This document summarizes several articles from the Journal of the American Academy of Dermatology (JAAD).
The first article finds that venous thromboembolism occurs in 6% of patients with pemphigus within 4 months of diagnosis. The second article finds an association between bullous pemphigoid and psoriasis. Liquid nitrogen cryotherapy and antibiotics help treat nodular scabies. Fractional CO2 laser with topical steroids clears hypertrophic lichen planus. Multiple direct immunofluorescence samples increases sensitivity for diagnosing mucous membrane pemphigoid. Voriconazole increases risk of skin cancer after allogeneic but not autologous hematopoietic cell
Presented at the joint International Eczema Council and National Alopecia Areata Foundation Symposium, "Atopic Dermatitis and Alopecia Areata: Comparison and Contrast”, held during the 2019 Annual American Academy of Dermatology meeting in Washington, DC to explore the similarities and differences between these two common but complex skin diseases and the implications from bench to bedside.
Journal club presentation: by RxVichuZ!! ;)RxVichuZ
My 97th powerpoint... deals with the comparative study of efficacy of piperacillin-tazobactam, as compared to meropenem in the treatment of ESBL(Extended spectrum beta-lactamases) infections.
A summarized insight has been provided, using research article from JAMA.
Presented at the joint International Eczema Council and National Alopecia Areata Foundation Symposium, "Atopic Dermatitis and Alopecia Areata: Comparison and Contrast”, held during the 2019 Annual American Academy of Dermatology meeting in Washington, DC to explore the similarities and differences between these two common but complex skin diseases and the implications from bench to bedside.
Dr. Leslie Castelo-Soccio presented an overview of what parents need to know about alopecia areata in children and adolescents, including the differences between pediatric and adult patients, and the risks and benefits of current and evolving off-label treatment options. Dr. Castelo-Soccio is Assistant Professor of Pediatrics and Dermatology at the University of Pennsylvania School of Medicine and head of the Pediatric Hair Clinic and Director of Research in Pediatric Dermatology at the Children’s Hospital of Philadelphia. Her clinical and academic research focus is on pediatric hair disorders.
Presented at the joint International Eczema Council and National Alopecia Areata Foundation Symposium, "Atopic Dermatitis and Alopecia Areata: Comparison and Contrast”, held during the 2019 Annual American Academy of Dermatology meeting in Washington, DC to explore the similarities and differences between these two common but complex skin diseases and the implications from bench to bedside.
Journal club presentation: by RxVichuZ!! ;)RxVichuZ
My 97th powerpoint... deals with the comparative study of efficacy of piperacillin-tazobactam, as compared to meropenem in the treatment of ESBL(Extended spectrum beta-lactamases) infections.
A summarized insight has been provided, using research article from JAMA.
Presented at the joint International Eczema Council and National Alopecia Areata Foundation Symposium, "Atopic Dermatitis and Alopecia Areata: Comparison and Contrast”, held during the 2019 Annual American Academy of Dermatology meeting in Washington, DC to explore the similarities and differences between these two common but complex skin diseases and the implications from bench to bedside.
Dr. Leslie Castelo-Soccio presented an overview of what parents need to know about alopecia areata in children and adolescents, including the differences between pediatric and adult patients, and the risks and benefits of current and evolving off-label treatment options. Dr. Castelo-Soccio is Assistant Professor of Pediatrics and Dermatology at the University of Pennsylvania School of Medicine and head of the Pediatric Hair Clinic and Director of Research in Pediatric Dermatology at the Children’s Hospital of Philadelphia. Her clinical and academic research focus is on pediatric hair disorders.
Factors affecting mortality in burns: a single center studyKETAN VAGHOLKAR
Background: Burns injury continues to be the greatest challenge to the trauma surgeon. A multitude of factors determine the mortality in burns patients. The present study aims at identifying those factors which have a significant impact on mortality in burns patients.
Methods: A total 80 patients presenting with burns injury were studied prospectively. Various factors which included age, sex, aetiology, mode of injury, total body surface area which is burnt (BSA), duration of stay, time interval up to admission, pregnant state, inhalation injury, systemic complications, wound complications, and psychological impact were studied.
