Publications by authors named "Kiran Motaparthi"

135 Publications

Training Dermatology Residents in Dermatoscopy: A Case Control Lecture Series Assessment.

Clin Dermatol 2022 Aug 7. Epub 2022 Aug 7.

Department of Dermatology, University of Florida College of Medicine, Gainesville, FL, USA. Electronic address:

Lack of standardized dermatoscopy training limits confidence and accuracy. We assessed the impact of a dermatoscopy lecture series on the diagnostic accuracy of dermatology residents' biopsies. Additionally, we evaluated resident comfort with and knowledge of dermatoscopy before and after the curriculum. Twelve dermatology residents were enrolled in a five-month dedicated dermatoscopy curriculum. To assess knowledge of and comfort with dermatoscopy, residents were given a 50-question assessment and 21-question survey before and after the curriculum. Change in diagnostic accuracy was assessed by comparing the suspected clinical diagnosis to the final histopathologic diagnosis of lesions biopsied by residents before and after the course. Upon completion of the curriculum, residents felt significantly more comfortable performing dermatoscopy (p = 0.002) and using dermatoscopy to identify melanocytic nevi (p = 0.037) and melanomas (invasive and in situ)(p = 0.012). PGY-2 residents also showed significantly improved diagnostic accuracy after the training course OR = 1.33 (95% confidence interval [CI]: 1.06 - 1.67; p = 0.013). Our study was limited by a small sample size of 12 residents from a single academic institution. A formal dermatoscopy course can effectively improve dermatology residents' knowledge, confidence, and diagnostic accuracy when using dermatoscopy.
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http://dx.doi.org/10.1016/j.clindermatol.2022.08.003DOI Listing
August 2022

Facial Discoid Dermatosis: What Is It?

Skinmed 2022 30;20(3):174-176. Epub 2022 Jun 30.

Department of Dermatology, University of Florida College of Medicine, Gainesville, FL;

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July 2022

Comparing cases of type I cryoglobulinemia with histopathologic findings of vasculitis.

JAAD Case Rep 2022 May 2;23:160-161. Epub 2022 Mar 2.

Department of Dermatology, University of Florida, Gainesville, Florida.

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http://dx.doi.org/10.1016/j.jdcr.2022.02.014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9062339PMC
May 2022

Diffuse blistering rash with ocular involvement.

JAAD Case Rep 2022 May 31;23:90-92. Epub 2022 Mar 31.

Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida.

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http://dx.doi.org/10.1016/j.jdcr.2022.02.041DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9046949PMC
May 2022

Necrotic Plaques on the Ears of a Patient With COVID-19.

JAMA Dermatol 2022 05;158(5):579-580

Department of Dermatology, University of Florida College of Medicine, Gainesville.

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http://dx.doi.org/10.1001/jamadermatol.2022.0745DOI Listing
May 2022

Acute generalized exanthematous pustulosis sine pustules: A case series.

JAAD Case Rep 2022 May 9;23:24-26. Epub 2022 Mar 9.

Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida.

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http://dx.doi.org/10.1016/j.jdcr.2022.02.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8980338PMC
May 2022

A Retrospective Review of Histopathologic Features Associated with Increased Risk of Recurrence of Non-melanoma Skin Cancer After Mohs Micrographic Surgery.

J Clin Aesthet Dermatol 2022 Jan;15(1):27-29

Dr. Agnetta, Dr. Bisbee, Dr. Torres, Dr. Hooey, Dr. Motaparthi and Dr. Konda are with the Department of Dermatology at University of Florida College of Medicine in Gainesville, Florida.

Objective: Mohs micrographic surgery (MMS) is the gold standard treatment for non-melanoma skin cancer (NMSC). However, NMSC recurrence may occur in a small proportion of patients. The aim of this study was to identify histopathologic features seen on the final stage of previous MMS, which may increase the risk of NMSC recurrence.

Methods: This was a single-institution retrospective study of 39 recurrent basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs), which were treated with MMS. Slides from the final stage of previous MMS were reviewed by two board-certified dermatopathologists for the following histopathologic features: perineural inflammation, dense inflammation, mucin, ruptured follicle, actinic keratosis, and missing tissue.

Results: Twenty recurrent BCCs and 19 recurrent SCCs were included. Histopathologic features identified on the final stage of previous MMS included missing tissue from the epidermis, dermis, and/or subcutis (69%), actinic keratosis (51%), perineural inflammation (10%), and dense inflammation (8%). Ruptured follicle was present in one BCC case, and mucin was not identified in any cases.

