Publications by authors named "Joseph Durgin"

The hair follicle is thought to be a site of ‘immune privilege,’ or relative protection from autoimmune and inflammatory responses. In particular, the long-lived, quiescent hair follicle stem cells (HFSCs) are strikingly resistant to cytotoxic immune effectors such as T cells and natural killer (NK) cells, even in systems where these cells are artificially directed to attack HFSCs. Nonetheless, many forms of alopecia are associated with immune-mediated damage of the hair follicle epithelium, suggesting a failure of immune privilege.

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Mesenchymal tumors may display morphologic and immunohistochemical overlap with melanocytic tumors, presenting a pitfall for misdiagnosis. We report a 62-year-old woman who presented with a recurrent dermal and subcutaneous tumor over the Achilles tendon 15 years following complete excision. Both the primary and the recurrent tumors were characterized by nests and sheets of epithelioid and spindle cells with eosinophilic cytoplasm and uniform ovoid nuclei.

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Article Synopsis
  • Pityriasis rosea is a temporary skin condition common in young adults, characterized by oval red, scaly patches mainly on the trunk and upper limbs, likely linked to reactivation of certain herpesviruses (HHV-6 and HHV-7).
  • There are also drug-related skin eruptions resembling pityriasis rosea, typically occurring in older individuals and lasting shorter, making it crucial to differentiate between the two.
  • A case study is presented about a patient with a drug eruption similar to pityriasis rosea due to imatinib mesylate treatment for chronic myeloid leukemia, emphasizing the importance of recognizing distinct histopathologic features for accurate diagnosis.
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Dermatofibrosarcoma protuberans (DFSP) is a cutaneous sarcoma with a high propensity for local invasion and recurrence. Although it is a rare event, the occurrence of multiple tumors in a single patient raises a diagnostic dilemma, as metastatic disease should be differentiated from multiple primary malignant events. In more than 90% of DFSP, a pathogenic t(17;22) translocation leads to the expression of COL1A1::PDGFB fusion transcripts.

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Background: ChatGPT is a free artificial intelligence (AI)-based natural language processing tool that generates complex responses to inputs from users.

Objectives: To determine whether ChatGPT is able to generate high-quality responses to patient-submitted questions in the patient portal.

Methods: Patient-submitted questions and the corresponding responses from their dermatology physician were extracted from the electronic medical record for analysis.

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Basal cell carcinoma (BCC) is the most common human malignancy and is a leading cause of nonmelanoma skin cancer-related morbidity. BCC has several histologic mimics which may have treatment and prognostic implications. Furthermore, BCC may show alternative differentiation toward a variety of cutaneous structures.

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Chimaeric antigen receptor (CAR) T cells can generate durable clinical responses in B-cell haematologic malignancies. The manufacturing of these T cells typically involves their activation, followed by viral transduction and expansion ex vivo for at least 6 days. However, the activation and expansion of CAR T cells leads to their progressive differentiation and the associated loss of anti-leukaemic activity.

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Prior to adoptive transfer, CAR T cells are activated, lentivirally infected with CAR transgenes, and expanded over 9 to 11 days. An unintended consequence of this process is the progressive differentiation of CAR T cells over time in culture. Differentiated T cells engraft poorly, which limits their ability to persist and provide sustained tumor control in hematologic as well as solid tumors.

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Article Synopsis
  • Researchers developed a new treatment using autologous CAR T cells aimed at a specific mutant protein (EGFRvIII) for patients with recurrent glioblastoma, a type of brain cancer (NCT02209376).
  • A 59-year-old patient who received this treatment lived for 36 months after her cancer returned, which is longer than expected for this disease.
  • Follow-up analyses showed significant tumor changes and reduced protein expression after treatment, plus the CAR T cells remained in the patient's bloodstream for 29 months, indicating potential for broader benefits in similar patients.
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In the past few decades, immunotherapy has emerged as an effective therapeutic option for patients with cutaneous T cell lymphoma (CTCL). CTCL is characterized by progressive impairment of multiple arms of the immune system. Immunotherapy targets these deficits to stimulate a more robust antitumor response, thereby both clearing the malignant T cells and repairing the immune dysfunction.

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Cutaneous T cell lymphomas (CTCLs) are malignancies of skin-trafficking T cells. Patients with advanced CTCL manifest immune dysfunction that predisposes to infection and suppresses the antitumor immune response. Therapies that stimulate immunity have produced superior progression-free survival compared with conventional chemotherapy, reinforcing the importance of addressing the immune deficient state in the care of patients with CTCL.

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This case series study of patients with granulomatous cheilitis at a tertiary referral center seeks to better describe the demographic characteristics, presenting features, associated disorders, and response to treatment of granulomatous cheilitis.

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Importance: Sézary syndrome (SS) is an advanced form of cutaneous T-cell lymphoma with few long-term remissions observed.

Objective: To profile 3 patients with SS who have experienced long-term remission following the addition of low-dose total skin electron beam therapy (TSEBT) to systemic regimens of extracorporeal photopheresis, bexarotene, and interferon-γ.

Design, Setting, And Participants: This is a retrospective case series with additional investigations of patient-donated samples to assess therapeutic response.

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Thirty-day readmission following glioblastoma (GBM) resection is not only correlated with decreased overall survival but also increasingly tied to quality metrics and reimbursement. This study aimed to determine factors linked with 30-day readmission to develop a simple risk stratification score. From 2005 to 2016, 666 unique resections (467 patients) of primary/recurrent tissue-confirmed glioblastoma were retrospectively identified.

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Despite the established efficacy of chimeric antigen receptor (CAR) T-cell therapy in hematologic malignancies, translating CAR T therapy to solid tumors has remained investigational. Glioblastoma, the most aggressive and lethal form of primary brain tumor, has recently been among the malignancies being trialed clinically with CAR T cells. Glioblastoma in particular holds several unique features that have hindered clinical translation, including its vast intertumoral and intratumoral heterogeneity, associated immunosuppressive environment, and lack of clear experimental models to predict response and analyze resistant phenotypes.

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Introduction:  Gliosarcoma (GS) is a rare, malignant mixed tumor of the central nervous system with a median survival of approximately 13 months across multiple studies. Although the value of the extent of resection (EOR) has been confirmed as a prognostic survival factor in glioblastoma, no such association has been defined for GS. The goal of this study was to establish an association between EOR and survival and to determine if a threshold of resection exists for which a survival benefit is conferred in GS.

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