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118


Reply to: Monogenic early-onset sarcoidosis is no longer a variant of "idiopathic" sarcoidosis [Letter]

Haimovic, Adele; Sanchez, Miguel; Judson, Marc A; Prystowsky, Stephen
PMID: 23768293
ISSN: 0190-9622
CID: 394122

Skin conditions of baseball, cricket, and softball players

Farhadian, Joshua A; Tlougan, Brook E; Adams, Brian B; Leventhal, Jonathan S; Sanchez, Miguel R
Each year in the United States over 80 million people participate in bat-and-ball sports, for example baseball and softball. Cricket, the world's second most popular sport, is enjoyed by hundreds of millions of participants in such countries as India, Pakistan, Australia, New Zealand, Bangladesh, South Africa, West Indies, Sri Lanka, United Kingdom, and Zimbabwe. Although any player can develop skin disease as a result of participation in these bat-and-ball sports, competitive team athletes are especially prone to skin problems related to infection, trauma, allergy, solar exposure, and other causes. These diseases can produce symptoms that hinder individual athletic performance and participation. In this review, we discuss the diagnosis and best-practice management of skin diseases that can develop as a result of participation in baseball, softball, and cricket.
PMID: 23456491
ISSN: 0112-1642
CID: 402112

Generalized essential telangiectasia

Gordon Spratt, Elizabeth A; Defelice, Taylor; Robinson, Maria; Patel, Rishi R; Sanchez, Miguel
Generalized essential telangiectasia, which is a rare condition that is characterized by the progressive development of telangiectases on the skin, is a clinical diagnosis of exclusion. We present a 65-year-old man with a ten-month history of an asymptomatic eruption of the trunk and proximal aspects of the arms and hands that was comprised of macules and patches of telangiectases. The clinical presentation, associated diseases, hypotheses regarding pathogenesis, differential diagnoses, and reports on treatment modalities are reviewed. The relatively new association of this entity with systemic signs that include hemorrhage as well as the occurrence of generalized essential telangiectasia in patients with a history of hepatitis is discussed.
PMID: 23286803
ISSN: 1087-2108
CID: 211292

Spiradenomas

Tran, Kathleen; Defelice, Taylor; Robinson, Maria; Patel, Rishi R; Sanchez, Miguel
We report a 52-year-old man with a one-year history of multiple, firm, skin-colored nodules on the vertex of the scalp. Histopathologic examination was consistent with a spiradenoma, which is a rare, benign adnexal tumor of controversial histogenesis. Multiple spiradenomas may arise in association with Brooke-Spiegler syndrome, which is an autosomal dominant condition of multiple cyclindromas, trichoeptheliomas, and cyclindromas.
PMID: 23286805
ISSN: 1087-2108
CID: 211312

Serratia marcescens folliculitis and concomitant acne vulgaris

Lehrhoff, Stephanie; Yost, John; Robinson, Maria; Patel, Rishi; Sanchez, Miguel
We present a unique case of S. marcescens folliculitis of the trunk in a 46-year-old woman with a history of facial acne vulgaris during her teen years. Her eruption occurred at the time of elective ambulatory surgery when she was treated with pre and post-operative antibiotics. The diagnosis of S. marcescens folliculitis was made on the basis of histopathologic features and tissue culture of a skin biopsy specimen of a pustule after her eruption was unresponsive to conventional treatment for inflammatory acne vulgaris. The history and pathophysiology of gram-negative folliculitis in the setting of acne vulgaris is reviewed.
PMID: 23286809
ISSN: 1087-2108
CID: 211332

Verrucous lymphangioma circumscriptum

Terushkin, Vitaly; Marmon, Shoshana; Fischer, Max; Patel, Rishi; Sanchez, Miguel R
A 19-year-old woman with a seven-year history of pruritic, grouped, verrucous papules and plaques on the left arm presented for consultation. The lesion slightly flattened in appearance with topical glucocorticoid treatment. The histopathological features were consistent with lymphangioma circumscriptum. This entity is the most common subtype of lymphangioma and presents with grouped, clear vesicles that may appear pink to purple. However, a rare verrucous type can present a diagnostic challenge. Whereas the definitive treatment option is surgical excision, other treatments, which include sclerotherapy, radiotherapy, and laser therapy, have been reported to cause resolution or improvement. In the future, propranolol may hold promise as a medical therapy for lymphangioma.
PMID: 23286799
ISSN: 1087-2108
CID: 211252

