47 results on '"Liebman TN"'
Search Results
2. The significance of crystalline/chrysalis structures in the diagnosis of melanocytic and nonmelanocytic lesions.
- Author
-
Balagula Y, Braun RP, Rabinovitz HS, Dusza SW, Scope A, Liebman TN, Mordente I, Siamas K, and Marghoob AA
- Published
- 2012
3. Evaluating the support of pigmented lesion expert dermatologists for the use of skin self-examinations.
- Author
-
Ingrassia JP, Swearingen A, Levine A, Liebman TN, Stein JA, Polsky D, and Adotama P
- Subjects
- Humans, Female, Male, Adult, Middle Aged, Skin pathology, Melanoma diagnosis, Melanoma pathology, Dermatologists statistics & numerical data, Self-Examination methods, Skin Neoplasms diagnosis, Skin Neoplasms pathology
- Published
- 2024
- Full Text
- View/download PDF
4. Subclinical persistence of residual acral melanoma in situ after treatment with topical imiquimod and retinoid creams.
- Author
-
Ingrassia JP, Greenwald E, Meehan S, Stein JA, and Liebman TN
- Abstract
Competing Interests: Dr Liebman and Dr Stein have diagnosed patients for MoleSafe, USA, for which she has received payments from the NYU Langone Department of Dermatology. Author Ingrassia, Dr Greenwald, and Dr Meehan have no conflicts of interest to declare.
- Published
- 2024
- Full Text
- View/download PDF
5. Diagnosis and Management of Acral Pigmented Lesions.
- Author
-
Ingrassia JP, Stein JA, Levine A, and Liebman TN
- Subjects
- Humans, Dermoscopy, Melanoma, Cutaneous Malignant, Melanoma diagnosis, Melanoma therapy, Melanoma pathology, Skin Neoplasms diagnosis, Skin Neoplasms therapy, Skin Neoplasms epidemiology, Nevus, Pigmented diagnosis, Nevus, Pigmented therapy
- Abstract
Background: Survival outcomes in acral lentiginous melanoma (ALM) are worse than for cutaneous melanoma. Diagnostic delays are believed to contribute to worse outcomes in ALM, including advanced-stage disease at initial presentation. Acral lentiginous melanoma, especially in its early stages, may be difficult to discern from benign pigmented acral lesions., Objective: The purpose of this article is to provide a comprehensive review of the diagnosis and management of acral pigmented lesions., Materials and Methods: A literature review was performed. The outcomes included were the clinical and dermoscopic features and the management frameworks and considerations for acquired and congenital melanocytic nevi, acral melanosis, nonmelanocytic pigmented lesions, and ALM., Results: Original research studies were primarily included. The use of dermoscopy, such as the 3-step algorithm and blotch (irregular), ridge pattern (parallel), asymmetry of structures, asymmetry of colors, furrow pattern (parallel), fibrillar pattern (BRAAFF) checklist, increases the diagnostic accuracy of acral pigmented lesions with high specificity and sensitivity. Short-term digital dermoscopic surveillance can be used to manage acral lesions, and histopathology should be collected when there is a concern for ALM., Conclusion: The use of dermoscopy and an understanding of how to manage acral lesions may limit the number of biopsies performed on the acral skin, decrease the time to diagnosis, and facilitate early detection of ALM., (Copyright © 2023 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF
6. Early Detection and Prognostic Assessment of Cutaneous Melanoma: Consensus on Optimal Practice and the Role of Gene Expression Profile Testing.
- Author
-
Kashani-Sabet M, Leachman SA, Stein JA, Arbiser JL, Berry EG, Celebi JT, Curiel-Lewandrowski C, Ferris LK, Grant-Kels JM, Grossman D, Kulkarni RP, Marchetti MA, Nelson KC, Polsky D, Seiverling EV, Swetter SM, Tsao H, Verdieck-Devlaeminck A, Wei ML, Bar A, Bartlett EK, Bolognia JL, Bowles TL, Cha KB, Chu EY, Hartman RI, Hawryluk EB, Jampel RM, Karapetyan L, Kheterpal M, Lawson DH, Leming PD, Liebman TN, Ming ME, Sahni D, Savory SA, Shaikh SS, Sober AJ, Sondak VK, Spaccarelli N, Usatine RP, Venna S, and Kirkwood JM
- Subjects
- Humans, Prognosis, Transcriptome, Public Health, Risk Assessment, Melanoma, Cutaneous Malignant, Skin Neoplasms diagnosis, Skin Neoplasms genetics, Skin Neoplasms pathology, Melanoma diagnosis, Melanoma genetics, Melanoma pathology
- Abstract
Importance: Therapy for advanced melanoma has transformed during the past decade, but early detection and prognostic assessment of cutaneous melanoma (CM) remain paramount goals. Best practices for screening and use of pigmented lesion evaluation tools and gene expression profile (GEP) testing in CM remain to be defined., Objective: To provide consensus recommendations on optimal screening practices and prebiopsy diagnostic, postbiopsy diagnostic, and prognostic assessment of CM., Evidence Review: Case scenarios were interrogated using a modified Delphi consensus method. Melanoma panelists (n = 60) were invited to vote on hypothetical scenarios via an emailed survey (n = 42), which was followed by a consensus conference (n = 51) that reviewed the literature and the rationale for survey answers. Panelists participated in a follow-up survey for final recommendations on the scenarios (n = 45)., Findings: The panelists reached consensus (≥70% agreement) in supporting a risk-stratified approach to melanoma screening in clinical settings and public screening events, screening personnel recommendations (self/partner, primary care provider, general dermatologist, and pigmented lesion expert), screening intervals, and acceptable appointment wait times. Participants also reached consensus that visual and dermoscopic examination are sufficient for evaluation and follow-up of melanocytic skin lesions deemed innocuous. The panelists reached consensus on interpreting reflectance confocal microscopy and some but not all results from epidermal tape stripping, but they did not reach consensus on use of certain pigmented lesion evaluation tools, such as electrical impedance spectroscopy. Regarding GEP scores, the panelists reached consensus that a low-risk prognostic GEP score should not outweigh concerning histologic features when selecting patients to undergo sentinel lymph node biopsy but did not reach consensus on imaging recommendations in the setting of a high-risk prognostic GEP score and low-risk histology and/or negative nodal status., Conclusions and Relevance: For this consensus statement, panelists reached consensus on aspects of a risk-stratified approach to melanoma screening and follow-up as well as use of visual examination and dermoscopy. These findings support a practical approach to diagnosing and evaluating CM. Panelists did not reach consensus on a clearly defined role for GEP testing in clinical decision-making, citing the need for additional studies to establish the clinical use of existing GEP assays.
