Journal Of Investigative Dermatology

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Updated: 2 hours 48 min ago

LB961 Disparities in dermatology referral and consultation patterns in the emergency department

Wed, 2020-07-01 00:00
While the Emergency Department (ED) frequently places outpatient follow-up referrals and in-ED consultations to dermatology, little is currently known about whether demographic factors such as race and sex impact these rates. Research in other contexts such as admission to cardiology has already demonstrated ED triage is impacted by race when controlled for other factors. We performed a retrospective chart review of all patients seen in the ED at two university hospitals between 1/1/2017 and 7/1/2019 for rash or dermatitis.

LB960 Oncodermatologic conditions in skin of color

Wed, 2020-07-01 00:00
Purpose: Dermatologic toxicities from anticancer treatments are an increasing challenge for patients and their providers. Effective prevention and clinical management of such toxicities can allow patients to remain on life-saving oncotherapeutics. The purpose of this study was to perform an analysis of cutaneous toxicities in skin of color patients that were referred to an oncodermatology clinic at a single academic institution. Methods: A chart review was conducted to investigate dermatologic toxicities in patients with skin of color on cancer treatment who were referred over the course of three years.

LB959 Lesion location for melanoma pathology analysis

Wed, 2020-07-01 00:00
Pathological imaging is the gold standard for the diagnosis of melanoma.Recent studies have shown that convolutional neural networks(CNNs) is effective on the diagnosis of melanoma from pathological images. However, CNN could only predict whether it was a melanoma, not locate the lesion. In this paper, we propose lesion location class activation mapping (LLCAM) method to precisely locate the lesion of melanoma in pathological images. First, we collect more than 300 skin digital whole-slide images, including 188 melanomas.

LB958 Imiquimod treatment of lentigo maligna with positive margins, close margins, or field of dysplasia

Wed, 2020-07-01 00:00
Lentigo maligna (LM) is a subtype of melanoma in situ more commonly found in sun-exposed areas. LM can occur with an extension of atypical melanocytes into the periphery known as the “field effect” that makes surgical resection alone challenging.1 For this reason, primary or adjuvant imiquimod therapy is commonly practiced in treating LM. Though its efficacy is evident in the literature, little is currently known about its efficacy in treating the cases with positive (PM) or close margins (CLM) or with field of dysplasia (FD).

LB957 Skin cancer recognition for whole slide histology images with state-of-the-art Convolutional Neural Networks

Wed, 2020-07-01 00:00
Whole Slide histology image remains the gold standard. But recent research reveals a high discordance between individual pathologists. In order to reduce the misdiagnosis made by doctors, the aim of this study is to using deep learning to assist pathologists for skin cancers diagnosis. 626 whole slide images were collected (162 melanoma, 115 basal cell carcinoma, 349 nevus) from Xiangya Hospital. All the lesions in the WSIs were selected and random sampled as patches. The resulting patches of 500 WSIs were used for the training of a convolutional neural network (CNN).

LB956 Adherence to adjuvant therapy in patients (pts) with resected melanoma

Wed, 2020-07-01 00:00
Treatment adherence can be impacted by several factors, including route of administration, dosing schedule, and pt perceptions. This study assessed pt-reported adherence and associated barriers in pts with melanoma treated with adjuvant therapy. Adult pts with resected stage 3/4 melanoma with no evidence of disease were recruited by a pt panel and the Melanoma Research Foundation to participate in an online survey. Pts were required to have received adjuvant therapy with nivolumab or pembrolizumab (intravenous [IV] cohort) or dabrafenib+trametinib (oral cohort).

LB955 Predicting metastatic melanoma from melanoma pathological images using a Convolutional Neural Network: A Multicenter Study

Wed, 2020-07-01 00:00
Pathological images are the gold standard for the diagnosis of melanoma.Recent studies have shown that convolutional neural networks(CNNs)' ability to diagnose melanoma from pathological images is as good as or slightly better than that of pathologists.However, few studies have verified whether CNN can directly predict the metastasis of melanoma from pathological images, which is an experiment of great medical significance. In the present study, We investigated whether CNNs can predict the metastasis of melanoma from pathological images.First, We collected 472 digital whole-slide images (metastatic melanoma 143, primary melanoma 329) to develop the model.

