Publications by authors named "Sylvia Hsu"

227 Publications

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

Baseline Demographics and Severity and Burden of Atopic Dermatitis in Adult Patients Initiating Dupilumab Treatment in a Real-World Registry (PROSE).

Dermatol Ther (Heidelb) 2022 Jun 20;12(6):1417-1430. Epub 2022 May 20.

Regeneron Pharmaceuticals, Inc, 777 Old Saw Mill River Road, Tarrytown, NY, 10591, USA.

Introduction: Dupilumab was initially approved in 2017 as the first biologic therapy for atopic dermatitis (AD). We characterized adults with AD initiating dupilumab in a real-world setting in the USA/Canada.

Methods: PROSE is an ongoing, longitudinal, prospective, observational, multicenter registry of patients with AD initiating dupilumab per country-specific prescribing information. We report baseline data (day of first dupilumab injection) for patients enrolled from April 2018 through July 2019.

Results: Among 315 patients (mean age 42.5 years, 55.2% female), the median AD duration was 17.0 years; 65.4% reported a history of type 2 inflammatory comorbidities (e.g., allergic rhinitis, asthma), and 93.3% reported treatment(s) for AD in the previous year, including topical corticosteroids (90.8%), systemic corticosteroids (36.2%), and nonsteroidal systemic therapies (14.0%). In total, 89.2% had an Overall Disease Severity score of 3 (moderate) or 4 (severe). Other mean disease severity scores included the following: Eczema Area and Severity Index 16.9 (range 0-72), body surface area affected 26.8%, Patient-Oriented Eczema Measure 18.5 (range 0-28), Dermatology Life Quality Index 12.7 (range 0-30), and pruritus Numerical Rating Scale score 6.9 (range 0-10).

Conclusion: Patients initiating dupilumab have longstanding moderate-to-severe AD with significant disease burden and frequent type 2 comorbidities.

Clinicaltrials:

Gov Identifier: NCT03428646.
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http://dx.doi.org/10.1007/s13555-022-00742-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9209562PMC
June 2022

Keratosis Pilaris in an Ovarian Cancer Patient Treated with Bevacizumab and Doxorubicin.

Skinmed 2022 30;20(2):139-140. Epub 2022 Apr 30.

Department of Dermatology, Temple University Lewis Katz School of Medicine, Philadelphia, PA.

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May 2022

Erythropoietic Protoporphyria: You May Not Have Seen It, but It May Have Seen You.

Cureus 2022 Mar 17;14(3):e23253. Epub 2022 Mar 17.

Dermatology, Temple University Hospital, Philadelphia, USA.

Erythropoietic protoporphyria is a rare skin condition that commonly presents in childhood. We report a case of a 35-year-old Hispanic male with a history of sun sensitivity, presenting with complaints of immediate burning and itching of the skin on his face and upper extremities upon sun exposure. On examination, there was minimal face erythema and calluses over the knuckles. Laboratory workup demonstrated substantially increased protoporphyrin (over 10 times the upper limit of normal) along with elevated liver enzyme levels. Liver biopsy confirmed stage 4 cirrhosis. Our patient's cutaneous manifestations were the primary complaint that led to the diagnosis of his terminal hepatic illness. We recommend screening for erythropoietic protoporphyria in patients who present with a life-long history of non-blistering, burning and itching of the skin, which begins immediately upon sun exposure.
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http://dx.doi.org/10.7759/cureus.23253DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9012550PMC
March 2022

Considering a Biologic: What's a Clinician to Do? Screening and Laboratory Monitoring for Biologic Therapies in the Treatment of Psoriasis.

Skinmed 2022 28;20(1):14-17. Epub 2022 Feb 28.

Department of Dermatology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA.

Biologic therapies have revolutionized the treatment of psoriasis; however, these immunomodulatory therapies may increase the risk of reactivation of latent and chronic infections. Tumor necrosis factor alpha (TNF-α) inhibitors, in particular, have been associated with the increased risk of reactivation of tuberculosis (TB) in patients with latent TB, as well as hepatitis B virus (HBV), in patients with chronic HBV infections. Currently, baseline TB tests are the only screening tests supported with strong evidence. High-grade evidence for HBV screening tests is lacking; however, these tests are sometimes performed in clinical practice. We describe current recommendations for screening tests prior to the initiation of biologic therapy.
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http://dx.doi.org/DOI Listing
April 2022

When Bullous Pemphigoid Is Not Bullous Pemphigoid: The Importance of Going Beyond Direct Immunofluorescence.