- Published
- 2023
- Full Text
- View/download PDF
7. Expert Consensus Statement on Proficiency Standards for Dermoscopy Education in Primary Care.
- Author
-
Tran T, Cyr PR, Verdieck A, Lu MD, Ahrns HT, Berry EG, Bowen W, Braun RP, Cusick-Lewis JM, Doan HQ, Donohue VL, Erlich DR, Ferris LK, Harkemanne E, Hartman RI, Holt J, Jaimes N, Joslin TA, Kabaeva Z, Liebman TN, Ludzik J, Marghoob AA, Simpson I, Stein JA, Stulberg DL, Tromme I, Turnquist MJ, Usatine RP, Walker AM, Walker BL, West RF, Wilson ML, Witkowski A, Wu DJ, Seiverling EV, and Nelson KC
- Subjects
- Humans, Dermoscopy methods, Skin, Primary Health Care, Melanoma diagnosis, Melanoma pathology, Skin Neoplasms diagnostic imaging
- Abstract
Background: Primary care providers (PCPs) frequently address dermatologic concerns and perform skin examinations during clinical encounters. For PCPs who evaluate concerning skin lesions, dermoscopy (a noninvasive skin visualization technique) has been shown to increase the sensitivity for skin cancer diagnosis compared with unassisted clinical examinations. Because no formal consensus existed on the fundamental knowledge and skills that PCPs should have with respect to dermoscopy for skin cancer detection, the objective of this study was to develop an expert consensus statement on proficiency standards for PCPs learning or using dermoscopy., Methods: A 2-phase modified Delphi method was used to develop 2 proficiency standards. In the study's first phase, a focus group of PCPs and dermatologists generated a list of dermoscopic diagnoses and associated features. In the second phase, a larger panel evaluated the proposed list and determined whether each diagnosis was reflective of a foundational or intermediate proficiency or neither., Results: Of the 35 initial panelists, 5 PCPs were lost to follow-up or withdrew; 30 completed the fifth and last round. The final consensus-based list contained 39 dermoscopic diagnoses and associated features., Conclusions: This consensus statement will inform the development of PCP-targeted dermoscopy training initiatives designed to support early cancer detection., Competing Interests: Conflict of interest: None., (© Copyright by the American Board of Family Medicine.)
- Published
- 2023
- Full Text
- View/download PDF
8. Patient- and County-Level Factors Associated with Late-Stage Merkel Cell Carcinoma at Diagnosis.
- Author
-
Shah P, Polsky D, Shao Y, Stein J, and Liebman TN
- Subjects
- Humans, Carcinoma, Merkel Cell diagnosis, Carcinoma, Merkel Cell pathology, Skin Neoplasms diagnosis, Skin Neoplasms pathology
- Published
- 2022
- Full Text
- View/download PDF
9. Melanoma surveillance for high-risk patients via telemedicine: Examination of real-world data from an integrated store-and-forward total body photography and dermoscopy service.
- Author
-
Tan A, Greenwald E, Bajaj S, Belen D, Sheridan T, Stein JA, Liebman TN, Bowling A, and Polsky D
- Subjects
- Dermoscopy, Humans, Photography, Melanoma diagnosis, Melanoma epidemiology, Skin Neoplasms diagnosis, Skin Neoplasms epidemiology, Telemedicine
- Abstract
Competing Interests: Conflicts of interest The NYU Department of Dermatology has a contract with MoleSafe USA to provide diagnostic services. Drs Stein, Liebman, and Polsky diagnose patients for MoleSafe USA, for which they receive payments from the Department. Authors Belen and Sheridan are employees of MoleSafe. Author Bowling is the founder of MoleMap NZ. Authors Tan, Greenwald, and Bajaj have no conflicts of interest to declare.
- Published
- 2022
- Full Text
- View/download PDF
10. Real-world outcomes of melanoma surveillance using the MoleMap NZ telemedicine platform.
- Author
-
Greenwald E, Tan A, Stein JA, Liebman TN, Bowling A, and Polsky D
- Subjects
- Dermoscopy, Humans, New Zealand, Melanoma diagnostic imaging, Melanoma epidemiology, Skin Neoplasms, Telemedicine
- Abstract
Background: MoleMap NZ is a novel New Zealand-based store-and-forward telemedicine service to detect melanoma. It uses expert review of total body photography and close-up and dermoscopic images of skin lesions that are suspicious for malignancy., Objective: The purpose of this study was to assess the effectiveness of MoleMap NZ as a melanoma early detection program., Methods: We conducted a review of 2108 melanocytic lesions recommended for biopsy/excision by MoleMap NZ dermoscopists between January 2015 and December 2016., Results: Pathologic diagnoses were available for 1571 lesions. Of these, 1303 (83%) lesions were benign and 260 (17%) lesions were diagnosed as melanoma, for a melanoma-specific benign:malignant ratio of 5.0:1. The number needed to biopsy to obtain 1 melanoma was 6. Among melanomas with available tumor thickness data (n = 137), 92% were <0.8 mm (range in situ to 3.1 mm), with in situ melanomas comprising 74%., Limitations: Only lesions recommended for excision were analyzed. Pathology results were available for 75% of these cases. Tumor thickness data were available for 53% of melanomas diagnosed., Conclusions: This real-world study of MoleMap NZ, a community-based teledermoscopy program, suggests that it has the potential to increase patients' access to specialist expertise via telemedicine. Additional studies are needed to more accurately define its efficacy., (Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF
11. Utility of confocal microscopy in the management of lentigo maligna and lentigo maligna melanoma.
- Author
-
Shah P, Gulati N, Stein J, Polsky D, Lee N, and Liebman TN
- Subjects
- Humans, Hutchinson's Melanotic Freckle pathology, Microscopy, Confocal, Skin Neoplasms pathology, Hutchinson's Melanotic Freckle diagnostic imaging, Hutchinson's Melanotic Freckle surgery, Margins of Excision, Skin Neoplasms diagnostic imaging, Skin Neoplasms surgery
- Published
- 2021
- Full Text
- View/download PDF
12. Association between halo nevi and melanoma in adults: A multicenter retrospective case series.
- Author
-
Haynes D, Strunck JL, Said J, Tam I, Varedi A, Topham CA, Olamiju B, Wei BM, Erickson MK, Wang LL, Tan A, Stoner R, Hartman RI, Lilly E, Grossman D, Curtis JA, Westerdahl JS, Leventhal JS, Choi JN, Chu EY, Ming ME, Stein JA, Liebman TN, Berry E, and Greiling TM
- Subjects
- Adolescent, Adult, Age of Onset, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Retrospective Studies, Risk Factors, Young Adult, Melanoma diagnosis, Neoplasms, Second Primary diagnosis, Nevus, Halo diagnosis, Skin Neoplasms diagnosis
- Published
- 2021
- Full Text
- View/download PDF
13. Dermoscopy Proficiency Expectations for US Dermatology Resident Physicians: Results of a Modified Delphi Survey of Pigmented Lesion Experts.
