Publications by authors named "Jacob Levitt"

82 Publications

Erythrasma in 4 skin of color patients with hidradenitis suppurativa.

JAAD Case Rep 2021 Jul 2;13:127-129. Epub 2021 Jun 2.

Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.

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http://dx.doi.org/10.1016/j.jdcr.2021.05.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8226396PMC
July 2021

Trichotillomania due to pica in a 23-month-old patient with concomitant iron deficiency anemia and lead poisoning.

JAAD Case Rep 2021 Jan 19;7:91-92. Epub 2020 Nov 19.

Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.

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http://dx.doi.org/10.1016/j.jdcr.2020.11.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7750178PMC
January 2021

Full scalp hair regrowth in a 4-year-old girl with alopecia areata and atopic dermatitis treated with dupilumab.

JAAD Case Rep 2020 Dec 15;6(12):1286-1287. Epub 2020 Oct 15.

Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.

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http://dx.doi.org/10.1016/j.jdcr.2020.10.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7701016PMC
December 2020

Resolution of pretibial myxedema with teprotumumab in a patient with Graves disease.

JAAD Case Rep 2020 Dec 15;6(12):1281-1282. Epub 2020 Sep 15.

Department of Dermatology, The Mount Sinai Hospital, New York, New York.

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http://dx.doi.org/10.1016/j.jdcr.2020.09.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7701010PMC
December 2020

Remote learning for medical student-level dermatology during the COVID-19 pandemic.

J Am Acad Dermatol 2020 Dec 14;83(6):e469-e470. Epub 2020 Aug 14.

Department of Dermatology, Mount Sinai School of Medicine, New York, New York. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2020.08.033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7426218PMC
December 2020

Resolution of pembrolizumab-associated lichenoid dermatitis with a single dose of methotrexate.

Dermatol Online J 2020 May 15;26(5). Epub 2020 May 15.

Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

We present a 53-year-old woman with severe lichenoid dermatitis secondary to pembrolizumab therapy that was refractory to both topical and oral steroids. After almost three months without improvement, the rash was effectively combated with a single 15mg dose of methotrexate. We hope this case will help guide the management of the cutaneous adverse effects of anti-PD1 immunotherapy.
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May 2020

Use of etanercept in management of tyrosine kinase-inhibitor-induced erythema nodosum.

JAAD Case Rep 2020 Jun 24;6(6):567-568. Epub 2020 Apr 24.

Department of Dermatology, The Mount Sinai Hospital, New York, New York.

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http://dx.doi.org/10.1016/j.jdcr.2020.04.016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7265067PMC
June 2020

Dupilumab-induced phenotype switching from atopic dermatitis to psoriasis.

JAAD Case Rep 2020 Mar 19;6(3):217-218. Epub 2020 Feb 19.

Icahn School of Medicine at Mount Sinai, New York, New York.

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http://dx.doi.org/10.1016/j.jdcr.2020.01.012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7033615PMC
March 2020

The utility of dupilumab for use in the pediatric population.

JAAD Case Rep 2019 Nov 24;5(11):943-944. Epub 2019 Oct 24.

Department of Dermatology, Mount Sinai Hospital, New York, New York.

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http://dx.doi.org/10.1016/j.jdcr.2019.08.023DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6827273PMC
November 2019

Recalcitrant prurigo nodularis treated successfully with dupilumab.

JAAD Case Rep 2019 May 8;5(5):471-473. Epub 2019 May 8.

Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.

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http://dx.doi.org/10.1016/j.jdcr.2019.03.016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6510953PMC
May 2019

Treatment of Arsenic-Induced Bowen’s Disease With Topical 5-Fluorouracil

J Drugs Dermatol 2019 May;18(5):477-479

Here, we present a case of arsenic-induced Bowen’s disease treated with a regimen consisting of topical 5-fluouracil and oral nicotinamide. The use of this therapy modality resulted in near complete resolution of all of the patient’s lesions except for those on her palms, soles, and scalp. Excellent wound care and treatment adherence were major factors contributing to the success of this treatment option. Our results ultimately provide an alternative approach to treating multiple arsenical keratoses in patients who are limited to a drug plan involving 5-FU and oral nicotinamide and who are able to be rigorously compliant with application of medication and wound care. J Drugs Dermatol. 2019;18(5):477-479.
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May 2019

Electrosurgical debulking of pretibial myxedema of the foot.

