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Tran MM, Orsillo L, Wei G, Mirza FN, Yumeen S, Wisco OJ. Applications and Best Practices for Geospatial Analysis Research in Dermatology. J Invest Dermatol 2024; 144:738-747. [PMID: 38519249 DOI: 10.1016/j.jid.2024.01.016] [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: 10/31/2023] [Revised: 01/02/2024] [Accepted: 01/23/2024] [Indexed: 03/24/2024]
Abstract
Dermatologic diseases often exhibit distinct geographic patterns, underscoring the significant role of regional environmental, genetic, and sociocultural factors in driving their prevalence and manifestations. Geographic information and geospatial analysis enable researchers to investigate the spatial distribution of adverse health outcomes and their relationship with socioeconomic and environmental risk factors that are inherently geographic. Health geographers and spatial epidemiologists have developed numerous geospatial analytical tools to collect, process, visualize, and analyze geographic data. These tools help provide vital spatial context to the comprehension of the underlying dynamics behind health outcomes. By identifying areas with high rates of dermatologic disease and areas with barriers to access to quality dermatologic care, findings from studies utilizing geospatial analysis can inform the design and targeting of policy and intervention to help improve dermatologic healthcare outcomes and promote health equity. This article emphasizes the significance of geospatial data and analysis in dermatology research. We explore the common processes in data acquisition, harmonization, and geospatial analytics while conducting spatially and dermatologically relevant research. The article also highlights the practical application of geospatial analysis through instances drawn from the dermatology literature.
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Affiliation(s)
- Megan M Tran
- The Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.
| | | | - Guixing Wei
- Spatial Structures in the Social Sciences, Population Studies and Training Center, Brown University, Providence, Rhode Island, USA
| | - Fatima N Mirza
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Sara Yumeen
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Oliver J Wisco
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
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2
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Tran MM, Mirza FN, Lee AC, Goldbach HS, Libby TJ, Wisco OJ. Dermatologic findings associated with semaglutide use: A scoping review. J Am Acad Dermatol 2024:S0190-9622(24)00532-2. [PMID: 38554940 DOI: 10.1016/j.jaad.2024.03.021] [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: 02/05/2024] [Revised: 03/05/2024] [Accepted: 03/12/2024] [Indexed: 04/02/2024]
Affiliation(s)
- Megan M Tran
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Fatima N Mirza
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | | | - Hayley S Goldbach
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Tiffany J Libby
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Oliver J Wisco
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
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3
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Wisco OJ, Diehl K, Funk T, Schlarbaum JP, Cohen LM. An Infant With Widespread Nodules and Papules. Am Fam Physician 2024; 109:263-264. [PMID: 38574217] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Affiliation(s)
- Oliver J Wisco
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Kyra Diehl
- Western University of Health Sciences, Pomona, California
| | - Tracy Funk
- Oregon Health and Science University, Portland, Oregon
| | | | - Lisa M Cohen
- Tufts University School of Medicine, Boston, Massachusetts
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4
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Chen A, Ray P, Rogers H, Bialowas C, Butala P, Chen M, Daveluy SD, Davidson C, Faringer P, Guarda H, Kantor J, Kaweski S, Lawrence N, Lickstein D, Lomax J, Parra S, Retson N, Suryadevara A, Smith R, Tollefson TT, Wisco OJ. Evidence-Based Performance Measures for Reconstruction after Skin Cancer Resection: A Multidisciplinary Performance Measure Set. Plast Reconstr Surg 2024; 153:424e-441e. [PMID: 38266139 DOI: 10.1097/prs.0000000000010916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
BACKGROUND The American Society of Plastic Surgeons commissioned the multidisciplinary Performance Measure Development Work Group on Reconstruction after Skin Cancer Resection to identify and draft quality measures for the care of patients undergoing skin cancer reconstruction. Included stakeholders were the American Academy of Otolaryngology-Head and Neck Surgery, the American Academy of Facial Plastic and Reconstructive Surgery, the American Academy of Dermatology, the American Society of Dermatologic Surgery, the American College of Mohs Surgery, the American Society for Mohs Surgery, and a patient representative. METHODS Two outcome measures and five process measures were identified. The outcome measures included the following: (1) patient satisfaction with information provided by their surgeon before their facial procedure, and (2) postprocedural urgent care or emergency room use. The process measures focus on antibiotic stewardship, anticoagulation continuation and/or coordination of care, opioid avoidance, and verification of clear margins. RESULTS All measures in this report were approved by the American Society of Plastic Surgeons Quality and Performance Measures Work Group and Executive Committee, and the stakeholder societies. CONCLUSION The work group recommends the use of these measures for quality initiatives, Continuing Medical Education, Continuous Certification, Qualified Clinical Data Registry reporting, and national quality reporting programs.
