Project ECHO dermatology in the deep south: a comprehensive SWOT assessment.

There are nearly 45,000 patients for each dermatologist in the rural State of Mississippi, causing many patients to wait months for an appointment in a city that may be hours away [1]. To address this critical gap, Project ECHO (Extension for Community Healthcare Outcomes) was launched at the University of Mississippi Medical Center (UMMC) in 2020 to teach rural primary care providers (PCPs) to care for common skin conditions. PCPs present images of their patients in a once monthly video teleconference that provides immediate feedback.

Skin cancer knowledge, attitudes, beliefs, and prevention practices among beachgoers: a narrative review.

People who spend time at the beach at increased risk for ultraviolet light (UV) exposure. This review assessed skin cancer-related knowledge, attitudes, beliefs, and prevention practices among beachgoers and sunbathers at the beach. Relevant articles were search in the following electronic databases: PubMed (Medline), Cumulative Index to Nursing and Allied Health (CINAHL), ERIC, and PsycINFO.

BCAAs acutely drive glucose dysregulation and insulin resistance: role of AgRP neurons.

Background: High-protein diets are often enriched with branched-chain amino acids (BCAAs) known to enhance protein synthesis and provide numerous physiological benefits, but recent studies reveal their association with obesity and diabetes. In support of this, protein or BCAA supplementation is shown to disrupt glucose metabolism while restriction improves it. However, it is not clear if these are primary, direct effects of BCAAs or secondary to other physiological changes during chronic manipulation of dietary BCAAs.

Transcriptomic Analysis of the Major Orphan Ichthyosis Subtypes Reveals Shared Immune and Barrier Signatures.

Preliminary work suggested upregulation of inflammatory pathways in patients with common forms of ichthyosis. However, a comprehensive characterization of skin from various ichthyosis subtypes is unavailable, precluding the development of targeted treatments. Thus, we sought to characterize the immune and barrier profiles of common and subtype-specific skin transcriptomes in a large group of patients with ichthyosis.

Cutaneous Manifestations of SARS-CoV-2 Infection.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the coronavirus disease 2019 (COVID-19) pandemic, affecting people worldwide. SARS-CoV-2 infection is a multisystem disease with potential for detrimental effects on various systemic organs. It affects people of all ages with varying degrees of disease severity.

Covid-19 skin manifestations: an update.

Purpose Of Review: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 is a multisystemic disease manifesting mainly with dry cough, fever, and pneumonia and can present with a myriad of cutaneous manifestations. This chapter will review SARS-CoV-2 associated cutaneous findings, including incidence and relevance to the pediatric population.

Recent Findings: The most commonly reported cutaneous findings described for COVID-19 in adults and children were chilblains-like lesions, followed by maculopapular eruption, urticarial lesions, vesicular lesions, and livedoid lesions.

Pediatric maculopapular cutaneous mastocytosis: Retrospective review of signs, symptoms, and associated conditions.

Background/objectives: Though maculopapular cutaneous mastocytosis is the most common form of pediatric mastocytosis, it remains unclear which patients will experience severe symptoms. We sought to better define the presentation and the cutaneous and systemic signs and symptoms in patients with maculopapular cutaneous mastocytosis.

Methods: We analyzed retrospective data on 227 patients diagnosed with maculopapular cutaneous mastocytosis prior to age 15 years from five US clinical sites.

PLAID syndrome: Characteristic presentation and a novel therapeutic option.

PLCG2-associated antibody deficiency and immune dysregulation (PLAID) is an autosomal dominant inherited disease caused by genomic deletion in PLCG2 and is characterized by cold urticaria, humoral immune deficiency, cutaneous granulomas, and autoimmune disease. The patient described in this case had a typical presentation for a PLAID phenocopy and experienced intense pruritus, a common complication of PLAID, starting in early childhood. After trialing H1 and H2 blockers with no improvement, oral glycopyrrolate was used with near resolution of the patient's symptoms.

