Jennifer A Stein, M.D., Ph.D.

Single versus multiple primary melanomas: Old questions and new answers
Hwa C; Price LS; Belitskaya-Levy I; Ma MW; Shapiro RL; Berman RS; Kamino H; Darvishian F; Osman I; Stein JA
2012 Jan 13;:?-?, Cancer
BACKGROUND: In patients with multiple primary melanomas (MPM), mean tumor thickness tends to decrease from the first melanoma to the second melanoma, and prognosis may be improved compared with the prognosis for patients who have a single primary melanoma (SPM). In this study, the authors compared the clinicopathologic features of patients with MPM and SPM to better characterize the differences between these 2 groups and to determine whether or not there is an inherent difference in tumor aggression. METHODS: In total, 788 patients with melanoma who were enrolled prospectively in the Interdisciplinary Melanoma Cooperative Group database from 2002 to 2008 were studied. Patients with SPM and with MPM were compared with regard to clinical and primary melanoma characteristics. RESULTS: Of 788 patients with melanoma, 61 patients (7.7%) had 2 or more primary melanomas. The incidence of developing a second primary melanoma 1 year and 5 years after initial melanoma diagnosis was 4.1% and 8.7%, respectively, and most of the risk accumulated within the first year. The incidence of MPM was greater in patients aged >/=60 years than in those aged </=60 years. The absence or presence of mitosis and other tumor characteristics did not differ significantly between patients with SPM and patients with MPM (P = .61). CONCLUSIONS: No difference was observed in the presence or absence of mitoses, a marker of tumor proliferation, in SPM and MPM. Because it has been demonstrated that the presence of mitosis is a powerful prognostic marker, the current findings suggested that the tumors behave similarly in patients with SPM and patients with MPM. The authors concluded that differences in tumor thickness and prognosis between SPM and MPM more likely are caused by factors other than tumor biology, such as increased surveillance. Cancer 2012;. (c) 2012 American Cancer Society
— id: 150011, year: 2012, vol: , page: ?, stat: Journal Article,

Exercise-induced progressive pigmentary purpura of the forehead
Hwa, Charlotte; Brauer, Jeremy A; Mundi, Jyoti P; Wu, Julie M; Patel, Rishi R; Greenspan, Alan; Stein, Jennifer A
2011 Nov;65(5):e149-e150, Journal of the American Academy of Dermatology
— id: 139478, year: 2011, vol: 65, page: e149, stat: Journal Article,

Achieving hemostasis after nail biopsy using absorbable gelatin sponge saturated in aluminum chloride
Hwa, Charlotte; Kovich, Olympia I; Stein, Jennifer A
2011 Mar;37(3):368-369, Dermatologic surgery
The authors have indicated no significant interest with commercial supporters
— id: 127233, year: 2011, vol: 37, page: 368, stat: Journal Article,

Letter: "mushroom-cloud sign" of melanoma
Mahlberg, Matthew J; Hwa, Charlotte; Kopf, Alfred W; Stein, Jennifer A
2011 Oct;37(10):1546-1548, Dermatologic surgery
JA Stein was supported by the Irwin I. Lubowe Fellowship in Dermatology
— id: 141706, year: 2011, vol: 37, page: 1546, stat: Journal Article,

Eruptive collagenomas
Batra, Priya; Loyd, Aaron; Patel, Rishi; Walters, Ruth; Stein, Jennifer A
2010 ;16(11):3-3, Dermatology online journal
A 24-year-old woman presented with hypopigmented papules of the abdomen that had been present for four years without a family history of similar cutaneous findings or associated medical problems. Histopathologic features confirmed the diagnosis of a connective-tissue nevus that was composed of collagen. Eruptive collagenomas are a rare form of acquired collagenomas, which are characterized by the sudden appearance of asymptomatic papules and nodules on the lower trunk and extremities; the lesions are composed of haphazardly arranged collagen fibers. The pathogenesis is unknown, lesions are persistent, and therapeutic options have not been reported
— id: 115715, year: 2010, vol: 16, page: 3, stat: Journal Article,