Cureus 2022 Feb 14;14(2):e22201. Epub 2022 Feb 14.

Dermatology, Temple University Hospital, Philadelphia, USA.

Bullous pemphigoid (BP) is the most common autoimmune bullous disease, but rarer forms of pemphigoid may appear identical to BP on routine histopathology and direct immunofluorescence (DIF). Here, we present the case of a 60-year-old man, who was initially thought to have BP, with supportive findings on routine histopathology and DIF. However, prominent oral involvement and cutaneous lesions refractory to conventional treatment suggested an alternate diagnosis. Further workup was performed, including indirect immunofluorescence (IIF) on salt-split skin, which showed binding of antibodies to the dermal floor rather than to the blister roof, and enzyme-linked immunosorbent assay for pemphigus and pemphigoid antibodies. With these additional tests, we concluded that the patient does not have BP but rather anti-p200 pemphigoid, anti-p105 pemphigoid, or a yet undiscovered form of pemphigoid. We reached a presumptive diagnosis of anti-p200 pemphigoid, as it is the most common pemphigoid with serum antibodies to the dermal floor of human salt-split skin by IIF. This case demonstrates that suspicion for other autoimmune bullous diseases in cases of treatment-refractory and clinically aberrant BP is essential. A limited workup may lead to a missed diagnosis and ultimately less efficient disease management.
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http://dx.doi.org/10.7759/cureus.22201DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8925621PMC
February 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

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

Annular bullous diseases.

Clin Dermatol 2022 Jan 1. Epub 2022 Jan 1.

Department of Dermatology, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA.

Annular bullous dermatoses represent an etiologically diverse group of cutaneous phenomena that present with a figurate morphology in association with vesicles and bullae. This group of diverse conditions consists of bullous pemphigoid; pemphigoid gestationis; epidermolysis bullosa simplex, Dowling-Meara type; linear immunoglobulin A bullous dermatosis; chronic bullous disease of childhood; anti-p200 pemphigoid; subcorneal pustular dermatosis; and immunoglobulin A pemphigus. Astute examination of clinical, histopathologic, and serologic features is crucial in distinguishing these bullous dermatoses. We review the clinical presentation, pathophysiology, histopathology, and treatments for each bullous annular disease to aid physicians in their recognition, diagnosis, and management.
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http://dx.doi.org/10.1016/j.clindermatol.2021.12.012DOI Listing
January 2022

Biopsy Is Not Recommended for Volar Psoriasis.

Skinmed 2021;19(5):378-379. Epub 2021 Oct 1.

Department of Dermatology, Temple University Lewis Katz School of Medicine, Philadelphia, PA.

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http://dx.doi.org/DOI Listing
February 2022

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

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

Pustular Psoriasis: A Narrative Review of Recent Developments in Pathophysiology and Therapeutic Options.

Dermatol Ther (Heidelb) 2021 Dec 9;11(6):1917-1929. Epub 2021 Oct 9.

Department of Dermatology, Temple University School of Medicine, Philadelphia, PA, USA.