Dermatol Online J 2019 Feb 15;25(2). Epub 2019 Feb 15.

Department of Dermatology, Mount Sinai Hospital, New York City, New York.

Pretibial myxedema or thyroid dermopathy constitutes dermal deposition of mucin, primarily hyaluronic acid and chondroitin sulfate. It is a manifestation of autoimmune thyroiditis, seen more in Graves disease than in Hashimoto thyroiditis. The time delay from treatment of hyperthyroidism to appearance of localized myxedema varies from one month to 16 years (mean 5.13 years). Despite a variety of therapeutic options, failure and relapse rates are high. Therapeutic options reported in the literature include compression, topical and intralesional corticosteroids, oral pentoxifylline, octreotide, rituximab, plasmapheresis, and high-dose intravenous immunoglobulin. We share our experience in two patients who were treated with electrosurgical debulking of selected longstanding myxedematous lesions, with one positive result and one negative result.
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February 2019

Protein-losing enteropathy and joint contractures caused by a novel homozygous ANTXR2 mutation.

Adv Genomics Genet 2018 27;8:17-21. Epub 2018 Jun 27.

Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Infantile systemic hyalinosis (ISH) is a rare autosomal recessive disorder and an allelic form of hyaline fibromatosis syndrome that is caused by mutations in the gene encoding the transmembrane anthrax toxin receptor 2. Its main features include characteristic skin lesions, joint contractures, persistent diarrhea, and failure to thrive due to accumulation of hyaline material in multiple organs. The resulting severe malnutrition can cause death in early infancy. Because of its rarity and high fatality rate, timely diagnosis is difficult and ISH may be underdiagnosed. In this report, we describe a 10-month-old male with severe protein-losing enteropathy, skin lesions, and painful joint contractures, diagnosed with ISH based on skin his-topathology and identification of a novel homozygous mutation, c.1127_1128delTG (p.V376Gfs*14). While its clinical outcome is poor without curative treatment, establishing a diagnosis of ISH starting from clinical suspicion to molecular analysis is important for appropriate medical management and for risk and carrier assessment of family members.
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http://dx.doi.org/10.2147/AGG.S159077DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6057141PMC
June 2018

Secukinumab emerges as a rapidly effective therapy for pityriasis rubra pilaris.

Cutis 2018 May;101(5):367-369

Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Refractory pityriasis rubra pilaris (PRP) often is treated off-label with the same biologic therapies that are approved for the treatment of psoriasis, most commonly tumor necrosis factor (TNF) α antagonists and ustekinumab; however, the IL-17A antagonist secukinumab also has shown efficacy in the treatment of PRP. We report 2 new cases of severe refractory PRP that responded rapidly to treatment with secukinumab.
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May 2018

Alopecia areata after dupilumab for atopic dermatitis.

JAAD Case Rep 2018 Mar 16;4(2):143-144. Epub 2018 Jan 16.

The Mount Sinai Medical Center, Department of Dermatology, New York, New York.

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http://dx.doi.org/10.1016/j.jdcr.2017.11.020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5790019PMC
March 2018

Advanced Therapy Treatment for Psoriasis: A Single-Site Retrospective Study of Prescribing Outcomes.

Skinmed 2017;15(6):493-495. Epub 2017 Dec 1.

Department of Dermatology, The Mount Sinai Hospital, New York, NY.

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July 2019

Isotretinoin and Surgical Extraction for Adult-Onset Nevus Comedonicus.

Skinmed 2017;15(4):309-310. Epub 2017 Aug 1.

Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY;

We present a case of postmenopausal-onset nevus comedonicus in a 58-year-old white woman with no relevant medical history. Two years before presentation, the patient had had a solitary red nodule, measuring 3.8 cm wide, on the mid lateral region of her left thigh. This progressed to a large area, 11.4 cm wide and 14 cm long, of multiple pruritic and painful red nodules, cysts, and deep open comedones extending across the lateral part of the left thigh, with less severe segmental extension to the lateral aspect of the left leg.
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July 2019

A Case of Granuloma Annulare Associated with Secukinumab Use.

