Teledermatology is an emerging field withindermatology that has allowed for increased access to care through web portals such as MyChart. MyChart is a password-protected website that offers patients 24-hour access to personal health information and permits patients to send messages and photographs pertaining to their medical concerns.
MMS is a microscopically controlled surgery used to treat skin cancers such as Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC), and Melanoma.
Mohs surgeons have increasingly utilized such portals post-operatively to keep track of patient progress2, but there has been sparse research that analyzes the characteristics of patient-initiated electronic and telephone communication after MMS. This study identifies the attributes and factors that contribute to patient-initiated contact after MMS.
Determine which elements of a lactating patient’s clinical presentation, including breast pump use and symptoms, are associated with a diagnosis of nipple thrush.
The histopathology of sebaceous carcinoma (SBC) can mimic other skin neoplasms, including basal cell carcinoma (BCC).Therefore, diagnostic biomarkers are needed for a subset of cases. Normal sebaceous glands express PRAME (PRAME nuclearreceptor transcriptional regulator), a melanoma-associated biomarker.Donell et al. showed that PRAME has strong immunoreactivity with basaloid sebocytes in SBC. Ng et al. reported patchy cytoplasmic staining in the germinative sebocytes only.Sebaceous glands (H&E stain and PRAME stain)
Objective: to evaluate the utility of PRAME immunohistochemistry as a diagnostic biomarker for SBC and its usefulness in the distinction of SBC from BCC.
Localized myxedema is a rare complication ofautoimmune thyroid diseases including the Hashimoto thyroiditis and Graves’ disease.Localized myxedema results from the accumulation of glycosaminoglycans in the dermis and subcutaneous layer of the skin.
Fibroblast-produced hyaluronic acid is the mainglycosaminoglycan in localized myxedema. Localized myxedema presents bilaterally with a “boggy” thickening of the skin. Lesions classically have “waxy” swelling and induration.Myxedematous lesions of the skin most often appear on the anterior aspects of the legs and dorsum of the feet. They are often asymptomatic. Targeted treatment to cutaneous lesions is usually reserved for symptomatic cases.
Atypical fibroxanthoma (AFX) is a rare pleomorphic, spindle cell neoplasm that typically presents as a solitary pink/red papule on the head or neck in elderlyindividuals.
Although they rarely metastasize, it is not uncommon for these tumors to locally recur, highlighting the importance of complete removal with negative surgical margins.
Current treatment guidelines recommend Mohs micrographic surgery (MMS) or wide local excision (WLE), yet MMS is generally preferred in clinical practice based on the limited data supporting superior recurrence rates.
However, there are very few studies that have compared these two surgical modalities, and some did not find meaningful differences in the rates of recurrence.
One percent to 3% of adults worldwide are impacted by psoriasis. 2% of US adults are impacted by atopic dermatitis. Psoriasis and atopic dermatitis are chronic illnesses with compounding costs of treatment. Biologics are desirable treatments for moderate to severe psoriasis and atopic dermatitis. Purpose: Provide a cost benefit analysis of all biologics compared to narrow band ultraviolet B(NVUVB) light therapy for the management of atopic dermatitis and psoriasis.
Neurofibromatosis type 1 (NF1) is an inherited tumor syndrome caused by heterozygous germline mutations in the NF1 gene, occurring in approximately 1/2600 individuals. A subset of patients with neurofibromatosis type 1 (NF1) develop juvenile xanthogranulomas (JXGs), a non-Langerhans cell histiocytosis, and some of these patients also develop juvenile myelomonocytic leukemia (JMML).Yet, these associations are poorly delineated.JXG is a benign proliferation of non-Langerhans cells histiocytes characterized by small yellow/brown papulonodules ranging from 1-20 mm in size. JMML is a mixed myeloproliferative-myelodysplastic disorder that affects children, most often before age 6.4. The first and only systematic review on this described therisk of developing JMML 20 to 30 times higher in patients with NF1 with JXG lesions compared to those without JXG. Since then, mostly isolated case reports have either refuted or confirmed this triple association.
Early diagnosis of melanoma is crucial to improved patient survival. Some melanomas can be difficult to diagnose from histopathology alone, and inter-observer disagreement among dermatopathologists in 15-35% of cases1 can delay diagnosis. PRAME (PReferentially expressed Antigen in MElanoma) is a tumorassociated antigen found to be overexpressed in human melanomas, making it a helpful tool in differentiating between benign vs. malignant melanocytic lesions. PRAME immunohistochemistry (IHC) has been used increasingly in dermatopathology practice, but there is currently no single biomarker or IHC stain that is diagnostic when used alone. S100A8 is a calcium-binding protein found to be highly expressed in certain inflammatory conditions and human cancers2,3. It was recently found by Kiuru et al. to be expressed by the keratinocyte microenvironment of melanomas but not that of melanocytic nevi4 , suggesting its role as a melanoma biomarker. The diagnostic utility of S100A8 IHC when compared to other commonly used melanoma biomarkers, including PRAME, has not yet been assessed. The objective of this study was to compare S100A8 immunohistochemistry with PRAME immunohistochemistry in benign and malignant melanocytic tumors to determine the diagnostic utility of S100A8.