Limitations: Limitations include retrospective study design, small number of recurrent cases, single institution, and lack of a control group consisting of NMSC cases which did not recur after MMS.

Conclusion: Mohs surgeons should carefully evaluate NMSC frozen sections for the presence of missing tissue, actinic keratosis, perineural inflammation, and dense inflammation as these histopathologic features may be associated with tumor recurrence. It is of paramount importance to acquire high quality frozen sections for thorough margin evaluation.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8903228PMC
January 2022

Serologic Abnormalities in Macular Lymphocytic Arteritis with Case Presentation.

Case Rep Dermatol 2022 Jan-Apr;14(1):12-18. Epub 2022 Jan 17.

Dermatology, University of Florida, Gainesville, Florida, USA.

Macular lymphocytic arteritis (MLA) is an indolent cutaneous small-medium-vessel vasculitis characterized by widespread asymptomatic livedo racemosa. A number of serologic abnormalities have been reported including an elevated erythrocyte sedimentation rate and antibodies associated with antiphospholipid antibody syndrome. We present a case of MLA with multiple serologic abnormalities, including those that have yet to be reported, such as anti-U1 ribonucleotide protein, anti-RNA polymerase III, anti-smith, and anti-proteinase 3 antibodies. We also provide a brief review of this unfamiliar entity with a focus on the appropriate workup.
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http://dx.doi.org/10.1159/000519658DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8832186PMC
January 2022

Vesiculobullous Diseases.

Medicina (Kaunas) 2022 Jan 26;58(2). Epub 2022 Jan 26.

Department of Dermatology, University of Florida College of Medicine, Gainesville, FL 32606, USA.

A diverse range of inflammatory dermatoses are characterized by vesicles or bullae [...].
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http://dx.doi.org/10.3390/medicina58020186DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8876315PMC
January 2022

Erythroderma in a neonate.

JAAD Case Rep 2022 Mar 19;21:97-100. Epub 2022 Jan 19.

Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida.

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http://dx.doi.org/10.1016/j.jdcr.2021.09.047DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8850577PMC
March 2022

Pencil-core Granuloma Forming 62 Years After Initial Injury.

Cutis 2022 Jan;109(1):E41-E42

Drs. Zelickson, Goldberg, Wu, and Rubenzik are from DermSurgery Associates, Houston, Texas. Dr. Motaparthi is from the Department of Dermatology, University of Florida College of Medicine, Gainesville.

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http://dx.doi.org/10.12788/cutis.0459DOI Listing
January 2022

Blastomycosis-like pyoderma: Treatment with serial excisions.

JAAD Case Rep 2022 Mar 7;21:29-31. Epub 2022 Jan 7.

Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida.

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http://dx.doi.org/10.1016/j.jdcr.2021.12.022DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8816650PMC
March 2022

Cytomegalovirus infection presenting as an isolated petechial eruption in an immunocompromised patient.

JAAD Case Rep 2022 Feb 15;20:6-9. Epub 2021 Dec 15.

Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida.

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http://dx.doi.org/10.1016/j.jdcr.2021.11.027DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8728513PMC
February 2022

Annular lichenoid diseases.

Clin Dermatol 2021 Dec 31. Epub 2021 Dec 31.

Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA.

Annular lichenoid diseases encompass a diverse range of pathologies that present as circular, raised, or flat lesions that may vary in size and number. Examples include annular lichenoid dermatitis of youth, annular lichen planus, erythema dyschromicum perstans, erythema multiforme, fixed drug eruption, lichen sclerosus, neonatal lupus, porokeratosis, subacute cutaneous lupus erythematosus, and lichenoid syphilis. Clinical morphology and histopathology can differentiate these entities.
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http://dx.doi.org/10.1016/j.clindermatol.2021.12.009DOI Listing
December 2021

Atrophy of sebaceous lobules in facial discoid dermatosis: a link to psoriasis and seborrheic dermatitis?

J Cutan Pathol 2022 03 4;49(3):320-323. Epub 2022 Jan 4.

Department of Dermatology, University of Florida College of Medicine.

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http://dx.doi.org/10.1111/cup.14190DOI Listing
March 2022

Identifying histopathologic features of erythema elevatum diutinum and granuloma faciale.