Case Rep Dermatol Med 2017 22;2017:5918708. Epub 2017 May 22.

Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, 5th Floor, New York, NY 10029, USA.

Granuloma annulare (GA) is a benign inflammatory dermatosis characterized clinically by dermal papules and annular plaques. The pathogenesis of GA is not well understood, although it is thought to result from a delayed-type hypersensitivity reaction in which inflammatory cells elicit connective tissue degradation. This condition has been seen following the use of several drugs, including tumor necrosis factor-alpha (TNF-) inhibitors, which paradoxically have also been reported to treat GA. We report the case of a patient who developed GA in association with secukinumab, an interleukin-17A antagonist, and discuss its implications for our understanding of the pathogenesis of GA.
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http://dx.doi.org/10.1155/2017/5918708DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5458363PMC
May 2017

Unique clinical presentations of pityriasis rosea: aphthous ulcers, vesicles and inverse distribution of lesions.

Dermatol Online J 2017 Feb 15;23(2). Epub 2017 Feb 15.

2Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York.

Pityriasis Rosea (PR) is a common skin disorderencountered in daily practice. Although its etiologyhas not been established, there has been widespreadresearch into possibilities. The lack of its characteristicmanifestations, specifically the herald patch andtruncal involvement, can lead to pitfalls in diagnosis.Whereas other conditions in the differential diagnosisshould be considered, PR can at times also manifest inan atypical manner. We wish to illustrate three casesof PR including those that presented with aphthousulcers, vesicles, and an inverse pattern.
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February 2017

Apremilast for treatment of recurrent erythema multiforme.

Dermatol Online J 2017 Jan 15;23(1). Epub 2017 Jan 15.

New York University, New York, NY.

Recurrent erythema multiforme with oralinvolvement is therapeutically challenging.Apremilast has been used with success in resolvingthe oral aphthae of Behçet disease, prompting theuse of the drug in patients with oral erosions fromerythema multiforme. Three patients with oralerythema multiforme were given apremilast at dosesof 30-60mg daily. Complete clearance of the lesionswere observed in all three patients, including thoserefractory to other standard therapies. Apremilast maypresent an effective option for recurrent erythemamultiforme for patients who have failed trials antiviraland immunosuppressive therapies.
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January 2017

MalaCards: an amalgamated human disease compendium with diverse clinical and genetic annotation and structured search.

Nucleic Acids Res 2017 01 28;45(D1):D877-D887. Epub 2016 Nov 28.

Department of Molecular Genetics, the Weizmann Institute of Science, Rehovot, 76100, Israel

The MalaCards human disease database (http://www.malacards.org/) is an integrated compendium of annotated diseases mined from 68 data sources. MalaCards has a web card for each of ∼20 000 disease entries, in six global categories. It portrays a broad array of annotation topics in 15 sections, including Summaries, Symptoms, Anatomical Context, Drugs, Genetic Tests, Variations and Publications. The Aliases and Classifications section reflects an algorithm for disease name integration across often-conflicting sources, providing effective annotation consolidation. A central feature is a balanced Genes section, with scores reflecting the strength of disease-gene associations. This is accompanied by other gene-related disease information such as pathways, mouse phenotypes and GO-terms, stemming from MalaCards' affiliation with the GeneCards Suite of databases. MalaCards' capacity to inter-link information from complementary sources, along with its elaborate search function, relational database infrastructure and convenient data dumps, allows it to tackle its rich disease annotation landscape, and facilitates systems analyses and genome sequence interpretation. MalaCards adopts a 'flat' disease-card approach, but each card is mapped to popular hierarchical ontologies (e.g. International Classification of Diseases, Human Phenotype Ontology and Unified Medical Language System) and also contains information about multi-level relations among diseases, thereby providing an optimal tool for disease representation and scrutiny.
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http://dx.doi.org/10.1093/nar/gkw1012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5210521PMC
January 2017

Porokeratotic Adnexal Ostial Nevus-Report of a Case With Unusual Clinical and Histologic Features.

Skinmed 2016;14(3):221-4. Epub 2016 Jun 1.

