Publications by authors named "Lucia Seminario-Vidal"

67 Publications

Long-Term Remission After Matched Sibling Donor Hematopoietic Cell Transplantation in a Patient With Primary Cutaneous CD8+ Aggressive Epidermotropic Cytotoxic T-Cell Lymphoma.

Cureus 2021 May 20;13(5):e15132. Epub 2021 May 20.

Hematology and Oncology, Moffitt Cancer Center, Tampa, USA.

Primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma (CD8+ PCAECTL) is an extremely rare neoplasm with a poor prognosis. Chemotherapy typically does not result in a sustained response, and hematopoietic stem cell transplant (HSCT) is the only therapy that has been shown to produce a durable response of any kind. Here, we report a case of a 25-year-old previously healthy male who presented with a painful ulcerative lesion on the bottom of his right great toe and local lymphadenopathy. The biopsy of the lesion was consistent with CD8+ PCAECTL. He received immediate chemotherapy followed by matched related donor HSCT (MRD-HSCT) and remained in complete remission (CR) for eight years post-transplant, longer than any CR reported in the literature. In conclusion, our report provides clinical evidence that early transplant consult and donor search is one of the key factors in the management of CD8+ PCAECTL.
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http://dx.doi.org/10.7759/cureus.15132DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8214246PMC
May 2021

Photodynamic therapy of mycosis fungoides: A systematic review of case studies.

Photodermatol Photoimmunol Photomed 2021 May 20. Epub 2021 May 20.

Department of Dermatology and Cutaneous Surgery, University of South Florida (USF), Tampa, FL, USA.

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http://dx.doi.org/10.1111/phpp.12698DOI Listing
May 2021

Long-term Physical and Psychological Outcomes of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis.

JAMA Dermatol 2021 Jun;157(6):712-715

Hennepin Healthcare, University of Minnesota Medical School, Minneapolis.

Importance: Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is known to cause multiple end-organ complications in its acute phase, but less is known about the long-term association with patients' mental health and quality of life.

Objective: To examine the chronic physical and psychological sequelae affecting patients with SJS/TEN.

Design, Setting, And Participants: A survey study conducted at 11 academic health centers in the US evaluated 121 adults diagnosed with SJS/TEN by inpatient consultive dermatologists between January 1, 2009, and September 30, 2019.

Interventions: Patients completed a survey that included the following validated questionnaires: Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Primary Care Post-Traumatic Stress Disorder Screen (PC-PTSD), and the 12-item Short Form Health Survey (SF-12). The survey also included questions created by the study team regarding fear, patient education, and long-term sequelae relevant to SJS/TEN.

Main Outcomes And Measures: Primary outcome measures were the percentage of patients reporting long-term physical sequelae; the percentage of patients with positive results on PHQ-9, GAD-7, and PC-PTSD screening; and the numeric score on the SF-12 (score of 50 defined as average physical and mental well-being).

Results: A total of 121 individuals (73 women [60.3%]; mean [SD] age, 52.5 [17.1] years) completed the survey (response rate, 29.2%). The most common long-term physical sequelae reported were cutaneous problems (102 of 121 [84.3%]), ocular problems (72 of 121 [59.5%]), and oral mucosal problems (61 of 120 [50.8%]). A total of 53.3% (64 of 120) of the respondents had results indicating depression on the PHQ-9, 43.3% (52 of 120) showed signs of anxiety on the GAD-7, and 19.5% had results indicating PTSD on the PC-PTSD. The mean (SD) SF-12 Physical Component Summary score was 42.4 (22.8), and the mean Mental Component Summary score was 46.1 (20.9). A total of 28.2% (33 of 117) of the respondents were unable to work, 68.1% (81 of 119) were fearful of taking new medications, and 30.0% (36 of 120) avoided taking prescribed medications for a diagnosed medical condition.

Conclusions And Relevance: This survey study found that long-term physical sequelae, depression, and anxiety appear to be common in patients with SJS/TEN, with implications for health and well-being. Improved awareness of these complications may assist health professionals in offering medical care, counseling, and support to patients with SJS/TEN.
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http://dx.doi.org/10.1001/jamadermatol.2021.1136DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8100906PMC
June 2021

Nivolumab-induced psoriasis successfully treated with risankizumab-rzaa in a patient with stage III melanoma.

