face unique health disparities.1 Routine collection of sexual orientation and gender identity (SOGI) data can optimize patient-provider interactions.2 Gender-neutral bathrooms promote inclusivity for LGBT patients.3 There is limited data on the extent to which dermatology practices make use of such features to deliver culturally competent care to LGBT patients.
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22
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Cartron AM, Challa N, Chung C, Trinidad JC. Umbilicated papules on the bilateral upper and lower extremities. Dermatol Online J 2020; 26:13030/qt4wq4t095. [PMID: 32815696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 07/29/2020] [Indexed: 06/11/2023] Open
Abstract
Cryptococcosis is a rare opportunistic infection with morphologically diverse cutaneous presentations. Primary infection typically occurs in the lungs with subsequent hematogenous dissemination to other organ systems, especially in immunocompromised patients. Herein, we report a woman in her 70's who presented with pruritic, umbilicated papulonodules of the bilateral upper and lower extremities present for many weeks. She was diagnosed with disseminated Cryptococcus and subsequently evaluated for potential pulmonary and meningeal disease involvement. She died as a result of multiple medical comorbidities.
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Affiliation(s)
| | | | | | - John C Trinidad
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH.
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23
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Cartron AM, Trinidad JC. Visual Dermatology: Herpes-Associated Bullous Dermatitis. J Cutan Med Surg 2020; 24:311. [DOI: 10.1177/1203475420915456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Alexander M. Cartron
- Department of Dermatology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - John C. Trinidad
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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24
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Cartron AM, Raiciulescu S, Trinidad JC. A Survey Study of Human Papillomavirus Vaccination Practices by Dermatologists. J Drugs Dermatol 2020; 19:431-432. [PMID: 32401459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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25
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Cartron AM, Osler M, Chung C, Trinidad JC. Nuclear matrix protein 2 antibody-positive adult dermatomyositis: a case report and review of the literature. Dermatol Online J 2020; 26:13030/qt9n50x88m. [PMID: 32609448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 05/01/2020] [Indexed: 06/11/2023] Open
Abstract
Dermatomyositis is a clinically heterogenous inflammatory myopathy with unique cutaneous features. Myositis-specific antibodies can aid in diagnosis and anticipation of patient prognosis. Herein, we report a 22-year-old man who presented with multifocal erythematous plaques with violaceous papules on his bilateral elbows, neck, and face. He was diagnosed with biopsy-proven dermatomyositis and determined to be seropositive for nuclear matrix protein 2 antibody (NXP-2). He was treated with systemic corticosteroids, then intravenous methylprednisolone and azathioprine, and ultimately achieved greatest treatment response with intravenous immune globulin therapy.
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Affiliation(s)
- Alexander M Cartron
- Department of Dermatology, University of Maryland School of Medicine, Baltimore, MD.
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26
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Cartron AM, Blaszczak A, Trinidad JC. Combination therapy with 5‐fluorouracil and salicylic acid in a treatment‐resistant case of filiform facial warts. Dermatol Ther 2020; 33:e13235. [DOI: 10.1111/dth.13235] [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: 12/31/2019] [Revised: 01/10/2020] [Accepted: 01/22/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Alexander M. Cartron
- Department of Dermatology University of Maryland School of Medicine Baltimore Maryland
| | - Alecia Blaszczak
- Division of Dermatology, Department of Internal Medicine The Ohio State University Wexner Medical Center Columbus Ohio
| | - John C. Trinidad
- Division of Dermatology, Department of Internal Medicine The Ohio State University Wexner Medical Center Columbus Ohio
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27
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Weinkle A, Kaffenberger BH, Trinidad JC, Ergen EN, Keller J, Seminario-Vidal L. Reply to: “Response: Distinguishing Stevens-Johnson syndrome/toxic epidermal necrolysis from clinical mimickers during inpatient dermatologic consultation—A retrospective chart review”. J Am Acad Dermatol 2020; 82:e113. [DOI: 10.1016/j.jaad.2019.11.014] [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: 10/24/2019] [Revised: 11/02/2019] [Accepted: 11/04/2019] [Indexed: 11/25/2022]
