Miguel R Sanchez, M.D.

Evidence for mycobacteria in sarcoidosis
Brownell, Isaac; Ramirez-Valle, Francisco; Sanchez, Miguel; Prystowsky, Stephen
2011 Nov;45(5):899-905, American journal of respiratory cell & molecular biology
Despite its recognition as a distinct granulomatous disease for over a century, the etiology of sarcoidosis remains to be defined. Since the early 1900s, infectious agents have been suspected in causing sarcoidosis. For much of this time, mycobacteria were considered a likely culprit, yet until recently, the supporting evidence has been tenuous at best. In this review, we evaluate the reported association between mycobacteria and sarcoidosis. Historically, mycobacterial infection has been investigated using histologic stains, cultures of lesional tissue or blood, and identification of bacterial nucleic acids or bacterial antigens. More recently, advances in biochemical, molecular, and immunological methods have produced a more rigorous analysis of the antigenic drivers of sarcoidosis. The result of these efforts indicates that mycobacterial products likely play a role in at least a subset of sarcoidosis cases. This information, coupled with a better understanding of genetic susceptibility to this complex disease, has therapeutic implications
— id: 140521, year: 2011, vol: 45, page: 899, stat: Journal Article,

Reply
Imahiyerobo-Ip J.I.; Sanchez M.R.
2011 ;65(3):644-645, Journal of the American Academy of Dermatology
— id: 137015, year: 2011, vol: 65, page: 644, stat: Journal Article,

Skin cancer awareness in communities of color
Imahiyerobo-Ip, Joyce; Ip, Ivan; Jamal, Sumayah; Nadiminti, Uma; Sanchez, Miguel
2011 Jan;64(1):198-200, Journal of the American Academy of Dermatology
— id: 133200, year: 2011, vol: 64, page: 198, stat: Journal Article,

Is Chronic Cutaneous Discoid Lupus Protective Against Severe Renal Disease in Patients With Systemic Lupus Erythematosus?
Merola, Joseph F.; Chang, Caroline A.; Sanchez, Miguel R.; Prystowsky, Stephen D.
2011 DEC ;10(12):1413-1420, Journal of drugs in dermatology : JDD
Objective: The aim was to assess the level of systemic involvement and character of renal disease in patients with chronic cutaneous lupus erythematosus of the discoid lupus variety (hereafter referred to as 'discoid lupus') and features of systemic lupus erythematosus (SLE). Clinical confusion with other types of cutaneous lupus erythematosus complicates interpretation of some previously reported studies. Methods: Over three years, sixteen patients met the diagnostic criteria of discoid lupus, positive anti-nuclear-antibody, and at least one extracutaneous manifestation. Results: Most patients (14/16) were female, between 26 to 66 years old. Arthritis was the most common extracutaneous manifestation followed by Raynaud's phenomenon. The anti-nuclear-antibody was speckled in ten patients with titers ranging from 1:40 to 1:1280 IU/mL. Elevated levels of double-stranded-DNA in low titers were found in four patients, anti-Smith-antibody in four; anti-Sjogren-syndrome-A-anti-body in seven, and anti-ribonucleoprotein-antibody in seven. Renal function markers were transiently high in some patients but normalized over time. Hematuria and/or proteinuria were present at some time in seven patients. The highest BUN and creatinine levels were 42 mg/dL and 1.5 mg/dL, respectively. One patient had membranous glomerulonephropathy class 5; however, discoid lupus developed well after the onset of renal disease during a time when renal function had returned to normal. Conclusion: Our observational data supports previous reports suggesting that patients with active discoid lupus rarely have progressive renal insufficiency. The mechanism for the development of discoid lupus may involve an immunologic mechanism that differs from that which produces severe organ involvement, especially advanced immune-complex-mediated renal disease. Patients with discoid lupus rarely have sustained high levels of antibodies to double-stranded-DNA. Discoid lupus appears to be a marker for a more benign lupus course. This clinical observation lays the groundwork for a larger prospective, longitudinal cohort study for further validation
— id: 147717, year: 2011, vol: 10, page: 1413, stat: Journal Article,

Skin Conditions in Figure Skaters, Ice-Hockey Players and Speed Skaters Part I - Mechanical Dermatoses
Tlougan, Brook E.; Mancini, Anthony J.; Mandell, Jenny A.; Cohen, David E.; Sanchez, Miguel R.
2011 AUG ;41(9):709-719, Sports medicine
Figure skaters, ice-hockey players and speed skaters experience a range of dermatologic conditions and tissue-related injuries on account of mechanical trauma, infectious pathogens, inflammatory processes and environmental factors related to these competitive pursuits. Sports medicine practitioners, family physicians, dermatologists and coaches should be familiar with these skin conditions to ensure timely and accurate diagnosis and management of affected athletes. This review is Part I of a subsequent companion review and provides a comprehensive review of mechanical dermatoses experienced by ice-skating athletes, including skater's nodules and its variants, pump bumps, piezogenic pedal papules, talon noir, skate/lace bite, friction bullae, corns and calluses, onychocryptosis, skater's toe and skate blade-induced lacerations. These injuries result from friction, shear forces, chronic pressure and collisions with surfaces that occur when athletes endure repetitive jump landings, accelerated starts and stops and other manoeuvres during rigorous training and competition. Ill-fitting skates, improper lacing techniques and insufficient lubrication or protective padding of the foot and ankle often contribute to the development of skin conditions that result from these physical and mechanical stresses. As we will explain, simple measures can frequently prevent the development of these conditions. The treatment of skater's nodules involves reduction in chronic stimulation of the malleoli, and the use of keratolytics and intralesional steroid injections; if malleolar bursitis develops, bursa aspirations may be required. Pump bumps, which result from repetitive friction posteriorly, can be prevented by wearing skates that fit correctly at the heel. Piezogenic pedal papules may be treated conservatively by using heel cups, compressive stockings and by reducing prolonged standing. Talon noir usually resolves without intervention within several weeks. The treatment of skate bite is centred on reducing compression by the skate tongue of the extensor tendons of the anterior ankle, which can be accomplished by use of proper lacing techniques, increasing pliability of the skate tongue and using protective padding, such as Bunga Pads (TM). Anti-inflammatory medications and cold compresses can also help reduce inflammation. Friction bullae are best managed by careful lancing of painful blisters and application of petrolatum or protective dressings to accelerate healing; preventative measures include the use of well fitting skates, proper lacing techniques and moisture-wicking socks. Corns and calluses are similarly best prevented by the use of well fitted skates and orthotic devices. Symptomatic, debridement reduces the irritant effect of the thick epidermis, and can be accomplished by soaking the area in warm water followed by paring. Application of creams with high concentrations of urea or salicylic acid can also soften callosities. Cases of onychocryptosis benefit from warm soaks, antibiotic ointments and topical steroids to reduce inflammation, but sometimes chemical or surgical matricectomies are required. Preventative measures of both onychocryptosis and skater's toe include cutting toenails straight across to allow for a more equal distribution of forces within the toe box. Finally, the prevention and treatment of lacerations, which constitute a potentially fatal type of mechanical injury, require special protective gear and acute surgical intervention with appropriate suturing. The subsequent companion review of skin conditions in ice skaters will discuss infectious, inflammatory and cold-induced dermatoses, with continued emphasis on clinical presentation, diagnosis, treatment and prevention
— id: 138470, year: 2011, vol: 41, page: 709, stat: Journal Article,