Atypical carcinoid metastasis to the skin
Blochin, Elen; Stein, Jennifer A; Wang, Nadia S
2010 Oct;32(7):735-739, American journal of dermatopathology
Carcinoid tumors are derived from neuroendocrine cells, and are most frequently found in the gastrointestinal tract and bronchopulmonary system. Cutaneous involvement of carcinoid tumors is relatively rare, with isolated case reports in the literature. We detail a patient with stage IV pulmonary atypical carcinoid tumor with skin metastasis. This case is unusual because the patient did not have any erythema or induration of the scalp, only a complaint of pain. On biopsy, the tumor cells had cytologic features of a carcinoid tumor, but were arranged as infiltrating cords, small aggregates and single units, rather than the organoid or trabecular pattern seen in the primary tumor. Further, along with neuroendocrine markers, the tumor cells had the staining pattern of cytokeratin 7+/cytokeratin 20-/thyroid transcription factor-1+, supporting a carcinoid tumor of lung origin. Thus, this case of skin metastasis from an atypical pulmonary carcinoid tumor illustrates a unique clinical and histologic presentation
— id: 112548, year: 2010, vol: 32, page: 735, stat: Journal Article,

Porokeratosis plantaris, palmaris, et disseminata
Hartman, Rachael; Mandal, Rajni; Sanchez, Miguel; Stein, Jennifer A
2010 ;16(11):22-22, Dermatology online journal
We describe a 73-year-old woman with a long-standing history of annular, hyperkeratotic papules that began on the palms and soles and gradually spread to her trunk, extremities, and face. The clinical presentation and biopsy findings were consistent with PPPD, which is a rare subtype of porokeratosis that begins on the palms and soles and gradually spreads to the trunk and extremities. Owing to the risk of malignant degeneration in porokeratosis, patients should be closely monitored with total body skin examinations. There is no definitive treatment for PPPD. Oral retinoids are sometimes helpful although relapses are common after discontinuation of therapy
— id: 115868, year: 2010, vol: 16, page: 22, stat: Journal Article,

Pemphigoid gestationis
Lu, Phoebe D; Ralston, Jonathan; Kamino, Hideko; Stein, Jennifer A
2010 ;16(11):10-10, Dermatology online journal
Pemphigoid gestationis is a rare autoimmune blistering disease of pregnancy. It is characterized by pruritic, urticarial plaques with the development of tense vesicles and bullae within the lesions. Pemphigoid gestationis has been associated with premature delivery, small-for-gestational-age infants. Recurrences with subsequent pregnancies are often more severe. Oral glucocorticoids are the mainstay of therapy. Differentiation of pemphigoid gestationis from pruritic urticarial papules and plaques of pregnancy is essential because management and outcomes differ. In instances in which clinical diagnosis is difficult, direct immunofluorescence tests, immunoblots, or ELISA studies of anti-basement-membrane zone antibodies are useful in establishing the diagnosis
— id: 115867, year: 2010, vol: 16, page: 10, stat: Journal Article,

Multiple eruptive milia
Batra, Priya; Tsou, Hui C; Warycha, Melanie; Votava, Henry J; Stein, Jennifer
2009 ;15(8):20-20, Dermatology online journal
A 61-year-old-man presented with a sudden onset of multiple, hyperpigmented papules with a central punctum on the face, chest, upper back, and arms. Histopathologic examination showed infundibular cysts. These findings are consistent with a diagnosis of multiple eruptive milia, which is a rare disorder that is characterized by the sudden development of crops of milia over weeks to months. They are more extensive in number and distribution than they are in primary milia. Milia may present spontaneously without a known cause, as part of an inherited familial condition, or as part of a genodermatosis. The etiologies are uncertain, and treatment options are varied
— id: 115866, year: 2009, vol: 15, page: 20, stat: Journal Article,