- Author
-
Fried LJ, Tan A, Berry EG, Braun RP, Curiel-Lewandrowski C, Curtis J, Ferris LK, Hartman RI, Jaimes N, Kawaoka JC, Kim CC, Lallas A, Leachman SA, Levin A, Lucey P, Marchetti MA, Marghoob AA, Miller D, Nelson KC, Prodanovic E, Seiverling EV, Swetter SM, Savory SA, Usatine RP, Wei ML, Polsky D, Stein JA, and Liebman TN
- Subjects
- Clinical Competence, Delphi Technique, Dermatologists education, Dermatology education, Dermatology standards, Dermoscopy education, Humans, Skin Diseases diagnosis, Surveys and Questionnaires, Dermatologists standards, Dermatology methods, Dermoscopy standards, Internship and Residency standards
- Abstract
Importance: Dermoscopy education in US dermatology residency programs varies widely, and there is currently no existing expert consensus identifying what is most important for resident physicians to know., Objectives: To identify consensus-based learning constructs representing an appropriate foundational proficiency in dermoscopic image interpretation for dermatology resident physicians, including dermoscopic diagnoses, associated features, and representative teaching images. Defining these foundational proficiency learning constructs will facilitate further skill development in dermoscopic image interpretation to help residents achieve clinical proficiency., Design, Setting, and Participants: A 2-phase modified Delphi surveying technique was used to identify resident learning constructs in 3 sequential sets of surveys-diagnoses, features, and images. Expert panelists were recruited through an email distributed to the 32 members of the Pigmented Lesion Subcommittee of the Melanoma Prevention Working Group. Twenty-six (81%) opted to participate. Surveys were distributed using RedCAP software., Main Outcomes and Measures: Consensus on diagnoses, associated dermoscopic features, and representative teaching images reflective of a foundational proficiency in dermoscopic image interpretation for US dermatology resident physicians., Results: Twenty-six pigmented lesion and dermoscopy specialists completed 8 rounds of surveys, with 100% (26/26) response rate in all rounds. A final list of 32 diagnoses and 116 associated dermoscopic features was generated. Three hundred seventy-eight representative teaching images reached consensus with panelists., Conclusions and Relevance: Consensus achieved in this modified Delphi process identified common dermoscopic diagnoses, associated features, and representative teaching images reflective of a foundational proficiency in dermoscopic image interpretation for dermatology residency training. This list of validated objectives provides a consensus-based foundation of key learning points in dermoscopy to help resident physicians achieve clinical proficiency in dermoscopic image interpretation.
- Published
- 2021
- Full Text
- View/download PDF
14. Acral Lentiginous Melanoma: A United States Multi-Center Substage Survival Analysis.
- Author
-
Kolla AM, Vitiello GA, Friedman EB, Sun J, Potdar A, Daou H, Farrow NE, Farley CR, Vetto JT, Han D, Tariq M, Beasley GM, Contreras CM, Lowe M, Zager JS, Osman I, Berman RS, Liebman TN, Stein JA, and Lee AY
- Subjects
- Adolescent, Adult, Age Distribution, Aged, Aged, 80 and over, Child, Databases, Factual, Female, Humans, Kaplan-Meier Estimate, Male, Melanoma classification, Melanoma mortality, Middle Aged, Neoplasm Recurrence, Local, Retrospective Studies, Sex Distribution, Survival Analysis, United States epidemiology, Young Adult, Melanoma epidemiology, Melanoma pathology
- Abstract
Background: Acral lentiginous melanoma is associated with worse survival than other subtypes of melanoma. Understanding prognostic factors for survival and recurrence can help better inform follow-up care., Objectives: To analyze the clinicopathologic features, melanoma-specific survival, and recurrence-free survival by substage in a large, multi-institutional cohort of primary acral lentiginous melanoma patients., Methods: Retrospective review of the United States Melanoma Consortium database, a multi-center prospectively collected database of acral lentiginous melanoma patients treated between January 2000 and December 2017., Results: Of the 433 primary acral lentiginous melanoma patients identified (median [range] age: 66 [8-97] years; 53% female, 83% white), 66% presented with stage 0-2 disease and the median time of follow-up for the 392 patients included in the survival analysis was 32.5 months (range: 0-259). The 5-year melanoma-specific survivals by stage were 0 = 100%, I = 93.8%, II = 76.2%, III = 63.4%, IIIA = 80.8%, and IV = 0%. Thicker Breslow depth ((HR) = 1.13; 95% CI = 1.05-1.21; P < .001)) and positive nodal status ((HR) = 1.79; 95% CI = 1.00-3.22; P = .050)) were independent prognostic factors for melanoma-specific survival. Breslow depth ((HR = 1.13; 95% CI = 1.07-1.20; P < .001), and positive nodal status (HR = 2.12; 95% CI = 1.38-3.80; P = .001) were also prognostic factors for recurrence-free survival., Conclusion: In this cohort of patients, acral lentiginous melanoma was associated with poor outcomes even in early stage disease, consistent with prior reports. Stage IIB and IIC disease were associated with particularly low melanoma-specific and recurrence-free survival. This suggests that studies investigating adjuvant therapies in stage II patients may be especially valuable in acral lentiginous melanoma patients.
- Published
- 2021
- Full Text
- View/download PDF
15. Technological advances for the detection of melanoma: Advances in diagnostic techniques.
- Author
-
Fried L, Tan A, Bajaj S, Liebman TN, Polsky D, and Stein JA
- Subjects
- Biomedical Technology, Dermoscopy methods, Dielectric Spectroscopy, Humans, Imaging, Three-Dimensional, Microscopy, Confocal methods, Machine Learning, Melanoma diagnostic imaging, Photography methods, Skin Neoplasms diagnostic imaging
- Abstract
Managing the balance between accurately identifying early stage melanomas while avoiding obtaining biopsy specimens of benign lesions (ie, overbiopsy) is the major challenge of melanoma detection. Decision making can be especially difficult in patients with extensive atypical nevi. Recognizing that the primary screening modality for melanoma is subjective examination, studies have shown a tendency toward overbiopsy. Even low-risk routine surgical procedures are associated with morbidity, mounting health care costs, and patient anxiety. Recent advancements in noninvasive diagnostic modalities have helped improve diagnostic accuracy, especially when managing melanocytic lesions of uncertain diagnosis. Breakthroughs in artificial intelligence have also shown exciting potential in changing the landscape of melanoma detection. In the first article in this continuing medical education series, we review novel diagnostic technologies, such as automated 2- and 3-dimensional total body imaging with sequential digital dermoscopic imaging, reflectance confocal microscopy, and electrical impedance spectroscopy, and we explore the logistics and implications of potentially integrating artificial intelligence into existing melanoma management paradigms., (Copyright © 2020. Published by Elsevier Inc.)
