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Open Access Publications from the University of California

Scholarly Works (10 results)

  • Article
  • Peer Reviewed
Dermatology Online Journal, Volume 23, Issue 6 (2017)

Background

Pemphigus foliaceus (PF) is a blistering disorder most commonly presenting in middle age. As PF is restricted to the superficial epidermis, it is considered more benign than other pemphigus diseases. However, progression to severe disease is not uncommon. Although rituximab’s efficacy has been well-documented in adults with refractory PF, little data is available on its role in adolescents.

Purpose

We describe a patient with juvenile PF treated with rituximab and review the literature for similar cases.

Methods

PubMed was searched for the terms: antibody, B cells, blistering, CD20, foliaceus, juvenile, pemphigus, rituximab, immunosuppression. As the first reported case of rituximab treated pemphigus was in 2001, only cases from 2001 and after were included. Juvenile PF was defined as disease diagnosis between ages 12-17.

Results

Five cases have been reported. The indication for rituximab in most cases was refractory PF unresponsive to systemic glucocorticoids and non-steroidal adjuvant therapies. All cases demonstrated significant improvement or complete remission and most experienced no adverse events.

Conclusions

Rituximab appears to be both well tolerated and efficacious for refractory juvenile PF. Therefore, it may be considered for severe cases of PF to avoid side effects associated with conventional glucocorticoid therapy.

    Cover page: Rituximab in the management of juvenile pemphigus foliaceusCreative Commons 'BY-NC-ND' version 4.0 license
    • Article
    • Peer Reviewed
    Dermatology Online Journal, Volume 15, Issue 10 (2009)
      • Article
      • Peer Reviewed
      Dermatology Online Journal, Volume 22, Issue 5 (2016)
      Penicillamine-induced skin changes are rare and include: hypersensitivity reactions, autoimmune reactions, and cutaneous elastoses. We report a case of a 73-year-old man with cystinuria taking penicillamine for over 50 years who presented with penicillamine-induced cutis laxa and milia en plaque. A brief review of penicillamine induced skin changes, specifically cutis laxa and milia en plaque, is presented.
        Cover page: Penicillamine-associated cutis laxa and milia en plaque - case report and review of cutaneous changes associated with penicillamineCreative Commons 'BY-NC-ND' version 4.0 license
        • Article
        Dermatology Online Journal, Volume 23, Issue 12 (2017)
        Pursuing research is encouraged in dermatology residency programs. Some programs offer specific research or investigative tracks. Currently, there is little data on the structure or scope of research tracks in dermatology residency programs. An anonymous online survey was distributed to the Association of Professors of Dermatology listserve in 2016. Program directors of dermatology residency programs in the United States were asked to participate and 38 of the 95 program directors responded. The survey results confirmed that a 2+2 research track, which is two years of clinical training followed by two years of research, was the most common investigator trackmodel and may promote an academic career at the resident’s home institution. Further studies will help determine the most effective research track models to promote long-term outcomes.
          Cover page: Characteristics of research tracks in dermatology residency programs: a national surveyCreative Commons 'BY-NC-ND' version 4.0 license
          • Article
          • Peer Reviewed
          Dermatology Online Journal, Volume 18, Issue 5 (2012)
            • Article
            • Peer Reviewed
            Dermatology Online Journal, Volume 23, Issue 5 (2017)
            Purpose: As established by the AccreditationCouncil for Graduate Medical Education (ACGME),dermatology residents in the United States mustparticipate in continuity clinic. This requirementmay be achieved through multiple means, allowingfor program variation. To better assess continuityclinic’s role in resident learning, more data onthis component of graduate medical education isneeded. Methods: An anonymous online survey wasdistributed via the American Board of Dermatologylistserv to all U.S. dermatology residents. Continuityclinic organization, setting, frequency, and patientand preceptor characteristics were assessed; residentsatisfaction and learning were compared. Results:Of 231 responses, 7.8% reported continuity clinicdaily, 77.1% weekly, 9.1% every other week, 3.0%monthly, 0.4% once every several months, and 2.2%only during certain blocks. Of the clinics reported,80.1% were “resident-run with attending” and 11.3%were attending-run. The rest were “resident-run withno attending” (0.9%), both resident and attendingrun(3.0%), or “other” (4.8%). Trainees in resident-runclinics (with attendings) reported greater continuityof care than those in attending-run clinics (p<0.001).Residents reported better teaching with attendingpresence during patient encounters than whenattendings were present only if concerns were raised(p<0.01).
              Cover page: Continuity of care in dermatology residency programs in the United StatesCreative Commons 'BY-NC-ND' version 4.0 license
              • Article
              • Peer Reviewed
              Dermatology Online Journal, Volume 25, Issue 2 (2019)
              Non-uremic calciphylaxis is a rare, life-threatening condition characterized clinically by cutaneous necrosis and histologically by calcium deposition in small vessel walls. The etiology of non-uremic calciphylaxis remains the subject of ongoing speculation and debate. Herein we present a patient with calciphylaxis who had normal kidney function and numerous rheumatologic diseases, namely systemic lupus erythematosus (SLE), Sjogren syndrome (SS), and myasthenia gravis (MG). We review the pathophysiology, possible mechanisms, and management for non-uremic calciphylaxis.
                Cover page: Non-uremic calciphylaxis in a patient with multiple rheumatologic diseasesCreative Commons 'BY-NC-ND' version 4.0 license
                • Article
                • Peer Reviewed
                Dermatology Online Journal, Volume 28, Issue 6 (2022)
                Wolf isotopic response represents the development of skin lesions of one particular morphology occurring at the same site as another morphologically distinct and unrelated skin lesion. Cutaneous lupus erythematosus (CLE) is an autoimmune connective tissue disorder encompassing a wide range of phenotypes that may be associated with systemic involvement. Although CLE is a well-described entity with a broad spectrum, the occurrence of lesions manifesting as an isotopic response is rare. We present a patient with systemic lupus erythematosus who developed CLE in a dermatomal distribution following herpes zoster. When CLE lesions present in a dermatomal distribution, these cases may be difficult to distinguish from recurrent herpes zoster infection in an immunosuppressed patient. Therefore, they pose a diagnostic challenge and require balancing antiviral therapy with immunosuppression to sufficiently maintain adequate control of the autoimmune disease while addressing possible infections. To avoid treatment delay, clinicians should have elevated suspicion for an isotopic response when disparate lesions erupt in areas previously affected by herpes zoster or in cases of persistent eruptions at sites of prior herpes zoster. We discuss this case within the context of Wolf isotopic response and review the literature for similar cases.
                  Cover page: A crack in the armor: Wolf isotopic response manifesting as cutaneous lupusCreative Commons 'BY-NC-ND' version 4.0 license
                  • Article
                  • Peer Reviewed
                  Dermatology Online Journal, Volume 18, Issue 6 (2012)
                    • Article
                    • Peer Reviewed
                    UC San Diego Previously Published Works (2018)
                    Although eosinophilic fasciitis is known to be part of the deep morphea spectrum, this first report of the coexistence of granulomatous fasciitis and morphea profunda suggests that granulomatous fasciitis may also be a part of the spectrum of deep morphea.
                      Cover page: Granulomatous fasciitis followed by morphea profunda: Is granulomatous fasciitis part of a spectrum of deep morphea? A case report and review of the literature
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