Skin Conditions in Figure Skaters, Ice-Hockey Players and Speed Skaters Part II - Cold-Induced, Infectious and Inflammatory Dermatoses
Tlougan, Brook E.; Mancini, Anthony J.; Mandell, Jenny A.; Cohen, David E.; Sanchez, Miguel R.
2011 JUN ;41(11):967-984, Sports medicine
Participation in ice-skating sports, particularly figure skating, ice hockey and speed skating, has increased in recent years. Competitive athletes in these sports experience a range of dermatological injuries related to mechanical factors: exposure to cold temperatures, infectious agents and inflammation. Part I of this two part review discussed the mechanical dermatoses affecting ice-skating athletes that result from friction, pressure, and chronic irritation related to athletic equipment and contact with surfaces. Here, in Part II, we review the cold-induced, infectious and inflammatory skin conditions observed in ice-skating athletes. Cold-induced dermatoses experienced by ice-skating athletes result from specific physiological effects of cold exposure on the skin. These conditions include physiological livedo reticularis, chilblains (pernio), Raynaud phenomenon, cold panniculitis, frostnip and frostbite. Frostbite, that is the literal freezing of tissue, occurs with specific symptoms that progress in a stepwise fashion, starting with frostnip. Treatment involves gradual forms of rewarming and the use of friction massages and pain medications as needed. Calcium channel blockers, including nifedipine, are the mainstay of pharmacological therapy for the major nonfreezing cold-induced dermatoses including chilblains and Raynaud phenomenon. Raynaud phenomenon, a vasculopathy involving recurrent vasospasm of the fingers and toes in response to cold, is especially common in figure skaters. Protective clothing and insulation, avoidance of smoking and vasoconstrictive medications, maintaining a dry environment around the skin, cold avoidance when possible as well as certain physical manoeuvres that promote vasodilation are useful preventative measures. Infectious conditions most often seen in ice-skating athletes include tinea pedis, onychomycosis, pitted keratolysis, warts and folliculitis. Awareness, prompt treatment and the use of preventative measures are particularly important in managing such dermatoses that are easily spread from person to person in training facilities. The use of well ventilated footgear and synthetic substances to keep feet dry, as well as wearing sandals in shared facilities and maintaining good personal hygiene are very helpful in preventing transmission. Inflammatory conditions that may be seen in ice-skating athletes include allergic contact dermatitis, palmoplantar eccrine hidradenitis, exercise-induced purpuric eruptions and urticaria. Several materials commonly used in ice hockey and figure skating cause contact dermatitis. Identification of the allergen is essential and patch testing may be required. Exercise-induced purpuric eruptions often occur after exercise, are rarely indicative of a chronic venous disorder or other haematological abnormality and the lesions typically resolve spontaneously. The subtypes of urticaria most commonly seen in athletes are acute forms induced by physical stimuli, such as exercise, temperature, sunlight, water or particular levels of external pressure. Cholinergic urticaria is the most common type of physical urticaria seen in athletes aged 30 years and under. Occasionally, skaters may develop eating disorders and other related behaviours some of which have skin manifestations that are discussed herein. We hope that this comprehensive review will aid sports medicine practitioners, dermatologists and other physicians in the diagnosis and treatment of these dermatoses
— id: 141719, year: 2011, vol: 41, page: 967, stat: Journal Article,

Atypical mycobacteria infection in an immunocompromised patient
Berger, Emily; Batra, Priya; Ralston, Jonathan; Sanchez, Miguel R; Franks, Andrew G Jr
2010 ;16(11):21-21, Dermatology online journal
A 61-year-old woman with systemic lupus erythematosus and Sjogren syndrome presented with a two-month history of symptomatic nodules on the buttocks and thighs that progressed to involve the dorsal aspects of the hands. On examination, infiltrative papules, nodules, and plaques were present in these regions. Biopsy specimens demonstrated granulomatous inflammation and acid-fast bacilli with the use of a Fite stain, although a culture and polymerase chain reaction analysis were negative. The patient continues to improve on long-term clarithromycin therapy. Atypical mycobacterial infections are becoming more common, especially in immunocompromised patients. Antimicrobial therapy, either with a single agent or multiple agents, often is prolonged. A high index of suspicion is warranted in immunocompromised patients, which includes those with connective-tissue diseases that are active or that require immunosuppression. In these patients, the differential diagnosis includes infectious as well as inflammatory, reactive, or neoplastic processes
— id: 115893, year: 2010, vol: 16, page: 21, 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,

Laugier Hunziker syndrome
Jabbari, Ali; Gonzalez, Mercedes E; Franks, Andrew G Jr; Sanchez, Miguel
2010 ;16(11):23-23, Dermatology online journal
Laugier Hunziker syndrome is a rare disorder that is characterized by adult-onset hyperpigmented macules of the lips, oral cavity, and fingertips. Longitudinal melanonychia is present in the majority of cases. We present a 45-year-old woman with adult-onset hyperpigmented macules of the oral cavity as well as linear melanonychia that involved multiple fingernails. The history, clinical examination, and paucity of laboratory abnormalities or systemic findings support a diagnosis of Laugier Hunziker syndrome
— id: 115894, year: 2010, vol: 16, page: 23, stat: Journal Article,

Thalidomide and Analogues: Potential for Immunomodulation of Inflammatory and Neoplastic Dermatologic Disorders
Ladizinski, B; Shannon, EJ; Sanchez, MR; Levis, WR
2010 JUL ;9(7):814-826, Journal of drugs in dermatology : JDD
Thalidomide and analogues are a class of immunomodulatory drugs or IMiDS Thalidomide was initially approved by the U S Food and Drug Administation for treatment of erythema nodosum in leprosy and is now approved for multiple myeloma as well A second generation IMiD, lenalidomide, is also approved for multiple myeloma and refractory myelodysplastic syndrome Discovery of this class of drugs has been serendipitous and empirical, as the drug targets have been unknown In this review, the authors integrate recent identification of drug targets of IMiDS, which include the inducible form of nitric oxide synthase (iNOS), Rho GTPase and caspase-1, with the developments in the understanding of the molecular biology of human inflammatory, infectious and neoplastic skin disorders Because thalidomide reemerged through leprosy, the original disease classified by the T cell, the authors have also emphasized advances in the understanding of T-cell subsets in human skin disorders
— id: 111336, year: 2010, vol: 9, page: 814, stat: Journal Article,

Neurosarcoidosis: presentations and management
Terushkin, Vitaly; Stern, Barney J; Judson, Marc A; Hagiwara, Mari; Pramanik, Bidyut; Sanchez, Miguel; Prystowsky, Stephen
2010 Jan;16(1):2-15, Neurologist
BACKGROUND: Sarcoidosis affects the central nervous system more frequently than previously appreciated. The diagnosis of neurosarcoidosis is often delayed, potentially leading to serious complications. Symptoms, when present, are not specific, may be subtle and resemble those of other neurologic diseases. REVIEW SUMMARY: During the past decade, significant progress has been made in understanding the epidemiology and pathophysiology of neurosarcoidosis, as well as the ability to diagnose and treat this disease. Studies have shown that the optimal diagnostic imaging modality for neurosarcoidosis is magnetic resonance imaging with gadolinium as it enhances visualization of granulomatous infiltration in neural tissue. Subclinical neurosarcoidosis may not be uncommon in patients with sarcoidosis. It is now evident that neurosarcoidosis does not invariably present as a catastrophic event. Adverse effects associated with high-dose systemic corticosteroids, the standard therapy, have discouraged practitioners from initiating treatment in the absence of significant symptomatic neurologic disease. However, other immunosuppressive agents as well newer biologic agents have emerged as an effective, well-tolerated therapeutic alternative to corticosteroids, which are often effective in corticosteroid-recalcitrant cases. CONCLUSION: Neurologists should be aware of the varying presentations of neurosarcoidosis since early recognition of neurologic involvement in patients with undiagnosed or proven sarcoidosis is currently possible and critical to the prevention of disabling complications
— id: 106206, year: 2010, vol: 16, page: 2, stat: Journal Article,

Dendritic cells in the pathogenesis of sarcoidosis
Zaba, Lisa C; Smith, Gideon P; Sanchez, Miguel; Prystowsky, Stephen D
2010 Jan;42(1):32-39, American journal of respiratory cell & molecular biology
Sarcoidosis is a noncaseating granulomatous disease, likely of autoimmune etiology, that causes inflammation and tissue damage in multiple organs, most commonly the lung, but also skin, and lymph nodes. Reduced dendritic cell (DC) function in sarcoidosis peripheral blood compared with peripheral blood from control subjects suggests that blunted end organ cellular immunity may contribute to sarcoidosis pathogenesis. Successful treatment of sarcoidosis with tumor necrosis factor (TNF) inhibitors, which modulate DC maturation and migration, has also been reported. Together, these observations suggest that DCs may be important mediators of sarcoidosis immunology. This review focuses on the phenotype and function of DCs in the lung, skin, blood, and lymph node of patients with sarcoidosis. We conclude that DCs in end organs are phenotypically and functionally immature (anergic), while DCs in the lymph node are mature and polarize pathogenic Th1 T cells. The success of TNF inhibitors is thus likely secondary to inhibition of DC-mediated Th1 polarization in the lymph node
— id: 134967, year: 2010, vol: 42, page: 32, stat: Journal Article,

