Publications by authors named "Naveed Sami"

73 Publications

Spironolactone-Induced Lichenoid Drug Reaction and Subsequent Diffuse Eruptive Squamous Cell Carcinomas Successfully Treated With Systemic Methotrexate.

Cureus 2021 Sep 4;13(9):e17713. Epub 2021 Sep 4.

Internal Medicine, University of Central Florida College of Medicine, Orlando, USA.

Antihypertensive agents such as spironolactone have been reported to cause lichenoid drug eruptions. Eruptive keratoacanthomas (KA), considered to be well-differentiated squamous cell carcinoma (SCC), may develop in the setting of such lichenoid reactions. Thus, definitive treatment is imperative. This case report describes a patient on spironolactone who developed a lichenoid drug eruption followed by eruptive KAs and SCC. The treatment approach used systemic methotrexate. While most treatment regimens for widespread eruptive KA/SCC employ intralesional methotrexate, this case demonstrated the utility of its systemic counterpart. This may have also facilitated the resolution of the patient's lichenoid eruption. There are only three other reports in the literature describing a spironolactone-induced lichenoid drug eruption. Further investigations are needed to evaluate the adverse cutaneous effects of spironolactone as well as the efficacy of systemic methotrexate in treating patients with a significant number of SCCs arising from lichenoid drug eruptions.
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http://dx.doi.org/10.7759/cureus.17713DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8489780PMC
September 2021

Efficacy of intralesional sodium thiosulfate for the treatment of dystrophic calcinosis cutis: A double-blind, placebo-controlled pilot study.

JAAD Int 2020 Dec 6;1(2):114-120. Epub 2020 Aug 6.

Department of Internal Medicine, University of Central Florida College of Medicine, Orlando, Florida.

Background: Intralesional injection of sodium thiosulfate has emerged as a promising therapy for calcinosis cutis, but to our knowledge there are no randomized controlled trials evaluating its efficacy as a treatment.

Objective: Conduct a prospective, double-blinded investigation of intralesional sodium thiosulfate versus normal saline in the treatment of dystrophic calcinosis cutis.

Methods: This prospective pilot study injected normal saline or sodium thiosulfate at 0.1 mL/cm into lesions at baseline and at 1- and 2-month follow-up. Subjects were followed for a total of 12 weeks. An in-person Physician Global Assessment score was assigned by the injecting physician at each visit and was repeated by an independent observer.

Results: Of 4 subjects who completed the study, only 1 experienced improvement in the size and Physician Global Assessment score of the lesion. By 3-month follow-up, there was no difference between the average size of the treatment and control lesions ( = .39).

Limitations: This was a small single-center study with limited demographic diversity and a short follow-up period. Only dystrophic calcinosis cutis subjects were included, and subjects received only 3 monthly injections of sodium thiosulfate.

Conclusions: With only 1 positive response, our results highlight the need for further study of sodium thiosulfate treatment for dystrophic calcinosis.
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http://dx.doi.org/10.1016/j.jdin.2020.07.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8362252PMC
December 2020

Pediatric epidermolysis bullosa acquisita: A review.

Pediatr Dermatol 2021 Aug 2. Epub 2021 Aug 2.

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

Epidermolysis bullosa acquisita (EBA) is an acquired autoimmune blistering skin disorder that is rare in adults and even rarer in childhood. This review aims to identify cases of pediatric EBA and report their clinical features and course. Our literature review was conducted in MEDLINE using the search terms related to juvenile epidermolysis bullosa acquisita. We identified 40 cases of pediatric EBA. Mucosal tissues were affected in 29 out of 40 cases. Treatment mostly consisted of a systemic corticosteroid combined with dapsone. Prognosis is favorable with 17 of 40 cases achieving complete remission, 9 of 40 with complete control with therapy, 12 of 40 with partial control with therapy, 1 of 40 with no response to therapy, and 1 of 40 terminating treatment early. Though it is a rare condition, childhood EBA should still be included in the differential diagnosis of pediatric blistering diseases.
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http://dx.doi.org/10.1111/pde.14722DOI Listing
August 2021

Galcanezumab-induced fixed drug eruption.

JAAD Case Rep 2021 Mar 30;9:90-92. Epub 2021 Jan 30.

UCF Health, Orlando, Florida.

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http://dx.doi.org/10.1016/j.jdcr.2021.01.015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7907008PMC
March 2021

Successful systemic treatment outcomes of lichen planus: A single-center retrospective review.

