Publications by authors named "Fatemeh Jafarian"

26 Publications

  • Page 1 of 1

Clinical Characteristics, Management, and Natural History of Chronic Inducible Urticaria in a Pediatric Cohort.

Int Arch Allergy Immunol 2021 Apr 1:1-8. Epub 2021 Apr 1.

Division of Pediatric Allergy and Clinical Immunology, Department of Pediatrics, McGill University Health Center, Montreal, Québec, Canada.

Background: Some forms of chronic urticaria (CU) can be specifically attributed to a response to a definite trigger, referred to as chronic inducible urticaria (CIndU). We aimed to assess the demographics, clinical characteristics, comorbidities, natural history, and management of pediatric patients with CIndU.

Methods: Over a 6-year period, children presenting to the allergy clinic at the Montreal Children's Hospital (MCH) with CIndU were prospectively recruited. CU was defined as the presence of wheals and/or angioedema, occurring for at least 6 weeks. A standardized diagnostic test was used to establish the presence of a specific form of urticaria. Resolution was defined as the absence of hives for 1 year without treatment.

Results: Sixty-four patients presented with CIndU, of which 51.6% were male, with a median age of 12.5 (interquartile range 7.3, 15.9) years. Cold CU and cholinergic CU were the most common subtypes (60.3 and 41.3%, respectively). Basophil counts were undetectable in 48.4% of the cases, and C-reactive protein levels were elevated in 7.8% of patients. Of all cases, 71.4% were controlled with second-generation antihistamines. The resolution rate was of 45.3% (95% confidence interval 33.1-57.5%), based on per-protocol population within the 6-year course of the study. Resolution was more likely in patients who presented with well-controlled urticaria control test scores and elevated CD63 counts and in those suffering from thyroid comorbidity.

Conclusion: The natural history of CIndU resolution in pediatric patients was relatively low and was associated with elevated CD63 levels, as well as thyroid comorbidity.
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http://dx.doi.org/10.1159/000514757DOI Listing
April 2021

Erythema multiforme-like eruption associated with plant-induced allergic contact dermatitis in a pediatric patient: A case report.

Pediatr Dermatol 2021 Jan 28;38(1):246-248. Epub 2020 Nov 28.

Division of Dermatology, McGill University Health Centre, Montreal, QC, Canada.

An 11-year-old boy presented to the emergency department 5 days after playing in the forest. His initial eruption, consistent with allergic contact dermatitis to poison ivy, progressed into target lesions involving his extremities, palms, upper trunk, and face, consistent with an erythema multiforme-like eruption. This report details the case and reviews the literature concerning this atypical and potentially underreported complication of plant-induced allergic contact dermatitis.
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http://dx.doi.org/10.1111/pde.14450DOI Listing
January 2021

Growing Role of Telemedicine in Dermatology: A Practical, Timely Application for Skin Cancer Screening in Organ Transplant Recipients.

J Cutan Med Surg 2021 Jan-Feb;25(1):104-105. Epub 2020 Sep 10.

54473 Division of Dermatology, MGill University HealthCentre, Montreal, Quebec, Canada.

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http://dx.doi.org/10.1177/1203475420957626DOI Listing
September 2020

Mohs Surgery for Cellular Dermatofibroma in a Child.

Dermatol Surg 2021 Apr;47(4):565-568

Division of Dermatology-Oncology, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Quebec, Canada.

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http://dx.doi.org/10.1097/DSS.0000000000002500DOI Listing
April 2021

Confusion Among Different Forms of Vitamin B3.

J Cutan Med Surg 2020 Nov/Dec;24(6):642-643. Epub 2020 Jun 22.

54473 Division of Dermatology, McGill University Health Centre, Montreal, Canada.

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http://dx.doi.org/10.1177/1203475420936649DOI Listing
June 2020

A pediatric case of Stevens-Johnson syndrome/toxic epidermal necrolysis with rapid response to intravenous cyclosporine.

JAAD Case Rep 2020 Jun 7;6(6):555-557. Epub 2020 May 7.

Division of Dermatology, McGill University Health Center-Glen site, Montreal, Quebec, Canada.