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Affiliation(s)
| | - Peter Ray
- East Hills Professional Center and Marshall University Joan C. Edwards School of Medicine
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5
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Wisco OJ, Diehl K, Clark MR, Gilson RT, Cohen LM. Pruritic Rash on the Shins. Am Fam Physician 2024; 109:Online. [PMID: 38227878] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Affiliation(s)
- Oliver J Wisco
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Kyra Diehl
- Western University of Health Sciences, Pomona, California
| | | | - Robert T Gilson
- University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Lisa M Cohen
- Tufts University School of Medicine, Boston, Massachusetts
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6
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Wisco OJ, Marson JW, Litchman GH, Brownstone N, Covington KR, Martin BJ, Quick AP, Siegel JJ, Caruso HG, Cook RW, Winkelmann RR, Rigel DS. Improved cutaneous melanoma survival stratification through integration of 31-gene expression profile testing with the American Joint Committee on Cancer 8th Edition Staging. Melanoma Res 2022; 32:98-102. [PMID: 35254332 PMCID: PMC8893124 DOI: 10.1097/cmr.0000000000000804] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 12/14/2021] [Indexed: 11/26/2022]
Abstract
Cutaneous melanoma (CM) survival is assessed using averaged data from the American Joint Committee on Cancer 8th edition (AJCC8). However, subsets of AJCC8 stages I-III have better or worse survival than the predicted average value. The objective of this study was to determine if the 31-gene expression profile (31-GEP) test for CM can further risk-stratify melanoma-specific mortality within each AJCC8 stage. This retrospective multicenter study of 901 archival CM samples obtained from patients with stages I-III CM assessed 31-GEP test predictions of 5-year melanoma-specific survival (MSS) using Kaplan-Meier and Cox proportional hazards. In stage I-III CM population, patients with a Class 2B result had a lower 5-year MSS (77.8%) than patients with a Class 1A result (98.7%) and log-rank testing demonstrated significant stratification of MSS [χ2 (2df, n = 901) = 99.7, P < 0.001). Within each stage, 31-GEP data provided additional risk stratification, including in stage I [χ2 (2df, n = 415) = 11.3, P = 0.004]. Cox regression multivariable analysis showed that the 31-GEP test was a significant predictor of melanoma-specific mortality (MSM) in patients with stage I-III CM [hazard ratio: 6.44 (95% confidence interval: 2.61-15.85), P < 0.001]. This retrospective study focuses on Class 1A versus Class 2B results. Intermediate results (Class 1B/2A) comprised 21.6% of cases with survival rates between Class 1A and 2B, and similar to 5-year MSS AJCC stage values. Data from the 31-GEP test significantly differentiates MSM into lower (Class 1A) and higher risk (Class 2B) groups within each AJCC8 stage. Incorporating 31-GEP results into AJCC8 survival calculations has the potential to more precisely assess survival and enhance management guidance.
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Affiliation(s)
| | | | - Graham H. Litchman
- Department of Dermatology, St. John’s Episcopal Hospital, Far Rockaway, New York
| | | | - Kyle R. Covington
- Research and Development, Castle Biosciences, Inc., Friendswood, Texas
| | - Brian J. Martin
- Research and Development, Castle Biosciences, Inc., Friendswood, Texas
| | - Ann P. Quick
- Research and Development, Castle Biosciences, Inc., Friendswood, Texas
| | | | - Hillary G. Caruso
- Research and Development, Castle Biosciences, Inc., Friendswood, Texas
| | - Robert W. Cook
- Research and Development, Castle Biosciences, Inc., Friendswood, Texas
| | | | - Darrell S. Rigel
- Department of Dermatology, Mount Sinai Ichan School of Medicine, New York, New York, USA
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Abstract
Importance: Reconstructing cosmetically sensitive defects in an aging population undergoing multiple Mohs micrographic surgeries (MMS) may be addressed with alternatives to surgery. Objective: Patients undergoing MMS with defect reconstruction in visually prominent areas receiving placental allograft were compared with traditional autologous tissue-based procedures—flaps and full-thickness skin grafts (FTSG). Design, Setting, and Participants: This retrospective case–control study evaluated patients who underwent MMS for removal of a basal or squamous cell carcinoma with same-day repair. Main Outcomes and Measures: The primary endpoint was the incidence and comparison of postoperative morbidity. Risk for developing medical or cosmetic sequelae was determined through multivariate logistic regression. Results: The study population consisted of 143 propensity score-matched pairs (n = 286) with moderate- to high-risk defects on the face, head, and neck. Compared with autologous tissue, placental allograft cases were associated with significantly lower risk for infection (p = 0.004), poor scar cosmesis (p < 0.0001), scar revision (p < 0.0001), or reoperation (p = 0.0007). Conclusions and Relevance: Postoperative complication rates for placental reconstructions did not exceed those demonstrated by autologous tissue counterparts, indicating this is a safe alternative to flap and FTSG in cosmetically sensitive repairs.