Generalized discoid lupus erythematosus
Farley-Loftus, Rachel; Mahlberg, Matthew; Merola, Joseph F; Votava, Henry J; Meehan, Shane; Stein, Jennifer; Shupack, Jerome L
2009 ;15(8):18-18, Dermatology online journal
A 79-year-old woman presented with a four-year history of generalized, erythematous, indurated plaques on the malar areas, back, and extremities. The lesions had been recalcitrant in the past to topical glucocorticoid therapy. A skin biopsy specimen was diagnostic of discoid lupus erythematosus (DLE). A minority of patients with DLE progress to develop systemic lupus erythematosus although generalized DLE is more frequently associated with systemic involvement than is limited disease. Standard therapy of cutaneous lupus includes broad spectrum sunscreens, topical and intralesional glucocorticoids, and antimalarial agents
— id: 108419, year: 2009, vol: 15, page: 18, stat: Journal Article,

Association between thin melanomas and atypical nevi in middle-aged and older men possibly attributable to heightened patient awareness
Haimovic, Adele; Hamilton, Heather Klein; Tay, Siang; Stein, Jennifer A; Polsky, David
2009 Dec;145(12):1457-1458, Archives of dermatology
— id: 105987, year: 2009, vol: 145, page: 1457, stat: Journal Article,

Hedgehog does not guide migrating Drosophila germ cells
Renault, Andrew D; Ricardo, Sara; Kunwar, Prabhat S; Santos, Ana; Starz-Gaiano, Michelle; Stein, Jennifer A; Lehmann, Ruth
2009 Apr 15;328(2):355-362, Developmental biology (Orlando)
In many species, the germ cells, precursors of sperm and egg, migrate during embryogenesis. The signals that regulate this migration are thus essential for fertility. In flies, lipid signals have been shown to affect germ cell guidance. In particular, the synthesis of geranylgeranyl pyrophosphate through the 3-hydroxy-3-methyl-glutaryl coenzyme A reductase (Hmgcr) pathway is critical for attracting germ cells to their target tissue. In a genetic analysis of signaling pathways known to affect cell migration of other migratory cells, we failed to find a role for the Hedgehog (Hh) pathway in germ cell migration. However, previous reports had implicated Hh as a germ cell attractant in flies and suggested that Hh signaling is enhanced through the action of the Hmgcr pathway. We therefore repeated several critical experiments and carried out further experiments to test specifically whether Hh is a germ cell attractant in flies. In contrast to previously reported findings and consistent with findings in zebrafish our data do not support the notion that Hh has a direct role in the guidance of migrating germ cells in flies
— id: 99590, year: 2009, vol: 328, page: 355, stat: Journal Article,

CASH algorithm for dermoscopy revisited
Henning, J Scott; Stein, Jennifer A; Yeung, Jensen; Dusza, Stephen W; Marghoob, Ashfaq A; Rabinovitz, Harold S; Polsky, David; Kopf, Alfred W
2008 Apr;144(4):554-555, Archives of dermatology
— id: 78336, year: 2008, vol: 144, page: 554, stat: Journal Article,

Treatment approaches for advanced cutaneous melanoma
Stein, Jennifer A; Brownell, Isaac
2008 Feb;7(2):175-179, Journal of drugs in dermatology : JDD
Advanced melanoma has a poor prognosis, and standard adjuvant treatment offers little survival advantage. Current efforts are aimed at combining chemotherapy and novel immunomodulators, which these include melanoma vaccines, cytokines and anti-CTLA4 antibodies. Hundreds of combination therapies are currently in trials. All advanced melanoma patients should be considered for enrollment in a trial for their own benefit as well as for the advancement of melanoma treatment. Thus far, no single investigative approach stands out as highly effective, however, they all hold promise with rare patients showing durable responses. Most treatment protocols are evaluating combinations of adjuvant therapies, hoping to achieve a synergistic effect. Ongoing research into the biology of melanoma continues to suggest new drug targets that will block tumor progression or enhance host response. Until the day that an effective treatment for advanced melanoma is found, prevention and early detection will remain paramount in combating this deadly malignancy
— id: 79138, year: 2008, vol: 7, page: 175, stat: Journal Article,