Results: The mean age was 24.07 years. 59 were females, 21 were males. 19 (23.75%) cases were suicidal in aetiology whereas the remaining 61(76.25%) were accidental. Flame injury was the most common mode of injury in 65 patients (81.25%). The mean BSA in the study was 53.5% whereas the mean BSA in those patients who expired was 71.4%. Mean duration of stay in hospital was 6.55 days whereas mean time interval between burns injury and admission to hospital was 101.33 minutes. All 12 pregnant women had spontaneous miscarriages with a mortality in 11 patients. Inhalation injury was seen in 49 patients (61%) with mortality of 42 (83.7%) patients. Systemic complications seen in 60 patients mortality and BSA was high in patients who had infection. 31 patients in the study had severe depression with a mortality of 91.32%. 50 out of the 80 patients studied expired.
Conclusions: Increased age, BSA, mode of injury, presence of inhalation injury, systemic complication, pregnant state, wound infection and depression had a significant impact on the mortality of burns patients.
Alex's Lemonade Stand Foundation holds an annual Childhood Cancer Symposium in Philadelphia. It is designed to be an educational resource, providing families with the opportunity to learn about issues and topics of treatment and beyond, while meeting other families in a group setting. Registration is free and is open to all those touched by childhood cancer, including patients and their siblings.
Hear from speaker Rochelle Bagatell, MD of Children's Hospital of Philadelphia as she discusses clinical trials and experimental treatments in childhood cancer cases.
For more information on Alex's Lemonade Stand Foundation's childhood cancer resources, click here: http://www.AlexsLemonade.org
Predicting Medical Test Results and Intra-Operative Findings in Chronic Pain ...Nelson Hendler
The Pain Validity Test can predict which patient will have abnormal medical test results with 95% accuracy, and surgical abnormalities with 94% accuracy. This on-line questionnaire takes only 5 minutes of staff time to administer, and takes only 15 minutes of patient time.Results are available immediately. This test can be used to document "medical necessity" for insurance pre-authorization for testing and surgery.
This presentation by Gail Clayton, Lead MS Clinical Nurse Specialist and Jacki Smee, MS Clinical Nurse Specialist at Cardiff and Vale University Health Board explores setting up an Alemtuzumab service. It includes: patient selection, infusion related and long-term side-effects, ongoing monitoring requirements, potential challenges and case studies.
It was presented at the MS Trust Annual Conference in November 2013.
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Austin Ophthalmology is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Ophthalmology.
The journal aims to promote latest information and provide a forum for doctors, researchers, physicians, and healthcare professionals to find most recent advances in the areas of Ophthalmology. Austin Ophthalmology accepts research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of Ophthalmology.
Austin Ophthalmology strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group also brings universally peer reviewed journals under one roof thereby promoting knowledge sharing.
Factors affecting mortality in burns: a single center studyKETAN VAGHOLKAR
Background: Burns injury continues to be the greatest challenge to the trauma surgeon. A multitude of factors determine the mortality in burns patients. The present study aims at identifying those factors which have a significant impact on mortality in burns patients.
Methods: A total 80 patients presenting with burns injury were studied prospectively. Various factors which included age, sex, aetiology, mode of injury, total body surface area which is burnt (BSA), duration of stay, time interval up to admission, pregnant state, inhalation injury, systemic complications, wound complications, and psychological impact were studied.
Results: The mean age was 24.07 years. 59 were females, 21 were males. 19 (23.75%) cases were suicidal in aetiology whereas the remaining 61(76.25%) were accidental. Flame injury was the most common mode of injury in 65 patients (81.25%). The mean BSA in the study was 53.5% whereas the mean BSA in those patients who expired was 71.4%. Mean duration of stay in hospital was 6.55 days whereas mean time interval between burns injury and admission to hospital was 101.33 minutes. All 12 pregnant women had spontaneous miscarriages with a mortality in 11 patients. Inhalation injury was seen in 49 patients (61%) with mortality of 42 (83.7%) patients. Systemic complications seen in 60 patients mortality and BSA was high in patients who had infection. 31 patients in the study had severe depression with a mortality of 91.32%. 50 out of the 80 patients studied expired.