Dermatol Ther 2021 05 7;34(3):e14903. Epub 2021 Mar 7.

Department of Medicine, University of Central Florida, Orlando, Florida, USA.

Lichen planus (LP) affects up to 4% of adults and can cause significant distress and morbidity, especially to those with persistent disease. As many as 20% of patients with LP may exhibit widespread or recalcitrant disease necessitating systemic treatment options. We sought to evaluate the effectiveness of systemic treatments for severe and recalcitrant LP not responsive to topical corticosteroids or calcineurin inhibitors. Over a 10-year period, 374 patients with cutaneous and mucosal LP were evaluated at a major regional tertiary medical center; 94 qualified for inclusion in the study. In all, 26 (28%) patients achieved remission, 52 (55%) experienced stable disease control, and 16 (17%) failed all attempted treatments. Among medications most trialed, intramuscular triamcinolone (IM TAC), hydroxychloroquine, and methotrexate were most successful with 79%, 61%, and 42% respective response rates. In contrast, oral corticosteroids and dapsone were less frequently successful at rates of 24% and 20%. IM TAC represented the highest level of treatment success and was statistically significant compared to other systemic treatments (P < .01). Among adjuvant therapies, intralesional triamcinolone (IL TAC) demonstrated higher success (71%) than oral corticosteroids (29%). Based on this multi-year evaluation, we recommend that clinicians consider IM TAC as a first-line systemic option for severe or refractory LP, with hydroxychloroquine as the steroid-sparing treatment of choice. For patients requiring adjuvant therapy, IL TAC should be considered to hasten response and symptom relief. Patients with severe or widespread disease may benefit from earlier initiation of systemic therapy to prevent significant morbidity and impact on daily function.
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http://dx.doi.org/10.1111/dth.14903DOI Listing
May 2021

Rituximab as an Adjuvant Rescue Treatment for Ocular Cicatricial Pemphigoid.

Cornea 2021 Nov;40(11):1440-1444

University of Central Florida Department of Medicine, Orlando, FL.

Purpose: Ocular cicatricial pemphigoid (OCP) can lead to devastating ocular complications without prompt treatment. A number of immunomodulatory agents have been attempted with varying success. The objective of this study was to evaluate the use of rituximab as an adjuvant to immunomodulatory treatments (IMTs) in refractory OCP.

Methods: The clinical records of 14 patients with treatment refractory OCP treated with rituximab as monotherapy or in combination with IMTs were retrospectively reviewed, with a focus on demographics, treatments prerituximab and postrituximab, total number of rituximab infusions, response to treatment, and ocular outcomes including staging and best-corrected visual acuity.

Results: Thirteen patients (92.9%) achieved a complete response with rituximab over a mean period of 4.3 months. The average sustained complete response time in those without relapse was 29.7 months. Five patients relapsed over a mean period of 15 months, 2 of whom were able to regain control over a mean of 2.5 months with additional rituximab treatments. At the final evaluation, rituximab-based therapy improved ocular outcomes in OCP by stabilizing Foster staging and preventing the deterioration of best-corrected visual acuity in 72% of eyes. In total, 90% of eyes with Foster stages 3 or less did not progress. All patients were able to decrease IMT dosage and/or transition to less potent adjuvant treatments.

Conclusions: The consideration of rituximab earlier in treatment of OCP as a rescue and/or maintenance therapy could result in an earlier arrest of disease progression, resulting in preservation of patients' vision, and enable tapering of adjuvant IMT.
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http://dx.doi.org/10.1097/ICO.0000000000002683DOI Listing
November 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

Abatacept-Induced Disseminated Superficial Porokeratosis.

J Clin Rheumatol 2020 Dec 15;Publish Ahead of Print. Epub 2020 Dec 15.

From the University of Central Florida College of Medicine UCF Health, Orlando, FL Department of Dermatology; New York Medical College, Valhalla, New York Department of Internal Medicine, University of Central Florida College of Medicine, Orlando, FL.

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http://dx.doi.org/10.1097/RHU.0000000000001691DOI Listing
December 2020

Dronedarone-induced photoallergic reaction.

JAAD Case Rep 2020 Dec 12;6(12):1208-1210. Epub 2020 Oct 12.

University of Central Florida College of Medicine, Orlando, Florida.