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Affiliation(s)
- Julia Toman
- Division of Facial Plastics and Reconstructive Surgery, Department of Otolaryngology Head and Neck Surgery, University of South Florida, Tampa, Florida, USA
| | - Georgina M Michael
- Department of Clinical Research, MiMedx Group, Inc., Marietta, Georgia, USA
| | - Oliver J Wisco
- Dermatology Health Specialists, Bend, Oregon, USA.,Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - John R Adams
- Advanced Dermatology and Skin Cancer Center, Manhattan, Kansas, USA.,Division of Dermatology, Department of Internal Medicine, University of Kansas School of Medicine, Wichita, Kansas, USA
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8
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Swetter SM, Tsao H, Bichakjian CK, Curiel-Lewandrowski C, Elder DE, Gershenwald JE, Guild V, Grant-Kels JM, Halpern AC, Johnson TM, Sober AJ, Thompson JA, Wisco OJ, Wyatt S, Hu S, Lamina T. Guidelines of care for the management of primary cutaneous melanoma. J Am Acad Dermatol 2018; 80:208-250. [PMID: 30392755 DOI: 10.1016/j.jaad.2018.08.055] [Citation(s) in RCA: 307] [Impact Index Per Article: 51.2] [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: 08/09/2018] [Revised: 08/28/2018] [Accepted: 08/29/2018] [Indexed: 12/12/2022]
Abstract
The incidence of primary cutaneous melanoma continues to increase each year. Melanoma accounts for the majority of skin cancer-related deaths, but treatment is usually curative following early detection of disease. In this American Academy of Dermatology clinical practice guideline, updated treatment recommendations are provided for patients with primary cutaneous melanoma (American Joint Committee on Cancer stages 0-IIC and pathologic stage III by virtue of a positive sentinel lymph node biopsy). Biopsy techniques for a lesion that is clinically suggestive of melanoma are reviewed, as are recommendations for the histopathologic interpretation of cutaneous melanoma. The use of laboratory, molecular, and imaging tests is examined in the initial work-up of patients with newly diagnosed melanoma and for follow-up of asymptomatic patients. With regard to treatment of primary cutaneous melanoma, recommendations for surgical margins and the concepts of staged excision (including Mohs micrographic surgery) and nonsurgical treatments for melanoma in situ, lentigo maligna type (including topical imiquimod and radiation therapy), are updated. The role of sentinel lymph node biopsy as a staging technique for cutaneous melanoma is described, with recommendations for its use in clinical practice. Finally, current data regarding pregnancy and melanoma, genetic testing for familial melanoma, and management of dermatologic toxicities related to novel targeted agents and immunotherapies for patients with advanced disease are summarized.
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Affiliation(s)
- Susan M Swetter
- Department of Dermatology, Stanford University Medical Center and Cancer Institute, Stanford, California; Veterans Affairs Palo Alto Health Care System, Palo Alto, California.
| | - Hensin Tsao
- Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Wellman Center for Photomedicine, Boston, Massachusetts
| | - Christopher K Bichakjian
- Department of Dermatology, University of Michigan Health System, Ann Arbor, Michigan; Comprehensive Cancer Center, Ann Arbor, Michigan
| | - Clara Curiel-Lewandrowski
- Division of Dermatology, University of Arizona, Tucson, Arizona; University of Arizona Cancer Center, Tucson, Arizona
| | - David E Elder
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Pathology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jeffrey E Gershenwald
- Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas; Department of Cancer Biology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | | | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut; Department of Pathology, University of Connecticut Health Center, Farmington, Connecticut; Department of Pediatrics, University of Connecticut Health Center, Farmington, Connecticut
| | - Allan C Halpern
- Department of Dermatology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Timothy M Johnson
- Department of Dermatology, University of Michigan Health System, Ann Arbor, Michigan; Comprehensive Cancer Center, Ann Arbor, Michigan
| | - Arthur J Sober
- Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - John A Thompson
- Division of Oncology, University of Washington, Seattle, Washington; Seattle Cancer Care Alliance, Seattle, Washington
| | - Oliver J Wisco
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon
| | | | - Shasa Hu
- Department of Dermatology, University of Miami Health System, Miami, Florida
| | - Toyin Lamina
- American Academy of Dermatology, Rosemont, Illinois
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9
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Wisco OJ, Hajar T, Grande DJ. Commentary: Skin cancer in the military. J Am Acad Dermatol 2018; 78:1193-1194. [DOI: 10.1016/j.jaad.2018.01.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 01/29/2018] [Indexed: 10/18/2022]
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10
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Johnson MM, Leachman SA, Aspinwall LG, Cranmer LD, Curiel-Lewandrowski C, Sondak VK, Stemwedel CE, Swetter SM, Vetto J, Bowles T, Dellavalle RP, Geskin LJ, Grossman D, Grossmann KF, Hawkes JE, Jeter JM, Kim CC, Kirkwood JM, Mangold AR, Meyskens F, Ming ME, Nelson KC, Piepkorn M, Pollack BP, Robinson JK, Sober AJ, Trotter S, Venna SS, Agarwala S, Alani R, Averbook B, Bar A, Becevic M, Box N, E Carson W, Cassidy PB, Chen SC, Chu EY, Ellis DL, Ferris LK, Fisher DE, Kendra K, Lawson DH, Leming PD, Margolin KA, Markovic S, Martini MC, Miller D, Sahni D, Sharfman WH, Stein J, Stratigos AJ, Tarhini A, Taylor MH, Wisco OJ, Wong MK. Skin cancer screening: recommendations for data-driven screening guidelines and a review of the US Preventive Services Task Force controversy. Melanoma Manag 2017; 4:13-37. [PMID: 28758010 PMCID: PMC5480135 DOI: 10.2217/mmt-2016-0022] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [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: 06/10/2016] [Accepted: 09/07/2016] [Indexed: 02/07/2023] Open
Abstract
Melanoma is usually apparent on the skin and readily detected by trained medical providers using a routine total body skin examination, yet this malignancy is responsible for the majority of skin cancer-related deaths. Currently, there is no national consensus on skin cancer screening in the USA, but dermatologists and primary care providers are routinely confronted with making the decision about when to recommend total body skin examinations and at what interval. The objectives of this paper are: to propose rational, risk-based, data-driven guidelines commensurate with the US Preventive Services Task Force screening guidelines for other disorders; to compare our proposed guidelines to recommendations made by other national and international organizations; and to review the US Preventive Services Task Force's 2016 Draft Recommendation Statement on skin cancer screening.