Rapidly eruptive, treatment-resistant, nodular Kaposi's sarcoma in an acquired immunodeficiency syndrome (AIDS) patient on highly active antiretroviral therapy
Chang, Caroline A; Sanchez, Miguel R; Karen, Julie K; Rosenman, Karla S; Prystowsky, Stephen D
2009 Feb;48(2):173-174, International journal of dermatology
— id: 97075, year: 2009, vol: 48, page: 173, stat: Journal Article,

Linear psoriasis
Chien, Peter Jr; Rosenman, Karla; Cheung, Wang; Wang, Nadia; Sanchez, Miguel
2009 ;15(8):4-4, Dermatology online journal
A 33-year-old man presented with verrucous, red-brown papules, which coalesced into linear plaques on the right buttock, waist, thigh, and genitals. A skin biopsy was consistent with psoriasis, and the unilateral distribution in a linear pattern led to a diagnosis of linear psoriasis, which is a rare variant of psoriasis. Although histopathologically it can be difficult to distinguish from inflammatory linear verrucous epidermal nevus (ILVEN), linear psoriasis presents in adulthood and responds to conventional topical antipsoriatic therapies
— id: 107816, year: 2009, vol: 15, page: 4, stat: Journal Article,

Pseudoxanthoma elasticum
Gonzalez, Mercedes E; Votava, Henry J; Lipkin, George; Sanchez, Miguel
2009 ;15(8):17-17, Dermatology online journal
Pseudoxanthoma elasticum is an incurable, autosomal-recessive, genetic disorder that is caused by mutations in the ABCC6 gene. It is characterized by progressive mineralization and fragmentation of the elastic fibers in the skin, retina, and blood vessels. The characteristic cutaneous features bring the patient to medical attention, but morbidity is related to the degree of extracutaneous involvement. The disease is progressive with phenotypic variability and no definite genotype-phenotype correlation. Treatment is supportive and is directed at prevention and early detection of adverse ocular and cardiovascular sequelae. We present two siblings with pseudoxanthoma elasticum, who have considerable differences in disease related morbidity, which highlights intra-familiar phenotypic heterogeneity
— id: 107815, year: 2009, vol: 15, page: 17, stat: Journal Article,

Neurovascular hamartoma
Lee, Arnold; Heidary, Noushin; Altiner, Ahmet; Votava, Henry; Kamino, Hideko; Sanchez, Miguel
2009 ;15(8):21-21, Dermatology online journal
A 29-year-old man presented with a large, asymptomatic, brown, hyperpigmented, depressed plaque over his left upper back, which included the scapular area, since childhood. Histopathological analyses of the biopsy specimens was consistent with a rare entity known as neurovascular hamartoma. This uncommon lesion has been reported in two publications, either as a possible marker of the malignant rhabdoid tumor or as a hamartomatous tongue lesion in children. Due to its possible association with the aggressive and often fatal rhabdoid tumor, periodic examination of this lesion may be warranted
— id: 107814, year: 2009, vol: 15, page: 21, stat: Journal Article,

Sarcoidosis of the skin: a review for the pulmonologist
Lodha, Saurabh; Sanchez, Miguel; Prystowsky, Stephen
2009 Aug;136(2):583-596, Chest
With vastly heterogeneous morphologic manifestations, sarcoidosis is one of the 'great imitators' of medicine. Because there is no specific confirmatory test, the diagnosis rests on clinical acumen coupled with supportive information from tissue or blood evaluation and the exclusion of other diseases. The characteristic histologic pattern of noncaseating, epithelioid cell granulomas is not always present in skin lesions, which may be visually distinctive or diverse in appearance. As a result of their high incidence of respiratory disease, patients with sarcoidosis frequently seek care from pulmonologists who may become their primary health-care providers. Physicians who treat patients with sarcoidosis should be aware of the disease's diverse organ manifestations, but particularly those appearing on the skin because these can be disfiguring, have prognostic importance, and may not be readily diagnosed even by skin specialists. In this comprehensive review, we sought to illustrate this diversity and to update the diagnostic approach, histologic spectrum, and therapeutic strategies involved in cutaneous sarcoidosis
— id: 101450, year: 2009, vol: 136, page: 583, stat: Journal Article,

Fixed cutaneous sporotrichosis
Mahlberg, Matthew J; Patel, Rishi; Rosenman, Karla; Cheung, Wang; Wang, Nadia; Sanchez, Miguel
2009 ;15(8):5-5, Dermatology online journal
Sporotrichosis is a subcutaneous mycosis that is caused by Sporothrix schenckii. Whereas the most common clinical presentation is the lymphocutaneous form, the fixed cutaneous form is not uncommon. Important clues from the clinical history, such as travel and occupation, can help to raise the suspicion of this infection in the differential diagnosis. However, histopathologic and tissue culture, which often require multiple specimens, are necessary to confirm the diagnosis. We present a patient with fixed cutaneous sporotrichosis whose delayed diagnosis led to appreciable scars and morbidity
— id: 105295, year: 2009, vol: 15, page: 5, stat: Journal Article,

Cutaneous piloleiomyomata
Smith, Gideon; Heidary, Noushin; Patel, Rishi; Rosenman, Karla; Meehan, Shane A; Kamino, Hideko; Sanchez, Miguel
2009 ;15(8):10-10, Dermatology online journal
A 49-year-old man presented with an eight-month history of intermittently painful, subcutaneous nodules that were increasing in size, number, and pain intensity. A biopsy specimen showed smooth muscle proliferation, which also stained positive for actin, and was consistent with piloleiomyoma. The patient was placed initially on gabapentin and then nifedipine with very limited success in pain control. The lesions continued to proliferate, and the patient was referred to surgery for excision
— id: 105292, year: 2009, vol: 15, page: 10, stat: Journal Article,

Raynaud's phenomenon: pathogenesis and management
Bakst, Richard; Merola, Joseph F; Franks, Andrew G Jr; Sanchez, Miguel
2008 Oct;59(4):633-653, Journal of the American Academy of Dermatology
Raynaud's phenomenon is a common clinical disorder for which patients frequently seek the expertise and care of dermatologists. It is manifested by recurrent vasospasm of the fingers and toes, often associated with exposure to cold temperature or emotional stress. The phenomenon is named after Maurice Raynaud, who, as a medical student, defined the first case in 1862 as episodic, symmetric, acral vasospasm characterized by pallor, cyanosis, suffusion, and a sense of fullness or tautness, which may be painful. Despite more than 140 years of research, the pathophysiology of Raynaud's phenomenon continues to elude investigators. Accordingly, although many pharmacologic treatments have been reported, there is still no cure or gold standard therapy. Further, response to treatment varies and is difficult to predict. Recently, there has been renewed interest in finding the pathogenetic mechanisms of Raynaud's phenomenon, an effort that has led to more potential targeted therapeutics. The purpose of this review is to discuss recent breakthroughs in the pathogenesis and treatment of Raynaud's phenomenon
— id: 86654, year: 2008, vol: 59, page: 633, stat: Journal Article,

Epidermodysplasia verruciformis in the setting of HIV infection
Chen, Peter Jr; Kamino, Hideko; Walters, Ruth F; Rosenman, Karla; Pomeranz, Miriam K; Sanchez, Miguel
2008 ;14(10):1-1, Dermatology online journal
A 56-year-old man with human immunodeficiency virus infection presented with pink-to-hypopigmented, thin, flat-topped papules coalescent to plaques on the trunk and extremities for five years. The histopathologic findings were consistent with flat warts resembling epidermodysplasia verruciformis. Typically an inherited condition, this entity has also been observed in the setting of immunosuppression; the risk of developing non-melanoma skin cancers is of concern. Treatment options vary considerably, but often the lesions will recur upon cessation of therapy
— id: 95645, year: 2008, vol: 14, page: 1, stat: Journal Article,

Invasive squamous-cell carcinoma and arsenical keratoses
Elmariah, Sarina B; Anolik, Robert; Walters, Ruth F; Rosenman, Karla; Pomeranz, Miriam K; Sanchez, Miguel R
2008 ;14(10):24-24, Dermatology online journal
A 42-year-old man presented with a six-month history of a slowly-enlarging ulcer on his right sole, a 30-year history of altered pigmentation of the trunk and extremities, and hyperkeratotic papules of the palms and soles. Histopathologic examination showed an invasive squamous-cell carcinoma of the right sole and hyperkeratosis with keratinocyte atypia of the left finger and left lateral foot. The clinical and histopathologic findings are consistent with chronic arsenicism, which most commonly occurs in the setting of drinking contaminated water or after occupational exposure. Evaluation should include a physical examination, basic laboratory work-up, and measurement of a 24-hour urine arsenic concentration. Vigilant surveillance for the development of cutaneous malignancies is required. Oral retinoids may be helpful in reducing hyperkeratosis secondary to chronic arsenicism
— id: 107817, year: 2008, vol: 14, page: 24, stat: Journal Article,