Pustular psoriasis is an unusual form of psoriasis that frequently presents clinical challenges for dermatologists. The condition presents with pustules on an erythematous background and has two distinct subtypes: localized disease on the palms and soles, called palmoplantar pustulosis (PPP), and generalized pustular psoriasis (GPP). The involvement of the fingers, toes, and nails is defined as a separate localized variant, acrodermatitis continua of Hallopeau, and is now thought to be a subset of PPP. The rarity of pustular psoriasis frequently makes the correct diagnosis problematic. In addition, treatment is limited by a relative lack of evidence-based therapeutic options. Current management is often based on existing therapies for standard plaque psoriasis. However, there remains a need for treatments with high, sustained efficacy and a rapid onset of action in pustular psoriasis. Recent advances in understanding of the pathogenesis of pustular psoriasis have provided insights into potential therapies. Treatment of pustular psoriasis is generally determined by the extent and severity of disease, and recent years have seen an increasing use of newer agents, including biologic therapies. Current classes of biologic therapies with US Food and Drug Administration and European Medicines Agency approval for treatment of moderate-to-severe plaque psoriasis in the USA (and elsewhere) include tumor necrosis factor alpha inhibitors (adalimumab, certolizumab pegol, etanercept, infliximab), interleukin (IL)-17 inhibitors (brodalumab, ixekizumab, secukinumab), an IL-12/23 inhibitor (ustekinumab), and IL-23 inhibitors (guselkumab, risankizumab, tildrakizumab). Recently, specific inhibitors of the IL-36 pathway have been evaluated in GPP and PPP, including spesolimab, an IL-36 receptor inhibitor which has shown promising results in GPP. The emerging drugs for pustular psoriasis offer the possibility of rapid and effective treatment with lower toxicities than existing therapies. Further research into agents acting on the IL-36 pathway and other targeted therapies has the potential to transform the future treatment of patients with pustular psoriasis. This article reviews the clinical features of PPP and GPP, and current understanding of the genetics and immunopathology of these conditions; it also provides an update on emerging treatments.
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http://dx.doi.org/10.1007/s13555-021-00612-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8611132PMC
December 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

Differentiating Pemphigus Foliaceus From Pemphigus Vulgaris in Clinical Practice.

Cureus 2021 Sep 11;13(9):e17889. Epub 2021 Sep 11.

Department of Dermatology, Temple University Hospital, Philadelphia, USA.

Pemphigus is a skin condition that causes intraepidermal separation of keratinocytes. Multiple types of pemphigus exist, including pemphigus vulgaris and pemphigus foliaceus. These can be differentiated by histopathology, clinical presentation, appearance of lesions, and antibodies, among other factors. It is important to distinguish between the two because of differences in management and prognosis. Here we present a case of pemphigus foliaceus, as well as a discussion of the key differences between pemphigus foliaceus and vulgaris.
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http://dx.doi.org/10.7759/cureus.17889DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8437008PMC
September 2021

Severe acute generalized exanthematous pustulosis with toxic epidermal necrolysis-like desquamation: A case series of 8 patients.

JAAD Case Rep 2021 Sep 27;15:115-122. Epub 2021 Jul 27.

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

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http://dx.doi.org/10.1016/j.jdcr.2021.07.018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8385397PMC
September 2021

Sulfonamide Contraindication in Rocky Mountain Spotted Fever.

Skinmed 2021;19(3):223-224. Epub 2021 Jun 1.

Department of Dermatology, Temple University Lewis Katz School of Medicine, Philadelphia, PA.

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http://dx.doi.org/DOI Listing
February 2022

Relative risks of COVID-19 fatality between the first and second waves of the pandemic in Ontario, Canada.

Int J Infect Dis 2021 Aug 1;109:189-191. Epub 2021 Jul 1.

Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Cancer Center and Yale University School of Medicine, New Haven, Connecticut, USA; Department of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, Connecticut, USA. Electronic address:

Objectives: To examine whether the case fatality rate (CFR) of COVID-19 decreased over time and whether the COVID-19 testing rate is a driving factor for the changes if the CFR decreased.

Methods: Analyzing COVID-19 cases, deaths and tests in Ontario, Canada, we compared the CFR between the first wave and the second wave across 26 public health units in Ontario. We also explored whether a high testing rate was associated with a large CFR decrease.

Results: The first wave CFR ranged from 0.004 to 0.146, whereas the second wave CFR ranged from 0.003 to 0.034. The pooled RR estimate of second wave COVID-19 case fatality, compared with first wave, was 0.24 (95% CI: 0.19-0.32). Additionally, COVID-19 testing percentages were not associated with the estimated relative risk (P=0.246).

Conclusions: The COVID-19 CFR decreased significantly in Ontario during the second wave, and COVID-19 testing was not a driving factor for this decrease.
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http://dx.doi.org/10.1016/j.ijid.2021.06.059DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8245301PMC
August 2021

Verrucous Sarcoidosis: A Rare Clinical Presentation of Sarcoidosis.

Cureus 2021 May 22;13(5):e15175. Epub 2021 May 22.

