Publications by authors named "Jessica Kaffenberger"

35 Publications

Interstitial granuloma annulare triggered by Lyme disease.

Dermatol Online J 2021 May 15;27(5). Epub 2021 May 15.

Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH.

Granuloma annulare is a non-infectious granulomatous skin condition with multiple different associations. We present a case of a man in his 60s with a three-week history of progressive targetoid plaques on his arms, legs, and trunk. Skin biopsy demonstrated interstitial granuloma annulare. Additional testing revealed IgM antibodies to Borrelia burgdorferi on western blot suggesting interstitial granuloma annulare was precipitated by the recent infection. Lyme disease is an uncommonly reported association with interstitial granuloma annulare.
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http://dx.doi.org/10.5070/D327553618DOI Listing
May 2021

Localized Bullous Pemphigoid Following Orthopedic Surgery.

J Clin Aesthet Dermatol 2021 Apr 1;14(4):36-37. Epub 2021 Apr 1.

Drs. Milani-Nejad, Rzepka, and Zirwas are with the Division of Dermatology in the Department of Internal Medicine at The Ohio State University Wexner Medical Center in Columbus, Ohio.

Bullous pemphigoid is an autoimmune condition whereby the immune system forms antibodies that target the skin, resulting in the formation of blisters in a generalized and symmetric pattern. Localized bullous pemphigoid can occur in special circumstances. Here, we describe two patients that developed localized bullous pemphigoid in one lower extremity following orthopedic surgery. We propose that underlying edema following orthopedic surgery is a potential trigger for localized bullous pemphigoid.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8142830PMC
April 2021

Patient perceptions of personal protective equipment use in an outpatient dermatology clinic during the COVID-19 pandemic.

Dermatol Online J 2021 Apr 15;27(4). Epub 2021 Apr 15.

Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH.

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April 2021

Lifestyle modifications associated with symptom improvement in hidradenitis suppurativa patients.

Arch Dermatol Res 2021 Apr 23. Epub 2021 Apr 23.

Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, 2012 Kenny Road, Rm 232, Columbus, OH, 43212, USA.

Background: Hidradenitis suppurativa (HS) is a chronic, inflammatory skin condition that substantially reduces patient quality of life. Many HS patients ask their dermatologist about potential lifestyle modifications, such as following particular diets or avoiding specific products, in an attempt to alleviate their symptoms. However, insufficient research has been conducted to support well-informed lifestyle modification counseling, and patients frequently defer to anecdotal endorsements of various interventions found on social media support groups. Therefore, we sought to clarify what lifestyle modifications were capable of improving HS symptoms.

Methods: We conducted a survey-based study to examine modifiable risk factors and their association with the severity of HS. Five hundred and ninety-one patients with HS participated in an online survey detailing the severity of their HS symptoms before and after various lifestyle interventions. Average improvements in both subjective and objective ratings of symptom severity were calculated and statistical differences between the levels of improvement seen among various categories of lifestyle interventions were determined.

Results: Numerous lifestyle interventions including substantial weight loss, smoking cessation, use of gentle skin and depilatory products, and menstrual regulation were associated with both subjective and objective improvements in symptom severity.

Conclusions: Our results suggest that patients affected by HS may experience clinically significant improvement from a variety of lifestyle modifications.
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http://dx.doi.org/10.1007/s00403-021-02233-yDOI Listing
April 2021

In vitro diagnostics for the medical dermatologist. Part II: Hypercoagulability tests.

J Am Acad Dermatol 2021 Aug 20;85(2):301-310. Epub 2021 Apr 20.

Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio. Electronic address:

The skin often provides initial clues of hypercoagulability with features such as livedo reticularis, livedo racemosa, retiform purpura, necrosis, and ulcerations. Because these cutaneous manifestations are nonspecific, laboratory testing is often needed to evaluate for underlying causes of hypercoagulability. Importantly, these disorders are reported to be the most common mimicker, resulting in an erroneous diagnosis of pyoderma gangrenosum. Understanding inherent properties of, and indications for, available tests is necessary for appropriate ordering and interpretation of results. Additionally, ordering of these tests in an indiscriminate manner may lead to inaccurate results, complicating the interpretation and approach to management. This second article in this continuing medical education series summarizes information on methodology, test characteristics, and limitations of several in vitro laboratory tests used for the work up of hypercoagulability and vasculopathic disease as it pertains to dermatologic disease.
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http://dx.doi.org/10.1016/j.jaad.2021.03.108DOI Listing
August 2021

In vitro diagnostics for the medical dermatologist. Part I: Autoimmune tests.