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28
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Cartron AM, Osler M, Chung C, Trinidad JC. Nuclear matrix protein 2 antibody-positive adult dermatomyositis: a case report and review of the literature. Dermatol Online J 2020. [DOI: 10.5070/d3263047981] [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: 11/08/2022] Open
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29
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Cartron AM, Challa N, Chung C, Trinidad JC. Umbilicated papules on the bilateral upper and lower extremities. Dermatol Online J 2020. [DOI: 10.5070/d3266049325] [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: 11/08/2022] Open
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30
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Haynes D, Hammer P, Malachowski SJ, Kaffenberger B, Yi JS, Vera N, Calhoun C, Shinohara MM, Seminario-Vidal L, Trinidad JC, Keller JJ, Ortega-Loayza AG. Characterisation and diagnosis of ulcers in inpatient dermatology consultation services: A multi-centre study. Int Wound J 2019; 16:1440-1444. [PMID: 31475449 DOI: 10.1111/iwj.13211] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 08/18/2019] [Indexed: 12/20/2022] Open
Abstract
Accurate and prompt diagnosis of skin ulcers is critical to optimise management; however, studies in hospitalised patients are limited. This retrospective review of dermatologic consultations included 272 inpatients with skin ulcers between July 2015 and July 2018 in four U.S. academic hospitals. The median age was 54 years and 45% were male. In 49.3% of the patients, skin ulcers were considered the primary reason for admission. Ulcers of 62% were chronic and 49.6% were located on the lower extremities. Pyoderma gangrenosum (17.3%), infection (12.5%), and exogenous causes (11.8%) were the leading aetiologies; 12% remained diagnostically inconclusive after consultation. Diagnostic agreements pre-dermatology and post-dermatology consult ranged from 0.104 (n = 77, 95% CI 0.051-0.194) to 0.553 (n = 76, 95% CI 0.440-0.659), indicating poor-modest agreement. This study highlights the diagnostic complexity and relative incidences of skin ulcers in the inpatient setting.
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Affiliation(s)
- Dylan Haynes
- Oregon Health & Science University, Department of Dermatology, Portland, Oregon
| | - Phoebe Hammer
- Oregon Health & Science University, School of Medicine, Portland, Oregon
| | | | | | - Jonathan S Yi
- University of Washington, Division of Dermatology, Seattle, Washington
| | - Nora Vera
- University of South Florida, Department of Dermatology, Tampa, Florida
| | - Cody Calhoun
- Ohio State University, Department of Dermatology, Columbus, Ohio
| | - Michi M Shinohara
- University of Washington, Division of Dermatology, Seattle, Washington
| | | | - John C Trinidad
- Ohio State University, Department of Dermatology, Columbus, Ohio
| | - Jesse J Keller
- Oregon Health & Science University, Department of Dermatology, Portland, Oregon
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Abstract
The postsynaptic density (PSD) is an electron-dense structure located at the synaptic contacts between neurons. Its considerable complexity includes cytoskeletal and scaffold proteins, receptors, ion channels and signaling molecules, in line with the role of PSDs in signal transduction and processing. The phosphorylation state of components of the PSD is central to synaptic transmission and is known to play a role in synaptic plasticity, learning and memory. The presence of a range of kinases and phosphatases in the PSD defines potential key players in this context. However, the substrates that these enzymes target have not been fully identified to date. We analyzed the protein composition of purified PSD samples from adult mouse brains by strong cation exchange chromatography fractionation of a tryptic digest followed by nano-reverse phase liquid chromatography coupled with electrospray ionization-quadrupole time of flight tandem mass spectrometry. This led to the identification of 244 proteins. To gain an insight into the phosphoproteome of the PSD we then purified phosphorylated tryptic peptides by immobilized metal ion affinity chromatography. This approach for the specific enrichment of phosphopeptides resulted in the identification of 42 phosphoproteins in the PSD preparation, 39 of which are known PSD components. Here we present a total of 83 in vivo phosphorylation sites.
