Journal Of Investigative Dermatology

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LB1074 Predicting treatment decisions in elderly patients with non-melanoma skin cancers

Sun, 2019-09-01 00:00
Over 5.4 million cases of non-melanoma skin cancer (NMSC) arise yearly, primarily in the elderly. In older patients with comorbidities, long-term benefits of treatment must be balanced with short-term risks. As limited life expectancy and Charlson comorbidity index have not been shown to affect treatment decisions, our study aimed to identify specific clinical characteristics differentiating untreated and treated patients among the elderly. We performed a retrospective cross-sectional review of biopsy-proven skin cancers between January 2017 and January 2018 at a single academic center.

LB1073 Exploring the influence of rural/metropolitan health disparities on melanoma outcomes in Iowa

Sun, 2019-09-01 00:00
Melanoma remains one of the most preventable types of malignancy, yet we do not fully understand the contribution that rural health disparities have on diagnosis and survival outcomes. Currently, there is limited data regarding the link between geographic location of patients and socioeconomic variables with regards to melanoma diagnosis, staging, and survival. We performed data extraction and retrospective analysis of the SEER database of all patients receiving a diagnosis of melanoma from 1996 to 2015, leading to the inclusion of 12,991 individuals.

LB1072 Psoriasis Prevalence in the United States: 2011-2017

Sun, 2019-09-01 00:00
Psoriasis prevalence has long been considered to be 2-4% in the United States (US). Recently, prevalence rates of 0.5-0.6% were reported in Medicare patients and 0.128% in commercially insured children. We investigated psoriasis prevalence among commercially insured individuals younger than 65 years. The Truven Health Analytics MarketScan Commercial Claims and Encounters databases, which includes beneficiaries of employer-based commercial insurance in the US, was interrogated for continuously enrolled beneficiaries from 2011-2017.

LB1071 The prevelence of sunscreen use in mardi gras parade attendants

Sun, 2019-09-01 00:00
Skin cancer is a major public health concern worldwide due to its significant cost burden. Exposure to UV light is a major risk factor for all types of skin cancer. Regular sunscreen use provides protection from UV light and decreases the incidence of skin cancer. This study aims to evaluate the patterns and proportion of Mardi Gras attendants that use sunscreen. By assessing the population, the study can gauge the amount of knowledge the New Orleans population has about sun safety and skin cancer.

LB1070 A comparative analysis between global burden of disease and patientslikeme.com dermatologic data

Sun, 2019-09-01 00:00
The purpose of this study is to appraise Global Burden of Disease (GBD) and PatientsLikeMe.com (PLM) databases for the evaluation of dermatologic disease. Utilizing the GBD results tool [http://ghdx.healthdata.org/gbd-results-tool], incidence and prevalence data was extracted. In PLM, total number of subscribers for each disease and male/female distribution were assessed. Diseases analyzed were of the top fourteen diseases with the highest disability-adjusted life-year. As of September 2018, there were 658,183 total members on PLM and 7.1x109 total diagnoses reported by the GBD.

LB1069 Keratinocyte carcinoma mortality in the United States as reported in death certificates, 2011- 2017

Sun, 2019-09-01 00:00
Keratinocyte carcinoma (KC) is the most common malignancy in white skin population and its incidence has been increasing. We sought to evaluate the trends in age adjusted KC mortality rates (MRs) in the United States as reported in death certificates for 2011-2017. Data was collected from CDC. Based on ICD10 codes we analyzed three KC categories: genital, perianal and the rest, which we present as “sun exposed”. We excluded the neoplasms of the scalp and neck due to reports of high number of misclassified cases.

LB1068 Factors relating to the development of non-melanoma skin cancers

Sun, 2019-09-01 00:00
Background: While sun exposure is a well-established risk factor for non-melanoma skin cancer (NMSC), limited data is available on the association of factors such as patient sun protection behaviors and skin cancer knowledge. The objective of this study was to investigate factors that may predispose patients to NMSC and determine if they are associated with patient sun protection behaviors, skin cancer knowledge, and how these may influence quality-of-life following NMSC diagnosis. Methods: From June 30th, 2017 to April 31st, 2018, we surveyed consecutive patients undergoing Mohs micrographic surgery for NMSC removal at Sylvester Comprehensive Cancer Center.