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http://dx.doi.org/10.1016/j.jdcr.2020.04.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7265061PMC
June 2020

Reply to: "Comment on 'Efficacies and merits of the cotton swab technique for diagnosing tinea capitis in the pediatric population'".

J Am Acad Dermatol 2020 09 13;83(3):e195-e196. Epub 2020 Apr 13.

Division of Allergy, Immunology and Dermatology, McGill University, Montreal, Quebec, Canada. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2020.04.029DOI Listing
September 2020

Efficacies and merits of the cotton swab technique for diagnosing tinea capitis in the pediatric population.

J Am Acad Dermatol 2020 Sep 12;83(3):920-922. Epub 2020 Jan 12.

Division of Allergy, Immunology and Dermatology, McGill University, Montreal, Quebec, Canada. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2020.01.009DOI Listing
September 2020

A novel nonsense mutation in exon 9 in the extracellular matrix protein 1 gene associated with lipoid proteinosis: A case report.

SAGE Open Med Case Rep 2019 19;7:2050313X19850359. Epub 2019 May 19.

Division of Pediatric Dermatology, McGill University Health Center, Montreal Children's Hospital, Montreal, QC, Canada.

Lipoid proteinosis is a rare autosomal recessive genodermatosis that is caused by loss-of-function mutations in the extracellular matrix protein 1 gene. This study identifies a novel nonsense mutation in exon 9 of the extracellular matrix protein 1 gene associated with lipoid proteinosis, contributing to recent advances in our understanding of the molecular genetics underlying this disease. It is important to identify the mutations in the extracellular matrix protein 1 gene that are associated with lipoid proteinosis and how these affect protein function. Understanding the molecular basis for such genetic disorders may lead to novel therapeutic approaches for treating hereditary genodermatoses.
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http://dx.doi.org/10.1177/2050313X19850359DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6537054PMC
May 2019

Successful management of pediatric oral pemphigus vulgaris with topical corticosteroid monotherapy.

Pediatr Dermatol 2019 Sep 9;36(5):730-731. Epub 2019 Jun 9.

Division of Dermatology, Montreal Children's Hospital, Montreal, Quebec, Canada.

Pemphigus vulgaris (PV) is an autoimmune intraepithelial bullous disease that affects the skin and mucous membranes. Typically, the management of PV is challenging, with systemic corticosteroids being the mainstay of treatment. We describe the case of a 14-year-old girl who was diagnosed with oral PV and successfully treated with topical corticosteroids alone. This case details a pediatric mucosal PV case successfully managed solely with topical corticosteroids.
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http://dx.doi.org/10.1111/pde.13876DOI Listing
September 2019

Identification of a novel substitution mutation (R103C) in the rod domain of the keratin 17 gene associated with pachyonychia congenita type 2.

Int J Dermatol 2019 Feb 15;58(2):233-236. Epub 2018 Jun 15.

Division of Dermatology, McGill University Health Center, Montréal, Quebec, Canada.

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http://dx.doi.org/10.1111/ijd.14082DOI Listing
February 2019

Insights into the Pathophysiology of Hypertrophic Scars and Keloids: How Do They Differ?

Adv Skin Wound Care 2018 Jan;31(1):582-595

Feras M. Ghazawi, MD, PhD, MSc • Resident Physician • Division of Dermatology • University of Ottawa • Ottawa, Ontario, Canada • Faculty of Medicine • McGill University • Montreal, Quebec, Canada Ramin Zargham, MD, PhD • Selective Surgical Pathology Fellow • Roswell Park Cancer Institute • Buffalo, New York Mirko S. Gilardino, MD, MSc • Plastic Surgeon • Division of Plastic and Reconstructive Surgery • McGill University Health Centre • Montreal, Quebec, Canada Denis Sasseville, MD • Dermatologist • Division of Dermatology • McGill University Health Centre • Montreal, Quebec, Canada Fatemeh Jafarian, MD • Dermatologist • Division of Dermatology • McGill University Health Centre • Montreal, Quebec, Canada.

General Purpose: To provide information about the clinical presentation of hypertrophic scars and keloids based on their varied structural components.