JAAD Case Rep 2021 May 27;11:74-77. Epub 2021 Mar 27.

Department of Dermatology & Cutaneous Surgery, University of South Florida, Tampa, Florida.

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http://dx.doi.org/10.1016/j.jdcr.2021.03.029DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8079959PMC
May 2021

A virtual faculty exchange program enhances dermatology resident education in the COVID-19 era: a survey study.

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

Department of Dermatology, University of California Irvine, Irvine, CA.

One of the many consequences of the COVID-19 pandemic was the cancelation of the 2020 American Academy of Dermatology Annual Meeting. This conference historically features lectures from world-renowned experts in all areas of dermatology, thus providing an important educational experience for dermatology residents. We hypothesized that the cancellation of this meeting produced a substantial educational loss for dermatology residents. To mitigate this impact, we developed a virtual faculty exchange program and surveyed dermatology residents' perspectives on its implementation. All participating residents found the virtual faculty exchange useful and would recommend it to other residents/programs. Moreover, all residents wanted to participate in more faculty exchange sessions as well as incorporate them throughout the academic year. Additionally, this educational program eliminated the potential cost of >$15,000 in flights and >24 metric tons of carbon emissions. This virtual faculty exchange program is a viable tool to enhance dermatology resident education in the COVID-19 era.
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March 2021

Dupilumab for treatment of atopic dermatitis in patients living with HIV: a case series.

Int J Dermatol 2021 Mar 4. Epub 2021 Mar 4.

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

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http://dx.doi.org/10.1111/ijd.15471DOI Listing
March 2021

Real-world drug survival and reasons for treatment discontinuation of biologics and apremilast in patients with psoriasis in an academic center.

Dermatol Ther 2021 03 12;34(2):e14826. Epub 2021 Feb 12.

Department of Dermatology and Cutaneous Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida, USA.

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http://dx.doi.org/10.1111/dth.14826DOI Listing
March 2021

Mapping cutaneous T-cell lymphoma in the state of Florida: A retrospective exploratory spatial analysis of incidence patterns.

J Am Acad Dermatol 2021 Jan 19. Epub 2021 Jan 19.

Department of Dermatology and Cutaneous Surgery, University of South Florida (USF), Tampa, Florida; Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2021.01.041DOI Listing
January 2021

Utility of flow cytometry and gene rearrangement analysis in tissue and blood of patients with suspected cutaneous T‑cell lymphoma.

Oncol Rep 2021 01 23;45(1):349-358. Epub 2020 Nov 23.

Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA.

Cutaneous T‑cell lymphoma (CTCL) is difficult to diagnose at an early stage. Current diagnostic tools include clinical examination, histomorphologic analysis, immunohistochemistry, flow cytometry of peripheral blood and/or lesional tissue, and evaluation of T‑cell receptor (TCR) clonality by gene rearrangement analysis (TCRGR). Advances in genomic sequencing, including high‑throughput sequencing (HTS), can be used to identify specific clones of rearranged TCR genes. Even with all of these tools, CTCL can take as long as a decade to definitively diagnose, potentially delaying treatment options and causing patient anxiety. This study aimed to evaluate the performance of the various ancillary testing modalities used to diagnose early‑stage CTCL. In a subset of patients the performance of HTS was compared to flow cytometry and conventional TCRGR analysis via polymerase chain reaction (PCR). Fifty‑five patients, with a total of 68 skin biopsies and peripheral blood draws, were evaluated using flow cytometry, PCR‑TCRGR, and HTS‑TCRGR to determine the sensitivity and specificity of each ancillary test. In tissue biopsies, flow cytometry (64%), PCR (71%) and HTS (69%) shared similar sensitivities; flow cytometry had the highest specificity (93%), followed by HTS (86%) and PCR (76.9%). However, flow cytometry and PCR had insufficient DNA quantities in 29 and 15% of the specimens, respectively. Peripheral blood testing was less sensitive than tissue testing (flow cytometry 14%, PCR 41%, HTS 33%); in peripheral blood, HTS was the most specific test (flow cytometry, 70%; PCR, 62.5%; and HTS, 100%). HTS is a highly specific molecular test for identifying CTCL in peripheral blood and skin biopsy specimens; however, our findings suggest a need for a continued search for more sensitive tests for early‑stage CTCL.
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http://dx.doi.org/10.3892/or.2020.7865DOI Listing
January 2021

Treatment of pyoderma gangrenosum: A multicenter survey-based study assessing satisfaction and quality of life.