Trichoepithelioma
Johnson, Hillary; Robles, Mirin; Kamino, Hideko; Walters, Ruth F; Lee, Arnold; Sanchez, Miguel
2008 ;14(10):5-5, Dermatology online journal
A 29-year-old man presented with a long-standing history of asymptomatic, skin-colored, facial papules and nodules. Histopathologic examination of a representative papule demonstrated trichoepithelioma. The patient had a history of a brother with a similar phenotype, which suggests a diagnosis of familial trichoepithelioma. Linkage and mutational analyses support genetic heterogeneity of familial trichoepithelioma, possibly sharing a clinical spectrum with Brooke-Spiegler syndrome and familial cylindromatosis since each entity has been associated with mutations the CYLD gene
— id: 95641, year: 2008, vol: 14, page: 5, stat: Journal Article,

Cutaneous umbilical endometriosis
Lee, Arnold; Tran, Hien T; Walters, Ruth F; Yee, Herman; Rosenman, Karla; Sanchez, Miguel R
2008 ;14(10):23-23, Dermatology online journal
A 35-year-old woman presented with a four-month history of a tender umbilical nodule that bleeds during her menstrual period. Physical examination showed a hyperpigmented umbilical nodule. A biopsy specimen showed fibrotic dermis with increased numbers of blood vessels and scattered glandular structures with areas of hemosiderin deposition consistent with a diagnosis of endometriosis. Cutaneous umbilical endometriosis is rare, with an estimated incidence of 0.5 to 1.0 percent. Although anti-gonadotropin medications, such as danazol, have been used for symptomatic control, but surgical excision is the treatment of choice owing to the possibility of malignant degeneration of cutaneous endometriosis
— id: 107818, year: 2008, vol: 14, page: 23, stat: Journal Article,

Advances in the genetics of sarcoidosis
Smith, G; Brownell, I; Sanchez, M; Prystowsky, S
2008 May;73(5):401-412, Clinical genetics
Sarcoidosis is an uncommon disease of granulomatous inflammation. Genetic predisposition to sarcoidosis is indicated by observations of familial clustering, increased concordance in monozygotic twins over other siblings, and variations in susceptibility and disease presentation among different ethnic groups. Published studies on sarcoidosis have investigated a variety of genetic associations. These studies used techniques ranging from classic human lymphocyte antigen genotype correlations to genome-wide linkage scans. Results have both supported and refuted disease associations with a number of genes potentially involved in the pathogenesis of sarcoidosis. Here, we review representative studies concerning the genetics of sarcoidosis. While investigations to date have failed to identify a unifying genetic signature associated with sarcoidosis, numerous studies have identified genetic associations with disease subtypes or within specific populations. These studies suggest that genetic susceptibility to sarcoidosis is complex and polygenic in nature. Future studies will help clarify the genetics of sarcoidosis and allow for the development of diagnostic, prognostic and therapeutic technologies
— id: 135347, year: 2008, vol: 73, page: 401, stat: Journal Article,

Steroid-responsive facial eruption with cornoid lamellae--a possible new entity
Tran, Hien; Bossenbroek, Nicole M; Rosenman, Karla; Meehan, Shane A; Sanchez, Miguel; Prystowsky, Stephen
2008 ;14(10):9-9, Dermatology online journal
The histopathologic presence of a cornoid lamella is often associated with a diagnosis of porokeratosis. However, this feature is not pathognomonic for porokeratosis and can be found in a number of other dermatologic conditions, which include seborrheic keratosis, verruca vulgaris, actinic keratosis, squamous-cell carcinoma in situ, basal-cell carcinoma, milia, and scar. Notably, the etiology of none of these entities is inflammatory. Wade and Ackerman consider cornoid lamellation to be a distinctive histopathologic reaction pattern that reflects the disordered progression of epidermal cells during cornification. As such, this pattern is not specific for any given disease process. We report a case in which the lesions appeared inflammatory clinically as well as histopathologically, did not resemble porokeratosis despite the presence of cornoid lamellae, and responded to topical glucocorticoids
— id: 95421, year: 2008, vol: 14, page: 9, stat: Journal Article,

Leprosy masquerading as lupus
Alberti, James R; Cabrera, Aloys; Martiniuk, Frank; Sanchez, Miguel; Levis, William R
2005 Apr;52(4):702-703, Journal of the American Academy of Dermatology
— id: 95841, year: 2005, vol: 52, page: 702, stat: Journal Article,

A systemic type I 5 alpha-reductase inhibitor is ineffective in the treatment of acne vulgaris
Leyden, J; Bergfeld, W; Drake, L; Dunlap, F; Goldman, MP; Gottlieb, AB; Heffernan, MP; Hickman, JG; Hordinsky, M; Jarrett, M; Kang, S; Lucky, A; Peck, G; Phillips, T; Rapaport, M; Roberts, J; Savin, R; Sawaya, ME; Shalita, A; Shavin, J; Shaw, JC; Stein, L; Stewart, D; Strauss, J; Swinehart, J; Swinyer, L; Thiboutot, D; Washenik, K; Weinstein, G; Whiting, D; Pappas, F; Sanchez, M; Terranella, L; Waldstreicher, J
2004 MAR ;50(3):443-447, Journal of the American Academy of Dermatology
Excessive sebum production is a central aspect of the pathophysiology of acne vulgaris. Sebaceous gland function is under androgen control and it is hypothesized that dihydrotestosterone is formed by the action of 5 alpha-reductase. Type I is the Controlling isoenzyme. This study describes a 3-month, multicenter, randomized, placebo-controlled clinical trial witha potent, selective inhibitor of type I 5 alpha-reductase used alone and in combination with systemic minocycline. Inhibition of type I 5 alpha-reductase was not associated with clinical improvement of acne when used alone and did not enhance the clinical benefit of systemic minocycline. These results indicate the need for further work at the molecular level to better understand the action of androgens on sebaceous gland function
— id: 42557, year: 2004, vol: 50, page: 443, stat: Journal Article,

New and re-emerging cutaneous infectious diseases in Latin America and other geographic areas
Bravo, F; Sanchez, MR
2003 OCT ;21(4):655-+, Dermatologic clinics
Due to environmental factors and inadequate public health measures in many developing countries, new tropical infections, as well as infections that were previously isolated to remote locales, are becoming more prevalent in several areas of Latin America. This article discusses some tropical infections and infestations with predominantly cutaneous manifestations. Previously uncommon diseases such as gnathostomiasis, mycobacteria ulcerans infection, paederus dermatitis, Balamuthia mandrillaris infection, and human T-lymphotrophic virus I dermatitis are increasingly being reported. Well-known tropical infections such as bartonellosis, leishmaniasis, chromomycosis, larva migrans, and larva currens are also becoming more prevalent. On the other hand, the incidence of Hansen's disease, the quintessential tropical infection, is dwindling all over the globe thanks to a highly effective eradication campaign launched by the World Health Organization. Because of increased immigration and tourist travel, the number of cases of these diseases in the United States may escalate
— id: 42548, year: 2003, vol: 21, page: 655, stat: Journal Article,

Cultural aspects in the treatment of patients with skin disease
Moy, Janet A; McKinley-Grant, Lynn; Sanchez, Miguel R
2003 Nov;21(4):733-742, Dermatologic clinics
As the cultural distance between patient and physician widens, so does miscommunication. Negotiation between the belief systems of the physician and the patient may create a therapeutic environment of mutual trust and respect that increases the possibility of successful clinical outcomes
— id: 46285, year: 2003, vol: 21, page: 733, stat: Journal Article,

Cutaneous diseases in Latinos
Sanchez, Miguel R
2003 Nov;21(4):689-697, Dermatologic clinics
The knowledge of many specific skin diseases that predominantly affect Latinos has been increasing; however, the understanding of common skin disease in Latinos is superficial. There are few prospective studies done in the Latino population and none that differentiate between diverse Latino backgrounds. In view of the expanding Latino population in this country, such research is timely
— id: 46286, year: 2003, vol: 21, page: 689, stat: Journal Article,

