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38


Implementation of Mohs micrographic surgery at the VA New York Manhattan Harbor Healthcare System eliminated need for re-excision and decreased time to treatment: A retrospective and prospective cohort study

Himeles, Jaclyn Rosenthal; Steuer, Alexa Beth; Sally, Rachel; Gutierrez, Daniel; Zampella, John G; Stevenson, Mary L; Carucci, John A; Lee, Nayoung
PMID: 38149943
ISSN: 1097-6787
CID: 5623592

Risk of Radiation Dermatitis in Patients With Skin of Color Who Undergo Radiation to the Breast or Chest Wall With and Without Regional Nodal Irradiation

Purswani, Juhi M; Bigham, Zahna; Adotama, Prince; Oh, Cheongeun; Xiao, Julie; Maisonet, Olivier; Teruel, Jose R; Gutierrez, Daniel; Tattersall, Ian W; Perez, Carmen A; Gerber, Naamit K
PURPOSE/OBJECTIVE:Acute radiation dermatitis (ARD) is common after radiation therapy for breast cancer, with data indicating that ARD may disproportionately affect Black or African American (AA) patients. We evaluated the effect of skin of color (SOC) on physician-reported ARD in patients treated with radiation therapy. METHODS AND MATERIALS/METHODS:We identified patients treated with whole breast or chest wall ± regional nodal irradiation or high tangents using 50 Gy in 25 fractions from 2015 to 2018. Baseline skin pigmentation was assessed using the Fitzpatrick scale (I = light/pale white to VI = black/very dark brown) with SOC defined as Fitzpatrick scale IV to VI. We evaluated associations among SOC, physician-reported ARD, late hyperpigmentation, and use of oral and topical treatments for RD using multivariable models. RESULTS:A total of 325 patients met eligibility, of which 40% had SOC (n = 129). On multivariable analysis, Black/AA race and chest wall irradiation had a lower odds of physician-reported grade 2 or 3 ARD (odds ratio [OR], 0.110; 95% confidence interval [CI], 0.030-0.397; P = .001; OR, 0.377; 95% CI, 0.161-0.883; P = .025), whereas skin bolus (OR, 8.029; 95% CI, 3.655-17.635; P = 0) and planning target volume D0.03cc (OR, 1.001; 95% CI, 1.000-1.001; P = .028) were associated with increased odds. On multivariable analysis, SOC (OR, 3.658; 95% CI, 1.236-10.830; P = .019) and skin bolus (OR, 26.786; 95% CI, 4.235-169.432; P = 0) were associated with increased odds of physician-reported late grade 2 or 3 hyperpigmentation. There was less frequent use of topical steroids to treat ARD and more frequent use of oral analgesics in SOC versus non-SOC patients (43% vs 63%, P < .001; 50% vs 38%, P = .05, respectively). CONCLUSIONS:Black/AA patients exhibited lower odds of physician-reported ARD. However, we found higher odds of late hyperpigmentation in SOC patients, independent of self-reported race. These findings suggest that ARD may be underdiagnosed in SOC when using the physician-rated scale despite this late evidence of radiation-induced skin toxicity.
PMID: 37060928
ISSN: 1879-355x
CID: 5502812

Tache and talon noir in patient with mycosis fungoides on acitretin

Obijiofor, Chinemelum; Yin, Emily; Shvartsbeyn, Marianna; Latkowski, Jo-Ann; Ahearn, Ian; Gutierrez, Daniel
PMID: 37921829
ISSN: 1087-2108
CID: 5614492

Osimertinib-associated erythema dyschromicum perstans-like eruption: A case series [Case Report]

Oh, Christina S; Martinez, Michael J; Meehan, Shane; Gutierrez, Daniel; Tattersall, Ian W
PMCID:10106340
PMID: 37078012
ISSN: 2352-5126
CID: 5466262

A cross-sectional survey of dermatologists: assessing practice patterns in sexually transmitted infections [Letter]

Chansky, Peter B; Shah, Payal; Gutierrez, Daniel; Kuhner, Christopher; Zampella, John
PMID: 35393686
ISSN: 1365-4632
CID: 5219712