Dermatol Ther 2021 03 12;34(2):e14736. Epub 2021 Jan 12.

Department of Dermatology, Oregon Health and Science University, Portland, Oregon, USA.

Pyoderma gangrenosum (PG) lacks consensus regarding treatment, and no prior studies assess treatment satisfaction in PG. The objective of this study was to determine patient-reported satisfaction in the treatment of PG, and associations with satisfaction. Methodology was a multicenter cross-sectional survey for patients who received systemic medication(s) to treat PG. Thirty-five patients completed the survey (mean age: 54.0 years, 65.7% female, response rate: 81.4%). Mean (± SD) SATMED-Q score was 75.0 (±16.2, range: 67.6-85.3). Older patients (72.6 ± 23.6 for 18-39 years, 74.4 ± 16.1 for 40-59, 77.1 ± 11.6 for 60+), plus those with higher incomes (72.9 ± 20.3 for $0-49 000; 74.0 ± 17.6 for $50 000-99 000; 79.0 ± 14.6 for $100 000+) and education status (69.4 ± 14.3 for high school equivalent, 72.9 ± 15.9 for undergraduate, 91.7 ± 10.6 for graduate), were more satisfied with treatment. Ulcerative PG had higher SATMED-Q scores (79.0 ± 13.2) than other subtypes (66.2 ± 19.3). For local therapy, wound care, or pain control, 63.2%, 100%, and 75% were satisfied, respectively. The mean DLQI was 8.6 (±7.6, range: 0-29), and higher DLQI was associated with decreased satisfaction. Satisfaction with providers was positively correlated with global satisfaction (Pearson's r = 0.638). The presence of pain and/or depression influenced both SATMED-Q (72.8 ± 18.8 with pain, 78.3 ± 11.2 without; 68.2 ± 18.8 with depression, 80.1 ± 12.2 without) and DLQI scores (12.1 ± 8.1 with pain, 3.9 ± 3.4 without; 10.3 ± 7.1 with depression, 7.4 ± 8.0 without). To optimize the patient experience, non-modifiable associations should be individually considered, and potentially modifiable associations such as satisfaction with specific providers, pain, and depression, may be targeted for management.
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http://dx.doi.org/10.1111/dth.14736DOI Listing
March 2021

Cutaneous T-cell lymphoma mimicking palmoplantar pustular psoriasis: A rare variant.

Australas J Dermatol 2021 May 1;62(2):e280-e282. Epub 2021 Jan 1.

Department of Dermatology, University of Central Florida College of Medicine, Orlando, FL, USA.

The development of pustular cutaneous T-cell lymphoma (CTCL) on the palms and soles is rare. Without confirmatory biopsy and molecular studies, CTCL can be misdiagnosed as many benign inflammatory skin diseases. We present a case of cutaneous T-cell lymphoma (CTCL) that mimicked palmoplantar pustular psoriasis, a rarely reported manifestation of the disease. We stress the importance of biopsy to confirm diagnoses, especially when preliminary diagnoses do not respond to empiric treatment.
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http://dx.doi.org/10.1111/ajd.13544DOI Listing
May 2021

Cutaneous squamous cell carcinoma arising within a mycosis fungoides patch: Case report and review of the literature.

JAAD Case Rep 2020 Dec 7;6(12):1288-1290. Epub 2020 Oct 7.

Department of Dermatology, Morsani College of Medicine, University of South Florida, Tampa, Florida.

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http://dx.doi.org/10.1016/j.jdcr.2020.09.016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7701026PMC
December 2020

Rosacea and the Microbiome: A Systematic Review.

Dermatol Ther (Heidelb) 2021 Feb 10;11(1):1-12. Epub 2020 Nov 10.

