Immunosuppression commonly disrupts the homeostasis of mutated normal skin, leading to widespread skin dysplasia and field cancerization. However, the immune system's role in maintaining the normal state of mutated tissues remains uncertain. Herein, we demonstrate that T cell immunity to cutaneotropic papillomaviruses promotes the homeostasis of ultraviolet radiation-damaged skin.
View Article and Find Full Text PDFImportance: Dermatologists submit direct immunofluorescence (DIF) biopsies on a daily basis, using an assay detecting immunoreactant deposition with a panel that has traditionally comprised immunoglobulin (Ig) G, IgA, IgM, C3, and fibrin, with or without albumin antibodies.
Objectives: To evaluate and compare the frequency of immunoreactants in DIF biopsies submitted over an 8-year period and assess use by dermatologists based on clinical impression.
Design, Setting, And Participants: A quality improvement study was conducted in a community outreach reference laboratory associated with a large academic medical center.
High-risk skin cancer is a rare, but severe, complication associated with discoid lupus erythematosus (DLE). Chronic scar, inflammation, UVR, and immunosuppressive medications are proposed explanations for this heightened skin cancer risk; however, the exact mechanism driving skin carcinogenesis in DLE is unknown. The distinct co-localization of multiple independent skin cancers with areas of active inflammation in two DLE patients followed over 8 years strongly suggested that lupus inflammation promotes skin carcinogenesis in DLE.
View Article and Find Full Text PDFThis randomized placebo-controlled study examines the results of squaric acid dibutyl ester for the treatment of herpes labialis in adults.
View Article and Find Full Text PDFThis article describes the presentations and discussions at a conference co-convened by the Council on Medical Education of the American Medical Association (AMA) and by the American Board of Medical Specialties (ABMS). The conference focused on the ABMS Maintenance of Certification (MOC) Part III Examination. This article, reflecting the conference agenda, covers the value of and evidence supporting the examination, as well as concerns about the cost of the examination, and-given the current format-its relevance.
View Article and Find Full Text PDFBackground: Cutaneous lymphadenoma (CL) is rare neoplasm that clinically and histologically resembles basal cell carcinoma (BCC). CL, composed of dermal basaloid epithelial islands with prominent admixed lymphocytes, characteristically contains cytokeratin 20 (CK20)-positive Merkel cells (MCs). However, CK20 may be of limited use because of low MC density in small samples.
View Article and Find Full Text PDFWe observed two patients with solitary lesions showing features of clear cell acanthoma with underlying eccrine syringofibroadenoma-like changes. The pathogenesis of these entities has been debated since their original descriptions, with most recent literature suggesting that both may represent reactive phenomena rather than true neoplasms. Our observation prompted us to perform a retrospective review of clear cell acanthoma cases to determine the frequency of such associated eccrine syringofibroadenoma changes.
View Article and Find Full Text PDFJ Am Acad Dermatol
July 2013
Since 2006, after completing a cognitive certifying or recertifying examination, dermatologists are automatically enrolled into Maintenance of Certification (MOC) and can access a personalized electronic table (at www.abderm.org) that presents the requirements over the 10-year cycle.
View Article and Find Full Text PDFJ Am Acad Dermatol
July 2013
Participation in Maintenance of Certification is a reality for the majority of board-certified physicians in the United States. It consists of 4 parts that focus the attention of participants on knowledge assessment, practice performance, communication skills, and patient safety. This continuing medical education article reviews the development and possible future of the program, data regarding Maintenance of Certification, what is currently not known about Maintenance of Certification, and how to navigate the requirements for dermatologists.
View Article and Find Full Text PDFImportance: Reported physiologic nipple changes in pregnancy do not include hyperkeratosis and are expected to resolve or improve post partum. Hyperkeratosis of the nipple and/or areola can develop in the context of inflammatory diseases (such as atopic dermatitis), in acanthosis nigricans, as an extension of epidermal nevus, after estrogen treatment, and/or in nevoid hyperkeratosis of the nipple and areola. We performed a clinicopathologic analysis of cases of pregnancy-associated nipple hyperkeratosis.
View Article and Find Full Text PDFNephrogenic systemic fibrosis (NSF) is a fibrosing disorder that occurs in some patients with renal insufficiency. Exposure to gadolinium-based contrast agents (GdCA) has been associated with the development of NSF. No uniformly effective treatment options exist.
View Article and Find Full Text PDFThe distinction between actinic keratosis (AK) and squamous cell carcinoma in-situ (SCCIS) is a subject of discussion among dermatopathologists. A previous study determined that there was excellent interobserver agreement among dermatopathologists using the current two-tiered grading system. Presently, we assessed concordance among dermatopathologists using a three-tiered keratinocytic intraepithelial neoplasia (KIN) diagnostic system.
View Article and Find Full Text PDFThe effects of various laser wavelengths and fluences on the fungal isolate, Trichophyton rubrum, were examined in vitro. Standard-size isolates of T. rubrum were irradiated by using various laser systems.
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