Department of Dermatology, Temple University, Lewis Katz School of Medicine, Philadelphia, USA.

Verrucous sarcoidosis is a rare cutaneous variant of sarcoidosis, an inflammatory disease characterized by non-caseating granulomas that primarily involves the lungs. The current literature on verrucous sarcoidosis is limited, with the majority of lesions presenting on the lower extremities of African American males. Here, we present two cases that highlight the unique manifestations of this uncommon cutaneous entity. The first case involves a middle-aged Hispanic woman with lesions on her arms and face, and the second case involves a middle-aged African American woman with sole facial involvement. A multi-disciplinary approach to diagnosis and treatment is required as verrucous sarcoidosis can present with clinical and histopathological features indistinguishable from infectious etiologies and has an association with pulmonary sarcoidosis. Adalimumab has demonstrated success in the treatment of verrucous sarcoidosis.
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http://dx.doi.org/10.7759/cureus.15175DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8216646PMC
May 2021

Rutoside and Ascorbic Acid in the Treatment of Schamberg Pigmented Purpuric Dermatosis.

Cureus 2021 Apr 20;13(4):e14592. Epub 2021 Apr 20.

Dermatology, Temple University Lewis Katz School of Medicine, Philadelphia, USA.

Schamberg disease is a type of pigmented purpuric dermatosis (PPD), which is a benign cutaneous capillaritis characterized by macules and patches most commonly found on the lower extremities. Rutoside and ascorbic acid have been shown in previous cases to be efficacious in the treatment of PPD lesions due to their free radical scavenging effect on capillaries. We present the case of a 19-year-old woman with Schamberg disease who achieved complete clearance of lesions within four months of daily rutoside and ascorbic acid treatment. The goal of this case report is to further demonstrate the effectiveness of this treatment and to call for investigation of its use as a standard of care in PPD.
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http://dx.doi.org/10.7759/cureus.14592DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8136452PMC
April 2021

Paraneoplastic pemphigus: Revised diagnostic criteria based on literature analysis.

J Cutan Pathol 2021 Sep 17;48(9):1133-1138. Epub 2021 Apr 17.

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

Background: Paraneoplastic pemphigus (PNP) is a rare autoimmune bullous disease classically associated with an underlying neoplasm. The heterogeneous clinical and histopathologic features of the disease make diagnosis challenging for clinicians. There are no formally accepted diagnostic criteria, and newer techniques for identifying antibodies directed against plakin proteins have largely replaced immunoprecipitation, the historic gold standard.

Methods: An analysis of 265 published cases of PNP was performed. The clinical, histopathologic, and immunologic features of PNP were assessed.

Results: Based on this review, we modified previous diagnostic criteria to capture 89.4% of PNP cases compared to 71.2% of cases captured by the most commonly referenced criteria devised by Camisa and Helm (p-value < 0.01, z-test; 95% CI [10.2, 33.6]).

Conclusion: These revised diagnostic criteria address the variable clinical, histopathologic, and biochemical features of PNP, allowing physicians to have greater confidence in diagnosis of this rare and often fatal disease. The revised criteria include three major criteria and two minor criteria, whereby meeting either all three major criteria or two major and both minor criteria would fulfill a diagnosis of paraneoplastic pemphigus. The major criteria include (a) mucous membrane lesions with or without cutaneous involvement, (b) concomitant internal neoplasm, and (b) serologic evidence of anti-plakin antibodies. The minor criteria include (a) acantholysis and/or lichenoid interface dermatitis on histopathology and (b) direct immunofluorescence staining showing intercellular and/or basement membrane staining.
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http://dx.doi.org/10.1111/cup.14004DOI Listing
September 2021

Considering a Biologic: What's a Clinician to Do? Management of Biologics in Surgery, Vaccinations, and Cancer.

Skinmed 2021 1;19(1):17-19. Epub 2021 Feb 1.