J Am Acad Dermatol 2021 Aug 20;85(2):287-298. Epub 2021 Apr 20.

Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio. Electronic address:

Despite the expansion of available in vitro laboratory tests at a rate far exceeding that of dermatologic pharmaceuticals, the existing literature is dominated by discussion of the latter. With the advent of numerous new tests, it can be difficult for practicing dermatologists to stay up-to-date on the available options, methodologies, and recommendations for when to order one test over another. Understanding the inherent strengths and weaknesses of these options is necessary to inform appropriate ordering and proper interpretation of the results. The first article in this continuing medical education series summarizes information on methodology, test characteristics, and limitations of several in vitro laboratory tests used for the work up of undifferentiated patients suspected of having dermatologic autoimmune diseases and it provides a general guide to ordering these tests.
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http://dx.doi.org/10.1016/j.jaad.2021.02.090DOI Listing
August 2021

Unconscious gender bias: A look at speaker introductions at the American Academy of Dermatology.

J Am Acad Dermatol 2021 Jan 8. Epub 2021 Jan 8.

The Ohio State University Division of Dermatology, Department of Internal Medicine, Columbus, Ohio. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2020.12.066DOI Listing
January 2021

A CASE OF MORBILLIFORM DRUG ERUPTION TO DULAGLUTIDE.

J Clin Aesthet Dermatol 2020 Apr 1;13(4):13. Epub 2020 Apr 1.

Drs. Rzepka and Kaffenberger are with the Division of Dermatology at the Ohio State University Department of Internal Medicine in Columbus, Ohio.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7605389PMC
April 2020

Erosive pustular dermatosis of the scalp.

Dermatol Online J 2020 Aug 15;26(8). Epub 2020 Aug 15.

Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH.

Erosive pustular dermatosis of the scalp (EPDS) is a rare inflammatory condition commonly associated with antecedent iatrogenic insult. EPDS may be diagnostically challenging owing to a lack of pathognomonic histologic findings and cutaneous manifestations that overlap with alternative dermatologic conditions. Therefore, EPDS may be more common than previously recognized. We present a 60-year-old woman with a four-year history of non-healing scalp erosions, progressive skin atrophy, and scarring alopecia despite intravenous antibiotics and intraoperative debridement who improved with systemic glucocorticoids. Our report emphasizes the importance of early recognition of EPDS when delayed wound healing and erosive disease occur in the setting of iatrogenic injury to the scalp. Timely treatment with systemic anti-inflammatory agents is paramount to prevent cicatricial alopecia and mitigate further scalp insult in EPDS.
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August 2020

The Association Between Oral Health and Skin Disease.

J Clin Aesthet Dermatol 2020 Jun 1;13(6):48-53. Epub 2020 Jun 1.

Mr. Macklis is with the Ohio State University College of Medicine in Columbus, Ohio.

Oral health and mucocutaneous inflammation might play an important role in the etiopathogenesis of many skin diseases, especially those that also involve the oral mucosa. This review examines the relationship between skin conditions and various oral health metrics to better understand how oral diseases, especially periodontitis, might influence the development or prognosis of several conditions, including aphthous stomatitis, atopic dermatitis, lichen planus, pemphigus, pemphigoid, and psoriasis. Using the PubMed search engine between Summer 2017 and Summer 2018, searches were performed for: OR AND , or OR . The abstract of articles written in English were reviewed by the investigators and selected for inclusion if the study involved a correlation between oral health/hygiene and skin disease. After studies were included, the references were reviewed for additional relevant studies. Diseases listed in the search terms that were not ultimately discussed in this review did not produce any articles of relevance. Aphthous stomatitis is correlated with poor periodontal health and greater plaque accumulation. Atopic dermatitis shows an association with gingivitis, toothaches, and oral infections. Heavier enamel plaque burden and reduced oral care are implicated in the exacerbation of lichen planus. Mucous membrane pemphigoid and pemphigus are intimately influenced by oral health, underscoring the important role of good oral health and hygiene. Psoriasis presents a strong connection with oral streptococcal bacterial burden, has been shown to be improved or even cured with tonsillectomy, and has treatment outcomes that are generally associated with periodontal disease. Comorbid disease associations are frequently being reported in dermatology, spurring collaboration between multiple specialists and dermatologists. This review emphasizes a need for closer collaboration between dermatologists and dentists to treat several common skin diseases.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7442307PMC
June 2020