- Published
- 2020
- Full Text
- View/download PDF
16. Technological advances for the detection of melanoma: Advances in molecular techniques.
- Author
-
Fried L, Tan A, Bajaj S, Liebman TN, Polsky D, and Stein JA
- Subjects
- Antigens, Neoplasm genetics, Cyclin-Dependent Kinase Inhibitor p16 genetics, Humans, Molecular Diagnostic Techniques, RNA, Long Noncoding genetics, Gene Expression Profiling methods, Genetic Testing, Melanoma diagnosis, Melanoma genetics, Pancreatic Neoplasms genetics, Skin Neoplasms diagnosis, Skin Neoplasms genetics
- Abstract
The growth of molecular technologies analyzing skin cells and inherited genetic variations has the potential to address current gaps in both diagnostic accuracy and prognostication in patients with melanoma or in individuals who are at risk for developing melanoma. In the second article in this continuing medical education series, novel molecular technologies are reviewed. These have been developed as adjunct tools for melanoma management and include the Pigmented Lesion Assay, myPath Melanoma, and DecisionDx-Melanoma tests, and genetic testing in patients with a strong familial melanoma history. These tests are commercially available and marketed as ancillary tools for clinical decision-making, diagnosis, and prognosis. We review fundamental principles behind each test, discuss peer-reviewed literature assessing their performance, and highlight the utility and limitations of each assay. The goal of this article is to provide a comprehensive, evidence-based foundation for clinicians regarding the management of patients with difficult pigmented lesions., (Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)
- Published
- 2020
- Full Text
- View/download PDF
17. A case of recalcitrant lichen planus pigmentosus treated by oral isotretinoin.
- Author
-
Shah P, Ugonabo N, and Liebman TN
- Published
- 2020
- Full Text
- View/download PDF
18. Calciphylaxis in Association with Alcoholic Cirrhosis and Hepatorenal Syndrome.
- Author
-
Liebman TN, Tamez R, and Daly JA
- Subjects
- Calciphylaxis etiology, Disease Progression, Female, Humans, Middle Aged, Purpura diagnosis, Purpura etiology, Calciphylaxis diagnosis, Hepatorenal Syndrome complications, Liver Cirrhosis, Alcoholic complications, Skin pathology
- Abstract
A 45-year-old woman with cirrhosis secondary to alcohol abuse was transferred from an outside hospital for management of a painful cutaneous eruption, progressively worsening over 2 weeks. On examination, the patient was a middle-aged white woman lying in bed in no acute distress, with jaundice and a protuberant abdomen consistent with ascites. The patient was afebrile (98.2°F), heart rate of 79 beats per minute, blood pressure of 105/61 mmHg, respiratory rate of 18 breaths per minute, and oxygen saturation of 93% on room air. She had multiple large stellate lesions of retiform purpura with central hemorrhagic necrosis on both thighs, with surrounding induration (Figures 1 and 2). These purpuric plaques and perilesional skin were exquisitely painful to palpation.
- Published
- 2020
19. Acquired Ichthyosis in the Setting of Active Pulmonary Tuberculosis.
- Author
-
Liang SE, Homayounfar G, Heilman E, and Liebman TN
- Abstract
Acquired ichthyosis is an uncommon disorder of cornification. It characteristically presents as symmetric scaling of the skin on the trunk and extensor surfaces of the extremities. It is clinically and histologically similar to ichthyosis vulgaris; however, acquired ichthyosis develops later in life and has been associated with various malignancies, infections, medications, autoimmune diseases, metabolic disorders, and malnutrition. We describe a case of a 35-year-old woman with active pulmonary tuberculosis and a history of breast cancer who presented with a several-month history of a widespread, scaly, pruritic skin eruption. Physical examination revealed fine, scaly patches on the extremities with relative sparing of the flexures and larger, scaly, ichthyosiform patches on the chest and back. Skin biopsy revealed orthokeratotic hyperkeratosis and a diminished granular layer, consistent with a diagnosis of acquired ichthyosis. Further evaluation, including positron-emission tomography/computed tomography scan, revealed hypermetabolic infiltrates and cavitation in the lungs, consistent with active pulmonary tuberculosis; there was no evidence of new or recurrent malignancy. The patient was treated with antituberculosis drugs and topical ammonium lactate cream. With incident cases rarely reported in the literature, this case of new-onset ichthyosis in the setting of active pulmonary tuberculosis highlights the distinctive clinical and histologic features of acquired ichthyosis and emphasizes the relationship of acquired ichthyosis with underlying systemic disease, particularly infection., Competing Interests: FUNDING:No funding was received for this study. DISCLOSURES:The authors have no conflicts of interest relevant to the content of this article.
- Published
- 2019
20. A 68-Year-Old Man on Azathioprine With New Systemic Symptoms and Widespread Skin Eruption.
- Author
-
Liang SE, Cohen JM, Meehan SA, Rothman LR, and Liebman TN
- Subjects
- Aged, Diagnosis, Differential, Humans, Male, Myasthenia Gravis drug therapy, Azathioprine adverse effects, Drug Hypersensitivity Syndrome immunology, Exanthema chemically induced, Immunosuppressive Agents adverse effects
- Published
- 2019
- Full Text
- View/download PDF
21. Folliculotropic mycosis fungoides.
- Author
-
Feng H, Beasley J, Meehan S, and Liebman TN
- Subjects
- Aged, 80 and over, Alopecia etiology, Eyebrows, Facial Neoplasms complications, Facial Neoplasms diagnosis, Female, Humans, Mycosis Fungoides complications, Mycosis Fungoides diagnosis, Pigmentation Disorders etiology, Skin Neoplasms complications, Skin Neoplasms diagnosis, Facial Neoplasms pathology, Mycosis Fungoides pathology, Skin Neoplasms pathology
- Abstract
Folliculotropic mycosis fungoides (MF) is a distinct subset of cutaneous T cell lymphoma (CTCL). The disease is typically marked by an aggressive course and is often recalcitrant to skin-direct therapy. We report a case of an 83-year-old woman with folliculotropic MF characterized by erythematous, scaly plaques on the forehead along with poliosis and alopecia of the right medial eyebrow.
- Published
- 2018
22. Botulinum toxin for treatment of Raynaud phenomenon in CREST syndrome.
- Author
-
Berk-Krauss J, Christman MP, Franks A, Sicco KL, and Liebman TN
- Subjects
- Administration, Topical, Aged, CREST Syndrome drug therapy, Diltiazem therapeutic use, Female, Humans, Nitroglycerin therapeutic use, Pain etiology, Raynaud Disease complications, Sildenafil Citrate therapeutic use, Treatment Failure, Ulcer etiology, Vasodilator Agents therapeutic use, Acetylcholine Release Inhibitors therapeutic use, Botulinum Toxins therapeutic use, Raynaud Disease drug therapy
- Abstract
Calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia (CREST) syndrome is a form of a rare, clinical subtype of systemic sclerosis, known as limited systemic sclerosis. Limited systemic sclerosis, including CREST syndrome, manifests as fibrotic skin changes restricted to the hands and face, with vascular, musculoskeletal, and visceral involvement. We present a case of a 75-year-old woman with a longstanding history of CREST syndrome complicated by a digital ulceration and persistent pain associated with recalcitrant Raynaud phenomenon. After failing a number of first-line pharmacologic therapies such as diltiazem, sildenafil, and topical nitropaste, the patient was started on a trial of botulinum toxin for the left second digit, with 10 unit injections into both webspaces for a total of 20 units. Following injection, the patient reported no further baseline pain in the affected finger and an over fifty-percent improvement in discomfort with manipulation of the digit at a follow-up time of one week. The ulceration started healing within the following three weeks. This result was maintained at a follow-up time of six weeks.
