Publications by authors named "Patrick E McCleskey"

18 Publications

  • Page 1 of 1

Cutaneous manifestations of COVID-19: a systematic review and analysis of individual patient-level data.

Dermatol Online J 2020 Dec 15;26(12). Epub 2020 Dec 15.

Department of Dermatology, The Permanente Medical Group, South Sacramento, CA Department of Dermatology, University of California, Davis, CA.

Distinctive patterns in the cutaneous manifestations of COVID-19 have been recently reported. We conducted a systematic review to identify case reports and case series characterizing cutaneous manifestations of confirmed COVID-19. Key demographic and clinical data from each case were extracted and analyzed. The primary outcome measure was risk factor analysis of skin related outcomes for severe COVID-19 disease. Seventy-one case reports and series comprising 144 cases of cutaneous involvement in COVID-19 were included. The most frequently occurring morphologies were: morbilliform (30.6%), varicelliform (18.8%), urticarial (13.2%), chilblains-like (12.5%), and acro-ischemic (9%). The median age of patients was 51 years (mean: 45.9, range: 0 to 91). Patients with chilblains-like eruptions had lower frequencies of extracutaneous COVID-19 symptoms (5/18, 27.8%, P<0.05) and were less likely to have severe COVID-19 disease (2/18, 11%, 95% CI 1.4% to 34.7%, P=0.02). Patients with livedoid and acro-ischemic morphologies had severe COVID-19 more frequently than those with other morphologies (17/21, 81%, 95% CI 58.0% to 94.5%, P<0.0001). The most frequently observed cutaneous manifestations of COVID-19 (morbilliform, varicelliform, and urticarial) are well-described patterns of viral exanthems. However, chilblains-like, livedoid, and acro-ischemic morphologies are not traditionally associated with viral infections and were significantly associated with severity of COVID-19 disease.
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December 2020

The relationship of diagnosed acne and weight status in adolescent girls.

J Am Acad Dermatol 2021 Mar 13;84(3):786-788. Epub 2020 May 13.

Department of Dermatology, Kaiser Permanente Oakland Medical Center, Oakland, California. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2020.05.029DOI Listing
March 2021

Anogenital Dermatitis in Men Who Have Sex with Men.

Dermatol Clin 2020 Apr 5;38(2):227-232. Epub 2019 Dec 5.

Department of Dermatology, Kaiser Permanente, 3701 Broadway, Oakland, CA 94611, USA. Electronic address:

Evaluation of anogenital dermatitis requires a detailed history, including a sexual history. Men who have sex with men have different risk of certain infectious causes compared with men who have sex with women. Infectious causes of balanitis and anal dermatitis are easily treatable once identified. Irritant contact dermatitis is a common cause of balanitis, and avoidance of irritants, including decreased soap washing, helps many patients improve. Detailed histories of the personal products used by the patient and partner(s), including soaps, lotions, perfumes, lubricants, condoms, topical medications, hygiene sprays, personal wipes, and laundry detergent, may reveal possible irritants or contact allergens.
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http://dx.doi.org/10.1016/j.det.2019.10.007DOI Listing
April 2020

Comment on "analysis of nail-related content of the basic dermatology curriculum".

Cutis 2019 08;104(2):125-126

Department of Dermatology, Kaiser Permanente Oakland Medical Center, California, USA.

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August 2019

Commentary: To improve melanoma detection, help teach our colleagues.

J Am Acad Dermatol 2015 Dec 21;73(6):966-7. Epub 2015 Oct 21.

Kaiser Permanente Oakland Medical Center, Oakland, California. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2015.09.035DOI Listing
December 2015

Palmoplantar keratoderma with progressive gingivitis and recurrent pyodermas.

Cutis 2014 Apr;93(4):193-8

Department of Dermatology, Kimbrough Ambulatory Care Center, 2480 Llewellyn Ave, Ste 5800, Fort Meade, MD 20755-5129, USA.

