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A prospective study evaluating the utility of a 2-mm biopsy margin for complete removal of histologically atypical (dysplastic) nevi

Terushkin, Vitaly; Ng, Elise; Stein, Jennifer A; Katz, Susan; Cohen, David E; Meehan, Shane; Polsky, David
BACKGROUND: Complete removal of individual dysplastic nevi (DN) is often accomplished by a second surgical procedure after the initial biopsy. The choice to perform the second procedure is strongly influenced by histopathologic margin status of the initial biopsy specimen. OBJECTIVE: To evaluate the clinical and histopathologic outcomes of in toto biopsy of DN using a predetermined margin of normal skin. METHODS: We conducted a prospective study of a saucerization method using a defined 2-mm margin in patients undergoing biopsy of a pigmented skin lesion. RESULTS: We performed 151 biopsies in 138 patients. Overall, 137 of 151 lesions subjected to biopsy (90.7%) were melanocytic: 86 DN (57.0%), 40 nevi without atypia (26.5%), and 11 melanomas (7.3%). Of 78 DN, 68 (87.2%) were removed with clear histopathologic margins (8 DN were excluded because of inadequate processing). There was no clinical evidence of recurrence at any of the biopsy sites that were simply observed (i.e., not re-excised) over a median of 16.9 months. LIMITATIONS: There were few biopsies performed on the face. CONCLUSIONS: The complete histopathologic removal of nearly 9 of 10 DN using a peripheral margin of 2 mm of normal skin and a depth at the dermis and subcutaneous fat junction has the potential to decrease second procedures at DN biopsy sites, thereby decreasing patient morbidity and saving health care dollars.
PMID: 28982585
ISSN: 1097-6787
CID: 2720142

Pulmonary sarcoidosis and latent tuberculosis in a patient with psoriasis treated with adalimumab

Korta, Dorota Z; Ochieng, Pius; Fishman, Donald; Katz, Susan E
Tumor necrosis factor (TNF) inhibitors are powerful biologic medications that have been used successfully in the treatment of a variety of inflammatory conditions, including psoriasis. Although TNF inhibitors are generally well tolerated, their use increases the risk of infections such as tuberculosis (TB), and paradoxically, they have been associated with development of sarcoidosis. We report the case of a 54-year old man with plaque psoriasis who developed a positive TB test and pulmonary sarcoidosis after 12 months of adalimumab treatment. After stopping adalimumab, his psoriasis worsened and he was started on ustekinumab and narrowband UVB, with improvement in symptoms. We provide a review of the literature and discuss treatment challenges.
PMID: 25612132
ISSN: 1087-2108
CID: 1448712

Muscarinic receptors on human eccrine sweat gland in aging and Alzheimer's disease

Ryer, H I; Katz, S E; Serby, M
Age and Alzheimer's disease-related changes have been reported in the peripheral cholinergic system controlling sweating. We present (1) evidence of a high affinity muscarinic receptor localized on human eccrine sweat gland and (2) muscarinic receptor concentrations on eccrine gland samples from 22 patients with probable Alzheimer's disease of various degrees of dementia, 8 age-matched controls, and 11 young controls. Muscarinic receptors were measured using autoradiography with 3H-NMS as ligand. We found no evidence of changes related to aging or Alzheimer's disease in the overall concentration of receptors or in the amount of gland showing binding. Nor was there any correlation between the degree of dementia as measured by the Global Deterioration Scale or the Mini-Mental State Exam and 3H-NMS binding. In conclusion, we find no evidence that previously reported sweat gland functional changes associated with aging and Alzheimer's disease are reflected in changes in eccrine gland muscarinic receptor density.
PMID: 7711163
ISSN: 0006-3223
CID: 314452

Erythema chronicum migrans, Lyme disease, and other borrelioses

Katz, S E
PMID: 2061450
ISSN: 0190-9622
CID: 1521732

In vitro autoradiography of muscarinic acetylcholine receptors in human skin

Ryer, H I; Nock, B; Serby, M; Katz, S; McEwen, B S
PMID: 3948927
ISSN: 0014-2999
CID: 314462