Try a new search

Format these results:

Searched for:



Total Results:


Staged melanoma excision requires larger margins for tumor clearance and results in low rates of recurrence

Himeles, Jaclyn Rosenthal; Criscito, Maressa C; Lee, Nayoung; Stevenson, Mary L; Carucci, John A
There is controversy regarding the optimal surgical modality and ideal recommended margins for treating melanoma in situ (MIS) and invasive melanoma (IM). Although wide local excision is recommended, staged excision offers excellent margin control and low recurrence rates. In this manuscript, we reviewed a 10-year experience of staged excisions for the treatment of MIS and IM. A retrospective review was performed of 130 MIS and 32 IM cases treated with staged excision from April 2012 to April 2022. Staged excision was performed on the head and neck in 102 (79%) MIS and 23 (72%) IM cases. Approximately 10% of cases required surgical margins above the current recommendations (11 (9%) MIS and 6 (19%) IM). Twenty-three (19%) MIS and 7 (22%) IM cases required more than one excision to obtain clearance. Recurrence rates among MIS and IM were 0.0% and 0.6%, respectively. Upstaging occurred in 5 (4%) MIS and 7 (22%) IM cases. Complex repairs were performed on 82 (63%) MIS and 17 (53%) IM cases. Our findings revealed that staged excision provides effective margin control and low recurrence rates. Approximately 10% of patients required margins greater than the current recommendations, leading to larger defects and more complex repairs.
PMID: 36416976
ISSN: 1432-069x
CID: 5384232

Applying Occam's Razor and Descending the Reconstructive Ladder: The Modified Cheek Advancement Flap for Reconstruction of Nasal Defects

Rosenthal Himeles, Jaclyn; Criscito, Maressa; Kellner, Rebecca; Lee, Nayoung; Stevenson, Mary L; Sclafani, Anthony P; Carucci, John A
INTRODUCTION/BACKGROUND:Nasal reconstruction has important functional and cosmetic considerations, as proper repair of nasal defects is necessary to maintain function of the nasal airway and to recreate the normal appearance of this central facial structure. Cheek advancement flaps provide matched, mobile and highly vascularized tissue for the reconstruction of nasal defects, allowing for the concealment of incisions within natural creases in a one-stage approach. However, cheek advancement flaps are often underutilized for nasal reconstruction because of their difficulty restoring nasal contour. METHODS:We describe reconstruction of 19 nasal dorsal and sidewall defects 0.8 to 3.0 centimeters (cm) in size. We incorporated a periosteal anchoring suture to maintain/restore nasal contour and additionally removed a half standing cone inferior to the defect to prevent encroachment of the nasal ala or alar crease. All patients were evaluated at least 3 months post-operatively. RESULTS:In all patients, we were able to restore concavity of the nasofacial sulcus, preserve the biconvex nasal tips, prevent alar flaring and retraction and conserve the alar groove. All patients had excellent functional and cosmetic outcomes. CONCLUSION/CONCLUSIONS:We believe this modified cheek advancement flap provides functionally and aesthetically superior results and can be considered as a first-line approach for repair of nasal dorsal and sidewall defects in sub selected patients.
PMID: 36075379
ISSN: 1098-8793
CID: 5337162

Characterizing cutaneous malignancies in patients with skin of color treated with Mohs micrographic surgery

Juarez, Michelle C; Criscito, Maressa C; Pulavarty, Akshay; Stevenson, Mary L; Carucci, John A
PMID: 36965670
ISSN: 1097-6787
CID: 5462992

Reconstruction of a Defect on the Dorsal Third Digit

Criscito, Maressa C; Lachman, Nirusha; Carucci, John A
PMID: 35066547
ISSN: 1524-4725
CID: 5154262

Assessing rates of compliance with national guidelines regarding sentinel lymph node biopsy for invasive melanomas treated with Mohs micrographic surgery

Cheraghlou, Shayan; Doudican, Nicole A; Criscito, Maressa C; Stevenson, Mary L; Carucci, John A
PMID: 35987400
ISSN: 1097-6787
CID: 5300462