Anetoderma secondary to antiphospholipid antibodies

Eungdamrong, John; Fischer, Max; Patel, Rishi; Meehan, Shane; Sanchez, Miguel
Anetoderma is an elastolytic disorder that is associated with a number of infectious and autoimmune disorders. We present a case of a patient with generalized anetoderma, who was later found to have positive antinuclear antibodies and antiphospholipid antibodies (APAs). Numerous other cases have been reported in literature and some authors have suggested that anetoderma is a highly specific sign of APAs, with or without other manifestations of systemic lupus erythematosus or antiphospholipid syndrome [14]. Thus, work up for connective-tissue disorders should be considered in any patients who present with this skin finding.
PMID: 23286816
ISSN: 1087-2108
CID: 211402

Is it Time to Re-evaluate the Treatment of Pemphigus?

Leventhal, Jonathan S; Sanchez, Miguel R
Pemphigus vulgaris, foliaceous, and vegetans are potentially fatal, autoimmune, vesiculobullous mucocutaneous diseases. In order to prevent potentially fatal infection and other complications, most patients with pemphigus require treatment with systemic corticosteroids and immunosuppressive agents, although these medications often cause chronic and serious adverse effects. Many case reports and several trials have documented remissions and clinical improvement in cases of pemphigus recalcitrant to standard therapy, who were treated with either intravenous immunoglobulin (IVIG) or rituximab, alone or in combination with each other. Collectively, the body of evidence from these reports is large enough to spark consideration of these treatments early in the management of pemphigus. Among the potential benefits of a therapeutic strategy that includes these biologic agents are more rapid induction of remission, prevention of corticosteroid-related adverse effects, and decreased cost of therapy. Considering the outcomes from recent trials with these novel therapies, reevaluation of the best-practice treatment of pemphigus seems prudent and timely.
PMID: 23134985
ISSN: 1545-9616
CID: 182192

Sarcoidosis: A comprehensive review and update for the dermatologist: Part II. Extracutaneous disease

Haimovic, Adele; Sanchez, Miguel; Judson, Marc A; Prystowsky, Stephen
Sarcoidosis is a multisystemic, granulomatous disease with protean manifestations and variable prognosis. Because the skin can be the only organ in which the disease is recognized, dermatologists may be responsible for the care of sarcoidosis patients. Therefore, dermatologists should be cognizant of the disease's extracutaneous manifestations to assure appropriate evaluation and treatment. Part II of this review describes the diagnostic approach and management of the extracutaneous manifestations of sarcoidosis.
PMID: 22507586
ISSN: 0190-9622
CID: 164371

Sarcoidosis: A comprehensive review and update for the dermatologist: Part I. Cutaneous disease

Haimovic, Adele; Sanchez, Miguel; Judson, Marc A; Prystowsky, Stephen
Sarcoidosis is a common systemic, noncaseating granulomatous disease of unknown etiology. The development of sarcoidosis has been associated with a number of environmental factors and genes. Cutaneous sarcoidosis, the "great imitator," can baffle clinicians because of its diverse manifestations and its ability to resemble both common and rare cutaneous diseases. Depending on the type, location, and distribution of the lesions, treatment can prevent functional impairment, symptomatic distress, scarring, and disfigurement. Numerous therapeutic options are available for the treatment of cutaneous sarcoidosis, but there are few well designed trials to guide practitioners on evidence-based, best practice management. In part I, we review the current knowledge and advances in the epidemiology, etiology, pathogenesis, and genetics of sarcoidosis, discuss the heterogeneous manifestations of cutaneous sarcoidosis, and provide a guide for treatment of cutaneous sarcoidosis.
PMID: 22507585
ISSN: 0190-9622
CID: 164370