- Published
- 2018
23. Melanoma risk after in vitro fertilization: A review of the literature.
- Author
-
Berk-Krauss J, Bieber AK, Criscito MC, Grant-Kels JM, Driscoll MS, Keltz M, Pomeranz MK, Martires KJ, Liebman TN, and Stein JA
- Subjects
- Female, Gonadotropins, Pituitary adverse effects, Gonadotropins, Pituitary pharmacology, Humans, Infertility, Female complications, Melanocytes drug effects, Melanocytes pathology, Melanoma epidemiology, Neoplasms, Hormone-Dependent epidemiology, Parity, Pregnancy, Receptors, Estrogen drug effects, Clomiphene adverse effects, Estrogens, Fertilization in Vitro methods, Melanoma chemically induced, Neoplasms, Hormone-Dependent chemically induced, Ovulation Induction adverse effects
- Abstract
Background: The role of female sex hormones in the pathogenesis of malignant melanoma (MM) remains controversial. Although melanocytes appear to be hormonally responsive, the effect of estrogen on MM cells is less clear. Available clinical data does not consistently demonstrate that increased endogenous hormones from pregnancy or increased exogenous hormones from oral contraceptive pills and hormone replacement affect MM prevalence and outcome., Objective: We sought to examine potential associations between in vitro fertilization (IVF) and melanoma., Methods: A literature review was conducted. Primary outcomes were reported as associations between IVF and melanoma risk compared with the general population. Secondary outcomes included associations stratified by type of IVF regimen and subgroup, such as parous versus nulliparous patients., Results: Eleven studies met our inclusion criteria. Five studies found no increased risk for MM among IVF users compared with the general population. Two studies found an increase in MM in clomiphene users, and 4 studies found an increase in MM among patients who were gravid or parous either before or after IVF., Conclusion: The reviewed studies do not reveal consistent patterns of association between IVF and MM among all infertile women. However, the data indicates a potential increased risk for MM in ever-parous patients treated with IVF. High-quality studies including a large number of MM cases that control for well-established MM risk factors are needed to adequately assess the relationship between IVF and MM, particularly among ever-parous women., (Copyright © 2018 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF
24. Acral Melanoma: A Patient's Experience and Physician's Commentary.
- Author
-
Greenwald E, Anonymous Patient, Polsky D, and Liebman TN
- Abstract
This article, co-authored by a patient diagnosed with acral melanoma, discusses the patient's experience of being diagnosed with and treated with surgery for this disease. The physician discusses the epidemiology, genetics, diagnosis, treatment, and prognosis of acral melanoma. Follow-up care plans are also discussed.
- Published
- 2018
- Full Text
- View/download PDF
25. Violaceous papules on the legs of an elderly Mediterranean man.
- Author
-
Liang SE and Liebman TN
- Subjects
- Aged, Herpesvirus 8, Human, Humans, Italy, Male, Multiple Myeloma, Sarcoma, Kaposi etiology, Skin Neoplasms etiology, Sarcoma, Kaposi diagnosis, Skin Neoplasms diagnosis
- Published
- 2018
- Full Text
- View/download PDF
26. Comment on "Prognostic value of sentinel lymph node biopsy according to Breslow thickness for cutaneous melanoma".
- Author
-
Greenwald E, Liebman TN, Polsky D, and Stein JA
- Subjects
- Humans, Prognosis, Skin Neoplasms surgery, Melanoma surgery, Sentinel Lymph Node Biopsy
- Published
- 2018
- Full Text
- View/download PDF
27. Recurrent Palisaded Neutrophilic and Granulomatous Dermatitis in the Setting of Systemic Lupus Erythematosus.
- Author
-
Liebman TN, Shagalov D, and Lowenstein EJ
- Subjects
- Aged, Female, Humans, Recurrence, Dermatitis etiology, Dermatitis pathology, Lupus Erythematosus, Systemic complications, Lupus Erythematosus, Systemic pathology
- Abstract
We present the case of a 66-year-old woman with a history of systemic lupus erythematosus, who presented with tender nodules on the forearms. The patient reported an 8-year history of pink bumps on the extensor surfaces of the forearms bilaterally that would arise episodically for a few weeks and subsequently resolve with no intervention. Her systemic lupus erythematosus was under good control with oral prednisone 10 mg daily, and the development of these lesions was not associated with concomitant flares of the systemic lupus erythematosus.
- Published
- 2018
28. Severe Oral Mucositis: A Rare Adverse Event of Pembrolizumab.
- Author
-
Lederhandler MH, Ho A, Brinster N, Ho RS, Liebman TN, and Lo Sicco K
- Subjects
- Adenocarcinoma secondary, Aged, Anti-Bacterial Agents therapeutic use, Azithromycin therapeutic use, Female, Humans, Lung Neoplasms pathology, Melanoma, Programmed Cell Death 1 Receptor antagonists & inhibitors, Severity of Illness Index, Stomatitis diagnosis, Stomatitis drug therapy, Adenocarcinoma drug therapy, Antibodies, Monoclonal, Humanized adverse effects, Antineoplastic Agents, Immunological adverse effects, Lung Neoplasms drug therapy, Stomatitis chemically induced
- Abstract
Treatment of malignancy with anti-programmed cell death 1 (PD-1) immune checkpoint inhibitors can cause mucocutaneous side effects resulting from T cell activation. Due to their recent development, the full side effect profile remains to be fully elucidated, however dermatologic adverse events are most common. The main oral toxicities of these immune checkpoint inhibitors include: xerostomia, dysgeusia, and lichenoid reactions. Oral mucositis occurs more rarely in the setting of PD-1 inhibition, and few other reports of a Grade 3 or higher, severe, stomatitis have been reported in the literature. We present a case of a 78-year-old woman with Grade 3 ulcerative oral mucositis that occurred 13 months after initiation of PD-1 inhibitor, pembrolizumab, for the treatment for lung adenocarcinoma. She was successfully treated with prednisone, and pembrolizumab was temporarily held by her oncologist. Physicians should be aware of the possibility of severe mucositis in the setting of PD-1 inhibitors, as well as the management. J Drugs Dermatol. 2018;17(7):807-809.
- Published
- 2018
29. Eczematous reaction to IVIG for the treatment of dermatomyositis.
- Author
-
Berk-Krauss J, Lee K, Lo Sicco KI, and Liebman TN
- Abstract
The use of high-dose intravenous immunoglobulin (IVIG) is an accepted therapy for patients with refractory dermatomyositis. Cases of eczematous reactions to IVIG have been reported in the literature, but to our knowledge, none in patients being treated for dermatomyositis. We report on the cases of two female patients with refractory dermatomyositis who developed pruritic, scaly pink plaques after receiving high-dose IVIG. This diffuse eczematous skin reaction to high-dose IVIG is a rare adverse event that most often occurs days after administration of therapy. Practitioners should be aware of this entity because the eczematous eruption may be extensive and can commonly worsen with subsequent re-exposure to IVIG.