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http://dx.doi.org/10.1016/j.jdcr.2020.10.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7695815PMC
December 2020

Secukinumab-induced scleroderma: a case report.

Rheumatology (Oxford) 2021 03;60(3):e99-e100

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

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http://dx.doi.org/10.1093/rheumatology/keaa603DOI Listing
March 2021

Eruptive Hypertrophic Discoid Lupus Erythematosus Mimicking Squamous Cell Carcinoma: A Clinical and Histopathological Diagnostic Challenge.

J Clin Rheumatol 2020 Sep 4. Epub 2020 Sep 4.

Dermatology and Plastic Surgery Institute Cleveland Clinic Cleveland, OH Department of Dermatology University Hospitals Cleveland Medical Center Cleveland, OH Department of Dermatology University of Alabama at Birmingham Birmingham, AL Department of Dermatology University of Central Florida College of Medicine Orlando, FL.

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http://dx.doi.org/10.1097/RHU.0000000000001548DOI Listing
September 2020

Treatment of Cutaneous Lupus Erythematosus With 1064-nm Neodymium-Doped Yttrium Aluminum Garnet Laser Verses Topical Corticosteroid Alone.

Dermatol Surg 2021 06;47(6):863-864

Department of Internal Medicine, University of Central Florida College of Medicine, Orlando, Florida.

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http://dx.doi.org/10.1097/DSS.0000000000002717DOI Listing
June 2021

The Effect of Abobotulinum Toxin A on the Symptoms of Raynaud's Phenomenon: A Case Series.

Cureus 2020 May 22;12(5):e8235. Epub 2020 May 22.

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

Raynaud's phenomenon (RP) is a relatively common syndrome occurring alone or in combination with autoimmune and inflammatory diseases. It is characterized by pain and ulceration due to vasospasm in response to cold and stress, most often affecting the digits. Although pharmacologic treatment for this condition exists, it is not always efficacious. Our case series demonstrates the use of abobotulinum toxin A in the treatment of RP. We report the cases of four patients who received injections of abobotulinum toxin A to treat their mild to severe RP symptoms. They experienced clinical improvement for up to one year after treatment.
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http://dx.doi.org/10.7759/cureus.8235DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306670PMC
May 2020

Updates on diagnosis and management of autoimmune blistering diseases.

G Ital Dermatol Venereol 2020 Feb 4;155(1):46-64. Epub 2019 Dec 4.

Emory Autoimmune Blistering Disease Clinic, Emory Department of Dermatology, Atlanta, GA, USA.

Over the last several decades, advances in the understanding of the pathogenesis of autoimmune blistering diseases has resulted in significant improvements in diagnosis and management. These improvements include new diagnostic assays and therapies targeted at specific disease mediators. Furthermore, the abundance of new therapies in clinic trials for autoimmune blistering diseases will translate to an enhanced therapeutic armamentarium for clinicians. The aim of this article is to review new developments in the understanding of autoimmune blistering diseases and to summarize advancements in their diagnosis and management.
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http://dx.doi.org/10.23736/S0392-0488.19.06517-9DOI Listing
February 2020

Notalgia paresthetica: treatment review and algorithmic approach.

J Dermatolog Treat 2020 Jun 25;31(4):424-432. Epub 2019 Apr 25.

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

Notalgia paresthetica (NP) is a sensory neuropathy of the back characterized by a well demarcated, hyperpigmented macule or patch located medial or inferior to the scapulae. Symptoms include localized pruritus and pain, and the clinical course consists of remissions and relapses. It can be an underrecognized and difficult disease to treat since conventional treatments for pruritus in inflammatory dermatosis have variable efficacy. There are a variety of treatment modalities, but strong evidence to suggest the superiority of any one treatment is lacking. This review describes the treatments that have been used for NP in the literature and evaluates their level of evidence with respect to their efficacy. We also present a treatment algorithm based on our analysis. MEDLINE search was performed using the terms 'notalgia,' 'paresthetica,' and 'treatment.' All resulting articles have been included in this review. Treatment options include topical agents (capsaicin, tacrolimus, anesthetic cream, and amitriptyline/ketamine), systemic agents (gabapentin, oxcarbazepine, and amitriptyline), procedural modalities (botulinum toxin A and narrowband UVB), and physical therapy. Treatment should begin with topical agents or physical therapy, then systemic agents, and finally procedural modalities. We recommend combining treatment options with physical therapy for sustained treatment response.
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http://dx.doi.org/10.1080/09546634.2019.1603360DOI Listing
June 2020

Biologic Therapy in the Treatment of Cutaneous Sarcoidosis: A Literature Review.