Papillon-Lefèvre syndrome (PLS) is a rare inherited palmoplantar keratoderma (PPK) that is associated with progressive gingivitis and recurrent pyodermas. We present a case exhibiting classic features of this autosomal-recessive condition and review the current understanding of its pathophysiology, diagnosis, and treatment. Additionally, a review of pertinent transgredient PPKs is undertaken, with key and distinguishing features of each syndrome highlighted.
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April 2014

Bilateral upper extremity erythematous plaques.

JAMA Dermatol 2014 Jun;150(6):645-6

Department of Dermatology, David Grant Medical Center, Travis Air Force Base, California.

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http://dx.doi.org/10.1001/jamadermatol.2013.8840DOI Listing
June 2014

Clinic teaching made easy: a prospective study of the American Academy of Dermatology core curriculum in primary care learners.

J Am Acad Dermatol 2013 Aug 14;69(2):273-9. Epub 2013 Feb 14.

Uniformed Services University of the Health Sciences, Bethesda, Maryland, and Department of Dermatology, David Grant Medical Center, Travis Air Force Base, California, USA.

Background: Dermatology instruction for primary care learners is limited, and the American Academy of Dermatology (AAD) has developed a new core curriculum for dermatology.

Objective: This study sought to prospectively evaluate short-term knowledge acquisition and long-term knowledge retention after using the AAD core curriculum during a clinical dermatology clerkship.

Methods: Resident physicians and physician assistant students performing clerkships at military dermatology clinics were given access to the AAD core curriculum teaching modules before their public availability. Knowledge acquisition was measured with pretests and posttests, and a follow-up quiz was given up to a year after the dermatology rotation to assess knowledge retention.

Results: In all, 82 primary care learners met inclusion criteria. Knowledge improved significantly from pretest to posttest (60.1 vs 77.4, P < .01). Of the 10 factors evaluated, only high use of the World Wide Web site was significantly associated with improved posttest scores (70.8 vs 82.2, P = .003). Long-term follow-up scores available from 38 participants were only slightly lower than their posttest scores (70.5 vs 78.9, P < .01) at a median time of 6.8 months after the clerkship. Students found the online modules clear, engaging, and worth their time and preferred them to other teaching methods such as textbook reading and lectures.

Limitations: The nonrandomized study was voluntary, so individual performance may be influenced by selection bias.

Conclusion: The more learners used the online curriculum, the better they scored on the posttest. This demonstrates the efficacy of the AAD core curriculum in teaching its goals and objectives for primary care learners performing a dermatology clerkship.
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http://dx.doi.org/10.1016/j.jaad.2012.12.955DOI Listing
August 2013

Serum lidocaine levels and cutaneous side effects after application of 23% lidocaine 7% tetracaine ointment to the face.

Dermatol Surg 2013 Jan 26;39(1 Pt 1):82-91. Epub 2012 Dec 26.

Department of Dermatology, David Grant Medical Center, Travis Air Force Base, Fairfield, California, USA.

Background: Few published studies have analyzed serum lidocaine levels and individual patient characteristics affecting metabolism after application of compounded topical anesthetics.

Objective: To measure serum lidocaine levels during and cutaneous side effects after standardized application of 23% lidocaine/7% tetracaine compounded anesthetic to the face of healthy volunteers.

Methods And Materials: Fifty-two volunteers were enrolled, and compounded 23% lidocaine/7% tetracaine ointment was applied to their faces for 2 hours. Lidocaine levels were determined every 30 minutes during application and for 2 hours after removal. Follow-up telephone calls 3 days later assessed cutaneous side effects.

Results: Median peak lidocaine level was 1.15 μg/mL, and the highest peak lidocaine level in an individual was 3.4 μg/mL. Higher serum lidocaine levels were found in men (p < .01), nonwhite volunteers (p = .02), and those with larger facial surface area (p = .04). Age and body mass index did not affect lidocaine levels. Irritant contact dermatitis was common, resulting in hyperpigmentation in some patients.

