Publications by authors named "Rajiv Nijhawan"
Objective: Metabolic reprogramming plays a critical role in modulating the innate and adaptive immune response, but its role in cutaneous autoimmune diseases, such as cutaneous lupus erythematosus (CLE), is less well studied. An improved understanding of the metabolic pathways dysregulated in CLE may lead to novel treatment options, biomarkers and insights into disease pathogenesis. The objective was to compare metabolomic profiles in the skin and sera of CLE and control patients using liquid chromatography-mass spectrometry (LC-MS).
View Article and Find Full Text PDFMohs micrographic surgery (MMS) is a tissue-sparing skin cancer resection technique that involves 100% margin analysis. This procedure is performed in the outpatient setting under local anesthesia by dermatologic surgeons who act as both the surgeon and the pathologist. The technique allows for prompt reconstruction immediately after cancer clearance and offers the highest cure rate for many skin malignancies, including basal and squamous cell carcinoma, as well as more rare tumors.
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- 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.
Solid organ transplant recipients (SOTRs) are at high risk of cutaneous squamous cell carcinoma (cSCC) metastasis. Despite prior studies identifying risk factors, mortality remains high. Understanding additional risk factors may aid in reducing mortality in this population.
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- Desmoplastic trichoepithelioma (DTE) is a rare benign skin tumor that can look like malignant conditions, making diagnosis challenging.
- A systematic review of 338 DTE cases highlighted that Mohs micrographic surgery (MMS) showed a 0% recurrence rate, significantly outperforming other treatments like standard excision (13.1% recurrence) and electrosurgery (2.1%).
- The findings suggest that MMS is the best option for treating DTEs, especially since these tumors are often located in sensitive cosmetic areas.
Background: Prophylactic antibiotic therapy is widely used in dermatologic surgery to prevent surgical site infections and bacteremia, which can lead to prosthetic joint infections (PJI) and infective endocarditis (IE) in high-risk populations.
Objective: To evaluate the incidence of bacteremia, PJI, and IE after dermatologic surgery and assess the current evidence for antibiotic prophylaxis.
Materials And Methods: A search of the computerized bibliographic databases was performed using key terms from the date of inception to March 21, 2021.
Background: Although current guidelines recommend a 5 mm surgical margin for the excision of melanoma in situ (MIS), increasing evidence has shown this may be suboptimal to achieve tumor clearance.
Objective: To evaluate margins required for optimal cure rates with excision of MIS on the head and neck and investigate tumor and/or patient factors in those requiring >5 mm margins to achieve tumor clearance.
Methods: A retrospective chart review was performed on 846 (807 primary and 39 recurrent) MIS cases on the head and neck treated in the authors' dermatologic surgery department over a 126-month (10.
Background: Currently, there are limited reviews in the dermatology literature on how to approach reconstruction of nasal lining in full-thickness nasal defects resulting from Mohs micrographic surgery. Given variable training and experience, dermatologic surgeons may seek additional references to help reconstruct certain advanced defects. We sought to synthesize literature from dermatologic surgery, plastic surgery, and otolaryngology to review repair options and considerations for repair of nasal lining defects.
View Article and Find Full Text PDFBackground: Amid a movement toward value-based healthcare, increasing emphasis has been placed on outcomes and cost of medical services. To define and demonstrate the quality of services provided by Mohs surgeons, it is important to identify and understand the key aspects of Mohs micrographic surgery (MMS) that contribute to excellence in patient care.
Objective: The purpose of this study is to develop and identify a comprehensive list of metrics in an initial effort to define excellence in MMS.
Background: Cutaneous squamous cell carcinomas (cSCCs) of the lip have been reported to be at higher risk for poorer post-treatment outcomes.
Objective: To examine outcomes of patients with SCC of the lip treated with Mohs micrographic surgery (MMS) and identify factors for recurrence.
Materials And Methods: This retrospective review of a single tertiary referral center's Mohs case logs from 2010 to 2019 identified cases of lip SCC.
Article Synopsis
- Proliferating pilar tumors (PPTs) are rare skin tumors linked to hair follicles that can be malignant and metastasize, primarily affecting older women and often located on the scalp.
- A systematic review of 114 articles covering 361 cases showed that the average patient age was 61.7 years, with only a fraction of cases classified for cytological atypia and malignancy, highlighting the need for better reporting practices.
- Current treatment data is inconclusive, but Mohs micrographic surgery has shown some success; however, the overall lack of sufficient varied studies limits definitive conclusions on the best treatment options for PPTs.
Background: Medical spa and cosmetic procedure markets have grown substantially in recent years. The lack of consistent medical oversight at medical spas raises safety concerns.
Objective: To understand how the public views medical spas compared with physician's offices as places to receive cosmetic procedures with a focus on safety.