Conclusions: Increased age, BSA, mode of injury, presence of inhalation injury, systemic complication, pregnant state, wound infection and depression had a significant impact on the mortality of burns patients.
Alex's Lemonade Stand Foundation holds an annual Childhood Cancer Symposium in Philadelphia. It is designed to be an educational resource, providing families with the opportunity to learn about issues and topics of treatment and beyond, while meeting other families in a group setting. Registration is free and is open to all those touched by childhood cancer, including patients and their siblings.
Hear from speaker Rochelle Bagatell, MD of Children's Hospital of Philadelphia as she discusses clinical trials and experimental treatments in childhood cancer cases.
For more information on Alex's Lemonade Stand Foundation's childhood cancer resources, click here: http://www.AlexsLemonade.org
Predicting Medical Test Results and Intra-Operative Findings in Chronic Pain ...Nelson Hendler
The Pain Validity Test can predict which patient will have abnormal medical test results with 95% accuracy, and surgical abnormalities with 94% accuracy. This on-line questionnaire takes only 5 minutes of staff time to administer, and takes only 15 minutes of patient time.Results are available immediately. This test can be used to document "medical necessity" for insurance pre-authorization for testing and surgery.
This presentation by Gail Clayton, Lead MS Clinical Nurse Specialist and Jacki Smee, MS Clinical Nurse Specialist at Cardiff and Vale University Health Board explores setting up an Alemtuzumab service. It includes: patient selection, infusion related and long-term side-effects, ongoing monitoring requirements, potential challenges and case studies.
It was presented at the MS Trust Annual Conference in November 2013.
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Austin Ophthalmology is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Ophthalmology.
The journal aims to promote latest information and provide a forum for doctors, researchers, physicians, and healthcare professionals to find most recent advances in the areas of Ophthalmology. Austin Ophthalmology accepts research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of Ophthalmology.
Austin Ophthalmology strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group also brings universally peer reviewed journals under one roof thereby promoting knowledge sharing.
Development of Best Practice Guidelines for Cutaneous T-Cell Lymphoma (CTCL) ...DUNCAN RASUGU
The use of the traditional method of whirlpools in controlling ulcerations in MF remains a great challenge. According to research, removal of the gross contaminants and toxic debris from the wounds together with the dilution of the surface bacteria is a threat that has been observed among many patients that undergo the traditional treatment. The purpose of this work is to develop the guidelines for an alternative treatment of wounds using Vashe Solution Therapy.
Presentation by Scott Oliver, MD. Presented at the 2018 Eyes on a Cure: Patient & Caregiver Symposium, hosted by the Melanoma Research Foundation's CURE OM initiative.
Abstract
Background: Olfactory neuroblastoma is a rare malignancy of the nasal cavity.
Methods: We describe a case of radiation-induced olfactory neuroblastoma in a patient with a history of radiation for Graves' ophthalmopathy. We also reviewed the literature and found four other cases of radiation-induced olfactory neuroblastoma reported since 2000, suggesting prior radiotherapy as one risk factor for this disease.
Results: We treated the patient with multimodality treatment consisting of surgery, radiotherapy and chemotherapy (6 cycles of cisplatin/ etoposide). Despite the previously irradiation, treatment was well tolerated without excessive short or long term radiation toxicity. The patient remains in long term remission with no evidence of loco-regional recurrence or systemic metastasis after 12 years of follow-up.
Conclusions: Prior radiotherapy appears to be a risk factor in a handful of cases of this rare malignancy. Although the literature is limited for radiation-related olfactory neuroblastoma, outcomes appear generally poorer for this group but highly variable. With careful patient selection, aggressive multi-modality therapy including post-operative radiotherapy may be feasible.
