Publications by authors named "Lisa Fronek"

5 Publications

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Multicentric reticulohistiocytosis masquerading as cutaneous connective tissue disease.

Dermatol Online J 2021 Mar 15;27(3). Epub 2021 Mar 15.

Department of Dermatology, HCA Healthcare/USF Morsani College of Medicine Largo, FL.

Multicentric reticulohistiocytosis (MRH) is a rare type of non-Langerhans cell histiocytosis characterized by coral-toned papules with predilection for dorsal surfaces in addition to severe arthropathy. It sometimes proves difficult to differentiate these joint and skin findings clinically from certain rheumatologic diseases, primarily dermatomyositis. Herein, we present an 82-year-old woman who presented with the clinical findings described above and was subsequently diagnosed with MRH after biopsy and review of relevant clinical history. Because about 25% of patients diagnosed with MRH have an underlying occult malignancy, our patient underwent a complete malignancy workup that was negative. She was treated with systemic corticosteroids and methotrexate, which resulted in an improvement of the arthritis and constitutional symptoms. This case demonstrates that in patients with both rheumatologic and dermatologic symptoms, particularly on acral surfaces, MRH must be a diagnostic consideration. Identifying this disease early in its course can prevent negative consequences for the patients, specifically arthritis mutilans and upper airway involvement.
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March 2021

Masquerading case of a lumpy bumpy face.

JAAD Case Rep 2020 Dec 16;6(12):1261-1263. Epub 2020 Oct 16.

HCA Healthcare/USF Morsani College of Medicine GME: Largo Medical Center, Largo, Florida.

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http://dx.doi.org/10.1016/j.jdcr.2020.10.014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7701036PMC
December 2020

Isolated Cutaneous Langerhans Cell Histiocytosis Presenting in an Adult Male.

Cureus 2020 Aug 19;12(8):e9861. Epub 2020 Aug 19.

Dermatology, Hospital Corporation of America / University of South Florida Morsani College of Medicine: Largo Medical Center Program, Largo, USA.

Langerhans cell histiocytosis (LCH) is an infrequent clonal proliferative disorder of myeloid dendritic cells. It has a wide variety of cutaneous manifestations and retains the possibility of systemic implications. Because LCH is predominantly a disease of childhood, there are well-established clinical definitions, as well as guidelines regarding workup and treatment, in the context of pediatric disease. Here we present a case of isolated cutaneous LCH in an adult male, followed by a discussion of our diagnostic plan and treatment course. The patient exhibited a small, excoriated, yellow papule on his inferior forehead during a skin examination. The specimen underwent tangential shave biopsy; histopathologic evaluation with appropriate immunohistochemical staining confirmed a diagnosis of cutaneous LCH. After thorough investigation via serologic and imaging diagnostics, we confirmed isolated cutaneous disease. The patient underwent wide local excision (WLE) with no evidence of recurrence. It is crucial to appropriately screen all patients diagnosed with cutaneous LCH for internal organ involvement. The authors aim to highlight the need for further investigations to ultimately dictate standardized management and treatment for isolated cutaneous LCH in the adult population.
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http://dx.doi.org/10.7759/cureus.9861DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7500710PMC
August 2020

A Rare Case of Cutis Verticis Gyrata with Underlying Cerebriform Intradermal Nevus.

Cureus 2019 Dec 29;11(12):e6499. Epub 2019 Dec 29.

Dermatology, Hospital Corporation of America/University of South Florida, Morsani College of Medicine, Largo Medical Center Program, Largo, USA.

Cutis verticis gyrata (CVG) is an uncommon condition of the scalp known for redundant, thickened folds, which emulate the cerebral gyri of the brain. This unusual finding is catalogued as primary essential, primary non-essential, and secondary. While primary essential CVG is an isolated and idiopathic condition, primary non-essential CVG is deemed to be related to neurological, ophthalmological, or psychiatric disorders. Secondary CVG may be due to a variety of systemic disorders, inflammatory dermatoses, or cutaneous neoplasms or infiltrates. This report serves as an example of secondary CVG due to a cerebriform intradermal nevus, with specific focus on clinical course, treatment options, and critical screening guidelines for these patients.
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http://dx.doi.org/10.7759/cureus.6499DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6988481PMC
December 2019

Nocturnal leg symptoms are not associated with specific patterns of superficial venous insufficiency.

Int Angiol 2017 Dec 30;36(6):565-568. Epub 2017 Aug 30.

La Jolla Vein Care, La Jolla, CA, USA.

Background: Certain nocturnal symptoms such as leg cramping (LC) and restless leg symptoms (RLS) are found in patients with venous disease. This study investigates the relationship between nocturnal symptoms and anatomic locations of superficial venous insufficiency.

Methods: A retrospective review of 371 consecutive patients presenting to a venous disease practice over a 1-year period was conducted. Patients underwent comprehensive assessment including standardized duplex scans. Superficial venous disease was classified by anatomic location (great saphenous vein [GSV], small saphenous vein [SSV], tributaries). Information on patient symptoms was obtained from questionnaires and patient interviews.

Results: Most patients in the cohort were female (315/371, 85%) with an average age of approximately 56 years. The 56 men had an average age of 63.2. Nearly all patients (92%) had findings of superficial venous reflux with the anatomic site of involvement as follows: GSV (51%), SSV (16%), and tributaries (33%). Thirty-two percent of patients experienced LC and 16% experienced RLS. The patterns of reflux did not differ between patients with nocturnal symptoms compared to those without nocturnal symptoms. Nine percent of patients with nocturnal symptoms had no evidence of venous disease. Of those patients with LC, 76% had reflux in the GSV, 48% had reflux in the SSV, and 92% had reflux in at least one segment of the superficial venous system. Of those patients with RLS, 78% had reflux in the GSV, 35% had reflux in the SSV, and 87% had reflux in at least one segment of the superficial venous system.

Conclusions: No significant difference was detected between patterns of superficial venous reflux in patients with nocturnal symptoms compared to those without nocturnal symptoms. In addition, the presence of nocturnal symptoms does not predict a specific pattern of disease. Future studies are needed to determine whether correction of the main truncal disease is sufficient or if ablation of both the truncal and tributary veins is necessary for alleviation of nocturnal symptoms.
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http://dx.doi.org/10.23736/S0392-9590.17.03881-0DOI Listing
December 2017