J Cutan Pathol 2022 03 4;49(3):323-326. Epub 2022 Jan 4.

Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA.

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http://dx.doi.org/10.1111/cup.14191DOI Listing
March 2022

Staphylococcal Scalded Skin Syndrome and Bullous Impetigo.

Medicina (Kaunas) 2021 Oct 24;57(11). Epub 2021 Oct 24.

Department of Dermatology, University of Florida College of Medicine, Gainesville, FL 32610, USA.

Staphylococcal scalded skin syndrome (SSSS) and bullous impetigo are infections caused by . The pathogenesis of both conditions centers around exotoxin mediated cleavage of desmoglein-1, which results in intraepidermal desquamation. Bullous impetigo is due to the local release of these toxins and thus, often presents with localized skin findings, whereas SSSS is from the systemic spread of these toxins, resulting in a more generalized rash and severe presentation. Both conditions are treated with antibiotics that target These conditions can sometimes be confused with other conditions that result in superficial blistering; the distinguishing features are outlined below.
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http://dx.doi.org/10.3390/medicina57111157DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8623226PMC
October 2021

Artificial intelligence in dermatology for the clinician.

Clin Dermatol 2021 Jul-Aug;39(4):667-672. Epub 2021 Mar 19.

Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA. Electronic address:

As medicine enters the era of artificial intelligence (AI)-augmented practice, dermatology is beginning to witness the integration of AI into the daily practice, particularly in the areas of diagnosis, prognosis, and treatment of skin diseases. Many of the current electronic medical records that dermatologists have incorporated provide guidance in billing, a form of AI at work. The recent advances in visual recognition AI make application and integration of the technology particularly suited for perceptual specialties such as radiology and dermatology. In dermatology, AI is poised to improve the efficiency and accuracy of traditional diagnostic approaches, including visual examination, skin biopsy, and histopathologic examination. This review highlights the current progress of AI in dermatology and provides a basic overview of the technology.
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http://dx.doi.org/10.1016/j.clindermatol.2021.03.012DOI Listing
November 2021

Probabilities, uncertainty, and cognitive bias in clinical diagnosis.

Am J Obstet Gynecol 2022 04 30;226(4):593. Epub 2021 Oct 30.

Lewis Katz School of Medicine, Temple University, 3401 North Broad St., Ste B500, Philadelphia, PA 19140. Electronic address:

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http://dx.doi.org/10.1016/j.ajog.2021.10.030DOI Listing
April 2022

Knuckle pads: an ancient disease frequently misdiagnosed because of minimal modern attention.

Dermatol Online J 2021 Sep 15;27(9). Epub 2021 Sep 15.

Department of Dermatology, College of Medicine, University of Florida, Gainesville, FL.

Knuckle pads are benign painless papules and nodules that most commonly appear on the extensor surfaces of the proximal interphalangeal joints. Knuckle pads are frequently misdiagnosed due to their location overlying joints, which can lead to costly interventions and patient discomfort for a relatively harmless condition. We describe a 44-year-old woman who presented with mildly painful nodules on multiple bilateral proximal interphalangeal joints. The patient did not have a family history of fibromatosis and the rheumatoid factor was negative. Histology showed mild epidermal hyperkeratosis, papillomatosis, and acanthosis with a deep dermal, poorly circumscribed, proliferative nodule made of spindled myofibroblasts without cytological atypia. The diagnosis of knuckle pads was established based on the clinical and morphological presentation of the nodules. Treatment with intralesional triamcinolone acetonide injection produced significant clinical improvement. Our findings highlight the challenging diagnosis of knuckle pads and the importance of increasing the familiarity of knuckle pads in modern medical practice.
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http://dx.doi.org/10.5070/D327955139DOI Listing
September 2021

Erythroderma and persistent erythema in adult-onset Still disease associated with macrophage activation syndrome.

JAAD Case Rep 2021 Nov 8;17:119-121. Epub 2021 Oct 8.

Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida.

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http://dx.doi.org/10.1016/j.jdcr.2021.09.037DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8551522PMC
November 2021

Vesicular spotted fever due to simulates the clinicopathologic features of rickettsialpox.

JAAD Case Rep 2021 Nov 5;17:87-91. Epub 2021 Oct 5.

Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida.

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http://dx.doi.org/10.1016/j.jdcr.2021.09.024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8531452PMC
November 2021

An Updated Review of Pemphigus Diseases.