- Published
- 2018
- Full Text
- View/download PDF
30. Mycoplasma pneumoniae, more than a lung disease.
- Author
-
Curtiss P, Melnick L, Sicco KL, and Liebman TN
- Subjects
- Adolescent, Diagnosis, Differential, Humans, Male, Mouth Diseases diagnosis, Mouth Mucosa pathology, Mucositis diagnosis, Mouth Diseases microbiology, Mucositis microbiology, Mycoplasma Infections diagnosis, Mycoplasma pneumoniae isolation & purification
- Abstract
Mycoplasma pneumoniae-induced rash and mucositis (MIRM) is a recently described clinical entity and should be considered in children who present with oral (94% of patients), ocular (82% of patients), and urogenital lesions (63% of patients). MIRM was first described as a distinct clinical entity from Stevens Johnson syndrome/Toxic epidermal necrolysis (SJS)/(TEN) in 2015 [1]. As a new, uncommon diagnosis it frequently poses a diagnostic and therapeutic challenge for pediatricians and dermatologists. We report a case of MIRM in a previously healthy 15-year-old boy.
- Published
- 2018
31. Cold panniculitis: Adverse cutaneous effect of whole-body cryotherapy.
- Author
-
Greenwald E, Christman M, Penn L, Brinster N, and Liebman TN
- Published
- 2018
- Full Text
- View/download PDF
32. Pregnancy and Melanoma: Recommendations for Clinical Scenarios.
- Author
-
Berk-Krauss J, Liebman TN, and Stein JA
- Abstract
Managing pregnant patients with a history of melanoma or with a melanoma diagnosis can be daunting and confusing for dermatologists. We present three clinical scenarios that raise questions about the safety of pregnancy in patients with a history of melanoma, skin biopsies during pregnancy, and excisions and sentinel lymph node biopsies during pregnancy. Our recommendations incorporate the most up-to-date clinical data to help guide clinicians when faced with pigmented lesions and melanoma in a pregnant patient.
- Published
- 2018
- Full Text
- View/download PDF
33. An immunosuppressed man with an isolated necrotic plaque on the chest.
- Author
-
Berk-Krauss J, Hoffmann R, Mu E, Kim R, Seminara N, Lo Sicco KI, and Liebman TN
- Published
- 2018
- Full Text
- View/download PDF
34. Dihydroxyacetone and sunless tanning: Knowledge, myths, and current understanding.
- Author
-
Huang A, Brody N, and Liebman TN
- Subjects
- Humans, Sunbathing, Cosmetics adverse effects, Dihydroxyacetone adverse effects, Health Knowledge, Attitudes, Practice
- Published
- 2017
- Full Text
- View/download PDF
35. Generalized eruptive syringomas.
- Author
-
Huang A, Taylor G, and Liebman TN
- Subjects
- Female, Humans, Middle Aged, Sweat Gland Neoplasms diagnosis, Sweat Gland Neoplasms pathology, Syringoma diagnosis, Syringoma pathology
- Abstract
Eruptive syringoma is a rare variant of syringoma, benign neoplasms of the eccrine sweat ducts that appear on the face, neck, chest, and axillae of predominately Asian and African American women before or during puberty [1, 2]. Lesions appear as small skin-colored or slightly pigmented, flat-topped papules [2]. The condition can be cosmetically disfiguring and difficult to treat, especially in dark-skinned patients. The investigators report a 52-year old Guyanese woman who presented with widespread, chronic, non-pruritic and nontender, skin-colored papules that arose approximately 20 years earlier. A punch biopsy of affected skin was obtained and the histological diagnosis was eruptive syringoma. The patient pursued no further treatment, after discussion of costs and risks.
- Published
- 2017
36. Acquired elastoma in a subungual location.
- Author
-
Wolner ZJ, Liebman TN, and Lowenstein EJ
- Subjects
- Humans, Immunosuppression Therapy, Kidney Failure, Chronic complications, Kidney Failure, Chronic surgery, Kidney Transplantation, Male, Middle Aged, Nail Diseases pathology, Nails, Malformed complications, Nevus pathology, Anus Neoplasms complications, Carcinoma, Squamous Cell complications, Nail Diseases complications, Nevus complications
- Abstract
Elastomas are connective tissue nevi or hamartomas. They may occur in isolation or can be associated with familial syndromes such as Buschke-Ollendorff syndrome. Elastomas typically present in childhood as small ivory papules or firm skin-colored nodules that can coalesce into larger yellow plaques. These lesions are typically distributed over the extremities, abdomen, and back. Herein, we report an unusual case of a renal transplant recipient who presented with an acquired subungual papule with associated koilonychia and distal nail plate dystrophy. Histopathologic findings were consistent with subungual elastoma.
- Published
- 2017
37. Dermoscopic Findings of an Unusual Acral Nevus on the Hand of a Child.
- Author
-
Liebman TN, Diakow MN, and Glick SA
- Subjects
- Adolescent, Biopsy, Needle, Diagnosis, Differential, Female, Follow-Up Studies, Humans, Immunohistochemistry, Melanoma pathology, Nevus, Pigmented pathology, Nevus, Pigmented surgery, Precancerous Conditions diagnosis, Precancerous Conditions surgery, Risk Assessment, Skin Neoplasms pathology, Skin Neoplasms surgery, Treatment Outcome, Dermoscopy methods, Fingers pathology, Melanoma diagnosis, Nevus, Pigmented diagnosis, Skin Neoplasms diagnosis
- Abstract
Distinguishing benign acral nevi from small early acral melanomas may be challenging in certain cases. Dermoscopy is a noninvasive imaging technique that can help clinicians better visualize deeper lesion structures and thus more easily differentiate benign nevi from melanoma. We report the case of a 13-year-old girl with a changing dark brown to black macule with a central papular component on the volar surface of the right third finger. Dermoscopy revealed asymmetrically distributed irregular black blotches on a bluish-black background. Histopathology revealed a traumatized compound melanocytic nevus. Certain melanocytic nevi, although histologically benign, may not conform to the limited selection of reassuring benign dermoscopic patterns. Nevi in children are often dynamic and have a high likelihood of dermoscopic change., (© 2017 Wiley Periodicals, Inc.)
- Published
- 2017
- Full Text
- View/download PDF
38. Pemphigus foliaceus exacerbated by radiation, in association with myasthenia gravis.
- Author
-
Liebman TN, Lieberman MR, and Burris K
- Subjects
- Abdomen, Adult, Breast Neoplasms complications, Complement C3 immunology, Disease Progression, Female, Humans, Immunoglobulin G immunology, Pemphigus diagnosis, Pemphigus etiology, Pemphigus immunology, Radiodermatitis diagnosis, Radiodermatitis etiology, Radiodermatitis immunology, Thorax, Breast Neoplasms radiotherapy, Myasthenia Gravis complications, Pemphigus pathology, Radiodermatitis pathology, Radiotherapy adverse effects
- Abstract
Pemphigus foliaceus (PF) is a sporadic autoimmune blistering disease of unknown etiology. The production of immunoglobulin G4 antibodies against desmoglein-1 is responsible for the clinical manifestation of PF. We present a case of a woman with a recent diagnosis of myasthenia gravis (MG), who was also recently treated with radiation therapy for breast cancer. The clinical exam, supported by biopsy and direct immunofluorescence, were consistent with PF. We present this case to increase the awareness of the potential exacerbation or induction of PF with radiation, and of the association of PF and myasthenia gravis. Only five prior cases of radiation-exacerbated or radiation-induced PF have been reported in the literature to date. Furthermore, the co-existence of the autoimmune entities of myasthenia gravis and PF has been reported in the literature in only 9 cases and was also noted in this patient.
