Searched for: person:ecm367
in-biosketch:true
Contact Dermatitis: Emerging Trends
Milam, Emily C; Cohen, David E
The field of contact dermatitis is constantly evolving. Trends in irritant and allergic contact dermatitis are shaped by the introduction of new chemicals, revival of older allergens, industrial practices, and consumer behaviors. This article discusses the most noteworthy trends within the field, organized by allergen category, with particular attention to newer and/or controversial allergens.
PMID: 30466685
ISSN: 1558-0520
CID: 3480812
Contact Dermatitis in the Patient with Atopic Dermatitis
Milam, Emily C; Jacob, Sharon E; Cohen, David E
Atopic dermatitis (AD) and allergic contact dermatitis (ACD) are common T-cell-mediated inflammatory skin conditions that can share clinical presentations. The variable expression of ACD among patients with AD represents the shades of gray of the multifaceted relationship between the 2 disorders, where increased allergen permeation in compromised epidermal barriers augments antigen presentation and sensitization, with subsequent immune dysregulation. Further studies are needed to define the relationship and immunologic intersection points of these 2 conditions.
PMID: 30598176
ISSN: 2213-2201
CID: 3562772
Use of Medical Photography Among Dermatologists: A Nationwide Online Survey Study
Milam, E C; Leger, M C
BACKGROUND:Medical photography enhances patient care, medical education, and research. Despite medical photography's widespread use, little is known about how dermatologists choose to implement photography in routine clinical practice, and how they approach issues of image storage, image security, and patient consent. OBJECTIVE:To characterize dermatologists' medical photography habits and opinions. METHODS:A 32-item anonymous, multiple-choice SurveyMonkey questionnaire about medical photography practices was emailed to program directors of the 117 United States (US) dermatology residency programs between May and August 2015, with a request to forward to faculty and affiliated dermatologists. Only board-certified dermatologists practicing in the US were eligible. The Institutional Review Board exempted our study from full review. RESULTS:Our survey included 153 board-certified dermatologists, primarily representing the northeast (43.1%) and identifying as academic dermatologists (75.5%). Medical photography is prevalent: 61.8% report everyday use and 21.7% photograph every patient. Those reporting rare use (3.3%) were, on average, 20 years older. Dermatologists most commonly use photography to mark biopsy sites (87.5%), track disease (82.9%), and for education/teaching (72.4%). Nearly half (46%) use smartphone cameras. Emailing and texting photographs with patients or colleagues are common (69.1%). Most dermatologists (75.7%) always request patient consent for photographs. Only 23.7% adhere to a photography protocol and 73.9% desire more training opportunities. CONCLUSION/CONCLUSIONS:Dermatologists value medical photography. While patterns of image acquisition, storage, and consent are noted, a variety of methods and preferences exist. Clearer photography guidelines and increased educational resources are likely to improve image quality, exchangeability, and confidentiality.
PMID: 29405432
ISSN: 1468-3083
CID: 2948062
Superficial granulomatous pyoderma of the leg improved after conservative management with Unna boot and intralesional steroid injections
Milam, Emily C; Brinster, Nooshin K
PMID: 30246130
ISSN: 2352-5126
CID: 3313922
Concurrent keratoacanthomas and nonsarcoidal granulomatous reactions in new and preexisting tattoos
Milam, Emily C; Leger, Marie C; McClain, Steve A; Brustein, Dennis M
PMID: 30893398
ISSN: 2326-6929
CID: 3735142
Does Inflammation Mediate the Association Between Obesity and Insulin Resistance?
Adabimohazab, Razieh; Garfinkel, Amanda; Milam, Emily C; Frosch, Olivia; Mangone, Alexander; Convit, Antonio
In adult obesity, low-grade systemic inflammation is considered an important step in the pathogenesis of insulin resistance (IR). The association between obesity and inflammation is less well established in adolescents. Here, we ascertain the importance of inflammation in IR among obese adolescents by utilizing either random forest (RF) classification or mediation analysis approaches. The inflammation balance score, composed of eight pro- and anti-inflammatory makers, as well as most of the individual inflammatory markers differed significantly between lean and overweight/obese. In contrast, adiponectin was the only individual marker selected as a predictor of IR by RF, and the balance score only revealed a medium-to-low importance score. Neither adiponectin nor the inflammation balance score was found to mediate the relationship between obesity and IR. These findings do not support the premise that low-grade systemic inflammation is a key for the expression of IR in the human. Prospective longitudinal studies should confirm these findings.
PMCID:4884488
PMID: 26956471
ISSN: 1573-2576
CID: 2024292
Basal Cell Carcinoma With Intravascular Invasion: A Therapeutic Conundrum [Case Report]
Milam, Emily; Bogart, Megan; Manolson, Pamela
PMID: 27153037
ISSN: 1524-4725
CID: 4482182
An Approach to Cosmeceuticals
Milam, Emily C; Rieder, Evan A
The cosmeceutical industry is a multi-billion dollar, consumer-driven market. Products promise highly desirable anti-aging benefits, but are not subject to regulation. We present an introduction to cosmeceuticals for the general and cosmetic dermatologist, including definitions and explanations of key terms, an approach to the evidence base, a dissection of chamomile and green tea, two paradigmatic cosmeceutical products, and a window into the underlying psychology of this vast marketplace.
PMID: 27050700
ISSN: 1545-9616
CID: 2332252
Well-Demarcated, Scaly Plaques
Milam, Emily C; Meehan, Shane A; Ramachandran, Sarika
PMID: 26836734
ISSN: 1538-3598
CID: 1931992
The use of oral antibiotics before isotretinoin therapy in patients with acne
Nagler, Arielle R; Milam, Emily C; Orlow, Seth J
BACKGROUND: Systemic antibiotics are used widely to treat moderate to severe acne, but increasing antibiotic resistance makes appropriate use a priority. OBJECTIVE: We sought to determine the duration of systemic antibiotic use in patients with inflammatory/nodulocystic acne who eventually required isotretinoin. METHODS: We performed a retrospective, single-site chart review of patients with acne diagnostic codes evaluated January 1, 2005 to December 31, 2014, at a dermatology practice in an academic medical center. Included patients were prescribed isotretinoin during the study period and received 30 days or more of antibiotics. RESULTS: The average duration of antibiotic use was 331.3 days. In all, 21 patients (15.3%) were prescribed antibiotics for 3 months or less, 88 patients (64.2%) for 6 months or more, and 46 patients (33.6%) for 1 year or longer. Patients treated only at the study site had a mean duration of antibiotic treatment of 283.1 days whereas patients who also received antibiotics from another institution had a mean duration of 380.2 days. This difference approached statistical significance (P = .054). LIMITATIONS: This study was limited to a single center. CONCLUSION: Expert guidelines recommend responsible use of antibiotics in acne in light of emerging resistance. We found that patients who eventually received isotretinoin had extended exposure to antibiotics, exceeding recommendations. Early recognition of antibiotic failure and the need for isotretinoin can curtail antibiotic use.
PMID: 26525749
ISSN: 1097-6787
CID: 1825782