Clinical and therapeutic overlap of pyoderma gangrenosum, cutaneous small vessel vasculitis, and immunoglobulin A.

Int J Dermatol 2020 Aug 2;59(8):e286-e288. Epub 2020 Mar 2.

Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA.

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http://dx.doi.org/10.1111/ijd.14841DOI Listing
August 2020

A Phase II Open-Label Study of Bermekimab in Patients with Hidradenitis Suppurativa Shows Resolution of Inflammatory Lesions and Pain.

J Invest Dermatol 2020 08 29;140(8):1538-1545.e2. Epub 2020 Jan 29.

XBiotech, Austin, Texas, USA.

The objective of this study was to evaluate the safety and efficacy of bermekimab, an IL-1α inhibitor, in the treatment of hidradenitis suppurativa (HS). This study was a phase II, multicenter, open-label study of two dose cohorts of bermekimab in patients with moderate-to-severe HS who are naïve to or have failed prior anti-TNF therapy. Patients with HS (n = 42) were divided into groups A and B based on whether or not they had previously failed an anti-TNF therapy. In group A (n = 24), bermekimab was administered subcutaneously at a dose of 400 mg weekly (13 doses) in patients who had previously failed anti-TNF therapy; in group B (n = 18), bermekimab was administered subcutaneously at a dose of 400 mg weekly (13 doses) in patients who were anti-TNF naïve. Bermekimab, previously found to be effective in treating HS, was evaluated using a subcutaneous formulation in patients with HS naïve to or having failed anti-TNF therapy. There were no bermekimab-related adverse events with the exception of injection site reactions. Bermekimab was effective despite treatment history, with 61% and 63% of patients naïve to and having failed anti-TNF therapy, respectively, achieving HS clinical response after 12 weeks of treatment. A significant reduction in abscesses and inflammatory nodules of 60% (P < 0.004) and 46% (P < 0.001) was seen in anti-TNF naïve and anti-TNF failure groups, respectively. Clinically and statistically significant reduction was seen in patients experiencing pain, with the Visual Analogue Scale pain score reducing by 64% (P < 0.001) and 54% (P < 0.001) in the anti-TNF naïve and anti-TNF failure groups, respectively. IL-1α is emerging as an important clinical target for skin disease, and bermekimab may represent a new therapeutic option for treating moderate-to-severe HS.
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http://dx.doi.org/10.1016/j.jid.2019.10.024DOI Listing
August 2020

Update on treatments for erosive vulvovaginal lichen planus.

Int J Dermatol 2020 Mar 20;59(3):297-302. Epub 2019 Oct 20.

Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

Vulvovaginal lichen planus (VVLP) is a debilitating disease that causes significant pain and psychological distress. Management is made difficult by the chronic course of the disease and its resistance to treatment. While topical steroids have been accepted as the first-line treatment, they fail to achieve symptomatic control in approximately 40% of patients. Second-line therapies include other topical treatments such as calcineurin inhibitors, systemic therapies including oral steroids, methotrexate, mycophenolate mofetil, biologics, and tacrolimus, and procedural options including surgery and dilation, photodynamic therapy, and ultrasound. This review provides an overview of the current treatments and explores the level of evidence supporting each of them.
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http://dx.doi.org/10.1111/ijd.14692DOI Listing
March 2020

Treatment of Recalcitrant Acrodermatitis Continua of Hallopeau With Brodalumab

J Drugs Dermatol 2019 Oct;18(10):1047

To the Editor: Acrodermatitis continua of Hallopeau (ACH) is a relatively rare chronic disorder with clinical findings of pustules and erythematous plaques on the digits.1 Although it is a variant of pustular psoriasis, it can be resistant to multiple lines of therapy. We describe for the first time a patient with recalcitrant ACH successfully treated with brodalumab, an interleukin-17 receptor A (IL-17RA) blocking antibody.
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October 2019

The impacts of oral health symptoms, hygiene, and diet on the development and severity of psoriasis.