A multicenter descriptive analysis of 270 men with frontal fibrosing alopecia and lichen planopilaris in the United States

Pathoulas, James T; Flanagan, Kelly E; Walker, Chloe J; Collins, Maya S; Ali, Shaheir; Pupo Wiss, Isabel M; Cotsarelis, George; Milbar, Heather; Huang, Kathie; Mostaghimi, Arash; Scott, Deborah; Han, Jane J; Lee, Karen J; Hordinsky, Maria K; Farah, Ronda S; Bellefeuille, Gretchen; Raymond, Ora; Bergfeld, Wilma; Ranasinghe, Geraldine; Shapiro, Jerry; Lo Sicco, Kristen I; Gutierrez, Daniel; Ko, Justin; Mirmirani, Paradi; Mesinkovska, Natasha; Yale, Katerina L; Goldberg, Lynne J; Tosti, Antonella; Gwillim, Eran C; Goh, Carolyn; Senna, Maryanne M
PMID: 36396001
ISSN: 1097-6787
CID: 5384952

Comment on "Skin disease of the breast and nipple" [Letter]

Gutierrez, Daniel; Steuer, Alexa B; Pomeranz, Miriam K; Femia, Alisa N
PMID: 31972256
ISSN: 1097-6787
CID: 4273982

Dermatologist Awareness of Scalp Cooling for Chemotherapy-induced Alopecia

Yin, Lu; Klein, Elizabeth J; Svigos, Katerina; Novice, Taylor; Gutierrez, Daniel; Oratz, Ruth; Lacouture, Mario E; Powers, Molly; Senna, Maryanne; Shapiro, Jerry; Lo Sicco, Kristen
PMID: 35278488
ISSN: 1097-6787
CID: 5221002

Radiation-induced skin changes after breast or chest wall irradiation in patients with breast cancer and skin of color: a systematic review

Purswani, Juhi M; Nwankwo, Christy; Adotama, Prince; Gutierrez, Daniel; Perez, Carmen A; Tattersall, Ian W; Gerber, Naamit K
INTRODUCTION/BACKGROUND:The purpose of this study is to systematically review data pertaining to breast cancer and radiation-induced skin reactions in patients with skin of color (SOC), as well as data pertaining to objective measurements of skin pigmentation in the assessment of radiation dermatitis (RD). METHODS AND MATERIALS/METHODS:We conducted a systematic review utilizing MEDLINE electronic databases to identify published studies until August 2022. Key inclusion criteria included studies that described RD in breast cancer with data pertaining to skin of color and/or characterization of pigmentation changes after radiation. RESULTS:We identified 17 prospective cohort studies, 7 cross-sectional studies, 5 retrospective studies and 4 randomized controlled trials. Prospective cohort and retrospective series demonstrate worse RD in African American (AA) patients using subjective physician-graded scales. There is more limited data in patients representing other non-White racial subgroups with SOC. 2 studies utilize patient reported outcomes and 15 studies utilize objective methods to characterize pigmentation change after radiation. There are no prospective and randomized studies that objectively describe pigmentation changes with radiotherapy in SOC. CONCLUSIONS:AA patients appear to have worse RD outcomes, though this is not uniformly observed across all studies. There are no studies that describe objective measures of RD and include baseline skin pigmentation as a variable, limiting the ability to draw uniform conclusions on the rate and impact of RD in SOC. We highlight the importance of objectively characterizing SOC and pigmentation changes before, during and after radiotherapy to understand the incidence and severity of RD in SOC.
PMID: 36335037
ISSN: 1938-0666
CID: 5358952

Improving knowledge of hair loss disorders: Assessing the efficacy of a dermatologist-developed social media video library for patient education

Klein, Elizabeth J; Karim, Maria; Sukhdeo, Kumar; Svigos, Katerina; Yin, Lu; Peterson, Erik; Gutierrez, Daniel; Shapiro, Jerry; Lo Sicco, Kristen
PMCID:9563319
PMID: 36248208
ISSN: 2666-3287
CID: 5360162