Departments of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY;

An 11-year-old Tanzanian girl presented with diffuse verrucous lesions of varying morphology, scarring alopecia, and keloid scars over the face with a predilection for the ears. Physical examination revealed dark keratoderma and patches of hypopigmentation near the midline of the dorsal trunk (Figure 1a). Her forearms were densely covered by verrucous lesions with the exception of a clear linear patch on the dorsal aspect of the left forearm (Figure 1b). The perioral area was notable for white spires projecting from verrucous papules (Figure 1c) while the oral mucosa and teeth appeared normal on visual examination. The rest of her body, including the palms and soles, was covered by patchy, scaly lesions of varying severity.
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September 2018

Future therapies for pemphigus vulgaris: Rituximab and beyond.

J Am Acad Dermatol 2016 Apr 11;74(4):746-53. Epub 2016 Jan 11.

Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.

The conventional treatment for patients with pemphigus vulgaris (PV) centers on global immunosuppression, such as the use of steroids and other immunosuppressive drugs, to decrease titers of antidesmoglein autoantibodies responsible for the acantholytic blisters. Global immunosuppressants, however, cause serious side effects. The emergence of anti-CD20 biologic medications, such as rituximab, as an adjunct to conventional therapy has shifted the focus to targeted destruction of autoimmune B cells. Next-generation biologic medications with improved modes of delivery, pharmacology, and side effect profiles are constantly being developed, adding to the diversity of options for PV treatment. We review promising monoclonal antibodies, including veltuzumab, obinutuzumab (GA-101), ofatumumab, ocaratuzumab (AME-133v), PRO131921, and belimumab.
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http://dx.doi.org/10.1016/j.jaad.2015.11.008DOI Listing
April 2016

The use of an imagery mnemonic to teach the Krebs cycle.

Biochem Mol Biol Educ 2016 May 13;44(3):224-9. Epub 2016 Jan 13.

Department of, The Mount Sinai Medical Center, Department of Dermatology, New York, New York.

The Krebs Cycle is a highly taught biochemical pathway that is traditionally difficult to learn. Twenty-seven undergraduate students were randomized to a rote memorization arm or to a mnemonic arm. They were given a pre-test, then shown a lecture corresponding to their assigned method, and then given an immediate Week 0 post-test and a Week 4 post-test. Groups scored comparably low on the pre-test (p = 0.7113). Students in the mnemonic arm performed better on the Week 0 post-test than those using rote (p = 0.0055). By Week 4, there was evidence of knowledge decay, with both arms' having comparably low scores (mnemonic vs. rote, p = 0.3739). The mnemonic assists in rapid acquisition of knowledge but probably has to be reviewed iteratively over time to demonstrate its full potential over rote memorization. A limited number of students from only one school was used. © 2016 by The International Union of Biochemistry and Molecular Biology, 44:224-229, 2016.
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http://dx.doi.org/10.1002/bmb.20932DOI Listing
May 2016

Skin simulators for dermatological procedures.

Dermatol Online J 2015 Nov 18;21(11). Epub 2015 Nov 18.

Icahn School of Medicine at Mount Sinai, New York.

Background: A variety of skin simulators are available on which to practice procedures; however, choice of a suboptimal substitute compromises realism and productive practice.

Objective: Skin simulators for basic dermatological procedures are reviewed.

Methods: The authors' anecdotal experience with various skin simulators for different procedures is shared.

Results: The following simulators are suggested:  an unripe banana for elliptical excision, pork belly for undermining, pork belly for simple interrupted and buried suture, capped needle on a human shoulder for intramuscular injection, ripe tomato or hotdog with skin for intradermal injection, eggplant for shave biopsy, pork belly for punch biopsy, plastic tape over a dark surface for cryosurgery, and beef liver for electrosurgery.  Flaps are best practiced with foam sandwiched between foam tape or artificial anatomical models created specifically for this purpose.

Limitations: The utility of one simulator over another was not compared in a controlled study.

Conclusion: Efficient, realistic skin simulators are readily available for practice, which should enhance the safety of the practitioner and improve outcomes of novices.
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November 2015

Understanding the logic of common suturing techniques in dermatologic surgery.