Department of Dermatology and Cutaneous Surgery, University of South Florida, Tampa, FL, USA.

Rosacea, a chronic inflammatory skin disease characterized by recurrent episodes of facial flushing, erythema, pustules, and telangiectasia, largely affects fair-skinned women over 30 years of age. Although a long-recognized entity, the exact pathophysiology of this disease is still debated. Current theories highlight the role of the cutaneous microbiome and its associated inflammatory effects in rosacea's pathogenesis. However, microbiological reverberations are not limited to the skin, as recent studies have described the potential cutaneous effects of alterations in the gastrointestinal (GI) microbiome. Associations with additional GI pathologies, including small intestinal bacterial overgrowth (SIBO), irritable bowel syndrome (IBS), and inflammatory bowel disease (IBD), have been investigated, as well as Helicobacter pylori infection. In an attempt to better understand and characterize these relationships, as well as current treatment options, we conducted a systematic review of the literature in PubMed, Cochrane, and Embase from their inception to August 6, 2020. We have synthesized the literature findings within three sections of this manuscript: the cutaneous microbiome, the gut microbiome, and therapeutic strategies. Future studies should focus on specific mechanisms linking GI pathology with rosacea manifestations and the role of enteral drugs in mitigating cutaneous symptoms.
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http://dx.doi.org/10.1007/s13555-020-00460-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7859152PMC
February 2021

JAAD Consultative Dermatology-Relaunched.

J Am Acad Dermatol 2021 Apr 2;84(4):905-906. Epub 2020 Sep 2.

Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina.

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http://dx.doi.org/10.1016/j.jaad.2020.08.104DOI Listing
April 2021

CD8-positive cutaneous lymphoproliferation associated with large granular lymphocyte leukemia in a patient with X-linked agammaglobulinemia.

J Cutan Pathol 2021 Apr 30;48(4):567-571. Epub 2020 Sep 30.

Department of Dermatology, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.

Patients with primary immunodeficiency are at increased risk for malignancy, especially hematologic neoplasms. This paper reports a unique case of a 47-year-old man with X-linked agammaglobulinemia who presented with progressive asymptomatic violaceous papules and plaques on his face, hands, and trunk for 1 year. Skin biopsies revealed deep, nodular infiltrates of histiocytes and CD8-positive lymphocytes, with a CD4:CD8 ratio of 1:10. Laboratory studies showed cytopenias. Flow cytometry in the skin, blood, and bone marrow (BM) showed a CD3+/CD8+/CD57+ large granular lymphocyte population. BM biopsy showed 30% involvement with these atypical T-cells. T-cell gene rearrangement studies of skin, blood, and BM revealed identical T-cell clones. He was diagnosed with T-large granular lymphocyte leukemia (T-LGLL) with an associated CD8+ cutaneous lymphoproliferation. Skin involvement was suspected to represent infiltration by T-LGLL. However, co-existence of two lymphoproliferative disorders (LPDs), T-LGLL and CD8+ granulomatous LPD, remains a possibility. In general, cutaneous infiltrates associated with LGLL are rare and poorly understood. It has been suggested that they are markers of poor prognosis. Our case report describes skin, blood, and BM findings in an immunosuppressed patient with T-LGLL in detail. These findings have not yet been reported and their significance requires further investigation.
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http://dx.doi.org/10.1111/cup.13860DOI Listing
April 2021

Amyloidosis cutis dyschromica treated with acitretin. A case report.

Dermatol Ther 2020 11 26;33(6):e13955. Epub 2020 Jul 26.

Department of Dermatology and Cutaneous Surgery, University of South Florida, Tampa, Florida, USA.

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http://dx.doi.org/10.1111/dth.13955DOI Listing
November 2020

Management of oral reactions from immune checkpoint inhibitor therapy: A systematic review.

J Am Acad Dermatol 2020 Nov 2;83(5):1493-1498. Epub 2020 Jun 2.

Department of Dermatology, University of South Florida, Tampa, Florida; Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2020.05.133DOI Listing
November 2020

Use of teledermatology by dermatology hospitalists is effective in the diagnosis and management of inpatient disease.