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Affiliation(s)
- Mariah M Johnson
- Department of Dermatology, Oregon Health & Science University, 3303 SW Bond Ave., Portland, OR, USA.,Department of Dermatology, Oregon Health & Science University, 3303 SW Bond Ave., Portland, OR, USA
| | - Sancy A Leachman
- Department of Dermatology, Oregon Health & Science University, 3303 SW Bond Ave., Portland, OR, USA.,Department of Dermatology, Oregon Health & Science University, 3303 SW Bond Ave., Portland, OR, USA
| | - Lisa G Aspinwall
- University of Utah, Salt Lake City, UT, USA.,University of Utah, Salt Lake City, UT, USA
| | - Lee D Cranmer
- University of Washington, Seattle, WA, USA.,University of Washington, Seattle, WA, USA
| | - Clara Curiel-Lewandrowski
- University of Arizona Cancer Center, Tucson, AZ, USA.,University of Arizona Cancer Center, Tucson, AZ, USA
| | - Vernon K Sondak
- Moffitt Cancer Center, Tampa, FL, USA.,Moffitt Cancer Center, Tampa, FL, USA
| | - Clara E Stemwedel
- Oregon Health & Science University, Portland, OR, USA.,Oregon Health & Science University, Portland, OR, USA
| | - Susan M Swetter
- Stanford University Medical Center & VA Palo Alto Health Care System, Palo Alto, CA, USA.,Stanford University Medical Center & VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - John Vetto
- Oregon Health & Science University, Portland, OR, USA.,Oregon Health & Science University, Portland, OR, USA
| | - Tawnya Bowles
- Intermountain Healthcare & University of Utah, Salt Lake City, UT, USA.,Intermountain Healthcare & University of Utah, Salt Lake City, UT, USA
| | - Robert P Dellavalle
- University of Colorado, Aurora, CO, USA.,University of Colorado, Aurora, CO, USA
| | - Larisa J Geskin
- Columbia University, New York, NY, USA.,Columbia University, New York, NY, USA
| | - Douglas Grossman
- University of Utah, Salt Lake City, UT, USA.,University of Utah, Salt Lake City, UT, USA
| | - Kenneth F Grossmann
- University of Utah, Salt Lake City, UT, USA.,University of Utah, Salt Lake City, UT, USA
| | - Jason E Hawkes
- University of Utah, Salt Lake City, UT, USA.,University of Utah, Salt Lake City, UT, USA
| | - Joanne M Jeter
- The Ohio State University, Columbus, OH, USA.,The Ohio State University, Columbus, OH, USA
| | - Caroline C Kim
- Harvard Medical School, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - John M Kirkwood
- University of Pittsburgh, Pittsburgh, PA, USA.,University of Pittsburgh, Pittsburgh, PA, USA
| | - Aaron R Mangold
- Mayo Clinic Arizona, Scottsdale, AZ, USA.,Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Frank Meyskens
- University of California, Irvine, Orange, CA, USA.,University of California, Irvine, Orange, CA, USA
| | - Michael E Ming
- University of Pennsylvania, Philadelphia, PA, USA.,University of Pennsylvania, Philadelphia, PA, USA
| | - Kelly C Nelson
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael Piepkorn
- University of Washington, Seattle, WA, USA.,University of Washington, Seattle, WA, USA
| | - Brian P Pollack
- Emory University & Atlanta VA Medical Center, Atlanta, GA, USA.,Emory University & Atlanta VA Medical Center, Atlanta, GA, USA
| | - June K Robinson
- Northwestern University Feinberg School of Medicine, Chicago, IL USA.,Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Arthur J Sober
- Harvard Medical School, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Shannon Trotter
- The Ohio State University, Columbus, OH, USA.,The Ohio State University, Columbus, OH, USA
| | - Suraj S Venna
- Inova Medical Group, Fairfax, VA, USA.,Inova Medical Group, Fairfax, VA, USA
| | - Sanjiv Agarwala
- St Luke's University Hospital & Temple University, Bethlehem, PA, USA.,St Luke's University Hospital & Temple University, Bethlehem, PA, USA
| | - Rhoda Alani
- Boston University, Boston, MA, USA.,Boston University, Boston, MA, USA
| | - Bruce Averbook
- Case Western Reserve University, Cleveland, OH, USA.,Case Western Reserve University, Cleveland, OH, USA
| | - Anna Bar
- Oregon Health & Science University, Portland, OR, USA.,Oregon Health & Science University, Portland, OR, USA
| | - Mirna Becevic
- University of Missouri, Columbia, MO, USA.,University of Missouri, Columbia, MO, USA
| | - Neil Box
