Publications by authors named "Megha M Tollefson"

Background: Many vascular anomalies harbor postzygotic somatic variants in GNAQ and GNA11; however, the phenotype of specific G-protein variants has not been well described. We report the clinical characteristics of 17 patients with a GNA11 R183C variant.

Methods: This case series is derived from a multinational cohort of vascular anomaly patients whose pathogenic mutations were identified using high-depth next generation sequencing.

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  • Infantile hemangiomas (IHs) are common vascular tumors that typically develop during the first few weeks of an infant's life, but the precursor lesions can be mistaken for other conditions.
  • A study reviewed nine cases of neonates with initial lesions observed on their first day, comparing these early signs with classic IHs and documenting treatment details.
  • Better identifying precursor lesions can enhance diagnosis, minimize unnecessary procedures, and lead to quicker evaluations for related syndromes in more severe cases.
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An otherwise healthy 4-week-old term female of Japanese heritage presented with a 1-week history of asymptomatic progressive, generalized skin lesions. The lesion morphology, distribution, and dermatopathology result was consistent with Sweet syndrome. The patient was found to have a congenital type H rectovestibular fistula.

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Cutaneous leishmaniasis (CL), a parasitic infection caused by Leishmania protozoa and transmitted by sandfly bites, can be classified into Old World and New World subtypes. We report a case of a 2-year-old female who developed complex CL after travel to Panama. Ultimately, successful treatment required two rounds of liposomal amphotericin B.

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  • The PI3K enzymes are important in regulating cell growth and differentiation, and variants in these enzymes are linked to cancer and related disorders.
  • Genetic variants in PI3K can lead to either undergrowth or overgrowth conditions, with differing impacts on protein interactions that influence cell activity.
  • The study uses molecular dynamics simulations to analyze these variants, revealing that variants causing undergrowth destabilize important protein interactions, while those linked to overgrowth enhance them, providing insights that could inform future therapies.
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  • The COVID-19 pandemic accelerated the adoption of telemedicine in dermatology, prompting an analysis of its effectiveness within the Mayo Clinic system from January 2020 to January 2021.
  • A total of 13,181 televisits were conducted with an average patient age of 34.1 years, and most appointments utilized live video conferencing, though about 30% concluded with a single visit.
  • Results indicated that older patients were more likely to need follow-ups after initial visits, particularly with asynchronous methods, suggesting that live video might be more efficient for some patient encounters.
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  • The study investigates dermatologic conditions in children with inflammatory bowel disease (IBD), focusing on their prevalence and relationship with disease severity.
  • Researchers reviewed data from 528 children and adolescents with IBD, identifying high rates of skin issues, particularly infections and common conditions like acne and eczema.
  • Findings revealed that children with Crohn's disease (CD) are more likely to have certain skin issues while more severe IBD cases are linked to specific dermatological problems like perianal disease and psoriasis.
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  • Acne vulgaris affects a wide range of people, including adults and adolescents aged 9 and older, prompting a study to develop management guidelines.
  • The study resulted in 18 evidence-based recommendations emphasizing strong treatments like benzoyl peroxide and oral isotretinoin for severe cases, along with conditional recommendations for other medications.
  • Good practice suggestions include combining therapies and minimizing systemic antibiotic use to enhance treatment effectiveness.
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Objectives: To examine multimorbidity in psoriasis and its association with the development of PsA.

Methods: A retrospective cohort study was performed using the Rochester Epidemiology Project. Population-based incidence (2000-2009) and prevalence (Jan 1, 2010) cohorts of psoriasis were identified by manual chart review.

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Idiopathic eruptive macular pigmentation (IEMP) is a rare, benign, self-resolving melanosis consisting of hyperpigmented macules typically on the face, trunk, and extremities that can occur in children and adolescents and often presents a diagnostic conundrum. We report a case involving an 8-year-old female whose previous clinical presentation was concerning for an atypical presentation of cutaneous mastocytosis or neurofibromatosis. The clinical and histopathologic evaluation was consistent with the diagnosis of IEMP, and no active intervention was pursued.