J Am Acad Dermatol 2021 Jun 7;84(6):1547-1553. Epub 2020 May 7.

Department of Dermatology, Mayo Clinic, Rochester, Minnesota.

Background: Patient outcomes are improved when dermatologists provide inpatient consultations. Inpatient access to dermatologists is limited, illustrating an opportunity to use teledermatology. Little is known about the ability of dermatologists to accurately diagnose disease and manage inpatients with teledermatology, particularly when using nondermatologist-generated clinical data.

Methods: This prospective study assessed the ability of teledermatology to diagnose disease and manage 41 dermatology consultations from a large urban tertiary care center, using internal medicine referral documentation and photographs. Twenty-seven dermatology hospitalists were surveyed. Interrater agreement was assessed by the κ statistic.

Results: There was substantial agreement between in-person and teledermatology assessment of the diagnosis with differential diagnosis (median κ = 0.83), substantial agreement in laboratory evaluation decisions (median κ = 0.67), almost perfect agreement in imaging decisions (median κ = 1.0), and moderate agreement in biopsy decisions (median κ = 0.43). There was almost perfect agreement in treatment (median κ = 1.0), but no agreement in follow-up planning (median κ = 0.0). There was no association between raw photograph quality and the primary plus differential diagnosis or primary diagnosis alone.

Limitations: Selection bias and single-center nature.

Conclusions: Teledermatology may be effective in the inpatient setting, with concordant diagnosis, evaluation, and management decisions.
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http://dx.doi.org/10.1016/j.jaad.2020.04.171DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204758PMC
June 2021

Cutaneous squamous cell carcinoma causing a rhinophymatous mass in a patient with clinically occult hypertrophic lupus erythematosus.

Lupus 2020 May 22;29(6):644-648. Epub 2020 Mar 22.

Department of Dermatology and Cutaneous Surgery, University of South Florida, Tampa, USA.

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http://dx.doi.org/10.1177/0961203320912838DOI Listing
May 2020

Society of Dermatology Hospitalists supportive care guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults.

J Am Acad Dermatol 2020 Jun 7;82(6):1553-1567. Epub 2020 Mar 7.

Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia.

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening conditions with high morbidity and mortality. Supportive care management of SJS/TEN is highly variable. A systematic review of the literature was performed by dermatologists, ophthalmologists, intensivists, and gynecologists with expertise in SJS/TEN to generate statements for supportive care guideline development. Members of the Society of Dermatology Hospitalists with expertise in SJS/TEN were invited to participate in a modified, online Delphi-consensus. Participants were administered 9-point Likert scale questionnaires regarding 135 statements. The RAND/UCLA Appropriateness Method was used to evaluate and select proposed statements for guideline inclusion; statements with median ratings of 6.5 to 9 and a disagreement index of ≤1 were included in the guideline. For the final round, the guidelines were appraised by all of the participants. Included are an evidence-based discussion and recommendations for hospital setting and care team, wound care, ocular care, oral care, urogenital care, pain management, infection surveillance, fluid and electrolyte management, nutrition and stress ulcer prophylaxis, airway management, and anticoagulation in adult patients with SJS/TEN.
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http://dx.doi.org/10.1016/j.jaad.2020.02.066DOI Listing
June 2020

Management of Recessive Dystrophic Epidermolysis Bullosa in a Newborn with Porcine-derived Extracellular Matrix.

Plast Reconstr Surg Glob Open 2019 Nov 12;7(11):e2519. Epub 2019 Nov 12.

Department of Dermatology and Cutaneous Surgery, University of South Florida Morsani College of Medicine, Tampa, Fla.

Epidermolysis bullosa is a debilitating dermatologic disorder affecting the adhesive capability between the epidermis and dermis. The severe recessive dystrophic variant is caused by mutations in COL7A1, the gene encoding type VII collagen which is the major structural protein of the anchoring fibrils linking these 2 skin layers.1 The management of recessive dystrophic epidermolysis bullosa (RDEB) remains complex with no curative therapy. We present herein the novel use of a porcinederived extracellular matrix dressing to effectively treat extensive erosions in a newborn.
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http://dx.doi.org/10.1097/GOX.0000000000002519DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6908358PMC
November 2019

Pembrolizumab-associated tumor development in a patient with Sézary syndrome.

