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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
PMID: 36248208
ISSN: 2666-3287
CID: 5360162

Risk of Radiation Dermatitis in Patients with Skin of Color Who Undergo Radiation to the Breast or Chest Wall Irradiation and Regional Nodes [Meeting Abstract]

Purswani, J; Oh, C; Xiao, J; Teruel, J R; Perez, C A; Gutierrez, D; Adotama, P; Tattersall, I; Gerber, N K
Purpose/Objective(s): Radiation dermatitis (RD) is common after RT for breast cancer with data indicating potentially worse RD in African American (AA) patients (pts). Current measures of RD, such as the CTCAE, do not include hyperpigmentation, which may disproportionately affect how RD is classified and treated in pts with skin of color (SOC). We aim to characterize RD in SOC and identify factors, including baseline skin pigmentation (BSP) that predict RD. Materials/Methods: Pts treated with whole breast (WB) or chest wall (CW) with regional nodal RT or high tangents with 50 Gy in 25 fractions from 2015-2018 were identified. Three dermatologists independently classified BSP using photographs from CT simulation based on the Fitzpatrick scale ([FS], range=I-VI; I=light/pale white to VI=black/ very dark brown). SOC was defined as FS IV-VI. Pt characteristics were investigated for association with interventions to treat RD, clinician-graded acute RD, and late skin toxicity (NCI CTCAE scale) with Chi-squared and logistic regression analyses.
Result(s): 325 pts met eligibility criteria (58 African American [AA], 42 Asian, 151 Caucasian, 77 other). 40% (n=129) had SOC, 60% underwent CW RT, 40% WB RT and 82% had systemic therapy. Pts with SOC were more likely to be Hispanic (14% vs 8% p=0.007), AA (43% vs 1%, p<0.001) and have greater mean BMI (28.0 vs 26.5, p=0.02). Acute grade 2/3 RD was lower in SOC (FS I 60%, FS II 63%, FS III 52%, FS IV 64%, FS V 40%, FS VI 41%; p=0.049). Increased BSP (OR 0.83; p=0.01) and AA pts (OR: 0.22; p<0.001) had lower odds of acute grade 2/3 RD, whereas bolus and dosimetric parameters such as increased PTV volume had increased odds. On multivariable analysis (MVA), AA pts and bolus remained significant (OR: 0.14, p=0.01; OR: 6.63 p<0.001, respectively). Topical steroid use to treat RD was less frequent and oral analgesic use was more frequent in SOC (43% vs 63%, p<0.001; 50% vs 38%, p=0.05, respectively). Pts with increased BSP (OR 0.73, p<0.001), AA race (OR 0.19, p<0.001) and greater BMI had lower use of topical interventions whereas any boost phase, bolus, IMN RT and increased PTV volume had greater use. On MVA, AA pts (OR 0.27, p=0.04), boost (OR 2.04, p=0.033), IMN RT (OR 2.73, p=0.003) and PTV V105% (OR=1.002, p=0.03) retained significance. Late grade 2/3 hyperpigmentation was greater in SOC (16% vs 3%, p=0.01). Increased BSP (OR 2.14, p=0.001), AA pts (OR 8.18, p=0.02), bolus and CW boost had greater odds of grade 2/3 hyperpigmentation. On MVA, increased BSP (OR: 3.76, p=0.03) and bolus (OR: 14.1, p=0.01) retained significance.
Conclusion(s): We found less clinician-graded acute RD in SOC and AA pts, less frequent use of topical interventions but more oral analgesic use. We also found higher rates of late pigmentation change with increased BSP independent of race. These findings suggest that RD may be under-diagnosed in SOC. This study confirms the necessity for objective measures of RD that account for variability in BSP to accurately classify the severity of radiation skin toxicity in SOC and treat accordingly.
ISSN: 1879-355x
CID: 5366242

HIV Pre-exposure Prophylaxis (PrEP): A Survey of Dermatologists' Knowledge and Practice Patterns [Letter]

Gutierrez, Daniel; Shah, Payal; Zampella, John G
PMID: 36446102
ISSN: 2326-6929
CID: 5383412

Response to Ranpariya et al.'s "Direct-to-consumer teledermatology platforms may have inherent conflicts of interest." [Letter]

Karim, Maria; Klein, Elizabeth; Gutierrez, Daniel; Adotama, Prince; Lo Sicco, Kristen
PMID: 34998962
ISSN: 1097-6787
CID: 5118172

Prominent dyspigmentation in a patient with dermatomyositis and TIF1-γ autoantibodies [Case Report]

Gutierrez, Daniel; Svigos, Katerina; Femia, Alisa; Brinster, Nooshin K; Lo Sicco, Kristen
PMID: 35355654
ISSN: 2352-5126
CID: 5219942