Current concepts in assessment of brain tumors - Dr Felice D'ArcoFelice D'Arco
An overview on state of the art in tumor assessment in pediatric neuro-oncology. Presented in the Course of advanced images in pediatric oncology 2018 (Madrid - Spain_ and Neuroscience meeting at Great Ormond Street Hospital for Children in London UK
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
2. Venous thromboembolism in patients with
pemphigus: A cohort study
Yael Anne Leshem, MD Lihi Atzmony, MD, Israel
Dudkiewicz, MD, Emmilia Hodak, MD, Daniel Mimouni,
MD
August 2017 Volume 77, Issue 2, Pages 256–260
3. Objective
Possibility of venous
thromboembolism as a cause of
morbidity/mortality in pemphigus
patients
5. Results
10 patients (6%) had a VTE, with a median
of 4 months time from the diagnosis
5 were DVT, 4 were PE, 1 had both
6. Conclusion and practice
VTE is not rare in patients with pemphigus
To possibly screen for it through physical
exam/coagulation profile during visits in
the first year of diagnosis
7. Association between bullous pemphigoid
and psoriasis: A case-control study
Khalaf Kridin, MD, Reuven Bergman, MD
August 2017Volume 77, Issue 2, Pages 370–372
8. Methods
study consisted of 287 patients newly
diagnosed with BP between 2000 and 2015
and 1373 age-, sex-, and ethnicity-
matched control subjects
10. Possible explanations
may be due to the antigenicity of the
basement membrane in psoriasis patients
being altered at a younger age,
stimulating antibasement membrane
autoantibody formation and BP
development earlier in life.
11. Conclusion and practice
There exists a significant association
between BP and Psoriasis
To add the possibility of BP in the DDx of
any patient, especially elderly, with
psoriasis that has presented with
unexplained blistering, urticarial lesions
or chronic pruritus.
12. Therapeutic Pearl : Liquid nitrogen
cryotherapy in the treatment of chronic,
unresponsive nodular scabies
Vijay Zawar, MD, DNB, DVD, FRCP
(Edin), Manoj Pawar, MD
Skin Disease Centre, Nashik, India
August 2017Volume 77, Issue 2,
Pages e43–e44
13. Challenge
Nodular scabies can lead to chronic pruritic prurigo
nodularis-like lesions , even after successful treatment
of scabies
Possibly explained as a hypersensitivity reactions to
particles of mites
14. Proposed solution
LNT for 2 cycles of 10 seconds to each
lesion
Followed by azithromycin 500mg OD
treatment for 3 days with topical
mupirocin until lesions heal
16. August CME : Bedside
Diagnostics in Dermatology
Robert G. Micheletti, Arturo R.
Dominguez, MD, Karolyn A. Wanat, MD
Excellent 2 part series of articles
17. Therapeutic pearl: Fractional carbon
dioxide laser in combination with topical
corticosteroid: An innovative treatment for
hypertrophic lichen planus
Imran Majid, MD
CUTIS Institute of Dermatology, Srinagar, Jammu and
Kashmir, India
September 2017 Volume 77, Issue 3, Pages e67–e68
19. Solution
fractional CO2 laser at 4-week intervals at
a fluence of around 60 J/cm2
topical clobetasol gel twice daily
between the laser sessions
20. Results
Excellent results are obtained with
complete or near-complete
clearance after 3 or 4 sessions
In the photo, circled lesion was
treated with combination treatment
and right sided lesion with topical
clobetasol alone
21. Multiple and repeated sampling increases
the sensitivity of direct
immunofluorescence testing for the
diagnosis of mucous membrane pemphigoid
Julia Marie Nitz, Detlef Zillikens, MD
Department of Dermatology, University of Lübeck,
Lübeck, German
October 2017 Volume 77, Issue 4, Pages 700–705.e3
22. Background
MMP has been known to have a low
sensitivity of DIF positivity when
compared to BP and PV
24. Methods
Reviewed the DIF results of 136
patients who were immunologically
confirmed to have MMP
25. Results
85% of patients who had more than one
biopsy sent for DIF at the initial workup
showed positive DIF compared to 69% of
patients who had only one sample
95% of patients showed positive DIF when
subsequent work-ups were done
26. Conclusions and practice
More than one samples give a higher rate
of positive DIF in the diagnosis of MMP
Whenever considering a diagnosis of MMP,
consider sending more than one biopsy
sample
27. Effect of voriconazole on risk of
nonmelanoma skin cancer after
hematopoietic cell transplantation
Presented at the 58th American Society of
Hematology Annual Meeting and
Exposition, San Diego, CA; December 2-4,
2016.