In the past two decades, biologic therapy has become ubiquitous in the treatment of psoriasis; however, important considerations should be taken with regard to biologic use in the context of surgery, vaccinations, and cancers. With conflicting evidence on the effects of perioperative biologic use, we recommend withholding tumor necrosis factor alpha (TNF-α) inhibitor therapy for one dose prior to surgical procedures. Although no studies have shown a direct link between live vaccines and infection in patients receiving biologics, due to the theoretical risk of live vaccines producing infection in patients with altered immune responses, we recommend withholding biologic therapy for 4 to 5 half-lives prior to the administration of live or live-attenuated vaccines. Finally, although an increased rate of cancer recurrence has not been demonstrated with biologic use, experts recommend withholding biologic therapy for 2 years after the completion of treatment for invasive cancers and 5 years after the completion of treatment for aggressive malignancies (including melanomas, breast cancers, sarcomas, urinary tract cancers, and myelomas); however, exceptions should be considered depending on the patient's circumstances and severity of the psoriasis. (. 2021;19:17-0).
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October 2021

Indeterminate Cell Histiocytosis Mimicking Rosacea.

Cureus 2021 Jan 22;13(1):e12850. Epub 2021 Jan 22.

Dermatology, Temple University Lewis Katz School of Medicine, Philadelphia, USA.

Indeterminate cell histiocytosis (ICH) is a rare proliferative disorder of histiocytes, which display morphologic and immunophenotypic characteristics of both Langerhans cell histiocytosis (LCH) and non-Langerhans cell histiocytosis (NLCH). We describe an unusual clinical presentation of ICH mimicking rosacea and provide a relevant review of the literature.
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http://dx.doi.org/10.7759/cureus.12850DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7897367PMC
January 2021

Painful Abdominal Outpouching in an Adult Male.

Cureus 2021 Jan 1;13(1):e12416. Epub 2021 Jan 1.

Dermatology, Temple University Hospital, Philadelphia, USA.

Post-herpetic abdominal pseudohernia is a neurologic complication of herpes zoster resulting from paresis of the abdominal wall muscles ipsilateral to the eruption. This poorly known condition may raise suspicion for true abdominal wall hernia or other concerning etiologies, resulting in extensive work-up and imaging. Post-herpetic abdominal pseudohernia is a relatively benign condition, which resolves spontaneously in the majority of cases. Therefore, it is important for the clinician to be aware of this complication in order to avoid unnecessary imaging or excessive management, which may increase the cost of care and burden to the patient.
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http://dx.doi.org/10.7759/cureus.12416DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7847781PMC
January 2021

Painful Abdominal Outpouching in an Adult Male.

Cureus 2021 Jan 1;13(1):e12416. Epub 2021 Jan 1.

Dermatology, Temple University Hospital, Philadelphia, USA.

Post-herpetic abdominal pseudohernia is a neurologic complication of herpes zoster resulting from paresis of the abdominal wall muscles ipsilateral to the eruption. This poorly known condition may raise suspicion for true abdominal wall hernia or other concerning etiologies, resulting in extensive work-up and imaging. Post-herpetic abdominal pseudohernia is a relatively benign condition, which resolves spontaneously in the majority of cases. Therefore, it is important for the clinician to be aware of this complication in order to avoid unnecessary imaging or excessive management, which may increase the cost of care and burden to the patient.
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http://dx.doi.org/10.7759/cureus.12416DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7847781PMC
January 2021

Diagnosis of Transient Neonatal Pustular Melanosis.

Skinmed 2020 1;18(6):372. Epub 2020 Dec 1.

Department of Dermatology, Temple University, Philadelphia, PA.

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October 2021

Central Centrifugal Cicatricial Alopecia and Lichen Planopilaris Can Look Identical on Histopathology.

Skinmed 2020 1;18(6):365-366. Epub 2020 Dec 1.

Department of Dermatology, Temple University Lewis Katz School of Medicine, Philadelphia, PA.

Central centrifugal cicatricial alopecia (CCCA) and lichen planopilaris (LPP) can look identical on histopathology. Both entities demonstrate perifollicular fibrosis, peri- infundibular lymphocytic infiltrates, and reduced follicular density. Presence of normal follicular units and preservation of sebaceous glands favor CCCA. An elastin stain, that is, Verhoeff-Van Gieson stain, can differentiate the tree trunk fibrosis of CCCA from the narrow wedge-shaped fibrosis of LPP. Look for important clues such as patient race and pattern of alopecia for diagnosis and treatment instead of relying solely on the pathology report.
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http://dx.doi.org/DOI Listing
September 2021
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