Am J Clin Dermatol 2019 Jun;20(3):409-422

Department of Medicine, University of Central Florida College of Medicine, Health Sciences Campus at Lake Nona, 6850 Lake Nona Blvd, Orlando, FL, 32827-7408, USA.

Sarcoidosis is an inflammatory disease defined by the presence of non-caseating granulomas. It can affect a number of organ systems, most commonly the lungs, lymph nodes, and skin. Cutaneous manifestations of sarcoidosis can impose a significant detriment to patients' quality of life. The accepted first-line therapy for cutaneous sarcoidosis consists of intralesional and oral corticosteroids, but these can fail in the face of resistant disease and corticosteroid-induced adverse effects. Second-line agents include tetracyclines, hydroxychloroquine, and methotrexate. Biologics are an emerging treatment option for the management of cutaneous sarcoidosis, but their role in management is not well-defined. In this article, we reviewed the currently available English-language publications on the use of biologics in managing cutaneous sarcoidosis. Although somewhat limited, the data in published studies support the use of both infliximab and adalimumab as third-line treatments for chronic or resistant cutaneous sarcoidosis. There were also scattered reports of etanercept, rituximab, golimumab, and ustekinumab being utilized as third-line agents with varying degrees of success. Larger and more extensive investigations are required to further assess the adverse effect profile and optimal dosing for managing cutaneous sarcoidosis.
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http://dx.doi.org/10.1007/s40257-019-00428-8DOI Listing
June 2019

Treatment Update of Autoimmune Blistering Diseases.

Dermatol Clin 2019 Apr 14;37(2):215-228. Epub 2019 Feb 14.

Department of Medicine, University of Central Florida, Health Sciences Campus at Lake Nona, 2627 Northampton Avenue, Orlando, FL 32827-7408, USA. Electronic address:

The treatment of refractory autoimmune blistering diseases (AIBDs) has always been a challenge. Because randomized controlled trials are lacking, treatment has been based on analysis of anecdotal data. The last 2 decades has seen the use of rituximab become a conventional treatment in the therapeutic armamentarium of AIBDs, leading to its Food and Drug Administration indication for pemphigus vulgaris in 2018. We review the current updated data on the use of rituximab including dosing, protocols, and its role in the algorithm of AIBDs. In addition, we discuss several promising novel emerging therapeutic agents for AIBDs.
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http://dx.doi.org/10.1016/j.det.2018.12.003DOI Listing
April 2019

The use of rituximab in treatment of epidermolysis bullosa acquisita: Three new cases and a review of the literature.

Dermatol Ther 2018 11 3;31(6):e12726. Epub 2018 Oct 3.

Department of Medicine, Health Sciences Campus at Lake Nona, Orlando, FL.

Epidermolysis bullosa acquisita (EBA) is a rare, subepidermal blistering disease affecting the skin and mucous membranes that often remains refractory to standard immunosuppressive therapy. We present three original cases and a review of the literature of 20 cases of refractory EBA treated with rituximab as monotherapy or in combination with other agents. Complete control (with or without therapy) and remission were seen in 56% of patients treated with rituximab monotherapy and 75% of patients treated with rituximab and immunoadsorption (IA). We conclude EBA refractory to standard immunosuppressive therapy may show a more favorable long-term response to the addition of rituximab; and rituximab in combination with intravenous immunoglobulin or IA may provide utility in terminating acute disease. Additional data are needed to evaluate the safety and long-term outcomes of rituximab-based treatment.
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http://dx.doi.org/10.1111/dth.12726DOI Listing
November 2018

Pediatric ocular lichen planus and lichen planopilaris: One new case and a review of the literature.

Pediatr Dermatol 2018 Nov 30;35(6):859-863. Epub 2018 Aug 30.

Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama, USA.

When lichen planus involves the scalp, it is known as lichen planopilaris, and when it involves the eye, it is known as ocular lichen planus; both are rare. Early detection and targeted therapy are crucial in preventing hair loss and scarring conjunctivitis. Little is known regarding appropriate treatment for lichen planopilaris. The objective of this case study is to present a new case of pediatric ocular lichen planus and lichen planopilaris and to identify all reported cases of pediatric lichen planopilaris, highlighting disease involvement, treatment, and response to treatment.
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http://dx.doi.org/10.1111/pde.13606DOI Listing
November 2018

Perforating disorder secondary to leflunomide and review of the literature of medications associated with perforating disorder.