- University of Colorado, Aurora, CO, USA.,University of Colorado, Aurora, CO, USA
| | - William E Carson
- The Ohio State University, Columbus, OH, USA.,The Ohio State University, Columbus, OH, USA
| | - Pamela B Cassidy
- Oregon Health & Science University, Portland, OR, USA.,Oregon Health & Science University, Portland, OR, USA
| | - Suephy C Chen
- Emory University & Atlanta VA Medical Center, Atlanta, GA, USA.,Emory University & Atlanta VA Medical Center, Atlanta, GA, USA
| | - Emily Y Chu
- University of Pennsylvania, Philadelphia, PA, USA.,University of Pennsylvania, Philadelphia, PA, USA
| | - Darrel L Ellis
- Vanderbilt University, Nashville, TN, USA.,Vanderbilt University, Nashville, TN, USA
| | - Laura K Ferris
- University of Pittsburgh, Pittsburgh, PA, USA.,University of Pittsburgh, Pittsburgh, PA, USA
| | - David E Fisher
- Harvard Medical School & Massachusetts General Hospital, Charlestown, MA, USA.,Harvard Medical School & Massachusetts General Hospital, Charlestown, MA, USA
| | - Kari Kendra
- The Ohio State University, Columbus, OH, USA.,The Ohio State University, Columbus, OH, USA
| | - David H Lawson
- Winship Cancer Institute of Emory University, Atlanta, GA, USA.,Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Philip D Leming
- The Christ Hospital, Cincinnati, OH, USA.,The Christ Hospital, Cincinnati, OH, USA
| | - Kim A Margolin
- City of Hope National Cancer Center, Duarte, CA, USA.,City of Hope National Cancer Center, Duarte, CA, USA
| | | | - Mary C Martini
- Northwestern University Feinberg School of Medicine, Chicago, IL USA.,Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Debbie Miller
- Oregon Health & Science University, Portland, OR, USA.,Oregon Health & Science University, Portland, OR, USA
| | - Debjani Sahni
- Boston University, Boston, MA, USA.,Boston University, Boston, MA, USA
| | - William H Sharfman
- Johns Hopkins University, Baltimore, MD.,Johns Hopkins University, Baltimore, MD
| | - Jennifer Stein
- NYU Langone Medical Center, New York, NY, USA.,NYU Langone Medical Center, New York, NY, USA
| | - Alexander J Stratigos
- Department of Dermatology, University of Athens, Andreas Sygros Hospital, Athens, Greece.,Department of Dermatology, University of Athens, Andreas Sygros Hospital, Athens, Greece
| | - Ahmad Tarhini
- University of Pittsburgh, Pittsburgh, PA, USA.,University of Pittsburgh, Pittsburgh, PA, USA
| | - Matthew H Taylor
- Oregon Health & Science University, Portland, OR, USA.,Oregon Health & Science University, Portland, OR, USA
| | - Oliver J Wisco
- Bend Memorial Clinic, Bend, OR, USA.,Bend Memorial Clinic, Bend, OR, USA
| | - Michael K Wong
- University of Texas MD Anderson Cancer Center, Houston, TX, USA.,University of Texas MD Anderson Cancer Center, Houston, TX, USA
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11
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Leitenberger JJ, Rogers H, Chapman JC, Maher IA, Fox MC, Harmon CB, Bailey EC, Odland P, Wysong A, Johnson T, Wisco OJ. Defining recurrence of nonmelanoma skin cancer after Mohs micrographic surgery: Report of the American College of Mohs Surgery Registry and Outcomes Committee. J Am Acad Dermatol 2016; 75:1022-1031. [DOI: 10.1016/j.jaad.2016.06.047] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 06/15/2016] [Accepted: 06/21/2016] [Indexed: 11/27/2022]
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12
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Wisco OJ. Case series: The use of a dehydrated human amnion/chorion membrane allograft to enhance healing in the repair of lower eyelid defects after Mohs micrographic surgery. JAAD Case Rep 2016; 2:294-7. [PMID: 27504483 PMCID: PMC4969256 DOI: 10.1016/j.jdcr.2016.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 11/30/2022] Open
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13
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Wisco OJ, Adelson D. Basal cell carcinoma screening drives a comprehensive approach to skin cancer. Br J Dermatol 2016; 174:1182-3. [PMID: 27317277 DOI: 10.1111/bjd.14707] [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: 11/29/2022]
Affiliation(s)
- O J Wisco
- Bend Memorial Clinic, Bend, OR, U.S.A.. .,Department of Dermatology, Oregon Health Sciences University, Portland, OR, U.S.A..