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Introduction: Pediatric heart transplant patients are routinely followed in dermatology clinics due to elevated risk of cutaneous malignancy. However, transplant patients may experience other, non-cancer-related dermatologic conditions including skin infections, inflammatory diseases, and drug eruptions that can cause significant medical and psychosocial comorbidity.

Methods: A retrospective chart review of all pediatric heart transplant patients at Mayo Clinic Children's Center in Rochester, MN, was performed to determine the prevalence and spectrum of non-cancer dermatologic conditions.

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Background: Bier anemic spots, cyanosis with urticaria-like eruption (BASCULE) syndrome is a recently described entity with episodic urticarial lesions and white anemic halos on a background of erythrocyanosis, commonly affecting the lower extremities. Possible association with autonomic dysfunction remains poorly understood. Existing publications are limited, but the condition is suggested as highly underrecognized.

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A 2-year-old boy presented with an extensive, asymptomatic, photosensitive eruption refractory to topical steroids and tretinoin; examination and biopsies were consistent with generalized linear porokeratosis involving the face, limbs, and trunk. Treatment with topical cholesterol-lovastatin was initiated, and it successfully improved early erythematous lesions. Whole exome sequencing that targeted mevalonate pathway genes crucial in cholesterol synthesis later revealed a pathogenic, paternally inherited, porokeratosis-associated MVD, c.

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Background: The PI3K/AKT pathway, extensively studied in cancer, is vital for regulating cell metabolism, differentiation, and proliferation. Pathogenic variants in the PIK3R1 gene, which encodes three regulatory units of class IA PI3Ks, have been found in affected tissue of individuals with vascular lesions. These variants predominantly occur in the iSH2 domain, disrupting inhibitory contacts with the catalytic unit and leading to PI3K activation.

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Background: Facial angiofibromas (FAs) are a major feature of tuberous sclerosis complex (TSC). Topical rapamycin can successfully treat FAs. A new stabilized cream formulation that protects rapamycin from oxidation has been developed in 0.

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We used the Psoriasis Caregiver Impact Scale to explore the quality of life (QoL) of parents/caregivers of children with psoriasis. We found that the QoL of parents of children with psoriasis is negatively affected in numerous domains including family and social life, emotional health, work, activities, and finances.

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  • This study investigates the transition of care practices in multidisciplinary vascular anomalies centers (VACs).
  • Out of 71 VAC leaders surveyed, 37 responded, revealing that only 16% of centers have established TOC programs.
  • Key challenges identified include limited resources and the struggle to locate expert adult providers.
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  • The study reviews cases of psoriasiform eruptions in children caused by TNF inhibitors, which are commonly used to treat nondermatologic conditions like inflammatory bowel disease.
  • 103 pediatric patients, predominantly around the age of 13.8, developed skin eruptions months after starting treatment, often without prior personal or familial history of psoriasis.
  • Treatment involved topical medications for all patients, with some requiring additional systemic therapies like methotrexate or corticosteroids to manage the skin condition.
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Background: Infantile perianal pyramidal protrusion (IPPP) is a rare benign skin condition that is typically seen in infant girls. This condition is often mistaken for other skin lesions such as acrochordons, condyloma acuminatum, and sequelae of sexual abuse. Many clinicians are unfamiliar with IPPP which can lead to aggressive workup and treatment.

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Background/objective: There is limited information about the potential relationship of socioeconomic status (SES) with acne in preadolescents. Our objective was to assess the possible relationship between SES and preadolescent acne.

Methods: A population-based retrospective cohort study was conducted to identify Olmsted County, Minnesota, residents with an initial acne diagnosis between 7 and ≤12 years old during 2010 to 2018 using the Rochester Epidemiology Project.

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