Medicina (Kaunas) 2021 Oct 9;57(10). Epub 2021 Oct 9.

Department of Dermatology, College of Medicine, University of Florida, Gainesville, FL 32606, USA.

Clinicians may encounter a variety of skin conditions that present with vesiculobullous lesions in their everyday practice. Pemphigus vulgaris, pemphigus foliaceus, IgA pemphigus, and paraneoplastic pemphigus represent the spectrum of autoimmune bullous dermatoses of the pemphigus family. The pemphigus family of diseases is characterized by significant morbidity and mortality. Considering the risks associated with a delayed diagnosis or misdiagnosis and the potential for overlap in clinical features and treatment, evaluation for suspected pemphigus disease often requires thorough clinical assessment and laboratory testing. Diagnosis is focused on individual biopsies for histopathology and direct immunofluorescence. Additional laboratory methods used for diagnosis include indirect immunofluorescence and enzyme-linked immunosorbent assay. Recent advancements, including anti-CD20 therapy, have improved the efficacy and reduced the morbidity of pemphigus treatment. This contribution presents updates on the pathophysiology, clinical features, diagnostic work-up, and medical management of pemphigus. Improved strategies for diagnosis and clinical assessment are reviewed, and newer treatment options are discussed.
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http://dx.doi.org/10.3390/medicina57101080DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8540565PMC
October 2021

Bullous Pemphigoid and Other Pemphigoid Dermatoses.

Medicina (Kaunas) 2021 Oct 4;57(10). Epub 2021 Oct 4.

Department of Dermatology, College of Medicine, University of Florida, Gainesville, FL 32606, USA.

The pemphigoid family of dermatoses is characterized by autoimmune subepidermal blistering. The classic paradigm for pemphigoid, and the most common member, is bullous pemphigoid. Its variable clinical presentation, with or without frank bullae, is linked by significant pruritus afflicting the elderly. Mucous membrane pemphigoid is an umbrella term for a group of subepidermal blistering dermatoses that favor the mucosal membranes and can scar. Epidermolysis bullosa acquisita is a chronic blistering disorder characterized by skin fragility, sensitivity to trauma, and its treatment-refractory nature. Clinicians that encounter these pemphigoid disorders may benefit from an overview of their clinical presentation, diagnostic work-up, and therapeutic management, with an emphasis on the most frequently encountered pemphigoid disease, bullous pemphigoid.
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http://dx.doi.org/10.3390/medicina57101061DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8539012PMC
October 2021

Pustular Psoriasis and Acute Generalized Exanthematous Pustulosis.

Medicina (Kaunas) 2021 Sep 23;57(10). Epub 2021 Sep 23.

Department of Dermatology, University of Florida College of Medicine, Gainesville, FL 32610, USA.

The similarity between pustular psoriasis (PP) and acute generalized exanthematous pustulosis (AGEP) poses problems in the diagnosis and treatment of these two conditions. Significant clinical and histopathologic overlap exists between PP and AGEP. PP is an inflammatory disorder that has numerous clinical subtypes, but all with sterile pustules composed of neutrophils. AGEP is a severe cutaneous adverse reaction that is also characterized by non-follicular sterile pustules. Clinical features that suggest a diagnosis of PP over AGEP include a history of psoriasis and the presence of scaling plaques. Histologically, eosinophilic spongiosis, vacuolar interface dermatitis, and dermal eosinophilia favor a diagnosis of AGEP over PP. Importantly, PP and AGEP vary in clinical course and treatment. PP treatment involves topical steroids, oral retinoids, and systemic immunosuppressants. Newer therapies targeting IL-36, IL-23, IL-1, and PDE-4 have been investigated. The removal of the offending agent is a crucial part of the treatment of AGEP.
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http://dx.doi.org/10.3390/medicina57101004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8538083PMC
September 2021

Neutrophil-rich, noncollagenous 16A domain-negative bullous pemphigoid associated with psoriasis.

JAAD Case Rep 2021 Oct 1;16:137-140. Epub 2021 Sep 1.

Department of Dermatology, University of Florida School of Medicine, Gainesville, Florida.

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http://dx.doi.org/10.1016/j.jdcr.2021.08.025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8463795PMC
October 2021

Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Review of Diagnosis and Management.

