Publications by authors named "Alyce Kuo"

Article Synopsis
  • The study focuses on establishing Minimal Important Difference (MID) estimates for the FACE-Q Skin Cancer Module, a tool to measure patient outcomes after facial skin cancer surgery.
  • Conducted at four U.S. hospitals from April 2020 to April 2022, 990 patients undergoing Mohs Micrographic Surgery provided data through various scales assessing satisfaction and distress at multiple time points.
  • The findings indicated specific MID estimates for the scales, which are key for improving the understanding and application of patient-reported outcomes in clinical settings.
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Article Synopsis
  • Paclitaxel is a common treatment for breast, ovarian, and lung cancers, but its use can be hindered by hypersensitivity reactions, potentially affecting about 11.9% of patients.
  • A study at Memorial Sloan Kettering analyzed 12,274 patients, revealing that factors like younger age, race, and allergy history were significant predictors of these immediate and delayed reactions, particularly in breast cancer patients.
  • Understanding these risk factors can help healthcare providers make better treatment decisions and consider alternatives like switching to nab-paclitaxel if patients experience troublesome skin reactions.
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  • Late alopecia, which is incomplete hair regrowth after chemotherapy or endocrine therapy, affects women's quality of life, leading this study to investigate oral minoxidil as a treatment option.
  • The study included 216 patients, primarily women with breast cancer, and found that 74% experienced improvement in hair regrowth after using oral minoxidil for about 3.5 months.
  • Results showed significant increases in hair density on both the frontal and occipital areas, indicating that oral minoxidil is well-tolerated and may help cancer survivors with late alopecia.
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Background: There is a paucity of literature describing family planning challenges faced by Mohs fellows.

Objective: To characterize perceptions about and experiences with family planning, fertility, lactation, and parental leave and identify ways to support parental health and family planning for Mohs fellows.

Materials And Methods: A voluntary, anonymous survey was distributed to Mohs surgeons who recently completed fellowship.

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Immune checkpoint inhibitors (ICI) target the PD-1/PD-L1 and CTLA-4 pathways and allows the immune system to deliver antitumor effects. However, it is also associated with well-documented immune-related cutaneous adverse events (ircAEs), affecting up to 70-90% of patients on ICI. In this study, we describe the characteristics of and patient outcomes with ICI-associated steroid-refractory or steroid-dependent ircAEs treated with dupilumab.

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Purpose: Keratinocyte carcinomas are amenable to many treatments, including radiation therapy (RT). Electronic skin surface brachytherapy (ESSB) enables the precise delivery of radiation without radioisotopes. In this prospective multicenter clinical trial, we characterized early outcomes of ESSB prospectively through both patient- and clinician-reported measures.

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Immune checkpoint blockade (ICB) improves survival in many types of cancers including melanoma, non-small cell lung, renal cell, breast, and cervical cancers. However, many of these therapies are also associated with high grade dermatologic adverse events (DAEs), including Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN), SJS/TEN-like reactions, high grade maculopapular and psoriasiform rashes, autoimmune bullous eruptions, drug reaction with eosinophilia and systemic symptoms (DRESS), and acute generalized exanthematous pustulosis (AGEP), which may limit their tolerability and use. It is important to properly identify and treat DAEs to ICB because these DAEs may be associated with positive anti-tumor response and patients may have limited options for alternative anti-cancer therapeutics.

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Immune-related adverse events (irAEs) frequently complicate treatment with immune checkpoint blockade (ICB) targeting CTLA-4, PD-1, and PD-L1, which are commonly used to treat solid and hematologic malignancies. The skin and gastrointestinal (GI) tract are most frequently affected by irAEs. While extensive efforts to further characterize organ-specific adverse events have contributed to the understanding and management of individual toxicities, investigations into the relationship between multi-organ toxicities have been limited.

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Background/objectives: Health disparities encompass a wide range of personal, societal, environmental, and system-based factors that contribute to inequitable health and health outcomes in vulnerable patient populations. The goal of this work was to scientifically summarize the existing published North American research on disparity as it pertains to pediatric dermatology.

Methods: A systematic review was performed according to PRISMA guidelines.

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Background: The rising prevalence of allergies can substantially impact the skin, which is one of the largest targets for allergic and immunologic responses.

Objective: Here, we describe the results of an online survey assessing self-reported allergy prevalence in Americans, outline the populations who report allergies, and characterize the skin conditions associated with allergy.

Methods: An online survey was conducted in the USA of 2,008 adults as a representative sample of the general American population.

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The skin is one of the largest immunologic organs in the body and a continuous target for allergic and immunologic responses. Impairment of the skin barrier increases the likelihood of external antigens and pathogens entering and creating inflammation, which can potentially lead to skin infections, allergies, and chronic inflammatory diseases such as atopic and contact dermatitis. Functionally, the skin barrier can be divided into four different levels.

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Background: Shared decision making (SDM) involves the sharing of best available evidence between patients and providers in the face of difficult decisions. We examine outcomes that occur when electronic health records (EHRs) are purposefully used with the goal of improving SDM and detail which EHR functions can benefit SDM.

Methods: A systematic search of PubMed yielded 1369 articles.

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Despite successful control of viremia by combined antiretroviral therapy, brain infection and its resulting neurocognitive impairment remain a prevalent comorbidity in HIV infected individuals. HIV invades the brain early in the course of infection via penetration through the blood-brain barrier (BBB). While the impact of HIV on BBB astrocytes and endothelial cells is relatively well studied, the role of pericytes in BBB regulation during HIV infection remains unclear; however, it is known that a selective population of pericytes is prone to infection.

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Unlabelled: In 2009, President Barack Obama signed into law the Health Information Technology for Economic and Clinical Health (HITECH) Act, which aims for the universal adoption of electronic health records (EHRs) in primary care settings and "meaningful use" of this technology. The objectives of "meaningful use" are well defined and executed in stages; one of the objectives of stage 2, beginning in 2014, was implementation of a secure messaging system between patients and providers. Secure messaging has been shown to positively affect patients who struggle with managing chronic diseases on a day to day basis.

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