"Erythema multiforme, Stevens-Johnson, toxic epidermal necrolysis"
Auerbach R; Sanchez M
Current dermatologic diagnosis & treatment Philadelphia : Lippincott Williams & Wilkins, 2001,
— id: 3697, year: 2001, vol: , page: 58, stat: Chapter,

Perforating disorders
Began D; Sanchez M
Current dermatologic diagnosis & treatment Philadelphia : Lippincott Williams & Wilkins, 2001,
— id: 3740, year: 2001, vol: , page: 154, stat: Chapter,

Current dermatologic diagnosis & treatment
Freedberg, Irwin M.; Sanchez, Miguel R.
Philadelphia : Current Medicine ; Lippincott Williams & Wilkins, c2001,
— id: 732, year: 2001, vol: , page: , stat: ,

Pruritus ani
Gallagher C; Sanchez M
Current dermatologic diagnosis & treatment Philadelphia : Lippincott Williams & Wilkins, 2001,
— id: 3750, year: 2001, vol: , page: 174, stat: Chapter,

Sexually transmitted diseases
Gallagher C; Sanchez M
Current dermatologic diagnosis & treatment Philadelphia : Lippincott Williams & Wilkins, 2001,
— id: 3758, year: 2001, vol: , page: 196, stat: Chapter,

Balanoposthitis and male genitalia diseases
Gallegher C; Sanchez M
Current dermatologic diagnosis & treatment Philadelphia : Lippincott Williams & Wilkins, 2001,
— id: 3681, year: 2001, vol: , page: 22, stat: Chapter,

Appendix A: Alternative and complementary medicine in dermatology
Graf J; Sanchez M
Current dermatologic diagnosis & treatment Philadelphia : Lippincott Williams & Wilkins, 2001,
— id: 3672, year: 2001, vol: , page: 222, stat: Chapter,

Psychocutaneous diseases
Joe E; Sanchez M
Current dermatologic diagnosis & treatment Philadelphia : Lippincott Williams & Wilkins, 2001,
— id: 3660, year: 2001, vol: , page: 180, stat: Chapter,

Appendix F: Treatment of cutaneous infections
Naik JS; Sanchez M
Current dermatologic diagnosis & treatment Philadelphia : Lippincott Williams & Wilkins, 2001,
— id: 3676, year: 2001, vol: , page: 231, stat: Chapter,

Appendix G: Selected dermatologic formulary
Sanchez M
Current dermatologic diagnosis & treatment Philadelphia : Lippincott Williams & Wilkins, 2001,
— id: 3677, year: 2001, vol: , page: 242, stat: Chapter,

Gyrate erythemas
Sanchez M
Current dermatologic diagnosis & treatment Philadelphia : Lippincott Williams & Wilkins, 2001,
— id: 3704, year: 2001, vol: , page: 74, stat: Chapter,

Lyme disease (Lyme borreliosis)
Sanchez M
Current dermatologic diagnosis & treatment Philadelphia : Lippincott Williams & Wilkins, 2001,
— id: 3720, year: 2001, vol: , page: 108, stat: Chapter,

Oral lesions
Sanchez M
Current dermatologic diagnosis & treatment Philadelphia : Lippincott Williams & Wilkins, 2001,
— id: 3731, year: 2001, vol: , page: 136, stat: Chapter,

Skin manifestations of HIV infections (noninfectious)
Sanchez M; Hennessey P
Current dermatologic diagnosis & treatment Philadelphia : Lippincott Williams & Wilkins, 2001,
— id: 3759, year: 2001, vol: , page: 198, stat: Chapter,

Syphilis
Sanchez M; Lau J
Current dermatologic diagnosis & treatment Philadelphia : Lippincott Williams & Wilkins, 2001,
— id: 3762, year: 2001, vol: , page: 204, stat: Chapter,

Molluscum contagiosum
Shapiro J; Sanchez M
Current dermatologic diagnosis & treatment Philadelphia : Lippincott Williams & Wilkins, 2001,
— id: 3723, year: 2001, vol: , page: 118, stat: Chapter,

Miscellaneous treatments: thalidomide, potassium iodide, levamisole, clofazimine, colchicine, and D-penicillamine
Sanchez MR
2000 Jan-Feb;18(1):131-145, Clinics in dermatology
— id: 11811, year: 2000, vol: 18, page: 131, stat: Journal Article,

Dermatologic principles
Cohen DE; Sanchez M
Goldfrank's toxicologic emergencies Stamford CT : Appleton & Lange, 1999,
— id: 2742, year: 1999, vol: , page: ?, stat: Chapter,

Alcohol, social behavior disorders, and their cutaneous manifestations
Sanchez MR
1999 Jul-Aug;17(4):479-489, Clinics in dermatology
— id: 6210, year: 1999, vol: 17, page: 479, stat: Journal Article,

Effects of aspirin or basic amino acids on collagen cross-links and complications in NIDDM
Contreras I; Reiser KM; Martinez N; Giansante E; Lopez T; Suarez N; Postalian S; Molina M; Gonzalez F; Sanchez MR; Camejo M; Blanco MC
1997 May;20(5):832-835, Diabetes care
OBJECTIVE: To determine if long-term therapy with aspirin or basic amino acids for subjects with NIDDM reduces the severity of clinical complications and/or reduces tissue levels of markers of glycooxidative damage. RESEARCH DESIGN AND METHODS: Subjects with NIDDM were administered either aspirin (100 mg/day) or a combination of basic amino acids consisting of L-arginine (2 g/day) plus L-lysine (0.5 g/day) for 1 year. The study was double-blind and placebo-controlled. The presence and severity of retinopathy, nephropathy, and neuropathy were assessed in all subjects at 4-month intervals, as were serum blood glucose, glycohemoglobin levels, and presence of albuminuria. Collagen cross-linking and collagen glycation were measured in skin collagen obtained by biopsy at the beginning and the end of the study. Skin biopsies were also obtained from age-matched control subjects. RESULTS: Skin samples obtained from NIDDM subjects at the beginning of the study had significantly increased levels of glucitolyllysine, pentosidine, and hydroxypyridinium, as compared with age-matched control subjects. Pentosidine levels were significantly correlated with severity of retinopathy and neuropathy, but not nephropathy. Subjects receiving aspirin, but not amino acids or placebo, had significantly decreased levels of skin pentosidine after 1 year of therapy. CONCLUSIONS: It is concluded that 1) low-dose aspirin may reduce glycooxidative damage in people with NIDDM, and 2) treatment may need to continue for more than 1 year before clinical status improves
— id: 15455, year: 1997, vol: 20, page: 832, stat: Journal Article,

Chronic actinic dermatitis associated with human immunodeficiency virus infection
Meola T; Sanchez M; Lim HW; Buchness MR; Soter NA
1997 Sep;137(3):431-436, British journal of dermatology
Chronic actinic dermatitis is a photodistributed, eczematous dermatitis that preferentially affects elderly men and persists for months to years. Its occurrence in individuals infected with human immunodeficiency virus (HIV) has been described in five patients. We report four additional cases of this uncommon, chronic photodermatosis associated with HIV infection. In two of the patients, photosensitivity was a presenting disorder leading to the diagnosis of HIV infection. All patients were men of skin type VI with a mean age of 50 years, all had decreased minimal erythema doses to ultraviolet B, three of the four patients had decreased minimal erythema doses to ultraviolet A and all had CD4 cell counts of < 200 x 10(6)/L
— id: 12167, year: 1997, vol: 137, page: 431, stat: Journal Article,

Guidelines of care for dermatologic conditions in patients infected with HIV. Guidelines/Outcomes Committee. American Academy of Dermatology
Rico MJ; Myers SA; Sanchez MR
1997 Sep;37(3 Pt 1):450-472, Journal of the American Academy of Dermatology
— id: 15454, year: 1997, vol: 37, page: 450, stat: Journal Article,