| | - D Adelson
- Department of Dermatology, Oregon Health Sciences University, Portland, OR, U.S.A
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14
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Balagula Y, Mattei PL, Wisco OJ, Erdag G, Chien AL. The great imitator revisited: the spectrum of atypical cutaneous manifestations of secondary syphilis. Int J Dermatol 2014; 53:1434-41. [PMID: 25312512 DOI: 10.1111/ijd.12518] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Syphilis is a well-known sexually transmitted infection infamous for its protean cutaneous manifestations. Over the last decade, the rate of infection in the USA has risen, particularly among human immunodeficiency virus (HIV)-infected individuals and certain ethnic groups. Although the primary chancre developing at the site of inoculation usually has typical and well-characterized features, cutaneous manifestations of secondary syphilis span a wide spectrum and mimic those of other dermatoses. This may be particularly evident in patients with HIV. Such deviations from the expected typical papulosquamous eruption may present a diagnostic challenge and delay diagnosis and therapy. Given the increasing incidence of syphilis among the immunosuppressed patient population, recognition of atypical cutaneous manifestations is critical for adequate management. We review a range of cutaneous manifestations of secondary syphilis and the skin diseases it may mimic.
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Affiliation(s)
- Yevgeniy Balagula
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Moss TA, Spillane AP, Almquist SF, McCleskey PE, Wisco OJ. Palmoplantar keratoderma with progressive gingivitis and recurrent pyodermas. Cutis 2014; 93:193-198. [PMID: 24818179] [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
Papillon-Lefèvre syndrome (PLS) is a rare inherited palmoplantar keratoderma (PPK) that is associated with progressive gingivitis and recurrent pyodermas. We present a case exhibiting classic features of this autosomal-recessive condition and review the current understanding of its pathophysiology, diagnosis, and treatment. Additionally, a review of pertinent transgredient PPKs is undertaken, with key and distinguishing features of each syndrome highlighted.
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Affiliation(s)
| | - Anne P Spillane
- Department of Dermatology, Kimbrough Ambulatory Care Center, 2480 Llewellyn Ave, Ste 5800, Fort Meade, MD 20755-5129, USA.
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Connolly SM, Baker DR, Coldiron BM, Fazio MJ, Storrs PA, Vidimos AT, Zalla MJ, Brewer JD, Smith Begolka W, Berger TG, Bigby M, Bolognia JL, Brodland DG, Collins S, Cronin TA, Dahl MV, Grant-Kels JM, Hanke CW, Hruza GJ, James WD, Lober CW, McBurney EI, Norton SA, Roenigk RK, Wheeland RG, Wisco OJ. AAD/ACMS/ASDSA/ASMS 2012 appropriate use criteria for Mohs micrographic surgery: A report of the American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery Association, and the American Society for Mohs Surgery. J Am Acad Dermatol 2012; 67:531-50. [DOI: 10.1016/j.jaad.2012.06.009] [Citation(s) in RCA: 224] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 06/07/2012] [Accepted: 06/12/2012] [Indexed: 10/27/2022]
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Connolly SM, Baker DR, Coldiron BM, Fazio MJ, Storrs PA, Vidimos AT, Zalla MJ, Brewer JD, Begolka WS, Berger TG, Bigby M, Bolognia JL, Brodland DG, Collins S, Cronin TA, Dahl MV, Grant-Kels JM, Hanke CW, Hruza GJ, James WD, Lober CW, McBurney EI, Norton SA, Roenigk RK, Wheeland RG, Wisco OJ. AAD/ACMS/ASDSA/ASMS 2012 appropriate use criteria for Mohs micrographic surgery: a report of the American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery Association, and the American Society for Mohs Surgery. Dermatol Surg 2012; 38:1582-603. [PMID: 22958088 DOI: 10.1111/j.1524-4725.2012.02574.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The appropriate use criteria process synthesizes evidence-based medicine, clinical practice experience, and expert judgment. The American Academy of Dermatology in collaboration with the American College of Mohs Surgery, the American Society for Dermatologic Surgery Association, and the American Society for Mohs Surgery has developed appropriate use criteria for 270 scenarios for which Mohs micrographic surgery (MMS) is frequently considered based on tumor and patient characteristics. This document reflects the rating of appropriateness of MMS for each of these clinical scenarios by a ratings panel in a process based on the appropriateness method developed by the RAND Corp (Santa Monica, CA)/University of California-Los Angeles (RAND/UCLA). At the conclusion of the rating process, consensus was reached for all 270 (100%) scenarios by the Ratings Panel, with 200 (74.07%) deemed as appropriate, 24 (8.89%) as uncertain, and 46 (17.04%) as inappropriate. For the 69 basal cell carcinoma scenarios, 53 were deemed appropriate, 6 uncertain, and 10 inappropriate. For the 143 squamous cell carcinoma scenarios, 102 were deemed appropriate, 7 uncertain, and 34 inappropriate. For the 12 lentigo maligna and melanoma in situ scenarios, 10 were deemed appropriate, 2 uncertain, and 0 inappropriate. For the 46 rare cutaneous malignancies scenarios, 35 were deemed appropriate, 9 uncertain, and 2 inappropriate. These appropriate use criteria have the potential to impact health care delivery, reimbursement policy, and physician decision making on patient selection for MMS, and aim to optimize the use of MMS for scenarios in which the expected clinical benefit is anticipated to be the greatest. In addition, recognition of those scenarios rated as uncertain facilitates an understanding of areas that would benefit from further research. Each clinical scenario identified in this document is crafted for the average patient and not the exception. Thus, the ultimate decision regarding the appropriateness of MMS should be determined by the expertise and clinical experience of the physician.