Deliberate practice-based surgical curriculum leads to enhanced technical proficiency among dermatology residents

Criscito, Maressa C; Wilken, Reason; Stevenson, Mary L; Carucci, John A
Deliberate practice-based medical education has demonstrated superiority in trainee acquisition and maintenance of skills in several surgical subspecialties. In an effort to highlight the impact of a deliberate practice-based surgical curriculum on the technical proficiency of dermatology residents, a prospective cohort study including first- and second-year dermatology residents was performed. A total of 87.5% (7 of 8) first-year dermatology residents completed three hands-on simulations at 6-week intervals. Additionally, six of eight (75.0%) second-year dermatology residents at the same institution were evaluated at a single point-in-time session without accessing the surgical curriculum prior. A 5-point global rating scale (GRS) was used to assess resident performance on six core surgical techniques. Nonparametric ANOVA statistical methods using the Kruskal-Wallis test was performed. The residents' overall GRS increased from a median of 1-2.75 after completion of the curriculum (p < 0.01). There was a significant improvement in the median scores of each tested surgical technique. The first-year residents had a greater overall GRS after completion of the curriculum compared to the second-year residents (median of 2.13 versus 1.88, p < 0.001). Limitations include the small sample size and lack of a synchronized control group. Our study highlights the use of deliberate practice-based strategies as an effective modality in teaching surgical skills to dermatology residents.
PMID: 35476153
ISSN: 1432-069x
CID: 5217482

Chronic lymphocytic leukemia and the skin: implications for the dermatologist

Fried, Lauren J; Criscito, Maressa C; Stevenson, Mary L; Pomeranz, Miriam K
B-cell chronic lymphocytic leukemia (CLL) is the most prevalent leukemia in the United States, and its diagnosis can have many dermatologic implications. For one, the cutaneous manifestations of CLL include several entities, most notably leukemia cutis, eosinophilic dermatosis of hematologic malignancy, and a heightened risk of skin infections. Additionally, CLL patients are at an increased risk of secondary malignancies, most commonly of the skin. Furthermore, a number of commonly utilized treatments for CLL have cutaneous implications which should be considered in the interdisciplinary management of CLL patients. In this review, we will provide an update on the diverse cutaneous manifestations of CLL and CLL-directed therapies in order to help guide dermatologic management of this increasingly prevalent patient population.
PMID: 33951189
ISSN: 1365-4632
CID: 4897992

A red plaque on the face of a healthy man

Criscito, Maressa C; Meehan, Shane A; Stevenson, Mary L
PMID: 35198704
ISSN: 2352-5126
CID: 5167752

Profound leukemia cutis in a patient with relapsed T-cell acute lymphoblastic leukemia [Case Report]

Nohria, Ambika; Criscito, Maressa C; Weston, Gillian K; Kim, Randie H; Lo Sicco, Kristen I; Femia, Alisa N; Hejazi, Emily Z; Milam, Emily C
PMID: 34815993
ISSN: 2352-5126
CID: 5063622

Papillary Dermal Elastolysis Secondary to Combination Nivolumab and Cabiralizumab Therapy: Histiocytes and Dermal Mucin as Clues to the Diagnosis

Yin, Lu; Criscito, Maressa C; Stokar, Evan; Siolas, Despina; Haimovic, Adele; Lo Sicco, Kristen; Brinster, Nooshin K
ABSTRACT/UNASSIGNED:Papillary dermal elastolysis has been described in the setting of experimental combination nivolumab and cabiralizumab immunotherapy. We report a third patient with distinctive, generalized atrophic macules that developed after a morbilliform eruption during a clinical trial for treatment of metastatic pancreatic adenocarcinoma. Histopathological findings demonstrated diminished elastic fibers in the papillary dermis, associated with a histiocyte-rich infiltrate and increased dermal mucin, features that should clue the dermatopathologist to this condition.
PMID: 34086644
ISSN: 1533-0311
CID: 4892152