- Published
- 2016
39. Growth-Curve Modeling of Nevi With a Peripheral Globular Pattern.
- Author
-
Bajaj S, Dusza SW, Marchetti MA, Wu X, Fonseca M, Kose K, Brito J, Carrera C, Martins de Silva VP, Malvehy J, Puig S, Yagerman S, Liebman TN, Scope A, Halpern AC, and Marghoob AA
- Abstract
Importance: Although nevi with a peripheral rim of globules (peripheral globular nevi [PGN]) observed with dermoscopy are associated with enlarging melanocytic nevi, their actual growth dynamics remain unknown. Because change is a sensitive but nonspecific marker for melanoma, beginning to understand the growth patterns of nevi may improve the ability of physicians to differentiate normal from abnormal growth and reduce unnecessary biopsies., Objective: To study the growth dynamics and morphologic evolution of PGN on dermoscopy., Design, Setting, and Participants: A total of 84 participants with 121 PGN from September 1, 1999, through May 1, 2013, were identified retrospectively. Cohorts were recruited from the Memorial Sloan Kettering Cancer Center; Melanoma Unit of the Hospital Clinic, University of Barcelona; and Study of Nevi in Children. All 3 cohorts underwent longitudinal monitoring with serial dermoscopic imaging of their PGN. Data analysis was performed from May 1, 2014, through April 1, 2015., Main Outcomes and Measures: Establishment of the natural growth curve of PGN. The secondary aim was to establish the median time to growth cessation in those PGN for which the size eventually stabilized and/or had begun to decrease during the study period., Results: The median duration of follow-up was 25.1 (range, 2.0-114.4) months. Most of the nevi (116 [95.9%]) enlarged at some point during sequential monitoring. The rate of increase in the surface area of PGN varied among cohorts and ranged from -0.47 to 2.26 mm2/mo (mean rate, 0.25 [95% CI, 0.14-0.36] mm2/mo). The median time to growth cessation in the 26 PGN that stabilized or decreased in size (21.5%) was 58.6 months. All lesions changed in a symmetric manner and 91 (75.2%) displayed a decrease in the density of peripheral globules over time., Conclusions and Relevance: Nevi displaying a peripheral globular pattern enlarged symmetrically with apparent growth cessation occurring during a span of 4 to 5 years. Our results reiterate the important concept that not all growth is associated with malignancy.
- Published
- 2015
- Full Text
- View/download PDF
40. TNF-inhibitor induced lupus in a patient treated with adalimumab for rheumatoid arthritis.
- Author
-
Lieberman MR, Liebman TN, Alapati U, and Khachemoune A
- Subjects
- Adalimumab therapeutic use, Aged, Antirheumatic Agents therapeutic use, Clobetasol therapeutic use, Diagnosis, Differential, Drug Therapy, Combination, Glucocorticoids therapeutic use, Humans, Lupus Erythematosus, Cutaneous drug therapy, Lupus Erythematosus, Cutaneous pathology, Male, Prednisone therapeutic use, Triamcinolone therapeutic use, Adalimumab adverse effects, Antirheumatic Agents adverse effects, Arthritis, Rheumatoid drug therapy, Lupus Erythematosus, Cutaneous chemically induced, Tumor Necrosis Factor-alpha antagonists & inhibitors
- Abstract
Anti-tumor necrosis factor induced lupus (ATIL) is a rare side effect reported in patients treated with anti-tumor necrosis factor medications such as infliximab, etanercept and adalimumab. Of the three, this condition has been least commonly reported secondary to adalimumab. In this report, we present a case of ATIL in a patient treated for rheumatoid arthritis (RA) with adalimumab. This report will increase physician awareness of the warning signs, diagnostic options and potential complications of ATIL. In this patient, adalimumab was discontinued and treatment was started, leading to improvement in the patient's status.
- Published
- 2014
41. One-year follow-up of dermoscopy education on the ability of medical students to detect skin cancer.
- Author
-
Chen LL, Liebman TN, Soriano RP, Dusza SW, Halpern AC, and Marghoob AA
- Subjects
- Early Detection of Cancer, Educational Measurement, Follow-Up Studies, Humans, Self Efficacy, Students, Medical, Clinical Competence, Dermatology education, Dermoscopy education, Education, Medical, Skin Neoplasms diagnosis
- Abstract
Background: Learning skin cancer detection skills is important, yet many medical schools lack a standardized skin cancer examination (SCE) curriculum., Objective: To determine medical students' skills in discriminating benign from malignant skin lesions on a 10-item image-based test one year after receiving a SCE intervention., Methods: Cohort 1 received SCE teaching only. Cohort 2 received SCE teaching with dermoscopy tutorial, and a dermatoscope. The same test was given to assess students post-intervention and one year later., Results: 43% (n = 145) and 38% (n = 143) of cohorts 1 and 2, respectively, participated one year later. Both cohorts improved or maintained their scores to correctly classify all lesions from post-intervention to one-year follow-up. After one year, cohort 2 maintained higher scores for successful identification of both benign and malignant lesions as compared to cohort 1., Conclusion: Medical students receiving a SCE intervention can improve their diagnostic skills after one year, especially with the aid of dermoscopy., (Copyright © 2013 S. Karger AG, Basel.)
- Published
- 2013
- Full Text
- View/download PDF
42. White shiny structures: dermoscopic features revealed under polarized light.
- Author
-
Liebman TN, Rabinovitz HS, Dusza SW, and Marghoob AA
- Subjects
- Carcinoma, Basal Cell pathology, Carcinoma, Squamous Cell pathology, Humans, Keratosis, Actinic pathology, Lichen Planus pathology, Melanoma pathology, Retrospective Studies, Dermoscopy methods, Light, Skin Diseases pathology, Skin Neoplasms pathology
- Abstract
Background: White shiny structures, including white shiny lines, white shiny areas and rosettes, are features only observed under polarized dermoscopy (PD)., Objective: To evaluate the prevalence of the varied morphologies of white shiny structures in melanoma, basal cell carcinoma (BCC), squamous cell carcinoma (SCC), actinic keratosis (AK) and lichen planus-like keratosis (LPLK)., Methods: Retrospective study using dermoscopic images of biopsy-proven melanoma, BCC, SCC, AK and LPLK., Results: A total of 538 lesions were assessed under PD. One or more types of white shiny structures were observed in 38.7% of study lesions (208/538). BCCs were significantly more likely to display a combination of white shiny areas and white shiny lines (short lines and/or ill-defined strands) (31.9%; 61/191) than any other lesions (P<0.001). BCC were more likely than other lesions to have white shiny lines distributed without any organized pattern (P<0.001). Lines in melanoma were significantly more likely than other lesion types to be oriented orthogonally (P<0.001). When white shiny lines were present, melanomas were significantly more likely than other lesions to exhibit short discrete white lines (P<0.001). Rosettes were significantly more likely to be observed in actinic tumours than other lesions (P<0.001)., Conclusion: The presence of white shiny lines of any length accompanied by white shiny areas is most suggestive of a diagnosis of BCC (P<0.001). Melanomas are more likely to display short white shiny lines in an orthogonal distribution (P<0.001) and without white shiny areas. Actinic tumours are most likely to exhibit rosettes (P<0.001)., (© 2011 The Authors. Journal of the European Academy of Dermatology and Venereology © 2011 European Academy of Dermatology and Venereology.)