LB954 Identification and characterization of patients with vitiligo treated with ruxolitinib cream based on the achievement of F-VASI50

Wed, 2020-07-01 00:00
Vitiligo is a chronic, inflammatory skin disease characterized by increased interferon-gamma signaling through Janus kinase (JAK) 1 and JAK2 and subsequent activation of CD8+ T cells, which target melanocytes resulting in areas of depigmentation. Ruxolitinib cream, a JAK1/JAK2 inhibitor, is under investigation for vitiligo treatment in a 52-week, randomized, double-blind, phase 2 study (NCT03099304). Significantly more patients treated with ruxolitinib cream vs vehicle achieved ≥50% improvement in facial Vitiligo Area Scoring Index (FVASI50) at Week 24 (primary endpoint); at Week 52, patients treated with ruxolitinib cream 1.5% twice daily (BID) attained the highest FVASI50 response (57.6%).

LB953 Melanoma cell invasion is inhibited in the absence of α3β1 integrin mediated paracrine signaling from keratinocytes

Wed, 2020-07-01 00:00
Our previous work established a critical role for the laminin-binding integrin α3β1 in regulating the ability of epidermal keratinocytes to modify the cutaneous microenvironment during skin development, tumorigenesis and wound healing. These modifications occur through direct modulation of extracellular matrix (ECM) and paracrine signals to stromal cells (e.g., endothelial cells, fibroblasts) that facilitate angiogenesis, inflammation, or ECM remodeling. Mass spectrometry of the keratinocyte secretome identified a number of α3β1-dependent secreted proteins that modulate the microenvironment including ECM proteins (e.g., fibulin-2), proteases (e.g., MMP-9), and growth factors/cytokines (e.g., MRP-3).

LB952 Multi-scale network for melanoma histopathology image analysis

Wed, 2020-07-01 00:00
Histopathology images have distinct histomorphological features on different scales. In the pathological image analysis, pathologists can only make proper diagnosis by comprehensively analyzing histomorphological features of dif-ferent scales. However, the current convolutional neural network with single-scale image input does not have the powerful ability to merge features of different scales. Accordingly, we propose a multi-scale convolutional network architecture for merging features of different scale images, with refer-ence to the doctors’ diagnosis process.

LB951 Interpretable pathologist-level classification of melanoma disease pathologies with a convolutional neural network pipeline

Wed, 2020-07-01 00:00
For diagnosing melanoma, hematoxylin and eosin (H&E) stained tissue slides remains the gold standard. Accurate diagnosis of melanoma pathology images plays an important role in early diagnosis and successful treatment for melanoma. Deep convolutional neural networks (CNNs) show strong discrimination power for complex medical image recognition tasks. However,the black box nature of CNNs limits their role in clinical settings, where interpretable diagnosis is indispensable. In this paper, we build a deep learning pipeline to precise diagnosis of melanoma using CNNs and localize possible malignant melanoma tissue by the gradient-weighted class activation mapping (Grad-CAM).

LB950 Geographic variations in cutaneous malignant melanoma distribution in Russian Federation

Wed, 2020-07-01 00:00
Cutaneous Malignant Melanoma (CMM) incidence has been rising around the world and over the last three decades at rates greater than for any other malignancy. Our objective was to describe geographic trends in incidence and mortality of CMM in Russia between 2001 and 2017 using geo-informatics technique (mapping) and descriptive statistical analysis. Additionally, we aimed to study the associations between ethnicity, geographic latitude/longitude and CMM incidence/mortality rates. We retrospectively analyzed the data from the Moscow Oncology Research Institute, Ministry of Health of Russian Federation for the period of the study.

LB949 Development of topical MEK inhibitor, NFX-179, as a chemopreventive agent for squamous cell carcinoma

Wed, 2020-07-01 00:00
Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer comprising over one million cases and contributing up to 9,000 deaths annually in the United States. We recently demonstrated that blockade of RAS signaling by MEK inhibitors reduces the formation of cSCCs in mice highlighting the potential of MEK inhibitors in chemoprevention of cSCC. However, the systemic toxicities of MEK inhibitors preclude their chronic usage in chemoprevention. To that end, NFlection Therapeutics has developed a topically formulated, novel and potent MEK inhibitor, NFX-179, designed to selectively inhibit MEK in SCC tumor tissue but with a high rate of clearance from plasma to limit systemic exposure.