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Affiliation(s)
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- Department of Dermatology, Mayo Clinic, Scottsdale, Arizona, USA
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Mattei PL, Beachkofsky TM, Gilson RT, Wisco OJ. Syphilis: a reemerging infection. Am Fam Physician 2012; 86:433-440. [PMID: 22963062] [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: 06/01/2023]
Abstract
Rates of primary and secondary syphilis have increased in the past decade, warranting renewed attention to the diagnosis and treatment of this disease. Men who have sex with men are particularly affected; however, increases in infection rates have also been noted in women, as well as in all age groups and ethnicities. Physicians need to vigilantly screen high-risk patients. The concurrent rise in congenital syphilis also requires special attention and reemphasizes the need for continued early prenatal care and syphilis screening for all pregnant women. Syphilis infection in patients coinfected with human immunodeficiency virus has also become more common. New experimental diagnostic approaches, including using the B cell chemoattractant chemokine (CXC motif) ligand 13 as a cerebrospinal fluid marker, may help identify suspected neurosyphilis cases. Additionally, point-of-care immunochromatographic strip testing has been suggested for screening high-risk populations in developing countries. Nontreponemal screening tests followed by treponemal confirmatory tests continue to be standard diagnostics; however, interpreting false-negative and false-positive test results, and identifying serofast reactions, can be challenging. Although doxycycline, tetracycline, ceftriaxone, and azithromycin have been used to successfully treat syphilis, penicillin remains the drug of choice in all stages of infection and is the therapy recommended by the Centers for Disease Control and Prevention. Close follow-up is necessary to ensure treatment success.
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Affiliation(s)
- Peter L Mattei
- 87th Medical Group, Joint Base McGuire-Dix-Lakehurst, NJ, USA.
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Mattei PL, Johnson RP, Beachkofsky TM, Wisco OJ, Hivnor CM, Murchland MR. Pruritic rash on trunk. J Fam Pract 2011; 60:539-542. [PMID: 21901180] [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: 05/31/2023]
Abstract
The patient had been treated with topical antifungals and steroids without relief, but a more detailed history suggested a serious infectious etiology.
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Affiliation(s)
- Peter L Mattei
- 2nd Air Refueling Squadron, Joint Base McGuire-Dix-Lakehurst, NJ, USA.
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Bandino JP, Norton SA, Aldrich SL, Wisco OJ, Hodson DS, Murchland MR, Grande DJ. Low-grade myxofibrosarcoma presenting at the site of prior high-grade disease. J Cutan Pathol 2011; 38:808-13. [PMID: 21752050 DOI: 10.1111/j.1600-0560.2011.01740.x] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Myxofibrosarcoma is one of the most common soft tissue sarcomas occurring in older adults. It can arise de novo or can be radiation induced, and the term myxofibrosarcoma was originally devised to encompass a spectrum of myxoid tumors with characteristics similar to malignant fibrous histiocytoma (MFH). Confusion exists, however, regarding the distinction between microscopic grade and characteristics of myxofibrosarcoma and MFH. Correct classification is vital to prognosis, as the degree of myxoid change is inversely related to the incidence of metastasis. We present a case of a 76-year-old man with a history of high-grade MFH of the left lower extremity, status post excision and radiation therapy, who presented 2 years later with a regional metastatic recurrence of high-grade MFH to the left groin as well as new nodules adjacent to and within his prior excision and radiation site. These new nodules were determined to represent low-grade myxofibrosarcoma. These new low-grade lesions either represent a low-grade recurrence of high-grade sarcoma or a new, radiation-induced soft tissue sarcoma occurring at the same site. Radiotherapy, however, is an unlikely cause; specific postradiation sarcoma criteria have not been fulfilled. This article discusses both the nosology and histopathological spectrum of these important soft tissue sarcomas, their aggressive and recurrent nature and their association with radiation therapy.
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Affiliation(s)
- Justin P Bandino
- San Antonio Uniformed Services Health Education Consortium, San Antonio, TX, USA.
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Beachkofsky TM, Wisco OJ, Osswald SS, Hodson DS. What is your diagnosis? Labial lichen planus. Cutis 2011; 88:13-20. [PMID: 21877500] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Moss TA, Beachkofsky TM, Almquist SF, Wisco OJ, Murchland MR. Alopecia with perifollicular papules and pustules. J Fam Pract 2011; 60:95-98. [PMID: 21301646] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Tyler A Moss
- A.T. Still University, Kirksville College of Osteopathic Medicine, Kirksville, MO, USA
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Clark SM, Beachkofsky TM, Wisco OJ, Hodson DS. Verrucous papule on thigh. J Fam Pract 2010; 59:645-648. [PMID: 21060903] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Affiliation(s)
- J Michael Wentzell
- Department of Dermatology, Billings Clinic, Billings, Montana 59107, USA.