Dermatol Online J 2019 Jul 15;25(7). Epub 2019 Jul 15.

Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus OH.

Numerous studies have suggested a correlation between oral health, the oral microbiome, and various dermatologic conditions, particularly psoriasis. In this study, we utilize a specially designed questionnaire administered to 265 patients at The Ohio State University's dermatology clinics to explore the relationship between psoriasis and a combination of factors that included dietary habits, oral health, and oral hygiene practices. Age, family history of psoriasis, previous diagnosis of strep throat or rheumatoid arthritis, and oral pain or discomfort experienced within the last 12 months were all found to be significant predictors of psoriasis. Additionally, higher body mass index scores, poor gum health, and speech difficulties related to dental problems were all correlated with more severe psoriasis symptoms. Conversely, patients who reported consuming fresh fruit at least once a day experienced milder symptoms. Our goal is to develop a better understanding of how and why psoriasis incidence is correlated with some of the oral health factors under review.
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July 2019

Factors influencing patients' choice of contraceptives when starting isotretinoin.

J Am Acad Dermatol 2019 Jul 25. Epub 2019 Jul 25.

Department of Internal Medicine, Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus OH 43210. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2019.07.066DOI Listing
July 2019

Safety of systemic therapies in the treatment of psoriasis with concomitant cirrhosis: a retrospective study.

Int J Dermatol 2019 Nov 23;58(11):e228-e229. Epub 2019 Jul 23.

The Ohio State University Wexner Medical Center, Columbus, OH, USA.

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http://dx.doi.org/10.1111/ijd.14556DOI Listing
November 2019

RECURRENCE OF LOCALIZED PEMPHIGUS FOLIACEUS INDUCED BY KNEE REPLACEMENT.

J Clin Aesthet Dermatol 2019 May 1;12(5):12. Epub 2019 May 1.

All authors are with the Division of Dermatology in the Department of Internal Medicine at The Ohio State University Wexner Medical Center in Columbus, Ohio.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6561719PMC
May 2019

A case of segmental Darier disease treated with doxycycline monotherapy.

Dermatol Online J 2018 Mar 15;24(3). Epub 2018 Mar 15.

Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio.

Darier disease is a rare autosomal dominant disorder that results from a mutation in the gene coding for the endoplasmic reticulum membrane calcium pump Ca2+-ATPase type 2 (SERCA2), leading to compromised intercellular adhesion. Patients typically present in the first two decades of life with keratotic, greasy papules in a seborrheic distribution. Segmental Darier disease is a variant with localized disease that follows Blaschko lines. Treatment options include topical and systemic agents including corticosteroids, retinoids, and antibiotics. We present a 67-year-old woman who came to our clinic with segmental Darier disease recalcitrant to topical therapy. Owing to cost and side effect profile, the patient declined treatment with oral retinoids. Doxycycline 100mg daily was started with significant improvement. Tetracyclines both chelate and assist calcium to cross membranes. This mechanism may correct the cellular calcium imbalance present in Darier disease. In addition, tetracyclines have been shown to inhibit metalloproteinase 9, an important part of Darier disease pathogenesis. Owing to its favorable side effect profile, further investigation is warranted to establish doxycycline as a more widely utilized treatment option for Darier disease.
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March 2018

Characterization of the 2016-2017 Dermatology Standardized Letter of Recommendation.

J Clin Aesthet Dermatol 2018 Mar 1;11(3):26-29. Epub 2018 Mar 1.

Ms. Wang and Drs. Zhang and Kaffenberger are with the Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center in Columbus, Ohio.