Skin response to ultraviolet B light in patients infected with human immunodeficiency virus
Kaporis A; Lim HW; Moy J; Soter NA; Sanchez M
1996 Oct-Dec;11(5-6):188-191, Photodermatology, photoimmunology, & photomedicine
Photosensitivity disorders have been reported in human immunodeficiency virus (HIV)-infected patients, often as the initial manifestation of the disease. The objective of this study was to evaluate whether the HIV-infected population demonstrates increased sensitivity to ultraviolet B (UVB) radiation. Minimal erythema dose values to UVB (MED-B) of 57 consecutive HIV-infected patients were compared to those of a control group of 57 consecutive patients with skin diseases, who were otherwise healthy and had no risk factors for HIV infection. MED-B determinations were performed in all individuals prior to the initiation of phototherapy for treatment of skin disease. None of the patients had a history of photosensitivity. Furthermore, the mean levels of the highest UVB doses received by each group during the treatment courses were compared. The mean age of the HIV-infected cohort was 43 years (range 26-61 years). The mean MED-B for this group was 82.8 +/- 3.8 (SEM) mJ/cm2. The mean age of the control group was 45 years (range 24-77 years), and their mean MED-B was 81.0 +/- 3.8 (SEM) mJ/cm2. After 12 weeks of treatment, one HIV-infected patient developed photosensitivity associated with a decreased MED-B value. The mean level of the highest UVB doses received by the HIV-infected group [427.5 +/- 67.2 (SEM) mJ/cm2] was lower than that received by the control group [640.8 +/- 65.9 (SEM) mJ/cm2], since HIV-infected patients received fewer treatments (mean: 34.7 treatments per patient) than the patients in the control group (mean: 65.6 treatments per patient). These data indicate that the HIV-infected patient population, without history of photosensitivity, does not show increased sensitivity to UVB light as determined by MED-B values
— id: 12537, year: 1996, vol: 11, page: 188, stat: Journal Article,

Efficacy of ultraviolet B phototherapy for psoriasis in patients infected with human immunodeficiency virus
Fotiades J; Lim HW; Jiang SB; Soter NA; Sanchez M; Moy J
1995 Jun;11(3):107-111, Photodermatology, photoimmunology, & photomedicine
To evaluate the efficacy of ultraviolet B (UVB) phototherapy for the treatment of psoriasis in patients infected with human immunodeficiency virus (HIV), the response of 14 patients was compared to that of matched seronegative control individuals. All patients were evaluated prior to treatment (baseline) and after 21 treatments for the extent of total body surface area (TBSA) involvement and the quantification of scale, erythema, and thickness of plaques using a scale of 0 (absent) to 4 (severe). The only concomitant medication allowed was salicylic acid in petrolatum. The cumulative score for scale, erythema, and thickness improved 1.9 +/- 0.5 [mean +/- standard error of mean (SEM)] in the HIV group and 2.4 +/- 0.3 in controls. There was 40.9 +/- 7.3% reduction of TBSA involvement in the former and 38.4 +/- 7.6% reduction in the latter group. None of the differences was statistically significant. There was no statistically significant difference in the response to therapy among various stages of immunosuppression in the HIV group. There was also no deterioration of immune status in this group. UVB phototherapy is an effective treatment for psoriasis in patients infected with HIV. The response is identical to that of matched control individuals
— id: 12765, year: 1995, vol: 11, page: 107, stat: Journal Article,

A 3-YEAR FOLLOW-UP EVALUATION ON 28 HIV-POSITIVE PATIENTS TREATED WITH ULTRAVIOLET-B (UVB) PHOTOTHERAPY
FOTIADES, J; SOTER, NA; SANCHEZ, MR; MOY, JA
1995 APR ;104(4):660-660, Journal of investigative dermatology
— id: 87385, year: 1995, vol: 104, page: 660, stat: Journal Article,

Skin response to ultraviolet B light in patients infected with human immunodeficiency virus
Kaporis, A; Lim, HW; Moy, J; Soter, NA; Sanchez, M
1995 OCT-DEC ;11(5-6):188-191, Photodermatology, photoimmunology, & photomedicine
Photosensitivity disorders have been reported in human immunodeficiency virus (HIV)-infected patients, often as the initial manifestation of the disease. The objective of this study was to evaluate whether the HIV-infected population demonstrates increased sensitivity to ultraviolet B (UVB) radiation. Minimal erythema dose values to UVB (MED-B) of 57 consecutive HIV-infected patients were compared to those of a control group of 57 consecutive patients with skin diseases, who were otherwise healthy and had no risk factors for HIV infection. MED-B determinations were performed in all individuals prior to the initiation of phototherapy for treatment of skin disease. None of the patients had a history of photosensitivity. Furthermore, the mean levels of the highest UVB doses received by each group during the treatment courses were compared. The mean age of the HIV-infected cohort was 43 years (range 26-61 years). The mean MED-B for this group was 82.8+/-3.8 (SEM) mJ/cm(2). The mean age of the control group was 45 years (range 24-77 years), and their mean MED-B was 81.0+/-3.8 (SEM) mJ/cm(2). After 12 weeks of treatment, one HIV-infected patient developed photosensitivity associated with a decreased MED-B value. The mean level of the highest UVB doses received by the HIV-infected group [427.5+/-67.2 (SEM) mJ/cm(2)] was lower than that received by the control group [640.8+/-65.9 (SEM) mJ/cm(2)], since HIV-infected patients received fewer treatments (mean: 34.7 treatments per patient) than the patients in the control group (mean: 65.6 treatments per patient). These data indicate that the HIV-infected patient population, without history of photosensitivity, does not show increased sensitivity to UVB light as determined by MED-B values
— id: 52918, year: 1995, vol: 11, page: 188, stat: Journal Article,

Dermatolgic testing and skin tests
Sanchez MR
Emergency diagnostic testing St. Louis MO : Mosby, 1995,
— id: 4553, year: 1995, vol: , page: 265, stat: Chapter,

Pentosidine content in skin collagen from type II diabetic patients
Contreras I; Reiser KM; Martinez N; Giansante E; Lopez T; Suarez N; Postalian S; Molina M; Gonzalez-Mujica F; Sanchez MR; et al
1994 Feb;22(1):13S-13S, Transactions (Biochemical Society (Great Britain))
— id: 15456, year: 1994, vol: 22, page: 13S, stat: Journal Article,

CHRONIC ACTINIC DERMATITIS ASSOCIATED WITH HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 (HIV-1) INFECTION
MEOLA, T; LIM, HW; SANCHEZ, M; BUCHNESS, MR; SOTER, NA
1994 APR ;102(4):603-603, Journal of investigative dermatology
— id: 52344, year: 1994, vol: 102, page: 603, stat: Journal Article,

Progressively enlarging painful annular plaque on the hand. Erysipeloid
Razsi L; Sanchez MR
1994 Oct;130(10):1311-2, 1314, Archives of dermatology
— id: 12884, year: 1994, vol: 130, page: 1311, stat: Journal Article,

Infectious syphilis
Sanchez MR
1994 Dec;13(4):234-242, Seminars in dermatology
Optimistic predictions about the extinction of syphilis have proven to be premature. During the beginning of the decade, the reported numbers of infectious syphilis cases were the highest in 40 years. Despite numerous publications about syphilis, the disease continues to challenge clinicians with its protean cutaneous and systemic manifestations. Co-infection with the human immunodeficiency virus does not appear to significantly influence the stage at presentation, clinical course or serologic positivity in most patients, but coinfected patients may be at risk of developing neurosyphilis and late complications even after administration of adequate treatment
— id: 6742, year: 1994, vol: 13, page: 234, stat: Journal Article,

Zygomycosis and HIV infection
Sanchez MR; Ponge-Wilson I; Moy JA; Rosenthal S
1994 May;30(5 Pt 2):904-908, Journal of the American Academy of Dermatology
The severe immunosuppression associated with HIV infection increases susceptibility to opportunistic fungi. We describe a primary gangrenous cutaneous infection caused by Rhizopus arrhizus in an HIV-infected intravenous narcotic user. In addition, we review nine reported cases of zygomycosis in HIV-infected patients and discuss the frequency and outcome of zygomycosis in HIV infection. Eight of 10 patients were intravenous drug users. Cutaneous infection occurred in four patients. Another case was associated with drug-induced neutropenia. With treatment, 60% of the patients recovered. HIV-induced immunosuppression rarely predisposes to zygomycosis except in intravenous drug users or persons with other risk factors for this fungal infection
— id: 56581, year: 1994, vol: 30, page: 904, stat: Journal Article,

THE CHARACTERIZATION OF HIV-ASSOCIATED PAPULAR ERUPTIONS
FOTIADES, J; SORTER, NA; LEE, MM; PONGEWILSON, I; MOY, J; SANCHEZ, M
1993 APR ;100(4):543-543, Journal of investigative dermatology
— id: 54247, year: 1993, vol: 100, page: 543, stat: Journal Article,