Lawrence F. Kuklinski, BA, Shufeng Li, MS,
Margaret R. Karagas, PhD, Wen-Kai Weng,
MD, Bernice Y. Kwong, MD
October 2017 Volume 77, Issue 4, Pages 706–712
29. Methods
Retrospective review of 1220 patients
who had allogenic HSCT and 1418 patients
who had undergone autologous HSCT
30. Results
Voriconazole showed an increased
incidence of NMSC in patients who had
undergone allogenic HSCT (1.82 hazard
ratio) but DID NOT show an increased risk
in those who had autologous HSCT
31. Conclusion and practice
Voriconazole, which had already been
shown in the past to increase risk of SSC
in solid organ transplant recipients, has
been shown to increase risk of NMSC in
patients undergoing Allogenic HSCT
32. Research Letter : Human papilloma virus
expression in immunocompetent patients
with actinic keratosis: A case series
Caterina Dianzani, MD, PhD, Francesca Paolini, PhD,
Claudio Conforti, MD, Elisabetta Riva, PhD, Emanuela
Beninati, MD, Aldo Venuti, MD, PhD
October 2017 Volume 77, Issue 4, Pages 770–772
33. Methods
Fresh samples from 40 patients with AK
were tested for HPV DNA using PCR
Samples from AK’s and healthy skin were
tested from each patient
34. Results
88.8% of AK lesions showed positivity for
HPV vs. 62% of healthy skin
Most common HPV serotype were 36 and
107
36. Research letter: Prevalence of
clinical signs of activity in Vitiligo
patients
Nader Aboul-Fettouh, BS, Jorge
Hinojosa, BA, Andrea Tovar-Garza, MD,
Amit G. Pandya
Department of Dermatology, University
of Texas Southwestern Medical Center,
Dallas, Texas
October 2017 Volume 77, Issue 4, Pages 774–775
37. Objectives
To assess the prevalence of three well
established signs of disease activity in
vitiligo patients
- Confetti lesions (black arrow)
- Trichrome lesions (white arrow)
- Koebner phenomenon
39. Conclusion and practive
Majority of patients who had active
vitiligo showed at least one of the three
markers of disease activity
Highly encouraged to examine all vitiligo
patients for these three markers
40. Clinical pearl : Use of Wood's lamp to
diagnose progressive macular
hypomelanosis
Rachel T. Pflederer, MD, John Paul
Wuennenberg, BA, Caitlyn Foote, MD,
Daniel Aires, MD, JD, Anand Rajpara, MD
October 2017 Volume 77, Issue 4, Pages e99–e100
41. Background and challenge
Progressive macular hypermelanosis is a condition
presenting with multiple hypopigmented macules all
over the trunk
Very commonly misdiagnosed as PIH or P.versicolor
42. Solution
Woods lamp examination
shows characteristic
punctate orange-red
follicular fluorescence
Likely arises due to p.acnes,
which is thought to be the
cause of the condition
43. Conclusion and practice
Use woods lamp examination in patients
which persistent lesions of PIH and
P.versicolor
Treatment of PMH is topical clindamycin
or topical benzoyl peroxide +/- NBUVB
44. Therapeutic pearl : “Two-step
phototherapy” for treatment-resistant
psoriasis on the lower extremities
aleb Jeon, BS, Mio Nakamura, MD
Department of Dermatology, University of California–
San Francisco, San Francisco, California
October 2017 Volume 77, Issue 4, Page e101
45. Challenge
Psoriasis on the distal lower extremities is
notoriously treatment-resistant
Dose of phototherapy from the middle of
the light bulb is much higher than the top
and bottom
47. Step 1
Patient stands on a stool and is exposed
to phototherapy, then the patient steps
off the stool and receives regular
phototherapy
Face and genitalia to be covered
48. Step 2
Patient steps on stool again and receives