Dermatol Online J 2015 Jun 16;21(6). Epub 2015 Jun 16.

Albany Medical College.

Although most trainees in dermatology learn that different suturing techniques are designated for a specific purpose (i.e., certain functional and cosmetic outcomes), students often have a difficult time visualizing how a given suture functions in its designated capacity. In this article, we address the logic behind the most common suturing techniques in dermatologic surgery, including the direction and magnitude of their pulling force with respect to the wound edges and the ensuing displacement of dermal and epidermal structures. To aid better understanding, we diagram the vectors of suture force with each of the techniques discussed.
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June 2015

The use of an imagery mnemonic to teach the porphyrin biochemical pathway.

Dermatol Online J 2015 Apr 16;21(4). Epub 2015 Apr 16.

Icahn School of Medicine.

We designed an imagery mnemonic to help medical students and residents learn the porphyrin pathway and associated diseases. Fourth year medical students at the Icahn School of Medicine at Mount Sinai in the spring of 2014 participated. One group (n=11) received the porphyrin pathway in a lecture explaining a mnemonic, whereas a second group (n=11) was simply taught the steps of the pathway. A pre-intervention assessment before the lectures was given to assess baseline differences in knowledge of the porphyrin pathway between the groups. Immediately following the lecture, 1 week after the lecture, and 3 weeks after the lecture, the students were given quizzes to assess their knowledge. Students were aware of the week 1 quiz and were asked not to study for it. The week 3 quiz was a surprise. There were no statistically significant differences in knowledge of the pathway at baseline (p=.45), at the immediate post-intervention (p=.22), or one week post-intervention (p=.40). Three weeks after the lecture, students in the mnemonic group scored 20% higher than controls (p=.02). Students who had learned the mnemonic demonstrated better long-term retention of information than students learning by the control method. This mnemonic minimizes study time while improving long-term retention.
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April 2015

Teaching the Simple Suture to Medical Students for Long-term Retention of Skill.

JAMA Dermatol 2015 Jul;151(7):761-5

Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.

Importance: Instructional methods for the simple suture technique vary widely and are seldom based on educational research. Published data indicate that video primers and structured instruction and evaluation decrease learning time and improve skill acquisition.

Objectives: To determine the amount of practice needed to attain simple suture proficiency and to identify the optimal teaching schedule for retention of skill.

Design, Setting, And Participants: First-year and second-year medical students at the Icahn School of Medicine at Mount Sinai with little to no suturing experience were randomly divided into 2 equal groups, with one being taught on day 1 and tested for proficiency on day 30 (control group) and the other being taught on day 1 and tested for proficiency on days 10, 20, and 30 (experimental group). Students were evaluated using the objective structured assessment of technical skills method and a checklist. Those initially not proficient on a given day were immediately prompted to practice and retest. This cycle continued until proficiency was achieved for that day. The study was conducted from April 7, 2014, to June 30, 2014.

Main Outcomes And Measures: Simple suture proficiency at 30 days and the mean number of practice sutures needed for proficiency on day 1.

Results: All students ultimately achieved proficiency. The mean (SD) number of practice sutures required to achieve proficiency at the initial training was 41 (15). Students in the control group had a 0% pass rate at the 30-day initial proficiency test, while students in the experimental group had a 91.7% pass rate at day 30 (P < .001). There were no differences in instructional time, cumulative number of sutures, or objective structured assessment of technical skills scores at proficiency between groups across the study.

Conclusions And Relevance: Single instructional sessions may not be sufficient to maintain simple suture proficiency over the course of a 30-day elective. We propose the use of preparatory instructional videos, followed by instructor demonstration to introduce the technique. Independent practice with intermittent evaluation and critique allows for skill acquisition and time efficiency at the initial training. Students should view instructional videos and practice at least 10 repetitions every 10 days to maintain their skill.
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http://dx.doi.org/10.1001/jamadermatol.2015.118DOI Listing
July 2015

Intensely pruritic eruption in a college student.

JAMA 2014 Oct;312(14):1458-9

Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.

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http://dx.doi.org/10.1001/jama.2014.7086DOI Listing
October 2014
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