We aimed to analyze the reformatted standard letter of recommendation (SLOR) for dermatology residents to examine trends in grading and content based on the positions of the letter writers, their backgrounds, and their relationship with the applicant, as well as to evaluate the SLOR's ability to discriminate applicants. This was a retrospective characterization study of dermatology SLORs from the 2016-17 application cycle. We examined SLORs received by The Ohio State University, the University of Oklahoma, and Hofstra University Northwell Health dermatology residency programs. We included dermatology residency applicants and their letter writers from the 2016-17 application cycle. A total of 141 SLORs were analyzed from 115 applicants. SLORs demonstrated grade inflation from letter writers of all backgrounds. Ratings for research potential and inquisitive nature were significantly lower than ratings for other categories. Letter writers with limited clinical and research contact graded applicants significantly lower than did writers who had more extensive contact. Word boxes were underutilized. The dermatology SLOR is useful in differentiating applicants, and ratings correlate with the relationships that letter writers have with their applicants. Residency programs should be aware of these findings when evaluating letters of recommendation for applicants.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5868781PMC
March 2018

Periorbital lupuslike presentation of graft-versus-host disease.

Cutis 2018 01;101(1):E28-E29

Department of Dermatology, Milton S. Hershey Penn State Medical Center, Hershey, Pennsylvania, USA.

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January 2018

A Retrospective Review of New-onset Dermatitis in Patients Aged 60 Years or Older.

J Clin Aesthet Dermatol 2018 Jan 1;11(1):19-20. Epub 2018 Jan 1.

Ms. Wang and Drs. B. Kaffenberger and J. Kaffenberger are with the Department of Internal Medicine, Division of Dermatology, at The Ohio State University Wexner Medical Center in Columbus, Ohio.

New-onset dermatitis in the elderly can be attributed to a variety of disease processes. We defined new-onset dermatitis in which the etiology is attributed solely to age-related processes as "dermatitis of immune senescence"-a diagnosis of exclusion based on clinical presentation and further diagnostic testing. Retrospective cohort of elderly patients with new-onset dermatitis to examine the differences in demographics, work-up, and treatments between patients with dermatitis of immune senescence and those patients ultimately given more specific diagnoses. Four hundred and thirty-three patients aged 60 years and older with new-onset dermatitis from 2011 to 2016 at Ohio State University were identified by chart review and categorized as "dermatitis of immune senescence" or "alternate diagnosis" based on patch testing, biopsy, and physician documentation. In this subset of patients, 10.2 percent (44/433) underwent patch testing and 16.2 percent (70/433) underwent biopsy. Furthermore, 86.4 percent of patients who underwent patch testing (38/44) and 57.1 percent who underwent biopsy (40/70) were given a more specific diagnosis following their test. Use of intramuscular steroids (<.001), oral steroids (=.004), and antihistamines (=.002) were significantly higher in the alternate diagnosis group. The low rate of patch testing and biopsy and the high rate of diagnosis change post-procedure demonstrate an underutilization of diagnostic testing in this population.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5788263PMC
January 2018

Does the dermatology standardized letter of recommendation alter applicants' chances of matching into residency?

J Am Acad Dermatol 2017 11;77(5):e139-e140

Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2017.05.058DOI Listing
November 2017

Frequent skin examinations in patients with actinic keratoses: Ethical, financial, and moral implications.

J Am Acad Dermatol 2017 11;77(5):985-987

Ohio State University, Division of Dermatology, Department of Internal Medicine, Columbus, Ohio. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2017.03.005DOI Listing
November 2017

The association between bullous pemphigoid and neurological disorders: a systematic review.

Eur J Dermatol 2017 Oct;27(5):472-481

Department of Internal Medicine, Division of Dermatology, The Ohio State University Wexner Medical Center, Gahana, Ohio, USA.

Studies suggest an association between neurological disorders and bullous pemphigoid. The goal of this systematic review was to characterize the occurrence of neurological disorders in patients with bullous pemphigoid. We performed a systematic review of the current English literature from 1984 to June 1, 2015 for documented cases of coexistent BP and neurological disorders. The literature search resulted in 53 articles meeting the inclusion criteria. Patients with bullous pemphigoid had an increased risk of stroke (OR: 4.43 [95% CI: 2.69-7.28]; p<0.001), dementia (OR: 5.48 [95% CI: 3.26-9.23]; p<0.001), Parkinson's (OR: 3.06 [95% CI: 1.97-4.77]; p< 0.001), and epilepsy/seizures (OR: 22.88 [95% CI: 2.64-198.21]; p = 0.0045). Neurological disorders preceded bullous pemphigoid in the majority of cases with a mean time interval of 6.7 years. The one-year mortality was increased in bullous pemphigoid patients who had concomitant stroke (OR: 2.87 [95% CI: 1.67-4.96]; p<0.001). Bullous pemphigoid patients have an increased association with neurological disorders which may increase mortality.
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http://dx.doi.org/10.1684/ejd.2017.3066DOI Listing
October 2017

Erythema multiforme as a reaction to imiquimod 5% cream.