LB948 Evaluation of creams containing ozonated sunflower oil

Wed, 2020-07-01 00:00
This study concerns the evaluation from the physical point of view of preparations for topical application containing sunflower oil (Helianthus annuus) as such and after ozonation. Six different creams with different amounts of either untreated or ozonated sunflower oil (3%, 5% and 10%) with respect to the original one without sunflower oil have been evaluated. Two different preparation methods have been adopted: i) adding the relative percentages of oil in the base cream; ii) replacing a part of a lipophilic component of the base cream.

LB947 Development of LY3454738, an agonistic antibody to human CD200R

Wed, 2020-07-01 00:00
CD200R is an immune receptor of the IgG family that is primarily expressed on cells of the myeloid lineage and was recently identified as a marker for Th2 biology (Blom et al 2017). In vivo studies with knockout mice of either the receptor or its ligand, CD200, have demonstrated that it is an inhibitory receptor capable of negatively regulating immune responses. Previous work using agonistic antibodies to mouse CD200R showed inhibition of mast cell activation in vitro and in vivo (Cherwinski et al 2005) as well as efficacy in multiple preclinical models of autoimmune diseases.

LB946 Improvements in acne-prone skin quality correlate with a reduction in saliva cortisol levels after use of an 8-week 3-step topical regimen

Wed, 2020-07-01 00:00
It is well established that both UV exposure and emotional stress can lead to an activation of stress response via the Hypothalamic Pituitary Adrenal (HPA) axis resulting in elevated cortisol levels negatively affecting skin. a, b, cIn this study, we found that subjects using a three-step skincare regimen not only experienced the expected skin benefits but also significantly lower cortisol levels after eight weeks. Thirty women, ages 18-45, applied a three-step skincare regimen featuring antioxidants, electrolytes, prebiotics and a sunscreen to their faces twice a day for eight weeks.

LB945 Using artificial intelligence to understand patient perspectives towards treatment of dermatological diseases

Wed, 2020-07-01 00:00
Patients with dermatologic conditions frequently use social media, generating millions of posts in which they share about their experience with disease and treatment. Using Artificial Intelligence (AI), we analyzed public social media posts and identified associations between Patient Global Impression of Change (PGIC) and patient sentiments which could provide insight into disease burden. Using the Crimson Hexagon (CH) AI-powered social media database, millions of publicly available social media posts were identified.

LB944 The impact of dermatology consultation for dermatology-related admissions in oncology patients

Wed, 2020-07-01 00:00
Dermatologic toxicities in oncology patients may result in unnecessary cessation of cancer therapy. Early diagnosis by dermatology can minimize treatment disruption. We aimed to characterize inpatient oncology admissions for dermatologic issues and the impact of dermatology consultation on management. We performed a retrospective chart review of inpatient dermatology consultations from 7/01/2018 to 1/22/2020 at University Hospitals Cleveland Medical Center. Of 794 consultations,138 were for oncology patients.

LB943 Calcipotriol and 5-fluorouracil as neoadjuvant therapy for mohs micrographic surgery in treatment of cutaneous squamous cell carcinoma

Wed, 2020-07-01 00:00
Cutaneous squamous cell carcinoma (cSCC) often occurs intermixed with numerous actinic keratoses (AK) within a field of significant actinic damage. When used together, calcipotriol and 5-Fluorouracil (C5FU) synergistically activate a CD4+ T cell-mediated immunity against AK resulting in a mean reduction in AK on the face and scalp when compared to the use of 5FU with Vaseline. We frequently encounter subclinical spread of cSCC in situ beyond the initial biopsied lesion. We investigated the use of C5FU preoperatively in patients with biopsy-proven cSCC compared to Mohs Micrographic surgery (MMS) alone.

LB941 Dupilumab for atopic dermatitis in children aged ≥6 to <12 years in phase 3 LIBERTY AD PEDS trial: Analysis by baseline weight

Wed, 2020-07-01 00:00
We evaluate dupilumab efficacy and safety by pre-specified baseline weight stratification in children aged ≥6 to <12 years with severe atopic dermatitis (AD) inadequately controlled with topical corticosteroids (TCS). In this double-blind, phase 3 trial (LIBERTY AD PEDS; NCT03345914), patients (pts) were randomized to receive either subcutaneous dupilumab 300mg every 4 weeks (q4w) regardless of baseline body weight; or every 2 weeks (q2w) as 100mg for pts <30kg and 200mg for pts ≥30kg; or placebo (PBO), for 16 weeks.

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