Target Audience: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

Learning Objectives/outcomes: After completing this continuing education activity, you should be able to: ABSTRACT: Hypertrophic scars and keloids are firm, raised, erythematous plaques or nodules that manifest when the cicatrix fails to properly heal. They result from pathologic wound healing and often cause pain and decreased quality of life. The appearance of such cosmetically unappealing scars affects the confidence and self-esteem of many patients. These scars can also cause dysfunction by interfering with flexion and extension across joints. Both possess some unique and distinct histochemical and physiologic characteristics that set them apart morphologically and at the molecular level. While these entities have been the focus of research for many years, differentiating between them remains challenging for clinicians.This article reviews the clinical presentation of aberrant scars and illustrates how they can be differentiated. It outlines their pathophysiology and emphasizes the unique molecular mechanisms underlying each disorder. It also examines how altered expression levels and the distribution of several factors may contribute to their unique clinical characteristics and presentation. Further research is needed to elucidate optimal treatments and preventive measures for these types of aberrant scarring.
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http://dx.doi.org/10.1097/01.ASW.0000527576.27489.0fDOI Listing
January 2018

Merkel cell carcinoma in organ transplant recipients: Case reports and review of the literature.

JAAD Case Rep 2015 Nov 24;1(6):S29-32. Epub 2015 Nov 24.

Department of Dermatology, University of California, San Francisco, California.

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http://dx.doi.org/10.1016/j.jdcr.2015.09.017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4809574PMC
November 2015

Linear atrophoderma of Moulin: an underrecognized entity.

Pediatr Rheumatol Online J 2015 Oct 6;13(1):39. Epub 2015 Oct 6.

Division of Dermatology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, 1001 Boulevard Décarie, Montreal, QC, H4A 3J1, Canada.

Linear atrophoderma of Moulin (LAM) is an acquired skin condition that manifests in early childhood and adolescence. It likely represents a form of cutaneous mosaicism that presents with linear, hyperpigmented and atrophic lesions appearing on the trunk and limbs. Its clinical appearance varies and may closely resemble that of atrophoderma of Pasini and Pierini (APP) and linear scleroderma. LAM usually follows a benign course and no effective treatment options exist. We present a case of a young and healthy patient that developed such lesions on her upper and lower extremities over 5 years. The initial clinical impression of linear scleroderma was reviewed in favor of LAM following histological examination of the lesions which revealed no significant inflammatory changes. LAM remains a rare and possibly under recognized entity with reports confined only to the dermatologic literature. This case highlights the importance of recognizing LAM and distinguishing it from linear scleroderma given the significant differences in management and prognosis.
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http://dx.doi.org/10.1186/s12969-015-0036-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4595104PMC
October 2015

Management of pediatric chronic spontaneous and physical urticaria patients with omalizumab: case series.

Pediatr Allergy Immunol 2015 Sep 14;26(6):585-8. Epub 2015 Jun 14.

Department of Pediatrics, Division of Allergy and Clinical Immunology, McGill University Health Centre, Montreal, QC, Canada.

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http://dx.doi.org/10.1111/pai.12407DOI Listing
September 2015

An atypical case of bullous systemic lupus erythematosus in a 16-year-old boy.

Pediatr Dermatol 2014 Nov-Dec;31(6):e164-6. Epub 2014 Jul 21.

Department of Dermatology, Montreal Children's Hospital, Montreal, Quebec, Canada.

Bullous systemic lupus erythematosus (BSLE) is a rare autoimmune subepidermal blistering disease with a female predominance characterized as an acute vesicobullous eruption in patients with systemic lupus erythematosus (SLE). Here we report a case of BSLE in a 16-year-old boy that does not adhere to the criteria originally established and suggest a new outlook on this condition.
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http://dx.doi.org/10.1111/pde.12389DOI Listing
November 2015

Images in clinical medicine. Lichen striatus and lines of Blaschko.

N Engl J Med 2012 Dec;367(25):2427

McGill University, Montreal, QC, Canada.

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http://dx.doi.org/10.1056/NEJMicm1200973DOI Listing
December 2012

Chronic hyperpigmented scaly plaques. Pityriasis rotunda (PR).