LB1067 Predictors of clearance without treatment versus with treatment in patients with atopic dermatitis

Sun, 2019-09-01 00:00
Clearance of atopic dermatitis (AD), defined as total absence of symptoms, may be achieved with or without treatment. Differences between those achieving clearance without treatment (remission) versus those achieving clearance with treatment (control) remain largely unstudied. We utilized a cross-sectional cohort design to identify factors associated with remission over control in children with AD. We used data from the Pediatric Eczema Elective Registry, an ongoing observational cohort of children with AD.

LB1066 The most common presenting location of melanoma varies by age, race, sex, and histologic subtype

Sun, 2019-09-01 00:00
The purpose of this study was to determine if the most common presenting location (MCPL) of melanoma varies by histologic subtype, age, sex, and race/ethnicity. Previous studies identified the MCPL of melanoma as the legs of women and back of men, however, these studies did not distinguish the MCPL by tumor subtype or other demographics. A total of 194,080 cases from the 2004-2015 National Cancer Database were analyzed in SPSS (Armonk, NY). The analysis was limited to nodular, lentigo maligna/lentigo maligna melanoma (LM), and superficial spreading (SS) melanomas.

LB1065 Review of admissions to an inpatient dermatology service in a large, academic hospital setting

Sun, 2019-09-01 00:00
Background: Dermatologic diseases account for over 650,000 hospital admissions annually, but in most, Dermatologists serve as consultants, as opposed to admitting physicians, even for severe dermatoses. Common dermatologic diseases are often misdiagnosed when admitted to general medicine services. We describe the demographics, diagnostic, and management trends of patients admitted to a dermatology inpatient service to analyze dermatology inpatient care of patients with dermatologic conditions. Methods: A retrospective chart review of admissions to the dermatology inpatient service at University of Miami Hospital, a large, metropolitan, academic hospital in Miami, Florida, from June 2014 to June 2017 was performed.

LB1064 Factors associated with sunscreen use in the Veterans Affairs Keratinocyte Carcinoma Trial

Sun, 2019-09-01 00:00
We sought to determine factors related with sunscreen use by studying a high-risk population of 932 veterans in the Veterans Affairs Keratinocyte Carcinoma Chemoprevention (VAKCC) Trial. Patients had a history of 2 keratinocyte carcinomas (KCs) in the 5 years prior to the study. Questions about sunscreen use at baseline, participants’ ability to tan, during winter time, whether they have freckles or not, education higher than high school, state of residence according to ultraviolet index (UV) were coded as binomial variables.

LB1063 Sex differences for incident cancer in patients with rosacea: Real world evidence from a large Midwestern US patient population

Sun, 2019-09-01 00:00
An association between rosacea and cancer, especially as it may relate to sex-specific differences, has not been well-delineated. We sought to determine if an association exists, and if sex-specific differences are evident utilizing a large patient population. A medical record data repository (>6 million patients) was searched (using ICD-9-10 codes) for data from dermatology patients with a rosacea diagnosis vs. patients without rosacea as a control population (follow-up ≥1 year; 01/2001-11/2018) and who had a subsequent diagnosis for any cancer.

LB1062 Gli2-driven basaloid squamous cell carcinomas are associated with prominent bone remodeling

Sun, 2019-09-01 00:00
While deregulated, cell-autonomous Hedgehog (Hh) signaling is associated with the development of human cancer, particularly basal cell carcinoma, relatively little attention has been focused on accompanying changes in surrounding tissues. We have previously shown that elevated Hh signaling in the epithelium of K5-tTA;tetO-Gli2 mice leads to development of basal cell carcinoma and odontogenic keratocysts. In addition, basaloid squamous cell carcinomas (BSCCs) arise in the jaws of these mice by 6 months of age.

LB1061 Novel noncalcemic vitamin D hydroxyderivatives downregulate SHH and Wnt signaling pathways and inhibit spheroid formation in human oral squamous cell carcinoma and murine basal cell carcinoma

Sun, 2019-09-01 00:00
A previously uncharacterized pathway of vitamin D3 metabolism has been confirmed to operate in vivo, and this pathway begins with hydroxylation at C20 or C22. Resulting products, 20(OH)D3 and 22(OH)D3, have been detected in human serum and skin, and they undergo further hydroxylation to produce biologically active compounds that are noncalcemic at high pharmacologic doses. Many of these compounds have shown to inhibit growth of melanoma cells and stimulate keratinocytes differentiation. The purpose of this study was to investigate whether these novel vitamin D hydroxyderivatives will demonstrate therapeutic efficacy against oral squamous cell carcinoma and basal cell carcinoma using CAL-27 and ASZ001 cell lines as models, respectively.