Dermatol Online J 2018 May 15;24(5). Epub 2018 May 15.

Department of Medicine, University of Central Florida, Orlando, Florida.

The perforating dermatoses are a group of disorders characterized by transepidermal elimination of a material from the upper dermis. The most widely accepted classification consists of four primary perforating disorders that are defined by the type of material eliminated and the type of epidermal disruption. Pathogenesis of the perforating dermatoses is poorly understood, but some appear to have a genetic component. There are also acquired forms, which have been associated with underlying systemic diseases and the use of certain drugs. In this report, we describe a perforating disorder that occurred secondary to leflunomide therapy. To our knowledge, this is the first case in which this has been reported. We also review the recent literature on medications associated with perforating disorders.
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May 2018

Rituximab and low dose oral immune modulating treatment to maintain a sustained response in severe pemphigus patients.

J Dermatolog Treat 2019 Jun 7;30(4):340-345. Epub 2018 Sep 7.

c Department of Medicine , University of Central Florida , Orlando , FL , USA.

This pilot retrospective study examined the role of continuous low-dose maintenance immunomodulatory treatment (IMT) as an adjunct to rituximab (RTX) rescue therapy in severe pemphigus vulgaris (PV) and pemphigus foliaceus (PF) after a complete response (CR) to RTX was achieved. Ten severe pemphigus patients who received RTX rescue therapy were evaluated after achieving CR. The post-RTX clinical course and long-term follow up was compared between patients who adhered to a low recommended dose (LRMD) to patients who were non-compliant with LRMD. Five patients relapsed due to discontinuing or tapering their LRMD therapy, whereas the five patients who adhered to their maintenance therapy did not experience a relapse after the initial post-RTX CR. A combination of increasing or adding IMTs and initiating subsequent RTX cycles was used to regain control in relapsed patients. We propose an alternative treatment strategy utilizing RTX as a rescue agent in combination with long-term LRMD as a means to maintain a sustained long-term CR post-RTX therapy in severe pemphigus patients. This strategy could prevent disease flares and the need for additional RTX cycles and higher dosages of immunomodulatory therapies.
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http://dx.doi.org/10.1080/09546634.2018.1510173DOI Listing
June 2019

Erythema Elevatum Diutinum Treated With Mycophenolate Mofetil.

J Clin Rheumatol 2019 09;25(6):e93-e94

School of Medicine, University of Alabama at Birmingham, Birmingham, AL University of Central Florida, Orlando, FL

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http://dx.doi.org/10.1097/RHU.0000000000000752DOI Listing
September 2019

Pyoderma gangrenosum in pregnancy successfully treated with infliximab and prednisone.

JAAD Case Rep 2017 Sep 30;3(5):387-389. Epub 2017 Aug 30.

Department of Dermatology, University of Alabama School of Medicine, Birmingham, Alabama.

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http://dx.doi.org/10.1016/j.jdcr.2017.03.016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5576974PMC
September 2017

Oral lichen sclerosus-a review of clinical presentation, treatment, and clinical outcomes.

Oral Surg Oral Med Oral Pathol Oral Radiol 2017 Oct 3;124(4):e243-e248. Epub 2017 Aug 3.

University of Alabama at Birmingham, Birmingham, AL, USA; University of Central Florida, Orlando, FL, USA. Electronic address:

Objective: The aim of this study was to evaluate the disease involvement, treatment and response, and malignant potential of oral lichen sclerosus (LS).

Study Design: We conducted a review of the literature of 37 cases of oral LS. We looked specifically for the following data: patient demographic characteristics, disease involvement, treatment, response to treatment, duration of follow-up, symptoms, risk factors for oral malignancy, and malignant transformation.

Results: The most common area of oral involvement included the labial mucosa (67.6%). Of patients with oral LS, 38.5% reported symptoms, and 35.1% exhibited extraoral manifestations. Patients were less likely to receive treatment when asymptomatic (62.5%) than when symptomatic (80%). Topical steroids were more efficacious (66.7%) compared with other treatments. Risk factors for malignancy were found in 25% of patients. No patient had malignant transformation of oral lesions at follow-up (mean follow-up 22.1 months; median 12 months).