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

College of Medicine, The Ohio State University, Columbus.

We describe a patient with erythema multiformefollowing a local site reaction after the use of topicalimiquimod 5% cream and review the literature forprevious reports of this cutaneous adverse effect.
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February 2017

A 64-Year-Old Woman With an Atrophic Plaque on the Thigh-Answer.

Am J Dermatopathol 2017 Jan;39(1):62-63

*The Ohio State University Wexner Medical Center, Columbus, OH; †Division of Dermatology, Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH; and ‡Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Gahanna, OH.

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http://dx.doi.org/10.1097/DAD.0000000000000371DOI Listing
January 2017

A 64-Year-Old Woman With an Atrophic Plaque on the Thigh-Question.

Am J Dermatopathol 2017 Jan;39(1):45-46

*The Ohio State University Wexner Medical Center, Columbus, OH; †Division of Dermatology, Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH; and ‡Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Gahanna, OH.

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http://dx.doi.org/10.1097/DAD.0000000000000372DOI Listing
January 2017

A Retrospective Analysis Comparing the New Standardized Letter of Recommendation in Dermatology with the Classic Narrative Letter of Recommendation.

J Clin Aesthet Dermatol 2016 Sep 1;9(9):36-42. Epub 2016 Sep 1.

Department of Internal Medicine, Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio.

In an effort to avoid numerous problems associated with narrative letters of recommendation, a dermatology standardized letter of recommendation was utilized in the 2014-2015 resident application cycle. A comparison of the standardized letter of recommendation and narrative letters of recommendation from a single institution and application cycle to determine if the standardized letter of recommendation met its original goals of efficiency, applicant stratification, and validity. Eight dermatologists assessed all standardized letters of recommendation/narrative letters of recommendation pairs received during the 2014-2015 application cycle. Five readers repeated the analysis two months later. Each letter of recommendation was evaluated based on a seven question survey. Letter analysis and survey completion for each letter was timed. Compared to the narrative letters of recommendation, the standardized letter of recommendation is easier to interpret (<0.0001), has less exaggeration of applicants' positive traits (<0.001), and has higher inter-rater and intrarater reliability for determining applicant traits including personality, reliability, work-ethic, and global score. Standardized letters of recommendation are also faster to interpret (<0.0001) and provide more information about the writer's background or writer-applicant relationship than narrative letters of recommendation (<0.001). This study was completed at a single institution. The standardized letter of recommendation appears to be meeting its initial goals of 1) efficiency, 2) applicant stratification, and 3) validity. ( 2016;9(9):36-2.).
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5110327PMC
September 2016

Xanthomatized Neutrophilic Dermatosis in a Patient With Myelodysplastic Syndrome.

Am J Dermatopathol 2017 May;39(5):384-387

*Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Gahanna, OH; and †Department of Pathology, University of Virgina, Charlottesville, VA.

We present an original case report of a 58-year-old man with a history of histiocytoid Sweet and myelodysplastic syndrome who presented with a new onset of tender plaques on his oral commissures. A biopsy revealed a dense dermal neutrophilic infiltrate, leukocytoclasis without frank vasculitis, and, most notably, the presence of many xanthomatized cells. Clinical presentation and histologic features were most consistent with an acute neutrophilic dermatosis, which we believe to be a xanthomized variant of Sweet syndrome. Recent cases have described patients with similar clinical features and neutrophilic dermatosis in the setting of a normolipemic xanthomatosis. These cases were ultimately diagnosed as neutrophilic xanthoma, suggesting a possible histologic overlap between neutrophilic xanthoma and Sweet syndrome. Given these findings, we propose xanthomatized Sweet syndrome as a new histologic variant.
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http://dx.doi.org/10.1097/DAD.0000000000000774DOI Listing
May 2017
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