Noninvoluting congenital hemangioma
Stein, Jennifer A; Heidary, Noushin; Pulitzer, Melissa; Schaffer, Julie V
2008 ;14(5):7-7, Dermatology online journal
An 8-year-old boy presented with a lifelong history of a vascular mass overlying his right mandible with central coarse telangiectasias and peripheral pallor. Histopathologic examination showed a proliferation of blood vessels in the dermis. Ultrasound examination identified a mix of high- and low-flow vessels within the lesion. These findings were consistent with a noninvoluting congenital hemangioma, a rare vascular tumor that is fully formed at birth that subsequently grows proportionately with the patient and does not regress
— id: 83990, year: 2008, vol: 14, page: 7, stat: Journal Article,

Mastocytosis with urticaria pigmentosa and osteoporosis
Stein, Jennifer A; Kamino, Hideko; Walters, Ruth F; Pomeranz, Miriam K
2008 ;14(10):2-2, Dermatology online journal
A 76-year-old man with a 52-year history of urticaria pigmentosa was found to have an elevated serum tryptase level as well as osteoporosis. Histopathologic alterations of one his skin lesions showed an infiltrate of mast cells. Urticaria pigmentosa patients are at risk for osteoporosis because of elevated heparin and stem-cell factor levels. These patients should be screened with serum tryptase levels and bone density studies to detect osteoporosis, regardless of their age
— id: 95644, year: 2008, vol: 14, page: 2, stat: Journal Article,

Anaplastic large-cell T-cell lymphoma
Stein, Jennifer A; Soldano, Anthony C; Latkowski, Jo-Ann M
2008 ;14(5):15-15, Dermatology online journal
A 64-year-old woman presented with 2 years of pruritic and ulcerated nodules and tumors on the trunk and arms. Histopathologic examination showed a diffuse infiltrate that consisted of predominantly small lymphocytes and scattered large atypical multinucleated cells positive for CD30. These findings were consistent with a diagnosis of anaplastic large-cell T-cell lymphoma, which is a CD30+ cutaneous lymphoma. This case highlights the importance of considering both histopathologic and clinical criteria in diagnosing a patient with a CD30+ cutaneous lymphoma
— id: 83991, year: 2008, vol: 14, page: 15, stat: Journal Article,

Actinic granuloma
Stein, Jennifer A; Fangman, Bill; Strober, Bruce
2007 ;13(1):19-19, Dermatology online journal
A 45-year-old man presented with a 3-year history of asymptomatic, annular, erythematous plaques on the face and neck. Histopathologic examination showed sarcoidal granulomas with an associated mixed-cell infiltrate, loss of elastic fibers, and no increase in mucin. These findings were consistent with a diagnosis of actinic granuloma, which is an uncommon, idiopathic disease that is characterized by granuloma annulare-like plaques on sun-exposed areas
— id: 83987, year: 2007, vol: 13, page: 19, stat: Journal Article,

Epidermolysis bullosa acquisita
Stein, Jennifer A; Mikkilineni, Radha
2007 ;13(1):15-15, Dermatology online journal
A 29-year-old woman presented with 8 months of multiple vesicles, erosions, and milia on the dorsa of her hands and feet. Histopathologic examination demonstrated a subepidermal blister, with a paucity of eosinophils and a lack of blood vessel wall thickening or caterpillar bodies. A direct immunofluorescence test showed a linear deposit of IgG at the dermo-epidermal junction. These findings were consistent with a diagnosis of epidermolysis bullosa acquisita. This case is a classic example of this rare blistering disease, in which patients produce autoantibodies to collagen VII, which is the major component of the anchoring fibrils
— id: 83986, year: 2007, vol: 13, page: 15, stat: Journal Article,