THE CHARACTERIZATION OF HIV-ASSOCIATED PAPULAR ERUPTIONS
FOTIADES, J; SOTER, NA; LEE, MM; PONGEWILSON, I; MOY, J; SANCHEZ, M
1993 APR ;41(2):A419-A419, Clinical research
— id: 54288, year: 1993, vol: 41, page: A419, stat: Journal Article,

The safety of UVB phototherapy in patients with HIV infection
Meola T; Soter NA; Ostreicher R; Sanchez M; Moy JA
1993 Aug;29(2 Pt 1):216-220, Journal of the American Academy of Dermatology
BACKGROUND: In patients with psoriasis and human immunodeficiency virus type 1 (HIV-1) infection, therapeutic options may be limited by their potential immunosuppressive effects. UVB radiation can activate HIV-1 gene expression in transgenic mice and in vitro. It is not known whether this viral activation leads to a clinically significant effect or if these findings can be extrapolated to humans. OBJECTIVE: This study was performed to evaluate the safety of UVB light treatment in HIV-infected persons. METHODS: We prospectively studied the effect of UVB phototherapy on five HIV-infected patients with psoriasis and one with pruritus. A complete blood cell count with differential count, CD4+ and CD8+ T-lymphocyte counts, serum beta 2-microglobulin and HIV-1 p24 antigen were obtained before UVB phototherapy and after 21 and 42 treatments. After every five treatments patients were evaluated for opportunistic infections, and psoriatic involvement was quantified with the Psoriasis Area and Severity Index (PASI). RESULTS: Cumulative UVB doses ranged from 3326 to 43,364 mJ/cm2. There were no statistically significant changes in laboratory findings after 21 and 42 treatments. Of three patients without detectable serum levels of HIV-1 p24 antigen before phototherapy, only one became positive after 42 treatments. None of the six subjects had an opportunistic infection or malignancy during phototherapy. The PASI improved in all five patients with psoriasis, and the other patient noticed decreased pruritus. CONCLUSION: Our results suggest that UVB phototherapy is efficacious in HIV-1-infected patients with UVB-responsive dermatoses and is not associated with short-term changes in immune function
— id: 6456, year: 1993, vol: 29, page: 216, stat: Journal Article,

A PRELIMINARY-STUDY OF THE SAFETY AND EFFICACY OF ULTRAVIOLET-B (UVB) PHOTOTHERAPY IN THE TREATMENT OF HIV-RELATED DERMATOSES
MEOLA, T; SOTER, NA; SANCHEZ, MR; MOY, JA
1993 APR ;41(2):A504-A504, Clinical research
— id: 54304, year: 1993, vol: 41, page: A504, stat: Journal Article,

A PRELIMINARY-STUDY OF THE SAFETY AND EFFICACY OF ULTRAVIOLET-B (UVB) PHOTOTHERAPY IN THE TREATMENT OF HIV-RELATED DERMATOSES
MEOLA, T; SOTER, NA; SANCHEZ, MR; MOY, JA
1993 APR ;100(4):597-597, Journal of investigative dermatology
— id: 54256, year: 1993, vol: 100, page: 597, stat: Journal Article,

Giant lipoma: case report and review of the literature
Sanchez MR; Golomb FM; Moy JA; Potozkin JR
1993 Feb;28(2 Pt 1):266-268, Journal of the American Academy of Dermatology
— id: 13265, year: 1993, vol: 28, page: 266, stat: Journal Article,

Ascher syndrome: a mimicker of acquired angioedema
Sanchez MR; Lee M; Moy JA; Ostreicher R
1993 Oct;29(4):650-651, Journal of the American Academy of Dermatology
— id: 6508, year: 1993, vol: 29, page: 650, stat: Journal Article,

Retinoid hepatitis [see comments]
Sanchez MR; Ross B; Rotterdam H; Salik J; Brodie R; Freedberg IM
1993 May;28(5 Pt 2):853-858, Journal of the American Academy of Dermatology
A 65-year-old woman treated with etretinate for pityriasis rubra pilaris developed chronic active hepatitis. The elevated transaminases were noted 2 months after initiation of therapy and peaked 2 months after discontinuation of etretinate. The spectrum of liver toxicity induced by etretinate is reviewed. We suggest that reported cases of retinoid-induced liver disease can be divided into four distinct categories: nonspecific reactive hepatitis, acute hepatitis, chronic active hepatitis, and severe fibrosis or cirrhosis
— id: 13168, year: 1993, vol: 28, page: 853, stat: Journal Article,

Primary lymphocutaneous nocardiosis caused by an unusual species of Nocardia: Nocardia transvalensis
Schiff TA; Goldman R; Sanchez M; McNeil MM; Brown JM; Klirsfeld D; Moy J
1993 Feb;28(2 Pt 2):336-340, Journal of the American Academy of Dermatology
We present the first case of lymphocutaneous nocardiosis caused by Nocardia transvalensis and the seventh report of infection caused by this microorganism. The patient was allergic to sulfonamides but responded to amikacin and cefotaxime and later to erythromycin. The treatment and criteria for differentiation of cutaneous Nocardia species infection are discussed
— id: 13260, year: 1993, vol: 28, page: 336, stat: Journal Article,

Cutaneous nocardiosis caused by Nocardia nova occurring in an HIV-infected individual: a case report and review of the literature
Schiff TA; Sanchez M; Moy J; Klirsfeld D; McNeil MM; Brown JM
1993 Jul;6(7):849-851, Journal of acquired immune deficiency syndrome
— id: 35835, year: 1993, vol: 6, page: 849, stat: Journal Article,

Multiple pilomatricomas: report of two cases and review of the association with myotonic dystrophy
Kopeloff I; Orlow SJ; Sanchez MR
1992 Oct;50(4):290-292, Cutis
Two patients are reported who experienced multiple pilomatricomas beginning in childhood. Although one patient had no evidence of associated diseases, the second patient was diagnosed with myotonic dystrophy subsequent to the onset of the pilomatricomas. Previous reports of multiple pilomatricomas and the association with myotonic dystrophy are reviewed
— id: 13405, year: 1992, vol: 50, page: 290, stat: Journal Article,

Localized vulvar pemphigoid in a child misdiagnosed as sexual abuse [see comments]
Levine V; Sanchez M; Nestor M
1992 Jun;128(6):804-806, Archives of dermatology
BACKGROUND--Various primary dermatoses can affect the vulva of children and be misdiagnosed as child abuse, with devastating social consequences. OBSERVATION--A 3-year-old girl with vulvar erosions was removed from her parent's care after a pediatrician and gynecologist diagnosed child abuse. Histopathologic and immunofluorescence studies were consistent with vulvar pemphigoid. CONCLUSION--Localized pemphigoid should be added to the differential diagnosis of vulvar lesions. Dermatologists, pediatricians, and gynecologists should be familiar with nonvenereal diseases that can exclusively affect this area. The dermatologist's expertise is particularly valuable in differentiating between primary diseases and sexual abuse
— id: 13570, year: 1992, vol: 128, page: 804, stat: Journal Article,

The cutaneous manifestations of violence and poverty
Moy JA; Sanchez MR
1992 Jun;128(6):829-839, Archives of dermatology
BACKGROUND--Violence is a public health issue that disproportionately affects the poor. Homelessness, drug abuse, and physical violence are seen with increasing frequency in poor communities. This article reviews the cutaneous manifestations of violence and the dermatologic problems commonly seen in the homeless. Particular emphasis is placed on the experience of municipal hospitals serving the urban poor. OBSERVATIONS--Dermatologic diseases are common in the homeless, and foot-related problems such as cellulitis and pyodermas are frequent causes of hospitalization. Unusual patterns of scarring and bruises in different stages of healing are seen in victims of physical violence. Trauma and sexually transmitted diseases result from sexual abuse. Serious skin infection and self-mutilating scarring are seen in intravenous drug abusers. CONCLUSION--Dermatologists are able to diagnose and treat the many skin problems seen in the poor and to identify the physical manifestations of abuse during routine skin examination. Findings of violence should be documented and reported to the appropriate investigational agencies
— id: 13569, year: 1992, vol: 128, page: 829, stat: Journal Article,

TREATMENT OF ORAL HAIRY LEUKOPLAKIA WITH PODOPHYLLIN
SANCHEZ, M; SPIELMAN, T; EPSTEIN, W; MOY, J
1992 DEC ;128(12):1659-1659, Archives of dermatology
— id: 51804, year: 1992, vol: 128, page: 1659, stat: Journal Article,