Ichthyosis molecular fingerprinting shows profound T17 skewing and a unique barrier genomic signature.

Background: Ichthyoses are a group of rare skin disorders lacking effective treatments. Although genetic mutations are progressively delineated, comprehensive molecular phenotyping of ichthyotic skin could suggest much-needed pathogenesis-based therapy.

Objective: We sought to profile the molecular fingerprint of the most common orphan ichthyoses.

Early-onset pediatric atopic dermatitis is characterized by T2/T17/T22-centered inflammation and lipid alterations.

Background: Although atopic dermatitis (AD) often starts in early childhood, detailed tissue profiling of early-onset AD in children is lacking, hindering therapeutic development for this patient population with a particularly high unmet need for better treatments.

Objective: We sought to globally profile the skin of infants with AD compared with that of adults with AD and healthy control subjects.

Methods: We performed microarray, RT-PCR, and fluorescence microscopy studies in infants and young children (<5 years old) with early-onset AD (<6 months disease duration) compared with age-matched control subjects and adults with longstanding AD.

Langerhans cell histiocytosis: A neoplastic disorder driven by Ras-ERK pathway mutations.

Langerhans cell histiocytosis (LCH) is a disorder of myeloid neoplasia of dendritic cells that affects 1 in 200,000 children <15 years of age and even fewer adults. LCH presents with a spectrum of clinical manifestations. High-risk stratification is reserved for infiltration of blood, spleen, liver, and lungs.

The spectrum of manifestations in desmoplakin gene (DSP) spectrin repeat 6 domain mutations: Immunophenotyping and response to ustekinumab.

Background: The immune abnormalities underlying the ichthyoses are poorly understood.

Objective: To determine the immunophenotype of an ichthyosis resulting from mutations in the spectrin repeat 6 (SR6) domain of desmoplakin gene (DSP) and target therapy on the basis of molecular pathogenesis.

Methods: Immunophenotyping was performed by using the blood and skin of a girl with SR6 region DSP mutations causing erythroderma/ichthyosis and cardiomyopathy.

Alterations in B-cell subsets in pediatric patients with early atopic dermatitis.

Background: B cells undergo maturation and class-switching in response to antigen exposure and T-cell help. Early B-cell differentiation has not been defined in patients with early-onset atopic dermatitis (AD).

Objective: We sought to define the frequency of B-cell subsets associated with progressive B-cell maturation and IgE class-switching.

Early-onset pediatric atopic dermatitis is T2 but also T17 polarized in skin.

Background: Atopic dermatitis (AD) affects 15% to 25% of children and 4% to 7% of adults. Paradigm-shifting discoveries about AD have been based on adult biomarkers, reflecting decades of disease activity, although 85% of cases begin by 5 years. Blood phenotyping shows only T2 skewing in patients with early-onset pediatric AD, but alterations in early pediatric skin lesions are unknown, limiting advancement of targeted therapies.

An IL-17-dominant immune profile is shared across the major orphan forms of ichthyosis.

Background: The ichthyoses are rare genetic disorders associated with generalized scaling, erythema, and epidermal barrier impairment. Pathogenesis-based therapy is largely lacking because the underlying molecular basis is poorly understood.

Objective: We sought to characterize molecularly cutaneous inflammation and its correlation with clinical and barrier characteristics.

Leishmaniasis Panamensis Masquerading as Myiasis and Sporotrichosis: A Clinical Pitfall.

We report a case of cutaneous leishmaniasis panamensis in nonendemic Costa Rica. A 19-year-old female presented with nonhealing, unilateral eruption of erythematous papules with superficial central ulceration in a sporotrichoid pattern on right upper arm and back. Given the clinical picture and geographic locale, the patient was initially diagnosed with myiasis or human botfly infestation; however, the sporotrichoid pattern of the bites is an unlikely finding in myiasis.