Association of melanoma and neurocutaneous melanocytosis with large congenital melanocytic naevi-results from the NYU-LCMN registry
Hale, E K; Stein, J; Ben-Porat, L; Panageas, K S; Eichenbaum, M S; Marghoob, A A; Osman, I; Kopf, A W; Polsky, D
2005 Mar;152(3):512-517, British journal of dermatology
Summary Background Large congenital melanocytic naevi (LCMN), which develop in utero and are present in approximately one in 20 000 newborns, are associated with markedly increased risks of cutaneous melanoma, leptomeningeal melanoma and neurocutaneous melanocytosis (NCM). Objectives This study examined clinical characteristics associated with melanoma and NCM among patients with LCMN, and estimated the risk of developing melanoma and NCM in these patients. Methods Two hundred and five LCMN patients enrolled in the New York University registry were studied. One hundred and seventy of these patients were followed prospectively. The remaining 35 patients had either melanoma at the time of entry into the registry (n = 6), or had insufficient follow-up information (n = 29). The outcome measures were the occurrence of melanoma and NCM. The associations between these outcomes and the clinical covariates (anatomical location of the LCMN, size of the LCMN, number of satellite lesions, family history of melanoma, patient sex and treatment) were assessed. Results Four of 170 (2.3%) prospectively followed patients developed melanomas, representing a standardized morbidity ratio of 324. Among the entire cohort (n = 205), there were associations between increasing numbers of satellite naevi and the occurrence of melanoma (P = 0.04), and the presence of NCM (P = 0.06). Compared with patients who did not develop these diseases, median LCMN diameters were larger among patients who developed melanoma (49 vs. 39 cm) and NCM (55 vs. 46 cm). Conclusions In LCMN patients, increasing numbers of satellite lesions and larger LCMN diameters are associated with melanoma and NCM
— id: 49368, year: 2005, vol: 152, page: 512, stat: Journal Article,

Confluent and reticulated papillomatosis associated with tinea versicolor in three siblings
Stein, Jennifer A; Shin, Helen T; Chang, Mary Wu
2005 Jul-Aug;22(4):331-333, Pediatric dermatology
We describe three teenage siblings with confluent and reticulated papillomatosis, all presenting during a 6-month period. Two of the three patients had confirmed tinea versicolor, with positive potassium hydroxide scrapings, in association with this entity. This is the largest series of siblings with confluent and reticulated papillomatosis, and the only report describing family members having both confluent and reticulated papillomatosis and tinea versicolor. This report lends further evidence to the hypothesis that confluent and reticulated papillomatosis may be etiologically linked to tinea versicolor, and also suggests a genetic predisposition for it
— id: 61333, year: 2005, vol: 22, page: 331, stat: Journal Article,

Slow as molasses is required for polarized membrane growth and germ cell migration in Drosophila
Stein, Jennifer A; Broihier, Heather Tarczy; Moore, Lisa A; Lehmann, Ruth
2002 Aug;129(16):3925-3934, Development
Drosophila germ cell migration is directed by attractive and repulsive guidance cues. We have identified a novel gene, slow as molasses (slam), which is required for germ cell migration. In slam zygotic mutants, germ cells fail to transit off the midgut into the mesoderm. We show that slam is required at this stage in parallel to HMG Coenzyme A reductase, a previously identified germ cell migration gene. Removal of both zygotic and maternal slam results in an earlier defect: a failure to form a cellular blastoderm. Consistent with this phenotype, we found that slam is one of the earliest genes to be transcribed in the embryo, and Slam protein localizes to the growing basal-lateral membrane during blastoderm formation, but Slam is not detected during later stages of embryogenesis. Because slam RNA and protein are expressed earlier than the time when we observe defects in germ cell migration, we propose that Slam is required for the localization of a signal to the basal side of blastoderm cells that is needed later in the posterior midgut to guide germ cells
— id: 52653, year: 2002, vol: 129, page: 3925, stat: Journal Article,