LB1060 Cytokine profile of Sézary Syndrome in relationship with expression of checkpoint inhibitors on Sézary cells

Sun, 2019-09-01 00:00
Traditionally, the lymphoma progression was viewed with a shift to Th1 to Th2 immune response along with an increase in the number of T regulatory cells (Treg) resulting in dampening cytotoxic immune responses. However, at present, the cytokine milieu expands beyond Th1/Th2 dichotomy. Here, we evaluate the expression of 64 biomarkers including cytokine of Th1, Th2, Th9, Th17, Treg as well growth factor, eotaxin MiG, RANTES21, IP-10, MCP, PDGF, MMP-1, MMP-7, MMP-8 from the serum of 186 healthy individuals and 11 Sézary syndromes (SS) patients.

LB1059 Squamous cell carcinoma secondary to plantar wart: A case report

Sun, 2019-09-01 00:00
We report a case of squamous cell carcinoma secondary to plantar wart in a 72-year-old Chinese woman. 20 years previously the patient found a 1-cm round grayish yellow plaque on her right heel. The lesion was diagnosed as plantar wart by every dermatologist the patient consulted, and can be gradually subsided after treatment such as cryotherapy and photodynamic therapy, but recurred frequently. 2 years previously the plaque enlarged accompanying with aggravated pain, biopsy indicated verrucous hyperplasia.

LB1058 Loss of autoimmune regulator (Aire) alters the development of precancerous lesions in mouse skin

Sun, 2019-09-01 00:00
Non-melanoma skin cancer (NMSC) is the most common cancer in the United States with over 5 million new cases each year; however detailed molecular mechanisms governing the development of NMSC are lacking. The protein function for autoimmune regulator (Aire) was originally characterized in the thymus, where Aire controls the expression of tissue-restricted antigens to develop T-cell tolerance and thus prevent autoimmunity. We recently identified Aire to be expressed in tumor-prone skin in mice and therefore sought to determine the impact of Aire loss on tumor development.

LB1057 Ultraviolet B light induces rapid changes in gene expression as detected by non-invasive, adhesive skin biopsies

Sun, 2019-09-01 00:00
The purpose of this study is to determine changes in skin gene expression following exposure to ultraviolet (UV) B radiation. Non-invasive, adhesive patch skin biopsies (DermTech, Inc., La Jolla, CA) were performed on the right and left post-auricular areas of 24 subjects before and 24-hours after UV-B exposure using an excimer laser dosed at 300mJ to mimic UV damage. RNA was isolated from the samples and assessed by reverse transcriptase followed by quantitative polymerase chain reaction to assess the expression of genes believed to play a role in skin cancer development.

LB1056 Neoantigens in mycosis fungoides: Whole exome sequencing discovery of immunotherapeutic targets

Sun, 2019-09-01 00:00
Mycosis fungoides (MF), the most common type of cutaneous T-cell lymphoma, has a dismal prognosis in advanced stages. The success of immune checkpoint inhibitors (ICI) in treating advanced malignancies has not extended to MF. There is an urgent need to identify predictive biomarkers, and to advance immunotherapies in MF. Neoantigens are ‘new’ peptides, generated by somatic mutations in tumour cells, that evoke an immune response. As tumour-specific markers, neoantigens are an attractive immunotherapeutic target.

LB1055 CRISPR/Cas9 for HTLV-1: A novel therapeutic approach to the first discovered human retrovirus

Sun, 2019-09-01 00:00
Human T-cell Leukemia Virus type-1 (HTLV-1) is a potent carcinogenic oncovirus that establishes a lifelong infection in human cells. In select individuals, the virus can lead to devastating complications such as adult T cell leukemia/lymphoma (ATLL) or HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). HTLV-1 has historically proven difficult to treat because it incorporates its viral DNA into the host genome and expresses few viral proteins. An ideal treatment for HTLV-1 would therefore involve complete excision or inactivation of the virus at the level of the integrated proviral DNA, thereby enabling targeting of cells expressing either active or latent infection.

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