Incidence of alopecia areata in lupus erythematosus
Werth VP; White WL; Sanchez MR; Franks AG
1992 Mar;128(3):368-371, Archives of dermatology
BACKGROUND--A small percentage of patients with alopecia areata have connective diseases such as systemic lupus erythematosus, discoid lupus erythematosus, rheumatoid arthritis, and scleroderma. Lupus erythematosus is associated with a number of different types of alopecia, but the incidence of alopecia areata in lupus erythematosus has not been examined. OBSERVATIONS--Of our cohort of 39 patients with lupus erythematosus, alopecia areata developed in 10% (four patients), in contrast to 0.42% of general dermatologic patients. Biopsy specimens of alopecia areata lesions in each of our patients showed continuous granular deposition of IgG at the dermoepidermal junction, a finding usually found in only a minority of alopecia areata cases. Intralesional injections of corticosteroids were effective treatment. CONCLUSIONS--The incidence of alopecia areata in patients with lupus erythematosus is increased. Recognition of this form of alopecia allows for specific therapy with intralesional corticosteroids
— id: 15457, year: 1992, vol: 128, page: 368, stat: Journal Article,

STAPHYLOCOCCAL SEPSIS IN HIV ANTIBODY SEROPOSITIVE PSORIASIS PATIENTS
Jaffe, D; May, LP; Sanchez, M; Moy, J
1991 Jun;24(6):970-972, Journal of the American Academy of Dermatology
The cases of three HIV-positive men with generalized psoriasis and staphylococcal sepsis are reported. In each case the skin appeared to be the source of infection. While the patients received antibiotic therapy, the psoriatic plaques resolved despite minimal or no topical treatment
— id: 32175, year: 1991, vol: 24, page: 970, stat: Journal Article,

Interaction of filaggrin with keratin filaments during advanced stages of normal human epidermal differentiation and in ichthyosis vulgaris
Manabe M; Sanchez M; Sun TT; Dale BA
1991 Sep;48(1):43-50, Differentiation
Filaggrin is a histidine-rich, basic protein whose name was first proposed based on its ability to aggregate intermediate filaments in vitro. Based on this in vitro observation, it has generally been assumed that filaggrin functions in vivo as a matrix protein which causes keratin filaments to become densely packed in the terminally differentiated cornified cells. Inconsistent with this view however, is the well-known observation that keratin aggregation appears to proceed normally in the affected epidermis of ichthyosis vulgaris patients despite a greatly reduced quantity of filaggrin. To address this issue, we used immuno-electron microscopy to localize filaggrin and its cross-reactive precursor, profilaggrin, in human and mouse epidermis, as well as in ichthyosis vulgaris epidermis. We found that the localization of filaggrin in lower cornified cells correlates precisely with the formation of aggregated keratin filaments, and the disappearance of filaggrin in upper cornified cells correlates precisely with the loosening of keratin filaments. Furthermore, we showed that, even in ichthyosis vulgaris, small amounts of filaggrin/profilaggrin are present as electron-dense deposits associated with keratin filaments in the granular cells, and that the localization of this small amount of antigen again correlates with the aggregation state of keratin filaments. These data strongly suggest that filaggrin is indeed involved in filament aggregation in vivo
— id: 13928, year: 1991, vol: 48, page: 43, stat: Journal Article,

REDUCED LEVEL OF DESMOGLEIN IN BASAL-CELL CARCINOMA AND FOLLICULOCENTRIC BASALOID PROLIFERATION
MEHREL, T; MANABE, M; WHITE, W; LESHIN, B; LOOMIS, C; SANCHEZ, M; LAVKER, RM; SUN, TT
1991 APR ;39(2):A527-A527, Clinical research
— id: 51627, year: 1991, vol: 39, page: A527, stat: Journal Article,

REDUCED LEVEL OF DESMOGLEIN IN BASAL-CELL CARCINOMA AND FOLLICULOCENTRIC BASALOID PROLIFERATION
MEHREL, T; MANABE, M; WHITE, W; LESHIN, B; LOOMIS, C; SANCHEZ, M; LAVKER, RM; SUN, TT
1991 APR ;96(4):619-619, Journal of investigative dermatology
— id: 51644, year: 1991, vol: 96, page: 619, stat: Journal Article,

Ulcerative lichen planus-like dermatitis associated with hydroxyurea
Renfro L; Kamino H; Raphael B; Moy J; Sanchez M
1991 Jan;24(1):143-145, Journal of the American Academy of Dermatology
— id: 14204, year: 1991, vol: 24, page: 143, stat: Journal Article,

Weekly low-dose methotrexate therapy for cutaneous sarcoidosis
Webster GF; Razsi LK; Sanchez M; Shupack JL
1991 Mar;24(3):451-454, Journal of the American Academy of Dermatology
Three patients with severe, treatment-resistant cutaneous sarcoidosis were treated with low-dose oral methotrexate on a weekly basis. Facial granulomas and ulcerations responded best. A response was apparent after several weeks of treatment, but 6 to 9 months were required to reach maximal effect
— id: 16925, year: 1991, vol: 24, page: 451, stat: Journal Article,

THE SPECTRUM OF SYPHILIS IN PATIENTS WITH HUMAN- IMMUNODEFICIENCY-VIRUS INFECTION
Gregory, N; Sanchez, M; Buchness, MR
1990 Jun;22(6):1061-1067, Journal of the American Academy of Dermatology
— id: 31864, year: 1990, vol: 22, page: 1061, stat: Journal Article,

HYPEREOSINOPHILIC SYNDROME WITH UNUSUAL CUTANEOUS MANIFESTATIONS IN 2 MEN WITH HIV-INFECTION
May, LP; Kelly, J; Sanchez, M
1990 Aug;23(2):202-204, Journal of the American Academy of Dermatology
— id: 31856, year: 1990, vol: 23, page: 202, stat: Journal Article,

Methotrexate therapy in cutaneous sarcoidosis
Webster, G F; Razsi, L K; Sanchez, M; Shupack, J R
1989 Sep 15;111(6):538-539, Annals of internal medicine
— id: 102446, year: 1989, vol: 111, page: 538, stat: Journal Article,

DERM/RX. A computer aid to the management of diseases of the skin
Kopf AW; Geronemus R; Sanchez M; Natow A; Grossman D; Goldberg D
1986 Oct;4(4):589-598, Dermatologic clinics
DERM/RX (dermatologic therapy) is a computerized data base representing a compendium of therapeutic management options for over 600 diseases of the skin. This data base is housed in the National Headquarters of the American Academy of Dermatology in Evanston, Illinois. It is accessible via DERM/INFONET to members of the American Academy of Dermatology via telephonic communication lines that blanket the United States. The data base is constantly updated by the Task Force on DERM/RX of the Committee on Biomedical Communications of the American Academy of Dermatology.
— id: 9210, year: 1986, vol: 4, page: 589, stat: Journal Article,

Conjunctivitis
Epstein WA; Sanchez M; Kechijian P
1985 Jul;121(7):838-838, Archives of dermatology
— id: 16356, year: 1985, vol: 121, page: 838, stat: Journal Article,

REDUCED LANGERHANS CELL IA-ANTIGEN AND ATPASE ACTIVITY IN THE ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS)
BELSITO, D; SANCHEZ, M; BAER, R; VALENTINE, F; THORBECKE, GJ
1984 ;82(4):398-398, Journal of investigative dermatology
— id: 40815, year: 1984, vol: 82, page: 398, stat: Journal Article,

Dermatology manpower projections
Ramsay DL; Grunberg AH; Sanchez M; Rosenthal LE
1984 Oct;120(10):1298-1300, Archives of dermatology
Since an oversupply of physician specialists leads to a waste of professional resources, planning of the number of physicians may be desirable. A model projecting the future supply of dermatologists was formulated on the basis of current residency capacity, which produces about 270 dermatologists per year, and on experience regarding the average length of active clinical practice. How changes in the training capacity affect the future supply of dermatologists was also examined. The model projects an equilibrium supply of about 9,500 dermatologists, or 3.2 per 100,000 population early in the 21st century, provided the number of new graduates remains at its present level. Assuming no economic barriers to access, 2.8 to three dermatologists per 100,000 population should be adequate to meet demand. Because of many unpredictable factors, periodic reassessment of dermatology training capacity is necessary
— id: 16770, year: 1984, vol: 120, page: 1298, stat: Journal Article,