JAAD Case Rep 2020 Jan 24;6(1):16-18. Epub 2019 Dec 24.

Department of Dermatology, Morsani College of Medicine, University of South Florida, Tampa, Florida.

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http://dx.doi.org/10.1016/j.jdcr.2019.11.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6938917PMC
January 2020

An erythematous facial rash.

J Fam Pract 2019 12;68(10):E9-E11

Moffitt Cancer Center, Morsani College of Medicine, University of South Florida, Tampa, USA. Email:

Two months of treatment with doxycycline provided no improvement. A biopsy of the patient's cheek led to a proper diagnosis.
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December 2019

Reply to: "Response: Distinguishing Stevens-Johnson syndrome/toxic epidermal necrolysis from clinical mimickers during inpatient dermatologic consultation-A retrospective chart review".

J Am Acad Dermatol 2020 03 8;82(3):e113. Epub 2019 Nov 8.

Department of Dermatology, University of South Florida Health Morsani College of Medicine, Tampa. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2019.11.014DOI Listing
March 2020

Pediatric drug reaction with eosinophilia and systemic symptoms: A systematic review of the literature.

Pediatr Dermatol 2020 Jan 5;37(1):124-129. Epub 2019 Nov 5.

Department of Dermatology and Cutaneous Surgery, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.

Background: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe adverse drug reaction including integumentary and internal organs. An extensive literature review of DRESS in the pediatric population has not been performed.

Methods: A literature search was performed to find reports of pediatric DRESS published between 1997 and March 2019. If not already included, each case was scored based on RegiSCAR criteria. Only "probable" or "definite" cases of DRESS were included in the analysis, totaling 130 cases.

Results: In the pediatric population, the average age of diagnosis for DRESS was 8.7 years old. The most common causative drugs include antiepileptics (50%) and antibiotics (30.8%). Time from drug exposure to DRESS presentation averaged 23.8 days. Common clinical symptoms include rash (99.2%) (typically morbilliform (89.2%)), fever (96.2%), eosinophilia (90%), and lymphadenopathy (74.6%). Human herpesvirus-6 reactivation was observed in 16.1% of cases. The most commonly affected internal organ was the liver (80%), followed by the spleen (21.5%) and kidney (15.4%). Management strategies involved, either alone or in combination, included corticosteroids (intravenous 60.8% and oral 41.5%), intravenous immunoglobulins (12.3%), plasmapheresis (2.3%), and ganciclovir (1.5%). Long-term sequelae occurred in 10.8% of patients, most commonly hypothyroidism (3.8%), liver failure (3.1%), and diabetes (2.3%). The mortality rate was 5.4%.

Conclusion: This literature review highlights the presentation and course of pediatric DRESS. Morbilliform eruption, fever, and eosinophilia appear to be clinical hallmarks of pediatric DRESS. Common causative agents, specifically carbamazepine, are comparable to the adult population. Furthermore, the mortality rate from DRESS is significant and is similar between pediatric and adult patients.
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http://dx.doi.org/10.1111/pde.14044DOI Listing
January 2020

Ipilimumab/nivolumab-induced pseudolymphoma in a patient with malignant melanoma.

J Cutan Pathol 2020 Apr 13;47(4):390-393. Epub 2019 Nov 13.

Department of Dermatology and Cutaneous Surgery, University of South Florida, Tampa, Florida.

Combination therapy with ipilimumab and nivolumab is an adjuvant treatment approach for metastatic melanoma that boasts increased 3-year survival when compared with a single immunotherapy agent. Combination therapy, however, is associated with increased toxicities, especially cutaneous side-effects. Here we present a patient with metastatic melanoma and a sudden eruption of painful nodules on the face and arms 10 days after the administration of the fourth dose of combination ipilimumab/nivolumab. Biopsies demonstrated lymphoid hyperplasia, not clinically or pathologically consistent with an infectious, malignant or autoimmune etiology; a diagnosis of pseudolymphoma secondary to ipilimumab/nivolumab was made. After a steroid taper, the lesions resolved, and the patient was restarted on nivolumab monotherapy 2 weeks later without recurrence of symptoms or disease.
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http://dx.doi.org/10.1111/cup.13604DOI Listing
April 2020

Characterisation and diagnosis of ulcers in inpatient dermatology consultation services: A multi-centre study.