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Beachkofsky TM, Wisco OJ, Osswald SS, Osswald MB, Hodson DS. Pulmonary cutaneous metastasis: a case report and review of common cutaneous metastases. Cutis 2009; 84:315-322. [PMID: 20166573] [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: 05/28/2023]
Abstract
The literature on cutaneous metastatic disease can be difficult to interpret because of inconsistent study design and analysis among authors. Furthermore, one should be careful when reviewing the statistics in the literature, as reported patient populations tend to vary and are not representative of the whole population. However, certain trends are notable and should be reported. Diagnosis of cutaneous metastatic disease carries a grave prognosis. We describe a patient with pulmonary cutaneous metastasis and provide a review of the literature on nonmelanomatous solid tumor malignancies that most commonly have cutaneous metastases. The review will focus on epidemiology, clinical presentation, histology and immunohistochemical staining, and prognosis and management. The most common cutaneous metastasizing carcinomas--breast, lung, and colorectal cancer--also are discussed.
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Beachkofsky TM, Wisco OJ, Owens NM, Hodson DS. Verrucous nodules on the ankle. J Fam Pract 2009; 58:427-430. [PMID: 19679023] [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] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Schwendiman MN, Beachkofsky TM, Wisco OJ, Owens NM, Hodson DS. Primary cutaneous nodular amyloidosis: case report and review of the literature. Cutis 2009; 84:87-92. [PMID: 19746766] [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: 05/28/2023]
Abstract
Primary cutaneous nodular amyloidosis (PCNA) is a rare form of primary cutaneous amyloidosis. It presents as waxy yellow-red nodules that are located preferentially on the lower extremities, face, scalp, and genitals. Recognition of this condition is of particular importance, as primary systemic amyloidosis can have a similar cutaneous presentation. We report a case of PCNA in a 52-year-old woman with systemic lupus erythematosus (SLE) and Sjögren syndrome (SS). We discuss the need to evaluate for systemic disease and provide a concise review of the literature focusing on clinical presentation, disease associations, and management.
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Affiliation(s)
- Mark N Schwendiman
- Des Moines University College of Osteopathic Medicine and Surgery, Iowa, USA
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Parra SL, Wisco OJ. What is your diagnosis? Perniosis (Chilblain). Cutis 2009; 84:15-29. [PMID: 19743718] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Sylvia L Parra
- Department of Dermatology, Mike O'Callaghan Federal Hospital, Nellis Air Force Base, Nevada, USA
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Affiliation(s)
- Oliver J Wisco
- Department of Dermatology, Wilford Hall Medical Center, Lackland Air Force Base, TX 78236, USA.
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Allen EJ, Ammirati CT, Bailin PL, Bhatia AC, Billingsley EM, Campbell LB, Minsue Chen T, Conologue TD, Do DV, Ebner J, Fulchiero GJ, Gasbarre CC, Grandinetti LM, Greco JF, Hayes CM, Jones CR, Lee KK, Marks VJ, Maytin EV, McGillis ST, Meine JG, Moosally AJ, Nguyen TH, Poblete-Lopez C, Ricks MR, Skvarka CB, Taneja A, Trost LB, Vidimos AT, Vogel PS, Wanitphakdeedecha R, Willey A, Wilson B, Wisco OJ, Woodhouse JG, Youker SR. Contributors. Dermatol Surg 2009. [DOI: 10.1016/b978-0-7020-3049-9.10021-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Wisco OJ, Sloan SB, Johnson RP. Erythematous annular lesions. Am Fam Physician 2007; 76:1709-1710. [PMID: 18092713] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Affiliation(s)
- Oliver J Wisco
- Brooke Army Medical Center, Fort Sam Houston, Texas, USA.
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Howe WR, Wisco OJ, Sartori C. Fixed cutaneous sporotrichosis in an adolescent boy: a case report. Cutis 2006; 78:337-40. [PMID: 17186793] [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: 05/13/2023]
Abstract
We present a case of an adolescent boy with a 3-week history of 3 painless purulent erythematous ulcers with raised hyperkeratotic borders associated with regional lymphadenopathy on the medial aspect of the right antecubital fossa. There were no known initiating factors and no other significant associated signs or symptoms. The patient initially was treated with antibiotics, with no improvement. Bacterial and fungal cultures of biopsy specimens demonstrated the presence of Sporothrix schenckii and confirmed the diagnosis of sporotrichosis. Itraconazole was initiated with an appropriate response. This case demonstrates the importance of understanding the clinical presentation of sporotrichosis in children without a history of the disease.
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Wisco OJ, Ritter SE, Murchland MR. What is your diagnosis? Benign familial chronic pemphigus. Cutis 2005; 75:208, 210-12. [PMID: 15916217] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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