- Published
- 2012
- Full Text
- View/download PDF
43. Effect of dermoscopy education on the ability of medical students to detect skin cancer.
- Author
-
Liebman TN, Goulart JM, Soriano R, Dusza SW, Halpern AC, Lee KK, and Marghoob AA
- Subjects
- Female, Humans, Male, Prospective Studies, Students, Medical, Young Adult, Clinical Competence, Dermoscopy education, Education, Medical, Skin Neoplasms pathology
- Abstract
Objectives: To determine students' ability to discriminate benign vs malignant lesions and to assess attitudes regarding skin cancer examination (SCE)., Design: Second-year medical students at 1 institution participated in an SCE intervention for 2 consecutive years., Intervention: Cohort 1 received intervention A, consisting of SCE teaching without a dermoscopy tutorial. Cohort 2 received intervention B, consisting of SCE teaching with a dermoscopy tutorial, access to online dermoscopy resources, and a dermoscope., Main Outcome Measure: Surveys before and after the lecture included an image-based test of 10 lesions to assess ability to differentiate benign from malignant lesions., Results: There were 130 participants from cohort 1 and 131 participants from cohort 2 at the postintervention survey. At baseline, students in both groups reported similar attitudes regarding the value of SCE (P = .05) and intention to perform SCE on patients (P = .55). Overall, cohort 2 exhibited improvement (P < .001) from preintervention (52.0% correct) to postintervention assessments (63.0% correct), whereas cohort 1 did not (47.0% and 46.0% correct, respectively; P = .50). Although both groups improved (P < .001) in the diagnosis of the superficial spreading melanoma, cohort 2 improved in the diagnosis of the basal cell carcinoma (P < .001) and cohort 1 displayed deterioration in identifying the malignant nature of this lesion (P < .001). For the nodular melanoma, correct diagnosis decreased significantly in cohort 1 (P < .001) and negligibly in cohort 2 (P = .90)., Conclusions: Students receiving the dermoscopy tutorial improve in diagnosis of cutaneous lesions compared with those not receiving the dermoscopy intervention. Teaching SCE with inclusion of dermoscopy may be an effective means of enhancing skin cancer knowledge.
- Published
- 2012
- Full Text
- View/download PDF
44. Dermoscopic features of basal cell carcinomas: differences in appearance under non-polarized and polarized light.
- Author
-
Liebman TN, Jaimes-Lopez N, Balagula Y, Rabinovitz HS, Wang SQ, Dusza SW, and Marghoob AA
- Subjects
- Humans, Light, Microscopy, Polarization, Predictive Value of Tests, Retrospective Studies, Carcinoma, Basal Cell pathology, Dermoscopy, Skin Neoplasms pathology
- Abstract
Background: Basal cell carcinomas (BCCs) can be diagnosed using different dermoscopic modalities., Objective: To evaluate dermoscopic features of BCCs using nonpolarized and polarized dermoscopy to highlight similarities and differences between dermoscopic modalities., Materials and Methods: Retrospective study of 149 BCCs under nonpolarized dermoscopy (NPD), polarized contact dermoscopy (PCD), and polarized noncontact dermoscopy (PNCD). Images were evaluated for a range of dermoscopic colors, structures, and vessels. Features were compared according to histopathologic subtype., Results: The most common dermoscopic structures in BCCs across all modalities included globules (50.3-51.0%), dots (49.7-50.3%), white structureless areas (63.1-74.5%), structureless gray-brown areas (24.2-24.8%), and ulcerations (28.2%). The most frequently observed vasculature included arborizing vessels (18.8-38.3%), short fine telangiectasias (SFTs) (73.8-82.6%), and vascular blush (41.6-83.2%). Structures with higher levels of agreement across modalities included pigmented structures and ulcerations. Lower levels of agreement existed between contact and noncontact modalities for certain vascular features. White shiny structures, which include shiny white lines (chrysalis and crystalline structures) (0-69.1%), shiny white areas (0-25.5%), and rosettes (0-11.4%), exhibited no agreement between NPD and polarized modalities., Conclusions: This study highlights differences in dermoscopic features of BCCs under three dermoscopic modalities. Shiny white lines (chrysalis and crystalline structures) and shiny white areas may be used as additional criteria to diagnose BCCs., (© 2011 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.)
- Published
- 2012
- Full Text
- View/download PDF
45. White shiny structures in melanoma and BCC.
- Author
-
Liebman TN, Rabinovitz HS, Balagula Y, Jaimes-Lopez N, and Marghoob AA
- Subjects
- Humans, Carcinoma, Basal Cell pathology, Melanoma pathology, Skin Neoplasms pathology
- Published
- 2012
- Full Text
- View/download PDF
46. Rosettes may be observed in a range of conditions.
- Author
-
Liebman TN, Scope A, Rabinovitz H, Braun RP, and Marghoob AA
- Subjects
- Carcinoma, Basal Cell diagnosis, Carcinoma, Basal Cell pathology, Carcinoma, Squamous Cell diagnosis, Carcinoma, Squamous Cell pathology, Humans, Keratosis, Actinic pathology, Melanoma diagnosis, Melanoma pathology, Predictive Value of Tests, Skin Neoplasms pathology, Dermoscopy methods, Keratosis, Actinic diagnosis, Skin Neoplasms diagnosis
- Published
- 2011
- Full Text
- View/download PDF
47. Detection of early basal cell carcinoma with dermoscopy in a patient with psoriasis.
- Author
-
Liebman TN and Wang SQ
- Subjects
- Humans, Male, Middle Aged, Carcinoma, Basal Cell complications, Carcinoma, Basal Cell diagnosis, Dermoscopy, Psoriasis complications, Skin Neoplasms complications, Skin Neoplasms diagnosis
- Abstract
A 49-year-old man with a history of basal cell carcinoma and psoriasis presented for routine skin exam and psoriasis management. He had multiple erythematous, scaly patches and plaques, originally diagnosed as psoriasis. Noticeably, one erythematous patch had a focal erosion. Dermoscopy revealed arborizing vessels, an erosion, pink structureless areas, and short, fine telangiectasias (SFTs), suggestive of superficial basal cell carcinoma (sBCC). Dermoscopy of all other lesions was consistent with psoriasis, exhibiting dotted vessels on a faint erythematous background. In conclusion, sBCCs may be overlooked in patients with multiple psoriatic plaques. In this case, the lesions were all initially presumed to be psoriasis. After detecting an erosion, the clinician was prompted to inspect further with dermoscopy and biopsy. Suspicion of sBCC was confirmed after visualization of dermoscopic structures consistent with sBCC. We highlight this case to encourage the use of dermoscopy in these patients for prompt diagnosis of BCCs.
- Published
- 2011
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.