Int Wound J 2019 Dec 2;16(6):1440-1444. Epub 2019 Sep 2.

Oregon Health & Science University, Department of Dermatology, Portland, Oregon.

Accurate and prompt diagnosis of skin ulcers is critical to optimise management; however, studies in hospitalised patients are limited. This retrospective review of dermatologic consultations included 272 inpatients with skin ulcers between July 2015 and July 2018 in four U.S. academic hospitals. The median age was 54 years and 45% were male. In 49.3% of the patients, skin ulcers were considered the primary reason for admission. Ulcers of 62% were chronic and 49.6% were located on the lower extremities. Pyoderma gangrenosum (17.3%), infection (12.5%), and exogenous causes (11.8%) were the leading aetiologies; 12% remained diagnostically inconclusive after consultation. Diagnostic agreements pre-dermatology and post-dermatology consult ranged from 0.104 (n = 77, 95% CI 0.051-0.194) to 0.553 (n = 76, 95% CI 0.440-0.659), indicating poor-modest agreement. This study highlights the diagnostic complexity and relative incidences of skin ulcers in the inpatient setting.
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http://dx.doi.org/10.1111/iwj.13211DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7948787PMC
December 2019

Purpuric ecchymoses in the elderly: senile purpura or hematologic malignancy? A case of blastic plasmacytoid dendritic cell neoplasm.

Int J Dermatol 2019 Aug 29. Epub 2019 Aug 29.

Department of Dermatology and Cutaneous Surgery, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.

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http://dx.doi.org/10.1111/ijd.14615DOI Listing
August 2019

Lymphomatoid Papulosis and Other Lymphoma-Like Diseases.

Dermatol Clin 2019 Oct 6;37(4):471-482. Epub 2019 Aug 6.

Department of Dermatology and Cutaneous Surgery, University of South Florida Morsani College of Medicine, 12901 Bruce B. Downs Boulevard, Tampa, FL 33612, USA. Electronic address:

Pityriasis lichenoides et varioliformis acuta and pityriasis lichenoides chronica are the 2 main subtypes of pityriasis lichenoides. They represent the acute and chronic forms of the disease; both may have clonal T cells. Several treatment modalities are used, but it has been difficult to determine efficacy because of the possibility of spontaneous remission. Cutaneous CD30+ lymphoproliferative disorders constitute many cutaneous T-cell lymphomas and comprise lymphomatoid papulosis and primary cutaneous anaplastic large cell lymphoma (ALCL). Both have an excellent prognosis. Lymphomatoid papulosis often only requires observation or treatment of symptoms. First-line therapies for primary cutaneous ALCL are surgical excision or radiotherapy.
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http://dx.doi.org/10.1016/j.det.2019.05.005DOI Listing
October 2019

Diagnosis and Management of Cutaneous B-Cell Lymphomas.

Dermatol Clin 2019 Oct 30;37(4):443-454. Epub 2019 Jul 30.

Department of Dermatology and Cutaneous Surgery, University of South Florida Morsani College of Medicine, 12901 Bruce B Downs Boulevard, Tampa, FL 33612, USA; Department of Cutaneous Oncology, Moffitt Cancer Center, 10920 McKinley Drive, Tampa, FL 33612, USA. Electronic address:

Primary cutaneous B-cell lymphomas are a group of diseases with indolent and aggressive behavior. The goal of the initial workup is to evaluate for systemic involvement, provide adequate staging, and guide therapy. Histopathological studies are a critical part of the workup for classification of these lymphomas because they are similar to their nodal counterparts. There are limited data for treatment guidelines, and thus, therapy differs among institutions. Overall, localized therapies are preferred for indolent types and chemotherapy or immunotherapy for the aggressive forms.
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http://dx.doi.org/10.1016/j.det.2019.05.004DOI Listing
October 2019