Conclusions: More data and longer follow-up are required to determine the long-term clinical outcomes of oral LS.
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http://dx.doi.org/10.1016/j.oooo.2017.07.005DOI Listing
October 2017

Successful Treatment of Cutaneous Small Vessel Vasculitis With Leflunomide.

JAMA Dermatol 2017 09;153(9):940-942

Department of Dermatology, University of Alabama School of Medicine, Birmingham, Alabama.

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http://dx.doi.org/10.1001/jamadermatol.2017.1316DOI Listing
September 2017

Systemic tacrolimus in the treatment of recalcitrant mucosal lichen planus.

JAAD Case Rep 2017 May 24;3(3):253-255. Epub 2017 May 24.

Department of Dermatology, University of Alabama, Birmingham, Alabama.

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http://dx.doi.org/10.1016/j.jdcr.2017.02.022DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5447370PMC
May 2017

Successful treatment with IVIg therapy of diabetes-associated scleredema severe progressive case and review of the literature.

Dermatol Ther 2017 Jul 2;30(4). Epub 2017 Jun 2.

Department of Medicine, University of Central Florida, Orlando, Florida.

Scleredema is a deposition disorder which presents as diffuse, symmetric, non-pitting skin induration from dermal deposits of glycosaminoglycans ("mucins"). It classically affects the upper back and posterior neck, often causing skin tightness and decreased range of motion. In most patients the clinical course is chronic and treatment options are limited. We report a case of a patient diagnosed with scleredema associated with longstanding insulin dependent diabetes who was treated successfully with IVIg. Additionally, we have reviewed the literature reporting other patients with scleredema treated with IVIg.
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http://dx.doi.org/10.1111/dth.12504DOI Listing
July 2017

Nasal, pharyngeal, and laryngeal pemphigus vulgaris successfully treated with rituximab.

Authors:
Naveed Sami

Ear Nose Throat J 2017 Apr-May;96(4-5):E35-E38

University of Alabama at Birmingham, 1520 3rd Ave., South, EFH 414, Birmingham, AL 35294-0009, USA.

Pemphigus vulgaris is a potentially fatal autoimmune blistering disease that can involve the nasopharyngeal and laryngeal tissues. The disease can be recalcitrant to conventional oral treatments, and treatment alternatives are limited. This retrospective study evaluated the efficacy of rituximab as a rescue agent in 5 patients with recalcitrant pemphigus vulgaris involving nasopharyngeal and laryngeal mucosa. All 5 patients were unresponsive to systemic steroids and at least one conventional oral immunosuppressive agent. The patients received rituximab infusions as a rescue agent because of recalcitrant disease. All 5 patients had a complete clinical response to rituximab and could discontinue systemic steroids and reduce the dosage of their initial immunosuppressive agent. No major adverse reactions were observed or reported with rituximab. Rituximab can be used as an effective rescue agent in the treatment of severe pemphigus vulgaris with nasopharyngeal and laryngeal involvement.
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March 2018

Photodynamic therapy effective for the treatment of actinic keratosis and basal cell carcinoma in bullous pemphigoid patients.

Photodiagnosis Photodyn Ther 2017 Jun 1;18:257-259. Epub 2017 Apr 1.

Department of Dermatology, University of Alabama at Birmingham, United States; Department of Medicine, University of Central Florida, United States. Electronic address:

Treating skin cancers and extensive actinic keratosis in patients with bullous pemphigoid (BP) can be challenging. Treatment options pose unique risks in these patients as surgical wounds can have delayed wound healing and photodynamic therapy (PDT) may exacerbate their blistering disease. We report the successful use of PDT to treat actinic keratosis and skin cancers in two patients with BP, both of whom had excellent response to PDT and tolerated treatment without any bullous disease flares. Carefully selected patients with skin cancers and stable, well controlled BP can be safely considered for treatment using PDT.
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http://dx.doi.org/10.1016/j.pdpdt.2017.03.019DOI Listing
June 2017

Dapsone and sulfasalazine combination therapy in dermatitis herpetiformis.

Int J Dermatol 2017 May 30;56(5):e90-e92. Epub 2017 Jan 30.

University of Alabama at Birmingham, Birmingham, AL, USA.

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http://dx.doi.org/10.1111/ijd.13542DOI Listing
May 2017
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