Arch Dermatol 2012 Sep;148(9):1073-8

McGill University, Montreal, Quebec, Canada.

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http://dx.doi.org/10.1001/archdermatol.2012.1494DOI Listing
September 2012

Deep cutaneous fungal infections in immunocompromised children.

J Am Acad Dermatol 2009 Nov 11;61(5):857-64. Epub 2009 Sep 11.

Division of Dermatology, CHU Sainte-Justine, Montreal, Quebec, Canada.

Background: Life-threatening infections from ubiquitous fungi are becoming more prevalent in adults and children because of the increased use of immunosuppressive agents and broad-spectrum anti-infective drugs. Extremely low birth weight premature neonates and patients with a disrupted epidermal barrier are also at increased risk. Lethality is high, particularly with delayed diagnosis. As cutaneous lesions are often the first manifestation of such infections, early recognition of suspicious lesions is crucial to decrease associated morbidity and mortality. The clinical features of deep cutaneous fungal infection (DCFI) in immunocompromised children deserve special attention.

Objectives: This study aimed to characterize our pediatric patients with DCFI, the causative fungi, and the associated risk factors.

Methods: A medical record review was conducted of pediatric patients with DCFI treated at out institution using data retrieved from the hospital's pathology and microbiology database (1980-2008).

Results: In all, 26 patients with DCFI were identified (9 girls and 17 boys) ranging in age from 1 day to 18 years (mean age: 8 years), the majority of whom had a hematologic disorder. All patients were immunocompromised, 90% were receiving broad-spectrum antibiotics, and 50% had severe neutropenia (absolute neutrophilic count < or = 500 x 10(6)/L). Necrotic ulcers (42%) and papules (34%) represented the most frequent lesion morphology. Fungal species were identified by culture in 20 (87%) of 23 patients tested and were observed histopathologically in 20 of 23 patients tested. Aspergillus was identified in 12 (44%) patients and Candida in 9 (33%). The other species included Fusarium (one), Exserohilum rostratum (one), Alternaria (one), Zygomycetes (two), and Blatomycetes (one). All but two patients received systemic antifungal therapy; wide surgical excision was performed in 13. Infection resolved in 20 (77%), whereas 6 (23%) died of disseminated infection.

Limitations: This study was limited by the small number of cases and the retrospective nature of the collected data.

Discussion: DCFI should rank high in the differential diagnosis of any suspicious skin lesions in immunocompromised children. Early biopsies should be performed for histopathology and microbiological analysis, as lethality is high if appropriate treatment is delayed.
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http://dx.doi.org/10.1016/j.jaad.2009.02.052DOI Listing
November 2009

A phase II, open-label study of the efficacy and safety of imiquimod in the treatment of superficial and mixed infantile hemangioma.

Pediatr Dermatol 2009 Mar-Apr;26(2):203-12

Division of Dermatology, Department of Pediatrics, CHU Sainte-Justine, University of Montreal, Montreal, Quebec, Canada.

Objectives: To explore the efficacy and safety of imiquimod 5% cream as a treatment for infantile hemangioma.

Design: Phase II, open-label, noncomparative study of imiquimod applied during 16 weeks, with posttherapy follow-up 16 weeks later (8 months total).

Setting: Outpatient pediatric tertiary care referral center in Quebec, Canada.

Participants: Healthy infants up to 8.8 months of age with previously untreated, nonulcerated, proliferative superficial or mixed infantile hemangioma, excluding periorbital, or perineal localization, > or =100 cm2 in size.

Intervention: Topical imiquimod applied three to seven times per week for 16 weeks to infantile hemangioma.

Main Outcome Measures: Lesion area, volume, depth (Doppler ultrasound), and color (erythema), serum drug, and interferon-alpha levels.

Results: Sixteen infants (11 girls, 5 boys) with a mean age at entry of 4.1 months and mean lesion area of 32.89 cm2, and volume of 39.98 cm3 were enrolled. Two participants discontinued treatment early, one for an adverse event (crying upon application), the other because of the lack of compliance. Local skin reactions were consistent with those reported in adults. Two cases had a decrease and three had an increase in lesion parameters; otherwise no meaningful changes in lesion area, volume, or depth were observed. At the 4-month posttreatment visit, 11 of 14 subjects had improvement in erythema (marginal homogeneity test = 2.668, p = 0.008). Measured serum drug and interferon-alpha levels were low or undetectable.