Medicina (Kaunas) 2021 Aug 28;57(9). Epub 2021 Aug 28.

College of Medicine, University of Florida, Gainesville, FL 32606, USA.

Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are rare diseases that are characterized by widespread epidermal necrosis and sloughing of skin. They are associated with significant morbidity and mortality, and early diagnosis and treatment is critical in achieving favorable outcomes for patients. In this scoping review, Excerpta Medica dataBASE and PubMed were searched for publications that addressed recent advances in the diagnosis and management of the disease. Multiple proteins (galectin 7 and RIP3) were identified that are promising potential biomarkers for SJS/TEN, although both are still in early phases of research. Regarding treatment, cyclosporine is the most effective therapy for the treatment of SJS, and a combination of intravenous immunoglobulin (IVIg) and corticosteroids is most effective for SJS/TEN overlap and TEN. Due to the rare nature of the disease, there is a lack of prospective, randomized controlled trials and conducting these in the future would provide valuable insights into the management of this disease.
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http://dx.doi.org/10.3390/medicina57090895DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8472007PMC
August 2021

Cutaneous solitary fibrous tumor: Report of three cases with review of histopathological mimics.

J Cutan Pathol 2022 Feb 17;49(2):167-171. Epub 2021 Oct 17.

Department of Dermatology, College of Medicine, University of Florida, Gainesville, Florida, USA.

Solitary fibrous tumor (SFT) is a relatively uncommon spindle cell mesenchymal neoplasm that is most often based on the pleura but may rarely arise in extrapleural locations, including the skin. Herein, we describe three cases of cutaneous SFTs. SFT is characterized by epithelioid and spindle cells arranged in random patterns with focal prominent stromal collagen and pericytomatous vessels. Immunohistochemical evaluation is required for definitive distinction of SFT from other benign and malignant cutaneous spindle cell neoplasms. Although aggressive biologic behavior is uncommon, accurate diagnosis of it is required for prognostication and counseling. CD34, bcl-2, and CD99 stains are positive in SFT, but not specific. STAT6 is the most sensitive and specific immunohistochemical marker to confirm diagnosis of SFT.
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http://dx.doi.org/10.1111/cup.14138DOI Listing
February 2022

Cerebriform congenital scalp mass.

JAAD Case Rep 2021 Oct 23;16:105-107. Epub 2021 Aug 23.

Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida.

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http://dx.doi.org/10.1016/j.jdcr.2021.06.033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8441098PMC
October 2021

What Effect Does Epstein-Barr Virus Have on Extranodal Natural Killer/T-Cell Lymphoma Prognosis? A Review of 153 Reported Cases.

Cureus 2021 Sep 15;13(9):e17987. Epub 2021 Sep 15.

Department of Dermatology, University of Florida, Gainesville, USA.

The primary aim of this review is to identify the relationship between Epstein-Barr virus (EBV) and prognosis in extranodal natural killer/T-cell lymphoma (ENKTL). Additionally, a literature review of ENKTL was carried out. The investigators designed and implemented a 21-year literature review using the online databases PubMed and Google Scholar. The total number of cases analyzed was 153 (64 case reports; one comparative study; one systematic review). Information related to ENKTL from July 1999 to February 2021 was included in the study. Study variables included: patient demographics, tumor classification, screening modalities, tumor characteristics, symptomatology, treatment, and prognosis. The average age at diagnosis was 50.9 years (range: 4-90 years). Patients of Asian ethnicity were most commonly affected, and there was a 1.6:1 male to female ratio. ENKTL was most frequently detected in the head and neck region, and 53.1% of cases metastasized. Of all head and neck cases, the nose was the most affected location. Immunohistochemistry positivity included: EBV (32.0%), CD2 (96.6%), CD3ϵ (81.7%), CD43 (91.7%), CD56 (86.4%), Granzyme (97.1%), Perforin (90.9%), TIA-1 (97.8%), p53 (33.3%). The most frequently employed single treatment modality was chemotherapy alone, and 34.2% of patients expired within five years of diagnosis. The average follow-up period was 16.51 months (range: 0.25-66 months). EBV was significantly associated with metastatic ENKTL (χ = 4.36; CV = 3.84; p = 0.037). We found no association between EBV and ENKTL prognosis (χ = 17.2; CV = 21.0; p = 0.14).
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http://dx.doi.org/10.7759/cureus.17987DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8445857PMC
September 2021
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