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Affiliation(s)
- J C Trinidad
- Mass Spectrometry Facility, Department of Pharmaceutical Chemistry, University of California, 513 Parnassus Avenue, San Francisco, CA 94143, USA
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Díaz Rodríguez C, Granja E, Vázquez Martul E, Sacristán F, Moreno Fernández A, González Rivero C, del Río Romero D, Trinidad JC. [Association between membranous glomerulonephritis and Crohn's disease]. Nefrologia 2004; 24:368-71. [PMID: 15455498] [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: 04/30/2023] Open
Abstract
We report the case of a 37 year old man who suffered from Crohn's Disease (CD), and was receiving treatment with mesalazine (5-ASA). Nine years after the diagnosis, because of detecting a slight proteinuria, a renal biopsy is made, being the anatomo-pathologic result compatible with membranous glomerulonephritis (MGN). Checking previous literature we have only found two cases reported of MGN in coincidence with Inflammatory Bowel Disease (IBD), one in association with Ulcerative Colitis and the other with Crohn's Disease in a 12 years old boy. This is, therefore, the second case presenting MGN associated with CD and the first in an adult patient.
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Affiliation(s)
- C Díaz Rodríguez
- Servicio de Nefrología, F. P. Hospital "Virxe da Xunqueira", Cée Coruña.
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Trinidad JC, Fischbach GD, Cohen JB. The Agrin/MuSK signaling pathway is spatially segregated from the neuregulin/ErbB receptor signaling pathway at the neuromuscular junction. J Neurosci 2000; 20:8762-70. [PMID: 11102484 PMCID: PMC6773073] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
The neuregulin/erbB receptor and agrin/MuSK pathways are critical for communication between the nerve, muscle, and Schwann cell that establishes the precise topological arrangement at the vertebrate neuromuscular junction (NMJ). ErbB2, erbB3, and erbB4 as well as neuregulin, agrin, and MuSK are known to be concentrated at the NMJ. Here we have examined NMJs from gastrocnemius muscle of adult rat using immunofluorescence confocal microscopy to characterize in detail the distribution of these proteins relative to the distribution of acetylcholine receptors (AChRs). We have determined that erbB2 and erbB4 are enriched in the depths of the secondary junctional folds on the postsynaptic muscle membrane. In contrast, erbB3 at the NMJ was concentrated at presynaptic terminal Schwann cells. This distribution strongly argues that erbB2/erbB4 heterodimers are the functional postsynaptic neuregulin receptors of the NMJ. Neuregulin was localized to the axon terminal, secondary folds, and terminal Schwann cells, where it was in a position to signal through erbB receptors. MuSK was concentrated in the postsynaptic primary gutter region where it was codistributed with AChRs. Agrin was present at the axon terminal and in the basal lamina associated with the primary gutter region, but not in the secondary junctional folds. The differential distributions of the neuregulin and agrin signaling pathways argue against neuregulin and erbB receptors being localized to the NMJ via direct interactions with either agrin or MuSK.
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MESH Headings
- Agrin/metabolism
- Animals
- Antigens, Differentiation/metabolism
- ErbB Receptors/metabolism
- Fluorescent Antibody Technique
- Microscopy, Confocal
- Microscopy, Electron
- Muscle, Skeletal/cytology
- Muscle, Skeletal/metabolism
- Neuregulins/metabolism
- Neuromuscular Junction/metabolism
- Neuromuscular Junction/ultrastructure
- Presynaptic Terminals/metabolism
- Presynaptic Terminals/ultrastructure
- Rats
- Rats, Sprague-Dawley
- Receptor Protein-Tyrosine Kinases/metabolism
- Receptor, ErbB-2/metabolism
- Receptor, ErbB-3/metabolism
- Receptor, ErbB-4
- Receptors, Cholinergic
- Schwann Cells/cytology
- Schwann Cells/metabolism
- Signal Transduction/physiology
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Affiliation(s)
- J C Trinidad
- Department of Neurobiology, Harvard Medical School, Boston, Massachusetts 02115, USA
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Trinidad JC, Iraburu M, Martínez A, Espiñeira M, Bañales T, Alvarez I. [Tuberous sclerosis. Description of a family study]. An Med Interna 1997; 14:351-4. [PMID: 9410122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We present tuberous sclerosis affecting all the members of a family, now and for three consecutive generations (probably four). A fortuitous study of cutaneous disease in one member led to diagnosis in all of them. A systematic study detected important visceral implication in all cases, mainly neurological, despite the fact only one of then showed related symptoms. We discuss the epidemiological and diagnostic aspects of an illness, which is widely underdiagnosed even today, despite the fact that detection is by sight.
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Affiliation(s)
- J C Trinidad
- Servicio de Medicina Interna, Hospital Juan Canalejo, La Coruña
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