Conclusions: Treatment of infants with infantile hemangioma with imiquimod up to seven times per week for 16 weeks was generally well tolerated with low systemic exposure. Improvement was observed in hemangioma coloration, but not lesion size, suggesting effects were limited to the superficial component.
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http://dx.doi.org/10.1111/j.1525-1470.2008.00857.xDOI Listing
July 2009

Dermatofibrosarcoma protuberans in childhood and adolescence: report of eight patients.

Pediatr Dermatol 2008 May-Jun;25(3):317-25

Division of Dermatology, Department of Pediatrics, Sainte-Justine Hospital, University of Montreal, Montreal, Quebec, Canada.

We reviewed all occurrences of dermatofibrosarcoma protuberans in children under 17 years of age who were evaluated at Sainte-Justine Hospital, a tertiary-care pediatric center, between 1980 and 2002. The medical records and histologic features of all were reviewed. Eight patients were identified, three boys and five girls. The interval between apparent onset and diagnosis ranged from 3 months to 14 years. All lesions except one were removed by surgical excision with a margin of 1.5 to 3 cm including underlying fascia or by Mohs technique. Follow-up ranged from 2 to 15 years with median of 5 years. To date all the patients are alive and none has had a recurrence.
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http://dx.doi.org/10.1111/j.1525-1470.2008.00674.xDOI Listing
August 2008

Plexiform fibrohistiocytic tumor in three children.

Pediatr Dermatol 2006 Jan-Feb;23(1):7-12

Department of Pediatric Dermatology, Ste-Justine Hospital, University of Montreal, Montreal, Quebec, Canada.

Plexiform fibrohistiocytic tumor is a very rare fibrohistiocytic tumor of intermediate malignancy. It can occur at any age but is more prevalent in children and in young adults. Here we present the clinicopathologic findings of three girls with this tumor. The patients were 8 months, 14 months, and 7 years of age. They each presented with a solitary, nontender, subcutaneous nodule or plaque. Light microscopy and immunohistochemical study findings were compatible with plexiform fibrohistiocytic tumor. We also review the previously published cases in the English-language literature.
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http://dx.doi.org/10.1111/j.1525-1470.2006.00160.xDOI Listing
July 2006

Malignant melanoma in childhood and adolescence: report of 13 cases.

J Am Acad Dermatol 2005 Nov 29;53(5):816-22. Epub 2005 Sep 29.

Division of Dermatology, Department of Pediatrics, Sainte-Justine Hospital, Montreal, Québec, Canada.

We reviewed all cases of malignant melanoma in children younger than 17 years of age who were evaluated at Sainte Justine Hospital, a tertiary care pediatric center, between 1980 and 2002. The medical records and histologic features of all cases were reviewed. Thirteen cases were identified, 4 boys and 9 girls. Fifty-three percent of patients were prepubescent. None of the patients had a predisposing condition (eg, giant congenital nevi, dysplastic nevus syndrome, or xeroderma pigmentosum). One patient had had chemoradiotherapy previously for an undifferentiated pleuropulmonary malignant tumor (blastoma) and another patient had Down syndrome. The most frequent reason for initial consultation was a recent increase in size of the lesion. Three patients had pyogenic granuloma-like lesions. Eighty-five percent of the observed melanomas were nodular in type. Tumor thickness ranged from 0 to 6 mm with a median and mean thickness of 2.8 and 3.2 mm, respectively. The overall 5-year survival rate was 58.8%. Lack of awareness and delay in diagnosis may lead to a higher incidence of thick and intermediate melanoma in children. Because it appears that the majority of melanomas in childhood and adolescence occur de novo, clinicians should consider this condition in the differential diagnosis of any suspect lesion in children and adolescents even without an identified predisposing factor.
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http://dx.doi.org/10.1016/j.jaad.2005.07.013DOI Listing
November 2005