Conclusion: Facial surface area, male sex, and nonwhite ethnicity were associated with higher serum lidocaine levels after topical application of lidocaine. Compounded anesthetics containing lidocaine should be used with caution under the direct supervision of a physician.
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http://dx.doi.org/10.1111/dsu.12064DOI Listing
January 2013

White epidermal nevi at birth in a patient with tuberous sclerosis.

Pediatr Dermatol 2014 May-Jun;31(3):360-2. Epub 2012 Oct 9.

San Antonio Uniformed Services Health Education Consortium, Fort Sam Houston, San Antonio, Texas.

We report a neonate who presented at birth with multiple, scattered, white macerated plaques. Punch biopsy confirmed epidermal nevi. At 3 months of age the patient presented with infantile spasms and, after full evaluation, was diagnosed with tuberous sclerosis complex (TSC). We suggest that physicians consider TSC in a neonate with epidermal nevi inconsistent with any described epidermal nevus syndrome.
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http://dx.doi.org/10.1111/pde.12005DOI Listing
December 2014

Erythematous, annular, scaling patches on the skin. Erythema annulare centrifugum.

Am Fam Physician 2011 Feb;83(3):307

David Grant Medical Center, Travis Air Force Base, CA, USA.

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February 2011

Medical Student Core Curriculum in Dermatology Survey.

J Am Acad Dermatol 2009 Jul 1;61(1):30-35.e4. Epub 2009 May 1.

Department of Dermatology, David Grant Medical Center, Fairfield, CA, USA.

Background: Few published articles focus on undergraduate dermatology education.

Objective: To quantify the amount and type of dermatology instruction for medical students and to rank specific diseases by the expectations of learners.

Methods: Electronic surveys were sent via e-mail to 109 dermatology residency programs as well as to 33 medical schools without dermatology programs.

Results: Responses were received from 64% of dermatology residency programs. Half of the responding institutions require 10 or fewer hours of dermatology instruction, and 8% require no dermatology instruction. Seventy-five percent or more of the responding dermatologists expected medical students to learn to diagnose or treat 33 skin diseases after completing a clinical dermatology rotation.

Limitations: Surveys were sent only to academic institutions.

Conclusions: Dermatology educators expect medical students to learn to diagnose or treat common skin diseases, but little time is designated for this in most medical schools. The aggregate opinions of dermatology educators may be used to prioritize future curricula.
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http://dx.doi.org/10.1016/j.jaad.2008.10.066DOI Listing
July 2009

Pathergy response to skin prick testing.

J Allergy Clin Immunol 2007 May 13;119(5):1270-2. Epub 2007 Mar 13.

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http://dx.doi.org/10.1016/j.jaci.2007.01.033DOI Listing
May 2007

Tender papules on the hands. Idiopathic chilblains (perniosis).

Arch Dermatol 2006 Nov;142(11):1501-6

Brooke Army Medical Center, San Antonio, TX, USA.

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http://dx.doi.org/10.1001/archderm.142.11.1501-aDOI Listing
November 2006

Minocycline-induced blue-green discoloration of bone. A case report.

J Bone Joint Surg Am 2004 Jan;86(1):146-8

Department of Orthopaedic Surgery, David Grant Medical Center, Travis Air Force Base, Fairfield, CA 94535, USA.

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http://dx.doi.org/10.2106/00004623-200401000-00023DOI Listing
January 2004

Palmar petechiae in dermatitis herpetiformis: a case report and clinical review.

Cutis 2002 Oct;70(4):217-23

David Grant Medical Center, Fairfield, California, USA.

Palmar petechiae or purpura is an unusual finding in dermatitis herpetiformis (DH) that occurs in children but is only rarely reported in adults. We describe a 46-year-old man with DH who presented with the classic pruritic papulovesicular eruption and associated volar finger and palmar petechiae. We discuss recent advances in the pathogenesis and treatment of DH.
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October 2002