phototherapy to the lower extremeties
while the rest of the body is covered
49. Results
Higher rates of patients treated with this
form of phototherapy responded
compared to regular phototherapy
50. Therapeutic pearl: Recognizing and
overcoming phototherapy-induced
initiation burn
Caleb Jeon, BS, Mio Nakamura, MD
Department of Dermatology, University
of California, San Francisco, California
October 2017 Volume 77, Issue 4, Page e103
51. Challenge
‘’initiation burns’’ are fairly commonly
encountered in clinical practice
Patients tend to refuse further
phototherapy
52. Solution
Abrubt treatment of pruritic and
‘’burned’’ areas with topical steroids
Resumption of treatment with
phototherapy at extremely low doses and
slower increment of dose each time
53. Suggested dosing protocol for a patient with initiation burn
Type of UV Initial dose, mJ/cm2
Subsequent dose
increments, mJ/cm2
Narrowband UV-B 30 10-30
Broadband UV-B 5 5-10
Psoralen + UV-A 0.25 0.5
54. Risk of malignancy with systemic psoriasis
treatment in the Psoriasis Longitudinal
Assessment Registry
David Fiorentino, MD, Vincent Ho, MD,
Mark G. Lebwohl, MD, Luiz Leite, MD,
Lori Hopkins, PharmD, Claudia Galindo,
MD, Kavitha Goyal, MD, Wayne
Langholff, PhD, Steven Fakharzadeh,
MD, PhD, Bhaskar Srivastava, MD, PhD,
Richard G. Langley, MD
Mount Sinai, NY, USA
November 2017 Volume 77, Issue 5, Pages 845–854.e5
55. Objective
Evaluation of the impact of Systemic
Treatment for psoriasis on the risk of
malignancy
To determine if the increase risk of
malignancy in psoriasis is related to the
disease itself or the immunosuppression
related to the systemic treatment
56. Methods
Prospective case-control study of 12090
patients with psoriasis
Compared MTX, anti TNF and
Ustekinumab
Divided each into three groups: 0-3
months on treatment, 3-12 months on
treatment, and more than 12 months of
treatment
57. Results
252 malignancies identified (excluding
NMSC)
Most common malignancies were (highest
to lowest): breast, prostate, lung,
melanoma, lymphoma
MTX and Ustekinumab were not
associated with higher risk of malignancy
Long term (>12 months) of treatment with
Anti TNF agents was associated with
increased risk (odds ratio 1.34)
58. Conclusion and practice
Long term treatment with Anti-TNF
agents for psoriasis appears to be
associated with higher risk of cancer
59. Folate and phototherapy: What should we
inform our patients?
Myron Zhang, MD, Gregory Goyert, MD,
Henry W. Lim
November 2017Volume 77, Issue 5, Pages 958–964
60. Objectives
Ultraviolet (UV) degradation of folate has
been studied in vitro and in vivo
To review effects on folate blood levels in
patients undergoing phototherapy and
provide adequate recommendation for
women of childbearing age
61. Methods
PubMed was searched for in vivo studies
comparing folate levels before and after
phototherapy.
Studies on folate levels with
sun,UVA,UVB,PUVA exposure from 1946 to
2016 were included
62. Results
No evidence of reduced folate levels after
UVA or Sun exposure
Exposure to NBUVB phototherapy at > 40
J/cm2 cumulatively and >2 J/cm2 per
treatment was associated with 19-27%
decrease in folate levels
Lower doses of NBUVB have not been
associated with decreased folate levels
63. Conclusion and practice
Since many pregnancies are unplanned
and low folate levels are associated with
NTD’s, it is recommended that women of
childbearing age to receive daily folate
supplementation for the duration of the
phototherapy